Food as Medicine: Healthful Eating for Healthy Living

One of the best-kept secrets in healthcare is that “something as simple as the food on your plate can truly be medicine.”

Introduction

Over the centuries food has been a central element in many traditional forms of medicine, which treated food as medicine until its role in curative medicine began to decline during the last century. The role of healthful eating in both preventative and therapeutic medicine has been documented in medical texts dating as far back as 500 BC.

A popular quote attributed to Hippocrates.

This popular phrase attributed to Hippocrates (460 BC to 370 BC) emphasizes the importance of healthy diets to prevent or cure disease. Ayurveda, one of the oldest healthcare systems that originated over three millennia ago in the Indian subcontinent, offers extensive insights about food and health based on certain unique conceptual as well as theoretical positions.

Healthful eating: Association of sub-optimal diets with disease

In my post, Chronic Diseases: the Silent Killers, I had highlighted that lifestyle-related chronic diseases are the leading killers globally, accounting for 70% of all deaths globally, in 2015. In another related post, Lifestyle-related Diseases: the Biggest Man-Made Disaster, I had discussed why these diseases can be labelled as man-made disasters. Here I had highlighted that bad lifestyle choices, including unhealthy diets, contribute to more than two-thirds of all major lifestyle-related diseases.

Several studies have examined the association of suboptimal diets with various lifestyle-related chronic diseases. A few of these will be discussed here briefly. A study titled ‘Health effects of dietary risks in 195 countries, 1990-2017: a systematic analysis’ for the global burden of disease study 2017’ published in the journal The Lancet in April 2019, evaluated the consumption of major foods and nutrients across 195 countries to quantify the impact of their suboptimal intake on non-communicable diseases (NCDs) mortality and morbidity. The study found that globally, consumption of nearly all healthy foods and nutrients was suboptimal in 2017. The study found that globally in 2017, dietary risks were responsible for 11 million deaths (22% of all deaths among adults) and 255 million disability-adjusted life-years (DALYs) (15% of all DALYs among adults). Cardiovascular disease was the leading cause of diet-related deaths (10 million deaths) and DALYs (207 million DALYs), followed by cancers (9,13,090 deaths and 20 million DALYs) and type 2 diabetes (3,38,714 deaths and 24 million DALYs). More than 5 million diet-related deaths (45% of total diet-related deaths) and 177 million diet-related DALYs (70% of total diet-related DALYs) occurred among adults aged younger than 70 years.

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‘Fat but Fit’ Paradox – Unravelling the Truth

Introduction

Obesity is now recognized as a serious chronic disease; in my post titled Is obesity a disease or a risk factor for other conditions? I had discussed the magnitude of obesity and why obesity is associated with so much ill-health. However, there are no easy solutions to obesity and managing your body weight is challenging at the best of times. In my post titled Weight Loss Maintenance After Weight Loss, I had discussed how over the long term, the vast majority of individuals regain the weight they have lost and that this relapse has a strong physiological basis and is not simply the result of the voluntary resumption of old habits. Some evidence suggests, however, that a high cardiorespiratory fitness (CRF) might mitigate the detrimental effects of excess body weight on cardiometabolic health, termed the ‘fat but fit’ paradox.

Recognition of the ‘fat but fit’ paradox

In my post, Complications of obesity: the mother of all diseases, I had discussed the various health complications associated with obesity.  However, accumulating evidence over the years suggests that being physically fit might attenuate some of the deleterious health consequences of obesity independently of some key potential confounders. About 3 decades ago, a study titled ‘Physical Fitness and All-Cause Mortality: A Prospective Study of Healthy Men and Women’ published in the Journal of the American Medical Association in Nov 1989, brought into focus the detrimental role of fitness (cardiorespiratory fitness [CRF]) vis-à-vis fatness on health, specifically all-cause mortality and CVD-related mortality. This longitudinal study followed up 10,224 men and 3120 women for slightly more than 8 years. The study found that better CRF, as measured by a maximal exercise test, was associated with decreased all-cause mortality in both sexes. Based on the maximal treadmill test, participants were stratified into quintiles of fitness categories. Age-adjusted all-cause mortality rates declined across physical fitness quintiles from 64.0 per 10,000 person-years in the least-fit men to 18.6 per 10,000 person-years in the most-fit men (fat but fit). Corresponding values for women were 39.5 per 10,000 person-years to 8.5 per 10,000 person-years. Lower mortality rates in higher fitness categories also were seen for cardiovascular disease and cancer of combined sites. Higher levels of physical fitness appear to delay all-cause mortality primarily due to lowered rates of cardiovascular disease and cancer.

A couple with obesity exercising together, i.e. fat but fit.
A couple with obesity exercising together – ‘fat but fit’.
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Aerobic Exercise Prescription for Optimum Health Benefits

Introduction

In my post, Health Benefits of Exercise: a grossly underutilised therapy, I have discussed the various health benefits associated with physical activity, as a result of which exercise is now aptly being recognised as ‘medicine’. However, to derive optimal health benefits from exercise, an exercise program needs to follow certain parameters, similar to drug prescription, such as frequency, dose (amount), time (duration) and type (of physical activity). In my post Exercise Prescription for Optimal Health Benefits, I have discussed the FITT-VP principles for exercise prescription. In this post, I shall be discussing ‘prescription for aerobic exercise’ based on the FITT-VP principles. Prescription for strength training as per FITT-VP factors will be discussed in the next post. Aerobic exercise is referred to in the literature, both scientific and lay, by various terms. In the scientific literature, it is referred to as cardiorespiratory endurance or aerobic endurance, while colloquially it is referred to as aerobic exercise or just aerobic, or cardio, or cardio exercises, or cardio workout. In this post, these terms will be used interchangeably.

People engaging in aerobic activities.
People engaging in various aerobic activities.
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Health Benefits of Exercise: a grossly underutilised therapy

Introduction

Exercise is being increasingly recognised to play an important role not only in the prevention but treatment as well of multiple lifestyle diseases (chronic diseases), health conditions and risk factors associated with these. In view of the above, exercise is now aptly being recognised as medicine. It is the cornerstone of lifestyle modification to achieve Holistic Health. However, like any other medicine, exercise too has some associated risks, though benefits of exercise on health, far outweigh the risks. However, before proceeding with the benefits and risks associated with exercise, it would be pertinent to understand some important related terms. Even though physical activity and exercise are often used interchangeably, they are not synonymous. The definition of these and some closely related terms are given below:

People of different age, gender and categories participating in different physical activities.
People of different age, gender and categories participating in different physical activities.
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Holistic Health Approaches: the Way to Wellness

Introduction

As I begin my new blog, it would be prudent to explain the terms ‘Wellness’ and ‘Holistic Health’; both today buzzwords in the health industry. Health, as we commonly understand as a layman, is the “absence of disease.” However, even though, people may lack the physical symptoms of a disease, they may still be bored, lack energy, and never feel like doing anything or simply unhappy with their lives. Such emotional states often set the stage for physical and mental disease. You will also notice that these feelings are aggravated or mitigated by what is happening around you; you are touched by everything that happens in your surroundings.

Even celebrities who seem to HAVE IT ALL, may not be happy. We come across people who are famous, rich, successful and inspiration for many – they seem to have it all, yet many of them have talked about feeling hollow from within, suffering from panic attacks, and even about being depressed. In an interview with The Telegraph a couple of years ago, Prince Harry had said: “I’ve spent most of my life saying ‘I’m fine. I can safely say that losing my mom at the age of 12 and shutting down all my emotions for the last 20 years has had quite a serious effect on my life…I have probably been very close to a complete breakdown on numerous occasions.” The most decorated Olympian of all time, swimmer Michael Phelps, while talking about his battle with loneliness within, said he was grateful for not taking his own life. So, obviously, there is something beyond the absence of disease which is necessary to help you feel better about yourself – energetic, joyous, at peace with your own self and your surroundings and have a purpose and meaning to life.

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