Wetenschap - 5 oktober 2011

In search of healthmakers

Don't eat that fat morsel, quit smoking and stop sitting in front of the tv. To stay healthy, avoid especially the sickly stuff. But you can also do it the other way round: instead of avoiding, go in search of factors which can make you healthy. Laura Bouwman, university lecturer in the Health and Society Group, will talk about this at the opening symposium of Food4You, a knowledge festival, this.evening.

Bouwmans' vision has its roots in salutogenesis, a movement which searches for ways to improve our health, instead of warding off threats.
Followers of this movement are sometimes considered as 'believers' but there is an increasing amount of evidence that it works. Therefore, says Bouwman, the time is ripe to give it more attention. 'We know a lot about people who eat unhealthily, but how much do we know about people who eat well?'
Being healthy has a somewhat different meaning in salutogenesis than in medicine.
'That's right. In biomedical science, you're either sick or you're not. A physician makes a diagnosis based on figures, such as the BMI and the cholesterol level. And yet, people with a chronic illness can still feel good, whereas others with no physical ailment can feel unwell.'
What does this mean in concrete terms?
'One of our protagonists always begins his presentations with a video show about a woman without arms. From a biomedical point of view, this woman must be having a very low quality of life. And yet, you can see that she manages very well. She therefore describes herself as healthy.'
The core of salutogenesis is the abstract concept of a 'sense of coherence'.  People who have a great deal of this feeling appear to be healthy, exercise more and use fewer drugs.  Antonovsky, the pioneer in this field, divides the concept into three parts: understand how society works and why things happen to you (understanding); be the boss over problems (competence); be able to give significance to life (meaning). Other 'sources' for health are living in a green environment and social belonging.
Can such vague terms say anything about your health?
'The quality of your life can predict your life expectancy better than your medical status quo can. Biomedical science examines only that which is measurable because that's easier to research into. But vitamins in themselves don't constitute a product, products aren't yet a meal, and a meal is not yet a diet. Salutogenesis in fact adopts a holistic approach.'
What then is a salutogenic health research about really?
'There is an interesting trend called 'positive deviance'.  You could research into people whom you expect to be eating badly, but in fact, they don't. A research conducted in Vietnam found out that the women in weak families can identify and make use of all kinds of 'sources' in their surroundings. For example, they feed their children the healthy green leaves of sweet potatoes. They also catch prawns while working in the rice fields and make these into a paste. Looking at such people, one can see how society can be organized in such a way that people can make healthy choices.'

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