‘Is it wrong to think of food as medicine?’

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We need our clinicians to buy in to the concept that “thy food is thy medicine, and thy medicine is thy food”. Instead of arguing over what Hippocrates meant by this, exactly – or whether he even said it – why not encourage his medical descendants to take up this mantle?

Arguably, most doctors are more equipped to write a prescription or make a referral than to discuss nutrition and lifestyle interventions. Without question, pharmaceuticals have their place, but so does food as medicine, and our brilliant doctors – in whom we trust – must take greater steps towards preventative care and lifestyle interventions that will address the growing burden of type 2 diabetes, obesity and malnutrition in this country.

An estimated 60 per cent of adults and one in four children in Ireland are either overweight or obese. The direct and indirect costs to the exchequer which are associated with obesity are estimated to exceed €1 billion per annum.

The Healthy Ireland Framework 2013-2025 states that the “health and wellbeing of everyone living in Ireland . . . is the most valuable asset that we possess as a nation”. The report goes further to say that health in Ireland will be unsustainable in the future due to lifestyle diseases and ageing populations. It makes a strong argument for greater emphasis on illness prevention.

Therefore, I ask our politicians, the HSE and the Department of Health: if our health and wellbeing is such a prized asset, why isn’t more being done to protect it?

Both hospitals and the food service sector are considered key areas for public policy interventions in this regard. Yet many doctors have no nutrition training. In the US, this has resulted in changes to curriculums whereby culinary medicine is being incorporated into doctor training in Harvard and Tulane universities, and even in some US hospitals. Nutrition knowledge and cookery education, like prescribed exercise, should become another tool in a clinician’s toolkit. Ironically, the one place that we go to to get help when chronically unwell is a hospital. Yet doctors working there are ill-equipped to intervene – or even get involved – in this critical area.

Hospital food

In the UK, £50 million has been spent on failed bids to improve hospital food. Reports suggest 17 separate government initiatives since 2000 have resulted in no discernible improvement in the quality of meals served to patients. Albert Roux, James Martin and Loyd Grossman have all tried. Prue Leith has now taken up the baton.

But remaking hospital menus isn’t easy.

Hospitals have to operate on strict budgets and food supply is frequently outsourced to companies that specialise in high volumes of food at a low cost – often resulting in packaged and processed foods. Research shows us that 30-40 per cent of hospitalised patients are considered to be at risk of malnutrition. However, hospitals are a place where “nutritionism” rules.

“Nutritionism” is a term coined by the Australian sociologist Gyorgy Scrinis, and popularised by food writer Michael Pollan. It means reducing the value of a food to specific nutrients it contains. It’s a little like the food pyramid – which forms the basis of diet recommendations in Ireland.

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