The Mediterranean Diet

This is an article from Saturday’s i paper by Paul Gallagher which goes beyond the usual hype of diets. I had heard of Dr Malhotra’s work, and he provides a rare insight into the problems of modern healthcare.

Dr Aseem Malotra is still on a mission. Almost 2 decades into a medical career that has seen him become a consultant cardiologist and co-founder of Actin on Sugar along he say, the obesity campaigner is turning his attention to changing the nation’s lifestyle – for 3 weeks at least – and in the process drastically reduce our risk of type 2 diabetes and heart disease.

“I came to the conclusion after a few yers of qualifying that the impact of nutrition on health is very profound -something we don’t hear in medical schools at all, though,” he says.

Stop and think about this for a moment, readers. The medical profession, the major source of advice and care for our health know nothing about diet. Until 1950 British doctors were taught herbalism. Today they know nothing about alternative therapies yet again they are the source of expert advice on them. Back to the article:

Already prominent in challenging mainstream advice on the role of saturated fat in the development of cardiovascular disease, he has co-written his first book with the documentary maker Donal O’Neil – The Pioppi Diet: A 21 Day Lifestyle Plan. The book takes its name from a tiny Italian village where the average lifespan is almost 90 and there is a dearth of chronic disease.

Dr Malhotra has been greatly influenced by Professor Ancel Keys, the American physiologist who first developed the idea of a Mediterranean Diet as being the ideal eating plan in the 1950s – and who spent 6 months of the year, every year for 30 years, in Pioppi conducting research. The village (population 190) is now protected by Unesco as a result. The authors spent a week there themselves,when they were making their documentary, The Big Fat Fix, in 2015 and were able to examine the locals more closely. 

“We noticed a lot of things: the average life expectancy is close to 90, which is almost 10 years more than the average Tour de France cyclist, and they don’t do any exercise. They age well – one of the guys who managed at a restaurant we ate in we saw fixing his roof the next day: he’s 85 years old. It was the food, the diet, the exercise – everyone walked everywhere – and it made a lot of sense from what we now know from the independent science about the optimum way of exercising. Everything was drowned in olive oil, lots of vegetables, oily fish. So we wanted to take the secrets of this place and combine those with the data and studies to apply it to modern western life.”

Speaking to i at The King’s Fund think-tank in central London, where he is a trustee, Dr Malhotra reiterates the importance of a healthy lifestyle in disease prevention – citing research that has shown almost 70% of people with type 2 diabetes ultimately develop dementia.

“We are treating the symptoms and not the root causes of chronic illness,” he says. “And a huge industry has developed with drugs for blood pressure pills, type 2 diabetes pills and cholesterol lowering drugs, where the evidence is very clear that most people taking these drugs are ineffective. Of course, some will benefit, but most people are not told the potential side effects and chances of the drugs not working.

Although praising the previous government for introducing the sugar tax – which will come into force next April – Dr Malhotra says. Theresa May “capitulated very easily” to the powerful food lobby when it came to publishing the Government’s childhood obesity strategy last august. The 13-page document was delayed and widely seen as having been watered down when it finally emerged.

“I think they abandoned it because… they put the interests of the food industry in front of the population’s health. They are shooting themselves in the foot. Until they realise that until you get population health better, you are not going to be able to prosper economically as we should be doing. This problem will only get worse. The statistics are already extraordinary. One in 5 children are obese by the time they leave primary school, rising to 1 in 3 by the time they leave secondary school. Obesity has increased from 15 to 26% of he population since 1993.

“The problem is junk food has become the default for so many people and the good, nutritious food has become the treat. We are trying to switch that back,”Dr Malhotra says.

There are so many issues here- for staters people should be eating locally, so this diet is not really suited to Britons. Taxing people into better behaviour is far from ideal – a carrot works better than a stick. We have a generation that has grown up on junk food, so lessons in cookery and home economics should be the first step – all kids should learn that healthy food tastes great, it is not a form of punishment. There are a lot of lifestyle issues – parents stressed out, living in poor housing on a tight budget so too often they bribe grizzling kids with sweet treats just for a bit of peace.

In the part of Italy noted for this diet, people do exercise – they walk in pleasant streets, with local shops where they see their neighbours rather than in concrete commuter belts where few know , never mind interact with their neighbours. I love walking, but flat streets full of belching vehicles are unpleasant, so off-putting. Many streets are lined with boring buildings, devoid of trees and any interest, so more disincentives to walking.  A lot of buildings no longer have stairs – apparently lifts and escalators are safer so for those of us who live in towns lacking in hills there are few opportunities for cardiovascular exercise in our daily lives. 

There are a lot of groups now recognising the importance of cityscapes for our physical and mental health. Whilst the sugar tax and Dr Malhotra’s advice on diet are welcome, they should be part of a wider look at the quality of life in our towns and cities, the standards of housing and of life in general. It reminds me of the nursery rhyme about the old woman who swallowed a fly. We need to discover why she did it rather than dealing with the results.

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