With Thanksgiving behind us and the remainder of the holiday season quickly approaching, it seems like a perfect time to talk about a seasonally popular subject matter: food. Michael Pollan, the best-selling author known for his books exploring the sociocultural impacts of food, once wrote, “Food is not just fuel. Food is about family, food is about community, food is about identity. And we nourish all those things when we eat well.”
While gatherings for a traditional meal check most of these boxes, the starchy dishes that tend to make up a typical Thanksgiving spread don’t clinically constitute eating well. So says Dr. Stephen Juraschek, an internist and primary care physician at Beth Israel Deaconess Medical Center in Boston, in a Time magazine report. In consuming such a meal, your body can experience “a sudden spike in blood sugar as carbohydrates are converted into glucose,” he says. “Blood pressure and fluid retention may also increase as your body processes fats and salt.”
Not to worry, says Juraschek. “Those spikes (from your mega meal) should come down, usually within a couple hours.” For most people, physical symptoms, if any, are generally no worse than bloating, heartburn or headaches. For people with chronic health conditions, there is much more that they must consider before embarking on such a meal. But for most folks, it’s unlikely they’ll see any lasting effects no matter how many calories the meal contains. “It’s really more of a longer-term pattern of eating that we worry about,” says Juraschek.
The point I am trying to make here is not to dampen anyone’s enthusiasm for enjoying a hearty holiday meal but to use this opportunity to point out how our bodies react to the food we put into it, as well as the damaging effects when essential nutrients are denied.
As the Centers for Disease Control and Prevention reminds us, “Good nutrition is essential to keeping current and future generations healthy across the lifespan. A healthy diet helps children grow and develop properly and reduces their risk of chronic diseases. Adults who eat a healthy diet live longer and have a lower risk of obesity, heart disease, type 2 diabetes, and certain cancers.” It is also stated that “healthy eating can help people with chronic diseases manage these conditions and avoid complications.”
“Most people in the United States don’t eat a healthy diet and consume too much sodium, saturated fat, and sugar, increasing their risk of chronic diseases,” the report goes on to say. “Fewer than 1 in 10 adolescents and adults eat enough fruits or vegetables.” It appears that decades of campaigns on healthy eating have failed to make much of a dent on eating habits, both in this country and around the world.
As recently reported by United Press International, a Tufts University Friedman School of Nutrition Science and Policy study that measured eating patterns of adults and children in 185 countries found that the combination of both too few healthy foods and too many unhealthy foods are “contributing to global challenges in achieving recommended dietary quality,” said Dr. Dariush Mozaffarian, a dean at the Friedman School. The report further points out that poor diets “are responsible for more than a quarter of all preventable deaths worldwide.”
Back in March 2019, I reported on what was then a growing interest in the concept of “food as medicine.” As suggested in a Time magazine report, if we start to truly consider food a critical part of a patient’s medical care, and treat it as we would medicine, many experts believe the approach could have as much power to heal as drugs.
“A person’s health is more than the sum of the medications they take and the tests they get,” I reported at the time. “It is deeply affected by how much people sleep and exercise, the stresses in their lives and, without question, what they are eating at every meal. When people eat well, they tend to be healthier and are more likely to control chronic diseases — maybe even avoid them altogether.”
In Texas, where I live, a program developed in 2015 was already moving in that direction. Reported last year by D magazine, culinary medicine classes for first-year medical students at the University of Texas Southwestern had begun. At the time, it was one of only 55 residency programs nationwide that used the curriculum. Within this program, physicians could “prescribe certain foods that can be paid for with insurance for patients with chronic conditions such as diabetes and can create medically-tailored meals for patients with HIV to reduce healthcare costs down the line,” reports Will Maddox.
Says Dr. Jaclyn Albin, an internist and pediatrician at UT Southwestern and the associate program director for the internal medicine/pediatrics residency program, “I felt that my students and residents were lacking in their ability to help people make lifestyle changes … I noticed that they wanted to help their patients, but the advice that physicians are trained to give around lifestyle change is ‘Eat less and exercise more,’ which clearly doesn’t work.”
The program also eventually grew to teach physical therapy and physician’s assistant students. “Culinary medicine has the opportunity to build inter-professional collaboration in a way that healthcare is not always doing a good job of,” Albin said at the time.
Says U.S. News and World Report, two Nemours Children’s facilities — one of the largest integrated pediatric health systems in the country — have established a “Can Grow Garden” program designed to help empower more families to do the same at home. It features raised beds outside the cafeteria that serve as a demonstration garden to show families how to grow their own produce.
Says Dr. Lisa Harris, CEO of Eskenazi Health, a public hospital located in Indianapolis, children represent “the biggest opportunity” for effecting a change to healthier eating habits.
As for more proof that the concept of food as medicine is taking hold at health care facilities across the nation, in an NPR interview with Pam Schwartz, executive director of community health at Kaiser Permanente, she announced that Kaiser Permanente has committed $50 million to its Food Is Medicine movement.