Abel Mariné talks about food and nutrition with the enthusiasm (and responsibility) of someone who has dedicated their life to studying this field. He is a great defender of “traditional” diet, which he supports with scientific arguments, historical references and conviction. He is currently an emeritus professor of nutrition and bromatology at the UB’s Faculty of Pharmacy on the Food and Nutrition Torribera Campus. From 1983 to 1986 he was a dean. He was then appointed Director-General of Universities in the Regional Government of Catalonia’s Department of Education. He has led hundreds of studies on food and nutrition, and his area of specialization is biogene amines and polyamines. He currently writes a column on nutrition for the general-interest newspaper El Punt/Avui. He also chairs the Catalan Food Science Association (ACCA).
Can a good diet help us to live longer and better?
«A good diet is certainly the best public health measure»
Yes. The answer is yes, but we shouldn’t exaggerate. A well-nourished person is a person who contributes to having good defences, and so is in a better position to withstand any kind of disease. It is not an absolute guarantee, for although diet is a very important factor for our organism, there are others: genetics, environmental conditions, etc. However, in principle, a good diet will definitely improve a person’s health. And a healthy person can live for longer. An English hygienist, Fraser Brockington, lived a hundred years, if I remember rightly. One of his quotes contains nothing new but illustrates the idea clearly: “a good diet is certainly the best public health measure”.
Do nutritional needs vary depending on age range?
Absolutely. Above all, there are two particularly important times: infancy and adolescence. In these periods of life the organism not only has to maintain and replace what it expends, but also increase in mass and volume. In just a few months, a child’s weight increases sharply. So the child as an individual needs less than an adult but, to put it this way, each kilo of child requires a lot more energy and nutrients than a kilo of an elderly person. In adolescence, the needs are even greater. An adolescent increases in volume and mass. And what’s more, grows. And what’s more, this is at a time when he or she is – or should be – very active. So the nutritional needs in adolescence are particularly high.
Normally, it’s considered that this growth ends at around 20-25 years old. Adulthood is a period of stability and as age advances, needs tend to drop. However, they don’t drop by a huge amount. Elderly people, for example, don’t depend as much as adolescents on the protein they eat, on the quantity and quality of protein. But of course they still have to consume protein, just not as much as before. The same is true of calcium: the organism incorporates calcium until around 30, 32 or 35 years old. Then it stops incorporating it. Calcium begins to have a negative balance, so we have to carry on ingesting enough of it to make up for this balance. However, what may happen to you in old age in terms of osteoporosis does not depend so much on the among of calcium you consume from 30 years on, but on the capital of calcium that you have built up from infancy to this age. It’s very important for young people, and particularly girls, to consume good sources of calcium, particularly milk and dairy products.
What basic nutritional recommendations would you give for elderly people?
The same as for all ages, it’s just that the needs are slightly lower. So the diet should be mainly plant-based: fruit, vegetables and garden produce. A certain amount of high quality protein also needs to be eaten. This could be animal protein, preferably from the leanest products possible, or a mixture of pulses and grains, which is a complete protein. If a person doesn’t have cholesterol problems, eggs are an excellent source of protein and other nutrients. And they’re cheap, which is an important factor in current times. In other words, the guidelines are not very different, but elderly people should eat less and disease should be taken into account. If a person has high blood pressure they should use less salt, opt for unsaturated fats and consume fewer calories. If a person has high cholesterol, the fats he or she consumes should come mainly from plants. Elderly people should take care of what they eat depending on their diseases. And it’s important to drink a lot, even when they are not thirsty.
Why is the risk of dehydration greater in elderly people?
Perception of thirst is very sensitive in young people. When we lose fluid, we rapidly feel thirsty. In fact, normally we don’t get to feel thirsty because our habits involve drinking: at breakfast we have coffee or tea or milk or fruit juices or fruit, and the main component of all of these is water. That is, we drink throughout the day without even realising. However, elderly people slightly lose the feeling of thirst. They may need to hydrate themselves, but don’t perceive this, so they must make an effort to drink water.
«Care should also be taken with the interaction between foods and medicines»
Something else that diminishes with age is taste sensitivity. This is lost partly because of ageing itself, but it may also be due to zinc deficiency. Why? The main sources of zinc are seafood and meat, which elderly people may only eat infrequently, because of difficulties in chewing or for financial reasons. Meat should be eaten in moderation, it isn’t good to eat too much, but it has to be eaten. And seafood too; even though it contains cholesterol and diseases should always be taken into account. Care should also be taken with the interaction between foods and medicines. Many drugs affect nutrition, which is another effect that should be monitored. And in addition to taking a lot of medication, elderly people are more likely to be undernourished than young people.
Maria Iglesia-Gómez, the head of the European Commission’s Health and Consumer Unit, has stated that malnutrition in elderly people costs the system more than childhood obesity and that there is social awareness of one issue, but not the other. Is it so common for elderly people to be undernourished when they are admitted to hospital?
Yes, yes. I don’t have the figures, but a lot of elderly people have inadequate levels of nutrition when they are admitted to hospital. They may not be very undernourished, but they are close to the limit with vitamin or other deficiencies, and this can affect their vitality, intellectual activity, etc. Still, we shouldn’t exaggerate, because people lose faculties when they get old, whether they eat well or not. However, we should consider all of these factors. Clearly, a good diet throughout life is another weapon to reach old age in good condition. Another weapon, but not the only one; there are more factors. But all the negative effects of age are withstood better.
Why does this happen if the population (and particularly adults) are well aware of the need to eat and to eat well?
One of the problems of elderly people is that they often eat badly for lack of financial resources, and because they are alone. We know socially or intuitively – and there are also studies to prove it – that people who eat alone, particularly if they’re elderly, don’t worry about cooking too much. A widowed grandmother who has to make lunch five days a week for the son who eats at her house or for her grandchild who is at the nearby school will cook, and will probably make a first and second course that is eaten around the table. So she’ll eat better than if she was alone, when “anything will do” and a person may end up eating a sandwich, which is not the best thing as a regular meal.
What are your recommendations on eating habits?
Take time, sit down and eat from a plate. Eating several meals is good for all ages, but particularly for the elderly who should eat five: breakfast, something halfway through the morning, lunch, an afternoon snack and supper. It’s better not to eat everything in one meal, because, among other factors, when we eat food we ask our organism to secrete insulin to metabolize it. And it is better to ask the body to secrete a little bit of insulin on different occasions than to ask it for a lot at once because we have eaten a lot. We should out take time and eat with care. And try to make it pleasurable. For example, chocolate, particularly dark chocolate that does not contain milk fats, is a neutral product in terms of cholesterol. So a person with high cholesterol does not need to be deprived of chocolate. Chocolate should be eaten in moderation as it contains a high number of calories. But isn’t it true that elderly people have a sweet truth? That’s because the sweet taste is the last to be lost.
And what daily intake of calories would be ideal?
If we are rigorous, calorie intake recommendations should be specific for each person. But governments provide guidelines of the kind “from this age to this age, the recommended number of calories is this”. In principle, these guidelines are well-considered; they are taken from statistical data. However, each person is different. In reality each person – and I say this very much in general terms – should eat according to how hungry they are and maintain a normal weight. From the point of view of calories, this would be the guideline.
We’ve discussed nutritional recommendations, but all of this must be accompanied by healthy habits: physical activity, intellectual stimulation and socializing, among others.
Physical activity helps a lot. It’s good for elderly people to do as much exercise as they can, depending on what’s appropriate for their state of health: walking, going to the gym if they can afford it, shopping in the market. And socializing is advisable for many reasons. Having company, talking to someone every day is very important.
A healthy and balanced diet is advisable for everyone, not just elderly people. What impact can a bad diet in childhood have on future stages?
Obese children are more likely to be obese when they are adults and therefore to suffer from all of the disorders associated with obesity. Obesity predisposes to type 2 diabetes, hypercholesterolemia, arteriosclerosis and other diseases… a series of “diseases of civilization”. Obesity reduces life expectancy, it’s shown statistically. There’re some data going around that show that this generation, the children and adolescents of today, will not live as long on average as their parents for the first time in the history of humanity. We’ve made this change.
But if humans are increasingly sedentary, haven’t our calorie needs decreased? Culturally, have we accepted that we need to eat less than before?
Culturally, and genetically. After many generations of people who were used to going hungry, the human organism is designed to store energy, not to expend it. Now we burn less, but our genetics still lead us to store.
In short, eating should be a pleasure?
«Of all the physiological pleasures in life, enjoyment of eating is the last one we lose»
A French gastronomist, Brillat-Savarin, wrote a book called The Physiology of Taste. This book contains a sentence that is worth remembering: “the pleasure of eating lasts all our lives, from when we are born until we die, when other pleasures are no longer attainable”. In other words, of all the physiological pleasures in life, enjoyment of eating is the last one we lose. So don’t sour an old person’s life with an unnecessary diet. Diets should be suitable, but also acceptable. If we propose diets that are too radical, the patient may not follow them and the situation will worsen. I don’t wish to trivialize or be relativist, but we also shouldn’t be too strict, particularly with the elderly. Because in reality reducing an elderly person’s cholesterol from 250 to 230 doesn’t make a huge difference (in a 30 year old, it does need attention). But the pleasure of eating also forms a part of quality of life. Let’s not make diet a penance.