a diet is not a prescription: be careful when you say “food is medicine”

““Food is medicine,” sounds good, but it’s too simple.

Our ties to food are far more complex than our ties to medicine.

We don’t pass down family recipes for Lisinopril. We don’t visit different cultures to test taste their Tylenols. Our eyes don’t roll to the tops of their sockets with pleasure when Metformin makes its way into our mouths.

It’s been said that in the concentration camps during World War II, Holocaust prisoners whispered recipes to one another at night to keep their dimly lit spirits flickering just a little brighter, just a little longer. They weren’t whispering poetry about filling prescriptions. They were gaining spirit and energy from simply talking about the joys of cooking and eating.

That’s some powerful shit right there.

Medicine, at its best, keeps the body alive. Food, though, food can keep the whole being alive.

Medicine is rooted in necessity or prevention. Food is rooted in necessity, too, but its significance splinters off into complex web; it can also be a source of expression, extends into cultural representation, tethers us to childhood, to a home that may no longer exist, it allows us to feel bonded to our community, and even reaches back into our time in the womb. Many don’t fully comprehend just how deep our ties to food often are.

When untrained or inadequately trained, messing with someone’s dietary intake can cause decades of damage, turning the relationship to food into a cesspit of sadness, confusion, shame, and guilt. It’s a cesspit that needs to be visited multiple times per day. Pointing to a specific food as the main reason someone looks a certain way or does/doesn’t have a disease is far too oversimplified to be true, but it sure is marketable.

Though seemingly innocent, the “food is medicine” messaging can get elitist, racist, and classist real quick. It’s dangerous to mix food up with medicine in a society where both food and medicine are difficult to afford and mainly cater to a white Western audience. That’s not practicing nutrition.

I’m not saying food isn’t a crucial component of health and well-being. It’s that the messaging implies there’s a “right” way to eat, and it’s up to the individual to afford and do everything “right” or their disease is their fault. It ignores the fact that food is only part of the much, much, MUCH larger health picture.

If we say food is medicine, we should also be saying in the exact same message that affordable housing is medicine, regular access to quality healthcare is medicine, community is medicine, sleep is medicine, healthy relationships are medicine, finding time to slow down is medicine, and hobbies are medicine, too. Along those lines, we might as well say that, more than food, “having money for food is medicine.”

To do nutrition work respectfully, we gather extensive information to check in on the above subjects to see what makes sense to recommend, food or otherwise. In this way, interacting with food can be medicinal. Am I being nitpicky here? Maybe, but based on what I’ve experienced as a patient in the medical system and stories I hear from my patients, I can’t keep this in.

Telling someone to just eat more vegetables won’t be meaningfully helpful if they’re struggling to make rent. A handful of blueberries will do little to nothing to help depression if someone is being battered with microaggressions all day. Blindly recommending the Mediterranean diet to someone who is tied to their cultural, non-Mediterranean foods will do nothing helpful if it rips them away from the flavors that shaped their life. Seeing the trend?

Food is not medicine simply because it is food; food is medicinal when it is adjusted in a way that reduces symptoms, reduces harm, and uplifts people instead of making them feel like pieces of shit all the time.

Practicing nutrition isn’t simply telling someone to change their food for options outside of their means or taste preferences; it’s collaborating over a span of time to create evidence-based, realistic, respectful alterations to their current health-related patterns in thoughtful consideration of their whole being.