Late last year, Whole Foods CEO John Mackey went live on the 听podcast and claimed that Americans don鈥檛 need better access to听health care. Instead, he said, 鈥淭he best solution is not to need health care. The best solution is to change the way people eat, the way they live, the lifestyle and diet.鈥 听You can probably imagine why: Mackey鈥檚听chain is expensive as hell. Eating only whole, nutrient-dense foods is financially (and ) out of reach for many. In 2020, experienced , meaning they were unable to听afford enough food to live an active, healthy life.
But Mackey is far from the first to claim that certain lifestyle choices, particularly eating the 鈥渞ight鈥 foods, can ward off or cure health problems. Dr. Oz, a but popular medical doctor whose talk show reached over last year,听repeatedly touts things like 鈥.鈥 He even wrote a bestselling dedicated to the idea that 鈥渟imple, healing, wholesome food鈥澨齣s a 鈥渞emedy for everything from fatigue to stress to chronic pain,鈥 according to the publisher鈥檚 summary. And the internet is rife with articles like 鈥,鈥 from WebMD, and 鈥,鈥 from the site Active.
At best, these claims blow small bits of evidence way out of proportion鈥攕ure, raisins contain nutrients that can contribute to healthy blood pressure, but eating them won鈥檛 magically cure hypertension. And at worst, the claims are听. Yes, food contributes to health and plays a role in the prevention and management of certain diseases, but food isn鈥檛 medicine, and no diet can replace good health care.听
We Can鈥檛 Always Control Our Health
Mackey鈥檚 statement about diet and lifestyle substituting for health care is based on the wildly inaccurate assumption that our behaviors alone cause our health outcomes. Actually, health behaviors鈥攅ating, physical activity, smoking, alcohol and drug use, and sexual activity鈥攁re just one of听many听听and account for around 30 percent of a person鈥檚 overall health outcomes, according to a published in the Annals of the New York Academy of Sciences that鈥檚 often cited by health experts and . Genetics, the environment, and clinical care (which includes medicine) also contribute, but social and economic factors鈥攊ncome, education, social support, and the experience of racism and other stigma鈥攁re far and away the most significant factors, accounting for about 40 percent of a person鈥檚 health outcomes,听according to the same research.听
鈥淔ood cannot disrupt the deep impacts of living in chronic poverty or disrupt the physical responses to microaggressions that many minorities face in their daily lives,鈥 says听, a Dallas-based dietitian.听A published in American Psychology听describes microaggressions as brief and commonplace indignities directed at people of color that the perpetrators are typically unaware of; examples include听a white woman clutching her purse as a Black man approaches, or a store employee monitoring听a customer of color听more closely. Several studies, including a听 in Social Science and Medicine and a听 in Psychoneuroendocrinology, have found that experiencing racial discrimination raises a person鈥檚 risk of chronic disease.听This likely听has something to do with stress. 鈥淩acial differences in stress exposure (e.g., experiences of racial discrimination) … stimulate pro-inflammatory processes that may contribute to differential health outcomes,鈥 wrote the authors of the 2019 study.
Johnson also used to believe that food could act as a person鈥檚 best medicine. 鈥淏ut through personal and professional experience, I鈥檝e found this to be at best shortsighted听and truly rooted in elitism,鈥 she says. A millionaire CEO of a 鈥渉ealthy鈥 chain telling people that they wouldn鈥檛 be so fixated on affordable health care if they would just eat nutritious food (that may or may not be accessible to them) perfectly illustrates Johnson鈥檚 point.
Maybe You鈥檙e Born with It
Social and economic factors aren鈥檛 the only health determinants that are somewhat听out of an individual鈥檚 control. We all have unique genetic predispositions鈥攕ome people are simply born more at risk for certain conditions, like heart disease, than others. also play a role. Sunlight, dust, chemicals, metal, plants, animals, and other things we鈥檙e exposed to daily can contribute to the onset of pretty much every illness, from kidney disease to infertility to skin cancer.听And of course, disease can be random. A in Science found that about two-thirds of cell mutations that lead to cancer are caused by random DNA replication errors, while only a third are caused by inherited genes, environmental factors, or behavior. (Although yes, some cancers are more directly linked to behavior; for example, smoking is of lung cancer.) Even diseases that are more strongly linked to lifestyle, like type 2 diabetes and heart disease, can occur in people with .
All of this disproves the notion that eating a certain way, or a certain food, can eliminate the need for health care and medicine. The fact that disease can (and almost certainly will) occur no matter what you do might be a tough pill to swallow. But Johnson explains that it can also bring relief in that you can stop blaming yourself for your health problems听or micromanaging your eating habits in the name of disease prevention.
Nutrition Is Just One Tool
The point here isn鈥檛 to totally discredit nutrition. Of course a nutritious diet can positively impact your health! The state that a healthy dietary pattern is associated with a lower risk of certain chronic diseases, including type 2 diabetes, heart disease, bone disease, breast cancer, and colorectal cancer. But听they never claim that any dietary pattern alone, like Whole 30 or paleo,听can prevent or cure disease. And they never mention superfoods,听because these don鈥檛 exist鈥攏o one food has the power to make or break your health. 鈥淔ood can be used to prevent onset of a disease up to a certain point,鈥 Johnson says. But again, there are no guarantees because of all the factors at play.
As is the case with disease prevention, food plays a supporting role in the management of certain diseases. Medical nutrition therapy (MNT)听is 鈥渢he evidenced-based approach to treating medical conditions with food,鈥 says , a dietitian based in Modesto, California. Dietitians are trained in MNT, and there are myriad applications for the approach. In some cases, short-term dietary changes can treat an acute (short-lasting and sudden) condition; Nosek gives the example of reducing sodium intake to help reverse edema, which is swelling caused by excess fluid trapped in your body鈥檚 tissues. In other cases, long-term dietary changes can help someone manage a chronic (long-term and often lifelong) condition. Johnson points out that those with celiac disease must completely avoid gluten to prevent long-term intestinal damage and other negative side effects. Similarly, someone with diabetes might use diet as part of their strategy to manage blood sugar. Some uses of MNT are even more clinical, like feeding someone through a tube or an IV if they鈥檙e unable to consume enough by mouth.
Both MNT and a nutritious diet can help improve health outcomes, but neither is a replacement for health care. (In fact, MNT is typically provided by a dietitian, which means that it鈥檚 a form of health care.) The best way to catch and treat potential problems early on is by scheduling regular visits with your primary-care provider.
Literally speaking, food is not medicine. No matter what Dr. Oz might imply听, arugula doesn鈥檛 鈥渇ight鈥 lung cancer and tahini won鈥檛 鈥渂oost鈥 your immune system. In contrast, medicine does have the power to treat or cure health conditions. Insulin injections are vital in the management of type 1 diabetes, whereas dietary choices can only do so much. Chemotherapy and radiation can treat colon cancer by killing cancerous cells, but a high-fiber diet won鈥檛 do anything of the sort and may . Fruits and vegetables won鈥檛 lower your risk of contracting ,听whereas vaccination will. Diet impacts health, but it isn鈥檛 nearly as powerful as medicine when it comes to treating disease.