Food, it’s good medicine

A UH professor's new book covers how nutrition affects people's health

Cultures throughout the world have their storehouses of remedies for illness. Exotic items such as horns or tree bark in a Chinese herbalist's repertoire, noni in the Hawaiian context or spices in almost every cuisine have curing properties. As increasing media exposure highlights blueberries, tomatoes, broccoli and a host of other foods for disease prevention, one has to wonder just what is good food for good health.

Nina Etkin, a medical anthropologist, has been researching the role of food in health for more than three decades. She is graduate chairwoman in the Department of Anthropology at University of Hawaii-Manoa and professor in the Ecology and Health Group at the UH School of Medicine. She has written a book called "Edible Medicines: An Ethnopharmacology of Food" (University of Arizona Press).

This is not a book for engaging bedside reading; it is a tome that draws on literature and research in the areas of anthropology, nutrition science, pharmacology, human evolution and food history, engaging the breadth of Etkin's background as a medical anthropologist. In short, it's scientific reading.

But Etkin focuses on real-life circumstances: people using combinations of foods and why they do so. Through her knowledge of the sciences, she assesses the physiological effects of food on people as well as the cultural contexts in which food is prepared. Her fascination is with how people conceive health and how they prevent and treat disease, and her observations bear a message worthy of recognition.

It is not surprising that food has always played a role in health. Biomedicine goes back to early Greek times and the Hippocratic Corpus, a text that systematically looked at disease and the role of diet in health.

"A key organizing principle was that all foods contain a single element that, when digested, repairs body tissues and provides energy. In other words, the way that all foods are alike has to do with their ability to mediate disease," writes Etkin.

Food and its therapeutic qualities prevailed in the treatment of illness up until the 19th century, when germ theory and specific cures for diseases became the dominant theme in medicine. The importance of the nutritional value of food was lessened because there were so many foods, says Etkin.

In the 20th century, diseases were cured through antibiotics and other medicines, while nutrition science heralded vitamins as magic bullets. As the management of chronic diseases became the focus of medical treatment in the 20th century, the health potential of foods began to re-emerge as an important player in general health.

Within the book, Etkin discusses various foods and their role in health. Spices, for example, help with food safety, their antimicrobial properties killing or inhibiting food-spoilage microorganisms. Animal foods, including insects, play a role in people's well-being in more ways than just filling the stomach. The role of coffee, gums, kava, chocolate, tea and other plant foods are examined within their social contexts as well as for their healthful properties. In short, every food possesses a trait that will enhance human well-being.

While she has seen many correlations between food and good health and food as medicine, Etkins says that she is an observer. "This is what people do," she states. "I don't advocate. I don't promote one way of eating or another. I have no interest in product development or talking with pharmaceutical companies. I'm just interested in what people do in the world of food and medicine."

But she admits we can learn from what people do. Perhaps one inference is that there is no one food, no magic bullet, that can cure ills. And that people should eat a variety of foods for general good health. This is not news; nutritionists and health advocates have been saying this all along.

"What's frustrating for me is the commodification of health," Etkin says in reference to information about specific properties of foods. "There's an overload of information that's not credible; the information is out to sell products."

Laboratory studies, she says in her book, are based on purified substances and healthy animals. "Thus, although some medicine-like action may be confirmed, there is no certainty that this will be the outcome when whole foods are consumed by sick humans. One gains more insight by considering food use in its broadest physiologic and cultural contexts, taking into account the details of preparation and the incidence and quantity of consumption. For that reason, the merits of most nutraceuticals remain potential rather than established."