How to use food as medicine to prevent diseases

 NEW ORLEANS — Encouraging a healthful diet in patients promotes the prevention and reversal of chronic diseases, such as CVD, diabetes, cancer and obesity, according to a presentation at the ACP Internal Medicine Meeting.

Of the ten leading causes of death in the United States, at least seven, including the top four, are directly related to diet choices,” Michelle McMacken, MD, assistant professor of medicine at New York University School of Medicine, said during her presentation.

These conditions include heart disease, cancer, lung disease, cerebrovascular disease, Alzheimer’s, diabetes and kidney disease, according to McMacken.

Power of nutrition

“Nearly half of all deaths due to heart disease, stroke and diabetes are due to poor, suboptimal diet,” she said.

We now know that a poor diet is responsible for more deaths from chronic disease at the population level than smoking... Most of our patients know that it’s probably not a good idea to smoke, but I don’t think they have a sense of the magnitude of the importance of the food choices they are making every day,” she added.

Foods and eating patterns fall into three different categories: healthful, debatable and unhealthful, according to McMacken. Foods labeled as healthful, including whole grains, legumes, fruits, vegetables, nuts and seeds, are foods which have a very broad consensus that they promote health and prevent disease, she said. Conversely, foods labeled as unhealthful, including processed meat, red meat, added sugar, refined grains and ultraprocessed foods, have a broad consensus that they produce harm, she said. Foods labeled as debatable, including poultry, eggs, dairy and fish, have shown both benefits and harms, she said.

Cardiovascular disease

Red and processed meat are associated with the most cardiovascular risk, according to McMacken. Individuals who follow a meatless diet have a 24% to 29% decreased risk of mortality and a 32% decreased risk of incident cases, she said.

Sugars and refined grains have a very powerful role in accelerating the risk of coronary artery disease, stroke and CVD, she said.

“Fruits and vegetables are associated with tremendous CV risk reduction... Just two and a half servings of fruits and vegetables a day lowered your risk of coronary heart disease by 8%, stroke by 16% and dying of anything by 10%,” 

Insulin resistance

Processed meat is the most closely linked to type 2 diabetes risk, conferring a 37% increased risk, McMacken said.

The risk of type 2 diabetes is also increased when carbohydrates are replaced with protein, she said.

On the other hand, consumption of whole grains and fruit lower the risk of diabetes, she said. Eating one piece of fruit a day decreased diabetes risk by 12% and eating one piece of fruit three times a week in patients who already have diabetes lowers

the risk of all-cause mortality by 17%, microvascular complications by 28% and macrovascular complications by 13%, she noted.