Can food be medicine? Pros and cons
“Food as medicine” may be an emerging concept in the Western world but has existed for centuries as the cornerstone of health for many cultures around the globe. However, the role of diet and food in disease prevention and management compared to conventional medicine has been questioned. This Honest Nutrition feature explains the benefits and limitations of a “food as medicine” healthcare approach.
Written by Amber Charles Alexis, MSPH, RDN on April 13, 2022 — Fact checked by Hannah Flynn
This series of Special Features takes an in-depth look at the science behind some of the most debated nutrition-related topics, weighing in on the facts and debunking the myths
The fact that diet can impact an individual’s health is well acknowledged by healthcare providers worldwide. People who have access to adequate nutrition are more likely to have strong immune systems, safer pregnancy and childbirth, lower risk of diabetes and cardiovascular disease, and they live longer.The reasons for this are myriad, complex, and not yet well understood. Some research has shown that a diet rich in added sugars, saturated and trans fats and excess sodium may induce chronic inflammation Trusted Source — an underlying risk factor in the development of heart disease, type 2 diabetes, poor gut health, and other chronic diseases.
Likewise, the American Heart Association
recently made diet and lifestyle recommendations that included a diet rich in fruits, vegetables, whole grains, legumes, low-fat dairy, and plant-based or lean animal protein to support cardiovascular health.
Experts think that this diet supports good health through its potential to reduce harmful risk factors of cardiovascular disease, including inflammation, elevated cholesterol, high blood pressure, and poor sleep
(WHO) also links nutritional status to immune health.
Furthermore, research also shows that carotenoids — antioxidants naturally found in some vegetables and fruits — in the diet can improve the blood metabolites of people with liver disease
Decades of scientific findings support the integral role of diet in health management, which should not be understated.According to the 2020-2025 Dietary Guidelines for Americans, the core of a healthy diet is built on high intakes of a variety of nutrient-dense foods and beverages, including:
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fruits
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vegetables
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whole grains
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low and non-fat dairy
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lean protein
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healthy fats and oils.
Added sugar, salt, saturated fats, and alcohol intake should be limited for good health. Some diets that may bring health benefits include the Mediterranean diet, dietary approaches to stop hypertension (DASH), and the U.S. Department of Agriculture (USDA) Healthy Eating MyPlate approach.
Food as medicine
“Food as medicine” is a practice built on the knowledge that food and diet play important roles in disease prevention and management.
There is no single definition of the “food as medicine” concept, but it generally refers to prioritizing food and diet in an individual’s health plan, with the goal of either preventing, reducing symptoms of, or reversing a disease state.
It is focused on the increased consumption of a variety of whole, minimally-processed plant-based foods, and limited intakes of highly processed foods rich in added sugar, oil, and salt.
Foods that proponents claim have medicinal properties, often due to supposed high levels of a particular micronutrient or biomolecule — sometimes referred to as functional foods — are of particular interest by people who consider food as medicine.
These include a variety of herbs and spices, legumes, nuts and seeds, whole grains, and fruits and vegetables.
The “food as medicine” approach to health management challenges the construct of conventional medicine, which relies primarily on technological medical advancements to manage health and disease with pharmaceutical drugs.
It is worth noting that conventional, Western medicine does prescribe dietary and lifestyle changes as a first-line treatment for some conditions, notably polycystic ovary syndrome (PCOS).
However, the focus is on the balance of macronutrients in the diet, and there is as yet little clarity as to what that should look like in humans, as outlined in a paper published in Nature
Benefits
Here are some benefits of a “food as medicine” healthcare approach.
Disease management
Medical nutrition therapy is a part of evidence-based health practice that uses diet and food to support the treatment of diseases, and it is a clear demonstration of the role that diet and food play in managing chronic disease. For instance, an increase in dietary fiber supports lower blood sugar levels in persons with pre-diabetes or diabetes, reducing the occurrence of nerve and blood vessel damage associated with high blood sugar levels. Improvements in diet quality can also reduce disease symptoms and improve quality of life.
One study suggests that a modified Mediterranean diet can reduce pain, fatigue, and discomfort in persons with lipoedema, a condition where there is an abnormal accumulation of fat in the lower extremities.
Likewise, observational studies identified that a healthful diet during breast cancer treatment may reduce negative symptoms caused by cancer treatment, including nausea, vomiting, and loss of appetite.
Cost-effective
The prevalence of chronic diseases has increased worldwide, along with associated healthcare costs.
In 2010, an estimated 86% — over $400 billion — of healthcare costs in the U.S. alone were due to treating patients with at least one chronic disease. These costs are shared between public resources and patients’ out-of-pocket expenses.
Using “food as medicine” could conceivably reduce healthcare costs by potentially reducing disease severity through better labwork, fewer medications, and fewer hospitalizations.
However, the issues and policies surrounding food apartheid and access to healthful foods among low-income communities across the U.S. that support improved health and lower healthcare costs must continually be addressed.
Limitations
“Food as medicine,” however, is not an approach without flaws. Here are some of its limitations.
It is not a cure-all
“Food as medicine” is not a stand-alone remedy for all health conditions.
The development of chronic diseases continues to be complex and may be attributed to non-diet-related causes, including genetic risk, exposure to environmental toxins, or autoimmune conditions.
Thus, while “food as medicine” may support disease management by improving symptoms and slowing disease progression in some diseases, it must not be used as a stand-alone treatment, rather in conjunction with appropriate medical therapy.
Fueled by misinformation
Social media can be an effective source of health promotion among health professionals and organizations. However, it can also be a source of misinformation and sharing of unverifiable information, especially where “food as medicine” or alternative medicinal therapies are concerned. As outlined in Food Isn’t Medicine by nutritionist Dr. Joshua Wolrich, the vilification of individual foods can lead to unhealthy eating behaviors.
Drug-nutrient interactions
It is also important to consider how foods interact with medications. This is referred to as drug-nutrient interaction, which may enhance or interrupt the effect of a medication in the body.
A common example is grapefruit juice, which doctors often advise should be avoided when taking some medications, although some research shows that it may enhance the effect of cholesterol-lowering statins.
Drug-nutrient interactions must be considered for the seamless relationship of “food as medicine” and appropriate medical interventions in the best interest of patient care.
The bottom line
“Food as medicine” may be an emerging concept in the Western world, but many cultures around the globe have long recognized the role of diet in health.
Various healthy diets high in fruits, vegetables, whole grains, nuts and seeds, lean protein, and low-fat dairy could reduce the risk associated with the development of chronic diseases, including heart disease, and type 2 diabetes.
However, “food as medicine” is not a cure for all and should be used in conjunction with appropriate medical treatment.
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