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The Prescription For Health

What we can learn from immigrants

Dr. Padma Garvey

The Prescription For Health

Wouldn’t it be nice to know the secrets to living a long, healthy, and productive life?  Turns out the answer is pretty obvious.

Lots of immigrants came to Hawaii around the 1900s to work on the plantations.  These immigrants came from countries throughout Southeast Asia like Japan and the Philippines.   Observing the health trends in these families over time tells us a lot about how diet impacts health.  The first generation plantation workers were generally quite healthy.  However, their children and their grandchildren tended to have more problems with heart disease and diabetes as time went on.  Genetics can’t explain this generational difference in health.  With each subsequent generation, the consumption of a Western diet increased.  Unlike their traditional diets, Western style food had more processed foods, meat, dairy, oil, salt, and sugar.  The first generation immigrants cooked and ate the way they had in their countries of origin but their children and their grandchildren tended to eat foods that were fattier, saltier, sweeter, and more processed. 

After World War I, American scientists noticed that urban Americans, including immigrants from Sicily, tended to have more heart disease and diabetes than people in Sicily.  They conducted a study comparing the diets between the two groups.  These studies, that were conducted in the 1930s, found that Americans consumed almost three times the amount of fat as did Sicilians.  Inhabitants of Sicily consumed 75% percent of their calories from carbohydrates like potatoes, pasta, bread, fruits, and vegetables.  Only about 10-15% of their calories came from fat.  These studies in the 1930s were what  formed the concept of the ‘healthy Mediterranean diet’. 

In 2008, Dan Buettner published his wonderful book, The Blue Zones.  He discussed what he learned from observing people in ultra- healthy regions of the world.  Though the Blue Zone people were from different regions, with different cultures and diet, there were some striking similarities in their lifestyles.  The three most important lifestyle features they all shared were that they ate a whole grain, unprocessed, largely plant-based diet, they walked a lot every day, and they had meaningful relationships with family and friends.

So why can’t we write down the prescription for health given what these stories tell us?  Most of it is because we want to focus on one single food as the culprit to poor health when in reality it is a lifestyle.  We need to look at the broader patterns of eating.  Just because Sicilians used olive oil does not mean we can look at unrestrained use of olive oil today as a ‘good’ fat, especially when we know that their fat consumption was a fraction of many of our diets.  Just because first generation Japanese immigrants to Hawaii ate some fish and pork does not mean that soaring consumption of animal products is good, especially when we realize that their overall meat consumption was limited.  In fact, the amount of animal protein consumed by people in the past was much less than what many of us consume today.  The adage ‘everything in moderation’ is dangerous because moderation is a relative term.  The statements that we need to eat some fat is dangerous because how much is some?  The tendency to label ‘carbs’ as bad is misguided because the healthiest people on earth eat a lot of complex carbohydrates.  A better adage for the prescription for health should be stick to a low fat, whole grain, unprocessed, largely plant-based diet....just like Hawaiians and Sicilians in the 1930s.

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