25 October 2018 - 15:30
Eat well, live better
Interview with Stefania Ubaldi about the relationship between diet and health
“With a healthy diet and lifestyle, 80% of chronic illnesses can be prevented. But the scientific community must do more.”
Stefania Ubaldi, Swiss doctor, founder and president of Medinvita, an association that promotes the culture of prevention, and president of the European Lifestyle Medicine Organization, which is set to hold its first pan-European convention in Geneva on November 10. We talked to her about the relationship between lifestyle and health.
Doctor Ubaldi, it seems that the last decade has seen a growing awareness among the scientific community about the link between diet and health. Is that the case?
The relationship between food and health has always been the subject of particular attention. Just think of all the research into the Mediterranean diet that began back in the 1950s. If you like we can go even further back in time to Hippocrates who also recognised the importance of the relationship between food and health. It’s true, however, that in the last decade there has been a kind of breakthrough: rather than the increased awareness of the scientific community, it’s more to do with technology, which has had a huge impact on molecular biology and enabled the observation of the cells in our bodies in increasing detail in order to test biochemical processes. In parallel, the number of studies based on epidemiological investigations of patients multiplied, reaching a peak in the nineties. At the beginning of the 2000s, thanks to the follow-up work carried out, we began to get quite a clear picture of the consequences of food on our health.
What do the studies focus on in particular?
On chronic illnesses. So, cardiovascular pathologies, obesity, neurodegenerative illnesses like Alzheimer’s, type II diabetes, which arises from an altered diet and a sedentary lifestyle, in addition to some forms of cancer that are linked to poor diet. 80% of these diseases can be prevented with a healthy diet and lifestyle and the percentage can rise to 90% in the case of strokes. Today we are able to develop programmes for the prevention of chronic illness.
Is that what you call “nutritherapy”?
Exactly. It’s a term that in my opinion communicates how diet and nutrition can help to avoid the inflammation of cells. The Mediterranean diet demonstrates how the right nutrition can be therapeutic as this particular diet can help reduce the risk of recurrence of cancer, for example, among women who have had operations for breast cancer.
Will “nutrigenetics” enable us to make further progress?
Nutrigenetics is the use of DNA studies to understand the modalities with which each of us metabolizes nutrients. It’s possible to observe how a gene functions in a patient; based on the response, we can adapt the dietary plan. We’re still at the beginning, but it is hoped that all this will lead to clear improvements. We will have personalized information about each patient, and therefore we’ll be able to prescribe personalized diets for the purpose of preventing illness.
If on one hand the connection between a healthy diet and preventing illness is becoming more apparent, on the other it seems that food allergies and intolerances are on the increase. Why is that?
On this matter it’s necessary to clarify that so far the only genetic intolerances that have been scientifically documented concern gluten, lactose and fructose. Nevertheless, a huge industry has grown up around such conditions. Think of the gluten free products that are promoted as being beneficial to everyone, when in reality that just isn’t the case. Let’s leave them for the people who really need them – the people that suffer from celiac disease.
There’s an increasing awareness of the importance of a good diet. But on a practical level, what’s the situation really like?
We are still lagging behind. Everybody knows now that eating healthily is good for us but few people really do so. The Mediterranean diet was conceived in Italy but few Italians follow it to the full. And just think, the Mediterranean diet is cheap too: many dishes can be prepared one day and consumed the next. The scientific community too can do much more. Among GPs there is still very limited training on the topic of healthy eating and prevention. It follows then that the flow of information between professionals to consumers/patients is not yet at an optimal level. What’s needed is a greater focus on training for doctors. And it is necessary to go to schools: dietary education needs to begin in the classroom, even in nursery schools.
All of this, however, depends also on government policies, doesn’t it?
Yes, we scientists can provide data, we can go out into in the field and raise awareness amongst the public. But it’s the institutions that must get to work to legislate for a genuine change of direction, spreading the culture of a healthy diet. On this front, unfortunately, progress is painfully slow. Partly it could depend on particular economic interests, as well as the fact that, for example, within Europe it’s complicated to find common ground between countries with such different dietary traditions. It is difficult to convince the countries of the north, for instance, to switch to products that belong to the Mediterranean diet. In any case, what’s necessary is to make it understood that this is the moment to act. More ministerial programmes are required, and more intervention, such as the prohibition or limitation of junk food in particular contexts, such as in school canteens or hospitals.
Can biotech encourage a sound diet and prevention?
That it can do so is beyond doubt, but I think it won’t have an immediate effect. I believe that it’s more important to return to simplicity, to a natural diet, as well as investing in lifestyle. Prevention does not only depend on what we eat. Physical activity is also fundamental, as is the way we sleep, whether we smoke or not, if we abuse alcohol or don’t consume it at all, and if we’re stressed, because chronic stress leads to cardiovascular illness. If we manage to restore a healthy lifestyle, if we manage to organise the way we eat and live, them we can prevent 80% of chronic illnesses.