The role food can play in prevention and treatment
Food and the diets we consume have become the focus of significant attention within the last decade.
Food is a hot topic
Media space and time spent on food, nutrition and health abound, there are blogs aplenty, online recipes , and social media is rich with images of foods in multiple combinations. Everyone seems to be talking about food, and because we all eat we all have an opinion to offer. There seems to be a pursuit for the perfect diet, a continual search for the key few must-have ingredients that will promote good health and keep ill health and disease at bay or at least under good control. Different dietary approaches are hot topics. People are eager to share their nugget of ‘dietary magic’ and must-have information. It is interesting to observe as the interest in super foods has emerged over the last few years, and trends and fads appear around certain foods. Not all of us live in circumstances of such privilege to be able to be so discerning.
Data from 2014 to 2016 (from the United Nations and the Food and Agriculture Organisation) indicate that around 795 million people (around 1 in 9 of the world’s 7.3 billion people) are chronically undernourished without access to adequate amounts of food for basic good health. 98% of these people live in the developing world. For these people, food is scarce and poverty and associated ill health remains a significant global public health issue. Poverty and undernutrition still exists in subpopulations within many developed countries and food insecurity (inability to obtain nutritionally adequate and safe food) is a real issue. Those of us fortunate enough to live with adequate access to food each day may take this for granted. We keep looking for magic bullet superfoods that will overcome our health problems instead of thinking more broadly about the overall pattern of foods we are fortunate to choose to eat each day.
Food and nutrition
Food at its most fundamental level – provides us with fuel to function and an array of nutrients to support this function and to grow, heal, repair and live. Food is comprised of macronutrients - Protein, Fat and Carbohydrates which contribute energy (kilojoules/ calories) to our diet in addition to supporting vital bodily roles and functions. Food is also comprised of an array of micronutrients (vitamins and minerals), and other compounds (such as phytonutrients), that are crucial in keeping us functioning. Even the parts of food that are not absorbed in the gut (collectively called dietary fibre) are important to maintaining good health.
Nutrition scientists have spent years of research, isolating different components of food and trying to understand their function. We have learnt a great deal by breaking down food components in this way. But the danger then lies in isolating the part from the whole when choosing what to eat. Within foods, all the various micronutrients exist within a complex food matrix which affects how they are absorbed by the body, how they interact with each other and how much of them it is possible to take in at one time. When nutrients are isolated and put in a pill, or added as fortificants to other foods, they can be poorly absorbed, interactions with other nutrients can be lost and it is easy to consume them in excess which can be harmful.
We are designed to eat foods not isolated nutrients.
One example that illustrates the importance of getting our nutrients from whole foods can be taken from the case of iron. Iron is essential for making the haemoglobin that carries oxygen in our red blood cells and myoglobin that carries oxygen into our muscles. It is also very important for normal growth and development. Iron occurs in many foods and it can be isolated from them as a simple mineral in the form of inorganic iron salts. Yet if we consume iron in this isolated form, it is very difficult for the body to absorb it. Moreover, if we take large doses of inorganic iron it can cause nausea, constipation or damage the gut wall. Not surprisingly, foods fortified with inorganic iron also may not give you iron in a form that is easily absorbed. The body absorbs iron much better when it is presented as iron bound to carrier proteins. These not only improve absorbability but also isolate the iron so that it is unable to cause damage to the body during the absorption process. One good example of iron in this form is haeme iron, which is found in many kinds of meat, particularly red meat. Nutrients in foods interact with one another. This also occurs with iron. If you eat foods rich in iron, together with foods rich in vitamin C, your iron absorption will increase. If you eat foods rich in iron together with foods high in dietary fibre (and containing phytates) your iron absorption will be much lower. This is only one example of the complexity of nutrients in foods compared to isolated nutrients.
Every food exists with its own unique array of nutrients and micronutrients – whilst different foods with similarities can be grouped together, no food is created equal. So to get the full benefits from foods we need to combine many different foods within our diet. In recent years, nutrition scientists have drawn attention not just to individual foods but to the importance of our overall dietary pattern. What combinations of foods do we choose? Which combinations are particularly healthy? Which are unhealthy?
One example of a healthy dietary pattern is the Mediterranean diet. This is not the diet currently eaten in countries around the Mediterranean which has been affected by many modern food practices, but the traditional diet that continued up until the 1950s in places like the island of Crete, in Greece. The traditional Mediterranean diet was characterised by high consumption of fruit, vegetables, legumes and whole-grain cereals, moderate consumption of fish and dairy foods (mainly as yoghurt and cheese), the use of olive oil as the main source of fat and very low intake of red meat (eaten rarely). Additionally, intake of alcohol was restricted to red wine which was drunk in small amounts and only during meals.
Interest in the Mediterranean diet first started when an American scientist named Ancel Keys studied the relationship between diet and heart disease risk in a famous study started in 1958 and now called The Seven Countries Study. In this study Keys compared the prevalence of heart disease among American men (where the number of heart attacks was growing rapidly) with the prevalence of heart disease among men of the same age (40 to 59 years) living in other countries who were eating very different types of diet. The countries chosen for comparison with the USA were: Greece, Italy, The Netherlands, South Africa, Japan and Finland. Keys found that men from Southern Europe, especially men living in the island of Crete in Greece, had much lower levels of heart attack than men living in Northern Europe or in the USA. Men living in Japan were also at lower risk. Since this first pioneering study was undertaken, a large number of different studies have examined relations between dietary patterns and disease. Solid evidence has shown that the Mediterranean dietary pattern increases longevity and reduces the risk of heart disease, stroke and diabetes, certain types of cancer and may also reduce the risk of dementia in old age.
Broad principles of healthy eating
Diet has a key role to play in the management of a variety of conditions and illnesses. But rather than focus our attention of finding the magic bullet to prevent or treat a certain condition, let’s embrace some broader principles of:
- Eating a diverse diet, and vary what you eat, when you can, from day to day and season to season.
- Be courageous! Try things you have never eaten.
- Buy something different when you go shopping that is inexpensive and in season.
- Swap food with a friend. Eat food that is abundant in flavour.
- Aim to eat with others as often as you can. In addition to the health functions, the social, personal and sensory benefits of sharing a meal are not to be underestimated.
- Be a role model for your children, your family and friends.
- Food (in addition to other modifiable and non-modifiable factors) has an important role to play in prevention and treatment of some diseases.
To help increase the variety of nutrients in our daily diets, when you next go food shopping aim to buy one to three new foods to try. It might be a vegetable you have always wanted to learn how to incorporate into your cooking, or perhaps a new fruit that you always thought looked interesting to try.
We would love to see what you have chosen! So why not take a picture, share it with @FLFoodAsMed on Twitter using the hashtag #FLNewfoods along with our regular hashtag #FLFoodAsMed then within the Comments, consider sharing with other learners the reason for your choice and how you plan to add them to your diet.
Don’t forget to explore the different types of foods that have been shared by other learners to find out how they’re increasing nutrients in their diets.
© Monash University