Hektoen International

A Journal of Medical Humanities

Life at the table

Isabel Azevedo
Porto, Portugal



Très Riches Heures du Duc de Berry, 1412 – 1416
Herman, Paul, and Johan Limbourg
Musée Condé, France

In the days when human time was organized differently and every hour had its meaning, meals were community events, mostly family events, where people met to socialize as well as dine. Someone took the task of preparing a meal seriously, paying attention to details, with dedication and without hurry. Feasts and simple meals alike were prepared in this manner, eliciting a feeling of convivial ambience and respect.

The habit of eating together, an early characteristic of all human life, persists in people living according to ancestral traditions and across places and cultures.1,2 It has been eroded by the world of finance and competition, ambition and individualism, leading to more people no longer having a fixed time or place for meals, let alone knowing how to cook. A strange evolution indeed, since modern science and technology should have reduced the time needed to run the economy! These advances should have given us time to contemplate, devote ourselves to others, cultivate, and enjoy life. Philosophers of our time such as Agostinho da Silva in Portugal3 and Edgar Morin in France4 have tried to turn people’s attention to this point and make them lead better lives.

Since the dawn of history, society, and religion in particular have prescribed and regulated eating habits, substituting cultural traditions for the primeval instinct. Eating became a socio-cultural event, behavior at the table an important marker of civilization,2 and the use of eating utensils led to behavior rules to which civilized people conformed. These rules prescribed a regular time for the meal, where to sit at the table, when to help oneself to food, when to start eating (not before the others), taking small bites (for aesthetic reasons and allow conversation), and when to finish (neither too much ahead nor too much after the other dinners).

When people live by these traditions, eating becomes an important event of the day, leaving no anxiety, no dilemma about what to eat,5 no need to weigh calories, and no likelihood of eating too much. There is control, by the person who chooses the menu and decides on the size of the portions, and by the others present at the table who do not feel or think they are being controlled. They enjoy the meal in company, eat slowly, and become naturally and easily satiated in a social manner. Eating in community at fixed hours favors slow eating through the observation of etiquette and participation in conversation.6-10 Eating slowly affects how much food is eaten.11

Unfortunately, modern eating habits and lifestyles bear little resemblance to ancient rituals, resulting in an epidemic of obesity and metabolic syndrome. Some researchers have proposed alternate causes to obesity12 beyond the two most prominent factors, food and physical activity. Indeed, there are many more elements to consider, including chronic stress, another characteristic of the modern condition.13-15 Yet, despite comprehensive research efforts, hundreds of published papers, and multiple recommendations, the problem persists.

One of the underlying causes may be that people have simply forgotten how to eat healthfully. A myriad of theories concerning diet and nutrition have been created with new scientific discoveries. One such proposition, nutritionism, holds that the value of food can be reduced to its individual nutrients.16 This theory led to rapidly changing, and sometimes contradictory, advice from experts: consume less fat, fewer carbohydrates, and more or less protein—depending on the proponent. The resulting confusion, after the abandonment of traditional eating patterns in favor of more “scientific” approaches to eating, left people worse off than before.

This is especially ironic, as one traditional diet, the so-called Mediterranean diet, has gained credence in some scientific circles.17,18 This diet, which is comprised of olive oil, nuts,19 wine,20, 21 fresh fruits, vegetables, and whole grains, is associated with a significant reduction in overall mortality, mortality from cardiovascular diseases, incidence of mortality from cancer, and incidence of Parkinson’s disease and Alzheimer’s disease.22 Although promising, research on isolated components of the diet has been inconclusive,22-26 suggesting that its benefits may be derived less from food and more from a decrease in psychological distress and a greater feeling of belonging to the community.27 Indeed, it may be necessary to refer more to a “Mediterranean lifestyle” of which diet is but one component.28 In a society in which obesity, hypertension, dyslipidemia, and diabetes are rampant, not to mention anxiety, sickness, depression, and unhappiness, scientists are discovering that the act of eating alone has a detrimental effect on the quality of life and the dietary status.29 By contrast, shared family meals among young adults are associated with healthier diets30and better eating habits.31

Regardless of the science, to eat together is to belong to a community, feeding both body and soul. This is what is experienced when sharing a meal in southern Europe, the home of Mediterranean culture, where “at the table” is not only a way of eating but also a way of living.



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ISABEL AZEVEDO, MD, PhD, Professor of Biochemistry, previously Professor of Pharmacology and Therapeutics, both at the Faculty of Medicine of Porto University. She has worked for 40 years as researcher and teacher, under the paradigm that for anyone to know science he has to have an experience of research work. She investigated mainly in the area of adrenergic mechanisms at the cardiovascular system and metabolism, having over 200 publications in international scientific journals, simultaneously trying to let not scientific work preclude the view of man and life in their fullness and richness.


Winter 2014  |  Sections  |  Food

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