Hippocrates, widely considered the ‘father of medicine’, supposedly once said: “Let food be thy medicine and medicine be thy food.”
Of course, that was in Ancient Greece, and the intention of his alleged words have long been hotly debated by his medical descendants. The world has also seen the invention of penicillin, vaccinations and several iPhone generations since Hippocrates walked the earth. However, as modern wellness continues to seek from the vaults of ancient wisdom, it seems we have come full circle, with the phrase “food is medicine” gaining both popularity and notoriety in recent years.
Long espoused by many in the burgeoning alternative medicine and wellness industries—the latter of which is valued at USD $4.5 trillion and considered one of the world’s largest and fastest-growing markets—it’s a phrase that has captivated many with its poetic simplicity and marketable allure.
And while it’s tempting to reduce health advice to an Instagrammable platitude, the notion of food as a generic cure-all for everything, from cancer to anxiety and depression—during one of the world’s worst pandemics, no less—is neither to be taken at face value, nor is it without potentially negative consequences.
“The concept of nourishing your body with good food is a positive message, but a blanket statement like this can be dangerous on multiple levels,” Dr. Raesha Jaffer, a Brisbane-based general practitioner, told ELLE.
“It undermines the complexity of any medical issue. Medical issues are influenced by multiple factors: genetics, hormones, environmental exposure and hence, treatment is often also multifactorial in that regard.”
Despite how well-intended the phrase often is, its outcome can be harmful, and potentially fatal, Dr. Jaffer emphasised.
“Overly simplified statements like this can cause people stop taking medicine when it is actually needed. For example, imagine someone with epilepsy stops taking their medication and instead changes their diet, only to be behind the wheel and experience a seizure—that can be fatal.”
“Similarly, it can cause delays in therapy. We see this a lot in cancer patients, where they change diets in the hope it cures it and in that time, their cancer has significantly progressed.”
But how does it translate in the realm of mental health, an area that is already rife with confusion and stigma due to its ‘invisible’ nature? According to Dr. Joshua Wohlrich, the U.K.-based surgeon who directly challenged Bieber’s ‘food is medicine’ post, it could increase a sense of shame for those who do take medication.
“The intention behind this post is good, but unfortunately the potential outcome is quite harmful. Food is many, many things but it’s not medicine. That’s not to say it isn’t important—it provides us with nutrition and energy to thrive, but it has its limitations,” he wrote in a comment that has since garnered over 9,000 likes.
“Anxiety and depression is very rarely as a result of food intake. Mental health is complex and boiling is down to the privilege of food choices is incorrect and stigmatising for those who struggle with it on a daily basis.
“For any of you who read this and felt a sense of guilt that if only you changed your food you wouldn’t struggle with mental health… please know that’s not accurate. You are doing a fantastic job—do not compare yourself to a celebrity with all the capacity for change and privilege in the world.”
However, is it fair to say it’s all snake oil? After all, outside consulting a professional, most health advice geared towards improving our general well-being typically boils down to: eat well, sleep well, drink water, meditate and, more often than not, do yoga. Despite the oversimplification of ‘food is medicine’, it seems there is some truth in food being a tool for aiding our mental health, and the science supports it.
While food is seldom the sole reason for a mental health problem, there is a growing body of research around what scientists call the ‘microbiome–gut–brain axis’, or the shortened ‘gut-brain axis’, with studies showing that diversity in gut bacteria, typically acquired through a varied plant-based diet, may help alleviate symptoms of anxiety and depression.
“What you do and don’t eat directly and indirectly can impact mood and mental health,” Jess Spendlove, an Accredited Practising Dietitian and co-founder of Health & Performance Collective, told ELLE.
“The American Gut Project was the largest study of its kind looking into how diet and lifestyle can affect the human microbiome (the ecosystem of bacteria in the gut). The study showed that the number of different plant types a person consumes plays a role in the diversity of their gut microbiome. Those who ate 30+ different plant foods per week had gut microbiomes that were more diverse than those who ate 10 or less.
“These people with the higher diversity also had fewer antibiotic resistance genes in their gut microbiomes. And interestingly, those in the study with mental health disorders were more likely to have low diversity in their gut microbiome. Certain types of bacteria may be more common in people with depression than those without.”
Food’s potential impact on mental health is thought to be linked in two ways. The first relates to the specific nutrients in foods that support functions in the body to operate normally and support our brain health and mood through nerve functioning and hormone function, among others. The second, is linked to the two-way relationship between the gut and brain.
“Some even refer to the gut as the ‘second brain’ due to the constant communication from the gut to the brain,” said Chloe McLeod, an Accredited Practising Dietitian and co-founder of Health & Performance Collective.
“The bacteria in the gut microbiome are thought to be a key influencer of this communication, so looking after gut health is a key dietary strategy to look after our overall health, in particular brain health and mental health. This is where the goal of consuming 30 plant-based foods stems from.”
The importance of good diet is undeniable, that much is clear. For those dealing with certain health conditions that require a change in diet, such as Coeliac’s Disease, it really can be the difference between leading a normal life or living in pain. At the same time, it seems unfortunately ironic that adopting a puritanical view of food as means to heal a health concern can result in an obsession that becomes, well, unhealthy.
Diane “V” Capaldi, an American motivational speaker, chef and psychologist formerly known as “Paleo Boss Lady” in wellness circles, knows firsthand what can happen when the thing that is supposed to be healing you becomes harmful.
She first turned to food to heal her multiple sclerosis after stumbling across “The Wahls Protocol”, which is essentially a version of the Paleo diet created by Dr. Terry Wahls, a functional medicine doctor and clinical professor who, after being diagnosed with multiple sclerosis, began studying food and vitamins.
In Capaldi’s case, she never expected the negative psychological impact that came with treating her health through food, that the very thing that was meant to heal her would result in nine years of orthorexia, an eating disorder that involves an obsessive focus on healthy food.
“I never saw any of the psychological outcomes of using food as medicine coming,” she told One Life Radio in April 2020.
“There were actually periods of time when I became afraid of food. Because when you begin to realise that what you’re eating has a profound effect on your body, and then you start trying to figure out what hurts your body and what doesn’t… I got to a place where I feared food in general.
“Autoimmune protocol, for me, is really what developed my orthorexic tendency because it’s an elimination [diet], and I got so hyper vigilant that I feared all food, because your body really does respond to everything you eat—and every response isn’t necessarily negative. But you just get in this sort of weird headspace, and I woke up one day and I was there, and I was like ‘Whoa, I’m afraid to eat now, how can I be afraid to eat?'”
She went on to describe how looking back at her pre-protocol diet fostered a sense of shame towards her pain, making her feel as though it was self-inflicted and feeding into what became orthorexic tendencies.
“For me, I did have some self-esteem issues, you mean that the 20 years that I lived in constant pain, I was doing this to myself? Like I did feel bad about myself, and those psychological things, coupled with the reactions of your body to food, put me—and a lot of other people—in this sort of orthorexic space, where what is healing us is, what we’re seeing psychologically, hurting us.”
Ultimately, Capaldi—who still uses food to manage her multiple sclerosis by following a tweaked Paleo and Keto lifestyle, and is a professional chef catering to ‘therapeutic diets’—reached a point where she realised that even people who have the same health condition, like multiple sclerosis, won’t necessarily reap the same outcomes of the same diet and its highly specific requirements.
“I became afraid of food. I really believe that when I was trying to figure out what foods were stronger triggers [for my multiple sclerosis], you know, tomatoes, peppers and eggplants… I followed the Dr. Terry Wahls Protocol—she has no problems with them. So it becomes very confusing, ’cause I’m doing exactly what she told me and my symptoms were getting better, but I’m still having a lot of issues, so I wanted to sort of ‘bio hack’ my way from that template,” she said.
“And I think that what happens is, we read books that have suggested protocols that we have to fit exactly in that mould, and if we don’t fit exactly into that mould, then we become afraid of food, and that’s exactly what happened.”
According to Capaldi, it’s not that food can’t be used as a fundamental health tool, but a lot more needs to be discussed about the risks that a ‘food as medicine’ approach can incur when blindly followed.
“For me, there’s a lot of work to be done to master a ‘food as medicine’ lens, and there’s no one talking about that. They just talk about ‘food as medicine’, but no one is saying ‘Hey, if you start using food as medicine just because you don’t feel well, then you’re going to start feeling deprived’.
“There needs to be a point in that ‘food as medicine’ journey where it’s a self-love lens and you no longer want to harm yourself, it’s not a lens of deprivation.”
Reconciling the concept of food as a means to heal—particularly when discussing eating disorders like orthorexia, where it is often imbued with a sense of morality—means remembering that it’s just one piece of a bigger, holistic puzzle.
“We have to take a step back and look at medical issues in a holistic manner. Every medical issue is complex, and hence, treatment is often not just about taking a tablet to fix it,” Dr. Jaffer explained.
“Food and diet is an extremely important part of the management of many medical issues, but it is not a substitute for it. It’s good to be informed of what you are putting in your body, but not to the extent where you might be missing out on your basic nutrition in an attempt to avoid it.”
Mary Hoang, the founder and principal psychologist at The Indigo Project, echoed the sentiment, emphasising that in the realm of mental health, food is just one component that leads to healing, and that placing it on a pedestal is “reductive”.
“When it comes to managing our mental health (or physical health, for that matter), we’ve learned the importance of approaching it from a holistic perspective—that is, there is no ‘one magic fix’ to address issues such as anxiety and depression, she told ELLE.
“These experiences are quite unique to the individual, and though the physiological health of the individual will play a key part, it really needs to be integrated with therapeutic strategies that also address psychological components, social and relational components, direction and values-based components, etc.
“So, while things like diet, sleep, exercise, etc. have been found to assist in the therapeutic process, it is only one part of the process. You can’t tell your mate to start drinking more kale smoothies to cure their depression. Although it might come from a good place, it’s quite reductive, a little shame-y, and really not that helpful.”