Bob Harrington and Mitch Elkind discuss whether food is medicine, as well as the American Heart Association initiative to study the best way to use food to treat cardiovascular disease.
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-TRANSCRIPT-
Robert A. Harrington, MD: Hi. I'm Bob Harrington from Weill Cornell Medicine, and I'm here for theheart.org | Medscape Cardiology at the American College of Cardiology (ACC) meeting in Atlanta. I love to use these opportunities at the big meetings to catch up with friends and colleagues, and to talk about things they're doing that might be of interest to the Medscape Cardiology listening audience.
I think we're going to have a terrific conversation for this one. We're going to explore the topic of "food is medicine." That topic has been talked about often online. There have been some recent papers out on the topic. What exactly does it mean? How are people thinking about it? How are patients understanding it?
I can't imagine a better person to join me today than my friend Mitch Elkind. Mitch is the chief clinical science officer at the American Heart Association (AHA) and is part of the large team at the AHA working on a "food is medicine" project.
Mitchell S.V. Elkind, MD, MS, MPhil: First of all, Bob, thank you so much for having me on the show today. Our initiative at the AHA is called Health Care by Food, which is healthcarexfood.org. People can find info online.
Harrington: That's fantastic. I want to start broad.
Elkind: Okay.
'Food Is Medicine' Is a Misnomer
Harrington: What's the concept of "food is medicine"?
Elkind: The concept of "food is medicine" is to provide nutritious food to people who have diet-related conditions. We at the AHA, the ACC, and many organizations have dietary guidelines and nutritional recommendations. We've been in the space for a long time, I think, of telling people what healthy foods are, what people should eat to prevent hypertension, diabetes, heart failure, and so forth.
"Food is medicine" really goes a step further. It's about actually providing that healthy food to people so they can eat it and consume it and try to prevent and manage cardiovascular and other conditions.
Harrington: Making the assumption that if you do that, they will have better outcomes.
Elkind: Correct.
Harrington: That's what we don't know yet.
Elkind: That's what we don't really know yet. That's right. The literature so far is limited and it's suggestive, but doesn't yet prove the point, for example, the way we might want to prove it for a medication, that providing meals and groceries or produce to people works.
Harrington: As I understand it, having been involved with this through the AHA, part of the challenge is that food means many things. There's the nutritional element to it. There's the social element to it. There's a cultural element to it. How does one think about all of that and try to improve health outcomes?
In some ways, you could say, well, don't we know what we're supposed to eat? Hasn't the AHA talked about this for years? In fact, there's still so much we don't know, isn't there?
Elkind: You're right. We know what the healthy and nutritious foods are, for the most part. There is certainly more work that could be done in that area of nutrition. For the most part, we know what people should be eating and we put out those recommendations. The problem is that people are essentially swimming upstream, right? It's very difficult in our modern world for people to easily consume the foods that are best for them. There are many pressures against them in terms of the easy availability of unhealthy foods. They're more affordable and so forth.
"Food is medicine" would be a way to provide those healthy foods directly to people, especially people who are food- or nutrition insecure, meaning they don't have that kind of access.
I think the term "food is medicine" is in some ways really a misnomer because food is not medicine. When we think of medicine, we think of a pill that we might use for heart failure, such as one of your four pillars of heart failure treatments.
Harrington: It's more than that now, but that's okay.
Elkind: I can't keep up. I'm a neurologist so I'm a little bit behind in the cardiology space. The medications are intentionally designed and manufactured to be identical from one pill to the next. You know the exact dose and you're giving it to a person in that same shape and form, regardless of their religion, their background, their cultural preferences, their personal tastes, and so forth.
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