[Food as Medicine] Food in health and disease

The role food can play in prevention and treatment

Food and nutrition

Food at its most fundamental level – provides us with fuel to function and an array of nutrients to support this function and to grow, heal, repair and live. Food is comprised of macronutrients - Protein, Fat and Carbohydrates which contribute energy (kilojoules/ calories) to our diet in addition to supporting vital bodily roles and functions. Food is also comprised of an array of micronutrients (vitamins and minerals), and other compounds (such as phytonutrients), that are crucial in keeping us functioning.

Nutrition scientists have spent years of research, isolating different components of food and trying to understand their function. We have learnt a great deal by breaking down food components in this way. But the danger then lies in isolating the part from the whole when choosing what to eat.

The food matrix

Within foods, all the various micronutrients(미량원소) exist within a complex food matrix which affects how they are absorbed by the body, how they interact with each other and how much of them it is possible to take in at one time. When nutrients are isolated and put in a pill, or added as fortificants to other foods, they can be poorly absorbed, interactions with other nutrients can be lost and it is easy to consume them in excess which can be harmful.

One example that illustrates the importance of getting our nutrients from whole foods can be taken from the case of iron. Iron is essential for making the haemoglobin that carries oxygen in our red blood cells and myoglobin that carries oxygen into our muscles.

It is also very important for normal growth and development. Iron occurs in many foods and it can be isolated from them as a simple mineral in the form of inorganic iron salts. Yet if we consume iron in this isolated form, it is very difficult for the body to absorb it.

Moreover, if we take large doses of inorganic iron it can cause nausea, constipation or damage the gut wall. Not surprisingly, foods fortified with inorganic iron also may not give you iron in a form that is easily absorbed. The body absorbs iron much better when it is presented as iron bound to carrier proteins. These not only improve absorbability but also isolate the iron so that it is unable to cause damage to the body during the absorption process.

One good example of iron in this form is haeme iron, which is found in many kinds of meat, particularly red meat.

Nutrients in foods interact with one another. This also occurs with iron. If you eat foods rich in iron, together with foods rich in vitamin C, your iron absorption will increase. If you eat foods rich in iron together with foods high in dietary fibre (and containing phytates) your iron absorption will be much lower. This is only one example of the complexity of nutrients in foods compared to isolated nutrients.

Dietary patterns

Every food exists with its own unique array of nutrients and micronutrients(미량원소) – whilst different foods with similarities can be grouped together, no food is created equal. So to get the full benefits from foods we need to combine many different foods within our diet.

In recent years, nutrition scientists have drawn attention not just to individual foods but to the importance of our overall dietary pattern. 

The Mediterranean diet

The traditional Mediterranean diet was characterised by high consumption of fruit, vegetables, legumes and whole-grain cereals, moderate consumption of fish and dairy foods (mainly as yoghurt and cheese), the use of olive oil as the main source of fat and very low intake of red meat (eaten rarely). Additionally, intake of alcohol was restricted to red wine which was drunk in small amounts and only during meals.

Broad principles of healthy eating

Diet has a key role to play in the management of a variety of conditions and illnesses. But rather than focus our attention of finding the magic bullet to prevent or treat a certain condition, let’s embrace some broader principles of:

• Eating a diverse diet, and vary what you eat, when you can, from day to day and season to season.
• Be courageous! Try things you have never eaten. (try three new foods!)
• Buy something different when you go shopping that is inexpensive and in season.
• Swap food with a friend. Eat food that is abundant in flavour.
• Aim to eat with others as often as you can. In addition to the health functions, the social, personal and sensory benefits of sharing a meal are not to be underestimated.
• Be a role model for your children, your family and friends.
• Food (in addition to other modifiable and non-modifiable factors) has an important role to play in prevention and treatment of some diseases.

Foods and prevention

JANEANE DART: video transcript

 In Australia, the recommendation is five serves of vegetables a day and two serves of fruit. 

What's important I guess is the range of colors, range of textures, and also the different cooking methods that these vegetables and fruits lend themselves to. And across different cultures, these plates would also look very different-- for example for a Vietnamese family, a Greek family, a Sudanese family. So I think that's important to keep in mind. And also we eat very differently across the different seasons.

 it hasn't been able to be replicated. And so eating foods in their whole state cooked-- prepared in different ways-- really holds the key to being able to use food as medicine.

Dairy products are our diets richest source of dietary calcium. And calcium is an essential nutrient in terms of building and maintaining good strong bone health and in preventing brittle bone disease, or osteoporosis.

Two fairly recent super foods that have been promoted and marketed are kale and quinoa. And while they both have unique blends of nutrients in them and they both have a role to play if you like them, there's nothing magic or particularly special about them over something like silver beet or brown rice. Kale has been around for centuries. It just lost its popularity. It's re-emerged. It's juiced. It's smoothied. It's in salads. It's deep fried. It's a crisp. It's everywhere. But there's actually nothing particularly special. It's a really healthy food choice. There's nothing more special than kale over silver beet. Quinoa is a grain that's been around for centuries in south America. Without proper cooking, it can have quite a bitter aftertaste. It does have a slightly higher iron intake in it compared to some other grains. But as for all grains, it's rich in fiber, a good source of B vitamins. It's low in sodium. And so a good diverse range of grains will offer your diet different flavours and different opportunities to cook with and prepare foods with. A key message to leave you with is really that vegetables and fruits have a major role to play in preventing ill health potentially and safeguarding you, and the people you cook for, the people you live with.

Foods and treatment

JANEANE DART: video transcript

from studies that have occurred subsequently, is that made things worse for about 50% of patients. What we know now, and what I've used in clinical practice, is linseed. So golden or cracked linseed. It can be added into water, sprinkled on yogurt, in salads. So, really easy to consume. Anywhere between about a tablespoon to two or three tablespoons a day can have significant benefit improving their symptoms. And there is a modest evidence in supporting people with constipation predominant irritable bowel. In addition, it's also really high in omega-3. So it's a really good vegetable source, or plant source of omega-3. 

Here are some oats, and a range of different legumes, so some lentils and some chickpeas. While they're not new, there's nothing fancy, including these foods regularly into your diet can have, again, significant impacts in reducing blood sugar levels, for people with diabetes. Because they're rich in fiber-- in particular, soluble fiber-- they also have a really good role to play in appetite regulation and supporting weight management.And of course, a healthy weight can actually be a very important management strategy in diseases such as diabetes,

More recent research, interestingly, is looking at ginger. And ginger is a root that's been around for years. It's been used in Indian and Chinese medicine for thousands of years, and certainly in other Asian cultures. It's a root. We can grate it into curries, into stir fries, we can use it in tea. But ginger is being studied for it's anti-nausea properties. So it's been used in pregnancy and travel sickness for a long time, but it's now being researched in the context of chemotherapy and cancer treatment.And there's some promising evidence that ginger can have a role to play to support chemotherapy treatment and cancer management.

Turmeric also is a rhizome. It looks like ginger. And it's been used in Indian and Chinese medicine for thousands of years. In the West, we're just beginning to use it more and learn more about it. And it's actually been isolated into a supplement because the active compound in turmeric is curcumin. It's an antioxidant and it's really just beginning to show some benefits, potentially in terms of anti-inflammation, so in managing something such as rheumatoid arthritis, and also my have a role to play in cancer management.

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Can the use of food as medicine go too far? Are we expecting too much?

Can food be a complete cure?

There are people who have views against conventional medicine and current evidence-based practice, and push non-evidence based treatments with tempting promises. It is common to see this conventional vs non-conventional theme around the world.

Why can’t we do both? Why one view or the other?

There are many examples of ‘diets’ that claim to cure different diseases, with strict food and diet regimes. One instance is a diet that makes promises to people suffering from cancer and recommends a diet of juices made from raw and organic foods, eating numerous times throughout the day, along with supplements. The reasoning behind this is that they claim this regime(관리방식,체제) ‘removes’ toxins from the body and allows the body to heal itself naturally.

Followers of this type of advice may stop conventional treatment in favour of what they see as a more ‘natural’ approach. And while eating more nutrient dense foods is important for health it is crucial that individuals are able to understand where the line is between food and dietary patterns that are able to assist with good health and healing vs ‘curing’.

One size does not fit all

It is important to note that just because one form of treatment ‘works’ for one individual, it does not necessarily mean it will work for another.

We are all individuals with differing genetics, environments and medical histories. We also must understand the difference between science and opinion; many people will offer an ‘opinion’ on what they think will ‘work’, usually with minimal science behind it.

Things change

Remember that just because a food was used for a purpose in the past, doesn’t necessarily mean it is the best choice now. Throughout history people have always used what has been at their disposal, not necessarily because it is the best choice but because it is all they have had.

A delicate balance

It is important to balance the current evidence; if you would like to use traditional medicine, understand how it fits in with conventional treatment and whether any studies have been carried out well to understand the possible properties; ask questions; do your research; and seek professional opinions from specialists within that area.

Remember, many people use food to help them reach their peak health levels, so to do this well it is important to understand current advances in nutrition science so you and your healthcare professional can work together to decide what is best for you.

 

How many different foods do you have every day?

Many nutrition and dietary guidelines recommend we eat a wide variety of foods each day, including a wide variety of fruits and vegetables.Not only does variety of foods assist us in health, but it can also assist in creating a range of different flavours, adding to the enjoyment of food.

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Reference 

Food as Medicine from Future Learn. free courses https://www.futurelearn.com/courses/food-as-medicine

Food As Medicine Online Nutrition Course - FutureLearn

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