Food is Not Medicine

rxI was at a party once and when a nice woman asked me what I did, I said I was a dietitian. She beamed and clasped her hands together and said, “Oh, that’s wonderful. Food is such medicine, isn’t it?”

I didn’t know how to respond at that moment. I was still recovering from years of restrictive eating, which had at one point taken the guise of “clean” eating, local eating, organic eating all for my “health” – when really I was just finding new ways to restrict for my weight. As I sautéed up a few stalks of chard in as little oil as possible, I would say things to myself like, “I’m gonna live forever!”

Obviously I cringe at that now. Why worry about living forever when the present is so miserable? That was my existence then – taking my medicine in the present in the hope of a longer future. I wasn’t happy then, so I was living as much in the future as possible.

But I couldn’t keep it up. Eating medicine is not as fun as eating food, and turning food into medicine is downright depressing. Food is food; it nourishes us, gives us energy, keeps us alive, and is necessary to our existence. Enjoyment of food is essential and here’s a great example of that: in a study from the 1970s, Thai and Swedish women were both given a traditional Thai meal1; the Thai women absorbed almost 50% more iron from the meal than the Swedish women, who were somewhat okay with the meal but felt it was too spicy. Then the traditional meals for both groups were pureed into mush and eaten. Guess what? Iron absorption for both groups decreased by 70% — even when eating their own traditional food. Why? Probably because for the most part, a pureed meal isn’t nearly as enjoyable as a non-pureed meal, especially if you’re not used to eating it that way. So, yes, enjoyment of your food is integral to good nutrition.

If you’re treating your food like medicine, holding your nose and shoving it in, or in a less extreme version, dutifully eating your “healthy” food but wishing you were having something else instead, you’re doing your body and your mind a disservice. The truth is, for most people, what you eat on a meal-by-meal basis is not as important as how you eat. Having a relaxed relationship to food, providing regular, reliable meals for yourself, allowing internal signals of hunger and fullness regulate your intake, and eating food you enjoy – otherwise known as eating competence  – actually helps you to be your healthiest self in respect to nutrition (I’ll explain more about eating competence in a future blog post). This is because people who approach eating this way tend to get the most variety in their diet, which ensures optimal nutrition.

Now, as a clinical dietitian, I do practice what is called medical nutrition therapy (MNT). There are certain disease conditions for which changing what you eat can help to manage that condition. But there is a big difference between disease management for people with disease vs. disease prevention for people with no disease. Eating low sodium your whole life will not necessarily stave off high blood pressure. Eating no carbs will not ensure you will never get diabetes. Many diseases have a genetic component, and eating a certain way does not guarantee that you will not get a disease. However, if someone is a competent eater, getting a variety of food reliably and enjoying their diet, this is the best disease prevention there is, since, as I linked to above, competent eaters have shown to be generally nutritionally (and socially and psychologically) healthier than non-competent eaters.

While diet can help manage conditions, it rarely cures them. Celiacs can strictly avoid gluten (which they must do) and live a very healthy life, but their condition is never cured by any particular food. People with hypertension can reduce dietary sodium to help manage their blood pressure, but there’s a whole host of other things they need to do too – exercise, manage stress, sometimes take actual medication. And you cannot cure cancer with food (I’m sorry, you just can’t). Food is important and will help keep someone with cancer alive because the body needs additional energy with a catabolic illness and while it receives actual medicine which really can cure. There is a reason we call this medical nutrition therapy and not medical nutrition medicine.

Unfortunately, I’ve seen food-as-medicine go wrong on too many occasions. One of my patients (a meat-eater) with MS was told by his doctor to go vegan to help manage his disease (for which there is some limited evidence). He did so, then gained 50 pounds and developed elevated off-the-charts triglycerides. He went back to his doctor who again said, “Go vegan!” to which he replied, “I already did!” After that, he switched to a different diet style he liked better that still managed to include lots of fresh vegetables, returned to his previous usual body weight, ended up with normalized lipids and generally felt pretty good. I’m not maligning vegan diets; it’s the diet-as-prescription mentality that can be the problem. A diet you don’t love is not good medicine. Too often, because of this food-prescription mentality, many of my patients think they can get good nutrition from a powdered supplement, and then develop all sorts of disordered eating habits to compensate for the actual food they are missing out on.

It’s true that many foods have medicinal properties. Cinnamon may help lower blood sugar in diabetics. Turmeric may have anti-inflammatory properties. Here’s the problem: will you start to sprinkle cinnamon on everything you eat even if it doesn’t taste good? I love turmeric – in a few dishes. A little goes a long way. But studies often show that in order to actually get enough of the medicinal properties of these foods, you usually have to have large quantities of it – more than you’d probably want to eat of anything in a day. Also, what we know about the synergistic properties of foods can so far fit in a thimble. Isolating compounds for their magic properties is reductive thinking at best. Food compounds interact with one another and we’re only just starting to understand this better now. Again, getting a varied diet will help you to get some of everything you need.

I know Hippocrates said, “Let food be thy medicine and medicine be thy food,” and back then that made sense when they didn’t have a lot of actual medicines. But now we’ve got another problem which is a world full of disordered eating, so maybe it’s time to back off this food-as-medicine idea for a while.

So food does not need to be medicine, especiallly in the absence of illness. Food just needs to be food – delicious, enjoyable, varied, reliable fuel for your body – because that’s how it serves us in the healthiest way possible.

1Hallberg L., Bjorn-Rasmussen E, Rossander L, Suwanik R. Iron absorption from Southest Asian diets. Am J Clin Nutr. 1977; 30:539-548.

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61 thoughts on “Food is Not Medicine

  1. Megan (@aprnstrngsandsf) April 19, 2016 / 10:51 pm

    This is one of the best articles I’ve read in ages. I want to read it to everyone I know and then shout it from the rooftops!

    • GlenysO April 20, 2016 / 12:34 pm

      I’m so glad you liked it! Thank you!

  2. watchheremerge April 21, 2016 / 8:05 pm

    Sometimes when someone is very sick, the “medicine” they need is really lots of comfort food. Somewhere in the last 20 (?) years that metaphor got distorted into something literal. Love this. You must hear a lot of the cringeworthy crap. Glad you’re shining a light.

    • GlenysO April 21, 2016 / 10:13 pm

      Yes, somehow “comfort food” was distorted into something quite different. When I had very sick patients on the brink of death at times in the hospital, with no appetite, I would encourage them to eat literally anything they wanted just to stay alive – nutrition supplements if they liked them (full of HFCS), ice cream, brownies, cookies, whatever they could get into themselves. Those aren’t the foods people would now typically describe as “good medicine.” They’re the foods that people demonize – but they’ll keep us alive if necessary. Food is nourishment, sometimes no matter what the food!

  3. cookwitch1 April 23, 2016 / 8:21 am

    There’s so much now that is, essentially, restriction without reason, but called by another name. Clean, wellness, etc.,

    I get that control is appealing, and that it’s the lure when life is disordered in other ways. But I wish that people could or would look further, past the glossy books and the white-tooth smiles, through those and into the actual research.

    The GAPS diet is a case in point, and someone far wiser than I articulates it in a fabulous way here:

  4. Life Mutated April 23, 2016 / 9:58 am

    What makes me cringe is people who decide that the medical industry is out to poison people so they go out into their garden and forage for replacement “herbal remedies” … as though that is any less dangerous, if not more so.

    It’s interesting how people take it for granted to be able to enjoy their food. Due to a genetic anomaly, I neither gain weight, nor have much of an appetite. Even if I wanted to, I can’t force myself to eat when my body is not interested as it just rejects it. I have lost count of the times that a nurse or a new doctor, unaware of my condition, wanted to send me to a therapist because they thought I had a eating disorder. Though I suppose, if you really wanted to you could look at it as such. Yet my weight hovers just below the “Healthy BMI” line, never dipping too low and never being able to raise it just above it.

    Certain foods I have a strong aversion to, like citrus or other acidic foods such as tomatoes, that is if I can even get my body to accept it. It’s almost like my body instinctively know that it’s not good for me and makes it as hard as possible for me to stand the taste.

    I guess you could say, I’m a medical conundrum in just about every way, though I would love to eat myself to bursting without it being due to the fact that the food is laced with MSG …

  5. Nisha Venkat April 23, 2016 / 10:49 am

    this was really enlightening! made me realize how I was treating my body by restricting all those calories- i plan to eat what makes my body happy starting now!

  6. Sabine April 23, 2016 / 11:35 am

    Couldn´t agree more. The beauty and satisfaction that lies into the ritual of cooking, eating and of course sharing a meal is one of my greatest pleasures in life. Seriously.
    Congrats on being “discovered”, that´s how I found you, too. All the best from PAris, SAbine

  7. Christina April 23, 2016 / 11:55 am

    This is brilliant! And I agree this is probably the mentality that causes many of us to have eating disorders of one sort or another!

  8. lovehanmade April 23, 2016 / 11:56 am

    Like the first comment, this is the most amazing article – common sense at its best!! Thank you. I will be putting this everywhere I can!!

  9. hannahkenway April 23, 2016 / 1:42 pm

    Strangely I stumbled on this after an evening at a friends house where I effectively gave away all my low sugar, paleo, clean or whatever else cook books simply because as a relatively healthy intuitive eater I had found myself becoming obsessional about carbs, about pureed raw veg about life and food in general. What you have said absolutely makes sense and I’m now even more delighted to be rid of such over hyped nonsense. Thank you

  10. Marjorie Witt April 23, 2016 / 4:11 pm

    This is so refreshing to read. I get so tired of trying to dine with friends who have self-imposed diet restrictions just because they think it will prevent something they don’t even have yet. To much of anything can be a bad thing. We just need to be reasonable.

  11. Weezelle April 23, 2016 / 5:00 pm

    I’ve recently had my eyes open to some of the absurd ways we reimagine food and our appetite. I recently read Small Acts of Disappearance- Australian woman’s writing on anorexia. I did a review on my blog, if you want to check it out.

    • GlenysO April 23, 2016 / 6:13 pm

      Thanks, I’ll check out! I love that the Australians have such a strong HAES contingent.

  12. Christina April 23, 2016 / 9:09 pm

    Thanks so much for this read! For a while, my mom had a tendency to isolate compounds for their medicinal properties. Unfortunately, it has made me not only question the ingredients of what I eat, but also stress over consuming foods I normally enjoy. I’ve recently come to terms by consuming varied foods that are both enjoyable and nutritious! 🙂

  13. soniasstoryge April 23, 2016 / 11:54 pm

    Great post. At the start I would not agree and thought but food can and indeed has been medicine for ages. You argumented so well that got me convinced. Thanks for this read. Food for thought for sure.

    • GlenysO April 24, 2016 / 1:37 pm

      Well that is the highest compliment, to say I may have changed (or at least turned a little bit) your mind on the topic – thank you!

  14. Madhulika April 24, 2016 / 12:23 am

    Awesome article on “food not medicine” but, I always wondered as to how some people would never gain weight despite eating large quantities of food while some never lost no matter how low calories their food contained

    • GlenysO April 24, 2016 / 1:40 pm

      The answer is our metabolism – some people have high burning metabolisms, others, slow. Some people’s bodies are gifted at storing fat (one evolutionary advantage in times of famine), others are gifted at developing muscle (another type of advantage). From an evolutionary standpoint, diversity in our body types and sizes would likely be the best for surviving all sorts of varied conditions on the earth.

  15. Jean April 24, 2016 / 6:42 am

    “However, if someone is a competent eater, getting a variety of food reliably and enjoying their diet, this is the best disease prevention there is, since, as I linked to above, competent eaters have shown to be generally nutritionally (and socially and psychologically) healthier than non-competent eaters.” Competent eater may I add that embraces cultural diversity in their food dishes.

    What is being lost in this whole thing is the influence of culture on one’s instinctive food choices. Competent eating still allows room for human error, human indulgences. It’s just a person has to recognize if they’ve eaten too much of something less nutritious, they will naturally turn away and choose something better later.

    However acquiring competence in food selection, does help a lot if one is raised as a child with broad, healthy views on food. I can see how tough it is if a person doesn’t have that benefit.

    • GlenysO April 24, 2016 / 1:52 pm

      Eating competence also assumes the intuition skills of being able to recognize when one is full or has eaten a lot of one thing. Eating competence does not put an emphasis on food selection other than to provide meals that include the 4 food groups. One of the most important aspects of the eating competence model is to provide regular, times meals and snacks. Ellyn Satter does not discuss in depth choosing of foods, quality of food, etc. Ensuring regular, planned meals will generally ensure variety, which results in nutritional adequacy. This can work very well for people with low economic status as well (she emphasizes in her training how to work with this population as well). I don’t believe cultural diversity is necessary to good eating. It’s nice that we can have that here, but it seems to me to be a particularly American phenomenon. Growing up in a small town in Canada, I had access to food from only one culture; and that probably is true still for a lot of areas there and here and for most of the world.

  16. C U T E c April 24, 2016 / 10:47 am

    Really enjoyed reading this. Food is something i am still trying to approach in a positive way. 🙂 XX

  17. justworkinonmyfitnessblog April 24, 2016 / 11:35 am

    Such a great post!! As a nurse practitioner, I often see patients forcing themselves to consume foods they HATED in hopes their health would benefit. I’ve had cancer patients eat a pescetarian diet because they read somewhere that this would decrease their cancer’s absorption of the nutrients and help shrink their tumors. It was especially sad to see when I worked in hospice because these individuals were clinging to that last hope that they would be cured, all the while being miserable in their last days.

    • GlenysO April 24, 2016 / 2:04 pm

      Yes, I’ve had a similar experience and it was so sad. A man in the last stages of cancer was being so severely restricted to manage his diabetes…she would not hear of letting him have sugar or any dairy products. I asked him what he would like to eat and he said, “I want ice cream but my wife won’t let me.” She was trying to save his life with nutrition when what he really needed was comfort. So sad!

  18. Dermott Hayes April 24, 2016 / 12:38 pm

    I’ve enjoyed this post and found myself,by and large, in agreement. One point you made, though, I would like clarification. I have hemochromatosis (iron overload)and, as a result, type 1 diabetes. This, you will understand, creates its own, theoretically, contradictory dietary needs, but when you made your point about the Asian and Swedish people eating Thai food, are you implying they absorbed less iron because the food was mush or because they didn’t like it as mush and, therefore, didn’t eat it? When I was diagnosed with diabetes in 1994, I was coached by nutritionists and dieticians about how and what, I should eat in a ludicrous system that involved measuring the carb value of everything I ate as ‘exchanges’. I ditched that as soon as I left the hospital. Since then, I’ve adhered to a very simple dietary mantra; low fat, high fibre and no sugar. I love food and my blood sugar control is so rigid and regular, it makes my endocrinologist want to do a happy dance. I have two blogs that might interest you, and

    • GlenysO April 24, 2016 / 2:02 pm

      To answer your first question about the study I referenced, I believe the study authors concluded that the lowered iron absorption was more likely due to the decreased enjoyment of the food, since chemically, the food would not have been altered (mechanical alteration of the food does not alter the food chemically). So while of course we can rarely point out causation, there was an association between the mushy food and their lack of enjoyment of the food. You can read more about this study in Linda Bacon’s book Health at Every Size and Ellyn Satter’s book Secrets of feeding a healthy family. As a type 1 diabetic, I’m sure you know now that insulin regimens are so improved that if a person doesn’t want to, they don’t need to avoid sugar, and many people get quite good at carb counting and consider it worth the headache if it means they can have a less restricted diet. However, if this is your diet preference, enjoy it! (that’s my basic mantra). I will check out your blogs, thanks!

      • Dermott Hayes April 24, 2016 / 2:16 pm

        GlenysO, so they didn’t like it, they didn’t eat it, unfortunately, were it that simple, people with an iron overload would simply eat less and maybe, starve to death. Ok, I’m being over dramatic but the point is, the correlation between diet and iron absorption is not an exact science. As for ‘insulin regimens are so improved’, I presume you are referring to the DAFNE programme (Dose Adjustment For Normal Eating) which, in my estimation, never did anything but provide modern medicine with another attractive acronym, since what it does is make a practice of what people like myself and many other sensible people did long ago, ie, stop ‘counting’ carbs and eat sensibly, a balanced diet, full of healthy, tasty, flavoursome things. I haven’t eaten anything processed for the past thirty years. Tonight, I had a baked fillet of hake with a spicy couscous crust on a bed of rainbow chard salad and mixed nuts and seeds. Delicious, How many carbs? I don’t know. What was my sugar level before I ate? 5.6 and what was it, after I ate? 4.7 How much insulin did I take? 2mls. Do I feel ok? Hell, yes. Did I enjoy my meal? You better believe it.

        • GlenysO April 24, 2016 / 2:54 pm

          Well, I assume their intake was accounted for and that the decrease in iron wasn’t simply due to a decreased intake of the food (that would be pretty bad science). The study is old but I’ll see if I can get a copy of it. With respect to your disdain for the improved insulin regimens (I have never heard the term DAFNE here), I think if you’re a child dealing with diabetes and whose parents don’t want to have to restrict that child’s intake, improved long-acting/fast-acting insulins have been a god-send. If we can avoid restricting children in what/how they eat, they can learn to become normal eaters in adulthood and avoid a lot of other problems, especially as they have to continue to manage their T1DM. If you’re an adult with full control over what you eat, perhaps it’s a different matter.

        • Dermott Hayes April 24, 2016 / 3:05 pm

          I agree and I don’t mean to sound glib or facetious in my comments. I do realize there are people with far more problems dealing with insulin, than I do. I wasn’t diagnosed with diabetes until I was 38 years old and, even though presenting with type 1 at that age, there were no symptoms apparent, pointing to the root cause of my condition, hemochromatosis, until six years later. I live in Ireland, where diabetes is classed a ‘long term illness’ and therefore, all medicines related to that condition are free and covered by State health care. It’s the same in many other European countries. All of this makes the production and supply of insulin and related products, a billion dollar/pound/euro, blue chip, industry that questions the resolve or imperative for research institutes or the people who finance them, to direct their energy towards a cure for diabetes. It would, you must admit, be like corporate hara kiri, killing the golden goose, so to speak?

        • GlenysO April 24, 2016 / 3:26 pm

          My view of that industry isn’t quite so jaded. I think if and when possible, they’ll figure out a cure without worry of insulin sales dropping off. I’ve never bought that view of the pharmaceutical industry. I think most researchers developing cures just want to help people. Perhaps I’m too much of an optimist!

        • Dermott Hayes April 24, 2016 / 3:37 pm

          Researchers, yes, but you can’t be so naive as to believe the pharmaceutical industry is not operated on profit and share dividends. If it’s not profitable or counter-productive to their bottom line and shareholders, then they’re in no rush to alter the status quo. When they reach a point where research has found a marketable cure, like a pancreatic stem cell treatment, they’ll have worked out a way to trade the cost of that cure for the shortfall in insulin sales and production. It’s simple because it’s all about money, not people.

  19. samratkel April 24, 2016 / 1:25 pm

    Interesting. I look forward to reading more!

  20. ReignofFaith April 24, 2016 / 6:54 pm

    Many people gain weight when they go vegan because they don’t actually cook. They eat a lot of processed foods. I went vegan a few years ago and felt great. My hair was long, eyelashes thick and I had a lot of energy. It can be a healthy option when done correctly. Of course, its not the only option.

    • GlenysO April 24, 2016 / 7:50 pm

      Many people assume my patient had been eating junk food as a vegan. I have no reason to believe this, since the diet-style he went to next involved copious amounts of fresh cooked vegetables and fresh meats. I’m not sure why he would have eaten junk food as a vegan and fresh, home-cooked foods as a non-vegan. I know thin vegans who eat a lot of Oreos – so I’m not sure the “junk food” theory holds much water.

      • ReignofFaith April 25, 2016 / 2:07 am

        I definitely ate Oreos it’s funny you mentioned that lol. But everything else I ate was so healthy it didn’t have a negative impact on how I felt. I’ve done vegan where I was healthy and vegan where I was not. The times where it was unhealthy I just simply wasn’t putting in the cooking time I had previously. It can be hard to cook things that are filling if one isn’t used to that type of cooking. But who knows not everyone’s body type may be vegan friendly. Some people may do better with meat in their diet. Anyways, interesting post.

    • sarika saggar April 27, 2016 / 3:43 am

      Yes…only if done correctly
      And eating fresh not out of the cold storage.

  21. ReignofFaith April 25, 2016 / 2:12 am

    I’ll also add that variety can be a struggle for those who aren’t used to cooking vegan.

  22. MamaFriday TC April 26, 2016 / 1:13 pm

    Even as a fitness expert I still use food for comfort.

    • GlenysO April 26, 2016 / 1:16 pm

      I think food for comfort is fantastic! It’s when people don’t do it well – ie, using it for comfort and still not dealing with what bothers them – that it goes awry. But absolutely, food and feeding ourselves is comforting!

      • MamaFriday TC April 26, 2016 / 1:23 pm

        I agree. I have a very judgmental friend who thinks my love for food is a sin. And well, her life is pretty boring so there you go:) Good to meet you. Best of luck <3

  23. sarika saggar April 27, 2016 / 3:40 am

    Simply wonderful…. Very well written. I’m myself a health freak and all along I felt I know a hell lot about healthy food, though I never equated food with medicine though I agree food does have a healing element.more so I believe food is very therapeutic. Eating food is a ritual…a meditative activity… And like any meditation it should be held in high esteem. Eating food is not just masticating and digestion,there is much more to it. I respect my food.
    But still…today with this articles some of my misconceptions have been shed away. One like eating food without enjoying it will not bring about any positive change rather can have adverse affect.
    Thank u

    • GlenysO April 27, 2016 / 8:57 am

      Thank you! I think what you describe is “nourishing” – I love thinking of food that way instead of “medicinal.” Nourishment is still so important to us!

  24. Erik April 30, 2016 / 11:46 am

    I agree and disagree! Food is what we humans started with and we were given everything we need to survive (nutrient wise). It is essential to stay healthy and I believe that it can also help us recover from illnesses because without the nourishment (as you have commented) we would simply not be equipped to fight off the illness. But we cannot ignore the wonders that modern day medicine have done for us, but in moderation, as it is proven that our bodies start building ammunities. So I say start with good food and leave medicine as a last resort!

    Check out my story and journey

  25. Susanne Youngblom July 27, 2016 / 4:12 am

    Thank you for sharing this😃

  26. Cindy August 1, 2016 / 11:03 pm

    This is great information!

  27. sophisticatedhomes August 4, 2016 / 9:33 am

    Great post. Thanks for the share.

  28. aliciavohealthbeautyfitness August 15, 2016 / 12:38 am

    Thanks for writing this! I’ve never thought of how importance it is to enjoy your food, rather than dieting and everything else.

  29. thewhoreofbabyl0n September 11, 2016 / 2:01 pm

    Finally someone had the balls to say this! Struggled from bulimia for years, and I can’t stand listening to all these food snobs that have suddenly spawned and preach about cutting out this and that.

  30. Sara R March 28, 2017 / 8:15 am

    As someone who has to avoid certain foods because they literally make me sick, I really struggle with enjoying my diet. I used to be such a foodie and loved to cook and bake all sorts of things. Finding my joy in cooking and eating has been a struggle of over a decade. I’m not there yet. At first it was fun challenge to alter recipes but as time went on it became cumbersome and I began to dread eating out. Even if I found a restaurant that had something I could eat, just not being able to choose anything from the menu began to restrict my enjoyment. I understand your points but I don’t understand if there is a solution for those who cannot eat anything they choose.

    Also, for me medicine didn’t work and made me more sick. It gave me pancreatitis and liver damage, so changing my diet has been the only way to control my Crohn’s disease. Why do we have to worship medicine? We also don’t want to take it unless absolutely necessary, not to make up for poor lifestyle choices. Also there is no medicine that cures cancer, and I do know people personally who have reduced tumors with diet and herbal medicine. I know you mean well but I think you also need to be open to accept other options may work for some people. We can’t be dogmatic either way and allow people to find their own path.

    • GlenysO March 28, 2017 / 1:10 pm

      What you are talking about is different from the point I was making. Treatment for Crohn’s falls under medical nutrition therapy as I mentioned. However, there are otherwise healthy people who become obsessive about their diets and longevity and prevention and also stop enjoying their food. First and foremost, food is meant to be enjoyed (for those without illness that have that luxury) and our current foodphobia/healthmania culture is working against that enjoyment. Sorry for your illness, that does make it harder for people to eat enjoyably. However, as you well know, there isn’t any food that cures Crohn’s – and this is the mentality I’m addressing. I don’t think I’m advocating for the worship of medicine, and I also don’t think the need for medicine should be stigmatized.

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