Food as Medicine

Have you and your doctor talked about “food as medicine” lately? Maybe not, so okay -- I'll make this my chance to tell you about my patient Irma. While we're here, let's also talk over a swimming lesson that you'd do well to avoid.

 Irma (not her real name) is a health worker, a friendly wife and mom in her early 50s. She has rheumatoid arthritis that can generate achey, swollen knees, wrists, and hands. Her rheumatologist had prescribed two medicines that were of some help, but she was hoping to avoid them -- and their side effects -- when possible, and to feel better.

 This kind of arthritis is made worse by a more general clinical picture of inflammation. That, in turn, can be affected by diet, and we can be thoughtful on how we use food to support our bodies while managing a medical condition.  Irma's habits were pretty good. She doesn't order out a lot, usually eats at home.

 But, it turns out, she has a sweet tooth, and she also ate quite a lot of refined, packaged food products: white bread, pastries, breakfast cereals, waffles. We have to work along with prescribed medical treatment, but  rather than reaching into the medicine cabinet  again as a next step, we talked about what's in the refrigerator.

Generally, more research is needed about  how diet relates to gut health, and specifically, how diet influences rheumatoid arthritis. But we know that over time those processed, packaged foods can have an inflammatory effect. Sometimes they even lead to the leakage of inflammatory food antigens from the gut can into the bloodstream.  

My Rx: fewer starches and carbs and bready foods, and a lot more fruits and green vegetables. Sometimes foods rich in omega 3 fatty acids can help this condition, too, along with  foods that have anti-inflammatory properties, like turmeric and ginger.

 Changing these habits takes time and focus. Therapeutic diets are short-term and the goal is finding a long-term sustainable plan for managing this kind of  chronic disease. But Irma's symptoms over almost a year improved so much that her doctor canceled one of her meds and reduced the dosage of the other one. Now she takes regular walks of a half-hour or more, and more movement leads to an even happier body. The medication is an important aid, but the dietary changes have worked well.

 As a recent Howard University study points out, diet can seriously affect a range of chronic disease risk factors and outcomes among African-Americans with either pre-diabetes, type 2 diabetes, high blood pressure, elevated cholesterol levels, obesity or a combination of these disorders.

 But despite “overwhelming evidence” demonstrating the impact of diet on health, many medical schools don't require that students take basic nutrition courses. That's one source of trouble.

 Another is that unwelcome swim I mentioned, in the Sea of Misinformation on the internet. You can even find the "waffles diet" online? C'mon now! At least 60 percent of U.S. consumers use the internet for medical information, according to another comprehensive study released last spring. On the web, “baseless trends and sensationalist news create opportunities for misinformation to proliferate," the study concludes. Listen to your physician, not your Twitter feed, for what you need.

When making decisions about our health, it’s important to reach into the refrigerator, not just the medicine cabinet.

As a a primary care physician, Dr. Valerie Pershad, has significant experience in a wide array of acute and chronic medical conditions, including working as a hospitalist during the COVID-19 pandemic. She has now shifted her focus to include a preventative and restorative approach to her patients’ care.

Dr. Pershad is board certified by the American Board of Internal Medicine and the Institute of Functional Medicine. She completed medical school at the George Washington University in Washington, DC and completed residency in internal medicine at North Shore University Hospital and Long Island Jewish Medical Center. She is an internal medicine physician, and she also practices functional medicine, an area of medicine that focuses specifically on how and why disease occurs for each individual and allows for a personalized treatment plan.