Ubale
Using Food to Heal the Gut, Brain, and Body: A Deep-Dive into Traditional
and Conventional Medicine’s Perspective on Plants, Nutrition, and Diet
Introduction
Clinical nutrition is the study of the connection between food and our bodily functions and is utilized by different forms of healthcare in order to determine preventive measures, diagnose, and manage nutritional changes in patients. The field centers around how scientists understand our ability to consume nutrients, including the ingestion, breakdown of food, absorption, and elimination within the body. It has been generally understood that nutrition has been considered an integral part of the medical world, yet the concept of “food as medicine” challenges the beliefs of conventional medicine, where treatments are more heavily dependent on technological advancements such as pharmaceutical drugs, radiation, and surgery. In contrast, nutrition and diet plays a significant role in alternative forms of medicine. They often serve as an added support to improve a patient’s overall health and well-being. In complementary forms of medicine, herbs, vitamins, and supplements are used in conjunction with an understanding of nutrition to address various, specific health concerns. There are a few specific regions of interest in complementary and alternative medicine (CAM) where nutrition plays a key role:
It clearly follows that nutrition plays a significant role in many different forms of alternative medicine. While nutrition is often stressed in conventional and Western biomedical practices, it is treated more as a preventive or complementary measure. The well-known ‘food pyramid’ diagram was released in 1992 by the U.S. Department of Agriculture (Fig. 1). Since then, there have been many adaptations and updates to what Western medicine considers a ‘healthy diet’. This variability suggests that nutrition is not as prioritized in conventional medicine as we saw it is in other forms of alternative and traditional medical methods. Nutrition is not a distinguishable component of current undergraduate medical education in the U.S. and there are no required nutritional assessments for clinical medicine physicians (Bray 194).
Figure 1: First Food Pyramid released by USDA in 1992, illustrating a “healthy” American Diet.
Additionally, this is not due to a lack of research – countless studies have examined the relationship between certain vitamins and bodily functions. Instead, this research is often weaponized by fad diets and supplements to promote the belief that the adoption of a specific dietary pattern will solve all health problems. As chronic diseases related to poor nutrition (i.e. obesity, type 2 diabetes) continue to increase at alarming rates, there is a strong motivation to adopt a more structured and evidence-based approach to nutrition in clinical Western medicine.
The goal of this paper will be to research and understand what our current medicinal and scientific understanding of the gut-mind connection is and how this plays a role in traditional and alternative forms of medicine. I will begin with a discussion about the physiological and historical background of the gut-brain connection, then I will delve deeper into how nutrition is currently utilized in conventional and alternative medicine. In this exploration, I will attempt to compare and contrast the two forms in order to ultimately determine whether nutrition is significant and if it should be integrated further into current Western and CAM practices. Throughout this essay, I will provide specific examples and case studies to support my final argument that nutrition is a very important piece in the general management of mental illnesses and other psychological and neurological stresses.
Physiological Background on the Gut-Brain Connection
The gut-brain connection refers to the bidirectional communication and interaction between the gut through the gastrointestinal tract and the brain through the central nervous system (CNS). This communication between the host organism and their microbiota involves complex physiological, biochemical, and neural signaling pathways via various routes including the vagus nerve, gut hormone signaling, the immune system, tryptophan metabolism, and microbial metabolites such as short chain fatty acids (Cryan et al. 1880-1881). Advances in neuroimaging techniques, molecular biology, and microbiome research have demonstrated the many factors that influence the composition of one’s gut bacteria ecosystem. These encompass early life (i.e. mode of birth delivery, use of antibiotic medications, host genetics, etc) and other ages as well. It has been shown that microbial diversity decreases with age and that stress can directly affect the gut-brain axis at any stage of life. Furthermore, recent research suggests that the gut microbiota plays a role in the development of many conditions, such as autism, anxiety, obesity, schizophrenia, Parkinson’s disease, and Alzheimer’s disease (Cryan et al. 1916). The key components supporting the communication between the microbiota, gut, and brain are the enteric nervous system (ENS), sympathetic and parasympathetic branches of the autonomic nervous system (ANS), neuroendocrine signaling pathways, and neuroimmune systems. The intricate network is controlled by neurotransmitters and hormones – specific spinal and vagal sensory neurons carry feedback from the gut to the hypothalamus and forebrain regions with support from humoral signaling molecules and hormonal components (Cryan et al. 1903).
The gut is home to a complex ecosystem of microorganisms collectively known as the gut microbiota. Trillions of microbes act as regulators and modulators of almost every other aspect in an organism’s physiology. The gut also contains the ENS, which is the complex neural network often referred to as the ‘second brain’. Using various neurotransmitters, hormones, and other bioactive molecules, the ENS acts independently but also interacts with the CNS through the vagus nerve. Being the longest cranial nerve, it is responsible for controlling extremely important internal systems, specifically breathing, cardiovascular activity, heart rate, and digestion, so unsurprisingly, there is clear evidence that communication through this nerve impacts brain function and behavior (Foster et al. 125). Specifically, recent research has demonstrated that bacteria is a key component of processes related to brain neurogenesis and neuroplasticity. While the elastic properties of the human brain is a relatively recent area of research in the Western biomedical world, the concept of the “self-healing” brain is one that is found in many other ancient civilizations and is a fundamental aspect of holistic and alternative medical approaches. The gut releases specific neurotransmitters and hormones that then influence the brain’s ability to function. A significant example commonly associated with mood regulation is serotonin is predominantly produced in the gut. About 90-95% of serotonin in the body is found in the gut, and it is involved in regulating gut motility, mood, and appetite (Foster et al. 128).
Overall, the physiological background on the gut-brain connection is complex and multifaceted. By involving the ENS, neurotransmitters, hormones, gut microbiota, immune system, and stress response, we see that an intricate set of interaction exists between the gut, brain, and body that illustrates why it is extremely important to maintain a healthy gut and microbiome for general physical and mental well-being. It follows that there are direct implications for prevention and treatment of disease and illnesses through the emphasis of nutrition and diet choices that will support one’s gut microbiota.
Historical Background on the Concept of “Food as Medicine”
Historically, observations about the gut-brain connection have been made as early as 1500 BCE. In Ancient Egypt, the Ebers Papyrus was developed and contained a compilation of medical texts with over 700 formulas. More importantly, this text contained accurate interpretations of how the human circulatory system works and even described the human heart’s function and the potential existence of blood vessels. Aloe, basil, and bayberry were also specific plants that were mentioned in the Papyrus in methods of healing (Metwaly et al. 5825-5827). At the same time, around the 4th century BC, ayurvedic medicine was first found in the Mahābhārata and central theories were being developed about toxicology and moderation of food intake (Yao et al. 8). Similarly, ancient Greek and Roman philosophers were making connections between the emotional and physiological state of a patient and the gut. Greek physician Hippocrates (460 - 370 BCE) utilized many herbal remedies, as described in one of his key medical texts: The Hippocrates Corpus. Hippocrates is often considered the “Father of Western Medicine” and this is demonstrated by the development of some of his botanical observations into forms of modern medical drugs (Conti 352). In ancient China, the healing practices of TCM were being established and Shennong Ben Cao Jing, a book describing agricultural and medicinal plants, was written around 206 BC to 220 AD (Yao et al. 7-8). Ultimately, the power of food as a healing resource was being examined in multiple different medical paradigms during the development of ancient civilizations.
The roots of nutrition in many traditional medical practices lie in the herbal traditions of millennia, such as traditional Chinese medicine of China and Ayurveda of South Asia. The understanding of food and diet as a source of healing is deeply intertwined with the key theories and principle beliefs of these alternative practices. In terms of western biomedicine, the knowledge of specific herbs and the importance of gut health stems back to ancient times as well. Hippocratic medicine and ancient Roman philosopher Galen’s food theories heavily influenced the Western perspective on nutrition and consuming natural resources. Nicolas Culpeper, an English herbalist, botanist, and physician who lived from 1616-1654, was heavily influenced by Hippocratic and Galenic food theories. Culpeper eventually published The Complete Herbal which consolidated his herbal and pharmacological knowledge. Throughout the course of the Renaissance and the subsequent centuries, physicians and scientists further developed their understanding of human anatomy and physiology. There was a movement from looking at the human body as a whole to examining the processes and mechanisms occurring at the cellular level (Tobyn et al). The technological advances in the 18th and 19th century led to sharp shifts from classical paradigms to the establishment of more conventional Western biomedical techniques.
Around the same time, medical licensure was first established in New York with the intention to protect patients and mandate licensed medical practices. By the early 1800s, the biomedical community had essentially become established as the ‘superior’ medical practice. These societies were able to maintain control by weaponizing licensing authority and demanding that practicing physicians obtain official licenses from medical institutions. Ultimately, by gaining control over what form and level of education was required to become an accredited physician, the biomedical community exploited the relationship between power and knowledge in order to further cement the biomedical paradigm in American society. These institutions were able to reconstruct the public’s idea of a standard, professional physician by reshaping education and the sharing of knowledge to better fit their personal perspectives. This had direct impacts on the training of naturopathic and homeopathic practices (Cohen 17). Teaching about whole herbs as a form of healing was not prioritized by the biomedical societies, ultimately leading to the decrease of their use in the Western medical world.
It is also extremely significant to discuss the role of African Americans, Native Americans, and other people of color in America during this time period. Due to their lack of access to Western medicine, they played key roles in the continuation of herbalism in the United States. In order to maintain general access to medicine, these oppressed communities used knowledge of plants for healing and treatment. Notable herbalists in American history include Harriet Tubman and George Washington Carver. Both of these black herbalists utilized and passed on herbal knowledge to aid other black Americans during the Civil Rights Movements, directly countering legislation from some states that made it illegal for enslaved people to teach or learn about herbal medicine (Tobyn et al).
It wasn’t until the 1950s that the whole foods and dietary supplements movement gained traction in the West. By this time, scientists had begun identifying specific minerals and vitamins that were then used to produce multivitamin supplements and to fortify foods. Ultimately, the historical background of ‘food as medicine’ has evolved over the centuries, from the development of traditional theories in ancient times to more scientific advancements in the modern Western world (Davis and Saltos). There is a clear divergence between traditional and Western medicine’s perspective of how natural plants and herbs should be used in a medical setting; recent research suggests that there is an intricate relationship between the gut, brain, and body and so integration of CAM’s herbal and food knowledge into Western medicine should be further examined.
Role Food and Diet Plays in Conventional vs. CAM Practices
As discussed earlier in this paper, we see that in conventional medicine, nutrition is often seen as an important component of preventive care and disease management. Additionally, nutritional knowledge is often provided to patients as a supplement to more evidence-based treatment plans. Generally, the guidelines and recommendations for food and nutrition in the Western world are based on rigorous clinical trials and scientific research. Furthermore, Western nutritional knowledge places an emphasis on the chemical composition and physiological process of nutrients and other substances in food. Rather than relying on whole foods and herbs, scientists isolate the vitamins and minerals in order to develop more standardized products. This allows physicians to recommend specific combinations of nutrients and vitamins through the administration of supplements and multivitamins. Ultimately, conventional medicine extracts the chemical and physiological properties from natural foods in order to focus more narrowly on a patient’s symptoms and deficiencies (Wongvibulsin et al. 3). In contrast to this, alternative and traditional methods utilize a much more holistic and integrative approach. In these paradigms, nutrition is a central component of treatment and prevention. Practitioners place a significant emphasis on using natural and plant-based therapies that are often based on cultural or traditional practices. Rather than standardized guidelines or scientific evidence, CAM practices, such as Ayurveda, TCM, and naturopathy, utilize an individualized medical program that allows for the physician to directly support a patient’s health and well-being. By placing a greater emphasis on the interactions between diet, lifestyle, and emotional state, the traditional perspective on food as medicine distinguishes patients as a whole person and then aims to treat their personal needs and health concerns.
The neuroprotective herb Ginkgo Biloba L. clearly demonstrates the difference in how conventional and traditional practices approach nutrients as medical tools. Ginkgo trees are considered ‘living fossils’ due to their incredible long life span of around 4000 years. They are highly tolerant to environmental stresses and pathogen infections, which may account for their powerful antioxidative properties. The tree has been used medically for over 5000 years, tracing back to the origin of Traditional Chinese medicine. In TCM, ginkgo leaves are categorized as a herb that relieves coughing and wheezing and is used to treat asthma and bronchitis. The ginkgo biloba leaf is considered neutral in nature and doesn’t affect the yin-yang balance in an individual, but instead detoxifies the body by replenishing qi and blood (Iriti et al. 3522). It is also important to note that the ginkgo seed and ginkgo root serve different purposes and are used to treat other bodily ailments depending on their specific balancing properties (Yao et al). Ginkgo also serves a significant purpose in conventional medicine. In the early 1970s, after German physicians recognized the healing antioxidative properties of Ginkgo trees, EGb 761 (the standardized extract of Ginkgo leaves) was produced and then distributed to create commercial medical products. This extract contains the main flavonoids, ginkgolides, and bilobalide that create the unique pharmacological capabilities of the Ginkgo plant. The efficacy of these extracts were investigated in randomized, double blind, placebo-controlled trials and then patented and distributed; currently, they are widely prescribed for improvement of memory and brain blood flow in America and Europe (Iriti et al. 3523).
It follows that there are distinct differences in how traditional and conventional medicine treats plants and herbs. The CAM approach is supported by a rich history of traditional usage and anecdotal evidence, which allows for a much more personalizable administration of the plants. By utilizing the plant in its natural form, the correlated treatments are more accessible and can be more easily integrated into a patient’s daily lifestyle. On the other hand, conventional medicine isolates the nutritional value of the natural plant and instead ascribes them to a clinical drug. While this removes the holistic and personalized properties of CAM practices, it allows for more widespread scientific research and evidence to be collected. Unlike traditional medicine which is based on much more variable evidence, determining effectiveness and safety of products in conventional medicine is much easier and more efficient. This allows for production and distribution of nutrients and supplements at larger scales, leading to more obtainable treatments. Ultimately, both conventional and traditional approaches to using food as medicine have positive and negative elements, suggesting that the integration of a more holistic approach to nutrition into conventional medicine could result in more comprehensive treatment plans.
The implementation of this integration will rely on incorporating better holistic nutrition knowledge into conventional medicine. This claim is supported by multiple studies that have demonstrated the inadequate recognition, support, and attention given to this subject in medical schools (WHCCAMP 11). A survey administered by the American Medical Association (AMA) and the Nutrition Foundation in the 1960s found that medical schools were lacking in the nutritional science curriculum. This outcome sponsored a 1962 conference on teaching of nutrition in medical schools. In 1972, these schools’ curriculum was reevaluated but participants felt that no real progress was being made. Throughout the 1970s, many other attempts were made to improve the quality and quantity of nutrition education in medical schools in the United States, but only 27% of medical schools had an identifiable nutrition course in 1983 (Bray 195). A key component to the lack of institutionalized nutrition education lies in the difference between conventional and CAM health care systems. Conventional methods tend to prioritize technological, pharmacological, and surgical medical practices and underemphasize prevention and general wellness, contrasting the emphasis placed on the health of the whole body in traditional medicine. A 1985 study by the National Research Council’s Committee on Nutrition in Medical Education illustrated the imbalance between the various topics taught at medical schools: they found that more than 80% of the schools taught about undernutrition, obesity, protein carbohydrate, lipid metabolism, and the major vitamins and minerals. On the other hand, only 30% to 60% of medical schools taught about “the relationship of nutrition to the immune system, renal disease, cancer, the central nervous system, and various phases of the life cycle” (Bray 196). These statistics demonstrate the significance that Western medicine places on the specific physiological processes of nutritional energy, rather than the connection between nutrition and other body systems. By not valuing the nutritional aspects in medical education, many physicians are not able to completely support their patients’ health and wellbeing.
This lack of education has negative effects in conventional medicine that spans past direct treatment. A study conducted in the 1970s demonstrated that after beginning medical treatment in Western hospitals, the nutritional status of about 50% of the patients declined. They also found that the percentage of malnutrition increased proportionally with the length of the hospital stay. This clearly illustrates that the conventional american health care system does not value the quality of food and diet in the healing process and that this underemphasis has direct impacts on the health of the patients. Furthermore, the study also reported on the medical staffs’ ability to identify the nutritional deficiencies in their patients. They found that “only 12.5% of the patients who were at nutritional risk were appropriately diagnosed” (Bray 198-199). It clearly follows that Western hospital systems’ do not value nutritional power in the way that traditional and CAM practitioners do. By defining nutrition as purely preventative and supplementary, there is not enough emphasis being placed on a patient’s diet in their overall journey for better health. It is also evident that the lack of respect and understanding of food as medicine stems from the inadequate nutritional education in the Western health care system. The integration of traditional nutritional values into the western medical paradigm is required to counteract the increase in chronic illnesses and diseases. Combined with a more developed and inclusive nutritional curricula in medical schools, a respect for whole foods and plants must be prioritized by the current medical institutions. Instead of relying on purely scientific, biomedical technology, such as surgery and drugs, conventional medicine must begin considering nutrition and holistic dietary recommendations as the central component of a person’s health.
Conclusion
This paper serves as a deep dive into the role that nutrition, food, and diet play in both conventional and traditional medicine. By understanding the physiological background of the gut-brain axis and the underlying mechanisms that define how the food we consume affects other systems in our body, we see that promoting better gut health through intentional and individualized food preparation and consumption positively impacts a body’s ability to protect and cure itself. Historically, we see that ancient traditional practices have always promoted these nutritional values but during the scientific evolution of western biomedicine, there was a paradigm shift that led to conventional medicine no longer prioritizing food as a form of medicine. Ultimately, it follows that an increase in respect for holistic medicine combined with a stronger academic understanding of whole plants, herbs, and nutrition as a principal component of medicine would improve the quality of preventive measures and hospital treatment in the Western biomedical world.
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