Monday, March 18, 2024

Growing up in Malta

Walk through any Mediterranean city and the fast food on sale has nothing to compare with the ideal diet that academics think we eat. 

Fast foods are accessible to everyone:  kebabs, burgers, butter and lard pastries, sweets, ice cream, donuts, fried chicken, and sodas are all the opposite of traditional diets. But the world is changing again. The growth of traditional food, inspired by our neighbors the Italians' "slow food" movement has brought back some of the local dishes, mostly from the Arabs. Food based on legumes cooked with garlic and chilies, roasted vegetables, and lean rabbit cooked in garlic and red wine. We ate fish pie nearly twice a week in summer when the fishermen came back to shore with their boats brimming with the local catch of Mahi Mahi (Lampuki). Before the popularity of fridges, everything had to be eaten fresh. The Mahi Mahi were so cheap that we had fish for a month and the housewives got creative in how to cook it. Fried, roasted, or in soup with lemon and rice ("aliota"). But the pie won favor as it included fish, spinach, and ricotta in a flour pastry shell. 

Then came the sweet pastries made without baking using leftover cake and biscuits mixed with nuts and candied fruits and drenched in evaporated condensed milk.  Some fruits that only grow in Malta are also making a comeback. A small sweet pear called a "Bambinella" (from the Italian meaning a small girl) is still a popular indigenous fruit. We had lots of healthy soups, such as minestrone made with squash that had been harvested and then left on top of the roofs of the farms to mature in the sun. When cut open and a slice is purchased it gives the soup a mellow rich body with that traditional orange color. But the absolute favorite foods have never left the island. The local "pastizzi" of filo pastry filled with ricotta or peas. And there is always the local bread baked in a traditional wood-fired oven that is rare to find nowadays, but you can still find it. 

Our memories of the past are tied to the foods we ate at the time. When I visit my parents, which I try and do every year, I go and look for these wonderful foods. Some restaurants cater to this new demographic. Food has become a time portal for me as it is the best way to transport myself to the past. I have a secret pleasure of going away on my own to the city and in some of the local shops that still make traditional "pastizzi" I order 6 and walk to the garden overlooking the harbor and watch the ships as I devour these small pastries. Such fleeting escapades remind me of who I am and where I came from. It anchors me to my culture and my foundation. Food has a way of transporting me across time and mostly good times.


Now, living in the United States, the food tastes like plastic. I try to capture the taste by buying organic and local produce, which is an improvement, but I cannot capture the same flavor of my past. Only when I travel back to Europe, especially Turkey and Sicily do I  taste some of those flavors again. Perhaps that is why I like traveling so much. But it is more than food. It is how I felt as a young boy. That feeling of hope, of having a whole world to explore. The hunger was not just for food but for the excitement of all those opportunities that I believed existed for me, all I had to do was be adventurous. Perhaps by trying to capture the foods of my past, I am trying to capture that feeling of hope, that the world is full of opportunities. 

Perhaps that is the secret, being able to meditate and enjoy the world around us, and food certainly helps.

It is that feeling of belonging that we are trying to capture. As a child, I felt close to my family. I used to rush home from school and I knew that I had a safe place and that mum would be cooking and we get to eat together and maybe dad would tell us stories about his work. There were always the vendors that came pulling their carts selling "bigilla" (bean chili paste) or just fresh stalks of chickpeas still on their branch. 

My favorite was the vendor who sold romance novels. Mum who never went to school could read in Maltese, English, and Italian. I used to go and buy the sheet from the vendor. It measured something like 4 by 4 feet. I will take it to the kitchen table fold it and very carefully, using the only knife we had, a serrated bread knife, cut the paper into individual pages. Mum would then sew the pages together to make a book. She used to follow these romance novels religiously, and every month another chapter was added and I had my job, cutting the pages. 

There was always something happening and I belonged with this family. Sharing the food was not so much about sharing, as we devoured our food like stray cats. Sharing meant being together. We cannot recapture that now as we rarely see each other as a family. Like most of us, we have our own families now. My mum has severe dementia and my dad is angry at the world. He did not expect his life to end like this. We, the children are lost, despite having our own families our parents still remain our foundation and how we knew we belonged. Now we offer this belonging to our children even though we seem to have lost it for ourselves.

Medicine and Long Life

Why do we have medicine?

The answer is obvious that a child can answer. It is to help people. To help them live long and healthy lives.

 

But does medicine help us live long?
Some medicines do, like some vaccines, and most interventions help people live slightly longer.

 

But people still die. In the last hundred years, we have only improved life expectancy at older age by 6 years. The great improvement in medicine has been in helping children survive childhood. And this was not just medicine it was because of public health. We made great progress in getting clean fresh water to communities and an efficient sewage system. Laws that protect the air we breathe, the hours worked, and age restrictions. It is these factors that have improved life the most rather than medicine.

 

For older people medicine performs invasive treatment like heart operations, setting bone fractures, and through medication like controlling blood pressure, cholesterol, and diabetes. These help some older people live slightly longer and in better health. But only slightly.

 

Two researchers examined what happens if we completely cure some chronic diseases.
Like a magician with their magic wand, they eliminate all diseases. This can only be done statistically. Kenneth Manton eliminated one disease at a time. By eliminating all of these killer diseases at 87 years of age, people live an additional 5.7 years for males and 6.5 years for females.

 

Another researcher eliminated one disease at a time and saw the effect this had on people’s lives. Again, they did this using statistics. Douglas G. Manuel reported that by eliminating cancer they predicted that one fifth of the years of life gained would be spent in poor health—and increased cost. This is because living longer results in these people getting dementia or other chronic disease such as atherosclerosis. On the other hand, eliminating musculoskeletal conditions would result in a year of good health for women and under half a year for men.

 

Many diseases are waiting for us in older age. The healthiest people on earth, like the Blue Zone people, one of which is in Okinawa, tend to live a long life. They only get sick for a few days before they die. There is no long period of sickness. In the end, it is best to be healthy as death comes quickly and our bodies seem to know how to shut down effectively when we are healthy.

 

We need to understand why our bodies are designed to shut down. We need to study aging not just specific diseases.

 

Then I return the question. Does medicine help people live long and healthy lives?

 

The answer might be that medicine allows us to believe we can change our nature. But as yet we do not understand “aging” enough to be able to change very much, but we all take what we can get right now.