What is the healthiest culture

Healthy nutrition in times of Corona - "Enjoyment is good for your health"

Misava Macamo (www.misava-macamo.de) is a certified dietitian and offers freelance holistic nutritional advice. She is studying it at the University of Fulda in the bachelor's degree in dietetics.

Ms. Macamo, you and some of your colleagues reacted angrily to an edition of our pleasure column, which is about nutrition in times of the corona pandemic. The stumbling block was a humorous remark by the nutritional sociologist Daniel Kofahl, who warned against "shouting into the general dietician's horn and glorifying an unreal hunger-hook ideal weight as the ultimate". What bothers you about this statement?

What bothered us most was that our work is linked to "hunger pangs". We always try to differentiate ourselves from any “miracle diets” and do not propagate a supposed ideal weight as the ultimate. Our work is hardly mentioned in the media. And when that happens, as in your column, it is in such a negative context. That hurt me personally. But I am not resentful and am happy about the opportunity to straighten something out.

What do you actually become a dietician? What is the difference between your profession and nutritionists?

It is a health profession with a three-year, partly clinical training. It's a lot about basics like nutrition, food science and professional law. The training also includes medical areas such as anatomy, physiology, biochemistry and pathology. On this basis, it then goes into dietetics, i.e. how to treat certain diseases with a balanced diet. After the training, you usually attend periodic, certified training courses, because that is the prerequisite for recognition by the professional association. Nutritionist, on the other hand, is not a protected professional title.

In the area of ​​nutritional advice, there are also many charlatans who spread salvation teachings with a claim to infallibility and sometimes abstruse esoteric backgrounds, such as veganism, paleo diet or nutrition according to blood groups. How can you differentiate yourself from it?

On the one hand, we have a highly regulated professional code and, for example, are not allowed to advertise products. Consumer protection organizations always point out these differences and publish checklists to qualify providers in the field of nutritional advice. We have a solid education and it is simply not part of our job description to spread any salvation teachings.

Many people associate the term “diet” with renouncing pleasure. But isn't the consumption of supposedly or objectively unhealthy food and luxury foods also essential for physical and mental health? I definitely don't want to miss roast wild boar and a good glass of wine.

I wouldn't want to forbid you to do that either. Eating and drinking is more than just eating. Enjoyment is an important component and also clearly health-promoting. That also has a social component. In principle, you can eat a vegetarian diet, but do you really have to push grandma’s dessert off the table at the family reunion because there’s something animal in it? Enjoyment is always part of my deliberations. There are also questions like mindfulness when eating and how much time you take for it.

Don't most people have an internal compass that shows what is good for them and what makes them happy?

We have to make a distinction. In the case of certain clinical pictures, it may be imperative to adhere to nutrition plans. A healthy person who listens to their inner voice when it comes to nutrition and enjoyment does not need any rules or advice from us. But many people have forgotten this intuitive eating, as can be observed especially in children. They have often adopted patterns that can be very damaging to their health. There is then also a need for advice and therapy.

Let's get to Corona. There are studies that show that in lockdown phases there is sometimes significant weight gain and increased eating disorders. Does this coincide with your experience and are there typical lockdown eating habits that you classify as particularly harmful?

Yes, that coincides with our experience. Clearly more carbohydrates are consumed and more alcohol is drunk. Many people lack the usual daily and work structure in the home office, which also lowers the motivation for health-conscious behavior. We often have to deal with “parent burnout” when, in addition to work, childcare and childcare have to be guaranteed at all times. When it comes to eating, it's all about being quick, and in the evening you “reward” yourself for the stress with a glass of wine more than usual, so you can relax.

Malnutrition undoubtedly has an impact on the general well-being and also on the immune system. Can malnutrition or malnutrition also promote serious illnesses after a corona infection?

Yes, there can be connections. In general, malnutrition weakens the immune system. And the therapy of infected people includes, for example, an increased protein intake. Nutritional therapy is very important to Covid patients, including in the inpatient area.

Malnutrition and the resulting diseases are a major social problem regardless of Corona. Where should one start and what role can dietitians play in this?

It is about nutrition education in all areas. The introduction of a school subject nutrition is currently being discussed. We would of course welcome that very much. We also have to pick up those in whose family environment the topic of healthy eating does not play a major role, for example through appropriate events in day-care centers. The problem is usually not the knowledge - everyone somehow knows that vegetables are healthy. The problem is the implementation of this knowledge in everyday life. So no mega-long lectures about nutrition, but rather design practical solutions for everyday life. We can get involved.

Rainer Balcerowiak asked the questions.