Food Isn’t Medicine

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No, no and absolutely not - NHS doctor and nutritionist Joshua Wolrich is on a mission to set the record straight.

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 a practice built on the knowledge that food and diet play important roles in disease prevention and management. The reason why we use food as medicine is because healthcare needs to shift,” he says. “Within healthcare itself, healthy food and honestly just healthy physical activity does not get anywhere near enough attention it should get.” 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. Social and economic factors aren’t the only health determinants that are somewhat out of an individual’s control. We all have unique genetic predispositions—some people are simply born more at risk for certain conditions, like heart disease, than others. Environmental factors also play a role. Sunlight, dust, chemicals, metal, plants, animals, and other things we’re exposed to daily can contribute to the onset of pretty much every illness, from kidney disease to infertility to skin cancer. And of course, disease can be random. A 2017 report in Science found that about two-thirds of cell mutations that lead to cancer are caused by random DNA replication errors, while only a third are caused by inherited genes, environmental factors, or behavior. (Although yes, some cancers are more directly linked to behavior; for example, smoking is the primary cause of lung cancer.) Even diseases that are more strongly linked to lifestyle, like type 2 diabetes and heart disease, can occur in people with no known lifestyle risk factors.The point here isn’t to totally discredit nutrition. Of course a nutritious diet can positively impact your health! The Dietary Guidelines for Americans state that a healthy dietary pattern is associated with a lower risk of certain chronic diseases, including type 2 diabetes, heart disease, bone disease, breast cancer, and colorectal cancer. But they never claim that any dietary pattern alone, like Whole 30 or paleo, can prevent or cure disease. And they never mention superfoods, because these don’t exist—no one food has the power to make or break your health. “Food can be used to prevent onset of a disease up to a certain point,” Johnson says. But again, there are no guarantees because of all the factors at play. It's refreshing knowing there's a doctor out there fighting to break down a lot of the shame-driven decisions we make, and that food holds no moral value over us. Sarah Nicole Landry (@thebirdspapaya) Decades of scientific findings support the integral role of diet in health management, which should not be understated. Today, he's a passionate advocate of health and every size and keen to bust the endless myths about what we consume and how we consume it, restrictive eating and ‘cure-all’ supplements or diets.

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. 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 is the case with disease prevention, food plays a supporting role in the management of certain diseases. Medical nutrition therapy (MNT) is “the evidenced-based approach to treating medical conditions with food,” says Clara Nosek, a dietitian based in Modesto, California. Dietitians are trained in MNT, and there are myriad applications for the approach. In some cases, short-term dietary changes can treat an acute (short-lasting and sudden) condition; Nosek gives the example of reducing sodium intake to help reverse edema, which is swelling caused by excess fluid trapped in your body’s tissues. In other cases, long-term dietary changes can help someone manage a chronic (long-term and often lifelong) condition. Johnson points out that those with celiac disease must completely avoid gluten to prevent long-term intestinal damage and other negative side effects. Similarly, someone with diabetes might use diet as part of their strategy to manage blood sugar. Some uses of MNT are even more clinical, like feeding someone through a tube or an IV if they’re unable to consume enough by mouth. Social media can be an effective source of health promotion among health professionals and organizations. Dr Joshua Wolrich routinely does an incredible job of sorting fact from toxic fiction. A must-read for those wanting to unlearn the toxic ideologies and beliefs we have been taught about ourselves by the diet industry! Stephanie Yeboah (@stephanieyeboah)They’re a little bit further ahead than us in terms of using this food-as-medicine concept and providing healthy meals and groceries to particularly disadvantaged communities,” Lambert says. She would like to see these approaches aimed at Australians with health conditions such as type 2 diabetes and high blood pressure, and those who are overweight or obese, “because those three big diseases drive the majority of chronic illness in Australia”. 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. All of this disproves the notion that eating a certain way, or a certain food, can eliminate the need for health care and medicine. The fact that disease can (and almost certainly will) occur no matter what you do might be a tough pill to swallow. But Johnson explains that it can also bring relief in that you can stop blaming yourself for your health problems or micromanaging your eating habits in the name of disease prevention. Nutrition Is Just One Tool Since the UNSW study ended, Emma has been missing it – especially when something as simple as a lettuce became unaffordable. “I really miss those basic things – I miss broccoli, cauliflower, all of that,” she says. She has reverted to some of her old “stodgy” foods, because they are cheaper.

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 — an underlying risk factor in the development of heart disease, type 2 diabetes, poor gut health, and other chronic diseases. 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. The simplest approach would be to subsidise access to fresh vegetables. “[Vegetables] have such a powerful effect from a health perspective, yet there is such a common perception that they’re unaffordable – and these days they potentially are in some communities,” Lambert says.

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).

Both MNT and a nutritious diet can help improve health outcomes, but neither is a replacement for health care. (In fact, MNT is typically provided by a dietitian, which means that it’s a form of health care.) The best way to catch and treat potential problems early on is by scheduling regular visits with your primary-care provider. 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. I love Dr Joshua Wolrich because of his no BS drive to make the world a better place. His advocacy mixed with his knowledge is wonderful. Kenzie Brenna (@kenziebrenna)

Nutrition Is Just One Tool

A voice of reason in a field of fake news. Honesty, integrity and compassion shine through everything he writes. The only medical doctor I've ever allowed on my timeline. Megan Crabbe (@bodyposipanda) 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 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 At best, these claims blow small bits of evidence way out of proportion—sure, raisins contain nutrients that can contribute to healthy blood pressure, but eating them won’t magically cure hypertension. And at worst, the claims are pseudoscience. Yes, food contributes to health and plays a role in the prevention and management of certain diseases, but food isn’t medicine, and no diet can replace good health care. We Can’t Always Control Our Health