Food Isn’t Medicine

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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) Food as medicine” is a practice built on the knowledge that food and diet play important roles in disease prevention and management.

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. The prevalence of chronic diseases has increased worldwide, along with associated healthcare costs. 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. So if those factors, and the other privileges I have give me the ability to influence, then I'm pleased to do that." Emma was one of the study participants. “I would open up these boxes and it was things that I hadn’t eaten in a long time or things that I just didn’t think were an option,” she says. Instead of a burger for breakfast, she started eating fruit; instead of chips, she had nuts and seeds.

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. Vegetables ‘have such a powerful effect from a health perspective, yet there is such a common perception that they’re unaffordable’, says Dr Kelly Lambert. Photograph: Diego Fedele/AAP However, there is some unconscious bias that slips through that muddies the waters. Most conclusions are from the view that no diet can ever work in the long run but there is very little about the importance making long term lifestyle changes. Nearly all of the discussions are about "weight loss" without distinguishing "fat loss" as a different thing.

Emma’s type 2 diabetes diagnosis turned her life upside down. “It is like having a baby that never grows up,” she says. “It is nagging at you as soon as you wake up.” Every single morsel of food has to be carefully chosen in case it sends her blood sugar levels spiking, which could cause her to pass out or worse. This book is exactly what we need right now. In a world where misinformation is spread easily online, it's brilliant to have a knowledgeable doctor like Josh cut through the scaremongering and diet culture that we see every day. It's definitely a must have! Lucy Bee (@lucybeecoconut) Healthy food is not just important for diabetes, says Prof Jason Wu, a University of New South Wales nutrition epidemiologist and head of the nutrition science program at the George Institute for Global Health in Sydney. He says many of the “top killers” in western societies, from diabetes to cardiovascular disease and some cancers, are linked to lifestyle “and diet is really one of the major causes”. 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:

Nutrition Is Just One Tool

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. Josh is a beacon of truth in a sea of misinformation when it comes to nutrition and wellness. He approaches every topic with evidence, rationality and empathy and his presence on the internet is much needed. Alice Liveing (@aliceliveing) 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. 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. Advocates believe better targeted, supported and funded prescriptive approaches are needed and that’s where the idea of food as medicine comes in. Wu and colleagues recently conducted a study involving 50 people with type 2 diabetes who were finding it hard to afford enough food. The group were “prescribed” a free box of fresh fruit, vegetables, wholegrains, lean meats and dairy – delivered to their home every week. They also had regular access to a dietician and were given recipes and advice on how to prepare healthy food using the ingredients.