KYLE KELLAMS: There can be a tendency to consider food and medicine as two completely different things we put into our body. The food as medicine approach, though, integrates healthy food into plans for preventing or managing chronic disease. The movement has the backing of the American Medical Association and other groups. For our recurring series Balance, which is focused on health, diet and exercise, we're focusing this time on food as medicine. Jamie Baum, associate professor in the University of Arkansas Department of Food Science and director of the Center for Human Nutrition at the U of A, and Sydney Boudrey, a registered dietitian with the center, recently returned to the Carver Center for Public Radio to talk about food as medicine.
Jamie Baum says there isn't necessarily one single strategy connected to the phrase.
BAUM: "Food is medicine” has a lot of meanings to different people across the spectrum of food, nutrition and medicine. And I think it got its start from ancient Greek philosophy with, "Let food be thy medicine, and medicine be thy food," I think, is the quote. And that's actually the quote we used when Erin and I first started working with Balance in our class, Good Medicine. And it's, I think it's really associated with the fact that seven out of the leading 10 causes of death in Arkansas, and really nationally, are diet-related diseases. Over the years, we have seen studies just looking at populations where they see people who eat more fruits and vegetables, less saturated fat, less salt, tend to live well longer, so have a healthier lifespan. And I think those were sort of the initial steps from decades ago that have started people thinking about food as medicine. So beyond just taking, it's not a replacement for what we traditionally think is medicine, but offering maybe something else. And now it has turned into, I think, a broad spectrum of things, from being a true prescription service, so like medically tailored meals. I think Tufts University is working on a study where you can actually go to your Walmart pharmacy and pick up meals tailored to you, or home delivery, or fruit and vegetable coupons. So really turning it into medicine with a prescription from a doctor.
BOUDREY: And I was just going to add to that. I think it really emphasizes health throughout the lifespan too, because it's enabling people to not only live longer, but live a healthier life and be able to go out and do the things that they want to do, because they're having a healthy body and those types of things as well.
KELLAMS: This isn't revolutionary, right?
BAUM: I would say, since Sydney's a dietitian and I've been in nutrition for over a couple decades, we would say it's not revolutionary. But I think the approach is. I think it's interesting because it has a medical approach.
KELLAMS: Gotcha.
BAUM: Rather than starting early with education and intervention, now we're going to write a prescription for you, and you pick it — your food — up at the pharmacy. So it's interesting to me how two different trainings or perspectives would approach this.
KELLAMS: Does this concept work for someone who is generally healthy, or for someone who's been diagnosed with a chronic condition?
BAUM: So I think depending on which avenue you take. I think education as food is medicine — I can't remember the exact name of the initiative, but the current Health and Human Services has now, I don't know if it's a mandate or a recommendation, that all medical doctors during medical school have 40 hours of nutrition training, which is something that's never been required before. Most doctors, unless they took an elective, have never had a nutrition course. So that could help with prevention, so being able at least to advise or understand the value of dietitians in preventing chronic disease.
But I think there's a lot of clinical trials out there that have focused on people with COPD — chronic obstructive pulmonary disease — or cardiovascular disease, receiving these medically tailored meals, or type 2 diabetics. And they have seen improvements. I think now the next question is what happens when people stop receiving these meals. So I think that's where some of the work we do in our lab at the Center for Human Nutrition at the U of A is educating them, how do you cook? A lot of people — an example on the American Heart Association's website is like, okay, you have this man, he's a widower, he's never cooked for himself. After his wife passed away, he became really unhealthy. So he is now getting these medically tailored meals to treat his heart disease. But then when the prescription ends, because we all know, in our current health care system, prescriptions may not last forever. How does he cook? How does he know how to grocery shop and prepare the foods, or the right serving sizes to eat? So I think there's still sort of a "what happens when the prescription runs out" question that we're interested in.
BOUDREY: Yeah. And I think there's also part of this that's a more collaborative impact to teach people how to cook. And part of that is teaching kitchens. I think there might be a few in Arkansas, but they're working with communities to try to enhance the cooking skills of individuals, so they can learn how to cook these healthier foods that they might not be familiar with.
KELLAMS: If, as a dietitian, you're working with either an individual or groups — I'm sure it's different for different people in different groups — but is there an approach I mean, I don't want to be lectured, right? I want to be educated.
BOUDREY: I think that any hands-on approach is the best way to go about it. So, for example, the teaching kitchens — if individuals are able to learn how to cook their own meals while they're there, and then take those skills home with them, that's the best approach. But that's not always feasible.
BAUM: I've also talked with other health care professionals and people working in health care settings where we have to meet people where they are. So, as a white American from the Midwest, there are certain foods that bring me comfort and that I love that we could make healthier, but they may not be something that our Hispanic or Marshallese neighbors want to eat, or people with different cultural backgrounds. So there has to be a cultural component where we understand cultural foods and then how to make the foods they eat healthier, or incorporate that into these food as medicine approaches, to help with compliance and things like that.
Because if you're sending someone a hamburger and mac and cheese, but that is not in their daily repertoire, then that's not something that they're going to comply with. So there's a component of cultural sensitivity, understanding different meals, or even that people practice different dietary beliefs. So meeting people where they are and giving them solutions for how to make the foods they like better.
I think something that's often overlooked.
BOUDREY: Also, evaluating where we are in our current health system. I think I read a statistic that over 70% of foods that we consume are ultra-processed. So trying to incorporate — whether we like it or not, we're going to be consuming processed foods — the best of those foods into our current dietary pattern as well.
BAUM: Because we just taught a community class a couple weeks ago, and we've actually been having this debate within our own lab, because we're starting a food as medicine intervention study with pulses. But what is processed with pulses? Yes. Like legumes.
KELLAMS: Oh, okay.
BAUM: Lentils. So trying to add pulses, or these higher protein, high fiber plant foods, to meat foods, to have higher protein but also higher fiber intake, to reduce or improve heart health.
KELLAMS: I also wonder if for some people there is the challenge — maybe you think you're eating healthy because you don't keep a checklist of everything. I had a banana this morning for breakfast, and I think I had an apple last night before I went to bed. I think I'm fine, but in between there might be more. I tend to remember the healthy things I ate, and I tend to sort of conveniently forget.
BAUM: I will say I've been living alone the last week because my husband and son have been out of town, and when I was going for Nutella ice cream — that's a thing now — at the end of the day, I then remembered that I had had a cookie and a pastry and a candy bar also that day, but I had forgotten until I was halfway through a pint of ice cream. So then I was like, well, it's all about balance. But if I were to track it and remember, sometimes I don't remember what I had for breakfast because my day gets so hectic, I would probably be shocked by how many grazer calories I have. You're at work, you grab a free cookie, there's leftovers on a table. So I'm a victim of the grazer calorie, where I'm just walking by and popping something. And Sydney is a baker, so she often brings baked goods to work, and I was like, work calories don't count.
BOUDREY: I feel like it's also important to remember that all foods can fit into a healthy dietary pattern. It's more about the pattern versus one thing that you may consume. So it's important to not assign a moral value to a specific food, and really focus on your whole dietary pattern, what you eat throughout the week, versus just one singular food.
KELLAMS: And thank you for that.
BAUM: Yeah. And I think that comes back to the theme of balance. I'm not sure we've ever talked about it on Balance, but one of the reasons we focus on fruits and vegetables is because there are special chemicals within fruits and vegetables that give them their colors. They're called phytochemicals, and they have antioxidant properties. Antioxidants can help remove some — at least in animal or cell studies — reduce cancerous growth, prevent certain types of cancers or certain diseases. So beyond just the vitamins and minerals and water and fiber that fruits and vegetables give you, they also have these other properties that have been shown to help fight chronic disease. And the chemicals are what give the fruits and vegetables their different colors. So there's a certain one for carrots or berries, but they combine together, and they're also thought to have anti-chronic-disease-fighting properties. So I think that's why we get a lot of focus on fruits and vegetables.
KELLAMS: It sounds like going to a farmer's market might be a good place to pick up food that can serve as good medicine.
BAUM: Yeah. And they do talk about that sort of in this initiative, especially doing things to help recipients of SNAP benefits get extra bucks for buying — Double Up Bucks, I think, is one of the programs that we had in Arkansas, or was tested — if you buy from your local market, your value counts double, to help offset some of the cost.
Yeah. And I think we can't forget also about movement, because, as Erin would say, exercise is also medicine.
KELLAMS: So Arkansas, Oklahoma, Missouri can have very rural places, can be food deserts, can be medical deserts. Are there online resources that might help somebody understand food as medicine, or good nutrition, or good diet a little bit better?
BAUM: There are some really good fact sheets out there, but I don't think they're in a place that the general public would find them easily accessible, because it's still in its infancy and test phase. But a good Google search will give you the definition and the idea. I don't think it's anything we haven't talked about several times on Balance, or that we've heard in the media: increased fruit and vegetable intake, decrease sodium, saturated fats and move.
KELLAMS: Really? Vegetables better than others? I mean, if I have a jalapeño on something, is that just as good as having a radish or a green bean?
BOUDREY: I would say we need a diverse dietary pattern, so we get different phytochemicals from different fruits and vegetables. We can't just specifically focus on one fruit or one vegetable to give us all of the nutrients we need. We need a diverse dietary pattern with protein as well, incorporated into those fruits and vegetables.
BAUM: And I don't know, Kyle, when you were growing up, but we always heard, "Eat the rainbow." Did they ever? I mean, I feel like that's an old-school thing.
KELLAMS: No, I never heard that. But I like that.
BAUM: Yeah. So that's what I always used to tell my son: eat the rainbow.
KELLAMS: So if you think of the rainbow as ROYGBIV — red apple, orange, orange grapes. Thank you both.
BAUM: Thank you.
BOUDREY: Thank you. I appreciate it.
KELLAMS: Jamie Baum is associate professor in the University of Arkansas Department of Food Science and director of the Center for Human Nutrition at the University of Arkansas. And Sydney Boudreau is a registered dietitian with the center. Our series focuses on different aspects of health, nutrition and exercise. Next time, as we begin the countdown to football season, we'll explore how not to suffer from food poisoning when consuming food at a tailgate. That's next time on Balance. This is Ozarks at Large.
Ozarks at Large transcripts are created on a rush deadline and edited for length and clarity. Copy editors utilize AI tools to review work. KUAF does not publish content created by AI. Please reach out to kuafinfo@uark.edu to report an issue. The audio version is the authoritative record of KUAF programming.
