Are we what we eat?
We know that we do not eat as well as we should. As recently as 2016 an international team of dietary experts published The Healthy Plate – Dietary Guidelines for Maltese Adults. This study defined a simple healthy approach to eating. And the take-home lesson is to eat fresh seasonal produce, eliminate processed food and be active.
But a study by Kristen Bromaghim and her colleagues, with the James Madison University and the University of Malta, found that, not surprisingly, older Maltese did not follow these guidelines. Instead we are eating too many carbohydrates in the form of bread and pasta and inadequate types and amounts of protein, besides our unhealthy dairy consumption, lack of fruits and vegetables and a high intake of sugar. Sounds familiar.
We are perhaps unaware of these recommendations. Results from a very small student survey revealed that a third of older Maltese aged 66 years and older never heard of the food pyramid. But neither do we care about knowing more.
For half of the sample who reported knowing a little about the food pyramid, a third were not interested in learning more. Printed educational material might not be the best option for older Maltese to learn about diet.
In 2008, the Health Interview Survey conducted in Malta concluded that around one in three older males and one in five older females have difficulty preparing meals. These vulnerable older adults are more likely to eat ready-made or processed food. And it shows in health outcomes.
In the National Obesity Campaign of 2010, half of all adults between the ages of 35 and 65 were found to be overweight or obese.
And this story can be predictable, like the weekly sermon, “thou shall not”. But I want to talk about a different kind of story that relates to food but has a surprisingly different answer.
Between 1955 and 1965, in Roseto, an Italian-American community in Pennsylvania, US, a local physician, Stewart Wolf, and later a sociologist, John Bruhn, observed that the locals seemed immune from heart disease – the main killer at the time, and still is.
Rosetans contradicted medical knowledge to this day because their diet and risk behaviours should have resulted in earlier deaths for all the residents. They fried food in animal fat (lard), ate cholesterol-rich salami and cheeses and heavily smoked old-style, Italian, very strong stogie cigars. Both genders drank copious amounts of wine.
In addition, Rosetan men worked in slate quarries that were not only toxic but environmentally dangerous. Socially, they were shunned by the neighboring English and Welsh ethnic groups and they themselves shunned others.
In contrast to such negative conditions, the community reported no crime and few people were on social assistance. There was very little obvious inequity. Everyone lived modest lives as a large family as they did before they emigrated from the same village of Roseto south of Rome. The rich and poor all had the same type of houses and same type of cars. And they had very low heart disease for more than two decades. But then these differences disappeared, and they disappeared because of one change.
In the 1980s, with an increasing influx of outsiders to the village, Roseto’s health benefits started to dissipate. The new residents did not grow up in the community. New larger houses started popping up, more expensive cars started showing up on the streets, and that sense of community eroded away. For the first time, there was a sense of inequity.
The lesson Roseto teaches us in Malta, more than half a century later, is that culture and family have a protective function. A sense of family that is grounded in a particular geography, having a sense of belonging, protects the body from disease, and might even promote longevity, despite what we eat.
We should follow the dietary recommendations of cutting out processed foods and sugars completely and eating fresh seasonal produce not because these seasonal foods are healthy but because they are pleasurable to eat. They do not bloat us up like processed food, bread or pastries. Changing our perspective to think about enjoying the quality of food might also teach us the lesson that Roseto provides us – that we should also be aware of our friendships and relationships.
Most guidelines omit to notice that eating is a social event. We like to eat with family and friends. With an increasing number of older Maltese living alone, perhaps we should look at food as a bridge to reach out to our ageing relatives.
Sharing some minestra (vegetable soup) or aliotta (fish soup), with family and friends, drinking some wine and sharing stories about the past might teach us about food, more than a food pyramid can ever teach us.
Mario Garrett was born in Malta and is currently a professor of gerontology at San Diego State University in California, US.