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Mortalidad y morbilidad atendida de personas mayores Medellín (Colombia)

In document El envejecimiento en América Latina: (página 76-96)

Contrary to what Westerners tend to assume, indigenous people of the past were not merely scraping by, skinny and starving, desperate to eat whatever scraps they could find. Their lives did revolve primarily around finding food, but they were experts at it, far more capable than we are of making nutrient-rich foods part of daily life. By fortifying the soil, they grew more nutrient-rich plants. By feeding their animals the products of healthy soil, they cultivated healthier, more nutrient- rich animals. And since different nutrients are stored in different parts of the animal, by consuming every edible part, they enjoyed the full complex. They used their own version of biotechnology to create the most nutrient-dense foods possible, foods that functioned to design every sinew and fiber of their bodies, and upon which we have now come to depend.

foods for lab analysis. His nutritional survey rivals that of our best nationally sponsored programs in having tested for all four fat-soluble vitamins A, D, E, and K, and six minerals, calcium, iron, magnesium, phosphorus, copper, and iodine. Here’s what he found:

It is of interest that the diets of the primitive groups […] have all provided a nutrition containing at least four times these minimum [mineral] requirements; whereas the displacing nutrition of commerce, consisting largely of white-flour products, sugar, polished rice, jams [nutritionally equivalent to fruit juice], canned goods, and vegetable fats have invariably failed to provide even the minimum requirements. In other words, the foods of the native Eskimos contained 5.4 times as much calcium as the displacing foods of the white man, five times as much phosphorus, 1.5 times as much iron, 7.9 times as much magnesium, 1.5 times as much copper, 8.8 times as much iodine, and at least a tenfold increase in fat-soluble activators [Price’s term for vitamins]. 63

He continues, listing the findings for each of the other groups he studied. There was a clear pattern: The native diets had ten or more times the fatsoluble vitamins and one-and-a-half to 50 times more minerals than the diets of people in the US. It is obvious that diets of people living in what doctors at the time would have called “backward” conditions were richer than those living in the technologically “advanced” US by an order of magnitude.

Though his laboratory was dismantled over 50 years ago, I consider Price’s data a more accurate indication of how much nutrition we need than the RDA, or Recommended Daily Allowance.

What makes his 60-plus-year-old data superior to the state-of-the-art nutrition science today? Chiefly, the fact that today’s state-of-the-art nutrition science leaves much to be desired. While Price’s data may be old, he identified the healthiest people he could and then systematically analyzed the nutrient content of their staple foods. But if you ever look into how today’s RDAs are set, you’ll find a hodge-podge of differing opinions, unstandardized techniques, and poorly thought-out studies.

For instance, the RDA of vitamin B6 for infants younger than one year old was set at 0.1 mg per day based on the average B6 content in the breast milk of only 19 women. Six of these women did not even themselves consume the RDA of vitamin B6 for their age group, and their breast milk contained only one tenth of the B6 of the women with healthier diets.64 So you might wonder, then, if a third of the women were by our own definition undernourished, shouldn’t they have been excluded from the study? The fact that they were not suggests to me that the researchers in charge of this study were not interested in what a baby might need to be healthy, but merely in calculating the averages and getting their job done quickly. This is just one example of the poor quality research that defines state-of-the- art, modern nutrition science. (It also determines what gets put into infant formula—and what gets left out.)

If you believe Price’s data, which I do, then clearly our bodies seem accustomed to a far richer stream of nutrients than we manage to sip, chew, swallow or scarf down on the way to work today. Our need for nutrients is, apparently, quite extraordinary. But what is more extraordinary is the totality to which indigenous cultures, and presumably also our ancestors, involved themselves in the production of these foods. In contrast to our general attitude of nourishment as a necessary evil demanding expediency, traditional life seemed to revolve around collecting and concentrating nutrition. To this end, no methodology—and no recipe—was too bizarre.

I will give a few examples from Price’s book to demonstrate how fully people immersed themselves in the production of food, and a few of the wonderful ingenuities that streamlined this undertaking. In the Scottish Isles, people built their houses using, chiefly, the grass that grew abundantly on the moors. The roofs were loosely woven and chimneyless so that the smoke from their cooking fires would pass directly through the thatch. When the roof was removed and rebuilt in spring after having been infused with mineral-rich ash all winter, the smoke thatch made fantastic fertilizer for their plant crops, chiefly oats. Their oats, in turn, were super sources of minerals and were incorporated into many dishes. One of the most important was a fish dish made from baked cod’s head (rich in essential fatty acids) that had been stuffed with oatmeal (rich in minerals) and chopped cod’s livers (rich in vitamins). On the other side of the world, in Melanesia, the original arrivals to the islands had brought with them a member of the pig family bred for its self-sufficiency at finding forage in the muddy and mountainous landscape. They’d released their hogs into the wild so they could colonize the forests. Soon, the hogs’ numbers had grown to the point that one could be hunted down just about anywhere. Every part of the quarry—from snout to tail—would be cooked, or smoked, or otherwise prepared and eaten. Another Melanesian favorite was the coconut crab, so called because of its ability to sever coconuts from the trees with monster claws. To catch the wellarmed crabs as they came down from the trees, natives would quickly girdle the tree with grass about 15 feet from the ground. Upon reaching the grass girdle, the crab—convinced it had reached terra firma—would release its grip, and fall. Stunned, the crab could be easily gathered. It would be tempting to eat them then and there. Nevertheless, the crabs were first confined in pens for several days and allowed to gorge on all the coconut they wanted—generally enough to burst their shells. According to Price, “They are then very delicious eating.”65 Around the world again to Northern Africa, he found Maasai life revolved around producing healthy cattle, used primarily for their milk and their blood and only occasionally for their flesh. Maasai men spent nearly a decade learning to tend their animals. This education included everything from identifying the best grazing grounds based on rainfall patterns, to selective breeding, to regularly drawing blood from the jugular vein using a bow and arrow with surgical precision. As the Maasai ate neither fruit nor grain, this milk, either fresh or curdled (and bacteriallyenriched), was their dietary staple. Recent studies have shown that Maasai milk contains five times the brain-building phospholipids of American milk.66 In the dry season, when milk yields

are low, they fortify the milk with blood to make another staple drink.

As focused as people once were on the production of healthy food, the chief crop—and the ultimate prize—was the next generation of healthy children. Traditional cultures made a science of it. As we’ll see in the next chapter, step one was planning ahead. Around the world, traditions reflected extensive use of special foods to boost a woman’s nutrition before conception, during gestation, for nursing, and for rebuilding before the next pregnancy. Some cultures thought it prudent to fortify the groom’s diet in preparation for his wedding ceremony.67 The shreds of surviving information suggest such knowledge was quite sophisticated. Blackfoot Nation women utilized the still-unknown nutrient systems found in the lining of the large intestine of buffalo (and later, cow) to “make the baby have a nice round head.”68 To ensure easy delivery, many cultures reinforced pre-conception and pregnancy diets with fish eggs and organ meats—loaded with fat-soluble vitamins, B12, and omega-3—as well as special grains carefully cultivated to be high in important minerals.69 The Maasai allowed couples to marry only after spending several months consuming milk from the wet season when the grass was especially lush and the milk much denser in nutrients.70 In Fiji, islanders would hike miles down to the sea to acquire a certain species of lobster crab which “tribal custom demonstrated [to be] particularly efficient for producing a highly perfect infant.”71 Elsewhere, fortifying foods didn’t just facilitate pregnancy; they made the difference between the baby making it to term or not. The soil of certain areas around the Nile delta is notoriously low in iodine, the lack of which can lead to maternal goiter and infant malformation. Tribes of the Belgian Congo knew that burning water hyacinth (rich in iodine) produced ashes capable of preventing these complications.72

These ingrained traditions existed throughout the world and, until recently, dictated the ebb and flow of daily life. This kind of dedication, study, and wise use of natural resources is what was required to amass and protect the genetic wealth that enabled people to survive in a very different, and harsher, wild, wild world. Of course, these days, most of us spend our time fighting traffic, not wild boar. But the same nutritional input that toughened and fortified the physiologies of these indigenous peoples can still be accessed today for the attainment of extraordinary health. Were the medical community to bring the same enthusiasm to the engineering and maintenance of healthy bodies as archaeologists bring to their study of ancient architectural wonders, they would soon call for a radical revision of what we understand to be a healthy human diet. The construction of a beautiful, sound building is not a matter of chance, but of planning, good materials, and reference to the collected body of relevant science. Winning the genetic lottery depends upon those very same prerequisites.

self-sufficient ancestors did, wasting opportunities to provide ourselves with essential nutrients at every turn. We fail to fortify and protect the substrate on which the life and health of everything depends—the soil. We raise animals in unspeakably inhumane and unhealthy conditions, fill their tissues with toxins, and color the meat to make it appear more appetizing. Being raised on open pasture is no guarantee that an animal’s body, and ultimate sacrifice, will be put to full use; typically, only the muscle is consumed. Much of the nutrients, bioconcentrated over the animal’s life, are thrown to waste. Grains—even those grown on relatively healthy soil—are too often processed in ways specifically damaging to the most essential, and delicate, nutrients. Once in the kitchen, the consumer takes one last swing at whatever nutrition has survived, through overcooking and the use of cheap, toxic oils. Finally, since we’ve not been told that certain vitamins and minerals are more bioavailable when combined with acids or fats (see Chapter 7), many of them pass right through us.

Given that we drop the ball at every stage in the process of bringing food to the table, it’s not surprising that recent studies show, far from exceeding the RDA as we should be, few—if any— people even meet it. For vitamin A, only 46.7% of healthy females meet the RDA,73 and levels are low in 87% of children with asthma.74 For vitamin D, 55% of obese children, 76% of minority children, and 36% of otherwise healthy, young adults are deficient.75 For vitamin E, 58% of toddlers between one and two years old,76 91% of preschoolers,77 and 72.3% of healthy females do not consume enough. Zero percent of breastfed infants were found to have achieved the minimum recommended intake of vitamin K.78 For the B vitamins, only 54.7% consumed adequate B2 (riboflavin);79 for folate, only 2.2% of women between the ages of 18–35 and 5.2% of women aged 36–50 achieved the recommended intake; and for calcium, fewer than 22% of African-American adolescent girls consumed the RDA.80 There are more studies, but you get the idea. Not one study shows 100% adequacy of any single nutrient, not to mention adequacy of all measurable nutrients. Presumably the vast majority of Americans are deficient in more than one, if not all, known vitamins, minerals, and other nutrients.

Many of my patients suffer from symptoms that could be attributable to poor nutrition, problems as common as dry skin, easy bruising, runny noses, yeast infections, and crampy digestive systems. Unfortunately, testing for vitamin adequacy is not easy. We haven’t even defined what “normal” levels are for many nutrients, including essential fatty acids and vitamin K. For those that have been so defined, the normal range may extend all the way down to zero. That’s right: You may have none of an essential nutrient in your bloodstream, yet still be considered to have consumed an adequate amount. So why bother testing? And since many vitamins are stored in the liver and other tissues, even if blood levels are adequate, overall body stores may be low. As far as I can tell, the best way to assure nutrient adequacy is not with testing, but with adequate nutrient consumption—itself no simple matter.

Aside from building a time machine and transporting back to the halcyon years of nutritional bounty, in the face of so many barriers to good nutrition, what is an ordinary American to do? Is it remotely possible, in this day and age, to get the nutrients you need without breaking your bank?

Absolutely. You can grow a garden, shop for fruits and vegetables by smell (as opposed to appearance), and buy animal products from farms that raise them humanely—on pasture and outside in the sun. In the coming chapters, I’ll go into more detail about special ways to make your food as nutritious as possible. But I can tell you right now, you’ll get the most bang for your buck, and the fastest return on investment, if you learn to enjoy something that many kids in many countries aside from this one will fight each other for—the organ meats.

These were the original vitamin supplements, and they comprise key components of almost all truly traditional heritage dishes. They are the missing ingredients whose disappearance from our

dinner tables explains many of our health problems, and whose replenishment would go a long way towards improving those dismal nutrition statistics. But like most middle class Americans, for most of my life I assumed such odd tidbits and wiggly things were best fed to my cats and dogs. I might have thought differently had I been raised some place where traditions of self-sufficiency are still alive and kicking. Some place where children can learn cherished recipes from their parents. Some place where there’s plenty of land and open water per capita, where the weather invites people to spend time outdoors with their extended families. Someplace like Hawaii.

In document El envejecimiento en América Latina: (página 76-96)