Mediterranean diet and primary care service: this is how we have become the healthiest country according to Bloomberg

2019 is closing with the still fresh news that Spain, according to Bloomberg, is the healthiest country in the world. According to the WHO data, indeed, we have one of the highest life expectancies of our small planet. How did we get there?

These data are curious, at least, if we remember that in Spain 25% of the population is obese or has problems with overweight, for example, according to a recent study by the Hospital del Mar Institute for Medical Research (IMIM). Public health, together with the Mediterranean diet, seem to be at the center of the assessment.

What the Bloomberg Index Says

Last February, the gigantic financial adviser, Bloomberg, published as every year its Healthiest Country Index, an index that collects data from 169 countries and compares various variables that, according to the company, "contribute to overall health" in each country. In this same index, Spain was in sixth place in 2017.

However, in 2019 we have overtaken all the other "contenders", including Italy, which held the top spot. In the Bloomberg index, we are currently first, followed by our Mediterranean neighbor and Japan, in third place. Among the least healthy countries are nations with developing or impoverished economies, including Haiti, Afghanistan or Yemen.

To obtain this ranking, they explain from Bloomberg, various types of factors are taken into account, ranging from eating habits to administrative health factors. In Spain, for example, data such as a diet based on the Mediterranean diet or a free, high-quality primary care service are determining factors.

How have we become the country with the longest life expectancy?

Interestingly, the Bloomberg index somewhat matches the World Health Organization's estimates of life expectancy. According to the latest data, in Spain we have one of the highest in the world. This would be around 85 years, although from the data published last April it can be assumed that we reached 86. The INE data, however, are not as flattering and lower the average to 83, which we leaves a not inconsiderable third place worldwide. How could we have overtaken, according to Bloomberg, the Italians or the Japanese?

The two key points, according to the financial one, are in the lifestyle and in our primary care system, two independent but united factors. As for the first, diet plays an essential factor. ** The Mediterranean diet is one of our prides in terms of health **. The analysis highlights the benefits of the Mediterranean diet and the role of extra virgin olive oil and nuts in health. According to the Predimed study, the Mediterranean diet has a lower incidence of cardiovascular diseases, which are the main cause of mortality in the world, which would reduce up to 50% of the diseases that most affect Spaniards. According to the data, activities that promote the reduction of sedentary lifestyle are a necessary and recurring complement in Spain.

Primary care in Spain is another one of those points. Despite the fact that nothing is perfect, our healthcare system is among the best in the world, as collected by researchers such as Fernández Díez, from the Instituto de Formación Sanitaria. For Bloomberg, both for efficiency and for the quality and quantity of services covered systematically by the State, the Spanish service is counted as a determining factor, especially if we compare it with Italy. Despite this, for experts such as Alba Santaliestra, president of the Professional College of Dietitians-Nutritionists of Aragon, it could be even better if more effort was devoted to prevention than to treatment.

The combination of a Mediterranean lifestyle with a good prevention system could help us not only to maintain the position granted by Bloomberg, but also to substantially improve our life expectancy. Precisely, just a year ago, a study by the University of Washington stated that Spaniards would reach the highest life expectancy, 85.8 years, three above the world average, in 2040. Despite the fact that many data point to In the same direction, however, there are other issues that draw attention to Spain as the healthiest country in the world.

Obesity on the rise: are we really the healthiest?

In 2016, the top ten causes of premature death in Spain were, in order, ischemic heart disease, Alzheimer's, lung cancer, stroke, chronic obstructive pulmonary disease, or COPD, colon and rectal cancer, the breast cancer, suicide, other cardiovascular diseases and lower respiratory infections. 25% of the population affected by the largest epidemic that exists right now lives in the country: obesity.

Studies show that overweight in Spain is growing at a rate very similar to that of the United States. During the last XXIV World Congress of the International Federation for the Surgery of Obesity and Metabolic Diseases, the experts did not hesitate to warn of this fact, which is increasing.

Shortly after, a study published by the Spanish Journal of Cardiology, and led by researchers from the Hospital del Mar Institute for Medical Research, pointed out that 80% of adult men will be obese or overweight by 2030. The study also estimates that in the In 2016 there were in Spain about 24 million people with excess weight, 70% of men and 50% of women. This study, the authors indicate, is the most up-to-date review available, based on fifty articles previously published.

What are we left with, then? Are we or are we not the healthiest country? First of all, you have to understand that the Bloomberg index is just that, a particular index of a great company (financial expert, of course, but particular), so they take their data and variables subjectively. Furthermore, it is curious to see among its variables behavioral data and economic forecast, such as the assessment of the primary health system, but giving such ephemeral weight to sensitive epidemiological information such as the growth of obesity in Spain.

On the other hand, we are talking about forecasts and estimates, data that, in any case, are not deterministic (or determined). Do you mean that this analysis is wrong? No, neither are the analyzes that seem to contradict it. The only thing we can know for sure is that we are talking about very complex analytics, with a multitude of variables and that we can only take this index as one more, specific indicator that could change in the light of new data and quickly, according to the analysis apply.

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