If Hippocrates were alive today, he’d probably be rich off of royalties earned from the usage of his phrase “Let thy food be thy medicine and medicine be thy food.” After all, this quote is repeated endlessly to inspire making dietary changes.
Oddly enough, I don’t see food being treated as medicine correctly — a dichotomy that I believe can be incredibly damaging to people’s mental and physical health.
As a dietitian, I truly believe that food is powerful and have seen first-hand how dietary changes can be beneficial and life-changing. I also believe that food is not medicine. That being said, if we treated dietary changes like medication changes, the world would probably be a healthier place.
Working in healthcare, I’ve witnessed the process for starting and adjusting medications. Often a “step therapy” approach is used, which means that less invasive and expensive medications with less side effects are used first. If unsuccessful, more invasive, expensive, and potentially risky interventions are tried. Additionally, different medications with the same mechanism can be prescribed based on cost, insurance coverage, and/or patient tolerance.
If food is medicine, then we should treat dietary changes with a step therapy approach. To be fair, most dietitians and other healthcare professionals already do this. It’s more so the sensationalized diets discussed in the media or online that disregard the importance of gradual changes in order to promote long-term health and well-being.
Here’s a common example. If someone came to me with a diagnosis of pre-diabetes wanting to change their diet, my first recommendation is never “don’t eat any white carbs” or to stop eating sugar altogether. Do they drink a lot of soda? Let’s change to water or other unsweetened beverages. Do they skip lunch and binge on candy after dinner? Let’s plan lunches to bring to work and come up with healthier after-dinner snack ideas. Do they eat fast food frequently out of convenience? Let’s come up with quick and easy meal ideas that incorporate more nutrient-dense foods.
No matter the person or the situation, my intervention depends on various factors including cooking ability, financial means, food access, and food preferences.
Further, it’s important to appreciate that, just like medication changes, the positive effects of dietary changes rarely reveal themselves immediately. Blood cholesterol levels don’t immediately decrease when you start taking a statin (or eating more fiber). Your hemoglobin A1c level won’t decrease overnight after your insulin dosage is increased (or you switch from regular to diet soda). Antidepressants often take several weeks to provide noticeable symptom relief (as does eating more healthy fats).
Don’t get me wrong — medically prescribed diets are powerful and important. There are reasons to make an immediate, drastic change such as food allergies or celiac disease, but cutting out all sugar, going keto, or doing a juice cleanse usually isn’t necessary. There are often smaller, less overwhelming changes that can improve your health and quality of life. It might take some weeks or months to reach your goals, but isn’t the point to create a lasting change that you can sustain?
Dietary changes that are tried and true for improving health are much simpler than you might think. Try those simpler changes first before bending over backwards for something that may harm you more than help you.
Further, some people may choose medication over dietary changes, or may decide to take medication in conjunction with lifestyle changes. That’s okay. No one should be made to feel like they’ve somehow failed because they need a little more than avocados and chia seeds to reach their optimal state of well-being.
In my opinion, expecting people to rely solely on food to treat ailments of the mind and body is unrealistic for most people and consequently can be damaging to people’s mental health.
It may take some trial and error, but find what works best for you, whether that be food, medication, other interventions, or a combination.