Article 9 : Prescribing Food

– Dr Ripudaman Singh Bajwa

Dr Rupy Aujla, an NHS-trained doctor, started experiencing multiple episodes of Atrial Fibrillation (irregular, rapid heart rhythm) three months into his work at the age of 24. Multiple cardiac consultations followed, and he was suggested to undergo cardiac ablation (a procedure that scars the heart to block erratic heart signals). His story involved a classic diet expected of a young, modern and aware person with occasional legal excursions. At last, he did not undergo the suggested procedure. Wait! Why? Isn’t this a serious condition? Technically he took his prescribed medicines but followed his mother’s advice of optimising his hospital sandwich to a meal cooked at home. He changed his diet and lifestyle and, ultimately, his heart condition. He became free from these episodes in months of prescribing himself food (1).

The concept of “Culinary Medicine” is a new one for many of us. It includes the crucial amalgamation of the centuries-old craft of cooking food with the modern-day practice of medicine. It carries along with the prescribed drugs with the wholesome food working as the preventive medicine for the current civilization overwhelmed with lifestyle diseases like never before. Increasing evidence points towards what we serve on our plates, how we “pamper” our gut microbiota and subsequently direct the brain nourishment, works for the human body like any magical potion (2).

Recent research has focused on foods for the good. A diet rich in legumes, beetroot, and sweet potato promotes healthier cardiovascular health while decreasing the risk of stroke and coronary artery disease with the abundance of potassium. Increased fibre content has linked and flourished the gut-brain molecular interaction with answers for its colon cancer-protecting effect. Fatty-fishes and fortified food with vitamin D now proves its play in neuropsychiatric disorders, neoplasms, endocrine disorders, respiratory ailments, and a lot more (3). These display a very limited number of examples. But It’s the right time where people start looking beyond the supplements and focussing more on the grassroots source. Easily, the suggestion would be to put more colours on the food plate, with quality fats, plant-focused, and fibre. Following a diet that suits a person, be it vegan, paleo, low-carb, or Mediterranean, will provide a foolproof idea for a healthier life. A question I have myself been searching for answers to for quite a bit of time now is about supplementation. Leaders of the industry have cited over and over again how either the marketing tricks work or the FOMO* because most popular over-the-counter supplements either have insufficient dosages or reach the consumer after the half-life has expired (4). I learned this is a place where the physician’s role becomes further important to guide the world on the path of choosing natural food and lifestyle medicine as the “supplementation” which should matter and be talked about.

As an emerging field, Culinary medicine plans to tackle the questions that are often left unanswered or answered in a generic tone for everyone by the general practitioner. The questions are always about When? Why? How much? Which? Food they can consume, Especially Indians. But does our Indian medicine curriculum prepare us for these answers adequately? is the big question here. The answer is pretty easy. Nutrition continues to be a neglected subject. Many countries, including the UK and the US, offer curricula in culinary medicine where medical students learn, execute and take up cooking learnt in school with them in their future practice of medicine and health promotion (5). The Indian curriculum needs to step up and provide another phenomenon like Yoga to the world, utilising the traditional Indian food values and grandmother’s tricks to heal, support, and sustain human health.

References

1. https://thedoctorskitchen.com/podcasts/141-being-productive-authentic-and-vulnerable-with-ali-abdaal
2. La Puma J. What Is Culinary Medicine and What Does It Do?. Popul Health Manag. 2016;19(1):1-3. doi:10.1089/pop.2015.0003
3. Sizar O, Khare S, Goyal A, Givler A. Vitamin D Deficiency. In: StatPearls. Treasure Island (FL): StatPearls Publishing; May 1, 2022.
4. https://www.washingtonpost.com/lifestyle/food/most-dietary-supplements-dont-do-anything-why-do-we-spend-35-billion-a-year-on-them/2020/01/24/947d2970-3d62-11ea-baca-eb7ace0a3455_story.html
5. Rothman JM, Bilici N, Mergler B, et al. A Culinary Medicine Elective for Clinically Experienced Medical Students: A Pilot Study. J Altern Complement Med. 2020;26(7):636-644. doi:10.1089/acm.2020.0063