Is Food the Safest and Most Powerful Form of Medicine?

In a new editorial by Aseem Malhotra, James DiNicolantonio and Simon Capewell in BMJ's Open Heart the authors argue that rather than chase calories in the endless pursuit of weight loss, our cardiovascular system can benefit much more from just improving the quality of our diet.
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Young man in supermarket comparing bottles of oil, rear view, close-up
Young man in supermarket comparing bottles of oil, rear view, close-up

The diet industry generates revenue of 60 billion a year, despite its disappointing long-term success rates. Many resort to medications in order to lower the risk of heart disease and other chronic illnesses, seduced by pharmacotherapy's alluring commercials and the promise of instant results.

Meanwhile are we ignoring a proven method to reduce the risk of heart disease?

In a new editorial by Aseem Malhotra, James DiNicolantonio and Simon Capewell in BMJ's Open Heart the authors argue that rather than chase calories in the endless pursuit of weight loss, our cardiovascular system can benefit much more from just improving the quality of our diet.

People wrongly believe, they say, that since the build of plaque in arteries and their stiffening and clogging progress over decades, reversing those damages with good eating habits will take just as long. But evidence shows otherwise. The authors describe several studies that show that diet can change outcomes rapidly. In one randomized controlled study, published in the New England Journal of Medicine, 7500 people at high risk of heart disease were given calorie-unrestricted diets, with the treatment groups given supplemental extra virgin olive oil and nuts. The olive oil and nut groups saw a 30% reduction in in major cardiovascular events, and this reduction in risk was already apparent 3 months into the diet change. In another study published in the Lancet more than 11000 patients who suffered a heart attack were given either omega 3 fatty acids, vitamin E, both or none. The fatty acid group (those fats can be found in oily fish and walnuts) had better survival, and that was apparent even after just 3 months.

...or the slowest form of poison

One can of course pick and choose studies, and there's no doubt that there's also evidence that weight loss - if successful and sustained - goes a long way to reduce the risk of diabetes and cardiovascular risk, and that medications prolong lives and reduce morbidity for many.

I do agree that we tend to underestimate the power of diets. As the authors contend, a soda habit of just 1 can a day can do measurable harm, trans-fat in fast food rapidly affects inflammation and increases bad cholesterol, while adding just a little more fruit, vegetables and nuts can lead to noticeable and quite rapid changes in health and wellbeing.

A bit of good news: Lately, people are indeed internalizing this message and trying to eat healthier rather than going on (yet another) a diet. According to an article in Fortune, the traditional weight-loss industry is contacting for the 2 year straight, with fewer people buying low-calorie foods and signing up for Weight Watchers.

Even if these efforts won't lead to weight loss, it's likely that overall health will improve.

Dr. Ayala

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