Can food be medicine?

Yes it absolutely can, if talking prevention.

Photo by Calum Lewis on Unsplash

I inhaled Dr Joshua Wolrich’s book Food isn’t Medicine: How Misinformation is Harming our Health in one lengthy sitting. But I couldn’t shake the feeling that there was something about it that profoundly disturbed me.

I’ve watched his videos on Instagram too, and he comes across as someone evidencing common sense and good intent albeit mixed with just a touch of trust-me-I’m-a-NHS-doctor-with-an-MSc-in-nutrition superiority (for example, see his take down of Joe Wicks). For sure he’s right that there’s a lot of what he terms “Nutribollocks” around, not least from other medical professionals alongside celebrities. And clearly if someone claims that eating nine blueberries a day cures cancer, even if they believe it worked for them, blueberries cannot, and should not, be hitherto universally cited by anyone as definitively cancer-curing.

However, while I fully support his premise of exposing Nutribollocks (notable examples include ‘milk contains pus’; ‘the carnivore diet cures depression’ or ‘Eating. eggs is as bad as smoking’), and while Wolrich concurs that “food can have a positive impact on someone’s health”, I think he conveniently skips a chunk of the discussion in his book in order for his ‘food isn’t medicine’ mantra to stick.

Here’s a quick extract: “ Having lots of fibre in your diet can significantly reduce your risk of colorectal cancer, but it won’t have any benefit if you already have the cancer.” But shouldn’t we be trying to prevent people getting colorectal cancer, using fibre, as found in food, as a precursor to the medicine they will inevitably end up requiring should they not eat sufficient fibre?

I’m not saying that Wolrich is not advocating this, but it is surely the flip side of the argument he seems to prefer?

Here’s another excerpt… “If food is medicine then it’s only fair that you say exercise is medicine, sleep is medicine, social connection is medicine, therapy is medicine… and you need to promote those just as loudly.” Oh but I do Dr Joshua, I do, it is my whole purpose! As it is for many others. Which is kind of the point. They are all potent tools, alongside home (which is the one that actually always gets forgotten), that we must encourage all and sundry to employ in their wellbeing toolbox.

He goes on to say that, “Despite the exact same logic, no one really uses those phrases because they’re simply not as exciting. It’s also not as easy to sell any of those as it is to sell a way of eating that promises to cure all your health problems.”

It may well be not as easy to sell but it is the truth, so to dismiss a whole part of the health equation on the basis that the rest of it isn’t sexy is surely to hoist himself by his own petard? In other words, it’s mightily convenient to say everyone else ignores those bits, so I will too, especially if you want to sell a book using the catchphrase ‘food isn’t medicine’.

Certainly food education is needed more than ever. With junk food promotions everywhere, it’s no surprise to read that food-related ill-health is costing the British economy almost £100 billion/year. Also, as I wrote in my last post, the UK is now dubbed the ‘Sick man of Europe’ because our sickness model of health care (turning up for people when they are already ill) doesn’t work.

We need to move towards a preventative primary care service, not one that relies on drugs and surgery to try to patch people up. Eating healthily, I maintain, can be a vital component in that. And yes, there is a whole discussion to be had about the effects of poverty and food desert zones in the UK where it is impossible to find fresh veg, but that’s not the argument I want to focus on here (with apologies) — if we were to dive into it though, it would surely be further fuel for the importance of food as medicine in maintaining health (ps two thirds of the UK’s independent fruit and veg shops have shut in the last 30 years, predominantly due to competition from supermarkets).

To be clear too, food should absolutely not replace any prescribed medication without expert advice and careful monitoring. Nor, if you already have a confirmed diagnosis of any illness, should conventional medical approaches be summarily rejected in favour of alternatives without serious discussion, and certainly not on the basis of something read on the internet. Such ‘alternative’ promises prey on the vulnerable. Because, if you, or a loved one, are sick, it’s a natural pursuit of agency to turn every which way to find something/anything that you hope might help.

Yet, this is the nub of my discontent with Wolrich’s book; diet can form an essential part of a medical protocol. Nutritious whole food can support healing. Plants, especially herbs, can have medicinal benefits beyond their edible ones, and what you eat will have a profound effect on your physical and mental wellbeing.

See my post on Ultra Processed Food if you doubt that. Also, look into the work of Dr William Li, recently interviewed by Dr Ragan Chatterjee on his podcast, who has centred his life’s work around the potential for food to absolutely be medicine.

Food is one of the best ways of nourishing and supporting your body (alongside exercise, sleep, outside time, mindset and unleashing the supportive power of home, as already discussed). To reiterate again though, I’m specifically talking about maintaining good health and preventing illness, not curing disease. My emphasis, study and research has always been on the side of encouraging an individual’s active and engaged participation in the protection of their health.

As I wrote in my book Happy Inside, “If you wilfully pollute your body, you increase your chances of becoming ill. So if you want your rocket to fly, put rocket fuel in it! But this needn’t mean throwing out all the cakes and biscuits and drinking only green juice with a side of raw celery sticks. It’s more about loading up on those foodstuffs that naturally work to clean up free radicals and any other nasties we may have absorbed.”

It’s why I started to formally study nutrition. I wanted to understand more about its place in the wellbeing toolbox. To be sure it is a science, and one that most medical students do not appear to study as part of their standard medical training. It’s also complicated by the fact that every single body is different, thus each individual will be unique in their responses to diet, as indeed they will be to medicines. 

Again, quoting from Happy Inside, I say, “Our doctors and health-care practitioners should be seen as our health partners in the quest for a healthy life, rather than people we rely on to patch us up, or even all-knowing medical sages trained to guesstimate what’s wrong with us in the first place. Medicine is an inexact science. It’s obviously based on extensive study and experience, but this doesn’t extend to absolute factual knowledge of your unique body. Your body is amazing at adjusting and adapting, but keep pushing the wrong buttons or not oiling those cogs, and something will eventually give. If you’re in this for the long game, you ignore what your body tries to tell you at your peril…

“We need to maintain awareness of their variability. After all, it is a rare individual who has perfect health and optimum vigour every single day, but if we can notice that we feel more off than usual – that we have varied significantly from whatever is normal for us – we have more chance of a speedy recovery. What we need to ensure is that we have enough space in our heads and schedules to check in with ourselves. Am I overdoing it a little? Did I skip breakfast too often this week? How much sleep have I had? Could I have picked up that virus that’s going around, or is it more than that?”

In my own posts on nutrition, I’ve tried to cut through the noise to find things I can state as facts rather than opinions, and steer away from anecdotal ‘evidence’. I do a huge amount of research before posting, caveat each piece with the words that this is research, not advice; and admit that the nutritional landscape is continually shifting. So even now, I may need to go back over them to see if any need updating.

But here’s a few of the things from Wolrich’s book that I wholeheartedly, based on my studies, concur with…

• We are not rodents. Obvious perhaps, but many a study, and therefore data cited as certified ‘proof’ for the efficacy of some supplements or treatments (especially in the new frontier of longevity), is based upon experiments carried out on mice and rats. How a mouse reacts to a drug being used as ‘proof’ of its effect on a human is clearly ridiculous. It might form a starting point for further research but should not be taken as any form of truth on its own.

• Sugar in and of itself is not the demon. This I cover off in my post Let’s Learn about Sugar. No-one that does not have diabetes needs to wear a glucose monitor. Your glucose levels go up and down. That is what they are supposed to do. It doesn't necessarily mean that you can no longer eat broccoli and it is my belief that certain extremely well-marketed organisations are ripping you off for your data. To be crystal clear, this latter statement is my personal opinion.

• Steer clear of any diet that advocates for the removal of an entire food group. We need the vitamins and nutrients from all three main groups: carbohydrates, fats and protein. There are however different sources available for all of these for example beans and legumes for protein if you choose not to eat meat. Also, carbs are not the devil. PS All fruit and vegetables are classified as carbohydrates, right alongside the wheat, bread and biscuits. Clearly though, some carbs are therefore ‘better’ than others, for example, the ultra processed forms.

• Food cannot change the pH of your blood. When we talk about acid-forming vs alkaline-forming food, it’s really important to understand that this is something that occurs in the process of digestion. Your blood does not become ‘acidic’ after eating meat or any other acid-forming food. If it did, you’d die. The pH of the body is very tightly regulated by its own genius. In short, the only thing that might possibly become a touch more acidic is your wee.

• Intermittent fasting is privileged starvation (excluding cultural or religious fasting). I’m not going to go into all the ins and outs of this, you can buy his book for that, but I concur that it’s unproven and unnecessary. Fasting is what happens when you sleep, that’s why the first meal of the day is called break-fast. That’s quite enough non-eating. That said, I do think it’s helpful to your digestive system to not to eat too near to bedtime, but restricting eating to within a specific window is unnecessarily stressful and potentially lays the foundation for an unhealthy relationship with food. Food is not just fuel (maybe this should be my follow up book?!)

• Developing a healthy relationship with food is better than any diet. Ie non-obsessive, and not focused around weight loss. Dr Joshua talks at length in his introduction about weight stigma, having suffered it himself. Also the fact that social determinants of health — access to quality healthcare and education; your community context and how rich/poor you are — have a huge impact on the length and quality of our lives.

However I do not think that Wolrich can definitively state as misinformation that ‘organic food reduces cancer risk’; or debunk the fact that pesticides are potentially dangerous. Taken individually, eg ‘antiperspirants cause breast cancer’, it would be accurate to say that any one of the things that he pillories in his book are unlikely to be directly causative of a chronic disease (smoking and lung cancer might be the only exception, yet even here we know of the the hard-smoking pensioner that puffs themselves happily into old age). We are as multi-faceted as are many diseases. As such it’s rarely a straight line from one defined input to one inevitable outcome.

However, there is little debate that certain toxins, additives, synthetic chemicals and pollutants can contribute to an environment, whether internally or externally, which paves the way towards tipping the balance towards a set of conditions that might encourage the onset of a chronic disease. This is what I talk about in my Let’s Talk About Toxic Load piece. And this is what’s missing from his narrative. By breaking his book down into individual debunkings, he fails to consider the holistic picture of today’s contemporary citizen trying to navigate their way through a world that is an increasingly contaminated Petri dish.

In many ways, it is precisely this situation which leads people to seek advice from un-verified sources. And not just people desperate for cures, it’s anyone increasingly freaked by stats such as 1 in 2 of us will be diagnosed within our lifetime with cancer. So the debunking is urgently required, especially around cancer. But it helps no-one if we also categorically negate the veracity of certain risks, and refuse to acknowledge the potential of others.

To state that food is not medicine without adequately clarifying the above, is in my opinion, also misinformation.