The problem with "food is medicine"
The language that we use to talk about food is powerful. Just look at how the clean eating movement's use of moralising language around food resulted in a backlash over fears of promoting orthorexia. The phrase "food is medicine" has been used more and more often. It isn't a new phrase at all, with Hippocrates famously being the person attributed to its invention thousands of years ago.
Food absolutely plays an undeniable role in our health. It provides raw energy for us to survive, macronutrients for us to enable essential functions in our bodies to run, and micronutrients that are involved in countless processes every day. We know that consuming certain foods play a role in disease risk, such as fibre reducing the risk of colon cancer, or iodine helping babies and children with their brain development. But there is an issue with conflating that function with medicine.
Food is so much more than calories and nutrients. Its role in our families, cultures and traditions are a key part of how we live our lives. People come together over food, celebrate and commiserate with it. Not only does turning food into mere medicine remove the enjoyment of it, but it implies that choosing a slice of birthday cake over a plate of cruciferous veg is bad, harmful even.
It sounds like a harmless turn of phrase; something to remind you of just how much good healthy eating can do for you. It might even sound empowering to some, or motivating at least. As so often in nutrition, you might say "what's the harm?". And that's the crutch. For one thing, if we are going to call food medicine, then we should also call exercise, sleep and stress reduction medicine. All these things play a key role in our health. At what point do you draw the line between what you call medicine and not?
Medicine is medicine
Food is medicine elevates the power of food to something pharmaceutical. Let's put it into context: a meta analysis in Nature found that there was a 17% reduction in risk of coronary heart disease for people who consumed more than 5 servings of fruit and vegetables compared to those who ate less than 3 servings per day (1). This risk reduction is based on observational studies, and doesn't guarantee the same risk reduction for everyone. Even where risk is reduced, there is no guarantee that illness will not occur. In contrast, pharmaceuticals can be prescribed to have a predictable reduction in risk, management or cure for a given condition. Of course, it is preferable to prevent illness than cure it where we can. That is why nutritionists and dieticians educate and promote healthy diets. However, conflating food with medicine puts our diet on the same pedestal as these drugs.
If food really is medicine, then why do we need drugs? Over emphasising the power of food can lead to distrust in conventional medicines. These medicines have allowed us to live long, healthy lives that our ancestors could barely imagined. If food truly is medicine, and we become sick, then are we to blame? This is one part of the wellness industry I feel is especially harmful. The suggestion that by living in a certain way -one that is often expensive and time consuming -is the key to health means that becoming ill is your fault.
I am studying an MSc in Nutrition because I know how vital a role food and nutrition plays on our health. However, the "food is medicine" rhetoric is one that oversimplifies its role on our physical, mental, social and cultural health. The food is medicine approach undermines the importance of both food and medicine as separate entities.
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