Delhi-based lawyer Vikas Kansal didn’t see it coming, but when symptoms such as frequent urination and excessive hunger became hard to ignore, he saw a doctor. The diagnosis: type 2 diabetes. As the doctor started writing him a prescription, Kansal stopped him. “I will reverse this naturally,” he said. That dietary interventions could manage several health conditions was something he had experienced at home. His father had benefited from a post-angioplasty diet, while his mother’s jock itch, a skin fungal infection, was cured with a prescription by her naturopath. Kansal saw a diabetes educator who put him on foods that also served medicinal functions; for instance, those rich in alpha-lipoic acid, N-acetylcysteine, and those with glycemic index less than 55. With some lean protein, select whole grains and fruits, Kansal brought his sugar levels within the optimal range.
A slow movement against a grim backdrop
The burden of nutrition-related and noncommunicable diseases (NCDs) like diabetes, hypertension and obesity is mounting. According to the annual ‘Health of the Nation’ report released by Apollo Hospital Group last month, diabetes and hypertension alone have become the leading cause of death in India, contributing to 65 percent over the past three decades. The economic burden of NCDs is estimated to be $4.8 trillion by 2030. It’s against this background that alternate systems of disease prevention and management are gaining traction. One gaining prominance among them is the Food is Medicine (FIM) movement, which recommends condition-specific prescriptions, such as low-sodium meals for patients with hypertension, carb and sugar-balanced ones for diabetics, and high-fibre, low-fat meals
for those with cardiovascular diseases.
Prevention lies on plate
Whether it’s highlighting the importance of holistic health or the richness of India’s ayurvedic wisdom, the spotlight is back on the value of ancient foods. “All India Institute of Ayurveda and National Institute of Nutrition are promoting the importance of medically tailored diets. With FSSAI’s Eat Right Movement to combat negative nutritional trends, food as medicine has come to a high point,” says one of the foremost FIM advocates, Madhavi K Sharma, nutritionist, diabetes and gut health expert from Delhi.
Until turning 72, Jayamma from Karimnagar in Telangana hadn’t tasted Njavara rice, a variety from the neighbouring state of Kerala. She was used to eating the not-so-healthy polished Sona Masuri rice. Last October, when she had a fall and injured her hand, the septuagenarian was supposed to undergo an emergency bone surgery. But her high blood sugar levels (fasting sugar of 460) prevented her from doing so. She would throw up food and the doctor insisted that she be fed some solids to regain strength and endure the pain. Her daughter Bhavani Devineni recalled reading about how a few varieties of rice are good for those in pain, and fed her mother a porridge made of Nyavara for lunch and Narayana Kamini rice for dinner. In three days, her blood sugar levels normalised and she underwent the operation. “We need to tap into our cultural and medicinal wisdom,” says Devineni, who runs a health food store in her house in Hyderabad and sources nearly 100 indigenous rice varieties, from Mappillai samba to Poongar rice from across the country, which are proven to improve PCOS, PCOD and arthritis.
Even though food has been the cornerstone of India’s healthcare system since millennia—the Rig Veda describes the medical use of 67 plants, while the Atharva and Yajur Veda describe 293 and 81, respectively—the alternative protocol is witnessing a resurgence only now. “A key driver is the increasing interest in ayurveda’s role in epigenetics, whereby gene expressions can be up- or down-regulated with diet management,” says Delhi-based acharya Manish. There has also been a renewed interest in ayurveda since Covid, with preventative health becoming a priority. The market for it, which includes fitness and wellness, foods and supplements, is projected to reach $197 billion by 2025, according to last year’s report by consulting firm Redseer Strategy Consultants in collaboration with Chiratae Ventures and Amazon Web Services. The global ayurvedic market is expected to grow at a CAGR of 12 percent during the 2022-2028 period. “It is, after all, the mahabhaisajya, the most superior medicine,” says Manish.
Growth, albeit challenges
The biggest challenge in the mainstream recognition of food as medicine is poor documentation. “While the philosophy has been a part of India’s oral wisdom, there are no written records. The adoption of English as the language of science made things worse. The information shared in native languages also got lost in translation or never qualified for the credentials,” says Sharma.
Will insurance cover food in the future? “The short answer is no, at least not in the foreseeable future,” says Rajeesh Raj (name changed), a Mumbai-based claims investigator at a well-known insurance company. “Even though medical food undergoes specialised processes to meet disease prevention and recovery, insurance companies won’t accept that as they’re driven by profits. In the 1970s, such foods were brought under the ambit of prescription drugs, but manufacturers later re-classified them as just food to reduce research costs. Despite petitions for insurance coverage, the requests have been denied, saying its medical necessity could not be legitimately established,” he says.
Lack of inclusivity for specialists practising food as medicine is another roadblock. “The difference in regulations for those trained abroad and those graduating from Indian universities pose challenges. The Indian Dietetics Association does not recognise foreign-trained professionals, disregarding their extensive work in using nutritional interventions to reverse diseases,” says Mumbai-based Shonali Sabherwal, a macrobiotic nutritionist, gut health expert and chef, and author.
Despite the challenges, the future is food-medicine. Whether it’s medically tailored meals, groceries or dietary solutions, FIM is making equitable access to nutrition possible. Ready to swallow the food pill?
with Manju Latha Kalanidhi