Nutrition as Medicine

We live in a world that encourages sacrificing long-term benefits for short-term pleasures. We buy big screen TVs instead of putting the money into an Individual Retirement Account (IRA) and watching it grow. We binge watch our favorite shows when we should be investing in our health at the gym. We scarf down a whole pint of ice cream (4 servings!) instead of benefitting from the nutrition offered by fresh fruit for dessert. According to the American College of Lifestyle Medicine, “what people eat, and fail to eat, is the leading cause of disease and death globally.”

If we are to compare food to medicine, let us consider which foods are most medicine-like. Fruits and vegetables are a logical start, as nutrition from plant-based diets is typically of higher quality than omnivorous diets. It is higher in fiber, vitamins and minerals, lower in calories, added sugars, fat, saturated fat, and sodium. A diet featuring predominantly unprocessed fruits, vegetables, whole grains, legumes, nuts and seeds, and minimally processed dairy and protein is more likely to promote good health.

Much attention is given to the energy nutrients; carbohydrates, fats, and proteins. While protein is the darling nutrient in “health food” circles, more is not necessarily better. Getting enough energy production from carbohydrates and fats will spare dietary protein for building of lean body tissue. Animal sources are meat, poultry, fish, eggs, and dairy. Plant-based sources include nuts, legumes, and soy.

When it comes to fat intake, the fats that are liquid at room temperature, usually from plant sources are more health promoting than those that remain solid at room temperature, which are associated with weight gain, heart disease, diabetes, and certain cancers. So, whenever possible, opt for vegetable oils and avoid lard, butter, and other animal fats.

The final energy nutrients, carbohydrates have been vilified mercilessly for the last decade or five, starting with the Atkins diet, South Beach Diet, Paleo, Keto, etc. What is rarely mentioned is that in populations worldwide where “carb” intake is the highest, obesity, and obesity related conditions are lowest. The confusion comes from the perception that carbs are cookies, cakes, and pies. While these all do contain carbohydrates, a significant amount of these foods’ calories come from fat. Conversely, pasta, bread, and rice are naturally low in fat. The problem may lie in the high-fat sauces and spreads often added to these grains. Use them sparingly.

When it comes to minerals, nutrition may begin to look more like medicine as supplementation in pill, gummy, or liquid form is more common. Two of the most common supplements are calcium and iron. Throughout a woman’s life, there is a 1 in 3 chance of bone disease as a result of long-term deficiency of calcium and vitamin D. This may be due to the fact that the many common food sources of calcium are high calories, such as high fat dairy products, like whole milk, cheese, and ice cream. So eliminating dairy is often a method of dieting that result in short-term weight loss but long-term health compromise. We have a huge store of calcium in our bodies, our bones. When our diets are lack calcium, our bodies supply adequate calcium levels in the blood at the expense of bone density. We may all have an older relative who broke a hip, or at least walks a lot more hunched over than in her/his youth. This is likely to be due to a life-long dietary shortage of the mineral. To avoid this fate choose low fat dairy options such as fat-free milk, yogurt, and cheese or consume plant-based sources of calcium such as bokchoy, broccoli, brussels sprouts, kale, collard greens, tofu, winter squash, and almonds, even fortified foods such as calcium fortified orange juice.

nutrition intake from a nutrient dense appropriate calorie diet can significantly lessen one’s chances of winding up with chronic conditions

Iron deficiency is the most common cause of anemia in the United States. When you think of nutrition as medicine, this is a good example of the concept of proper dosing. Women from the onset of menstruation to menopause lose a significant amount of blood and hence, iron on a monthly basis, making their need for dietary iron more than double what the typical man needs. As is the case with calcium, bottles of iron supplements are available, but a diet rich in iron is preferable.  Meat, poultry, and seafood are the best sources of iron, but those opting for a more plant-based diet can get adequate amounts from legumes, grains, and beans. Further, pairing plant sources of iron with sources of vitamin C, also highly available in plant-based food sources, is known to increase the absorption of iron.

Vitamins viewed as medicine include Vitamin A and C. Vitamin A may be more commonly found in the form of its precursor, beta-carotene since whole, active Vitamin A can become toxic at high levels. While deficiency is less common in the US, inadequate dietary vitamin A is a common cause of blindness throughout the world. Here in the United States, our abundant food supply offers wonderful sources of beta-carotene such as sweet potatoes, spinach, raw carrots, cantaloupe, butternut squash, beef liver, dairy, plant milks, and fortified cereals.

Vitamin C is available, especially in plant-based diets, and deficiencies have become uncommon.   Foods high in vitamin C include bokchoy, parsley, broccoli, cantaloupe, brussels sprouts, pineapple, cabbage, cauliflower, mustard greens, papaya, green peas, kale, tomatoes, strawberries, turnip greens, orange, guava, kiwi, mango, and red pepper. Other sources include spinach and most other leafy green vegetables, including collard greens, celery, and fruits, including cherries, pears, and canned peaches. Interestingly, toxic levels of vitamin C were unknown until supplemental mega doses of the vitamin became easily available. Due to this availability in addition to widespread misinformation, the Mayo Clinic has now found an association between intakes exceeding 2,000 mg a day with diarrhea, nausea, vomiting, heartburn, stomach cramps and headache.

At its best, nutrition intake from a nutrient dense appropriate calorie diet can significantly lessen one’s chances of winding up with chronic conditions such as diabetes, hypertension,  certain cancers and prevent deficiency conditions, such as anemia, osteomalacia, blindness, and scurvy. Moreover, a healthful diet, rich in fruits and vegetables, whole grains, low fat dairy or dairy substitutes, and lean, minimally processed proteins can provide optimal amounts of what we need to fuel activity, both physical and mental, which pays off with improved quality of life. Can anyone find a medicine that can do the same?