¿Qué es una ración de fruta y qué de verdura?
La Mirada de Juan Revenga

¿Qué es una ración de fruta y qué de verdura?

Una de las recomendaciones actuales más preclaras sobre los patrones saludables de alimentación consiste en la inclusión de 5 raciones al día entre frutas y verduras. Hoy aclararemos porqué de esta recomendación y en qué constituye una ración
9 diciembre, 2018
Juan Revenga
  • Sanidad

La Mirada deJuan Revenga

¿Qué es una ración de fruta y qué de verdura?

Juan Revenga
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No, no se trata de hacerse vegetariano ni mucho menos. O sí, al fin  al cabo esta sería una elección de índole personal, perfectamente válida si, al margen de las modas, se sabe qué se está haciendo. El caso es que la mayor parte de los principales consensos a la hora de describir las características de una alimentación saludable, centran el grueso de su mensaje en la inclusión, al menos, de 5 raciones al día  de alimentos de origen vegetal fresco, es decir, entre frutas, verduras y hortalizas. Puedes pensar que los consensos son herramientas que aportan una escasa evidencia científica, y acertarías. Por eso lo primero que vamos a hacer es revisar si se cuenta con un cuerpo de evidencia suficiente como para hacer esta clase de recomendaciones.

¿Existe una relación entre el consumo de vegetales, la salud y la mortalidad?

Afortunadamente, para atender esta tarea podemos aprovecharnos del magnífico post que publicó poco tiempo atrás Luis Jiménez, en el que se dedicó a revisar qué dice la ciencia sobre las bondades de incluir más o menos raciones diarias de este tipo de alimentos en nuestras mesas. El artículo que tienes a tu disposición en este enlace para consultarlo con todo lujo de detalles, reúne las revisiones y metaanálisis que se han publicado al respecto en los últimos años. Así, se han venido haciendo estudios que han observado la cantidad de frutas y verduras consumidas en poblaciones concretas y la incidencia en ellas de las enfermedades no transmisibles más relevantes en nuestro medio, tales como los accidentes cerebrovasculares, la enfermedad coronaria cardíaca, el cáncer, la diabetes y por supuesto la mortalidad total. La información es considerable y pero las conclusiones “reman” siempre en la misma dirección. El resumen lo podemos encontrar en la conclusión de uno de los más reciente metaanálisis: “las ingestas de frutas y verduras se asociaron con un menor riesgo de enfermedad cardiovascular, cáncer y mortalidad por todas las causas. Estos resultados respaldan las recomendaciones relativas a la salud pública para que se aumente la ingesta de frutas y verduras con el fin de las enfermedades cardiovasculares, el  cáncer y la mortalidad prematura”.

¿Qué dicen las guías de alimentación saludable sobre este grupo de alimentos?

Lo cierto es que uno de los cambios más importantes en la última década al respecto de las recomendaciones que podemos encontrar en la mayor parte –pero no en todas- de las guías de alimentación saludable refiere al ascenso en cuanto a importancia de este grupo de alimentos en detrimento de aquellos que podíamos considerar “feculentos”, es decir, pastas, arroces, pan, cereales, etcétera (máxime si no son integrales). Una de las primeras instituciones en levantar la liebre fue el Departamento de Agricultura de los Estados Unidos (USDA) cuando en sus guías de 2010 (y vigente hasta la fecha de hoy en las guías de 2015) se optó, sabiamente, por cambiar el concepto piramidal del asunto con los cereales en la base (el típico) por el formato de “el plato”. En concreto recibe el nombre de MyPlate. Al seguir el anterior enlace se puede contrastar el preeminente papel del grupo de alimentos considerados vegetales frescos: frutas, verduras y hortalizas. Muchos otros han seguido la estela de este mensaje, entre ellos la guía denominada Healthy Eating Plate  de la Escuela de Salud Pública de la Universidad de Harvard, que transmite el mismo concepto.

El mismo también que el conocido como Triángulo de la Alimentación Saludable Flamenco en el que a pesar del cambio de formato, el mensaje permanece inalterable: los vegetales primero… y luego ya veremos. A este tenor la Organización Mundial de la Salud también se suma (y desde hace bastante tiempo) al mensaje relativo a la importancia de los alimentos vegetales y afirma que aumentar el consumo de este grupo de alimentos reduciría el riesgo de las enfermedades no transmisibles: “Las frutas y verduras son componentes importantes de una dieta saludable. Un bajo consumo de frutas y verduras está asociado a una mala salud y a un mayor riesgo de enfermedades no transmisibles. Se estima que en 2010 unos 6,7 millones de muertes se debieron a un consumo inadecuado de frutas y verduras”. Y de ahí su consejo, que no puede ser más inequívoco: “Como parte de una dieta saludable baja en grasas, azúcares y sodio, la OMS recomienda consumir más de 400 gramos de frutas y verduras al día para mejorar la salud general y reducir el riesgo de determinadas enfermedades no transmisibles”.

¿Qué es una ración de frutas y verduras?

Llegados a este punto es normal que nos asalten dudas a la hora de sopesar una ración de estos alimentos. Y no es para menos ya que no existe un consenso entre las distintas administraciones sanitarias e instituciones que abogan por incrementar la ingesta de frutas, verduras y hortalizas. Es decir, no hay acuerdo a la hora de decidir qué es una ración o cuántos gramos al día de estos alimentos debemos incorporar. Sin ir más lejos tenemos el dato de la OMS que cifra esta cantidad en 400 gramos, pero por otro lado tenemos a la  Asociación para la Promoción del Consumo de Frutas y Hortalizas, más conocida como “5 al día”, que considera que “cinco” es la cifra adecuada… solo nos hace falta saber qué es una ración.

Siguiendo la estela de “5 al día” podemos llegar hasta este documento en el que en su anexo número cuatro (a partir de la página 40) menciona con todo tipo de detalles qué se considera una ración tanto de las diversas frutas como de las casi innumerables verduras y hortalizas. En un esfuerzo por sintetizar toda esta información ya que no es lo mismo una pieza de fruta cuando hablamos de cerezas que cuando lo hacemos de melones, el documento resume que una ración de fruta o bien de verdura viene constituida por, aproximadamente, 144 gramos de cualquiera de estos productos. Esta cantidad refiere al producto ya limpio y sin desperdicio (piel, hueso, otras partes no comestibles, etcétera) y no está exenta de excepciones (y de ahí las tablas del anexo 4).

Cuestiones prácticas

Mi consejo es que no te agobies con el tema de los pesos (yo no peso ni las manzanas, ni los trigueros, ni las berenjenas… ni nada) y te centres en meter, así por las bravas, más alimentos de origen vegetal fresco en tu día a día. A fin de cuentas y tal y como dice la muy recomendable Gemma del Caño: una ración de frutas y verduras es, simplemente, el primer paso para llegar a las cinco diarias.

De este modo y habiendo dejado más o menos clara la importancia de incluir más alimentos de origen vegetal fresco en nuestras minutas diarias, solo quedaría saber cómo hacerlo. De este modo y tirando de experiencia como dietista-nutricionista clínico, y al mismo tiempo teniendo muy presente aquella como hijo (sí, un día me nacieron y me dieron de comer durante bastantes años) y sin olvidar la de ser padre, opino que una medida muy sencilla de cumplir para quedarse muy cerca de las consabidas 5 raciones consiste en incluir una ración de verduras u hortalizas en las dos ingestas principales (comida y cena) y, al mismo tiempo incluir por sistema en estas mismas tomas la fruta como postre. Lo que ya suman cuatro raciones.

A estas alturas del cuento habrá a quien estas sencillas directrices le parezcan inasumibles, pero como decía era una tónica habitual en casa de mis padres (y sigue siéndolo aunque ya no viva con ellos) al igual que es la tónica en mi casa, desde siempre, con dos preciosas hijas de 10 y 14 años.


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