HERE WE REFER TO HEALTHCARE as something distinctly different than health in that it refers to the organizational structure and system designed to support health. In this regard access to safe and healthy food can be as important as the healthfulness of the food itself, and so this can involve transportation issues, safety net programs to address food insecurity, and other related factors. National dietary guidelines, such as the recently developed Canadian guidelines, can be an important component of the healthcare system, offering guidance on specific types and groups of foods to include and emphasize vs. avoid and limit. In the context of food and healthcare, this brings up the age-old adage to “let food be thy medicine” attributed to Hippocrates. This is particularly relevant in countries such as the US where the costs of medically treating chronic diseases and their symptoms are crippling the healthcare system, and large benefits could be realized if substantive dietary shifts at the population level could be achieved that prevented and reduced the burden of such diet-related chronic diseases as cardiovascular disease, cancer and diabetes.
Nutritious food is essential for health, and it’s important for all people to have access to affordable, nutritious food. When we talk about food “access,” we’re talking about both physical access and economic access. In addition to food being available in the food supply, it needs to be available in locations that people can reach by foot, public transit, or car, and it also needs to be affordable. If people need to expend a lot of time, effort, and money to obtain nutritious foods, it’s not realistic to expect that they will choose healthy options on a consistent basis. Improving the quality of people’s diets is challenging — it may not be enough to simply add a supermarket to a neighborhood that lacks one, as there are other factors at play such as access to transportation, walkability, and neighborhood safety; household income and the relative affordability of nutritious foods; and food knowledge and preferences.
Hippocrates stated back in Ancient Grecian times to “Let food be thy Medicine”. Today, we have scientific research showing us the power and impact of the right nutrition. We know that eating a healthy diet rich in fruits and vegetables helps to prevent many chronic diseases. Once someone is diagnosed with a disease/s they often require prescribed diets, such as a diabetic diet, a renal diet or heart healthy diet. These may sound generic but they are very complicated and require science to pair the right nutrients for each illness. Just like medicines prevent or treat a disease, food can do the same. When battling a disease or multiple diseases your diet can play an important role in your health outcomes.
Fast food tends to be high in saturated fat, sugar, salt and calories so it is natural to assume that areas with a higher density of fast food restaurants would have higher rates of chronic disease and obesity. However, while some studies have found positive associations between the two, others have not. This discrepancy in results could be due to differences in methodology and study design. There are likely many factors behind the rise in obesity and chronic diseases we have seen in communities across the world, beyond just an increase in availability of inexpensive and unhealthy food. In our work with Baltimore City we have seen that areas with a higher prevalence of diet related diseases also struggle with poverty, lower levels of education, and higher rates of crime and violence.
Concern over the safety of fresh produce has grown in recent decades with the increase in pesticide use as well as the history of bacterial contamination. While this shouldn’t be a reason to avoid vegetables, there is value in thoroughly washing any produce that consumers bring back from the market place, which may contain pesticide residues or potentially harmful bacteria. Exposure can be minimized by thoroughly rinsing with running water. Spraying with a veggie wash or soaking in a mixture of vinegar and water or distilled water can also remove unwanted dirt and help kill some but not all bacteria. It is not a good idea to use detergent or soap to clean your produce. It is also important to wash your hands and clean kitchen surfaces before you prepare your produce. Ideally, if possible, choose organic or pesticide-free produce which is less likely to cause concerns, especially if grown in healthy soil. Supporting these types of farming practices is also a way to promote environmental sustainability in the food system.
Canada’s most recent version of their food guide was released in 2019, and represented a major shift in dietary guidance in Canada. Moving away from guidance that focused on telling Canadians exactly what and how much of each food group should be consumed, the new food guide now emphasizes simple messages like having plenty of vegetables and fruit, making water your drink of choice, and limiting highly processed foods. The food guide mentions that healthy eating is about more than the food you eat, and that mindful eating practices and enjoying foods, eating meals with others, cooking food and building traditions around food are all part of building healthy dietary practices. And perhaps the most exciting aspect of the new food guide is the explicit mention of choosing plant-based proteins more often, which we know can contribute to improving the health of people and the planet.
Obesity refers to excess fat mass, while fit and strong refer to having highly functioning muscles, heart and lungs. High fitness is normally related with being physically active, but regular exercise generally results in very small amount of fat loss. For example, increasing your physical activity to what is recommended by the physical activity guidelines (150 min of moderate activity without dieting) normally results in less than 2lbs of weight loss per month. This is why you can be fit and strong while having obesity. Even while being fit and strong, obesity still increases your risk for several negative health consequences including shortened life expectancy and so it is rightly called a disease.