Many times, due to too much information, or because it is not very specific, or is not reliable, it is difficult to know how to take care of yourself. To achieve healthy aging, it is essential to be clear about the order of priorities in terms of care. To explain it simply and correctly, Maria Puntí, a dietitian specializing in digestive health and director of the Integra Salud School (ISS) academy, has written The Longevity Pyramid (Vergara publishing house, Columna in Catalan), where she breaks down—and orders according to its importance—everything necessary to grow older in the best possible conditions.
The main objective of the microbiota expert is to help people learn to take care of themselves to live longer, in the best conditions. “In the book I emphasize not focusing on living longer, but on longevity with a higher quality of life. The important thing is not to live more, but to live better, being able to enjoy along the way,” emphasizes Puntí, who at 27 years old has created two clinics and has written her first book. We talked to her about how you have to take care of yourself to age healthily.
What motivated you to write The Longevity Pyramid?
The main reason is to help the reader make decisions about their health in a coherent way and putting priorities where they belong. I frequently observe in my patients that, faced with overexposure to so much information, often contradictory and poorly contrasted, they do not know where to start or what to prioritize when making decisions about their care. This causes them stress and even frustration for ‘not doing everything perfectly’. Therefore, although I think that nutrition, physical exercise and mental health are equally important, I have established a pyramid of priorities.
What are the main concepts that we should take into account to achieve healthy aging?
When we talk about healthy longevity, we will seek to take actions so that our cells maintain a strong, fluid cell membrane, allowing the correct exchange of molecules and above all, protect the stability of DNA at all costs, since we do not want genes to be expressed that should remain silenced. To do this, we need to keep chronic inflammation and, with it, oxidative stress under control.
How do both factors – chronic inflammation and stress – affect our way of aging, and how could we control them?
An inflamed intestine and body means that our brain will be suffering the consequences. This is not favorable for the prevention of neurodegenerative diseases, keys to healthier longevity. To control this state of chronic inflammation, we must take into account some triggers such as chronic stress, a pro-inflammatory diet, inadequate body composition and chronodisruption. As the well-known psychologist Kelly McGonigal mentions in her books, what matters is not the stress itself, but how we experience and manage it. In the book I place special emphasis on mental health, the first pillar, and what we can do to regulate our nervous system. Also on how to build our healthy plate and what exercise to do to improve our body composition, to maintain an optimal fat percentage and have good muscle mass. This will predispose us to have lower levels of inflammation, stronger bones, a more effective immune system and, without a doubt, will make us feel much better mentally.
You have studied what it is like to live in the oldest areas of the world. What has caught your attention the most, and what lessons can we learn from it?
Some of the longest-lived regions in the world are Okinawa, Loma Linda, Ikaria, Sardinia, and the Nicoya Peninsula. The characteristic that they all share is the importance of the tribe, of social connections. The population of these regions places great importance on strong social relationships and strong community ties. Of course, they also share strong spiritual beliefs that provide them with inner peace and meaning in life, and promote greater community. Human beings are a very social animal, who need to connect with other people. It is not a whim, it is a basic need: feeling that other people care about us, that we are part of a group and that we care for each other is key to giving meaning to our existence.
And in terms of diet, what is it like in the blue zones, those geographic areas where the population has exceptionally high longevity?
Curiously, they do not follow any specific diet. Apart from, of course, avoiding highly processed foods, the blue zones base their diet on plants, with a moderate consumption of meat (non-existent even in some parts), fish, eggs, fruit, whole grains, nuts… That is why I am not a fan of strict diets or a diet for longevity. No matter how well we eat and exercise, if our lives lack purpose, it will be very difficult to enjoy good overall health.
All in all, diet plays an essential role in promoting longevity, how do you approach this issue?
Plays a fundamental role. Currently, I observe two profiles of people: those who have no knowledge about nutrition and eat as if their body were a garbage can, and others who are obsessed with calories and tremble if they eat a French fry. We must learn to navigate between grays, know that there are foods that frequently consumed are related to a greater predisposition to inflammation, such as the hydrogenated fats present in ultra-processed foods, the excessive abuse of sugar in all its forms such as fructose, syrups or maltose, fried foods and the abuse of processed meat. Although that does not mean that occasional consumption is going to kill us, we must be flexible.
What would be the best diet to achieve healthy aging?
The message is that there is no universal diet and even less so an ‘ancestral’ diet. The human being who lived during the Paleolithic in what is now Alaska did not eat the same as the one who lived in Okinawa. Not even those who lived in what is now Nigeria ate the same as those who lived in Norway. The human being has adapted to what he had in his area and is a very versatile animal, which easily adapts to what he has available around him. Although diets such as the Atlantic and Mediterranean diets have solid scientific evidence on their relationship with good health, nutrition must be adapted to the needs of each person and their stages of life.
In 1992, food allergies accounted for 3.6%, while in 2015 they were already 11.4%, according to data from the Spanish Society of Allergology and Clinical Immunology (SEAIC) and it seems that older age is a risk factor. Today, an increase among older people in various food intolerances, such as gluten or lactose?
It is true that some older people develop food intolerances, such as gluten or lactose intolerance. In part it could be attributed to greater awareness and diagnosis of these conditions today. Studies have shown that the more frequent consumption of ultra-processed food, low in fiber, especially rich in wheat, and the increase in obesity caused largely by a sedentary lifestyle, added to greater use of medication such as antibiotics, has caused irreversible changes. in our microbiota, making it less diverse. Less diversity is synonymous with less health. But there is a modifiable part: the intestine has villi, to increase the absorption surface. A pro-inflammatory lifestyle predisposes this surface to become inflamed and hyperpermeable, which will make it more likely that we will develop food intolerances.
What is your perspective on the role of physical activity and exercise in preventing age-related diseases?
Vital. The strength of your grip is a marker of longevity. And not because of the strength itself, but because it tells us what your physical condition is, the quality of your muscle mass and general strength. Multiple studies have shown that there is an association between muscle strength and longevity. Muscle mass also plays an important role.
What would be the importance of muscle strength?
Muscle strength is an important marker of physical function and the ability to perform daily activities, which can influence quality of life as we age. In addition, it is related to the prevention of falls and injuries, crucial for maintaining independence as you age. It will also be essential for good bone health, key for example in advanced stages such as menopause, where estrogen deficiency is related to a greater risk of osteoporosis: good nutrition and strength training are essential for its prevention.
And in the case of muscle mass, what benefits does it bring us in our senior years?
Lean muscle mass is associated with a lower risk of chronic diseases such as type 2 diabetes and cardiovascular disease. It also plays an important role in metabolism and blood glucose regulation, which can have positive effects on long-term health. Several studies have also shown that higher levels of VO2 max [the maximum volume of oxygen the body can absorb] are associated with a lower risk of cardiovascular disease, type 2 diabetes, and all-cause mortality. This is in part because aerobic capacity is linked to better cardiovascular and metabolic health, as well as a greater ability to perform daily activities and maintain an active lifestyle.
And how can we take care of both strength and muscle mass?
In summary, I would recommend doing between 75 and 150 minutes per week of high-intensity exercise and between 150 and 300 minutes per week of moderate physical activity. Complying with the minimum of moderate and high intensity activity can also reduce mortality from cardiovascular diseases between 22% and 31% and a lower risk of developing cancer. A study by JAMA Oncology shows that performing 4.5 minutes of vigorous intermittent physical activity (VILPA) per day is associated with a 31% to 32% reduction in the incidence of cancer related to physical activity.
You talked about it at the beginning of the interview, but how do stress and emotional health specifically influence the aging process?
Stress leads to a chronic, persistent elevation of cortisol. This hormone has been key in the survival of human beings, as it puts us in a state of alert, improves our ability to react, overcome and be resilient. However, having high levels for months and months depresses our immune system, inflames us and constricts our blood vessels, which therefore predisposes us to lower longevity and quality of life. How we cope with adversity, and the decisions we make about our lives, therefore, are key. We grow up thinking that ‘this is the life we ??have been given’, we let ourselves be carried away by circumstances, without taking control or without thinking much about whether I really like the life I have. Without knowing what I want, how can I choose a job that makes me happy and doesn’t make me anxious? How am I going to choose a partner who makes me feel at peace? Answering these questions is part of the path to achieving healthy longevity.
What are the common myths about aging that you debunk with your book?
For example, regarding the consumption of eggs, dairy products and meat, there is a lot of alarmism and often unjustified. There are also myths about the ketogenic diet or fasting, which although they are dietary strategies that can be useful, for example in cases of epilepsy or prediabetes, they are not at all the holy grail and many people end up developing an unjustified phobia of carbohydrates and disorders. of eating behavior.
What role do genetics and hereditary factors play in the aging process, and how can they be managed from an integrative medicine perspective?
Actually only between 20 and 25% of the variability of human life depends on genetics. The rest is influenced by a series of interrelated factors, such as the quality of medical care, the availability of food and drinking water, access to education, socioeconomic status, social and environmental environment or lifestyle. Most of them, more or less controllable or, at least, modifiable. We have placed too much responsibility on health centers and the doctor as our ‘dad’ who takes care of our health, and this is a mistake. It is you who must take care of yourself at home, and it is the role of health workers, educators and the government to transmit that education to the population.
And how would it be achieved, what guidelines should be followed?
Start with more dieticians, psychologists and physical activity and sports professionals in public health. One in four hospitalized patients in Spain is at risk of malnutrition, a percentage that increases to 37% if the patients are over 70 years old. Hospital nutrition is key: if in a hospital they give us María and Cola-Cao cookies, how will the population understand the importance of avoiding processed foods, if whoever should take care of them does not give it any importance?
What would be your main recommendations for readers who want to improve their quality of life and promote longevity and good aging?
May they begin to love themselves and others more. If you do not treat yourself as an ally, if you are in a constant fight against yourself, without allowing yourself to rest, or setting limits, without taking the nutrients for the correct regeneration of your organs and without giving movement and love to your body, how can you Do you expect it to last your whole life? Let’s not see pain or illness from hatred and anger at your body, but from the vision of what can I do to help you, body? Self-care is the first step to enjoying good health. Add a change of habits every month, don’t try to start doing everything always perfect, because it is impossible.
