Food as Medicine: What It Means and How to Reap the Benefits

You know your diet plays a huge role in weight and energy, and even your mood. But did you know it could help save your life, too?

That’s the whole idea behind the “food as medicine” movement — a philosophy that has roots in the HIV epidemic and began in the 1980s, when public health advocates launched nutrition programs to aid management of AIDS.

Now, many people are catching on to the notion that certain eating styles have the potential to influence disease prevention, too, not to mention influence quality of life, health, and longevity.

“We have known for literally decades that 80 percent of all chronic disease and premature death that happens in the world around us is completely preventable just by routine physical activity, not smoking, and eating optimally. The only complicated variable in that is eating optimally,” says David Katz, MD, founder and CEO of DietID in Detroit, and past president of the American College of Lifestyle Medicine.

If you’re interested in the why and how of these benefits, look no further. Whether you’re hoping to help fend off a disease or manage one you already have, or simply eat healthier to look and feel better, these days there’s no shortage of resources that can enable you to take advantage of using food as medicine.

How a Healthy Diet Can Help Keep Disease at Bay

What types of food usually fill your plate? The answer can play a major role in your risk for future chronic disease.

After all, each year poor nutrition is responsible for 11 million global deaths from ailments such as cardiovascular disease, certain types of cancer, and type 2 diabetes, according to a study published in April 2019 in The Lancet.

Meanwhile, in the United States, its estimated 900 deaths per day from heart disease, stroke, or type 2 diabetes could be the result of poor diet, according to a study analyzing the association of diet and heart-metabolic linked deaths published in March 2017 in the Journal of the American Medical Association. Young, Black, Hispanic, and relatively less-educated people are more likely to die due to poor diet, the authors wrote.

Generally speaking, the characteristics of a poor diet include consuming too much sodium, meat (especially the red or processed variety), and sugar-sweetened beverages, or not eating enough fruits, vegetables, nuts and seeds, whole grains, polyunsaturated fats, and seafood-based omega-3 fatty acids.

Certain diet plans are scientifically supported to help prevent many chronic diseases. Dr. Katz points to research on the heart-healthy DASH diet, which has been shown to lower blood pressure and LDL cholesterol, per the National Heart, Lung, and Blood Institute. He also cites the plant-based Portfolio diet, which when combined with a low-fat regimen has been shown to lower potentially harmful low-density lipoprotein (LDL) cholesterol and lower cardiovascular disease risk, according to a review published in the May–June 2018 issue of Progress in Cardiovascular Disease.

Similarly, some research, such as a study published in September 2015 in Alzheimer’s & Dementia, has shown that the MIND diet, which focuses on combining tenets of the DASH and Mediterranean diets, may play a role in warding off Alzheimer’s disease, the most common type of dementia. On its own, the Mediterranean diet — an eating approach that includes produce, whole grains, fish, olive oil, dark chocolate, and some red wine — may help lower your chances of developing conditions including Alzheimer’s and Parkinson’s disease, certain types of cancer, and heart disease, as the Mayo Clinic notes.

Katz further cites the Diabetes Prevention Program, which showed that a 7 percent weight loss, achieved through a low-fat diet and exercise, lowered blood sugar and reduced the rate of developing type 2 diabetes in individuals with prediabetes by 34 percent. “Diet truly is medicine, not just prevention, not just health promotion — literally treatment and reversal of disease,” says Katz. 

In the same vein, healthy plant-based diets that are higher in whole grains, fruits, vegetables, nuts, legumes, including the Mediterranean diet are linked to numerous protective benefits. According to a 2019 study published in the Journal of the American Heart Association, this includes a lower risk of cardiovascular disease, as well as lowered risk of death from all causes.

Using Food to Manage Disease Stems Back to Early Grassroots Efforts

As mentioned, the roots of the food as medicine movement on a grassroots level stem back to the ’80s. For these programs, food has primarily been used as a means to manage, not prevent, disease.

The members of the Food Is Medicine Coalition (FIMC) are among those who have been at this movement the longest. The FIMC is comprised of nonprofit food and nutrition service organizations that focus on providing “complete, evidence-based, medical food and nutrition intervention to critically and chronically ill people in their communities.”

Many coalition members started as HIV service organizations during the early days of that epidemic, says Lisa Zullig, RDN, director of nutrition services for the New York City–based coalition member God’s Love We Deliver. Her organization and others evolved to serve other people with chronic and serious diseases that come with special nutrition requirements. God’s Love We Deliver alone cooks and home-delivers more than 2.2 million medically tailored meals each year for people whose diseases prevent them from shopping or cooking for themselves.

Altogether, coalition member organizations serve over 12 million meals to 57,000 people across the nation, according to an FIMC press statement. Of those served, 35 percent are living with HIV or AIDS, 18 percent with cancer, 12 percent with cardiovascular disease, and 11 percent with diabetes as their primary diagnoses. Many live with more than one diagnosis, though.

A wealth of research suggests using food in conjunction with traditional care, such as medication and surgery, to help manage disease is a worthwhile effort. Diseases that you can improve with diet changes include everything from diabetes and chronic kidney disease to cancer and gastrointestinal diseases like ulcerative colitis and Crohn’s, notes the National Institute of Diabetes and Digestive and Kidney Diseases.

Fad Diets for Medicine: Yay or Nay?

That said, not all eating styles are created equal. These days, more people are trying fad diets on their own in hopes of improving a health condition, losing weight, or promoting general well-being, like increasing energy, improving sleep, or eliminating so-called brain fog.

But unlike with the aforementioned programs run by FIMC, there isn’t always rigorous scientific research to support trying a given diet plan for the desired result. And many people are going it alone when making diet changes, which may offer the desired result in some cases, while in others it may do nothing or pose harm.

For example, the number of people in the United States who adhere to a gluten-free diet without having celiac disease — an autoimmune condition that disrupts the digestion of proteins found in certain cereal grains, such as wheat — tripled between 2009 and 2014 to 2.7 million, according to a 2016 research letter published in JAMA Internal Medicine. This is despite that there isn’t much evidence that the diet helps people who don’t have formally diagnosed celiac disease, according to an article published in February 2018 in Gastroenterology & Hepatology.

Likewise, the ketogenic diet remains one of the most popular diets for weight loss, and it has gained a reputation online for treating certain diseases as well. While it’s been shown effectiveness for treating epilepsy in children, and is now being used in some adults, as January 2019 research in Frontiers in Neuroscience shows, other health uses are more controversial. Still, some programs, such as the Cleveland Clinic’s therapeutic ketogenics program and the telemedicine company Virta’s individualized nutritional therapy program, argue that with medical supervision, the ketogenic diet can be a sustainable way to help individuals better manage type 2 diabetes.

If restrictive diets like these are helpful for you and your doctor okays them, great. However, Katz emphasizes that it’s important not to get too drawn in by the idea that specific food (or food group) or the lack of it is a magic bullet. “This is a classic instance of missing the forest for the trees. You know, inevitably what gets the most marketing is somebody’s tree. So, just eat this superfood and all will be well. The reality is the really strong predictions come from dietary patterns.”

Instead, for optimal health, he says, “All of the best themes, or rather, all the best variants on a theme of optimal diet share the following: They are mostly made up of unprocessed or minimally processed whole plant foods. So, lots of vegetables, fruits, whole grains, beans, lentils, nuts, seeds, and plain water, preferentially, for thirst. And that’s pretty much, full stop.”