According to the 2020-2025 Dietary Guidelines for Americans, the core of a healthy diet is built on high intakes of a variety of nutrient-dense foods and beverages, including: Social and economic factors aren’t the only health determinants that are somewhat out of an individual’s control. We all have unique genetic predispositions—some people are simply born more at risk for certain conditions, like heart disease, than others. Environmental factors also play a role. Sunlight, dust, chemicals, metal, plants, animals, and other things we’re exposed to daily can contribute to the onset of pretty much every illness, from kidney disease to infertility to skin cancer. And of course, disease can be random. A 2017 report in Science found that about two-thirds of cell mutations that lead to cancer are caused by random DNA replication errors, while only a third are caused by inherited genes, environmental factors, or behavior. (Although yes, some cancers are more directly linked to behavior; for example, smoking is the primary cause of lung cancer.) Even diseases that are more strongly linked to lifestyle, like type 2 diabetes and heart disease, can occur in people with no known lifestyle risk factors.

As is the case with disease prevention, food plays a supporting role in the management of certain diseases. Medical nutrition therapy (MNT) is “the evidenced-based approach to treating medical conditions with food,” says Clara Nosek, a dietitian based in Modesto, California. Dietitians are trained in MNT, and there are myriad applications for the approach. In some cases, short-term dietary changes can treat an acute (short-lasting and sudden) condition; Nosek gives the example of reducing sodium intake to help reverse edema, which is swelling caused by excess fluid trapped in your body’s tissues. In other cases, long-term dietary changes can help someone manage a chronic (long-term and often lifelong) condition. Johnson points out that those with celiac disease must completely avoid gluten to prevent long-term intestinal damage and other negative side effects. Similarly, someone with diabetes might use diet as part of their strategy to manage blood sugar. Some uses of MNT are even more clinical, like feeding someone through a tube or an IV if they’re unable to consume enough by mouth. Josh is a beacon of truth in a sea of misinformation when it comes to nutrition and wellness. He approaches every topic with evidence, rationality and empathy and his presence on the internet is much needed. Alice Liveing (@aliceliveing) The simplest approach would be to subsidise access to fresh vegetables. “[Vegetables] have such a powerful effect from a health perspective, yet there is such a common perception that they’re unaffordable – and these days they potentially are in some communities,” Lambert says. Both MNT and a nutritious diet can help improve health outcomes, but neither is a replacement for health care. (In fact, MNT is typically provided by a dietitian, which means that it’s a form of health care.) The best way to catch and treat potential problems early on is by scheduling regular visits with your primary-care provider.

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The development of chronic diseases continues to be complex and may be attributed to non-diet-related causes, including genetic risk, exposure to environmental toxins, or autoimmune conditions. Dr Joshua Wolrich routinely does an incredible job of sorting fact from toxic fiction. A must-read for those wanting to unlearn the toxic ideologies and beliefs we have been taught about ourselves by the diet industry! Stephanie Yeboah (@stephanieyeboah)

The prevalence of chronic diseases has increased worldwide, along with associated healthcare costs.A free ‘prescribed’ box of fresh food had a marked effect on study participants’ diet quality. Photograph: Gregory Davies/Alamy Decades of scientific findings support the integral role of diet in health management, which should not be understated. Foods that proponents claim have medicinal properties, often due to supposed high levels of a particular micronutrient or biomolecule — sometimes referred to as functional foods — are of particular interest by people who consider food as medicine. At the moment, a Medicare-subsidised chronic disease management plan – for management of diseases such as type 2 diabetes – includes the option of a single appointment with a dietitian as one of a large variety of allied health professionals available for limited number of subsidised appointments. Josh's desire to educate others stands upon a foundation of compassion that we might experience more freedom and take our opportunity to question the damaging messages we so easily absorb. Anna Mathur (@annamathur)

The reasons for this are myriad, complex, and not yet well understood. Some research has shown that a diet rich in added sugars, saturated and trans fats and excess sodium may induce chronic inflammation — an underlying risk factor in the development of heart disease, type 2 diabetes, poor gut health, and other chronic diseases.

Nutrition Is Just One Tool

Using “food as medicine” could conceivably reduce healthcare costs by potentially reducing disease severity through better labwork, fewer medications, and fewer hospitalizations. All of this disproves the notion that eating a certain way, or a certain food, can eliminate the need for health care and medicine. The fact that disease can (and almost certainly will) occur no matter what you do might be a tough pill to swallow. But Johnson explains that it can also bring relief in that you can stop blaming yourself for your health problems or micromanaging your eating habits in the name of disease prevention. Nutrition Is Just One Tool Likewise, observational studies identified that a healthful diet during breast cancer treatment may reduce negative symptoms caused by cancer treatment, including nausea, vomiting, and loss of appetite. Cost-effective However, it can also be a source of misinformation and sharing of unverifiable information, especially where “food as medicine” or alternative medicinal therapies are concerned.