Cómo realizar una compra bariátrica inteligente? Hoy en día, realizar una compra bariátrica se torna cada vez más difícil para todos y con más razón para un paciente en su primer año postcirugía. Con la ley de etiquetado nutricional, tenemos la sensación que no podemos comer nada. Todo tiene el signo pare. Y por otro lado, la persona que quiere cuidar su peso, siempre busca los alimentos bajos en grasa, diet o light y muchos de estos también poseen signos. Si el pan que te recomendó la nutricionista o esas galletas “saludables” que antes comías ahora tienen sellos, entonces ¿no puedes comprar nada?
La respuesta es depende. Por eso, una compra inteligente te permitirá hacer la mejor elección y te sentirás tranquila que la ida al supermercado no termine siendo un suplicio.
Como todo en la vida, debemos aplicar juicio y criterio a la hora de escoger.
En este video (que realizamos en nuestro grupo de Facebook) te resumimos en dos minutos cómo realizar una compra bariátrica inteligente.
¿Qué pasa en Chile con las leyes y los mensajes?
El 27 de junio del año 2015 entró en vigencia en Chile, la ley N°20.606, acerca de la composición nutricional de los alimentos y su publicidad. Esta ley se implementó durante tres años en tres etapas, según el siguiente cuadro:
Los sellos de advertencia “alto en” nos permiten distinguir con sólo una mirada aquellos alimentos menos saludables y preferir los alimentos sin sellos o menos sellos.
¿Por qué los límites se establecieron por 100 gr ó 100 ml?
– Porque lo más importante es conocer la calidad nutricional de los alimentos, y al medir los nutrientes en 100 gr o 100 ml se está observando la esencia del alimento en sí mismo.
– Porque un alimento de buena calidad nutricional tiene menos calorías, azúcares, grasas saturadas y sodio.
– Porque de esta manera es más fácil compararlos entre ellos, ya que las porciones de consumo son arbitrarias entre los fabricantes.
Por eso recomendamos en tu compra bariátrica preferir alimentos de buena calidad nutricional, sin sellos de advertencia o con menos sellos de advertencia.
¿Diet o Light?
Otros de los términos que se ven en los envases son “diet” o “light”, estos no están reconocidos como descriptores por el reglamento sanitario de los alimentos, debido a que estos denominadores se han registrado como marca, solo son nombres de fantasía que sugieren una propiedad nutricional.
Por consiguiente, el empleo de esos términos -“diet” o “light”- no refleja una característica del producto. Por ejemplo, un alimento denominado “light” puede significar: bajo en calorías, liviano en grasas o reducido en sodio, entre otros significados. En muchos casos, estos productos coinciden con que son alimentos más saludables pero deben declarar muy bien cuál fue el componente reducido y en qué cantidad, puesto que no es lo mismo bajo en azúcar que libre de azúcar.
Los 6 pasos de la compra bariátrica inteligente:
En Rincón Bariátrico queremos ayudarte a hacer esa compra informada e inteligentemente.
Las 6 etapas a seguir.
Paso 1. Conoce las diferencias.
Cada vez que revisas una etiqueta te encuentras con:
- Porción en medida casera (cucharita, unidad, mililitros)
- Número de porciones por envase
- Cantidad de nutrientes que aporta por porción y por 100g de producto
- Signos pares del producto (compara a cuántas porciones equivale ese signo pare)
Paso 2. Revisar la porción de consumo.
La porción de consumo habitual es declarada por el fabricante, pero de manera arbitraria, no todos los fabricantes declaran la misma porción. Por lo que en el yogurt 1, la porción puede ser 120cc y en el yogurt 2, la porción puede ser 175g. Verifica bien cuánta cantidad puedes comer y revisa el aporte nutricional de la porción que vas a consumir. Como paciente bariátrico muchas veces comerás menos de una porción, nunca te pases.
Paso 3. Comparar entre productos.
Compara los productos entre sí y escoge el que tenga menos aporte calórico y más aporte nutricional de ambos. En este caso, siempre la comparación es mejor hacerla para 100g. Pues las porciones son diferentes entre un fabricante y el otro.
Paso 4. Revisar el aporte proteico de tu compra bariátrica.
Revisa el aporte proteico. El paciente bariátrico necesita asegurar su ingesta de proteínas en al menos 80g diarios, lo cual varía de acuerdo al género, actividad física, condición de salud y cantidad de masa muscular.
- Productos que posean sobre 4g de proteína, se considerarán buena fuente.
- Productos que contengan sobre 8g por porción, son altos en esta fuente.
Paso 5. Revisar el contenido de grasa.
Si el producto posee más de 3g de grasa por porción, deja de ser bajo en lípidos y debe declarar el tipo de grasa que contiene:
- Grasa saturada
- Grasa monoinsaturada
- Grasa poliinsaturada
- Grasa trans y colesterol
Los pacientes bariátricos, ya sea producto del cambio anatómico a nivel intestinal, sobre todo el caso de bypass gástrico, presentan muy mala absorción de las grasas, y peor todavía en el caso de los pacientes con colecistectomía (extracción de la vesícula biliar). Por tal razón, evita los productos altos en grasa.
Las grasas trans se producen cuando los aceites pasan de estado líquido a sólido. Esto hace que aumente la vida útil del alimento. En el caso de la grasa trans se ha estudiado que son más dañinas que las saturadas, pues aumentan el colesterol malo y a la vez disminuyen el bueno. Ejemplos de estas grasas son:
- Chocolates grasos y bajos en cacao
- Papas fritas y envasados
- Mantecas y margarinas
Un producto libre de grasas trans, debe contener menos de 0,3g por porción.
Paso 6. Revisar el aporte de sodio y azúcar.
Sodio
Si consumes mucho sodio, tienes más probabilidades de retener líquido y amentar tu riesgo de hipertensión. Así que elige alimentos bajo en sodio.
Debo aclarar, que la sal no es lo mismo que el sodio. La sal contiene en su composición cloruro de sodio, 1g de sal contiene 390mg de sodio.
La recomendación mundial es una ingesta máxima de 2000 mg de sodio al día. El problema es que existen alimentos envasados que ya aportan 1600gr y no queda nada para el resto del día. Así que ¡MUCHA ATENCIÓN!
Un alimento es bajo en sodio, cuando contiene menos de 140mg por porción.
Azúcar de mesa (sacarosa)
El azúcar merece una especial atención, pues los azúcares simples también se denominan azúcares totales y representan la sumatoria de los monosacáridos más los disacáridos, los que pueden tener distinto origen.
La principal fuente de azúcares de la dieta proviene de los alimentos que naturalmente tienen azúcar, como frutas, verduras y lácteos, cuyo consumo se debe privilegiar y de los azúcares agregados, de los cuales se debe reducir el consumo para no sobrepasar la ingesta diaria recomendada
- Máximo 25g que equivalen a 5 cucharaditas de té
El paciente bariátrico debe evitar llegar esos 25g diarios, pues su condición de cirugía lo predispone al Síndrome de Dumping, el cual no es más que un alza y baja abrupta de glicemia producto de un desfase en el alza de insulina que se acompaña después de ingerir el alimento con azúcar. Esto puede generar temblores, mareos y desmayo.
Por eso es importante reconocer los nombres químicos del azúcar al mirar las etiquetas y reconocer cuáles tipos de azúcar tienen el mismo compartimiento en nuestra salud:
SACAROSA = GLUCOSA = JARABE DE MAÍZ ALTO EN FRUCTOSA = JARABE DE GLUCOSA
Un producto es bajo en azúcar, mientras tenga menos de 5g por porción de consumo y es libre de ella mientras tenga menos de 0,5g.
Por otro lado, el efecto en tu glicemia final va a depender de muchos factores, entre ellos si el producto posee solo azúcar o viene acompañado de otros macronutrientes (proteínas o grasa) o de fibra dietética, lo cual provoca alzas menos pronunciadas en tu glicemia.
FIBRA
Un producto es buena fuente (sobre 2,5g por porción) o alto en fibra (sobre 5g por porción). Esta cantidad contribuye a enlentecer la elevación brusca de glicemia o triglicéridos después de una comida. Todo paciente bariátrico en su compra debe incorporar el consumo de fibra después del tercer o tercer mes de operado.
Entonces, ¿qué hago finalmente con mi compra bariátrica?
- Mirar y comparar el etiquetado siguiendo los 6 pasos mencionados.
- Siempre los alimentos con menos sellos de advertencia serán opciones más saludables y si no tienen sellos, mejor. Aquellos que posean 3-4 sellos son los menos aconsejados.
- Aumenta el consumo de alimentos frescos, naturales y preparaciones caseras. Es la mejor fuente de vitaminas y minerales que puedes proporcionarte.
- Planifica el domingo los alimentos que necesitas para la semana, contando el número de veces que necesitas snacks y/o preparaciones que debes programar para cada día de la semana.
- Si hay una porción de alimento que se pasa de los límites dados, divídela en la mitad para poder cumplir con los límites de nutrientes por cada porción.
- Por último: Edúcate e infórmate. Conoce tu dosis y frecuencia al elegir los alimentos en tu compra bariátrica.
Referencias:
- Normas Técnicas sobre directrices nutricionales que indica, para la declaración propiedades saludables de los alimentos.
Resolución Exenta N°764/09. Publicada en el Diario Oficial de 05.10.09. - Minsal 2013. “Estudio para revisión y actualización de las Guías Alimentarias para la población chilena.
- Reglamento Sanitario de los Alimentos (RSA), D.S. N° 977, Santiago Chile, 2001.
- Zacarías, I. y Vera, G. Selección de Alimentos, Uso del Etiquetado Nutricional para una Alimentación Saludable. Manual de consulta para profesionales de la salud.
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