The Fallacy of Food As Medicine

Originally printed in the September 2023 issue of Produce Business.

There are certain words or phrases that make me cringe. Yes, kale, but also “food is medicine,” or “food as medicine.” I believe both phrases overpromise benefits while also taking away the joy, pleasure, and enjoyment of eating — especially when it comes to fresh produce.

Think of the beautiful colors, enticing aromas, crunchy textures, sweetness, juiciness, and other positive sensory properties of fruits and vegetables. Now, think about the aftertaste in your mouth when you take a pill without enough water to quickly swallow it, or you take a big swig of cough syrup. Awful, right? So, why would we want to compare food to medicine?

Dylan MacKay is a nutritional biochemist and an assistant professor of community health sciences in the Rady College of Medicine at the University of Manitoba who is credited with saying, “Food is food, medicine is medicine, and both of them are really amazing.” I couldn’t agree more with this statement. Both food and medicine need to be recognized and appreciated for all they can do, but they should not be equated.

Because I’m a registered dietitian nutritionist, many people in the produce industry are surprised to learn I don’t support the “food as medicine” platform. There are many reasons for my lack of enthusiasm, but perhaps my primary reason is that when it comes to fruits and vegetables, people already know these foods are good for them. The last thing produce needs is another hurdle to overcome.

Many associate the first use of the phrase “food is medicine” to an organization called God’s Love We Deliver, which was founded in New York City in 1985 with a mission “to improve the health and well-being of people living with HIV/AIDS, cancer and other serious illnesses by alleviating hunger and malnutrition.”

“Food is food, medicine is medicine, and both of them are really amazing.”

— Dylan MacKay, Rady College of Medicine, University of Manitoba

The first people to be served by the organization were men dying of AIDS. Patients too weak to leave their homes were given free meals, thoughtfully prepared to promote better health. The term “food is medicine” was used to encourage financial contributions to the nonprofit organization at a time when there were very few medicines available for patients with HIV or AIDS. Food was one of the only treatments that could extend life a few months or modestly improve quality of life during a patient’s last few months.

God’s Love We Deliver gave birth to the Food Is Medicine Coalition, an organization whose clinical committee, made up of registered dietitian nutritionists who are experts in treating serious illness with nutrition, has issued guidelines based on more than 30 years of experience developing the science of medically tailoring meals. This organization also does advocacy work to ensure more private and public health insurance systems include reimbursements for medically tailored meals.

Fast forward to today when many people across the produce industry and other sectors are saying “food is medicine” liberally in conversation. Nearly every speaker on the stage at the International Fresh Produce Association 2023 Foodservice Conference used the phrase. Yes, IFPA is focused on ensuring produce is included in nutrition program policy in D.C. — this is a good thing. But, I believe it is not in the best interest of the industry to use “food as/is medicine” in casual conversation or in consumer communication and marketing.

The only way food can truly, appropriately, and responsibly be used as medical treatment is when a Registered Dietitian Nutrition (RDN) or other professionally trained, credentialed healthcare professional includes food recommendations as part of medical nutrition therapy for patients with conditions like diabetes, kidney disease, an organ transplant, or a host of other conditions for which your food choices can have an impact of your short- or long-term health and well-being.

Anyone who saw the look on my face when a speaker at IFPA recommended restaurants put nutrition claims on menus likely thought I was going to implode from disbelief and anger. Putting nutrition information on menus, beyond the basic nutrition facts mandated by federal menu labeling laws, is ridiculous. It hasn’t worked in the past, and it won’t work in the future. Consumers have moved past that. They have personalized views of what is best for themselves. Diners are seeking specific ingredients that have actual or perceived benefits — ingredients like avocados, extra virgin olive oil, pomegranate arils or walnuts.

Yes, our eating patterns have an impact on health outcomes. Yes, there are certain foods with specific nutrient benefits that, when consumed as part of an overall healthful eating pattern, can be very beneficial. But, no, food is not medicine. Food is food.

Let’s stop overpromising, and let’s get back to marketing fruits and vegetables with a focus on all the reasons to love them, including color, aroma, crunch, juiciness and taste, as well as the experience of enjoying it with people we love.

Amy Myrdal Miller, MS, RDN, FAND is a farmer’s daughter from North Dakota, award-winning dietitian, culinary nutrition expert, and founder and president of Farmer’s Daughter Consulting, Inc. She is the culinary and foodservice strategist for the Produce for Better Health Foundation, the retail nutrition marketing and foodservice specialist for the Buy California Marketing Agreement/CA GROWN, a member of the Texas A&M Institute for Advancing Health Through Agriculture AgriLife External Advisory Board, a member of the Bayer Vegetable Seeds Horticultural Advisory Council, and co-author of Cooking á la Heart, a 500-recipe cookbook based on plant-forward eating cultures from around the world. You can learn more about her business at www.farmersdaughterconsulting.com, and you can follow her insights on food and flavor on social media @AmyMyrdalMiller.