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Food is Medicine: A Strategy Whose Time Has Come!

Michelle Simon, PhD, ND Michelle Simon, PhD, ND

You are what you eat. We’ve all heard that. But it is a little more complicated; you are what you eat, process, absorb and fail to eliminate correctly. Digestion and nutrient absorption are fundamental aspects of our health and understanding the gut microbiome is now a cutting edge of medicine. A study published in June 2021 in the journal Nature described advances in the understanding of the pathways in which gut bacteria affect mood in mice. When germ-free mice were administered Enterococcus faecalis, their corticosterone levels dropped and their social behaviors improved. From the study abstract, “These studies suggest that specific gut bacteria can restrain the activation of the HPA axis, and show that the microbiome can affect social behaviors through discrete neuronal circuits that mediate stress responses in the brain.” More research needs to be carried out to understand the connection to human systems, but this alone is a fascinating development. And one of the factors to affect the population and distribution of the gut microbiome? Food. We are what we eat. A movement aiming to put the concept that “Food is Medicine” front and center is forming. There are numerous articles, interest groups and companies forming that are pushing this concept toward the mainstream. When I create a social media post with the hashtag #Foodismedicine, I find myself in the company of folks from Mayo Clinic, Emery and Henry Colleges, Center for Health Policy and Law Innovation at Harvard Law, and so many others.

INM is deeply invested in this approach through two of our own programs. One is our North Carolina Public Health Pilot Program done in partnership with Standard Process, Inc. Our program, a 12-week interventional research study to be conducted with 25 participants from a primarily minority county in rural North Carolina, will focus on food and education to increase the participants health literacy.

Chronic disease is responsible for the majority of the health care costs in America. North Carolinians are projected to spend more than $65 billion every year in medical costs and lose $26.6 billion annually in reduced workplace productivity. The number of North Carolinians with three or more chronic diseases is expected to more than double by 2030—from 1.1 million to 2.7 million. According to estimates from the Institute for Health Metrics and Evaluation, North Carolinians lost 364,227 years of healthy life (disability adjusted life years) due to dietary risk factors in 2016; 84,267 of those lost years were attributable to low fruit consumption; and 54,080 were attributable to low vegetable consumption. North Carolinians lost 47,349 years of healthy life in 2016 due to low physical activity.

Our study aims to test the theory that with the food as medicine approach, participants can turn the tide away from chronic disease and learn strategies to employ beyond the study timeframe that will continue to accrue health benefits. Through weekly group sessions and one-on-one communication with a naturopathic doctor as teacher, the study participants will be provided information to help them become their own “Health CEO.” Without knowledge about how and why we become diseased and what to do to prevent it, the course toward chronic disease is all the more certain.

In addition to the group video sessions and reference materials provided, we will be using a gamification app, 1Huddle, to increase learning retention, to provide a quantification of their increased knowledge, and to provide healthy competition with other participants.

Our other program is INM’s Naturally Well, our childhood nutritional education program, which is designed to be a combination of hands-on and video learning formats for children in grades four to six. By providing kids at this pivotal developmental age with concrete knowledge that they can become ambassadors for in their own families, we aim to change the trajectory of the children’s health, their families’ health and the health of the community by extension. Kids are curious about how their bodies work, how food determines health and what they can do to help themselves, and their parents become more healthy and energetic. This program helps feed their curiosity.

We believe it is time for medically supportive Food and Nutrition Services to be front and center in our approach to health care, at least at the state level if not yet the Federal level. That is why INM signed on to support CalAIM in recommending a waiver to include an expansion of home-delivered and medically tailored meals into the state Medicaid program, MediCAL. The proposed waiver included medically supportive food and nutrition services as an expansion of home-delivered and medically tailored meals. The waiver was recently approved, paving the way for California to join North Carolina, Massachusetts and Oregon in providing food-based support to improve health outcomes and reduce health care costs. We were not alone in supporting this pioneering, and yet common sense, approach to health. See the coalition of close to 100 different organizations that signed on to support this direction here: www.spur.org/sites/default/files/publications_pdfs/CalAIM%20Public%20Comment%203_6_20.pdf.

We believe by supporting proactive, preventive health care policy, and by adding to the research database on how Food is Medicine, plus changing lives by changing the minds of our youngsters are smart strategies. If you are interested in bringing Naturally Well to your community, or supporting our work, please reach out to me at msimon@naturemed.org. Be well!

Michelle Simon, PhD, ND President & CEO, Institute for Natural Medicine. In 1992, the leadership core of naturopathic doctors established the Institute for Natural Medicine (INM) as a not for profit organization dedicated to advancing natural medicine. The purpose of the INM is to increase awareness of, broaden public access to, and encourage research about natural medicine and therapies. Among its milestones the INM counts the launch of the Association of Accredited Naturopathic Medical Colleges (AANMC) as an independent organization, leading California’s efforts to obtain licensure, developing an interactive childhood education program focused on healthy eating and lifestyles called Naturally Well in 2017, and expanding residency access by establishing and funding a residency program in 2018. INM has joined forces with the American Association of Naturopathic Physicians (AANP), serving as the charitable arm, to deepen access to naturopathic care, public education and research. Dr. Michelle Simon serves as president and CEO of INM, is a licensed naturopathic physician, clinician, educator, and leader in many organizations dedicated to improving the quality and delivery of health care. In addition to holding a naturopathic doctorate from Bastyr University, she also holds a PhD in Biomedical Engineering from the University of North Carolina at Chapel Hill. Dr. Simon has served on the boards for the Integrative Healthcare Policy Consortium (IHPC), the AANP and the Naturopathic Physicians Research Institute (NPRI). Dr. Simon also served nine years on the Washington State Health Technology Clinical Committee which is part of the Health Technology Assessment program that examines the scientific evidentiary basis for efficacy, safety and cost effectiveness of health care technologies. She was also an invited participant for health care economics at “Summit on Integrative Medicine and the Health of the Public” at the Institute for Medicine (IOM) in 2009. Dr. Simon was recognized as the 2018 Physician of the Year by the AANP.