For would-be doctors in the US, at least 10 medical schools now offer courses in culinary medicine – the use of food to treat and prevent disease.
It's the way of the future, says dietitian Sue Radd.
![Tasty option: Go with wholegrain for health.](/web/20161017231230im_/http://www.smh.com.au/content/dam/images/g/s/2/j/u/g/image.related.articleLeadwide.620x349.gs2jiz.png/1476654713955.jpg)
"Doctors are well trained in the science of medicine but not in the science of food as a way to tackling disease. Yet if doctors understand food and the shortcuts to healthier eating they can pass that knowledge on," she says.
It's not hard to find examples of how a diet makeover can work as well as a prescription drug. There's the DASH (Dietary Approaches to Stop Hypertension) Diet that includes nine serves of vegetables and fruit daily, together with lean protein foods and wholegrains but less salt – it lowers blood pressure by boosting levels of potassium, magnesium and calcium but reducing sodium.
![Right recipe: Roasted vegetables on couscous with Moroccan dressing.](/web/20161017231230im_/http://www.smh.com.au/content/dam/images/g/s/2/j/u/f/image.related.articleLeadNarrow.300x0.gs2jiz.png/1476654713955.jpg)
The cholesterol busting Portfolio Diet, high in a mix of specific plant foods found to reduce cholesterol, is another. Designed by University of Toronto researchers, it's been found to work as well as a low dose statin, says Radd, the author of Food as Medicine, a new book that shows how to put evidence-based nutrition science to work in the kitchen.
"Even if you've already had a heart attack, the Lyon Diet Heart Study showed that by adopting a Mediterranean style diet you could reduce your risk of having a second heart attack by 50 per cent. The diet worked better than medication or the low fat diet recommended by the American Heart Association that the Lyon Diet was compared to," she adds.
The most common problems Radd tackles in her own Sydney practice, often in conjunction with GPs, include type 2 diabetes, high cholesterol, high blood pressure, fatty liver and reflux. Her "prescription"? A plant-based diet – meaning a pattern of eating rich in vegetables, fruit and legumes with minimally processed grains, although not necessarily vegetarian. Healthy fats from whole foods like nuts and seeds, together with extra virgin olive oil are an important part of this eating style.
"Plant-based diets are a no-brainer – in one hit they tackle so many of the problems that underlie chronic conditions like inflammation, high blood pressure and high cholesterol. Plant-based diets also make it easier to lose weight without having to obsess about counting kilojoules," she says.
"This is because of their higher content of fibre and polyphenols which can positively influence the microbes living in our gut. When you feed these microbes certain fibres, for example, they produce short chain acids such as propionate – a substance that helps us to eat less and which slows the generation of new fat cells."
The inflammation Radd refers to is the low level persistent kind perpetuated by lifestyle influences like a Western diet and inactivity and linked to chronic diseases such as type 2 diabetes, atherosclerosis and a decline in memory and brain function.
Research has found that fatty fast food can trigger inflammation, impairing the function of blood vessels.
"One small study of healthy people showed that within just hours of eating a single fatty fast food meal, their arteries' normal ability to relax was reduced by half – but many people will go on to stress their arteries repeatedly with unhealthy meals," she says.
"It's not just arteries that are affected, either. A study from the University of Newcastle showed that four hours after feeding a meal high in kilojoules and unhealthy fats to stable asthmatics, there was a significant increase in inflammation in their airways and a reduced ability of asthma medication (Ventolin) to work properly compared to when they were fed low-fat yoghurt."
The rise of convenience food combined with the devaluing of home cooking – except as a spectator sport on TV – has been disastrous for our health, Radd says.
"So many people never learn to cook – especially how to cook with protective foods like whole grains and legumes and if you leave yourself at the mercy of food in packages, or fast food, you're paving your way to chronic disease," she adds.
Although a cleaner diet means many of her clients can avoid prescription drugs or at least reduce them, Radd isn't anti-medication.
"I'm not saying people should avoid it – in some cases people need both food and medication."
She also believes we need to know more about the "why" of eating more plant foods.
"Telling someone 'you need to eat more vegetables and legumes' doesn't mean much. But if you explain that they contain prebiotic fibres that feed friendly gut microbes to help them produce substances that fight inflammation, they start to join the dots."
5 anti-inflammatory food swaps
Pro-inflammatory Anti-inflammatory
White bread Wholegrain, seeded bread; sourdough
Potato crisps Raw unsalted nuts
Refined vegetable oil high
in omega-6 fats, eg safflower Extra virgin olive oil
Red meat Legumes, nuts, oily fish
Minced meat Chopped mushrooms, chopped nuts
Source: Food as Medicine
Food as Medicine by Sue Radd is published by Signs Publishing, rrp $55.00