Taking a bite of the notion that food is medicine

Editorial, Dylan MacKay PhD

Hippocrates supposedly said, “Let food be thy medicine and medicine be thy food.” I disagree. Food is not medicine.

I can hear people saying, “But Dylan, you have type 1 diabetes and a PhD in human nutritional sciences. Surely you of all people know that food has a powerful impact on health?”

I do. But that still doesn’t make food medicine.

Hippocrates’ maxim is likely a misquotation – one that many people have a vested interest in continuing to promote. All too often, the phrase is used by unscrupulous people to sell nutritional nonsense like the latest detox or cleanse. It’s also frequently used by reputable people trying to promote the importance of healthy diets, but they should shelve it so they aren’t confused with the quacks.

What’s wrong with thinking about food as medicine? It does a disservice to both food and medicine.

Food is so much more than medicine. Food is intrinsically related to human social interactions and community. Food is culture, love and joy. Turning food into medicine robs it of these positive attributes.

A healthy relationship with food is essential to a person’s well-being, but not because it has medicinal properties. Food is not just fuel and it is more than nutrients – and we don’t consume it just to reduce our disease risk.

Seeing food as a medicine can contribute to obsessing about macronutrient intake, to unfairly canonizing or demonizing certain foods, and to turning eating into a joyless and stressful process.

People tend to overvalue the immediate impact of what they eat, thinking that a “super food” can have instant benefits while undervaluing the long-term effects of what they consume over their lifetime.

To be sure, what we eat today can have small, subtle influences on health, but they become powerful when repeated over the lifespan. Yet diet is just one of many factors that interact to influence health. The environment, physical activity and genes all play important roles, too.

One more argument that food is not medicine: people who are completely healthy still need to eat.

Medicines are substances we use to maintain health and prevent or treat disease. I use medicine every day to stay alive. I could eat the healthiest foods every day but without medicine, I would still die. I’m alive and able to write this article only because of an essential medicine (special thanks to Frederick Banting and Charles Best, the inventors of insulin). We’re living longer than ever due in great part to public health efforts and modern medicines.

When Hippocrates may have suggested that food is medicine, most people who became sick with a serious ailment died. The ancient Greeks didn’t know what bacteria or viruses were and many people believed diseases were punishments from the gods.

Although that concept has largely fallen by the wayside, the food-is-medicine philosophy brings us back to the disease-as-punishment mindset. If you get sick, you must have failed by eating the wrong food. People who are sick don’t need that extra baggage.

The food-is-medicine notion can be harmful in another way. People sometimes forgo life-saving medical treatments in favour of so-called alternative therapies like juice diets and the like to try to cure cancer, AIDS and other serious diseases.

Every time I see a story about someone choosing a food-based or dietary-supplement-based treatment over modern medicine, I blame “Let food be thy medicine.”

Pseudoscience and quackery love the food-is-medicine philosophy because it helps them sell their nutritional supplements, diet books and therapy sessions. That’s reason enough for us to stop misquoting Hippocrates.

Food is food, medicine is medicine and both of them are really amazing.

Dylan MacKay, PhD (@DylanMacKayPhD), is a nutritional biochemist at the Richardson Centre for Functional Foods and Nutraceuticals in the Department of Human Nutritional Sciences at the University of Manitoba in Winnipeg, and an expert adviser with EvidenceNetwork.ca.

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