- hace 8 minutos
La llegada de nuevos medicamentos ha transformado las posibilidades de tratar la obesidad, pero también ha generado expectativas que es necesario poner en contexto.
Esta condición no se reduce al peso corporal ni tiene una solución exclusivamente farmacológica. En este episodio conversamos con Ana Cristina Montenegro Arenas, jefa del Departamento de Medicina Interna de la Fundación Santa Fe de Bogotá, sobre los alcances y límites de estos tratamientos, la importancia de construir hábitos saludables y las dificultades de mantenerlos en el tiempo. También hablamos de la transición epidemiológica en Colombia, de las particularidades de la salud de las mujeres y de por qué necesitamos una atención que comprenda al ser humano de manera integral.
Esta condición no se reduce al peso corporal ni tiene una solución exclusivamente farmacológica. En este episodio conversamos con Ana Cristina Montenegro Arenas, jefa del Departamento de Medicina Interna de la Fundación Santa Fe de Bogotá, sobre los alcances y límites de estos tratamientos, la importancia de construir hábitos saludables y las dificultades de mantenerlos en el tiempo. También hablamos de la transición epidemiológica en Colombia, de las particularidades de la salud de las mujeres y de por qué necesitamos una atención que comprenda al ser humano de manera integral.
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00:00After many studies, we have realized that there are things that impact women's lives from even
00:07the birth.
00:08So, the same thing is going to happen with these, for example, these new weight loss medications that are now
00:14They're so fashionable now that people wear them just because, why not.
00:19If that doesn't have a strong enough, solid enough foundation for the patient to understand that
00:28It's helpful, but it's not a miracle cure, it's not a vaccine for obesity.
00:34It's not just about the number on the scale; the number on the scale is important, but how is the
00:41muscle, what is the relationship between muscle and fat, what is your visceral fat, because we need muscle in
00:49our old age.
00:59Dr. Ana Cristina Montenegro, welcome to the viewer, welcome to this space of Health Awareness, what a pleasure to have you.
01:06Thank you very much Diego, thank you very much for the invitation, it's a pleasure for me to be here.
01:09We're going to talk with you about the changes the world is experiencing in terms of health, which surely everyone...
01:17We notice them, but we don't always know how to put them into words, and we're also going to talk about how you, from health, from
01:28Patient care is adapting to these changes; they are providing better care based on how the world
01:36It's changing, Doc.
01:37So, it's sure to be a very useful conversation for people. Again, thank you so much for these few minutes.
01:45Doctor, the world has experienced some very important changes in health over the last few decades; from your perspective, what are these changes?
01:54have left, have resulted in a world in what terms in health.
02:01Well, let's just say people aren't dying from the same things they used to. The leading causes of death,
02:08For example, in developing countries, the causes were infectious diseases; people died of diarrhea, they died
02:16of respiratory infectious diseases.
02:18And as time went on, excepting, of course, for the difficult time we experienced during the pandemic, people began
02:27to die from chronic non-communicable diseases,
02:31which are obviously secondary to underlying risk factors that are currently present and that probably did not exist before,
02:39but they are also closely related to the aging process of the population.
02:44We know clearly that we are living in a world with more elderly people and fewer children, and of course, this too
02:52has led to a very large epidemiological change
02:54in the causes of why people are currently dying.
02:59That's what you doctors know as epidemiological transition, and it's basically a bit of a...
03:05And to make it perhaps much clearer for people, 50 years ago in Colombia, cases of dengue fever,
03:13of malaria,
03:14Of all these vector-borne diseases, some were incredibly dangerous and even threatened the lives of thousands.
03:22of people.
03:23Today, although they remain a problem in many areas of the country, we now have bigger problems and are in this transition,
03:29So we're talking about diseases like cancer, like diabetes, diseases that are not transmitted by a mosquito,
03:38but they come a bit with what you were saying, the risk factors.
03:42We're not talking about that transition, are we?
03:44Exactly. If we look at the statistics from the World Health Organization,
03:4770% of the causes of mortality in the world population are related to chronic non-communicable diseases.
03:56These chronic non-communicable diseases include hypertension, diabetes, coronary heart disease, and stroke.
04:05When we look at the data, roughly 18 million people die each year worldwide due to
04:11cardiovascular disease, for example.
04:14Of these, approximately 7 million die from causes directly related to high blood pressure.
04:20So, what does it take to be hypertensive?
04:23And so we go to the root of this whole problem, which is the increase in risk factors
04:30cardiovascular
04:30all of which come together to produce diseases that will ultimately lead to the death of patients.
04:37So, we include obesity, we include sedentary lifestyle, we include smoking,
04:43We include some dramatic changes that have occurred in recent years in people's diets
04:48And obviously all of this comes together to form disease.
04:53These diseases, in addition to killing many people every year worldwide,
04:59They generate a great deal of morbidity, and it is this disability that patients begin to experience.
05:05of being able to be integrated and work together in society because they do not have the capacity
05:11because they are chronically ill.
05:13Therefore, they not only generate a great deal of mortality, but also a great deal of morbidity.
05:19And that, of course, leads us to completely change the landscape where we have a responsibility
05:26in health, to have a comprehensive impact on the well-being of patients
05:31to, of course, carry out huge prevention campaigns regarding these risk factors
05:38but also to be able to impact them comprehensively so that if they already have an established disease
05:44or their illnesses, so that we can treat them in a much more holistic way,
05:49much more comprehensive and obviously we can have a very positive impact on their quality of life.
05:55Sure, several very interesting points. I was thinking as I listened that of course
05:59That transition speaks to some very important health achievements, doesn't it?
06:04For example, we have already more or less solved the problem of access to drinking water in large cities,
06:11At the time, this represented a reduction in risk from countless diseases.
06:17But that transition, as you said, has created new challenges in terms of health
06:23And I found what she mentioned about risk factors very interesting.
06:28There are some modifiable risk factors, and I think it's very valuable that we talk about what's important.
06:36These are things that people don't usually consider so important in their daily lives, right?
06:40What you eat, moving a little more each day, physical activity.
06:44These risks, these risk factors, doctor, if they are not controlled, are what is generating
06:52This whole rise in chronic diseases, right?
06:55Agreed. Diego, as you rightly said, and this is invaluable,
06:59We have made great strides in health.
07:02We have vaccines, vaccines that have prevented a lot of people from dying.
07:07from such dramatic things that have affected us recently as COVID
07:11even things that used to kill us like smallpox, measles and other diseases.
07:17But these risk factors have a lot to do with the way we currently live.
07:24So, we live in a faster-paced world, a world with more screens,
07:29in a world where children face situations from their earliest moments,
07:35From their early childhood, they greatly affect their future risk factors when they are adults.
07:44We have a large proportion of patients in early childhood who have obesity
07:50And obesity and overweight are directly related to poverty lines in countries
07:57because people do not have the financial means to access healthy food,
08:05to healthy lifestyle habits, but we are also surrounded by stress,
08:10of psychological conditions, mental illness, which also affect,
08:15They have a huge impact on people's lives.
08:18Therefore, a depressed person is unlikely to focus on healthy eating.
08:24It doesn't focus on physical activity, it doesn't focus on what the other diseases are
08:30which she also has, in addition to her mental illness, because she is completely overwhelmed
08:34with regard to his mental illness.
08:36And on the other hand, there are other factors that greatly influence our daily lives,
08:41For example, the change in professions.
08:44There are now a lot of professions that are limited to the desk,
08:48in front of a screen all the time.
08:50Our children are constantly exposed to screens and social media,
08:56to all this influence of modern things, which are wonderful, are fantastic,
09:02They unite the world, they bring us closer to a lot of things we didn't have before,
09:06but they also distance us from very good habits we used to have.
09:10So, let's say the invitation is to try to find that balance from the very beginning.
09:17and obviously to identify which factors directly influence this
09:22about our health in the medium and long term and being able to treat them.
09:28Obviously, we are also making an effort, that is, it's not that we've stopped doing it.
09:33In other words, the food pyramid was recently changed in the United States.
09:38That's a huge political effort in the face of a lot of industry.
09:44that encouraged the consumption of cereals, processed foods, and other things
09:49that in the end the voice of the people prevailed, saying, shouting, about such serious illnesses
09:57such as obesity, diabetes, and cardiovascular disease.
10:01Listen, we can't go on like this.
10:03We need to seek change from a social perspective, from the deepest level.
10:08And they changed the food pyramid.
10:11They even changed it so much that they turned it upside down.
10:14At its base, which is no longer its base, but its roof,
10:19They presented a very powerful message about real food, real food.
10:25The day they presented it, the invitation from the United States public health department
10:30We need to go back to eating real food, fruits, vegetables, and protein.
10:37and leave processed foods, carbohydrate-rich foods, etc., etc., until last.
10:45So, let's say I think that starts to have an impact,
10:50But just as it took us many years to change,
10:54Changing humanity's vision and policies is very complicated.
11:00So, yes, we know we need to do more exercises.
11:04Yes, we know that we have to not smoke, not vape,
11:08We know we have to control stress,
11:11But implementing it is not so easy.
11:14No, and the scenario it describes creates an immense challenge.
11:20Because of course vaccines were a discovery
11:23and an application of a wonderful technology,
11:26But getting a vaccine is much easier.
11:28to create a healthy lifelong habit,
11:32what to do physical activity, what to eat.
11:35That, what you were saying at the end,
11:37that notion of holism,
11:40that we are complete and whole beings,
11:43It's difficult, it's even more difficult to assimilate it in everyday life
11:47from the individual,
11:48but also from society, from the State,
11:52That path is difficult.
11:54Yes, I believe we need to migrate to philosophy
11:57of person-centered care,
11:59and not disease-centered care.
12:02Person-centered care
12:04Look at the patient as a whole being,
12:07as an integral being in its physical sphere,
12:10in their mental sphere, in their family sphere,
12:12in its socioeconomic context.
12:15In other words, to really go to the deepest part of the patient.
12:20The problem is that speed and velocity are coming back again.
12:25with which humanity progresses
12:27And they tell us,
12:29Give the patient a 15-minute consultation.
12:31So, in 15 minutes,
12:33This person-centered care,
12:35Well, he has to prescribe the patient,
12:39address their concerns, look at their laboratories.
12:41In other words, he has to do a lot of things
12:44And 15 minutes probably isn't enough.
12:47in order to address it in a comprehensive way.
12:49Then, other problems begin to appear
12:52that have to do with public policies,
12:55that have to do with the possibility
12:59so that the patient can access a quality health service,
13:02etcetera, etcetera,
13:04which obviously happens when the patient is already sick
13:07It's much more difficult.
13:09If we manage to impact him from the most basic level,
13:14If we can get children away from screens
13:17and start playing again, running, going out,
13:20to enjoy nature,
13:22If we impact them from a young age by telling them,
13:25Look, vapes are bad.
13:27Cigarettes are bad.
13:28Yes, that kind of thing,
13:30from early childhood,
13:32because we're not going to find them sick in their adulthood
13:34and we'll be able to limit it a little.
13:37and focus a little bit on attention
13:39of those patients who are sick.
13:41But the problem really starts very early on.
13:46We were just talking off-camera,
13:48For example,
13:48of emerging factors specific to women
13:52that we didn't take into account before
13:54and that after many studies
13:57We've realized that there are things
13:59that impact women's lives
14:01from even birth.
14:04If you are a woman who was born with low birth weight,
14:08Your doctor should be monitoring you at all times.
14:12of what your metabolic condition is like,
14:14your nutritional status,
14:15that you don't smoke,
14:17that you do physical activity,
14:18because it's already clear that in the future
14:21that woman who was born underweight
14:23has a higher cardiovascular risk
14:25than one who was born at a normal weight.
14:27Or if you had preeclampsia during your pregnancy
14:30or you had pregnancy-related hypertension
14:33or you had diabetes
14:34or your period came very early
14:37or you had early menopause,
14:40that has a negative impact
14:43about your cardiovascular health
14:45and often the women
14:47We are not aware of that
14:49out of ignorance,
14:51because our doctor doesn't tell us.
14:53or even because the doctor doesn't know.
14:55So,
14:56It is very important
14:58that we can impact
15:00those vulnerable populations.
15:02Obviously,
15:03We have genetic risk factors
15:05that are difficult to change.
15:07There are things that affect us metabolically
15:11to have high cholesterol
15:12and giant atherosclerotic plaques
15:15in our arteries
15:16and that are conditioned
15:18due to genetic nature
15:21of the patients
15:22and that it is very difficult
15:23that we can prevent it.
15:25Obviously,
15:25They have treatment,
15:27But these are things we cannot change.
15:29We cannot change aging,
15:30We cannot change the conditions
15:33from the country where you were born
15:36or your genetic sex.
15:38Those are things we cannot change.
15:40But if we can make an impact
15:42the other side of the scale
15:43and be able to make an impact
15:45in how the patient is fed,
15:48in how they cope with everyday stress,
15:51in how they manage their mental health,
15:54in how it impacts
15:56with regard to their feeding habits,
16:00all those things,
16:01Well, obviously we're going to achieve it
16:03that in the future
16:03there are fewer complications
16:06with regard to chronic diseases
16:08non-transmissible
16:09that we can prevent.
16:11Clear,
16:11listening to her as well,
16:12I thought about the importance
16:13that comprehensive view
16:15and complete
16:16then begin
16:17from a very early age,
16:19precisely to recognize
16:20that context
16:21in which we humans are born,
16:23in which we move
16:24whether or not we have access
16:25a X food
16:28or to X opportunity
16:30of exercising,
16:31That should be it then.
16:33taken into account
16:34From very early on, right?
16:36That's right, that's right.
16:37For example,
16:39clear,
16:40we know that the countries
16:41They make giant efforts
16:42in Colombia,
16:43we have made great progress
16:46in, I don't know,
16:47parks
16:48where you find
16:50exercise equipment,
16:52public policy campaigns
16:54where it is stimulated
16:55physical activity,
16:57car-free day,
16:58the bike path,
16:59Yeah?
16:59Things in which
17:00the country
17:02It tries to make an impact
17:03positively
17:04to the population,
17:05But I think
17:06that these campaigns
17:07awareness
17:08how
17:09we must make an impact
17:11holistically,
17:13globally
17:13to the patients
17:15they must begin
17:16from early childhood
17:17and they must continue
17:18in time
17:19because establish
17:21healthy habits
17:22It's difficult,
17:23Yeah?
17:24When we
17:25we face
17:25to a patient
17:26already ill,
17:27to a patient
17:28hypertensive,
17:29diabetic,
17:30obese,
17:31smoker,
17:32that has consumed
17:34alcohol,
17:36sedentary,
17:37well tell him
17:37overnight,
17:38No, sir,
17:39Please turn around.
17:40the athlete,
17:42quit smoking,
17:43eat a healthy diet,
17:44Take your medication.
17:45It's difficult
17:46and the patient
17:47It comes out as a percentage
17:49And that too.
17:49It's very well studied
17:51already in a percentage
17:52important of the cases
17:53if you have
17:54a conversation
17:55enough
17:56real and sincere
17:57with the patient,
17:58the patient
17:59understands
18:00and the patient
18:01He leaves convinced.
18:02from the consultation,
18:03but maintain
18:04That's in the long term
18:06It's super difficult,
18:08So the patient
18:09manage to stay
18:11in weight,
18:12I achieved
18:13continue in his
18:14physical activity,
18:16I achieved
18:16even leave
18:17smoking
18:18or not vaping
18:19or abandon
18:20full
18:20consumption
18:21of alcohol,
18:22It's difficult
18:23in the long term,
18:24so
18:24What needs to be done?
18:25Then follow it
18:26intervening
18:26and intervening
18:27and intervening
18:28And that's where
18:28It gets complicated
18:30the situation
18:31because
18:31or the patient
18:32He's not coming back
18:33or it no longer covers you
18:34your insurance
18:34or couldn't
18:36pay more,
18:37I mean,
18:37There are many factors
18:38that socially
18:40impact the patient
18:41and that prevent
18:43in many cases
18:43that the patient
18:44continue
18:45with their habits
18:46healthy lifestyle,
18:47We even see it
18:48in diseases
18:48so complex
18:49such as obesity
18:50in which
18:51the patients
18:51are taken
18:52metabolic surgery,
18:54bariatric surgery,
18:55they drop sharply
18:57of weight
18:58and recover
18:59in many cases
19:00her lost weight
19:01because they didn't do it
19:03like everything else
19:04the process
19:05handling
19:06comprehensive
19:07of his condition
19:07metabolic,
19:09so
19:09and the same
19:10It's going to happen
19:11with these,
19:11For example,
19:12these new drugs
19:13to download
19:13of weight
19:14that now
19:15they are so
19:16fashionable
19:17and that now
19:18They put them on
19:19just because,
19:19why not,
19:20if that doesn't have
19:22a fund
19:23enough
19:24strong,
19:25enough
19:26solid
19:26so that the patient
19:28can understand
19:28That's helpful.
19:30but that is not
19:31a miraculous remedy,
19:33It's not the vaccine
19:34obesity
19:35and?
19:36a percentage
19:38giant
19:38of the disease
19:39It's in your habits
19:41in your form
19:42to eat
19:42in the form
19:43in which you interact
19:44with food
19:45well that patient
19:46is going to leave
19:47the medication
19:48And he's coming back
19:48to gain weight
19:50or will use
19:52the medication
19:52lifetime
19:53Well,
19:53Yeah,
19:54it is likely
19:54yes
19:55but it doesn't work
19:57to achieve
19:57the impact
19:58enough
19:59about your health
19:59if it is not done
20:00aware
20:01of his illness.
20:02Doctor,
20:03precisely the topic
20:04obesity
20:04It seemed to me
20:05a great example
20:05to talk
20:06of,
20:07to continue talking
20:08a bit
20:09of this need
20:10to understand
20:10these problems
20:11complex
20:12in its complexity
20:13and in a comprehensive manner
20:14because the emergence
20:15of these medications
20:16as you say
20:17It has been a great revolution
20:18But it has returned to us
20:20a bit
20:20to this myth
20:21What problems
20:22so complex
20:23like this
20:24They have an easy solution.
20:25and it's injecting
20:26something
20:27and that's it
20:27the topic
20:28obesity
20:29It is important
20:29to understand
20:30that we have to
20:31take into account
20:32the medication
20:33but also
20:33so
20:34impact
20:34physical activity
20:35mental health
20:36and a lot
20:38of factors
20:38that explain
20:40fairly
20:40that a person
20:41be obese
20:42or not
20:42clear
20:43so
20:43the problem
20:44obesity
20:45It's terrible.
20:47It's a pandemic
20:48world
20:48then we have
20:50a pandemic
20:50world
20:51of an illness
20:52which is extremely difficult
20:53to try
20:53extremely difficult
20:54to try
20:55and we found
20:57a solution
20:58easy
21:00which is precisely
21:01in psychology
21:02of the obese patient
21:04what he is looking for
21:05because in the end
21:07no obese patient
21:08He wants to be obese
21:09obese patients
21:11They want to lose weight
21:12But it's difficult.
21:13because their relationship
21:14with food
21:14It's difficult
21:15because they don't exercise
21:16because they have
21:18some habits
21:19life
21:20which are
21:21difficult
21:22because they carry
21:23lifetime
21:23being obese
21:24because they are children
21:25of obese people
21:26so
21:27change that
21:28It's very complex.
21:30and then it appears
21:31a formula
21:32magic
21:33in which
21:34you inject yourself
21:35and you lose weight
21:36Yeah?
21:37ready
21:38perfect
21:38but that
21:39has to come
21:40united
21:40to look
21:41strategies
21:42to make an impact
21:43the other factors
21:45that affect
21:46about obesity
21:46because it's not about
21:48just from the scale
21:49I often
21:50many times
21:50I tell the patients
21:51It's not about
21:52only from the number
21:53from the scale
21:54the number
21:55from the scale
21:56It is important
21:57but
21:58But how is it?
21:59the muscle
22:00How is the relationship?
22:01of the muscle
22:01with the fat
22:02How is your fat?
22:04visceral
22:04Yeah?
22:05because we
22:06we need muscle
22:07in our old age
22:08so
22:09What's going to happen?
22:10with these people
22:11that go down
22:12so much weight
22:13so fast
22:14and that it doesn't
22:15They do physical activity
22:16and that they don't take care
22:17protein consumption
22:18in their diet
22:19and that they don't have
22:20some habits
22:21healthy eating
22:22well, in the end
22:23They're going to be
22:24sarcopenic
22:25which is a loss
22:26muscle
22:27extremely important
22:28and the muscle
22:28It is our support
22:29of the bone
22:30then afterwards
22:31They will develop osteoporosis.
22:32They're going to break
22:33and we have already seen
22:34that the elderly
22:35sarcopenic
22:36More people are dying
22:38that those who have
22:39a good muscle mass
22:40so
22:41It's not just about
22:43of the number
22:43from the scale
22:44but make him understand
22:46that to a person
22:47that saw
22:48in the medication
22:49his lifeline
22:50and that it is not
22:51so difficult
22:52Well, it's complex.
22:54so
22:54so
22:55to be able to
22:56tackle
22:57as an individual
22:58in all aspects
23:00that affect it
23:00probably
23:02be much more effective
23:03that just put
23:04the medication
23:05without subtracting
23:06what is
23:06of course
23:07probably
23:08the medication
23:10of the century
23:10this type of medication
23:11be the medications
23:13of the century
23:13because really
23:14are having an impact
23:15very positively
23:16life
23:17of people
23:18with obesity
23:19and overweight
23:20but neither
23:21we can
23:21cross to the other side
23:23I don't know
23:23if I am
23:24so clear
23:26in my view
23:27but we can't
23:28cross to the other side
23:30we can't see it
23:30as a solution
23:31magic
23:32It has to be
23:33an approach
23:34enough
23:35comprehensive
23:36of that patient
23:37so that the patient
23:39introspect
23:39and realize
23:40that if one day
23:41the medication
23:41does not exist
23:42He can't buy it
23:43He can't put it on
23:44or generates
23:46an adverse effect
23:47in it
23:47that he does
23:48that I can't use it
23:49He will be able to
23:50continue with your plan
23:52will be able to continue
23:52with his life
23:53will be able to continue
23:55managing their weight
23:56and for that
23:58because it is needed
23:59that patient
24:00be impacted
24:01in all the rest
24:02of aspects
24:02and not only
24:03in the number
24:04from the scale
24:05clear
24:05also because
24:07particularly
24:07For example
24:08on this topic
24:09obesity
24:09and the medicine
24:10well, ideally
24:10For example
24:11would be that
24:12Or I don't know if it's ideal
24:14But if there is a question
24:15that's very important
24:16And if
24:17if people
24:18are intended
24:19for example
24:19to consume
24:20the medication
24:20lifelong
24:21I mean
24:22Ideally,
24:23have enough
24:24changes
24:25in all other respects
24:26so that the medicine
24:27at some point
24:28may
24:29if they are indicated
24:30the doctors
24:31and so on
24:31then retire
24:32a bit
24:32of
24:33clear
24:33when it is precisely
24:34used for obesity
24:36For example
24:37these medications
24:38were initially
24:39treaties
24:39for handling
24:40diabetes
24:41created for handling
24:42diabetes
24:43for treatment
24:43diabetes
24:44clear
24:45Then they realized
24:46that impacted
24:46positively
24:47in weight
24:48because they have
24:49effects
24:50about many
24:51factors
24:51that affect
24:52about weight
24:53including
24:54the cerebral cortex
24:55the stomach
24:57I mean
24:57There are a lot
24:58of things
24:59that are impacted
24:59with this type
25:00of medicines
25:01but
25:02but
25:02There are already doses available.
25:04established
25:05for handling
25:06punctual
25:07obesity
25:07and the idea is
25:09well, that the patient
25:09don't have to consume it
25:11lifetime
25:11if he/she is a patient
25:12only obese
25:13well when the patient
25:14I managed to reach my weight
25:16should be able to
25:16Do not consume
25:17the medication
25:18The problem is
25:19if you already succeeded
25:21impact him
25:21from the other
25:22perspectives
25:23so that that patient
25:24don't have to use it
25:26the rest of his life
25:27clear
25:27and so?
25:28because it also implies
25:29a lot of things
25:30in public policy
25:32in costs
25:33in
25:33in the value
25:35health
25:36I mean
25:36There are a lot
25:37of things
25:37that are impacted
25:39with that
25:39so
25:40So I think
25:41that
25:41that this is a very
25:43good example
25:44of the importance
25:45of
25:46integrate
25:47to the patient
25:47I don't know if that word
25:48be correct
25:49but
25:49but to return it
25:51a being
25:51Yeah
25:52turn it back
25:52an individual
25:53that has
25:54many points
25:55that impact
25:57and that obviously
25:58from the attention
25:59person-centered
26:00must overturn
26:02to the entire service
26:03It's for everyone.
26:04the actors
26:05health
26:06not only
26:07to the doctors
26:08Yeah
26:09This has to
26:10include
26:11psychology
26:12It must include
26:14people
26:16experts
26:16in activity
26:17physics
26:18clear
26:19There are doctors
26:20but also
26:20There are people
26:21what do they do
26:22physical education
26:23There are coaches
26:25personal
26:26I mean
26:26This should have an impact
26:27to the entire population
26:29that affects
26:30life
26:30of the patient
26:31Yeah
26:32to the nutritionists
26:33to
26:34I don't know
26:36I mean
26:36There are so many
26:38There are so many
26:39actors
26:40within the system
26:41health
26:41that not only
26:43We are the doctors
26:44me too
26:45whenever I board
26:46these types of patients
26:47with chronic diseases
26:48non-transmissible
26:49I tell them
26:50a phrase
26:51which is very important
26:52and it is
26:52I put it on
26:53my 100
26:54my 100%
26:55my 100%
26:56in knowledge
26:57my 100%
26:59Currently being updated
26:59medical
27:00my 100%
27:01in the scientific part
27:03but I need
27:04your 100
27:04back
27:06100%
27:07is
27:07good adhesion
27:08to the treatment
27:09pharmacological
27:10but also
27:11that you go
27:12where we
27:13Let's consider
27:14that there is
27:14people
27:15that they can
27:16impact
27:17in all those
27:17aspects
27:18of his life
27:18staff
27:19to the psychiatrist
27:20to the psychologist
27:23to the gym
27:24or exercise
27:25on the street
27:25or to rehabilitation
27:26cardiac
27:27if you've already had a heart attack
27:28I mean
27:28or to the group
27:31detoxification
27:32to the cigarette
27:33I mean
27:33There are so many things
27:34that you can
27:35impact
27:36in a patient
27:36with diseases
27:37chronicles
27:38or without diseases
27:40but with great
27:40risk factors
27:42but the patient
27:43It also has to
27:43be willing
27:44And here it comes
27:46the importance
27:47that people
27:49become aware
27:50of what is important
27:52which is to maintain
27:53good health
27:54and good health
27:55It's not about
27:56only
27:56arrest
27:57the correct number
27:58on the scale
27:59or to have
28:00the correct numbers
28:02in an exam
28:03There are many people
28:04that weigh
28:05normal
28:05and that they have
28:06correct numbers
28:07in their exams
28:08and that stress
28:10it produces them
28:11coronary artery disease
28:12or what they do
28:13a stroke
28:14because it went up on them
28:15blood pressure
28:16with numbers
28:17with numbers
28:18perfect
28:18so
28:19This is not only
28:20It is about
28:20to have numbers
28:21perfect
28:22I think that
28:22that need to be looked for
28:23go a little further
28:25and become very aware
28:27that we are
28:27a machine
28:28perfect
28:29perfect
28:30operation
28:31who created us
28:32unique
28:33wonderful
28:34and perfect
28:34but that
28:35There are so many things
28:37that affect
28:39today to the world
28:39that involve us
28:41and that by getting involved
28:43well we
28:43we have to do it
28:45aware of those
28:46and put
28:47our 100%
28:48in order to handle them
28:50that a look
28:51and also
28:51infinitely improves
28:53the possibility
28:54of an outcome
28:55positive
28:56for one person
28:58what you were saying
28:59also
28:59represents savings
29:01important
29:01for the system
29:02health
29:02this decision
29:04doctor
29:05to look
29:06because also
29:06It's a decision
29:07to look
29:08health
29:08of a person
29:09in its entirety
29:10that take
29:11institutions
29:12like the Foundation
29:13Santa Fe
29:14from Bogotá
29:14that involve
29:15for you
29:16as an institution
29:17on the route
29:18of the patient
29:18because also
29:19It is a path
29:21that is decided
29:22take
29:22from the institutional perspective
29:24and that implies
29:25i guess
29:25some challenges
29:25different
29:26that's how it would be taken
29:28another way
29:28clear
29:29This involves some challenges
29:31gigantic
29:32I started
29:33to work
29:33at the Foundation
29:3426 years ago
29:35in the year 2000
29:36I went to boarding school
29:37at the Foundation
29:38and he always called me
29:40a lot of attention
29:41this approach
29:42attention
29:43person-centered
29:44but this too
29:44has left
29:46perfecting
29:47and structuring
29:48in a way
29:49very forceful
29:51during the step
29:52of the years
29:53and now
29:55have
29:55all our
29:56certifications
29:57in that model
29:59attention
30:00focused
30:00in the person
30:01in which we
30:02we are looking for
30:03from different
30:04perspectives
30:05impact
30:07about the main ones
30:08diseases
30:08that affect
30:09to the patients
30:10but search
30:11integrality
30:12seek management
30:13multidisciplinary
30:14seek management
30:15as a team
30:16seek a change
30:18in the medical model
30:19so that the doctors
30:21Let us also understand
30:22the important thing
30:24What is work?
30:25as a team
30:25for well-being
30:27of the patient
30:27always thinking
30:29in the patient
30:30like the point
30:31integral and central
30:32of the attention
30:33so
30:34We have examples
30:35very nice
30:36like the centers
30:37clinical care
30:38in which
30:39from an illness
30:42we generate
30:43all the handling
30:44comprehensive
30:45of those patients
30:46impacting them
30:47from all
30:48the prospects
30:49from education
30:50from nursing
30:52from nutrition
30:54from a psychological perspective
30:57from a psychiatric perspective
30:58searching
30:59that patient
31:00not only be
31:01identified
31:02like a disease
31:03but rather be an individual
31:04with an illness
31:06in which
31:07we are looking
31:08all standards
31:09quality
31:09to treat it
31:10but we understand
31:12as a person
31:13and that upon understanding it
31:15as a person
31:15There are many centers
31:17that are related
31:19For example
31:19we have the metacenter
31:21the cardiometabolic center
31:23which is a center
31:24where we belong
31:26thromboembolic disease
31:27acute myocardial infarction
31:29stroke
31:30diabetes and obesity
31:32when you realize
31:34those five diseases
31:36They are the consequence
31:38of a patient
31:40coming
31:40for many years
31:42sick
31:42of conditions
31:44cardiometabolic
31:46and that finally
31:47triggered
31:48in a disease
31:49but we are
31:50interrelated
31:52and handling it
31:52in a way
31:53comprehensive
31:54so
31:55I think that
31:56that philosophy
31:57of the attention
31:58person-centered
31:59does
32:00that medicine
32:02be different
32:02for patients
32:04and sometimes
32:05one says
32:07in addition
32:08and I don't want to sound
32:10pejorative
32:11from none
32:12perspective
32:12but one
32:14he says to himself
32:15I would like
32:16that all patients
32:17were approached
32:19from this way
32:20Yeah
32:20because I believe
32:22that everyone
32:22have the right
32:23all patients
32:24have the right
32:25to be treated
32:26that way
32:27clear
32:27It's an approach
32:28much more human
32:29a lot more
32:30I suppose that
32:31the patient
32:31It also feels
32:32more understood
32:34sometimes
32:34what you were saying
32:35now
32:35a little at the beginning
32:36of these quotes
32:37short
32:38where the patient
32:39not even
32:40ends as
32:41to put into words
32:41what he is feeling
32:42because sometimes
32:43one arrives
32:44to the medical appointment
32:45without understanding
32:46altogether
32:47one arrives
32:48It hurts here
32:48But I don't know.
32:49nothing else
32:50then also
32:51this approach
32:52comprehensive
32:52what do they do
32:54at the institution
32:54It also allows
32:55that the patient
32:56can be felt
32:58understood
32:59and understood
33:00besides
33:00on a topic
33:01such as health
33:02that to all
33:03We are very worried.
33:03There is nothing more
33:05that might torment him
33:05one at night
33:06that feels bad
33:08physically
33:08or emotionally
33:09clear
33:10the invitation
33:11is
33:12is to not have
33:13that torments
33:14to think about health
33:16how do you think
33:17in the importance
33:18of your work
33:19or how do you think
33:20in the importance
33:21of your family
33:22or having children
33:24or to have
33:25a couple
33:28if we
33:29we had
33:30a sincere
33:31worry
33:31for our health
33:32without being sick
33:35we would win
33:36a lot
33:36of land
33:37the problem
33:37the thing is
33:38the thing is
33:39We're only worried
33:40our health
33:40when we are sick
33:42when something bothers us
33:43exactly
33:44then the invitation
33:45is
33:45to worry
33:47for our health
33:47without being sick
33:49if we
33:50We achieved that
33:51Well, obviously
33:51we're going to
33:52to impact
33:54about those factors
33:55What are they going to do?
33:56that it does not get triggered
33:57a health problem
33:58obviously
33:58Well, if it gives you
33:59appendicitis
34:00Well, there's no way to do that.
34:01to solve it
34:03if you understand me
34:03But if you want
34:05avoid
34:05that gives you diabetes
34:07type 2
34:08Well, it's clearly
34:10related
34:10with obesity
34:11so
34:12if you don't want to
34:13that gives you diabetes
34:13because you don't get obese
34:15And if you don't become obese
34:16Well, so you don't get obese.
34:18You need to eat healthy
34:19You need to exercise
34:20you have to
34:22Don't stress
34:23if there are a lot of
34:24Yeah
34:24lower cortisol
34:26understand that everything is connected
34:27exactly
34:28that everything
34:29Everything is connected
34:30and give it a value
34:30a bit
34:31to think more about the body
34:33consciously
34:34in nutrition
34:34consciously
34:35we need to become
34:37we need to become
34:38conscious
34:39one has to
34:39we have to go back
34:40a bit
34:41to that awareness
34:43about what
34:43that we are a machine
34:46impressively
34:47perfect
34:48but
34:49also
34:50we are very fragile
34:51facing the environment
34:53facing the world
34:54compared to what
34:55it moves
34:56all around us
34:57And that, well, obviously.
34:59it shocks us
35:00in
35:01in the first
35:02and more importantly
35:03for us
35:03which is our health
35:05and that in that fragility
35:06then those little ones
35:07daily decisions
35:08if one modifies them
35:09They make a big difference
35:11they make a big difference
35:12and the invitation
35:13And that's why I think
35:15these spaces
35:16They are extremely valuable
35:16the invitation is
35:18every day
35:19put it
35:20a grain of sand
35:21but to think that
35:22you are giving
35:23Your 100 for your health
35:24You're giving it your all.
35:25for your well-being
35:26and
35:27and in those little things
35:29of life
35:29that one thinks
35:30that are not so relevant
35:32may be
35:33the solution
35:34to problems
35:35that in the future
35:35they could return
35:36very serious problems
35:38for health
35:38of people
35:39so
35:40put a little bit
35:42every day
35:43of that effort
35:44eating better
35:46in doing a little bit
35:47more aware
35:47of what you eat
35:48in doing a little bit
35:49physical activity
35:50in search
35:52spaces
35:53to get away
35:54of the work
35:55to relax
35:56to have
35:57emotional well-being
35:58They are also very important
36:00and obviously
36:00they will have an impact
36:01very positively
36:03in health
36:03and obviously
36:05preventive medicine
36:06Yeah
36:06have your checkups
36:08annual
36:09make you
36:10obviously
36:10get your vaccines
36:12visit the gynecologist
36:14if you are a woman
36:15visit the urologist
36:16if you are a man
36:17be on the lookout
36:19of those factors
36:20that you see
36:20that in your family
36:21They are strong
36:22if you know
36:23that your parents
36:24They had heart attacks
36:25youths
36:25or have the disease
36:27arterial young people
36:28or if they have
36:29cholesterol
36:29very high
36:30from a very young age
36:31or if they have
36:32history of cancer
36:34Let's say they have
36:36a component
36:37important genetic
36:38such as breast cancer
36:39or colon cancer
36:41Well, that's what we have to do
36:42tell the doctor
36:44and express
36:45the concern
36:46to know
36:47if one is well
36:48That's responsibility.
36:51of the patient
36:51and also
36:52of us
36:53but it's a
36:54great responsibility
36:55of the patient
36:56because
36:57one doesn't know either
36:58so
36:59we have to tell him
37:01to the patient
37:01Sure, one can do it
37:03actively ask
37:04but if the patient
37:05comes consulting
37:06because in his family
37:08all women
37:08of the latest
37:09four generations
37:10have had cancer
37:11breast
37:11well, probably
37:12earlier
37:14we will be able to detect
37:15the disease
37:16in the case
37:16that it has
37:17a genetic component
37:18the same thing happens
37:19with the colon
37:20with the pancreas
37:20now
37:21For example
37:22in cancer
37:23There are medications
37:24which are
37:25fantastic
37:26cancers
37:27than before
37:27They didn't have
37:28treatment
37:28recently
37:30well, a treatment
37:31for cancer
37:32of the pancreas
37:33that they presented
37:34I mean
37:34That's a milestone.
37:36in history
37:36health
37:38and cancer
37:40but
37:40if the patient
37:41consult early
37:42But if you already consult
37:44with cancer
37:45metastatic
37:46everywhere
37:46Well, that won't work.
37:48That's not going to be resolved
37:50for more medicines
37:51wonderful
37:51that exist
37:52clear
37:52Going back to what you were saying
37:53be very aware
37:55of our health
37:56and listen to it
37:57and request attention
38:00when one finds
38:01something there
38:02and even much earlier
38:03as you said
38:04don't wait until something bothers you
38:05but precisely
38:06always be
38:07constantly vigilant
38:08to our body
38:09Dr. Ana Cristina
38:10thank you so much
38:11I'm sure
38:11that people
38:12has he left or is he there
38:13listening to something
38:14that you will be able to apply
38:15in their daily lives
38:16thank you so much
38:17through this space
38:17to you
38:18through this space
38:19really
38:20We really appreciate it
38:21and our invitation
38:23from the Santa Fe Foundation
38:25and obviously
38:25from our medical side
38:28It's something to worry about.
38:30for our health
38:30and also to have an impact
38:31to our families
38:33to our children
38:34to the young
38:36from our homes
38:37so that they can be made again
38:39a little more aware
38:41of his body
38:41and of their health
38:42and their well-being
38:42to the young
38:55CC by Antarctica Films Argentina