Food as Medicine needs a new name.

Thanks to quick algorithm hacks that made me feel I mattered, because usually I see no rhyme or reason to my feeds, more and more “Doctors” and “Experts” are weighing in about how the Food as Medicine (Some will say Food is Medicine, which encapsulates the same perspectives on both sides.) concept is wrong, harmful, expensive, not as researched, and not as good as modern medicine. I have not seen any of these people, yet, defend the idea for what it really is.

First off, when talking about food, I do want to point out that foods that can be eaten safely are neither bad or good, they are on a spectrum of health. If you have come this far in reading and would claim that kale (which I will use to represent healthy foods) is not a healthy food, or that bacon (which I will use to represent unhealthy foods) is a healthy food, then you can quit now and find something else here to spend your time on. But if you can agree with me, and billions of other people, that kale is healthy and bacon is unhealthy, then we can proceed.

Using food as medicine as has been practiced for centuries, millennium some would say. We have been using things we can ingest safely to help feel better when we are sick, help mend our injuries, and help prevent illness. I am not going to go into all of the history and talk about how aspirin came from a plant. We have heard and read all about that hundreds of times. And this is not the perspective that those for and against Food as Medicine are talking about. If you are recovering from an injury, are training for an athletic event, or want to decrease your “menopause middle”, you can find thousands of experts, both legitimate and not, telling you to get more protein in your diet. THAT is Food as Medicine. THAT is NOT part of the debate. Why not? We are using protein in food, or a substance manufactured to replace food, as a medicine to help us build muscle and heal, gain strength, and/or lose weight. (And yes, I do know that it is the exercise, the physical activity, that actually helps just as much or more than the protein intake, but protein intake does its job.)

What the debate is about is that apparently some people are taking Food as Medicine to mean that they can ditch their prescribed medicines and just eat certain foods. No where in legitimate medicine does Best Practice, evidence based medicine, or Standards of Care, tell healthcare professionals to disregard the benefits of medications and advocate for a certain eating pattern (AKA diet) of certain foods, or just the consumption of one or two particular foods and food groups, to help treat a condition. For some conditions early in the diagnosis it is Standard of Care for healthcare professionals to discuss diet, like they would exercise or physical therapy, cutting back or cutting out alcohol, smoking cessation, or stress management in the form of seeking out mental health therapy. But much of modern day medicine is practiced in a way that skips over this step, or glosses over it at the most. They do this not because they don’t know the importance of a healthy lifestyle or diet as the first prescription, but because of decades of the healthcare system, separate from the practice of healthcare, has been molding what it wants the practice of medicine to be in the name of efficiency, customer service, profits, and what is best for business medicine. Business medicine is masquerading itself as what is best for medical practice.

But I do not want to go down the path so many other healthcare professionals have in these kinds of forums and bitch and moan about our healthcare system and its flaws as much as I want to spend time on the understanding of what Food as Medicine is and can better become, in name, and in influence. However, I will say that one thing that has been lacking in the conventional medicine that the great majority of us healthcare professionals practice, and patients experience, is the lack of listening or being heard, respectively. It has taken decades of passing down eroded bedside manner as the norm, and the knee jerk to medication and procedures as our treatment of choice, that we are coming to the pinnacle of our achievement with both healthcare professionals and patients saying there has to be a better way.

But which way will win out? Conventional, historical, modern day medicine? That which has been built by all of us together over the years with behind the scenes puppeteering by major insurers and the idea that American healthcare has to appear to be the best by how much it spends on looking like it is the best. Or will this current bubble of consumerism, influencer, manufactured facts win out? The type built around the notion that we are all alike and we all can eat a very prescribed way, take a certain supplement, drink a manufactured food that doesn’t conform to the established scientific facts but evades truth by also sounding scientific, and fads that tells us that all of our conventional truth is false. Finally, will it be conventional truth, the boring stuff, the hard stuff? What we have known for a long time, and are honestly actually craving, will and should win out.

What we have known all along is that food, in its wholest, simplest, cheapest form will and should win out. All the efforts into making the conventional unconventional are just to make someone other than you money. All those efforts are for you to spend money on the bacon and to believe it is healthy. In the process, some spend more time and effort working to discredit even those who have spent careers advocating for our best choices in good faith, than to sit and listen. Isn’t that what we want our doctors to do? So why aren’t we doing this for each other? Just sit and listen.

Listen to this, or sit and read this. Decades of research has proven that a diet that is plant based and made up of whole foods beats all others when it comes to health. I am not going to spoon feed you links, anyone can search Pubmed themselves. There is no study that can claim that for the majority of people, the majority of their lives, regardless of condition, that a supplement or manufactured food can improve health to the extent a sustained whole food, plant based eating pattern can. Getting your “Plant based” out of manufactured food might have to be the vape stick bridge for some, and that can be part of any personalized transition if that is what is chosen as the best route to take between them and their healthcare provider.

Kale wins over bacon. Not a new concept.

But we must not jump to conclude that what we eat is a replacement for all else. Our decisions to eat this over that is one, albeit large, piece of the health puzzle we make every day. These decisions can be for better, or worse. They can be influenced and not our own, or they can be ours.

Some of us have limits in our choices due to budget, time, availability, who we live with and eat with, who we make food for, food allergies, food intolerances, culture, sleep patterns, stress levels, energy needs, and medications. We also make choices based on who and what we have allowed to influence us, what we read on line, what we choose to read in books, listen to in podcasts or on the radio, friends and family. But notice I did not list that our food choices have to do with taste, texture, temperature, or satiation. All food choices have these things in common and so they are common denominators in our choices, in both kale (healthy) and bacon (unhealthy), and are not limitations.

Food as Medicine uses the knowledge of the research on diets, food choices and the limits that influence them for each person, and healthcare professional practices to help both healthcare professional and patients, as well as the communities they live in, make healthier food choices. This practice takes into account the patient as a person using insights about their limitations, current diet, medical history, and goals, and helps to provide accommodating education and support so that the patient can have control over their health thought diet. This all is in additional to available treatment plans that fall within the Standards of Care for a patient’s current condition. Food is a medicine just as much as the statin, the cath, the insulin, the GLP-1, etc. When it can be part of the treatment plan, the patient is included in the goal formation, agrees to the plan, and can accommodate the change.

Food as Medicine is not a replacement of medicine or procedures. It is an opportunity. An opportunity for a patient to have a personalized, sustainable, and cost effective adjunct to our health that is also empowering and doesn’t get in the way of other treatments that are also part of our evidence based Standards of Care. It is an opportunity for healthcare professionals to gain satisfaction in practice, empowerment to be a positive influence, and have an extra card to play when a patient is in the early stages and wants to stave off needing medicines or a procedure.

As time goes on, there has been and will continue to be people who have changed their eating patterns from one to another and have seen dramatic health changes often times to the same extent as which their diets were changed. Would anyone be surprised to hear that a young person entering adult life on their own, who finally has choice in all eating, and chooses fast food, ultra processed food, and a few beers a night as their primary diet would end up with negative health consequences? Especially if this young person was coming from living with their parents, eating most meals at home, and not drinking alcohol? Why then would it seem implausible that the opposite would be true? If this young person, after a few years of eating and drinking in the way most of us would agree was unhealthy, was diagnosed with pre-diabetes and hypertension, could they now reverse these conditions with diet? Could their healthcare provider help them though this with knowledge of Food as Medicine? Would any of us be surprised if this young person, switching to a diet the opposite of fast food, ultra processed food, and alcohol, like one that is whole food and plant based, did get healthier and was then reversing their pre-diabetes and hypertension?

What if this same person is now not so young and kept on eating and drinking fast food, ultra processed food, and had similar alcohol consumption for a few decades? Would anyone be surprised if they now had diabetes dependent on insulin, cardiovascular disease and renal disease as a consequence of their long standing hypertension? Even if they went to their healthcare provider and their healthcare provider was following Standards of Care and Evidence based algorithms for all of the person’s prescriptions, procedures, consultations, etc.? Even if the person followed all the recommendations to take their medications and follow up, would anyone be surprised if their progress towards continued ill health mapped out this way?

I sure am not surprised. This scenario is 85% of what our healthcare system sees every day. Patients like this person can and do follow the rules and want to. But if we tell them that Food as Medicine is a non-starter because we don’t want to give them the impression that either it can’t work for them, we have no confidence in them, or that it is a false practice as food can’t replace medicine. Of course it can’t. It is not supposes to. If anyone needs not to be misinformed, it is the healthcare professionals.

Can food cure cancer? No. Can food cause cancer? Yes. Can food help decrease cancer risk, or help a patient cope with Standard of Care cancer treatment? Yes. Can food cure Crohn’s disease? No. Can food make Crohn’s symptoms better or worse? Yes. Can food cure arthritis? No. Can food make inflammation worse? Probably. Does this need more research? Sure. Do we need more research into thousands of other conditions and their possible treatments? For sure.

Food as Medicine is the concept that what we put into our bodies is just as important to health for better and worse than the next thing. Whether it be prescription medicines, over the counter medicines, supplements, food, drink, injectable drugs both legal and illegal, and anything we inhale, it is all important to consider. Food as Medicine is the consideration of food as being as important at the very least.

Knowing all of this, does Food as Medicine need a name change? Or does the masses need a re-education? Do those of us who have done the work of certification and practice in one of the main fields that Food as Medicine has become a prominent pillar need to up our game? Or is this just another reason to change our healthcare system into a constructive one that gives credibility to Food as Medicine and the time and attention needed to apply it as it gives to writing prescriptions and scheduling procedures?

For anyone thinking of changing their diet, their eating pattern, in any major way towards whole foods and plant based, or towards fast and ultra processed foods, please let your healthcare provider know. Maybe they would not know what to do with this information, but maybe they would. If they don’t listen, one reason could be that they don’t know what to do with the information or your interest and they could be a product of the decades old healthcare complex, so it is not all their fault. But one big reason to let them know is that making decisions about health in isolation, especially if you have chronic illness or are on medications, can be worse.