White Coat Underground

Food isn’t medicine

The fake doctors at HuffPo are at it again. This time, Patricia Fitzgerald is writing about the “Top 10 Healing Foods of the Decade.” The article has just enough correct information in it to be exceptionally wrong.

One of the more ironic aspects to this is her quoting Michael Pollan. I have problems with some of Pollan’s ideas, but I like his little saying, “Eat food. Not too much. Mostly plants.” When he first wrote this in a New York Times piece, he was arguing against “nutritionism”, the idea that you can break foods down into their components and then consume the component nutrients for specific benefit. Instead, he argued, eating real foods in proper amounts is a healthier practice for individuals and societies.

And yet Fitzgerald is embracing the same kind of fetishism that Pollan decried. By selecting certain foods as “best of the decade” she is engaging in food fad-ism rather than a rational, simplified approach to nutrition. Most experts agree that eating a balanced diet of real foods (rather than “food products”) in amounts sufficient to maintain a normal body habitus is the best approach to healthy eating. Beyond that, there is no magic in food. Too many calories leads to obesity and obesity leads to disease. It’s awfully hard to become obese on a diet that relies on fresh fruits and vegetables.

It’s not that some of the foods Fitzgerald writes about aren’t good for you—many are just fine. They just don’t live up to her hyperbolic claims. To say that a food is an “anti-inflammatory” or anti-oxidant is meaningless; neither of these terms has any real medical meaning. To say that a particular food lowers cholesterol isn’t meaningless, but it is deceptive—eating less can lower cholesterol in many people but not all. And any cholesterol-lowering effects gained by eating certain foods is dwarfed by the cholesterol-lowering effects of medications. If you have cholesterol high enough to significantly impact your health, no particular food is going to lower it enough to lower your risk of heart disease.

I get why she wants to call her self “Dr” despite not having any degree widely regarded as deserving of the label. Anyway, plenty of real doctors are quacks, so it doesn’t much matter. But when she starts using the Dr label to lend legitimacy to silly dietary advice, that’s just crappy.

Comments

  1. #1 History Punk
    December 30, 2009

    What you see here people is a battle between “Big Pharma” and “Big Farm.” See the drug companies want you to believe that foods aren’t magical and can’t heal you like in the video games. However, the Big Farm companies want you to think that their foods are magical so they can sucker you into buying them. So you all need to be wise consumers and do your research, even if you lack the knowledge, skills, or intelligence to do so.

  2. #2 daijiyobu
    December 30, 2009

    I don’t know how many times I’ve read naturopaths’ web sites which quote Hippocrates per ‘let food be your medicine and medicine be your food’.

    And then you leave their office with a bag full of supplements – often pills, tinctures, or twigs & leaves.

    That’s how they rake in half their dough [pun intended].

    -r.c.

  3. #3 Russell
    December 30, 2009

    Oh, come on, Dr. Pal. ‘Tis true that Fitzgerald omitted the most important curative food. But it’s real! My two glasses of red wine daily helps my BP stay low, decreases my risk of Alzheimer’s, sharpens my wits, makes me a man amongst men, and a hero to women.

    Really.

    Truly.
    ;-)

  4. #4 becca
    December 30, 2009

    that’s crazytalk Pal. chocolate = perfect medicine for depression
    Also, pizza has been known to cure the disease of hunger.

  5. #5 Dianne
    December 30, 2009

    let food be your medicine and medicine be your food’.

    Picturing swallowing 10 mg of oatmeal every morning and following it up with a big bowl of antihistamine for breakfast…can’t be what he meant…

  6. #6 Noadi
    December 31, 2009

    I hate article like that. Every food on that list except green tea are ones I find absolutely delicious. Don’t mar my love of chocolate and pomegranates by claiming they have miraculous properties.

  7. #7 oderb
    December 31, 2009

    So I should ignore the studies that show pomegranate reduces carotid plaque by over 30% (what drug does that?) at a lower cost, no dangerous and lethal side effects and a helluva lot tastier than a statin.

    Yes I agree that food shouldn’t be eaten just for its medicinal benefits. But to ignore the impressive research on most all the foods listed in the article is just plain stupid. Particularly when most of the foods in the article are delicious.

    Interesting that you were unable to refute any of her claims – other than asserting that anti inflammatory effects are meaningless. Right.

    Some foods are just healthier than others and have specific and often dramatic benefits. So I for one will follow Pollan’s advice – but also the latest research showing which foods help me the most. Just common sense to me. A quality lacking in your posts.

  8. #8 Dianne
    December 31, 2009

    So I should ignore the studies that show pomegranate reduces carotid plaque by over 30%

    Citation?

  9. #9 Donna B.
    December 31, 2009

    Food is not medicine for normal folks with normal digestive systems. And if you are one of unfortunate with an abnormal digestive system… food still isn’t a medicine, but some of it can be near a poison. And there are those that must take supplements because of a screwed up gut.

    So… being one of those with a screwed up guy, I absolutely despise, and am disgusted by the “normal” people who I see as hypochondriacs wanting to have a digestive problem.

    Of course that is an emotional overreaction on my part… but that doesn’t mean they’re not idiots.

  10. #10 Donna B.
    December 31, 2009

    OK… I meant screwed up GUT, not guy. Although my husband does have some strange moments…

  11. #11 PalMD
    December 31, 2009

    Dianne, I think I found the cite—it is a pilot study of 10 patients. I’m going to try to dig up the full text.

  12. #12 bob koepp
    December 31, 2009

    The philosopher in me wants explicit definitions of ‘food’ and ‘medicine’ — absent such definitions it’s not possible to determine whether the two are actually exclusive (as Pal implies) or whether there might be some overlap.

  13. #13 Rob Monkey
    December 31, 2009

    I suppose if you were hypoglycemic from diabetes, then yes, an orange or candy bar would be “medicine” in a sense, but I think in general, it’s not that hard to see where the distinction lies. My nutrition professor in college made sure to point out that any extra vitamin C you ingested from vitamin pills and the like would just come out in urine within 24 hours, and there wasn’t any reason to think it helped the immune system at all. As long as you ate a normal diet where you didn’t get scurvy, extra vitamin C was a waste of money. As far as all the “new studies about such-and-such,” I’ve found far too often you would have to consume improbably large amounts of the compound to see the effect (see resveratol).

  14. #14 k8
    December 31, 2009

    I thought of you when I was reading that article. No joke. I’ve come here enough to know what you think about that.

  15. #15 rob
    December 31, 2009

    this blog post reminded me of the 80′s Gauntlet game:

    “Warrior needs food badly”

  16. #16 Denice Walter
    December 31, 2009

    I think that food faddists severely restrict their diet, lose weight,look and feel better, and attribute the transformation to the *type* rather than the *quantity* of food.There’s also a *soupcon* of “magical elixir” magical thinking surrounding particular,novel exotic foods ( e.g. *acai*),which is of course, exploited by the woo-meisters.True story:(I read it in Vogue, so it *has* to be true!)Famous female designer goes “raw food” & yoga, loses 30 lbs., looks terrific in her own designs,goes totally woo and donates money for a “holistic center”(whatever that is) at a major NYC hospital.So it must have been the sprouts.

  17. #17 Paul Heikkila
    December 31, 2009

    I wonder how you feel about Dr. Daniel Amen.
    http://www.amenclinics.com/meet-dr-amen/

    Dr. Amen makes many of the same claims for the value of specific foods for specific purposes. Walnuts and blueberries are the ones I recall from his TV presentations.

    Dr. Amen does have an MD degree (from Oral Roberts Univ. specialing in psychiatry). Does that make his arguments for walnuts as a source of Omega-3s and blueberries for their anti-oxidants okay? Is food as medicine ok if a “real” doctor prescribes it?

    Isn’t the point of the various “Doctors” that a lifetime of eating properly may position you so that you’ll need less real medication when you’re older and in a real Doctor’s care? What’s wrong wid dat?

  18. #18 PalMD
    December 31, 2009

    With Amen, his quackery runs so deep that it’s impossible to know if he simply is like a stopped clock from time to time.

  19. #19 Kim
    December 31, 2009

    Interesting that she leads off with a food many alternative food thinker type people consider harmful (honey) and has nothing to say about that. Barely even touches on the mess that is salmon farming. Doesn’t bother to mention that broccoli is also goiterogenic (kind of a nice tidbit of info to share with an audience presumably made up of fashionably chronic dieters). Pomegranate is delicious, but its “super food” aura is a product of the POM Wonderful people pumping tens of millions of dollars into research (not that research sponsored by the vendor is *necessarily* suspect, but still). And even green tea is not without some backlash now, IIRC (my memory for the details is fuzzy, but I think there’s some preliminary evidence that it interferes with insulin function in some populations?).

    So basically this comes off as a somewhat facile and irresponsible list even if you’re up on your “super food” woo.

  20. #20 Dianne
    December 31, 2009

    And even green tea is not without some backlash now, IIRC (my memory for the details is fuzzy, but I think there’s some preliminary evidence that it interferes with insulin function in some populations?).

    I don’t know about insulin function, but green tea definitely interferes with the anti-cancer action of velcade, a newish drug used in multiple myeloma.

  21. #21 NP
    December 31, 2009

    Oderb:

    So I should ignore the studies that show pomegranate reduces carotid plaque by over 30% (what drug does that?) at a lower cost, no dangerous and lethal side effects and a helluva lot tastier than a statin.

    No, don’t ignore it. But don’t ignore the rest of the literature on this either. When interpreting smaller studies, it’s important to note that randomization can be suboptimal (i.e. the two treatment groups can be unbalanced, leading to confounding), the possibility of getting a chance result, and the issue of publication bias. Don’t cherry-pick studies, but critically weigh the available evidence.

    As Dr. Lipson points out, the study you are probably referring to is a small study. A more recent randomized, blinded clinical trial did not find such a dramatic effect of pomegranate juice consumption (PMID: 19766760)

  22. #22 Kim
    December 31, 2009

    Ah, I’m confused about the green tea, the concern is that it may aggravate some autoimmune conditions. I read about this via one of the big-name nutrition guys (John Berardi) who had previously been recommending cups and cups of the stuff, which is why I probably misremembered it as a metabolic thing. It’s unclear to me rereading the original article if this is fully mainstream science or a speculative interpretation of the mouse model Sjorgen’s syndrome stuff.

  23. #23 bob koepp
    January 1, 2010

    I’m still wondering about the borderlands between food and medicine. PKU, anyone?

  24. #24 Jim
    January 1, 2010

    I have no formal education in medicine or nutrition.However I have observed over my 68 years on the earth that the better and healthier my nutrition; the less I am sick and the less medicine I need. My goal is to improve my nutrition and physical ability to the extent I no longer need continue the two prescription drugs I currently take. I am not sure I really need them now, as I try to sort out whether the motivation of some of these educated derelicts is directed to what is in the best interest of the patient or their best financial interest. I am also learning that we have quite a few innocent practioners that are “brainwashed” by big business interests or trapped by financial interests. Meanwhile I continue my quest in Integrated Health Concepts. We desperately need true health reform in our great Nation, but nothing like we are currently being shown by politicians.

  25. #25 PalMD
    January 1, 2010

    If you really think most doctors have any financial incentives to “promote” medications, you don’t know much about the practice of medicine or doctors.

  26. #26 Kristen
    January 1, 2010

    I am in a unique position as mother of five children. My husband has a good job, but I don’t work because I have an autistic son and my fourteen-year-old sister I am raising has bipolar disorder. I feed my children the most nutritious things I can on the budget I have.

    If you asked me, the “superfoods” are the ones that pack a great deal of nutrition for the price. Our bodies are amazing in that they can function just fine on a variety of diets. Potatoes, broccoli, tomatoes (I live in Virginia), cabbage, apples, oranges, beans and the like are very nutritious and inexpensive.

    My point being; we are led to believe by the “holistic” and “natural” crowd that if we don’t do what they say is healthy we are doomed. People today worry far too much about what they eat. Use common sense and don’t believe everything heard in the media. Especially don’t vilify the staple foods that very many people around the world depend on.

    I’ll bet my children are just as well if not better off than those with parents who are following the latest food fads.

    That was just a long way of saying I agree food is for sustenance and should be enjoyed, not eaten because it is supposed to make you more disease-proof. It certainly can’t and doesn’t.

  27. #27 Chris
    January 1, 2010

    Kristen:

    I feed my children the most nutritious things I can on the budget I have….snip… Potatoes, broccoli, tomatoes (I live in Virginia), cabbage, apples, oranges, beans and the like are very nutritious and inexpensive.

    You hit the nail on the head on why when we moved into this house I concentrated on an edible garden (I also thought that having an edible garden would reduce the chance of having poisonous plants. I actually laughed when I went to a landscape seminar at a garden show and the guy showed a picture of castor bean plant planted next to an elephant ear plant, which are both very poisonous). I did have edibles in my previous modest garden (inspired by my mother’s cousin who planted tomatoes and squashes as landscape plants amongst the flowers in the rockery). But I went crazy with the new house and its slightly bigger yard!

    The most important thing is having a good set of herbs as ground cover (thyme, oregano, marjoram) and small shrubs (sage, rosemary… which is not so small! and lavender).

    Then there is using Bright Lights chard, tiny lettuces, heritage beets, spinach and kale instead of ornamental kale as greens to throw into a meal.

    Of course, the healthiest thing about my garden is not the food (which comes and goes depending on the blankety blank white cabbage butterflies), but the exercise in tending it.

    Then there was the time I tried (emphasis on “tried”) to get kids interested by planting miniature vegies. The only big hit was the Tom Thumb corn, with is a popcorn variety (you put the whole ear which is three inches long into a paper bag, and the microwave it to get popcorn… it was really cool)

    The backbone of the garden are the fruits. From a fence that is made up of espaliered apple trees to a hedge of blueberries. I belong to a local tree fruit garden society. And, yes, we are all a bit crazy!

  28. #28 Kristen
    January 2, 2010

    Once again, Chris, thank you for your wonderful insight.

    We just bought a house because of our much larger family. We have a corner lot, hence a much bigger yard. I want to plant a garden this spring. You just gave me some good ideas.

    My younger children and I planted a patio garden at our apartment. They loved to see the plants grow. My son hates to be outside because of the brightness, bigness and noise. But he loves to help with growing things. He goes outside and plants, waters and harvests (and eats all the sugar snap peas before we can bring them in:)).

    The little girls are much less enthusiastic, but they love popcorn, so I will have to try that.

    I have a plum tree, I was a bit worried what we would do with so many plums, but I am sure there are plenty of kids in the neighborhood to help.

    Well I got spoiled yesterday and was able to sit at the computer, it was very nice. But, back to life, computer time wedged in between crises.

  29. #29 Paul Heikkila
    January 4, 2010

    Nicholas Kristoff’s op-ed (“World’s Healthiest Food”) in the NY Times today brings another perspective on food as medicine. Micronutrients such as folic acid, iodine, iron, zinc, and vitamin A can be added to basic foods thus preventing many health problems, especially those affecting pregnant women and their fetuses.

    In much of the world “a balanced diet of real foods” just isn’t a readily available option for the poor and uneducated.

    http://www.nytimes.com/2010/01/03/opinion/03kristof.html?em

  30. #30 khalihs
    January 5, 2010

    On quack doctors in general, I appreciate the comment a PhD in Ecology, with whom I used to work, had made relative to a poor-doctor experience I’d had at a good Hospital. She asked me, “Do you know what they call medical students who pass at the bottom of their class?” “They call them Doctor.”

    We all know somebody who holds a degree, but cannot hold a job. (There is a sense of irony not unnoticed by me as I write this, as I’ve been unemployed in my field for 7 months now; though I held the job for two years, and the project I’d been billed to lost work.)

    In the world of Toxicology (the study of toxicity in human organisms, with emphasis on specific human organs), the best known phrase is “The Dose Makes the Poison”.

    This applies to food, as well; given that foods are vessels for nutrients that our bodies require in order to properly function. The problem is that, for various evolutionary reasons, we are programmed to eat foods that taste “yummy”, which generally means high in sugars and fats.

    Heck, we’re predisposed towards eating fatty rich foods, as they were hard to come by in primitive hunter-gatherer times; one had to catch their fatty foods to consume them, not walk into Wal-Mart and by the cheapest foods off the shelf (highest fat and sugar contents).

    Good article: “Science and Your Appetite”, by Jeffrey Kluger, p 110 of TIME’s “Your Brain: A User’s Guide”. Try to find it in your bookstore on magazine rack before it’s pulled, and reappears later as an overpriced hardcover edition. November, 2009.

    Too much of anything is not good for you (to my immediate knowledge, I can think of no exceptions to this statement).

    The key to good health, in my opinion, is recognizing (and controlling) the differences between hunger for a nutritional need, and hunger for a taste-buds need. And to eat ‘wholer’ foods. I’m not talking about super-pricey Whole Foods outlet stuff; you can still eat healthier on a budget. I’m talking about reading the ingredients, and recognizing that fewer additives, or more listings that are NOT chemicals, equates to a product that is more readily processed and digested by your body. After all, whether you ascribe to the creationism or evolutionary camps, our bodies were not ‘created’ to digest chemicals in a raw form; they were developed to process nutrients digested from consuming other lifeforms found naturally in our world.

    So I, personally, generally avoid foods made with diglycerides, monoglycerides, polyglycerides, sucralose (not to be confused with sucrose, dextrose, fructose, maltose or galactose), aspartame, acesulfame …, petroleum glycol (an optional antifreeze component for your car), or other disturbing ingredients to make the product artificially sweeter, fluffier, thicker, thinner, or more like what it’s not but damnit it tastes the same and works almost as well in cooking things with just a fraction of the calories so I won’t have to actually exercise to watch my weight!!!

    And listening to the National Institute for Health, or other reputable scientific studies, doesn’t hurt either. I know when I see a new fad online (or new to me), like coconut oil consumption, I run it through Google with “NIH” as well, to see what relevant research they have conducted. At the very least it’s more informative than studies conducted by/for the sellers of coconut oil commercially. :p

    Generally, eat less; eat stuff that consists of less artificial components (I am not promoting organic here, of which only tomatoes have been scientifically shown, to my knowledge, to provide more benefit than non-organically grown equivalents); exercise more; sleep more (I suck at this one); and stress less (stress screws with your system, in too many ways to adequately cover in this response).

    And treat your body like the detoxifying system that it is, recognizing that overloading any system in your body is like putting too much strain on a mechanical system – even the best machine can be broken.

    I am 40 years old, have sleep apnea, am 315 lbs at 6 ft 2 in, had a catscan of my heart that puts my health-equivalent to a 30 year old male (no plaque, no strain, no artery issues), don’t drink, don’t smoke, don’t do drugs, minimize my exposure to second-hand smoke, moved into the country, and prefer a push mower to a rider as it has greater benefit to my exercise and lessens my carbon footprint (and saves money on excess fuel). My last physical I was accused of having low blood pressure, because my levels were what athletes and marathon runners usually rate. People say I look like I weight 250, and that I appear to be in my late 20s to early 30s. Some of that is genetic (Scandinavian); I attribute most of it to not overtaxing my detoxification systems (lungs, liver, kidneys, pancreas). I did overtox my gallbladder, but it got cut out last year. This doesn’t mean I can eat high-fat foods now. It means that my body already lost one organ to excessive living, and I should do my best to maintain the rest of them. :p

    Okay, a bit of a verbose response. My apologies.

    Dr. Pal is in the right area, though, in stating that food is not medicine. Medicine is created by identifying medicinal properties in natural products, isolating them, concentrating the doses, extracting the potency, and delivering it in a manner that is more readily and efficiently taken up in our bloodstream, to be more effective than consuming (by example) a truckload of dandelions.

    But when you consume foods that are largely chemical in nature, you are not even really eating food. Which is why you’re still hungry. (Likewise drinking anything other than water first, when you’re thirsty – especially if it contains caffeine.)

  31. #31 Vicki
    January 5, 2010

    Some friends and I were talking about some of the “locavore” stuff and other food fads, and the ways that some of their proponents will make them seem like moral imperatives. It can become another way to look down on poor and even many middle-class people who either have other priorities or simply can’t afford this.

    I buy at the local farmers’ market for a few reasons, one of them being that farms are green, open space and I want to keep having some nearby. But I can afford this. My apples cost the same as at the supermarket, but I’m paying higher for berries, onions, potatoes, often greens, and mushrooms. It doesn’t make me a better person (a happier one, sometimes). Not that I could be a locavore in any case: they don’t grow tea, chocolate, or rice near enough to my home.