What’s Wrong with Talking About “Food as Medicine”

Some credit Hippocrates with the saying, “Let food be thy medicine and medicine be thy food.”

With the spread of messages and health promotion programs using the food as medicine slogan, you may have seen an uptick in headlines and social media posts with a contrary message: “No, food isn’t medicine. It’s food.”

When you read a little further, most of these articles don’t dispute that nutrition contributes to health. The disagreement is over how the food as medicine message gets extended.

Healthy Eating Habits Don’t Mean You Can Forget Medical Treatment.
The major problem with “food as medicine” occurs when people interpret it to mean that if people eat well, they will never develop a health problem like cancer . . . or if they do, they can fix it with diet alone.

Reports have shown that misinformation in the media (especially social media) has led many people astray by suggesting that certain foods or diets can cure cancer, sometimes even prompting them to skip medical treatment. Research does not support such claims.

Research shows that with healthy eating habits, you can reduce the risk of cancer, as well as heart disease and diabetes. A healthy lifestyle—combining healthy eating with avoiding tobacco, limiting alcohol and getting regular physical activity—can prevent about 42% of today’s cancers. We can significantly decrease the cancer burden in our country. But healthy eating won’t stop it all.

No specific foods can prevent or stop cancer.
Research on the benefits of healthy eating has moved beyond a focus on single nutrients or compounds. And no single food can provide all the protectors that you get from an overall healthy eating pattern.

A pattern of healthy choices supplies a variety of vitamins, minerals, phytochemicals and dietary fibre that work together. It’s the overall eating pattern that is associated with a lower risk of cancer and better overall health.

Food as medicine does not mean that you should choose food like you’re going to a pharmacy.
Some advocates of “food as medicine” talk about planning meals or shopping for food as if your grocery list is a list of over-the-counter medications. This approach misses the boat on several levels.

First, evidence from laboratory studies showing the effects of a nutrient or phytochemical turning off expression of cancer-related genes or supporting antioxidant defences does not prove that a food containing that compound will have those effects in your body. As you can see from entries in AICR’s Food Facts Library, the intricate pathways of compounds in our body are much more complex than that.

Second, looking at food mainly as a pharmaceutical choice, is overlooking the bigger picture about food. Yes, food can promote health. Food is also a part of living and passing on cultural traditions. Food provides pleasure. Food offers a way to connect with friends and family. When we turn our view of healthy food into a search only for medicinal effects, we are losing some of the benefits it can provide for quality of life, and perhaps even for emotional health.

Food as Medicine Offers Important Potential
Evidence is now strong that eating habits can support health and reduce the toll of cancer and other chronic diseases.
Food can be a sort of medicine because it has the power to promote health.

A less-poetic tweak? Since no single food can offer this protection alone, perhaps the phrase should be, “diet as medicine.” But many people think of “diet” as a temporary fix that you go on and then go off. So maybe we should say, “eating habits as medicine.” Long-term eating patterns are where we are most likely to find health protection.

Healthy eating is part of—not instead of—healthcare. Sometimes healthy eating and an overall healthy lifestyle stop a disease from developing. Sometimes early warning signs or risk factors (like inflammation or high blood pressure) can be kept under control with healthy eating. Sometimes medical treatment is needed. When it is, that doesn’t negate the role healthy eating plays in supporting health. Healthy eating and medical care work together.

Healthy eating habits depend on what you do eat and what you don’t eat.
In his presentation at the latest AICR Symposium, Dr. Mozaffarian emphasized that eating habits affect health through foods that increase risk of chronic diseases and foods that protect it. Applying statistical modelling to evidence from research on diet and cancer, a group of scientists concluded that eating too little healthy foods—like whole grains, vegetables and fruits—seems to account for a larger portion of cancer risk than does eating too much unhealthy food.

Still, eating habits with excessive portions of red and processed meat and sugar-sweetened beverages as frequent choices, do increase cancer risk. 

Food as medicine does not depend on any specific diet or eating pattern.
AICR Recommendations show how to build healthy eating habits by including more foods that protect against cancer and limiting foods that increase risk when they’re too large a part of your diet. These Recommendations are like a blueprint that can be used to build eating habits that fit individual and cultural preferences and other health circumstances.

Because plant foods—whole grains, vegetables, fruits and pulses (like dried beans and lentils)—fill the largest part of your plate in the AICR blueprint, this style of eating is often called a plant-based diet. Some people may choose to eat only plants. But the Recommendations simply call for plant-focused eating habits.

Counting on “plants only” as the key to food as medicine overlooks crucial evidence showing that even a plant-based diet can be healthy or unhealthy depending on which plant foods you include. AICR Symposium presentations by Elizabeth Feliciano, ScD, SM, and Isaac Ergas, MPH, PhD, addressed what this may mean for people living with and beyond cancer. They discussed research about diet quality shortly after diagnosis of breast cancer and up to six years after diagnosis. Including more health-promoting plant foods (like whole grains and vegetables) and less unhealthy plant foods were each associated with better overall outcomes.

Food as Medicine in Context: It’s a Bigger Picture
Even as we talk about food as medicine and emphasise that we mean “eating habits as medicine,” the bigger picture is that it’s really “lifestyle as medicine.”

In his symposium presentation, Dr. Ergas shared results from his research showing that the most positive outcomes were seen when healthy eating was part of an overall healthy lifestyle. This is the message of the AICR Cancer Prevention Recommendations, which emphasize that the greatest benefit comes when healthy eating habits are combined with regular physical activity, avoiding tobacco and limiting or avoiding alcohol.

How  to Make Food as Medicine Work
Now you see that the “controversy” over food as medicine need not be much of a controversy, as long as its interpretation isn’t pushed beyond what’s supported by research.

As part of an overall healthy eating pattern and healthy lifestyle, the food you eat can help reduce risk of cancer and other chronic diseases, support recovery and be a delicious, enjoyable part of life.

Especially when a change in eating habits has you including unfamiliar foods, you need to learn how to prepare the foods in ways that fit your personal, family and cultural preferences. Check the AICR website’s recipe section to help you learn how to fix new foods, or old favorites in new ways. Step by step, you can find ways to include more whole grains, vegetables, fruits and beans.

Food can be medicine. Now let’s focus on how we can make it happen . . . individually and across communities.