Food as Medicine is No Longer a Fringe Idea

Dr. Daniel Nadeau gives Allison Scott a few tips on getting kids to eat healthy, at Ralph's Supermarket in Huntington Beach.

Dr. Daniel Nadeau gives Allison Scott a few tips on getting kids to eat healthy, at Ralph's Supermarket in Huntington Beach. (David Gorn/KQED)

Several times a month, you can find a doctor in the aisles of Ralph’s market in Huntington Beach, wearing a white coat and helping people learn about food. On one recent day, this doctor was Daniel Nadeau, wandering the cereal aisle with Allison Scott, offering ideas on how to feed kids who studiously avoid anything that tastes healthy.

“Have you thought about trying smoothies in the morning?” he asks her. “The frozen blueberries and raspberries are a little cheaper, and berries are really good for the brain.”

Scott knows about smoothies, actually. She’s been cooking a plant-based diet for her family for about nine months, a decision prompted by her husband being diagnosed with systemic inflammation. Scott cooks a couple of hours a day to prepare meals from whole foods. So when she saw a doctor in Ralph’s, Scott says, she was delighted to find someone talking about the very thing that has been consuming her life: food as medicine.

Nadeau is program director of the nearby Mary and Dick Allen Diabetes Center, part of the St. Joseph Hoag Health alliance. The Center’s Shop with Your Doc program sends doctors to the grocery store to meet with any patients who sign up for the service, plus any other shoppers who happen by with questions.

“In America, over 50 percent of our food is processed food,” Nadeau says. “And only 5 percent of our food is plant-based food. I think we should try to reverse that.”

It can be hard work, as anyone who’s tried to eat more vegetables or quit sugar knows. Part of the work is learning about nutrition and making time to cook, says Scott, who in the beginning ran all her menus past a nutritionist, and sometimes uses a service that delivers her a box of organic food and recipes to prepare it. And for her, another part is getting her two boys, 5 and 8, to make the same changes.

“I always make them try a bite of every single thing I make,” she says. “The kids get so mad at me, still, even though they’re starting to eat better.”

A Small Revolution Brewing

Scott and Nadeau are part of a small revolution brewing across California. The food-as-medicine movement has been around for decades, but it’s making new inroads as physicians and medical institutions make food a formal part of treatment, rather than relying solely on medications. By prescribing nutritional changes or launching programs such as Shop with Your Doc, they’re trying to prevent, limit or even reverse disease by changing what patients eat.

“There’s no question people can take things a long way toward reversing diabetes, reversing hypertension, even preventing cancer by food choices,” Nadeau says.

Clients in a pilot program for pregnant women with diabetes choose from an array of fresh fruits and vegetables, at the Community Wellness Program Center at Zuckerberg San Francisco General Hospital.
A client in a pilot program for pregnant women with diabetes chooses from an array of fresh fruits and vegetables, with help from a volunteer, at the Community Wellness Program Center at Zuckerberg San Francisco General Hospital. (UCSF)

In the big picture, says Dr. Richard Afable, CEO and President of St. Joseph Hoag Health, medical institutions across the state are starting to make a philosophical switch to becoming a health organization, not just a health care organization.

That sentiment echoes the tenets of the Therapeutic Food Pantry program at Zuckerberg San Francisco General Hospital, which completed its pilot phase and is about to expand on an ongoing basis to five clinic sites throughout the city. The program will offer patients several bags of food prescribed for their condition, along with intensive training in how to cook it.

“We really want to link food and medicine, and not just give away food,” says Dr. Rita Nguyen, the hospital’s medical director of Healthy Food Initiatives. “We want people to understand what they’re eating, how to prepare it, the role food plays in their lives.”

In Southern California, Loma Linda University School of Medicine is offering specialized training for its resident physicians in Lifestyle Medicine—that’s a formal subspecialty in using food to treat disease.

Research on the power of food to treat or reverse disease is beginning to accumulate, but that doesn’t mean diet alone is always the solution, or that every illness can benefit substantially from dietary changes. Nonetheless, physicians say they look at the cumulative data and a clear picture emerges: that the salt, sugar, fat and processed foods in the American diet contribute to the nation’s high rates of obesity, diabetes and heart disease. According to the World Health Organization, 80 percent of deaths from heart disease and stroke are caused by high blood pressure, tobacco use, elevated cholesterol and low consumption of fruits and vegetables.

“It’s a different paradigm of how to treat disease,” says Dr. Brenda Rea, who helps run the family and preventive medicine residency program at Loma Linda University School of Medicine.

Choosing What Foods to Prescribe

The lifestyle medicine subspecialty is designed to train doctors in how to prevent and treat disease, in part, by changing patients’ nutritional habits. The medical center and school at Loma Linda also has a food pantry and kitchen for patients.

St. Joseph Hoag Hospital gives out shopping bags to people who consult the doctor about food choices.
St. Joseph Hoag Hospital gives out shopping bags to people who consult the doctor about food choices. (David Gorn/KQED)

Many people don’t know how to cook, Rea says; they only know how to heat things up. That means depending on packaged food with high salt and sugar content. So teaching people about which foods are nutritious and how to prepare them, she says, can actually transform a patient’s life. And beyond that, it might transform the health and lives of that patient’s family.

“What people eat can be medicine or poison,” Rea says. “As a physician, nutrition is one of the most powerful things you can change to reverse the effects of chronic disease.”

Studies have explored evidence that dietary changes can slow inflammation, for example, or make the body inhospitable to cancer cells.

In general, many lifestyle medicine physicians recommend a plant-based diet—particularly for people with diabetes or other inflammatory conditions.

“As what happened with tobacco, this will require a cultural shift, but that can happen,” says Dr. Nguyen. “In the same way physicians used to smoke, and then stopped smoking and were able to talk to patients about it, I think physicians can have a bigger voice in it.”

From her own experience, Allison Scott suggests that anyone making the switch to a plant-based diet have support, because “it’s a complete lifestyle change.”

“You  have to stop buying what’s on sale,” she says. “You have to go into the store knowing what you want to buy.”

And if you’re cooking for a family, she says, plan all your food in advance and have it already on hand.

One more tip for people who want to quit sugar: read labels. Most salad dressings, soups and breads contain sugar. Even Amy’s organic tomato soup. Go figure.

  • Hillary Clintub

    Can’t wait until libs have to have a prescription to buy food. None of this over-the-counter stuff for them. Only pharmaceutical grade styrofoam is good enough.

    • BayKat

      What an angry woman you seem to be. No one is forcing you to eat healthier. Go ahead, feed your children twinkies for breakfast, lunch and dinner. Us “libs” don’t really care. Shorter lifespans for ignorant republicans will be better for the US and the planet.

  • Leonard

    Can’t wait it I was diagnosed with type 2 Diabetes and put on Metformin on June 26th, 2016. I started the ADA diet and followed it 100% for a few weeks and could not get my blood sugar to go below 140. Finally i began to panic and called my doctor, he told me to get used to it. He said I would be on metformin my whole life and eventually insulin. At that point i knew something wasn’t right and began to do a lot of research. On August 13th I found Lisa’s diabetes story (google ” HOW EVER I FREED MYSELF FROM THE DIABETES ” ) I read that article from end to end because everything the writer was saying made absolute sense. I started the diet that day and the next morning my blood sugar was down to 100 and now i have a fasting blood sugar between Mid 70’s and the 80’s. My doctor took me off the metformin after just three week of being on this lifestyle change. I have lost over 30 pounds and 6+ inches around my waist in a month. The truth is we can get off the drugs and help myself by trying natural methods

  • Hillary Clintub

    “How would you like that steak, rare, medium, well done or intravenous?”

  • Ken Immer

    This is a great first step, but the realities that “You mean I would have to make it?” or “The kids just won’t eat it” are not just something that the mother should just have to ‘get over’. The ‘getting over it’ is the most important part of the puzzle. The doctors’ advice about which foods are ‘better’ for you in a grocery store are great, but where they lack skill is in the “how”. Culinary Health is a science and a method for truly addressing all the concerns: what SHOULD you eat, and how can you make choices that lead to eating those foods in a way that works for your lifestyle.

  • Thrilled that KQED is covering culinary medicine–blending of the art of cooking with the science of medicine to create top quality meals and drinks that help prevent and treat disease. Great work!

    Dr. Nadeau (full disclosure: a friend and colleague) is also the author of The Color Code, which describes the colorful phytonutrients in plants and what they do. But any food that is naturally brightly colored (um, not Trix) is better for you than any food that’s not. And nearly anything you cook for yourself is better than nearly anything you buy.

    Our own work, with Chef Clinic and ChefMD, and with Tulane, has now been adopted by about 25% of U.S. medical schools: teaching culinary medicine, and sometimes lifestyle medicine, as David Gorn writes.

    Clinicians are finally able to begin to catch up to patients–doctors should write recipes on prescription slips too. I do!

  • Ringingthebells

    Good idea, to follow the doctors orders, always….. I think we also have to go back to the old way of doinng things,,,walk, walk, walk is the key.. When Jesus was on earth, he walked and remained thin..and healthy…

  • Allison Scott

    I worked in the healthcare industry for fourteen years and write a health and female advocacy blog. My family eats 90% organic, plant based meals cooked from scratch. It is very difficult to stay committed to this diet because it takes a lot of time and is expensive. My kids are allowed some fun food in their lives so they enjoy their mac n’ cheese! My husband had a cardiovascular workup which scared our family, so I have been committed to eating this way for a while. It’s hilarious I was quoted as having a love affair with processed, boxed foods. I had every meal I made for six month analyzed by a nutritionist until I finally learned how to cook this way. I really enjoyed meeting David and Dr. Nadeau, who are both supporting the right cause. Cheers and Happy New Year to both of you!

  • wandagb

    A local organization is working to transform the school lunch programs in the Bay Area. Looks like an interesting project:

    http://www.consciouskitchen.org/schools
    The Conscious Kitchen partners with schools to shift the paradigm around food service, based on five foundational terms that define our commitment to fresh, local, organic, seasonal, non-GMO (FLOSN) meals.

  • genecrazy

    All this nutrition talk and no mention of Registered Dietitians and their contribution to..you know…nutrition and health.

    • Allison Scott

      Agreed. And this was by design to advertise the select few featured in this article who are changing the world – LOL

    • Emily Goodman

      Thank you for thinking of us! As a Registered Dietitian myself, and a member of the Dietitians in Integrative and Functional Medicine practice group, in disbelief that RDs didn’t even get a mention. I rely on NPR to write well researched, thorough articles (which they mostly do). Fell quite short this time. This may be a new idea to MDs (who have mostly ignored RDs and the power of nutrition for the past few decades), but it surely isn’t to dietitians! It is the basis of our practice!

  • Mark Braun

    As a type 2 myself, it continues to unravel what is right and wrong to eat, but kicking cereal off the menu saw my mid-day sugar spikes drop. And preparing a protein-smart breakfast does not consume more time, it just required me to reclaim time for my own safety. You can, too. Thanks for a great article! Wishe we had a docotr in the aisles around here!!!

  • Allison Scott

    Wow! This article did not turn out as I expected. It was clearly designed to make the doctor look smart. My family eats 90% organic, plant based meals which I prepare. It is very difficult to stay committed to this diet because it takes a lot of time and is expensive. KQED did a great job blaming me, (the evil mother who was interviewed) to present the problem. Thanks for telling me whole wheat pasta & smoothies are the solution. This article is out of touch with reality. Do you know what I had to go through to learn how to eat a 90% plant based diet? (Which they omitted?) Maybe that would have made the story more interesting. I had every meal I made for six month analyzed by a nutritionist until I finally learned how to cook this way. I did this due to “doctor’s orders” for my husband’s health issues so I wasn’t just being a snob. I guess being affluent is an underlying assumption made by NPR/KQED about their audience. And even if Kraft Mac n Cheese is a little too blue collar, please don’t take pity on my kids. They’re doing just fine!

  • Wende Kirckhoff

    I couldn’t be happier to hear about the Loma LInda school teaching about nutrition, after watching The Global Truth about Cancer an how those Doc’s had little to no teaching through their receptive schools was an eye opener, teach how a drug works but not food. I had an A1C test done 2 yrs ago in June, it was 9.5, an they wanted me on Metformin, apparently the go to for Dr’s, I went to the drugs website, read all the side effects an said, OH Hell NO!, that day I throw out the pills an went on a raw diet, cut all sugar, meat, and processed foods, an got myself a really nice cruising bike, an rode every morning, weather permitting, an got up to 11 miles a day, an 1 month later, I was 20 lbs lighter an my A1C was 6.2, done all by myself, and I’m still doing fine.

  • Veg Nik

    For more info, check out

    Food for Thought — and Action
    https://sites.google.com/site/foodfood411/

Author

David Gorn

David Gorn is the former Deputy News Director of KQED Radio, and currently works as a freelancer for National Public Radio. He has worked for three daily Bay Area newspapers, has been Editor-in-Chief of several magazines, and has taught journalism at San Jose State University and San Francisco State University.

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