The posts on my food blog and rant blog are the same this week, because I’m ranting about the relationship between diet and disease.
Another type of diversity conversation. And a call to action.
Alongside the wonderful Paul Loper, I’ll be heading back this time next year to the beautiful Mexican Pacific coast as guest faculty at the Modern Elder Academy. I’m looking forward to learning more than I teach (as always) and in particular to enjoying the work of the most important faculty member at MEA, the person whose contribution has the potential to make the greatest difference in the lives of those attending…yes, I’m talking about this guy: Tony Peralta. Chef.
But for now, I’m still in London Covid world, with stern warnings everywhere I turn that elders like me are more at risk than younger people of serious illness and even death if we become infected by the virus. The message is one designed to evoke passivity and fear; I’m being told what to avoid and what not to do.
It seems to me to be dangerously superficial as well as offensively ageist to throw all elders into the same box. I’m not alone. A paper in the international journal of the British Geriatrics Society states:
- The public discourse during COVID-19 misrepresents and devalues older adults.
- The ageist attitudes circulating during COVID-19 make some people think that the pandemic is an older person problem. (Ageist attitudes include the belief that ill health is inevitable, intervention ineffective, and improved outcomes inherently not valuable to society).
The same paper goes on to say that it doesn’t have to be this way; that there is substantial untapped potential to modify the relationship between chronological age and health, and to relieve the so-called burden of ageing on individuals, families and society.
One of the fundamental reasons why some older people can be badly affected by Covid is a lack of diversity in the gut microbiome. In case you didn’t know, your microbiome is made up of more bacteria and fungi than you have cells, and diversity in its composition protects us from disease, affects our metabolism and weight, our inflammatory response, cognition, appetite, mood….
Over the age of 40, the diversity of these bacteria in our gut tends to decline. The reasons for this are many and include diet (many people slide into habitual and unhealthy eating patterns), hormone levels, diabetes, use of antibiotics, painkillers, antidepressants, and drugs such as statins which are used to manage blood lipids.
At a time when we are being advised to wash our hands and stay away from other people, the risk of reducing the diversity of our gut bacteria is even greater – cutting down on opportunities for the virus to enter our system also means that we’re preventing bacteria getting in, so we need more than ever to protect and boost the ones already in there. In this necessarily disinfected environment, we need to do even more to sustain the diversity of our microbiome and thus protect ourselves from those dangerous inflammatory infections caused by Covid.
This is where our hero, Tony, comes in. One way to slow the age-related decline in microbiome diversity is by changing our eating habits to something more like a Mediterranean (or what I tend to think of as a Pacific Mexican) diet of the type served up by Tony and his team – plenty of colourful fruit and vegetables, grains, fresh fish, some fermented foods (and, yes, the occasional glass of excellent Baja California wine). It helps also to snack less, taking long pauses between meals to give your gut a break. Exercise has also been shown to support microbiome diversity.
To learn more about this, Prof. Tim Spector is definitely worth a follow, and this article of his on how to boost your gut microbiome is very helpful. I’m looking forward to his upcoming book, Spoonfed, on diet myths which I’ll feature here when it comes out in a couple of months time.
I’d love us to turn Covid19 from a reason to hide away into a reason to act. To take this opportunity to do 2 things:
- as individuals, rather than allow ourselves to be wholly dominated by the vulnerability narrative, take action and start to re-build the diversity of our microbiome so that we improve our resistance. In short, “Cook like Tony.”
- as a movement, start to draw attention to the fact that the medicine business and pharmaceutical trials have historically and shamefully under-represented older people, black people and women. A paper by multiple academics from London, Shanghai and Mexico written in 2014 decried the under-representation of older people in research and healthcare thus, “effective (healthcare) intervention in older people is complicated by ageism, complex multimorbidity, and poor access to age-appropriate care…older people tend to be excluded from clinical trials that would generate specific evidence to inform their treatment, even for drugs that are mainly prescribed in older age.”
 The burden of disease in older people and implications for health policy and practice
Martin J Prince, Fan Wu, Yanfei Guo, Luis M Gutierrez Robledo, Martin O’Donnell, Richard Sullivan, Salim Yusuf
Missing Microbes. How the overuse of antibiotics is fueling our modern plagues. Martin J. Blaser.