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Dieta o metodo Dukan Postura GREP-AEDN Marzo 2011

Authors:
  • Academia Española de Nutrición y Dietética
Grupo de Revisión, Estudio y Posicionamiento de la Asociación Española de Dietistas-Nutricionistas
http://www.grep-aedn.es/
info@grep-aedn.es
Marzo de 2011
1
“Dieta” o “método” Dukan. Postura del GREP-AEDN. Marzo de 2011
Autores:
Julio Basulto
*
, Maria Manera
*
, Eduard Baladia
*
, Violeta Moizé
**
, Nancy Babio
*
, Mar Ruperto
*
y Mª Glòria Sorigué
*
.
Revisores
*
:
Pilar Amigó
*
, Esther Blanco
*
, Maria Blanquer
*
, Josep Lluch
*
, Andrea Gil
*
, Juan Revenga
***
, Luís Roka
*
y Mercedes Sotos
*
.
* Dietistas-Nutricionistas. Más datos en: www.grep-aedn.es/miembros.htm
**
Dietista-Nutricionista, Unidad de Obesidad del Servicio de endocrinología y nutrición del Hospital Clínic de Barcelona.
*** Dietista-Nutricionista, miembro de la Junta de Gobierno de la Asociación Española de Dietistas-Nutricionistas.
Este documento ha sido refrendado por la Estrategia Naos (Ministerio de Sanidad), en abril de 2011:
https://twitter.com/#!/sanidadgob/status/6608226174 9071872
y
www.naos.aesan.msps.es/csym/saber_mas/dietas/DietaDukan .html
Introducción y justificación
Los libros escritos por el Sr. Pierre Dukan (“No consigo adelgazar”, El método Dukan ilustrado” y “Las recetas de Dukan”) ocupan
actualmente los primeros puestos en los rankings de ventas de “no ficción”. Es por tanto muy importante que la población tome en
consideración la veracidad y legalidad de las afirmaciones de dicho autor, máxime cuando nuestra sociedad está claramente preocupada
por los aspectos relacionados con el peso corporal y la figura
.
Consideraciones que justifican la postura del GREP-AEDN
El Grupo de Revisión, Estudio y Posicionamiento de la Asociación
Española de Dietistas-Nutricionistas (GREP-AEDN, voz científica de
la Asociación), desaconseja encarecidamente el “método” o “dieta”
propuesto por el Sr. Dukan, tal y como se detalla en el apartado
“Postura del GREP-AEDN”, por ser ineficaz, fraudulento y
potencialmente peligroso. Esta opinión se sustenta en las siguientes
seis consideraciones al respecto de dicha “dieta” o “método”.
1.- Ausencia de fundamento científico.
Ninguna de las bases de datos científicas españolas o
internacionales (Elsevier, Excelenciaclinica.net, Guías de práctica
clínica en el Sistema Nacional de Salud, Scielo, Scirus,
ScienceDirect, clinicaltrials.gov, PubMed) contiene estudio alguno
que haga referencia a esta dieta o que apoye su eficacia o
seguridad. Las palabras de su autor y las experiencias personales de
sus testigos o de otros individuos concretos no tienen ninguna
validez desde el punto de vista de la evidencia científica o de la
salud pública.
2.- Cumple las caraterísticas que definen a las dietas
fraudulentas
La “dieta” o el “método” Dukan cumple las características de una
dieta fraudulenta. Según la Asociación Americana de Dietética
1
y la
Asociación Española de Dietistas-Nutricionistas
2
, las características
de las dietas fraudulentas o de los métodos fraudulentos para
perder peso, son, entre otras
3
:
- prometen resultados "rápidos",
- prometen resultados "mágicos",
- prohíben el consumo de un alimento o grupo de alimentos,
- contienen listas de alimentos "buenos" o "malos",
- exageran la realidad científica de un nutriente,
- aconsejan productos dietéticos a los que se atribuyen pro-piedades
extraordinarias,
- incluyen relatos, historias o testimonios para aportar credibilidad,
y
- contienen afirmaciones que contradicen a colectivos sanitarios de
reputación reconocida.
La "dieta" o “método” del Sr. Dukan cumple todos los puntos
anteriores. Se puede comprobar leyendo la contraportada de uno
sus libros ("No consigo adelgazar"):
"Con el Método Dukan usted logrará adelgazar de forma inmediata
y mantener su peso estable durante el resto de su vida [...] Más de
1 millón de lectores en Francia ya han adelgazado siguiendo los
cuatro pasos de esta dieta basada en el consumo de proteínas
naturales”.
3.- Ilegalidad de sus afirmaciones
Las siguientes aseveraciones, recogidas en la contraportada del libro
“No consigo adelgazar”, incumplen la legislación y suponen una
"infracción grave”:
1) “Con el Método Dukan usted logrará adelgazar de forma
inmediata”
Grupo de Revisión, Estudio y Posicionamiento de la Asociación Española de Dietistas-Nutricionistas
http://www.grep-aedn.es/
info@grep-aedn.es
Marzo de 2011
2
2) [podrá] “mantener su peso estable durante el resto de su vida",
3) “dieta basada en el consumo de proteínas naturales”, y
4) "más de 1 millón de lectores en Francia ya han adelgazado
siguiendo los cuatro pasos de esta dieta”.
Puede comprobarse la ilegalidad de dichas frases revisando el Real
Decreto 1907 / 1996, de 2 de agosto, que especifica claramente:
"Queda prohibida cualquier clase de publicidad o promociones
directa o indirecta, masiva o individualizada, de productos,
materiales, sustancias, energías o métodos con pretendida
finalidad sanitaria en los siguientes casos":
- [...] Que sugieran propiedades específicas adelgazantes o contra
la obesidad.
- Que proporcionen seguridades de alivio o curación cierta.
- Que utilicen el término «natural» como característica vinculada a
pretendidos efectos preventivos o terapéuticos.
- Que atribuyan a determinadas formas, presentaciones o marcas de
productos alimenticios de consumo ordinario concretas y específicas
propiedades preventivas, terapéuticas o curativas.
- Que pretendan aportar testimonios de profesionales sanitarios, de
personas famosas o conocidas por el público o de pacientes reales o
supuestos, como medio de inducción al consumo.
La página web del Sr. Dukan, además de publicitar o promocionar
sus libros, contiene un apartado llamado “Tienda”
(www.mitiendadietadukan.com) en la que se encuentran productos
como “Devorcal”, al que se atribuye la siguiente propiedad: “quema
de forma específica las calorías procedentes de proteínas y grasas”.
Además de ser falsa e ilegal, esta afirmación es particularmente
insólita cuando se observa que se aconseja su uso durante 37 días:
“Cura de 37 días a renovar en caso necesario”.
4.- Errónea atribución de capacidad adelgazante a las proteínas
dietéticas
Una revisión sistemática de la literatura publicada en 2003 concluyó
que no existen pruebas que sustenten que una dieta con un mayor
contenido en proteínas ayude a la pérdida de peso (contrariamente
a lo propuesto por el Sr. Dukan)
4
. Un estudio más reciente, que
asignó aleatoriamente a 811 adultos con sobrepeso a cuatro dietas
con diferentes porcentajes de macronutrientes, concluyó que la
pérdida de peso se justifica por el tiempo que se sigue la dieta y por
las calorías que se dejan de ingerir, no por la distribución de dichos
macronutrientes
5
. La misma conclusión se recoge en las últimas
guías dietéticas para los americanos (publicadas en 2011), que
contaron con la asistencia de la Colaboración Cochrane, en las que
se revisó sitemáticamente la literatura científica sobre este tema
6
.
No es de extrañar, por tanto, que la Autoridad Europea de
Seguridad Alimentaria (EFSA) considere que no existen pruebas
científicas para asociar el consumo de proteínas con ventajas en el
control del peso corporal
7
.
Es necesario destacar, asimismo, que la alta ingesta de proteína
dietética (algo que muy probablemente ocurre en los seguidores de
este tipo de “dietas” no sólo a corto plazo, sino también a medio o
largo plazo) no está exenta de riesgos. Por una parte, un
seguimiento de la alimentación de 22.944 personas adultas durante
10 años mostró que el consumo prolongado de dietas pobres en
carbohidratos y ricas en proteínas se asocia con un incremento en la
mortalidad total
8
. Llegó a similares conclusiones un estudio de
seguimiento de 85.168 mujeres durante 26 años, y de 44.548
hombres durante 20 años
9
.
Por último, la alta ingesta de proteína ha sido asociada a
enfermedades crónicas como osteoporosis, cálculos renales,
insuficiencia renal, cáncer, enfermedad cardiovascular y obesidad
10
.
5.- Contradicciones con los consensos de expertos en obesidad
La frase Con el Método Dukan usted logrará adelgazar de forma
inmediata y mantener su peso estable durante el resto de su vida”,
que aparece en la contraportada del libro “No consigo adelgazar"
contradice a todos los consensos (sean españoles o internacionales)
en tratamiento del sobrepeso o de la obesidad
11-17
Ninguna estrategia para adelgazar ha mostrado efectividad
inmediata y mantenida de por vida en todos los grupos de
población
18
. Tal y como afirma la Asociación Americana de Dietética
en un documento de postura sobre el manejo del peso corporal,
“Los profesionales sanitarios deben ayudar a los pacientes a aceptar
un cambio de peso modesto pero sostenible en el tiempo, que
pueda ser conseguido de forma razonable”
19
.
En cualquier caso, la cantidad de afirmaciones que contradicen a los
citados consensos en los libros del Sr. Dukan es ingente, por lo que
no se analizarán en este documento por razones de brevedad.
6.- Potenciales daños asociados al seguimiento de su “método” o
“dieta”
En un extenso documento publicado en noviembre de 2010, la
Agencia Francesa para la Seguridad Alimentaria, del Medio
Ambiente y Ocupacional (ANSES), señala que la dieta propuesta por
el Sr. Dukan puede comportar desequilibrios nutricionales y puede
ser altamente arriesgada ya que su seguimiento podría comportar
alteraciones somáticas, psicológicas, hormonales, de crecimiento o
de rendimiento deportivo
20
.
Grupo de Revisión, Estudio y Posicionamiento de la Asociación Española de Dietistas-Nutricionistas
http://www.grep-aedn.es/
info@grep-aedn.es
Marzo de 2011
3
La Asociación Francesa de Dietistas-Nutricionistas coincide con la
postura de ANSES, y añade que la dieta o método Dukan presenta
“graves riesgos para la salud”
21
.
La Asociación Británica de Dietética, por su parte, también
considera que esta “dieta” o “método” puede comportar riesgos
para la salud pública, pero añade que provoca, además, confusión
en las personas que la siguen
22
.
Postura del GREP-AEDN
Por todo lo anteriormente expuesto, el GREP-AEDN considera que el
"método" del Sr. Dukan es fraudulento e ilegal, no sirve para
adelgazar y supone un riesgo para la salud pública.
Es por ello que el GREP-AEDN:
- Desaconseja encarecidamente a la población el seguimiento del
“método” o de la “dieta” propuesta por el Sr. Dukan, e
- Insta a las autoridades sanitarias a proteger a la población de las
consecuencias negativas de la difusión de este tipo de fraudes,
ofreciéndose como fuente acreditada en todo lo relacionado con el
control de peso, para aportar opiniones objetivas y apoyadas en
pruebas científicas de eficacia y seguridad, con la finalidad de
preservar la salud pública.
Bibliografía citada
1. Wansink B, American Dietetic Association. Position of the American
Dietetic Association: food and nutrition misinformation. J Am Diet
Assoc. 2006; 106(4): 601-7.
2. AEDN Informa. ¿Está dispuesta la sociedad a perder peso poniendo en
riesgo su salud, y además a un precio desorbitado? En línea:
www.aedninforma.com/2011/01/confusion.html [Consulta: 8 de febrero
de 2011]
3. Williams MH. Nutrición para la salud, condición física y deporte, 7ª
ed. Mexico: McGraw Hill; 2006. p.144.
4. Bravata DM, Sanders L, Huang J, Krumholz HM, Olkin I, Gardner CD,
et al. Efficacy and safety of low-carbohydrate diets: a systematic
review. JAMA. 2003; 289(14): 1837-50.
5. Sacks FM, Bray GA, Carey VJ, Smith SR, Ryan DH, Anton SD, et al.
Comparison of weight-loss diets with different compositions of fat,
protein, and carbohydrates. N Engl J Med. 2009; 360(9): 859-73.
6. Dietary Guidelines Advisory Committee. What is the optimal
proportion of dietary fat, carbohydrate, and protein to lose weight if
overweight or obese. En línea:
www.nutritionevidencelibrary.com/conclusion.cfm?conclusion_statemen
t_id=250209 [Consulta: 1 de marzo de 2011]
7. European Food Safety Authority. Scientific Opinion on the
substantiation of health claims related to protein and increase in satiety
leading to a reduction in energy intake (ID 414, 616, 730), contribution
to the maintenance or achievement of a normal body weight (ID 414,
616, 730), maintenance of normal bone (ID 416) and growth or
maintenance of muscle mass (ID 415, 417, 593, 594, 595, 715) pursuant
to Article 13(1) of Regulation (EC) No 1924/2006. EFSA Journal 2010;
8(10): 1811.
8. Trichopoulou A, Psaltopoulou T, Orfanos P, Hsieh CC, Trichopoulos D.
Low-carbohydrate-high-protein diet and long-term survival in a general
population cohort. Eur J Clin Nutr. 2007; 61(5): 575-81.
9. Fung TT, van Dam RM, Hankinson SE, Stampfer M, Willett WC, Hu FB.
Low-carbohydrate diets and all-cause and cause-specific mortality: two
cohort studies. Ann Intern Med. 2010; 153(5): 289-98.
10. Institute of Medicine. Dietary reference intakes for Energy,
Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino
Acids. Washington, D.C.: Institute of Medicine; 2005. p.694.
11. Salas-Salvadó J, Rubio MA, Barbany M, Moreno B; Grupo Colaborativo
de la SEEDO. Consenso SEEDO 2007 para la evaluación del sobrepeso y la
obesidad y el establecimiento de criterios de intervención terapéutica.
Med Clin (Barc). 2007; 128(5): 184-96.
12. World Health Organization. The challenge of obesity in the WHO
European Region and the strategies for response. Denmark: WHO; 2007.
13. National Heart, Lung, and Blood Institute. Clinical Guidelines on the
Identification, Evaluation, and Treatment of Overweight and Obesity in
Adults. The Evidence Report. NIH publication 98-4083. Washington:
NHLBI; 2000.
14. American Heart Association. Dietary protein and weight reduction: a
statement for healthcare professionals from the Nutrition Committee of
the Council on Nutrition, Physical Activity, and Metabolism of the
American Heart Association.Circulation. 2001; 104(15): 1869-74.
15. Arrizabalaga JJ, et al. Grupo de Trabajo sobre Obesidad de la
Sociedad Española de Endocrinología y Nutrición. Recomendaciones y
algoritmo de tratamiento del sobrepeso y la obesidad en personas
adultas. Med Clin (Barc). 2004; 122(3): 104-10.
16. Gee M, Kathleen Mahan L, Escott-Stump S. Control del peso. En:
Kathleen Mahan L, Escott-Stump S, editores. Krause dietoterapia. 12ª
ed. Barcelona: Elsevier Masson; 2009. p.531-562.
17. Grupo de Estudio para el Tratamiento de la Obesidad Severa. Guía
Clínica para el Tratamiento de la Obesidad Severa. Monográfico en
Internet. Disponible en:
www.seen.es/pdf/guias/GUIA%20CLINICA%20OBESIDAD%20SEVERA%20GE
STOS.pdf [Consulta: 8 de febrero de 2011]
18. Aphramor L. Validity of claims made in weight management
research: a narrative review of dietetic articles. Nutr J. 2010; 9: 30.
19. Seagle HM, Strain GW, Makris A, Reeves RS; American Dietetic
Association. Position of the American Dietetic Association: weight
management. J Am Diet Assoc. 2009;109(2): 330-46.
20. ANSES. Agence Nationale de Sécurité Sanitaire de l’Alimentation, de
l’Environnement ed du Travail.Working Group Expert Committee on
“Human Nutrition”. Evaluation of the risks related to dietary weight-loss
practices. Monografía en internet. Disponible en.
www.afssa.fr/Documents/NUT2009sa0099EN.pdf [Consulta: 8 de febrero
de 2011]
21. Association Française des Diététiciens et Nutritionnistes. Regimes
alimentaires : gardons les pieds sur terre !. En línea :
http://afdn.org/fileadmin/pdf/101201-regimes_alimentaires.pdf
[Consulta: 8 de febrero de 2011]
22. The British Dietetic Association. Top 5 Worst Celebrity Diets to Avoid
in 2011. En línea: www.bda.uk.com/news/101213weirddiets.html
[Consulta: 1 de marzo de 2011]
ResearchGate has not been able to resolve any citations for this publication.
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Full-text available
Data on the long-term association between low-carbohydrate diets and mortality are sparse. To examine the association of low-carbohydrate diets with mortality during 26 years of follow-up in women and 20 years in men. Prospective cohort study of women and men who were followed from 1980 (women) or 1986 (men) until 2006. Low-carbohydrate diets, either animal-based (emphasizing animal sources of fat and protein) or vegetable-based (emphasizing vegetable sources of fat and protein), were computed from several validated food-frequency questionnaires assessed during follow-up. Nurses' Health Study and Health Professionals' Follow-up Study. 85 168 women (aged 34 to 59 years at baseline) and 44 548 men (aged 40 to 75 years at baseline) without heart disease, cancer, or diabetes. Investigators documented 12 555 deaths (2458 cardiovascular-related and 5780 cancer-related) in women and 8678 deaths (2746 cardiovascular-related and 2960 cancer-related) in men. The overall low-carbohydrate score was associated with a modest increase in overall mortality in a pooled analysis (hazard ratio [HR] comparing extreme deciles, 1.12 [95% CI, 1.01 to 1.24]; P for trend = 0.136). The animal low-carbohydrate score was associated with higher all-cause mortality (pooled HR comparing extreme deciles, 1.23 [CI, 1.11 to 1.37]; P for trend = 0.051), cardiovascular mortality (corresponding HR, 1.14 [CI, 1.01 to 1.29]; P for trend = 0.029), and cancer mortality (corresponding HR, 1.28 [CI, 1.02 to 1.60]; P for trend = 0.089). In contrast, a higher vegetable low-carbohydrate score was associated with lower all-cause mortality (HR, 0.80 [CI, 0.75 to 0.85]; P for trend </= 0.001) and cardiovascular mortality (HR, 0.77 [CI, 0.68 to 0.87]; P for trend < 0.001). Diet and lifestyle characteristics were assessed with some degree of error. Sensitivity analyses indicated that results were probably not substantively affected by residual confounding or an unmeasured confounder. Participants were not a representative sample of the U.S. population. A low-carbohydrate diet based on animal sources was associated with higher all-cause mortality in both men and women, whereas a vegetable-based low-carbohydrate diet was associated with lower all-cause and cardiovascular disease mortality rates. National Institutes of Health.
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It is the position of the American Dietetic Association that successful weight management to improve overall health for adults requires a lifelong commitment to healthful lifestyle behaviors emphasizing sustainable and enjoyable eating practices and daily physical activity. Americans are increasing in body fat as they become more sedentary. Obesity has reached epidemic proportions and health care costs associated with weight-related illnesses have escalated. Although our knowledge base has greatly expanded regarding the complex causation of increased body fat, little progress has been made in long-term maintenance interventions with the exception of surgery. Lifestyle modifications in food intake and exercise remain the hallmarks of effective treatment, but are difficult to initiate and sustain over the long term. The dietitian can play a pivotal role in modifying weight status by helping to formulate reasonable goals which can be met and sustained with a healthy eating approach as outlined in the Dietary Guidelines for 2000. Any changes in dietary intake and exercise patterns which decrease caloric intake below energy expenditure will result in weight loss, but it is the responsibility of the dietitian to make sure the changes recommended are directed toward improved physiological and psychological health. A thorough clinical assessment should help define possible genetic, environmental, and behavioral factors contributing to weight status and is important to the formulation of an individualized intervention. The activation of treatment strategies is often limited by available resources and cost. Reimbursement by third party payers for services is limited. Health care dollars are consumed for treatment of weight-related diseases. Public policy must change if the obesity epidemic is to be stopped and appropriate weight management techniques activated.
Article
It is the position of the American Dietetic Association (ADA) that food and nutrition misinformation can have harmful effects on the health, well-being, and economic status of consumers. Nationally credentialed dietetics professionals working in health care, academia, public health, the media, government, and the food industry are uniquely qualified to advocate for and promote science-based nutrition information to the public, function as primary nutrition educators to health professionals, and actively correct food and nutrition misinformation. Enormous scientific advances have been made in the area of food and nutrition, leading to a fine-tuning of recommendations about healthful eating. Consumers have become increasingly aware of the nutrition-health link and reliant on nutrition information to base their decisions, and have assumed partial responsibility for changing their eating behaviors. Unfortunately, these same trends also create opportunities for food and nutrition misinformation to flourish. News reports rarely provide enough context for consumers to interpret or apply the advice given, and preliminary findings often attract unmerited and misleading attention. Effective nutrition communication must be consumer-friendly and contain sufficient context to allow consumers to consider the information and determine whether it applies to their unique health and nutritional needs. Consistent with ADA's organizational vision that members "are the leading source of nutrition expertise," ADA recognizes its responsibility to help consumers identify food and nutrition misinformation in the following ways: (a) ADA members should provide consumers with sound, science-based nutrition information and help them to recognize misinformation; (b) ADA members need to be the primary source of sound, science-based nutrition information for the media and to inform them when misinformation is presented; and (c) ADA members should continue to diligently work with other health care practitioners, educators, policy makers, and food and dietary supplement industry representatives to responsibly address the health and psychological, physiological, and economic effects of nutrition-related misinformation.