Actividad física y nutrición en la educación médica
DOI:
https://doi.org/10.35454/rncm.v2n2.005Palabras clave:
ejercicio, salud pública, curriculum, Enfermedades no transmisiblesResumen
Las enfermedades no transmisibles (ENT) son la principal causa de muerte en todo el mundo (70 %). En Colombia mueren por ENT 178.000 personas al año, 73 % de todas las muertes, debido, en gran medida, a las malas prácticas en los estilos de vida, especialmente inactividad física, sobrealimentación y tabaquismo. En Colombia, el exceso de peso ha aumentado en la población adulta de 18 a 65 años (56,5 %) mientras que el porcentaje de personas adultas que cumplen las recomendaciones de actividad física (51,3 %) ha venido en descenso. El médico, y en general el personal de salud, tienen un papel fundamental para ayudar a los pacientes y sus familias en la construcción de un estilo de vida saludable. Los temas de actividad física y nutrición deben ser parte obligatoria de los currículos de las carreras de salud. Para el tema de nutrición se recomienda centrar la instrucción en cuatro ejes: nutrición básica, diagnóstico clínico nutricional, intervención nutricional y tratamiento dietario de la enfermedad, y en el tema de actividad física se recomienda que la intervención se enfoque en cuatro aspectos: evaluación de la actividad física y de la condición física, prescripción e implementación del ejercicio, consejería y estrategias de cambio comportamental y salud del personal médico. Se muestra la experiencia de los autores con el programa de Medicina del Deporte de la Escuela de Medicina y Ciencias de la Salud de la Universidad del Rosario
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Organización Mundial de la Salud. Monitoreo de avances en materia de las enfermedades no transmisibles 2017. Switzerland.2017. Available from: https://apps.who.int/iris/handle/10665/259806 [consultado 6 de junio 2019].
Chopra M, Galbraith S, Darnton-Hill I. A global response to a global problem: the epidemic of overnutrition. Bull World Health Organ. 2002;80(12):952-8.
Organization WH. Global status report on noncommunicable diseases. Switzerlanul2014. Available from: www.who.int/ncd.[consultado 6 de Junio 2019]
Blair SN. Physical inactivity: the biggest public health problem of the 21st century. Br J Sports Med. 2009;43(1):1-2.
Instituto Colombiano de Bienestar Familiar I, Minsalud, Prosperidad Social, Instituto Nacional de Salud, Universidad Nacional de Colombia. Encuesta nacional de la situación nutricional en Colombia (ENSIN) 2015. 2015.
Joy E, Blair SN, McBride P, Sallis R. Physical activity counselling in sports medicine: a call to action. British Journal of Sports Medicine. 2013;47(1):49-53.
Weiler R, Chew S, Coombs N, Hamer M, Stamatakis E. Physical activity education in the undergraduate curricula of all UK medical schools: are tomorrow’s doctors equipped to follow clinical guidelines? Br J Sports Med. 2012;46(14):1024-6.
Ross R, Blair SN, Arena R, Church TS, Després JP, Franklin BA, et al. Importance of Assessing Cardiorespiratory Fitness in Clinical Practice: A Case for Fitness as a Clinical Vital Sign: A Scientific Statement From the American Heart Association. Circulation. 2016;134(24):e653-e99.
Pate RR, Heath GW, Dowda M, Trost SG. Associations between physical activity and other health behaviors in a representative sample of US adolescents. Am J Public Health. 1996;86(11):1577-81.
Pedersen BK, Saltin B. Evidence for prescribing exercise as therapy in chronic disease. Scand J Med Sci Sports. 2006;16 Suppl 1:3-63.
Lee IM, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT, et al. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet. 2012;380(9838):219-29.
Meltz J, Heffernan A. The exercise cure: a doctor’s all-natural, no-pill prescription for better health & longer life. Emmaus, editor. Pennsylvania 2013. p. 298.
Cardinal BJ, Park EA, Kim M, Cardinal MK. If Exercise is Medicine, Where is Exercise in Medicine? Review of U.S. Medical Education Curricula for Physical Activity-Related Content. J Phys Act Health. 2015;12(9):1336-43.
Van Duyn MA, Pivonka E. Overview of the health benefits of fruit and vegetable consumption for the dietetics professional: selected literature. J Am Diet Assoc. 2000;100(12):1511-21.
Organization WH. Preventing chronic diseases a vital investment: WHO global report. Switzerland 2005. Available from: www.who.int/chp/chronic_disease_report/en/.[consultado 6 de Junio 2019]
Phillips E, Pojednic R, Polak R, Bush J, Trilk J. Including lifestyle medicine in undergraduate medical curricula. Med Educ Online. 2015;20:26150.
Burke EJ, Hultgren PB. Will physicians of the future be able to prescribe exercise? J Med Educ. 1975;50(6):624-6.
Connaughton AV, Weiler RM, Connaughton DP. Graduating medical students’ exercise prescription competence as perceived by deans and directors of medical education in the United States: implications for Healthy People 2010. Public Health Rep. 2001;116(3):226-34.
Education CoNiM. Nutrition Education in U.S. Medical Schools. Washington (DC)1985. Available from: http://www.nap.edu/catalog/597.html. [consultado 6 de Junio 2019]
Torabi MR, Tao R, Jay SJ, Olcott C. A cross-sectional survey on the inclusion of tobacco prevention/cessation, nutrition/ diet, and exercise physiology/fitness education in medical school curricula. J Natl Med Assoc. 2011;103(5):400-6.
Kohlmeier M, Uhley V, Nelson J. Teaching Population Health: Innovative Medical School Curricula on Nutrition 2016 [Available from: https://www.aamc.org/initiatives/diversity/portfolios/449534/nutritionwebinar.html. [consultado 6 de Junio 2019]
Kris-Etherton PM, Akabas SR, Bales CW, Bistrian B, Braun L, Edwards MS, et al. The need to advance nutrition education in the training of health care professionals and recommended research to evaluate implementation and effectiveness. Am J Clin Nutr. 2014;99(5 Suppl):1153S-66S.
Investments that Work for Physical Activity. British Journal of Sports Medicine. 2012;46(10):709-12.
Health Program Nutrition and Physical Activity Initiative. Lots to Lose: How America’s Health and Obesity Crisis Threatens our Economic Future. Washington, DC 200052012.
Program H, Initiative NaPA. Teaching Nutrition and Physical Activity in Medical School:Training Doctors for Prevention-Oriented Care. Washington, DC 200052014.
Polak R, Pojednic RM, Phillips EM. Lifestyle Medicine Education. Am J Lifestyle Med. 2015;9(5):361-7.
National Physical Activity Plan Alliance. National Physical Activity Plan 2013. Available from: http://physicalactivityplan.org/docs/2016NPAP_Finalforwebsite.pdf [consutado 6 de junio 2019].
Gates AB, Ritchie IK, Moffatt F, Breda J. Leadership in physical activity: is this the currency of change in the student healthcare curriculum? Br J Sports Med. 2018;52(23):1484-5.
Lobelo F, Duperly J, Frank E. Physical activity habits of doctors and medical students influence their counselling practices. Br J Sports Med. 2009;43(2):89-92.
Tovar G, López G, Ibáñez M, Alvarado R, Lobelo F, Duperly J. Institutionalized physical activity curriculum benefits of medical students in Colombia. Educ Health (Abingdon). 2016;29(3):203-9.
Tovar G, Rodríguez Ä, García G, Tovar J. Actividad física y consejería en estudiantes universitarios de primero y quinto año de medicina de Bogotá, Colombia. Revista Universidad Salud. 2015;18(1):16-23.
Initiative HPNaPA. Teaching Nutrition and Physical Activity in Medical School: Training Doctors for Prevention - Oriented Care. Washington, DC 200052014.
Ministerio de Salud y Protección Social. Plan Decenal de Salud Pública 2013.
Duperly J, Lobelo F, Segura C, Sarmiento F, Herrera D, Sarmiento OL, et al. The association between Colombian medical students’ healthy personal habits and a positive attitude toward preventive counseling: cross-sectional analyses. BMC Public Health. 2009;9:218.
Frank E, Tong E, Lobelo F, Carrera J, Duperly J. Physical activity levels and counseling practices of U.S. medical students. Med Sci Sports Exerc. 2008;40(3):413-21.
Quintero GA. Medical education and the healthcare system--why does the curriculum need to be reformed? BMC Med. 2014;12:213.
Lloyd-Jones DM, Hong Y, Labarthe D, Mozaffarian D, Appel LJ, Van Horn L, et al. Defining and setting national goals for cardiovascular health promotion and disease reduction: the American Heart Association’s strategic Impact Goal through 2020 and beyond. Circulation. 2010;121(4):586-613.
Lobelo F, Rohm Young D, Sallis R, Garber MD, Billinger SA, Duperly J, et al. Routine Assessment and Promotion of Physical Activity in Healthcare Settings: A Scientific Statement From the American Heart Association. Circulation. 2018;137(18):e495-e522.
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Derechos de autor 2019 Gustavo Tovar Mojica, Erika Viviana Ladino Marín
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-CompartirIgual 4.0.