Body Weight Loss and Heavy Smoking Quitting by a Low Socio-Economic Level Farmer in a Small Village of Crete, Greece

Special Article: Case Reports in Nutrition

Austin J Clin Case Rep. 2023; 10(9): 1311.

Body Weight Loss and Heavy Smoking Quitting by a Low Socio-Economic Level Farmer in a Small Village of Crete, Greece

Anthony Kafatos*

Department of Social Medicine, Preventive Medicine and Nutrition Clinic, University of Crete School of Medicine, Heraclion, Crete, Greece

*Corresponding author: Anthony Kafatos Department of Social Medicine, Preventive Medicine and Nutrition Clinic, University of Crete School of Medicine, Heraclion, Crete, Greece. Email: kafatos@med.uoc.gr

Received: November 02, 2023 Accepted: December 11, 2023 Published: December 18, 2023

Abstract

Obesity has tripled in our planet the last 4 years. The problem is particularly acute in Greece, ranking first in the European Union childhood obesity and holding one of the top positions in adult obesity with 63% of the Greeks over 18 years old to be overweight and obese. Also in 2019, 18.4 of people over 15 years of age in the European Union were daily smokers. Daily smokers range from 6.4% in Sweden, 9.9% in Finland to 23.6% in Greece and 28.7% in Bulgaria [1-4].

Case report

In 2009, a case report was published about a professor of internal medicine at the University of Crete School of Medicine [5]. At the age of 58 years he had an acute myocardial infraction in the parking of the University Hospital and was immediately transferred to intensive care unit and recovered with great efforts. Our team from the Preventive Medicine and Nutrition Clinic examined him after his exit from intensive care. His lifestyle and dietary habits were a big surprise. Although he was a professor of internal medicine and had a duty to teach patients and medical students, his diet and way of living were exactly the opposite of healthy recommendations. It was fortunate that he was no smoker and strictly followed the fasting recommendation of the Christian Orthodox Church (COC) since childhood. COC recommendations include abstinence from meat, dairy products, eggs for 180-200 days per year. Fish is allowed more frequently such as 40 days before Christmas with the exception of Wednesdays’ and Fridays. Also, fish intake is allowed in the saint Apostoles fasting in June [6,7]. The COC dietary recommendations are unique internationally as they are completely different from vegetarian diets, since sea foods and snails are allowed in all fasting days. If the professor did not follow the COC diet, his myocardial infraction could have occurred 10 or 15 years earlier. It was negative that, in the non-fasting days (180-200 days per year) he consumed 500gr/daily beef (excessive iron intake, nitrates and saturated fats increase the risk of MI) without any vegetables and minimal fruit and rarely wholegraincereal, bread and legumes. He had no physical activity at all. Following strictly our advises, his health status reversed within 5 months and now is without second myocardial infraction for the last 15 years.

Completely opposite is the case of a 71 year old farmer from a small village in Crete, with very low socio-economic level, graduated only from the elementary school of his village. Without any professional advice from physicians, dieticians, or psychologists he discontinued smoking in 2012. He started smoking at the age of 14 years with 2 or 4 packages of cigarettes per day and between the years 1990 & 2000 consumed 6 packages per day (120 cigarettes/daily). During his elementary school years he used his teachers’ cigarette ends.

After the discontinuation of smoking in 2012, he started gaining weight and in 2021 he reached 95 kg body weight. Two years ago he, himself decided to lose weight by improving his diet without any professional advice. The last 1 ½ year his weight was 70 kg and remains stable up to now (BMI 23.6 kg / per m2 from 33.7 kg / m2). His daily physical activity is over 2 hours per day fast walking on the mountains. His daily food intake includes plenty of vegetables, 4-5 portion of fruits per day from his own garden. He reduced olive oil intake, the chicken intake is 100-150g per week, rabbit 3 times per week, fish -mostly sardine- 3 times per week and legumes 3-4 times per week. Sweets he eats only 1-2 times per month.

Conclusion

In conclusion, as a professor of Preventive Medicine & Nutrition, I rarely succeeded to convince patients to reduce their weight and discontinue smoking. In case they manage to lose some kilos, soon they come back to their previous weight. Serious health episodes such as myocardial infraction led some to change their mind and permanently improve their lifestyle. The poor but humble farmer without any medical assistance, by himself decided to change permanently health and lifestyle habits. This shows that persistence and self-motivation may well be the most important factors in weight loss and smoke quitting.

References

  1. GBD 2019 Risk Factors Collaborators. Risk factor collaborators. Global Burden of 87 risk factors in 204 countries and territories, 1990-2019: a systematic analysis of the Global Burden of disease study 2019. Lancet. 2020; 396: 1223-49.
  2. Michas G, Magriplis E, Micha R, Chourdakis M, Koutelidakis A, Dimitriadis G, et al. Prevalence and factors associated with smoking in a national representative sample of Greek adults: the Hellenic National Nutrition and Health Survey. Hellenic J Cardiol. 2022; 67: 19-27.
  3. Touloumi G, Karakosta A, Kalpourtzi N, Gavana M, Vantarakis A, Kantzanou M, et al. High prevalence of cardiovascular risk factors in adults living in Greece: the EMENO National Health Examination Survey. BMC Public Health. 2020; 20: 1665.
  4. Janssen F, El Gewily S, Bardoutsos A. Smoking epidemic in Europe in the 21st century. Tob Control. 2021; 30: 523-9.
  5. Kafatos A. Is Clinical Nutrition teaching Needed in the Medical Schools? Ann Nutr Metab. 2009; 54: 129-30.
  6. Rodopaios N, Mou et al. Effects of periodic abstinence from dairy products for approximately half a year on bone health in adults following the Christian Orthodox Church fasting rules for decades. Arch Osteoporos. 2019; 14: 1-8.
  7. Sarri K et al. Greek Orthodox Church fasting rituals: a hidden characteristic of the Mediterranean diet in Crete. Br J Nutr. 2004; 92: 227-84.

Citation: Kafatos A. Body Weight Loss and Heavy Smoking Quitting by a Low Socio-Economic Level Farmer in a Small Village of Crete, Greece. Austin J Clin Case Rep. 2023; 10(9): 1311.