Chapter 26

Using Food as Medicine

IN THIS CHAPTER

Listing diets for special medical conditions

Using food to ease annoying but relatively minor health problems

Eating to prevent disease and promote a healthy body

Knowing when food is not your best medicine

A healthful diet gives you the nutrients you need to keep your body in top-flight condition. In addition, evidence suggests that eating well may prevent or minimize the risk of a long list of serious medical conditions, including heart disease and high blood pressure.

This chapter describes what nutritionists know right now about how to use food to prevent, alleviate, or cure what ails you.

Defining Food as Medicine

Start with a definition. A food that acts like a medicine is one that increases or reduces your risk of a specific medical condition or cures or alleviates the effects of a medical condition. For example:

• Eating foods, such as wheat bran, that are high in insoluble dietary fiber (the kind of fiber that doesn’t dissolve in your gut) moves food more quickly through your intestinal tract and produces soft, bulky stool that reduces your risk of constipation.
• Eating foods, such as beans, that are rich in soluble dietary fiber (fiber that dissolves in your intestinal tract) seems to help your body mop up the cholesterol circulating in your bloodstream, preventing it from sticking to the walls of your arteries. This reduces your risk of heart disease.
• Eating sufficient amounts of calcium-rich foods (accompanied by vitamin D, as noted in Chapter 10) ensures the growth of strong bones early in life.
• Eating very spicy foods, such as chili, makes the membrane lining your nose and throat weep a watery fluid that makes blowing your nose or coughing up mucus easier when you have a cold.
• Eating (or drinking) foods (or beverages) with mood-altering substances such as caffeine, alcohol, and phenylethylamine (PEA) may lend a lift when you’re feeling down or help you chill when you’re tense. (For more on food and mood, see Chapter 24.)

The joy of food-as-medicine is that it’s cheaper and much more pleasant than managing illness with drugs. Given the choice, who wouldn’t opt to control cholesterol levels with oats or chili (all those yummy beans packed with soluble dietary fiber) than with a list of medicines whose possible side effects include kidney failure and liver damage? Right.

Naming Diets with Absolutely, Positively Beneficial Medical Effects

Some foods and some diet plans are so obviously good for your body that no one questions their ability to keep you healthy or make you feel better when you’re ill. For example, if you’ve ever had abdominal surgery, you know all about liquid diets — the water–gelatin–clear broth regimen your doctor prescribed right after the operation to enable you to take some nourishment by mouth without upsetting your intestines.

Or if you have type 1 diabetes (an inherited inability to produce the insulin needed to process carbohydrates), you know that your ability to balance the carbohydrates, fats, and proteins in your daily diet is important to stabilizing your illness.

Other proven diet regimens include

• The high-fiber diet: A high-fiber diet quickens the passage of food through the digestive tract. This diet is used to prevent constipation. If you have diverticula (outpouchings) in the wall of your colon, a high-fiber diet may reduce the possibility of an infection. It can also alleviate the discomfort of irritable bowel syndrome (sometimes called a nervous stomach). Extra bonus: A diet high in soluble fiber also lowers cholesterol (see the preceding section, “Defining Food as Medicine”). A word to the wise: When increasing your dietary fiber intake, be sure to drink enough fluid (see Chapter 12) to prevent the fiber from clumping in and maybe even blocking your digestive tract.
• The sodium-restricted diet: Sodium is hydrophilic (hydro = water; philic = loving). It increases the amount of water held in body tissues. For people who are sensitive to the effects of sodium, a diet low in salt often lowers water retention, which can be useful in treating high blood pressure, congestive heart failure, and long-term liver disease. By the way, not all the sodium in your diet comes from table salt.
• The extra-potassium diet: People use this diet to counteract the loss of potassium caused by diuretics (drugs that make you urinate more frequently and more copiously, causing you to lose excess amounts of potassium in urine). Some evidence also suggests that the high-potassium diet may lower blood pressure a bit.
• The low-protein diet: This diet is prescribed for people with chronic liver or kidney disease or an inherited inability to metabolize amino acids, the building blocks of proteins. The low-protein regimen reduces the amount of protein waste products in body tissues, thus reducing the possibility of tissue damage.

Using Food to Prevent Disease

Using food as a general preventive is an intriguing subject. True, much anecdotal evidence (“I did this, and that happened”) suggests that eating some foods and avoiding others can raise or lower your risk of some serious diseases. But anecdotes aren’t science. The more important indicator is the evidence from scientific studies tracking groups of people on different diets to see how things such as eating or avoiding fat, fiber, meat, dairy foods, salt, and other foods affects their risk of specific diseases.

The general name for foods that deliver a health benefit is functional foods. One example of a group of natural functional foods that prevent illness is the vitamin A-rich collection of dark green, yellow, red, and orange fruits and vegetables that protect the ability to see in dim light. An example of a manufactured functional food is margarines made with heart-and-brain protective omega-3 fatty acids, whipped up by food technologists. (See Chapter 7 for more information on specific dietary fats.)

Battling deficiency diseases

The simplest example of food’s ability to act as preventive medicine is its ability to ward off a deficiency disease, a condition that occurs when you don’t get sufficient amounts of a specific nutrient. For example, people deprived of vitamin C develop scurvy, the vitamin C–deficiency disease; or there’s pellagra, the deficiency disease due to a lack of the B vitamin niacin. Because flour processing often removes B vitamins found in the germ of the grain, virtually all grain products sold in the United States are enriched with the B vitamins.

Reviewing the evidence on anticancer diets

Is there really an anticancer diet? Probably not. The problem is that cancer isn’t one disease; it’s many diseases with many causes. Some foods seem to protect against some specific cancers, but none seem to protect against all. For example:

• Fruits and vegetables: Plants contain some potential anticancer substances, such as antioxidants, chemicals that appear to prevent molecular fragments called free radicals from hooking up to form cancer-causing compounds.

  However, despite early predictions that antioxidant-rich plant foods would reduce the risk of cancer overall, to date, no seriously controlled study has ever shown that belief to be true. However, several such studies do demonstrate a relationship between eating lots of fruits and vegetables and having a lower risk of a specific type of cancer. For example, in 2010, data from a study conducted by The National Institute for Public Health and the Environment in the Netherlands and published in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research, did suggest that this kind of diet would decrease the risk of one type of lung cancer in current smokers. Besides, fruits and veggies taste good. So enjoy them.

• Foods high in dietary fiber: Human beings can’t digest dietary fiber, but friendly bacteria living in your gut can. Chomping away on the fiber, the bacteria excrete fatty acids that appear to keep cells from turning cancerous. In addition, insoluble dietary fiber helps speed food through your body, reducing the formation of carcinogenic compounds.

  For more than 30 years, doctors have assumed that eating lots of dietary fiber reduces the risk of colon cancer, but in 1999, data from the long-running Nurses’ Health Study at Boston’s Brigham and Women’s Hospital and Harvard’s School of Public Health threw this assumption into question. Since then, several very large studies — one with more than 350,000 people! — confirmed that dietary fiber probably has no protective effect against colon cancer. But even if dietary fiber doesn’t fight cancer, it does prevent constipation. One out of two ain’t bad.

• Low-fat foods: Dietary fat appears to increase the proliferation of various types of body cells, but not all fats appear to be equally guilty. In several studies, fat from meat seems linked to an increased risk of colon cancer, but fat from dairy foods comes up clean. In the end, the link between dietary fat and cancer remains up in the nutritional air … so to speak.

FEAST ON FISH

Over several decades, a plethora of studies have suggested a higher risk of colon cancer among meat eaters than among vegetarians. Exactly how beef, pork, and lamb exercise their adverse effect remains a matter of controversy, but in 2015, researchers at Loma Linda University in California added a new twist to the story: Don’t just pass up the meat, they said; Pick up the fish.

Their advice is based on an analysis of the daily menus of more than 70,000 men and women. As previously noted, following a vegetarian diet lowered the risk of colon cancer by 22 percent. But adding fish produced an even greater reduction in risk, 43 percent lower than meat eaters.

The beneficial veggie-plus-fish-and-other-seafood diet is not just tasty and maybe protective. It even has a catchy new name: pescovegetarian from piscis, the Latin word for fish.

The American Cancer Society Advisory Committee on Diet, Nutrition, and Cancer Prevention issued a set of nutrition guidelines that shows how to use food to reduce the risk of cancer. These are the American Cancer Society’s recommendations:

• Choose most of the foods you eat from plant sources. Eat five or more servings of fruits and vegetables every day. Eat other foods from plant sources, such as breads, cereals, grain products, rice, pasta, or beans, several times a day.
• Limit your intake of high-fat foods, particularly from animal sources. Choose foods low in fat. Limit consumption of meats, especially high-fat meats.
• Be physically active. Achieve and maintain a healthy weight. Be at least moderately active for 30 minutes or more on most days of the week. Stay within your healthy weight range.
• If you drink alcohol, drink in moderation. Chapter 9 lays it out: Moderate consumption means no more than one drink a day for a woman, two for a man.

THREE DEGREES OF VEGETARIANISM

Vegetarianism isn’t one diet; it’s four plant-based menu plans, each one distinguished by what’s allowed to be on the dinner plate along with the plants.

• Vegetarian variation #1 is a diet for people who don’t eat meat but do eat fish and poultry or just fish. (Fairness dictates that I state that many strict vegetarians don’t consider people who eat fish or poultry to be vegetarians.)
• Vegetarian variation #2 is a diet for people who don’t eat meat, fish, or poultry but do eat other animal products, such as eggs and dairy products. Vegetarians who follow this regimen are called ovo-lacto vegetarians (ovo = egg; lacto = milk).
• Vegetarian variation #3 is a diet for people who eat absolutely no foods of animal origin. Vegetarians who eat only plant foods are called vegans.
• Vegetarian variation #4 is a diet comprising only fruit. Naturally, vegetarians who use this diet are called fruitarians.

DASHing to healthy blood pressure

More than 50 million Americans have high blood pressure (also referred to as hypertension), a major risk factor for heart disease, stroke, and heart or kidney failure.

As you can read in High Blood Pressure For Dummies, by Alan L. Rubin, MD (Wiley), the traditional treatment for hypertension has included drugs (some with unpleasant side effects), reduced sodium intake, weight reduction, alcohol only in moderation, and regular exercise. But data from multiple sources, including the National Heart, Lung, and Blood Institute (NHLBI) study, “Dietary Approaches to Stop Hypertension” (2002) — DASH, for short — and a second NHLVI study, DASH Sodium (2000), offer strong evidence that the diet that protects your heart and reduces your risk of some forms of cancer may also help control blood pressure.

The DASH diet, which often comes in number one on lists of healthy ways to eat is rich in fruits and vegetables, plus low fat-dairy products with controlled sodium levels. No surprise there. But the DASH diet suggests that you get no more than 27 percent of your calories each day from fats, lower than the 35 percent considered standard by several other diets.

The difference does seem to make a difference. Your blood pressure is measured in two numbers that look something like this: 130/80. The first number is your systolic pressure, the force exerted against artery walls when your heart beats and pushes blood out into your blood vessels. The second, lower number is the diastolic pressure, the force exerted between beats.

When male and female volunteers with high blood pressure followed the DASH diet during clinical trials at medical centers in Boston, Massachusetts; Durham, North Carolina; Baltimore, Maryland; and Baton Rouge, Louisiana, their systolic blood pressures dropped an average 11.4 points and their diastolic pressures an average 5.5 points. And unlike medication, the diet produced no unpleasant side effects — except, of course, for that occasional dream of chocolate ice cream with real whipped cream, pound cake… .

Conquering the common cold

This section is not about chicken soup. That issue has been settled, and Dr. Mom was right. In the 1980s, Marvin Sackler of Mount Sinai Medical Center in Miami, Florida, published the first serious study showing that cold sufferers who got hot chicken soup felt better faster than those who got plain hot water, and dozens of studies since have said, man, he’s right. Nobody really knows why chicken soup works, but who cares? It works.

So moving on to other foods that make you feel better when you have the sniffles — for example, sweet foods. Scientists do know why sweeteners — white sugar, brown sugar, honey, molasses — soothe a sore throat. All sugars are demulcents, substances that coat and soothe the irritated mucous membranes.

Lemons aren’t sweet, and they have less vitamin C than orange juice, but their popularity in the form of hot lemonade (tea with lemon and sugar) and sour lemon drops is unmatched. Why? Because a lemon’s sharp flavor cuts through to your taste buds and makes the sugary stuff more palatable. In addition, the sour taste makes saliva flow, which also soothes your throat.

FOOD AND SEX: WHAT DO THESE FOODS HAVE IN COMMON?

Oysters, celery, onions, asparagus, mushrooms, truffles, chocolate, honey, caviar, bird’s nest soup, and alcohol beverages. No, that’s not a menu for the very, very picky. It’s a partial list of foods long reputed to be aphrodisiacs, substances that rev up the libido and improve sexual performance. Take a second look, and you’ll see why each is on the list.

Two (celery, asparagus) are shaped something like a male sex organ. Three (oysters, mushrooms, and truffles) are said to arouse emotion because they resemble parts of the female anatomy. (Oysters are also high in zinc, the mineral that keeps the prostate gland healthy and ensures a steady production of the male hormone testosterone. A 3-ounce serving of Pacific oysters gives you 9 milligrams of zinc, about 82 percent of the 11 milligrams a day recommended for adult men.)

Caviar (fish eggs) and bird’s nest soup are symbols of fertility. Onions — and Spanish fly (cantharides) — contain chemicals that produce a mild burning sensation when eliminated in urine; some people, masochists to be sure, may confuse this feeling with arousal. Honey is the quintessential sweetener: The Bible’s Song of Solomon compares it to the lips of the beloved. Alcohol beverages relax the inhibitions (but overindulgence reduces sexual performance, especially in men). As for chocolate, well, it’s a veritable lover’s cocktail, with stimulants (caffeine, theobromine), a marijuanalike compound called anandamide, and phenylethylamine, a chemical produced in the bodies of people in love.

So do these foods actually make you feel sexy? Yes and no. An aphrodisiac food isn’t one that sends you in search of a lover as soon as you eat it. No, it’s one that makes you feel so good that you can follow through on your natural instincts, which is as fine a description as you’re likely to get of oysters, celery, onions, asparagus, mushrooms, truffles, chocolate, honey, caviar, bird’s nest soup, and wine.

Hot stuff — such as peppers, horseradish (freshly grated is definitely the most potent), and onions — contains mustard oils that irritate the membranes lining your nose and mouth and even make your eyes water. As a result, it’s easier to blow your nose or cough up mucus.

Finally, there’s coffee, a real boon to snifflers. When you’re sick, your body piles up cytokines, chemicals that carry messages among immune system cells that fight infection. When cytokines pile up in brain tissue, you get sleepy, which may explain why you’re so drowsy when you have a cold. True, rest can help to boost your immune system and fight off the cold, but once in a while you have to get up. Like to go to work.

The caffeine in even a single cup of regular coffee can make you more alert. Caffeine is also a mood elevator (see Chapters 24 and 30) and a vasoconstrictor (a chemical that helps shrink swollen, throbbing blood vessels in your head). That’s why it may help relieve a headache. When I have a cold, one cup of espresso with tons of sugar can make life bearable. But nothing’s perfect: Drinking coffee may intensify the side effects of OTC (over-the-counter) cold remedies containing decongestants and/or caffeine that make some people feel jittery.

Check the label warnings and directions before using coffee with your cold medicine. Vasoconstrictors reduce the diameter of certain blood vessels and may restrict proper circulation. Check with your doctor, too, if you’re taking meds for a chronic condition such as high blood pressure.

Eating for a Better Body (And Brain)

Citrus fruits are rich in vitamin C, an antioxidant vitamin that seems to slow the development of cataracts. Bran cereals provide fiber that can rev up your intestinal tract, countering the natural tendency of the contractions that move food through your gut to slow a bit as you grow older (which is why older people are more likely to be constipated). Getting enough calories to maintain a healthy weight helps protect against wrinkles. And although a diet with adequate amounts of fat doesn’t totally prevent dry skin, it does give you a measure of protection. That’s one reason virtually all sensible diet gurus, including the American Heart Association and the Dietary Guidelines, recommend some fat or oil every day.

And now for a word about memory. Actually, two words: Varied diet.

As long ago as 1983, a study of 250 healthy adults, age 60 to 94, at the University of New Mexico School of Medicine showed that the people who ate a wide range of nutritious foods performed best on memory and thinking tests. According to researcher Philip J. Garry, PhD, professor of pathology at New Mexico School of Medicine, overall good food habits seemed to be more important than any one food or vitamin. Maybe people with good memory are just more likely to remember that they need a good diet.

Or maybe it’s really the food. In 1997, another survey, this time at Complutense University (Madrid, Spain), showed that men and women age 60 to 90 who eat foods rich in vitamin E, vitamin C, folic acid, dietary fiber, and complex carbohydrates do better on cognitive tests. Is it the antioxidant vitamins? Does a low-fat diet protect the brain? No one knows for sure right now, but it may turn out that sticking with this same-old, same-old low-fat, high-fiber diet as you grow older may help you to remember to stick to the same-old low-fat, high-fiber diet — for years and years and years. (For much more on feeding your brain at any age, see Chapter 24.)

The Last Word on Food versus Medicine

Sometimes, a person with a life-threatening illness is frightened by the side effects or the lack of certainty in standard medical treatment. In desperation, she may turn down medicine and turn to diet therapy. Alas, this decision may be hazardous to her already-compromised health.

No reputable doctor denies the benefits of a healthful diet for any patient at any stage of any illness. Food not only sustains the body but also can lift the spirit, and some foods may enhance the effects of many common drugs. But there is no evidence that food alone is an adequate, effective substitute for (among other medicines)

• Antibiotics and other drugs used to fight infections.
• Vaccines or immunizations used to prevent communicable diseases. The emergence of an “antivax” movement has proven not that vaccines are hazardous but that avoiding them is. In the past few years, in parts of the United States where parents have refused to vaccinate their children against childhood diseases, such as measles or whooping cough, the inevitable result has been epidemics of preventable illness.
• Medicine used to treat cancer.

If your doctor suggests altering your diet to make your treatment more effective, your brain will tell you, Hey, that makes sense. But if someone suggests chucking your doctor and tossing away your medicine in favor of food alone, heed the natural warning in your head. You know there’s no free lunch and — as yet — no truly magical food, either.

THE HISTORY OF FOOD AND MEDICINE

Common wisdom to the contrary, doctors do have a sense of humor. Witness this “history of medicine” attributed to that famous author Anonymous and currently making the rounds of medical meetings and blogs:

• 2000 B.C: "Here, eat this root."
• A.D. 1000: "That root is heathen. Here, say this prayer."
• A.D. 1850: "That prayer is superstition. Here, drink this potion."
• A.D. 1940: "That potion is snake oil. Here, swallow this pill."
• A.D. 1985: "That pill is ineffective. Here, take this antibiotic."
• A.D. 2000: "That antibiotic doesn't work. Here, eat this root."