Medication, not wholesome meals, remains to be one of the best drugs

Late last year, Whole Foods CEO John Mackey went live on the Freakonomics podcast, claiming Americans don’t need better access to health care. Instead, he said, “The best solution is not to need medical care. The best solution is to change the way people eat, how they live, their lifestyle and diet. “People weren’t happy. You can probably imagine why: Mackey’s chain is expensive as hell. Eating only whole, nutritious foods is financially (and physically) unreachable for many. In 2020, 15 percent of Americans were affected by food insecurity, which meant they couldn’t afford enough food to lead active and healthy lives.

But Mackey is far from the first to suggest that certain lifestyle habits, especially eating the “right” foods, can ward off or cure health problems. Dr. Oz, a controversial but popular doctor whose talk show reached over 20 million people last year, repeatedly touts things like “superfoods to fight cancer.” He even wrote a bestselling book on the idea that “simple, healing, healthy eating” is a “cure for everything from fatigue to stress to chronic pain,” the editor concludes. And there are numerous articles on the Internet such as “10 Amazing Disease Fighting Foods” from WebMD and “16 Foods to Cure Common Illnesses” from the Active website.

At best, these claims disproportionately break small evidence – sure, raisins contain nutrients that can contribute to healthy blood pressure, but eating them doesn’t magically cure high blood pressure. And at worst, the claims are pseudoscience. Yes, food contributes to health and plays a role in the prevention and treatment of certain diseases, but food is not medicine and no diet can replace good health care.

We cannot always control our health

Mackey’s proposition about diet and lifestyle replacing health care is based on the extremely imprecise assumption that our behavior alone affects our health outcomes. In fact, health behaviors – eating, physical activity, smoking, alcohol and drug use, and sexual activity – are just one of many determinants, accounting for around 30 percent of a person’s total health outcomes from the New York Academy of Sciences, according to a 1999 strategy paper published in the Annals Often cited by health professionals and policy makers. Genetics, the environment, and clinical care (including medicine) also contribute, but social and economic factors – income, education, social support, and the experience of racism and other stigmatizations – are by far the most important factors, accounting for about 40 percent of health Results of a person, according to the same research.

“Food cannot interfere with the profound effects of living in chronic poverty or the physical responses to microaggression that many minorities face in their daily lives,” said Christyna Johnson, a Dallas-based nutritionist. A paper published in American Psychology in 2007 describes microaggressions as brief and everyday indignities directed against people of color whom the perpetrators normally do not know about. Examples include a white woman clutching her purse when a black man approaches, or a shop clerk closely monitoring a customer with paint. Several studies, including a 2017 analysis in social sciences and medicine and a 2019 study in psychoneuroendocrinology, have found that racial discrimination increases a person’s risk of developing chronic diseases. This probably has something to do with stress. “Racial differences in exposure (e.g. experiences with racial discrimination) … stimulate pro-inflammatory processes that can contribute to different health outcomes,” the authors of the 2019 study wrote.

Johnson also believed that food could be a person’s best medicine. “But through personal and professional experience, I’ve found this to be short-sighted at best and really rooted in elitism,” she says. A millionaire CEO of a “healthy” chain who tells people that if they only eat nutritious foods (which may or may not be accessible to them) they would not be so fixated on affordable health care perfectly exemplifies Johnson’s argument.

Maybe you were born with it

Social and economic factors are not the only health factors that are beyond an individual’s control. We all have a unique genetic make-up – some people are simply born at a higher risk for certain conditions, such as heart disease, than others. Environmental factors also play a role. Sunlight, dust, chemicals, metal, plants, animals, and other things we are exposed to on a daily basis can contribute to the occurrence of virtually any disease, from kidney disease to infertility to skin cancer. And of course, illness can be accidental. A 2017 scientific report found that about two-thirds of cell mutations that lead to cancer are caused by random DNA replication errors, while only one-third are caused by inherited genes, environmental factors, or behavior. (Although yes, some cancers are more directly related to behavior; for example, smoking is the leading cause of lung cancer.) Even diseases that are more lifestyle related, like type 2 diabetes and heart disease, can occur in people with no known Lifestyle risk factors.

All of this belies the notion that eating some kind or 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, can be a difficult pill to swallow. But Johnson explains that if you can stop blaming yourself for your health problems or micromanaging your eating habits in the name of disease prevention, it can also bring relief.

Diet is just a tool

The point here is not to completely discredit diet. Of course, a nutritious diet can have a positive effect on your health! The nutritional guidelines for Americans state that eating healthy habits is associated with a lower risk of certain chronic diseases, including Type 2 diabetes, heart disease, bone disease, breast cancer, and colon cancer. However, they never claim that a diet alone, like Whole 30 or Paleo, can prevent or cure disease. And they never mention superfoods because they don’t exist – no food has the power to improve or harm your health. “Food can be used to prevent disease from occurring up to a point,” says Johnson. But here too, due to all the factors, there are no guarantees.

As with disease prevention, foods play a supportive role in treating certain diseases. Medical Nutritional Therapy (MNT) is “the proven approach to treating disease with food,” said Clara Nosek, a Modesto, California-based nutritionist. Dietitians are trained in MNT and there are innumerable uses for the approach. In some cases, short-term dietary changes can treat an acute (short-lived and sudden) condition. Nosek gives the example of reducing sodium intake to reverse edema that swells from excess fluid trapped in the tissues of your body. In other cases, long-term dietary changes can help someone cope with a chronic (long-term and often lifelong) condition. Johnson points out that those with celiac disease must avoid gluten entirely to avoid long-term bowel damage and other negative side effects. Similarly, someone with diabetes could use diet as part of their blood sugar control strategy. Some uses of MNT are even more clinical, e.g. B. feeding a person by tube or infusion when they cannot consume enough by mouth.

Both MNT and a nutritious diet can help improve health outcomes, but are not a substitute for health care either. (In fact, MNT is usually provided by a nutritionist, which means it’s some form of health care.) The best way to identify and treat potential problems early on is to schedule regular visits to your family doctor.

In the truest sense of the word, food is not medicine. No matter what Dr. Oz in this article implies arugula does not “fight” lung cancer and tahini does not “boost” your immune system. In contrast, medicine has the ability to treat or cure health conditions. Insulin injections are crucial in the management of type 1 diabetes, while eating habits can only go so far. Chemotherapy and radiation can treat colon cancer by killing cancer cells, but a high-fiber diet can’t do any of these things and may not even help prevent it. Fruits and vegetables do not reduce the risk of contracting an infectious disease like COVID-19, while vaccinations do. Diet affects health, but it is nowhere near as effective as medicine at treating disease.

Main Photo: Stephen Simpson / Getty

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