Have We Been Here Before?
To build a better future for food as medicine, we need to evaluate the challenges of its past.
The other day, a professor of mine shared that she viewed food as medicine as a natural extension of what nutritionists have been trying to accomplish for years. To her, this meant helping folks develop a better understanding of the way food interacts with their body, and advocating equitable access to culturally accessible and health supportive food regardless of income or background.
I agreed in the moment, but as I thought about this month’s post, I kept coming back to a nagging question: is this really what the field of nutrition aims for? Maybe that’s not it. Rather, is this what the nutrition field is set up for?
I don’t doubt that there are nutritionists actively working to ensure people of all bodies, and backgrounds get the food and guidance they need. But with the rise of nutrition advice on social media and food influencers running wild, it’s becoming harder to decipher which nutritionists have our best interests at heart and who are just hawking something for us to purchase. This sends cracks through the foundation of our understanding about not only what is healthy, but how we can reasonably incorporate healthful habits into our lives, a practice that is as unique to each individual as their favorite food. And when we can’t trust foundations of our understanding , then how can we look to the future with confidence?
If food as medicine is to be the natural successor to nutrition and dietetics, then it’s important for us to consider the foundations of both these fields. Anjali Prasertong notes in her fabulous newsletter “Antiracist Dietician,” that the space of nutrition has its own complex history, and in recent years has been critiqued for the ways that history perpetuates thinness, eating disorders, and racism.
I’ve written before about food as medicine’s roots in thousands of years of practices, of how factors like colonialism, patriarchy, and and the modernization of medicine, technology, and agriculture have expanded the distance between who we are and what we eat. It isn’t a coincidence that as we have become further separated from our food we have entered into an era of unparalleled diet-related disease and death. It’s estimated that more than one in five deaths around the world is associated with poor diet1 and that over 650,000 Americans die each year from diet- and nutrition-related issues.2
The fields of nutrition and food as medicine are arguably working to address these challenges. But the ways they advocate for change can also drive forward dangerous and unrealistic standards. My worry is that if these standards are not addressed, they’ll be incorporated into our approaches to food as medicine and, for example, used to deny someone insurance coverage or access to programming because of them.
When I received my training in Food Therapy from the Institute of Culinary Education (ICE), I was introduced to the work of Annemarie Colbin. She’s considered to be a bit of a pre-founder of food as medicine, and was the founder of the Natural Gourmet Institute, a health-supportive and plant-based cooking school located in New York City that was later absorbed into ICE. Her approach and curriculum has been adapted to train a slew of plant-forward and holistic chefs, food business owners, nutritionists, and holistic health practitioners. Her book Food and Healing has been in print since its publication in 1986 and is credited with exposing pop culture to the idea that diet impacts your health.
I have a complicated relationship with this book. In some areas, it contains thoughtful advice that is valuable to remind ourselves of even today. Prioritize whole, local, and seasonal ingredients. Eat fresh fruits and vegetables and avoid foods that are heavily processed or artificially flavored. Food should honor traditions and cultures and, most importantly, be delicious.
But in others, Colbin perpetuates the idea that our individual choices are the main driver of what and how we eat, and holds us to unattainable standards. Readers are instructed to avoid frozen and canned vegetables since they lack the vitality of fresh ones, ignoring the reality that for many, frozen or canned vegetable are all that is available, and that these ingredients still provide excellent nutrition. Changing one’s diet is viewed as a matter of will, and Colbin is almost flippant in her descriptions of clients who report what she calls withdrawal symptoms like headache and fatigue when significantly cutting out meat and dairy from their regular intake.
To me, Colbin’s influence is apparent in so much of today’s nutrition content. A brief search for “food as medicine” on TikTok spits out polished video after polished video featuring a slew of white women, mostly blonde, mostly thin, discussing how they used their organic, vegan, green juice and seed-based diet to rebalance their hormones, reduced inflammation, or healed their body (from what is never made clear).
Even if we give them the benefit of the doubt, it is too easy to see the lines connecting these content producers to the very systems that continue to uphold diet culture, unreasonable standards for what healthy living can or should be, and the idea that healthy food is exclusively fresh, organic, and expensive. These accounts are actively laying a groundwork for what our understanding of food as medicine is, and that has the potential to limit what it could possibly expand to be.
The definition of what food as medicine can and should be is still shifting, which means there’s still an opportunity create space for the field to truly become the equitable and thoughtful evolution of nutrition that my professor thought it might be. I am eagerly searching for more folks out there operating at the intersection of public health policy and compassionate, individualized food as medicine practice. Leaders like Aletha Maybank, Rupa Marya, Andrea Beaman, and Maneet Chauhan are using their influence to drive conversation about the field’s equitable expansion while remaining delicious and culturally sensitive.
To me, the question is how to protect or adapt the heart of the traditions we have around food, and how do we translate those histories into thoughtful and accessible approaches to food as medicine as a field. But to move into this future, we must understand and carefully select the roots we want to build upon. Will we grow this new field from a foundation of limitation and restriction, or one of expansiveness, creativity, access, and compassion?
Thanks for reading! Please let me know if there are other topics you’d like me to explore, questions you have, or ideas for future posts!
United States Food and Drug Administration. Improving Nutrition to Turn the Tide on Diet-Related Chronic Disease. Published 03/24/2022. Accessed via: https://www.fda.gov/news-events/fda-voices/improving-nutrition-turn-tide-diet-related-chronic-disease.
Center for Science in the Public Interest. Why Good Nutrition Is Important. Accessed via: https://www.cspinet.org/eating-healthy/why-good-nutrition-important