Clinical nutrition is a modern medicine because it is interested in Man in his triple dimension: biological, psychological and social.
The act of eating satisfies nutritional, relational and symbolic needs at the same time, allowing its subject to tend towards health, well-being and balance within its environment.
Nutritional science has made considerable progress in the field of nutritional physiology and pathophysiology in recent years. At the same time, psychology, psychophysiology and sociology have taken an interest in this vital function and have led to a new look at the specialty.
The doctor brings his attention and his care to a subject who is suffering or is in a situation of deteriorating his health: his role is of course to diagnose, relieve and prevent.
If we stick to a biological definition, nutrition makes it possible to create the production of the body’s energy. To produce this energy, the body needs fuel: these are carbohydrates and lipids and, to a lesser extent, proteins. Other much smaller elements are essential for the proper functioning of the metabolic system, such as vitamins and minerals.
The medical specialty of nutrition is defined as the science that analyzes the relationship between food and health:
– a part, dietetics: is the study of the composition of foods, their properties, and their use by the body.
However, it is a much broader specialty since scientific studies have clearly demonstrated that the way we eat has an influence on cardiovascular problems, cancer, osteoporosis, high blood pressure, type 2 diabetes, obesity, autoimmune diseases, Alzheimer’s disease.
Nowadays, in developed countries we are confronted with an epidemic of overweight or even obesity (on average in Western countries, including Israel Obesity and overweight are around 60% of the population) The most important explanatory factor is probably that called the “nutritional transition”.
• A richer diet:
Indeed, almost everywhere in the world, the end of food shortages, the global installation of Western food in the world (the price of a McDonald’s meal is a comparative economic index, in most countries of the world) allows a affordable food, especially since it is of low nutritional quality (energy dense, because it is too fatty and too sweet but devoid of high added value elements, for example vitamins or minerals).
• A reduction in physical expenditure:
The transformation of the nature of work with industrialization has taken us since the Second World War from physical work that expends a lot of calories to sedentary work requiring in theory far fewer calories.
In 70 years, the modification of our way of life with the development of technology and the almost permanent use of transport (car or bus instead of walking or cycling) has made us collectively lose the notion of physical expenditure. .
Who has not used or does not yet use the car for small daily journeys (like fetching bread or bringing the children to school under the pretext of saving time, the watchword of our current civilization)
In short, this “nutritional transition” leads to the storage of excess energy which manifests itself in the accumulation of excess and excessive fat mass and therefore in overweight.
The definition of nutritionist is not so simple: it is actually necessary to speak of doctor nutritionist and dietitian-nutritionist. Both can give advice on nutrition, but only the doctor-nutritionist can:
– prescribe medication (to help with weight loss and to treat any complications of this weight gain),
– Prevent and manage the complications of overweight and/or obesity, such as high blood pressure, hypercholesterolemia, hypertriglyceridemia, type 2 diabetes, which can result from overweight. These pathologies most often require follow-up with a prescription for medication and/or a blood test.
Dieticians are health professionals with a State-recognized Dietitian Diploma, trained exclusively in the nutritional care of patients. They are authorized to supervise patients, in particular to make a dietary assessment in order to detect dietary errors and rectify them through appropriate dietary education.
– In any case, the dietician is not authorized to prescribe medication: this remains the role of the doctor.
Above all, it is fundamental for me to know you in order to help you better.
Of course, all your medical history is fundamental, but your way of life and your character will also influence your care.
In case of overweight, I will of course focus on:
1-Rectify the dietary mistakes you make without knowing it.
2- define with you reasonable objectives and find help with you thanks to the therapeutic arsenal at our disposal (each drug has a specific place in the treatment strategy) which will allow you to lose weight of course but above all not to regain weight .
But know that you are also and above all an actor of your body and your life and that my goal is to train you to have the right reflexes of food, monitoring, and physical activity.
I would also take into consideration all the pathologies and complications that could arise from your overweight: high blood pressure, lipid balance abnormalities to take stock of them, give you the right advice and the appropriate treatments.
Together we will pose the indication of a simple diet, adjuvant drugs such as GLP1 (Ozempic-Trulicity) or even the indication of bariatric surgery. In any case, know that physical exercise is essential.
Pregnant women, athletes, patients who, on the contrary, want to gain weight or patients after bariatric surgery will also benefit from personalized care adapted to their particular case…