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Dr Peter Hill

Dr Peter Hill

Food As Medicine

We need to get into the habit of seeing our food as medicine, and not just as fuel for energy.

We can thank the Greek philosopher and physician, Hippocrates, who lived around 2500 years ago for title of this week’s blog. He first coined the phrase, “ Let food be thy medicine and medicine be thy food”.1

 ‘Food As Medicine’, is a topic that is especially relevant given the pandemic status of  the so-called chronic diseases of lifestyle or  the metabolic syndrome. These diseases include heart disease, type 2 diabetes, high blood pressure, many cancers, Alzheimer’s disease even psychological disorders such as mood disorders and  depression. 2-3

Research shows that what we eat and drink, how much stress we have, how much sleep we get, how much exercise we get and if we smoke – all play significant roles in the development of these lifestyle related diseases.4 If these lifestyle habits are associated with the development of disease then they must also play a big part in prevention and treatment.

We know that being overweight, and especially being obese, is a major risk factor for these lifestyle diseases. As we also know that what we eat and drink is the main driver of obesity,  then it is not difficult to think of Food As Medicine in the context of disease prevention and treatment.  We need to get into the habit of seeing our food as medicine, and not just as fuel for energy.

It is thought that as many as 70% of adult South African women and over 30% of men are overweight or obese.5 Research also shows that approximately 40% of adult South Africans have high blood pressure.6 This means that the majority of adult South Africans are at significant risk of developing serious life-threatening chronic diseases.

What is really important when thinking about dealing with these chronic diseases, is that many of them can be prevented –  and if not wholly prevented, then at least the complications of these diseases can, in many instances, be minimised. We know, for example, that people have been able to reverse type 2 diabetes by simply changing their diets.7

Some cancers too respond  positively to dietary and other lifestyle changes, as does depression. 8   Another interesting   aspect  relating to the prevention of this cluster of diseases, is that it does not generally require expert and expensive  medical care.

What is needed, however, is sustained and empowered self-care and this, in turn, means we need a self-care toolbox. If we were to open our self-care toolbox we would need to look no further than the tool marked, ‘Food As Medicine’.  That’s right, the most important tool in our self-care toolbox are the foods we eat and the beverages we drink. This is especially true when it comes to preventing, and treating, obesity – the ‘anchor tenant’ of the metabolic syndrome ‘mall’. 

We have been misled into believing that people are overweight because they eat too much and don’t exercise.  Research reveals that most people are overweight or obese because of a metabolic dysfunction called insulin resistance, which is also the main actor in many of the other lifestyle diseases. 4

Insulin has been called the fat-building hormone.When insulin levels rise we are able to store fat and when they drop we can burn fat for energy.9 An imbalance between fat storage and fat burning is the root cause of being overweight. High consumption of sugar and refined carbohydrates  gives rise to high levels of insulin, especially if we are ‘carbohydrate intolerant’ or insulin-resistant. 4

Having a blood test is the best way to tell if you are insulin-resistant and at risk for diseases of the metabolic syndrome. Another much less invasive option of assessing risk is to simply measure your waist to height ratio. 10 This is an easy ‘test’ and it will not cost you anything.  Start by measuring your waist and height in centimetres. Then take your waist measurement and divide it by your height, and  then multiply by 100 to give you a ratio expressed as a  percentage. Any value above 50% spells increased risk for serious lifestyle-related diseases. 10

Preventing or treating insulin-resistance does not necessarily require the use of medication. Getting rid of the spare tire will go a long way to improving health outcomes and the most cost-effective and easy way to do this is to simply eliminate sugar and other refined carbs from your diet.4,9 Adding some exercise does help but the main weapon we have in combating obesity and its fellow travellers is our diet.Hard to believe, I know, given what we have been told in the past but it’s  really as simple as this.

Begin by cultivating the habit of reading food  and beverage labels. The one ingredient on  a food label that you want to keep a close eye on is the one marked ‘glycaemic carbohydrate’.  It is important that you bear in mind that 4g of glycaemic carbohydrate = one teaspoonful of sugar in terms of the effect on blood sugar and insulin levels. 11

If it’s made in a factory and doesn’t have a label don’t buy it. Remember too my little mantra of  ‘if it’s not in your trolley it’s not on your body’. One final tip for the week: avoid anything that says ‘Low-Fat’ or that has added sugar.   Most low-fat products contain added sugars to improve their taste.  And remember this: sugar by any other name is still sugar.

I’m Dr Peter Hill

Until next week – take care and stay safe.

References

  1. Witkamp R F, van Norren K. Let food be thy medicine…when possible. European Journal of Pharmacology. 2018;836:120-114
  2. Newcomer JW. Metabolic Syndrome and Mental Illness. Am J Manag Care. 2007;13:S170-S177
  3. Alberti G, Zimmet P, Shaw J. The metabolic syndrome—a new worldwide definition. Lancet. 2005;366:1059-1062
  4. Lustig R. Fat Chance: the bitter truth about sugar. Fourth Estate. London.2013
  5. https://businesstech.co.za/news/lifestyle/331389/heres-how-many-south-africans-are-overweight-according-to-discovery/
  6. Guwatudde, D., Nankya-Mutyoba, J., Kalyesubula, R. et al. The burden of hypertension in sub-Saharan Africa: a four-country cross sectional study. BMC Public Health 15, 1211 (2015). https://doi.org/10.1186/s12889-015-2546-z
  7. https://www.frontiersin.org/article/10.3389/fendo.2019.00348
  8. Rao TS, Asha MR, Ramesh BN, Rao KS. Understanding nutrition, depression and mental illnesses. Indian J Psychiatry. 2008 Apr;50(2):77-82. doi: 10.4103/0019-5545.42391.
  9. Taubes G. Why we get fat and what to do about it. Anchor Books. New York. 2011
  10. Ashwell,MargaretHsieh,Shiun Dong Six reasons why the waist-to-height ratio is a rapid and effective global indicator for health risks of obesity and how its use could simplify the international public health message on obesity Int.J.Food Sci.Nutr. 2005; 56(5): 303-307
  11. Kelly T, Unwin D, Finucane F. Low-Carbohydrate Diets in the Management of Obesity and Type 2 Diabetes: A Review from Clinicians Using the Approach in Practice. Int J Environ Res Public Health. 2020 Apr 8;17(7):2557. doi: 10.3390/ijerph17072557

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