The concept of “food as medicine” needs a rebrand using solution-focused language if there is to be any hope of affecting long-term behavioural change, according to one expert.
Dr Susan Kleiner, founder of the consultancy High Performance Nutrition, has worked in the field of sports nutrition for 40 years – which makes her a health professional with a very specific focus, she says.
“The interesting thing about studying human performance is that really, we are studying super health,” she told an audience at the Future of Nutrition Summit, which ran as part of this year’s Food ingredients Europe event. “Can you be even more healthy, super healthy, and push out the walls of performance?”
However, as it is difficult to find statistical significance when researching how to make already healthy people healthier, instead we “take sick people and see if we can make them better”.
As a result, conversations on health revolve around that data, “meaning that we are always reacting to a disease state and moving toward health”.
“We are a disease-oriented society,” she said – one in which people tend to wait until they are unwell or even in a disease state before they make changes to their diet or lifestyle.
While the purpose of the “food as medicine” concept may be for people to think about being proactive rather than reactive, Kleiner argued that it in fact upholds the very opposite ideal.
“The concept of food as medicine really promotes this medicalisation of the way we behave, of our belief system,” she said. “And what I want to propose to you today is maybe thinking about a little bit different terminology, because we know that marketing and advertising is very powerful. It changes society. It changes our belief system and our behaviours.”
The Hippocrates quote “let food be thy medicine” may be well known – but in truth, there is “a lot of messiness around this concept”, Kleiner argued.
“In our context, medicine does not mean wellness,” she said. “Medicine is a substance or a preparation to treat disease. And while this may seem like semantics, in our current-day language, the overarching, subtle message reinforces reactive health behaviours versus proactive health behaviours.”
Meanwhile, there is a danger for consumers to have a literal understanding of the concept, “and when they take that literally... you actually may be putting them at risk because they think that they can treat their disease with this medicine”.
She gave the example of laetrile, a partly synthetic form of amygdalin, a plant substance found in raw nuts, bitter almonds, and apricot and cherry seeds, that in the past was promoted as an alternative cancer treatment.
As it was not approved as a medical practice in the US, consumers seeking the cure had to go to Mexico, with many travelling at great expense to receive a treatment that “typically didn’t work”.
Kleiner said: “One would think, no harm, no foul. But it took time, and it took money, and in many of those cases, they didn't get the treatment that they could have gotten had they not gone to Mexico for something that didn't work.”
Some came home and eventually received treatment in the US, but there were many others who took too long before accessing medical treatment, or had used up their finances in the meantime.
“The harm done was not from the laetrile itself. The harm done was what it didn't do,” Kleiner explained.
She added: “[I]f you over-promise and under-deliver, it may not be the harm done from the product itself, but [from] the misdirection to the consumer.”
To add to the confusion, sometimes food really can act as medicine: Kleiner gave the example of honey, which has been shown to outperform over-the-counter cough medicines in children.
Meanwhile, looking at functional foods, for example, “people do not buy functional foods to treat a problem. They buy functional foods to promote health. That's what they tell us in all the marketing surveys”.
“We don't really mean food as medicine – we really mean food is health. And so there's just a whole lot of muddling of that messaging that doesn't do any service to the concept that you're trying to promote,” she added.
All of these are reasons to redefine the concept, she argued, and called for the industry to “go from reactive to proactive, away from disease orientation toward health promotion”.
Kleiner called for “food as medicine” to be reframed as “food fuels health”.
This emphasises a proactive, preventative approach, she argued, adding that a “holistic approach” to marketing using this phrase could help normalise the idea that healthy eating is one element of a balanced lifestyle, moving away from the concept of restriction in the hope of positively influencing behavioural change.
“Shifting from problem-focused language like ‘medicine’ to positive, solution-focused language like ‘health’ can lead to different outcomes in population behaviour,” she said. “Now, why didn't I say food as health, or food is health? There's no action there.”
Health-focused marketing “can appeal to people's desire for long-term wellness, potentially encouraging more reflective and enduring behavioural changes”, she said, explaining: “Health-focused language taps into intrinsic motivation... whereas disease-oriented language may rely on extrinsic motivators like fear of illness, which can lead to temporary behaviour changes, but not long-lasting ones.”
She concluded: “By changing the paradigm... we can use language in a more intentional way, creating a more positive, empowering narrative around food that promotes proactive wellness and health.
“This shift may help a disease-oriented society move toward a more holistic, prevention-focused health culture, enhancing and expanding the health and wellness market – and, hopefully, my goal of enhancing public health.”
