Reach Into the Refrigerator, Not Just the Medicine Cabinet

Dr. Pershad attended medical school at George Washington University and completed her residency in internal medicine at the North Shore University Hospital and Long Island Jewish Medical Center. She is board certified by the American Board of Internal Medicine and a Functional Medicine practitioner certified by the Institute of Functional Medicine.

Have you and your doctor talked about “food as medicine” lately? Maybe not, so okay — I’ll make this my chance to tell you about my patient Irma. While we’re here, let’s also talk over a swimming lesson that you’d do well to avoid.

Irma (not her real name) is a health worker, a friendly wife and mom in her early 50s. She has rheumatoid arthritis that can generate achey, swollen knees, wrists, and hands. Her rheumatologist had prescribed two medicines that were of some help, but she was hoping to avoid them — and their side effects — when possible, and to feel better.

Valerie Pershad, M.D.

This kind of arthritis is made worse by a more general clinical picture of inflammation. That, in turn, can be affected by diet, and we can be thoughtful about how we use food to support our bodies while managing a medical condition. Irma’s habits were pretty good. She doesn’t order out a lot, usually eats at home.

But, it turns out, she has a sweet tooth, and she also ate quite a lot of refined, packaged food products: white bread, pastries, breakfast cereals, waffles. We have to work along with prescribed medical treatment, but rather than reaching into the medicine cabinet again as a next step, we talked about what’s in the refrigerator.

Generally, more research is needed about how diet relates to gut health, and specifically, how diet influences rheumatoid arthritis. But we know that over time those processed, packaged foods can have an inflammatory effect. Sometimes they even lead to the leakage of inflammatory food antigens from the gut and into the bloodstream.

My Rx: fewer starches and carbs and bready foods, and a lot more fruits and green vegetables. Sometimes foods rich in omega 3 fatty acids can help this condition, too, along with foods that have anti-inflammatory properties, like turmeric and ginger.

Changing these habits takes time and focus. Therapeutic diets are short-term and the goal is finding a long-term sustainable plan for managing this kind of chronic disease. But Irma’s symptoms over almost a year improved so much that her doctor canceled one of her meds and reduced the dosage of the other one. Now she takes regular walks of a half-hour or more, and more movement leads to an even happier body. The medication is an important aid, but the dietary changes have worked well.

As one of many recent, useful studies of food as medicine point out, this is not just about rheumatism and similar sources of joint pain. Diet can seriously affect a range of chronic disease risk factors and outcomes among patients with either pre-diabetes, type 2 diabetes, high blood pressure, elevated cholesterol levels, obesity, or a combination of these disorders.

But despite “overwhelming evidence” demonstrating the impact of diet on health, many medical schools don’t require that students take basic nutrition courses. That’s one source of trouble.

Another is that unwelcome swim I mentioned, in the Sea of Misinformation on the internet. You can even find the “waffles diet” online? C’mon now! At least 60 percent of U.S. consumers use the internet for medical information, according to another comprehensive study released last spring. On the web, “baseless trends and sensationalist news create opportunities for misinformation to proliferate,” the study concludes. Listen to your physician, not your Twitter feed, for what you need.

When your risk factors have been carefully calculated by your doctor, and the most reasonable lifestyle alternatives are considered, then diet may well be part of the picture. It is not the whole-medicine-cabinet picture, but the whole-health picture that I help my patients strive for.

Looking for Guidance on Making Healthy Choices?

I prioritize new research and healthy lifestyle changes into my prescriptions by allowing for longer office visits and physicals. The journey to optimal health looks different for everyone, and WellcomeMD can help!

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