Birgit Schramm
Prof. Hans Hauner
Prof. Helmut Heseker

Starved and stuffed – are we eating ourselves sick?

Dialogue forum on 3 April 2014

Obesity is becoming a problem in more and more countries. Cancer, diabetes and cardiovascular diseases are on the rise. The question of why our eating habits have changed so strongly, and what can be done to remedy this, was the subject debated by the panellists at the fourth dialogue forum of the series entitled "Starving in the midst of abundance?". The panel of experts consisted of nutritional therapist Birgit Schramm, Prof. Hans Hauner, Director of the Else Kröner-Fresenius Centre for Nutritional Medicine at the Technical University of Munich, and Prof. Helmut Heseker, President of the German Nutrition Society (DGE).

The role played by genes and and hereditary disposition in determining whether we are healthy or whether we become ill must not be underestimated. However, lifestyle is also an important factor. "We, personally, are responsible for protecting ourselves against illness, and nutrition plays a central role in this", commented physician Hauner decidedly. In his opinion, the majority of Germans actually eat themselves ill. The consequences: the number of people suffering from overweight is growing steadily, chronic and widespread public health problems are on the rise. "Cancer is caused in approximately 30 to 40 per cent of the cases by incorrect nutrition, in the case of diabetes, the percentage is as much as 70 to 90 percent", Hauner explained. Recent studies show that Alzheimer, too, is strongly influenced by a bad diet. The costs of this undesirable development for our society are demonstrated by the approximately 100 billion euros that we in Germany alone must pay for diet-related illnesses. "An enormous sum; unfortunately it is hardly ever discussed in our health system", he complained.

Diets fail in daily life
For nutritional scientist Heseker, overweight is not a cosmetic problem but rather one of the greatest challenges facing society. "If a 40-year old has a body-mass index of over 30, his life expectancy sinks by five to eight years. The influence is therefore similar to smoking", he continued, explaining the problem. However, until now there has been a lack of preventative and therapy programmes leading to measurable results under everyday conditions. "Diets are difficult to implement in daily life, the weight lost is soon back on again." What is decisive is to reduce the total supply of energy in the long run. An exactly defined mixture of carbohydrates, fat or protein, in contrast, plays a subordinate role. For Heseker, a major obstacle on the way to a healthier diet is the fat and sugar lobby, which does everything it can to make sure we do not change our eating habits.

A first step towards a more conscious diet could be a food diary. "Pen and paper are the best diet", nutritional therapist Birgit Schramm is convinced. Some people eat 10 to 15 different kinds of food in a week, she explained. Others, who lead a very health-conscious life, have a much more varied diet consisting of 50 to 60 products. The most common nutritional mistake made, she commented, is irregular eating, possibly during other activities, or frequent snacking. "The feeling for hunger or satiation can be lost as a result", the nutritionist explained. Another problem is the of lack nutrients caused by too much fast food and not enough freshly cooked meals. However, "it isn't specific foods that make people ill, it always depends on how much and how frequently we eat something." Eating an excess of fruit or fibres can therefore also lead to illness.

Hidden sugar a major problem
Sugar, in particular, makes it difficult to practise moderation. "Many people are not even aware of all the hidden sugar that is lurking everywhere. It ranges from approximately five per cent in milk products to 18 percent in beverages", pointed out the expert. Against this background, the daily amount of 25 grams of sugar per capita recommended by the World Health Organisation is, in her opinion, an illusion. "I don't have a simple answer to the question of how we can manage to live healthily", she admitted. But she is sure that finger wagging will not help in any case.

Heseker believes that contradictory approaches to nutritional subjects in the press can sometimes also prevent us from changing our behaviour. Sugar was first of all supposed to cause cancer, then a lack of sugar was supposed to lead to depression. "How can the poor consumers know how what to do; they can choose between death by the rope or from cancer."

Contrary to many tempting promises, there are no dietary supplements that melt away excess body fat. The pharmacological therapy options are also not recommendable considering the adverse effects, which can even include death. A strong increase, on the other hand, can be observed in surgical interventions such as bariatric surgery. "This allows body weight to be reduced dramatically. But it has substantial consequences for the body and does not lead to a change in lifestyle", criticised Heseker.

Avoiding high-calorie, processed foods
The much vaunted fasting cure is also not a long-term solution. "A waste of time and money, and it endangers the organism through the extreme deprivation of calories and protein", argued clinical nutritionist Hauner. Considering the fact that our genes are optimally oriented to surviving a lack of food, only conscious control of the energy balance can help fight the flab. Easier said than done: convenience food contains 200 to 300 calories per 100 grams and consequently twice to three times more energy than a balanced vegetable-based diet incorporating a moderate proportion of meat. The food pyramid issued by the German Nutrition Society (DGE) is a good orientation tool. It gives us a feeling for the proportions of certain types of food that we should eat as part of a healthy diet.

"We must learn how to handle our body with care." However, the realisation that you are responsible for your own health is not very widespread", complained Heseker. For this reason, the DGE is calling for nutritional education to be promoted at schools and for food labelling in regard to the calorie contents. "Every person can find their own way", Hauner is convinced. Nutrition offers a broad corridor of what can be called sensible and reasonably healthy, and human metabolism is extremely adaptable. "For this reason, there can be no narrowly defined recommendations for an optimum diet. The point is to avoid excesses."

The last dialogue forum evening will take place on 13 May 2014 and will address the subject of "Food – a pawn in the hands of speculators?". 

CB, 25 April 2014