While “eating right” is no substitute for medicine, can herbs and spices help some chronic health conditions?
The use of foods for their medicinal purposes dates back hundreds of years. Ginger is known to help reduce nausea. Green tea may help protect against certain cancers. And flaxseed may also lower cholesterol. But are there foods that can help prevent or treat other chronic conditions such as diabetes and heart disease?
While numerous research studies have explored the benefits, there is strong debate within the healthcare community on whether now is the time for physicians to begin promoting food as an alternative medicine.
Food as Medicine
Americans’ interest in the use of natural products, such as herbs and probiotics, to stay healthy has seen considerable growth in recent years. In a 2007 National Health Interview Survey, which included a comprehensive survey on the use of complementary health approaches, almost 18% of American adults had used a nonvitamin/ nonmineral natural product in the past year — with fish oil/omega 3s as the most commonly used product.
And while interest in these natural products has spiked, experts agree that no one is suggesting that patients with diabetes or heart disease swap their prescribed medications for what’s in their kitchen cabinets.
“While foods cannot replace prescribed medications, they have been shown to be part of a disciplined approach by many to ward off chronic health conditions and even to reverse them in some cases,” says Kantha Shelke, PhD, a food scientist and principal at Corvus Blue. “Drugs have an important role in managing the symptoms in chronic health conditions such as diabetes and heart disease, but foods, if used judiciously, can go a long way to help prevent the chronic condition from happening.” Corvus Blue is a food science and research company in Chicago.
Nutrition expert Roger A. Clemens, Dr.PH, an adjunct professor at the University of Southern California School of Pharmacy and past president of the Institute of Food Technologists, says the theory of food as medicine is not a new one. “Hippocrates is credited by saying, ‘Let food be thy medicine,’ and so now we ramp ourselves forward several centuries since that time, and the whole notion that food be thy medicine seems to be emerging,” he says.
“One of the challenges, though, is that … when you put food in the same sentence with ‘cure, mitigate, treat, diagnose, or prevent,’ it signifies a drug, and there is a different standard to look at drugs from a therapeutic perspective versus overall health,” he continues.
Clemens says he is adamant about drawing the line in the sand when it comes to food and health claims, and weighing the burden of proof or the quality of evidence is crucial.
“Hippocrates also said ‘do no harm,’” he adds. “As we pursue food as thy medicine, it’s incumbent on us to first do no harm because we just don’t know with [some of the elevated doses of these foods required].”
Nora Saul, manager of nutrition services at Joslin Diabetes Center in Boston, agrees that for patients with a chronic condition such as diabetes, the suggestion of food treating or preventing their condition is risky. “Food and exercise are the two biggest components of diabetes treatment,” she explains. “But, I consider it a triad, with medication as needed as the third major component”.
“There are some patients who follow an excellent lifestyle program of eating healthy and exercising that allows them to never need medication or to get off medications, but that’s just some patients,” Saul continues. “There are other patients who will never be able to get off their medications. I think it’s important to give patients a realistic idea of what’s possible.”
At the McCormick Science Institute (MSI), in Hunt Valley, Md., 22 clinical studies are being funded to explore the potential health benefits of culinary spices and herbs. The role of spices in the prevention or treatment of diabetes is commonly researched.
For example, a small MSI-funded study published in 2012 in the Journal of the Academy of Nutrition and Dietetics reported that adding 6 grams of ground cinnamon to 50 grams of instant farina breakfast cereal lowered blood glucose in both normal weight and obese participants.
In another study appearing in the January 2013 issue of Diabetic Medicine, researchers studied 22 men with type 2 diabetes to see whether adding a polyphenol-rich spice mixture to a hamburger before cooking would reduce postprandial lipid oxidation and endothelial dysfunction compared with a hamburger cooked with salt only. The men who ate the burger and spice mixture, which included cinnamon, ginger, oregano, and turmeric, had a reduction in urine malondialdehyde, an increase in urinary nitrate/nitrite, and improved postprandial endothelial dysfunction.
“Giving these hamburgers to people decreased their lipid peroxidation in urine by 30%,” says study author Susanne Henning, PhD, from the Center for Human Nutrition at UCLA’s David Geffen School of Medicine. “After we saw this effect, we were not surprised to also find a significant effect on endothelial function. However, the effect on endothelial function is most likely due to several mechanisms, not only a decrease in lipid peroxidation, but also an increase in nitric oxide.”
Our research clearly demonstrated a beneficial health effect of adding spices to your meat prior to frying, Henning adds. “A mixture of turmeric and/or oregano was the best among the ones tested in our research. Disappointing was that garlic didn’t reduce the generation of lipid peroxides. However, garlic has other health benefits such as the oregano-sulfur compounds.”
Ground cinnamon is another spice associated with some improvements in fasting blood glucose, total cholesterol, and insulin sensitivity. Many, though, debate whether the hard science exists. “There have been a number of studies that have shown cinnamon might have some small benefit of reducing blood glucose levels, but this a small effect,” says Saul. “It’s not the kind of reduction you would see with medication.”
What’s more, says Clemens, is that suggesting spices to patients is off-label “and physicians don’t want to do things off-label.”
“Medications are standardized, but when you come with cinnamon or ginger, it becomes complicated when you want to suggest a certain profile or characteristic that is not regulated,” Clemens says. “Today we have a higher expectation. We just are not there yet.”
The federal government agrees. The National Center for Complementary and Alternative Medicine (NCCAM) states that high-quality clinical evidence to support the use of cinnamon for any medical condition is “generally lacking.” NCCAM cites a 2012 systematic review of 10 randomized controlled trials that did not support using cinnamon for type 1 or type 2 diabetes.
Cinnamon does have a place in a diabetes meal plan, however. Saul says patients can use cinnamon as an adjunct to their medication. “The truth is, there’s very little harm in using cinnamon in our food. And it tastes good.”
Boosting the “Diabetes Diet”
Although science may not yet support the notion that food can replace medicine, food does play a significant role in diabetes treatment, says Saul. The right foods for a diabetes meal plan have a low-glycemic index and provide key nutrients. “The basis of a diabetes diet has lots of non-starchy vegetables, fruits, proteins, low-fat dairy products, lots of legumes, and some of the healthy fats,” she explains.
Saul admits that many of her patients sometimes struggle with adopting the new diet. The issue is often that healthy foods don’t always taste good, they say, without salt and fat.
But Shelke says that healthful foods do not have to taste bad, and foods without added fat and salt don’t have to taste bland (see sidebar). “The art and science of combining food ingredients into healthful and delicious finished foods has been alive for a long time,” she explains. “History has established the tastiness of many foods that are good for those struggling with chronic conditions such as diabetes or with sodium and fat intake.”
— Fauntleroy is a freelance writer based in Carmel, Ind., and a regular contributor to Endocrine News. She wrote about Cushing’s disease in the May issue.