Editorial MONOGRAPH ON NUTRITION

Non-transmissible diseases are currently the main public health problem, causing 70% of deaths in the world; cardiovascular diseases stand out among them, as they are responsible for the majority of deaths (18 million every year). An unhealthy lifestyle plays a fundamental role in these diseases as the triggering factor, including physical inactivity, an unhealthy diet, exposure to tobacco smoke and environmental pollution.¹ This monographic edition of Clínica e Investigación en Arteriosclerosis covers four topics of maximum interest in modern nutrition, from a clinical viewpoint as well as in terms of physiopathology and health repercussions. An internationally highly prestigious group of authors with wide clinical and research experience in the field of nutrition have contributed to this edition.

In the first of these papers, Hernández-Ruiz et al. tackle the importance of the “dual burden of malnutrition” (DBM), which is defined as the coexistence of undernourishment and overeating in the same population throughout their lifecycle. In Latin America, the transition from a predominantly low-weight population to one that is overweight and obese has increased more quickly than it has in other regions of the world. Undernourishment and micronutrient deficiencies, especially of minerals and vitamins, cause a high level of heterogeneity in these countries, making it a growing health problem. The harm DBM does to our organism can be explained to a certain degree by the uncontrolled increase over recent years of cardiometabolic diseases. The authors analyse the clinical importance of reducing DBM, which requires changing the current food production and distribution system by means of social interventions that bring about comprehensive change that is sustainable over time.

On the other hand, the diet is gradually deteriorating in countries with more resources. In our context this is leading to abandonment of the Mediterranean diet and increasing consumption of processed and ultra-processed foods. This is negative for health, of which one example is the obesity pandemic and the resulting metabolic complications. Furthermore, the process of food production up to the moment it is consumed is known to be a major cause of global heating. Within this context Pérez-Jiménez reflects on the responsibility of medical professionals to redefine and scientifically evaluate a new model of food production and consumption, one that respects our planet and is healthy for the present and future population. In contrast, people are increasingly aware of the need for dietary innovation in the future, for technological innovation to create new disruptive foods and increase the offer of nutrients because of population growth, while global heating also has to be countered.

One of the signs deriving from the increasing worldwide prevalence of cardiometabolic diseases is non-alcoholic fatty liver disease (NAFLD). This has given rise to an urgent need to implement health policies that will tackle its development and resulting complications. The patients involved are at increased risk of hepatic and cardiovascular morbimortality, as well as death due to any cause. Currently, and given that there is no officially indicated pharmacological treatment for this disease, lifestyle interventions are still the first-line therapeutic option. In their narrative review Katsiki et al. analyse the effects of different types of diet on the incidence and progression of this disease. The Mediterranean diet is considered to be a good way of preventing and treating NAFLD and its complications. Other types of diet which are rich in vegetables and poor in saturated fats, refined carbon hydrates and red and processed meat are also beneficial, while more data are required to establish the role of ketogenic diets and intermittent fasting. Nevertheless, there is no “one size fits all” dietary intervention for treating NAFLD, so that we have to personalize diets depending on their goals and individual preferences and eating habits.

The final subject covered in this monograph covers the role played by chronodisruption in the development of cardiovascular disease (CVD). The evidence indicates that it is not enough to simple try to control traditional risk factors. Chronobiology, the science of biological rhythms, has therefore now become a major field of research. Circadian chronodisruption, defined as a major alteration in the internal temporal order of physiological circadian rhythms, increases the risk of CVD. In this paper García-Ríos et al. review the latest evidence which in the near future may affect how CVD is prevented and treated.

Finally, I would like to thank all of the authors involved for their work in writing the papers that form this monograph, as the final result is excellent and will ensure that readers enjoy it.

Conflict of interests

The author has no conflict of interests to declare.