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Is food to be deemed a medicine? Pros and cons and if and when to consider supplements

The idea that “food is medicine” has been around for millennia, dating back to Hippocrates’ famous aphorism, “Let food be thy medicine and medicine be thy food”. In recent decades, with the rise of lifestyle and dietary-related diseases, this idea has gained renewed attention. While many recognize the potential of food to prevent, manage, and even treat certain diseases, there are also limitations and risks to relying solely on nutrition as a therapeutic tool. In this article, we’ll look at the pros and cons of the concept of food as medicine.

Pros: food as medicine

Numerous studies show that a balanced diet rich in whole foods can prevent many chronic diseases, including type 2 diabetes, cardiovascular disease, and some cancers. For example, the Mediterranean diet, which includes generous portions of fruits, vegetables, whole grains, fish, and healthy fats, is associated with a lower risk of chronic disease and increased longevity (Estruch et al., 2013). Many chronic diseases, including arthritis, heart disease, and Alzheimer’s disease, are linked to chronic inflammation. Anti-inflammatory foods, such as berries, fatty fish (salmon, sardines), olive oil, and nuts, can help reduce inflammation (Calder et al., 2009). Foods rich in antioxidants, fiber, vitamins, and minerals can reduce inflammation, improve cardiovascular health, and support immune function, helping to prevent degenerative diseases.

A diet rich in micronutrients, such as vitamin C, vitamin D, zinc, and polyphenolic antioxidants, can strengthen the immune system, protecting the body from infections and diseases. For example, foods such as citrus fruits, leafy greens, and nuts are associated with improved immune function. In support of this view, it is no coincidence that the Autoimmune Protocol (AIP) diet was developed, designed to include foods whose nutritional richness serves to exert a generalized anti-inflammatory effect with specific control over abnormal immune responses. The AIP diet is a much stricter version of the Paleo diet (based on meat, fish, vegetables, nuts and seeds), and recommends eliminating foods that can cause inflammation in the gut, eating types rich in nutrients.

The AIP diet is based on the belief that autoimmune conditions are caused by the phenomenon of “leaky gut.” In fact, it exempts potatoes, tomatoes, eggplants, and peppers from vegetables, which are Solanaceae containing lectins. Lectins, or phytohaemagglutinins, are a family of proteins found in almost all foods, especially legumes and grains. It is well established that frequent and large consumption of them can damage the lining of the digestive tract and may be linked to autoimmune diseases. Therefore, the rationale for avoiding foods with lectins in autoimmune diseases would be based on the principle of “adding gasoline to the fire.” However, a whole foods diet is not only cost-effective compared to drugs and medical treatments, but can also be maintained over time as part of a healthy lifestyle.

Cons: the limitations of food as medicine

Although food can play a significant role in preventing and managing disease, it cannot replace drug treatments in serious or acute conditions. Diseases such as cancer, serious infections, and autoimmune diseases often require complex medical therapies that cannot be managed by diet alone, despite the best intentions and optimization of existing drug therapies or very careful selection of foods with nutrients required to treat the condition you are suffering from. Dietary changes can take a long time to show tangible effects. People with chronic diseases may need more immediate intervention and cannot wait months or years to see significant improvements. Some dietary approaches tend to promote single “superfoods” as miracle cures for complex diseases.

For example, although berries are rich in antioxidants, eating berries alone will not be enough to prevent or cure chronic diseases. Good health requires a comprehensive approach to diet and lifestyle. Some fad diets, such as extremely low-carb or high-fat diets, can promote nutritional deficiencies or long-term health problems if followed without professional supervision. And there is no “one size fits all” diet. People have different nutritional needs based on genetics, age, health conditions, and lifestyle. What works for one person may not work for another. For example, some people may benefit from a vegetarian diet, while others may find it does not meet their nutritional needs.

Food supplements: the rationale

Relying solely on food as medicine may lead some people to ignore or delay necessary medical treatments. This can make health conditions worse, especially when it comes to serious diseases such as cancer or advanced cardiovascular disease. Many of the claims about food as medicine come from observational studies that may show correlations, but not necessarily causation. Evidence regarding the effectiveness of certain foods in treating disease is often incomplete or inconclusive. This is why supplements exist, which are absolutely not a prescription to replace real medical care or their exclusive use. The misleading food industry has capitalized on the idea of ​​”food as medicine,” promoting supplements and functional foods as quick fixes to improving health. However, many of these products are not supported by solid scientific research and can create unrealistic expectations. The best approach remains to supplement a healthy diet with appropriate medical treatments, adopting a lifestyle that promotes disease prevention, but without neglecting medical science and professional advice.

Edited by Dr. Gianfrancesco Cormaci, PhD, specialist in Clinical Biochemistry.

Scientific references

Ley SH et al. (2014). The Lancet, 383(9933), 1999-2007.

Estruch R et al. (2013). New Engl J Med, 368(14), 1279-90.

Calder PC et al. (2009). Brit J Nutrition, 102(5), 627-635.

Sacks FM et al. (2001). New Engl J Medicine, 344(1), 3-10.

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Dott. Gianfrancesco Cormaci
Dott. Gianfrancesco Cormaci
Laurea in Medicina e Chirurgia nel 1998; specialista in Biochimica Clinica dal 2002; dottorato in Neurobiologia nel 2006; Ex-ricercatore, ha trascorso 5 anni negli USA (2004-2008) alle dipendenze dell' NIH/NIDA e poi della Johns Hopkins University. Guardia medica presso la casa di Cura Sant'Agata a Catania. Medico penitenziario presso CC.SR. Cavadonna (SR) Si occupa di Medicina Preventiva personalizzata e intolleranze alimentari. Detentore di un brevetto per la fabbricazione di sfarinati gluten-free a partire da regolare farina di grano. Responsabile della sezione R&D della CoFood s.r.l. per la ricerca e sviluppo di nuovi prodotti alimentari, inclusi quelli a fini medici speciali.

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