S2E1: How is food medicine?

Can food really be medicine? Let's learn how paying attention to what you put into your body can have lasting impacts on your overall health and well-being.  And we will also find out how Food Equality Initiative is working to make sure everyone has access to nutritious food and knows why it is important.

Guest:

Erin Martinez, Interim CEO of Food Equality Initiative

Sources Referenced:

NPR - The U.S. Diet is Deadly.

White House Conference - Hunger, Nutrition, & Health

Transcript:

Erin Martinez: Everything we put into our bodies will affect our bodies typically at a cellular level. 

Sofia Gillespie: So you are what you eat. 

Erin Martinez: Yes.

SG: In season one, we dove into the food allergy world; and coming up in season two, we tackle food and the planet. On today's show we're pleased to welcome Food Equality Initiative’s CEO, Erin Martinez. She's going to talk to us today about what Food Equality Initiative does, how we're making the world better, and then also give us some tips and tricks when it comes to improving general nutrition and grocery shopping. So, Erin, thanks for coming on the show. 

EM: Thank you for having me on today.

SG: So, tell me a little bit about what got you excited about FEI's mission. 

EM: Food Equality Initiative stands for helping the underserved and those with special diets. And from our family’s lived experience with celiac disease, I knew that the impact of a diet-treated condition on a family’s grocery budget and just overall household income can have a very significant impact. I knew I wanted to help make a difference for other families to get the food that they need and be able to thrive and survive. 

SG: I know Food Equality Initiative started in the celiac disease/food allergy realm, but has since expanded beyond that. Can you tell us a little bit about what prompted that expansion? 

EM: Many people came seeking support from Food Equality Initiative. However, they didn't always necessarily meet the qualifications of having a celiac diagnosis or a food allergy, but more along the lines of a gluten intolerance or Crohn’s, or something else that could not be identified as a food allergy or celiac disease, but still had to eliminate particular foods from their diet. And so, the more requests we got along these lines, we took about a year to assess, and came to the decision that we need to expand our services to include those other diet treated conditions. 

SG: So basically it was just getting stuck in the weeds.

EM: Stuck in the weeds, and that there were many different types of ways that diet helps people and needing to expand our reach a little bit more.

SG: Can you list a couple of examples of other diet-treated diseases outside of food allergies.

EM: Diabetes is the first one that often comes to mind, because you have to eliminate more of the processed foods that will cause those insulin spikes and eat a generally more nutritious, healthier diet in order to balance your insulin levels and be able to manage the diabetes. And then, along with that, there's also cardiovascular disease - dealing with high blood pressure and eating those low sodium diets, and so getting those foods and having access to that can be cost prohibitive. And so we like to make sure that people can follow the diet that their medical practitioners have recommended for them to follow in order to be able to manage their disease states. 

SG: Did you see the article from NPR that they posted in the very end of August about how the US diet is dangerous? 

EM: Yes. The standard American diet is often called the sad diet. Because of that, it is heavily processed, and we've kind of fallen away from seeing the nutrient value of food, and gone more into the efficient, fast, highly processed, what tastes good, and immediately satisfies, instead of seeing food for that longer term health. 

SG: But does it really taste good? Is that something that's kind of been a myth? Because I feel like when I was growing up, you get that narrative of “broccoli's gross, spinach is gross,” but, mac-and-cheese is great (specifically boxed mac-and-cheese). But of course, whenever I've tried, you know, handmade, homemade mac-and-cheese, it's always so much better than the boxed stuff. 

EM: I think that there's a little bit of truth, and a little bit of myth, too, because our pallets can be shaped by the foods that we eat. We know that food manufacturers want their foods to be highly palatable and really have an effect on our brains to make us crave more, so that we purchase more, so that their bottom lines increase. To eat the broccoli and to eat the spinach, there are ways to make it taste great. There are different ways of cooking it, different ways to season it, and the more you eat it, the more your body does crave it, and does enjoy those foods. 

SG: So why is access to nutrition and not just food important?

EM: Food Equality Initiative fights for nutrition security. And the reason that we switched from just food security to nutrition security is because people can eat a McDonald's burger and satisfy that hunger for a moment. But then to be able to eat, let's say a homemade, well-balanced meal that may cost more, but is without all the processing, it can nourish the body at a nutrient level. Typically, it's higher in fiber, so that you feel satisfied longer. It'll be lower in sugar and lower in unhealthy fats. And so, there are other ways that you're nourishing the body that are more for that long term.

SG: Whenever you have a diet-treated disease, or if you're just trying to eat healthier, there is a financial barrier, right? Let's take a look at it from the food as medicine standpoint, where you have it prescribed diet that you need to follow, and that's medically prescribed by physicians or or your dietitian, or whoever. So, who covers that added expense of the specialty foods for people who need it? Is that something that you can get through insurance? 

EM: Unfortunately, right now, insurance doesn't cover very much as far as food as medicine goes. There are some coverages coming up down the pipeline for medically tailored meals, and then there are some assistance programs like the double up bucks at farmers markets and other ways to get produce. There are expenses to having these more whole foods and more nutrient-dense foods, but those expenses, when you weigh that over the long term, are actually cheaper than the highly processed foods. 

SG: So what you're saying is the healthier foods are cheaper in the long run. I don't know if I am fully grasping how it's cheaper in the long run. Is that because you get more servings? I'm just picturing the scenario you set up earlier with McDonald's where you buy one burger for a dollar fifty, or however much it is now, versus maybe you spend, I don't know, eight dollars getting ingredients to make a burger at home, but it's not just one burger you'll be making - you'll be making six or seven, maybe, burgers. I don't know how big those burgers will be, but it's going further, I suppose, a little bit. 

EM: But also when you look at the long-term health effects of that McDonald's burger versus a homemade burger…

SG: Ah, so you mean like in being treated for disease later on. 

EM: Correct.

SG: Gotcha, so this is more preventative. 

EM: Right. Food as medicine does have preventative measures.

SG: I’ve heard that there is a food as medicine movement. Can you tell us a little bit about that and what FEI is doing in that movement? 

EM: There is a food is medicine movement throughout the US. And there's also a Food is Medicine Coalition, and Food Equality Initiative is part of that coalition. But at Food Equality Initiative, we see more to food is medicine than just medically tailored meals. We see it in the grocery side, we see it in the more individual side, because the insurance companies tend not to cover those. 

SG: I know that something Food Equality Initiative is trying to get into is not just providing access to food, but also helping people learn about nutrition and how to really, you know, prepare that food on their own once they're able to afford it or access it in different ways. So can you talk a little bit about that? What does Food Equality Initiative do in the education space?

EM: Food Equality Initiative has this podcast, and has a magazine that focuses on the free-from lifestyle, which includes everything from being free-from allergens, free-from gluten, free-from high sugar diets, free-from sodium… The education that we're doing is at a level so that we can meet people where they're at and increase their knowledge about nutrition. We have several people that we serve that are children, and so we like to make sure that the information is child-friendly and easily understood. We are looking at expanding our education program so that we can reach more people and move people actually from a baseline to a desired level of nutrition education through our services.

SG: Back to the expense of specialty foods prescribed for people. It is covered by insurance in certain instances, but for the vast majority, that is not so. What does Food Equality Initiative have to say about that? How are we helping people get access to those foods? 

EM: Food Equality Initiative steps in when people are at or below 250% of the federal poverty line, and have been diagnosed with a diet treated condition. The way that we serve is through providing a monthly subsidized access to these foods that they need where they can have the food delivered directly to their door. And it's that nutrient-dense food, it's not just a box of mac-and-cheese like you would get at a food pantry. But we understand, too, that people want choice. People may be in a hurry sometimes and need some of those quick, heat-and-eat foods. We follow a little bit more of the 80-20 rule where we want people to have 80% of their diet be the good, highly nutritious food that they need, and then 20% snacks and the fun, quick and easy food that may not be quite as nutritious as the other options. We want people to be able to have access to choice.

SG: Absolutely. Why should we care about this type of stuff? How does it impact people without diet-treated diseases? I guess, generally, why is nutrition important?

EM: With the stats recently from the CDC, in the US, one out of every two people have either pre-diabetes or diabetes. The White House has even recognized that the United States is having a really serious crisis in health. And so, there is the Conference on Hunger, Health, and Nutrition this month. At Food Equality Initiative, we are working to really intervene in this health crisis, to take a step back and help people understand that the foods parents are feeding their children, the food that teenagers eat into adulthood, it really shapes their health and well-being the rest of their lives. And if we can have an impact as early on as we possibly can, then our hope is that people can live more fulfilling lives being able to access not only the food that we believe they should have a right to, but also being able to achieve the goals that they want to achieve because they're as healthy as possible.

SG: And that means things like better energy levels, or better sleep…

EM: O better cognitive function, and lowered inflammation… All of that would be impacted by your diet, which is something you don't necessarily think about.

SG: A lot of times, we think I can just eat this because it makes me happy in the moment, which I think there is some power in that, of course. If you want a chocolate bar, it's okay, you can eat that chocolate bar. But here's some other impacts that you may not be realizing, or it may impact you further down the road. Can you find as much joy, perhaps, in something else that you haven't thought about yet?

EM: Or you may start understanding that you can eat that chocolate bar, but do you need to eat it every day? And then, starting to recognize that you could eat either a small portion every day, or maybe you just have it once a week, or even less than that. As you eat healthier and you increase your physical activity and you are sleeping better, your body will start to crave those healthier foods. You will have trained your body to enjoy and thrive off of the more nutrient-dense foods.

SG: This is your wake up call! Start questioning it!

EM: It can be hard to make those initial changes, and you know your body wants to have those quick-fixes - your body wants and craves those, because that's what it's relied upon for so long. And it can be very challenging, and to make the changes to eat the more nutrient-dense foods that may have been prescribed for you. But working together with your medical team and gaining education around more nutritious eating and nutritious lifestyles will hopefully help convince you to make those changes.

SG: I was actually just talking with my mother about this earlier today. I think this is a common occurrence in the Food Allergy community that whenever you're diagnosed or your child is diagnosed with some sort of diet-treated disease, you start having to read the labels. So you flip the food around, and you're like, ‘Oh, I didn't know all this stuff was in this food to begin with.’ And my mom, she said, when I was diagnosed as a child, she was like, ‘Wow! How have I been feeding my children this food?’ She hadn't stopped to look so. I was diagnosed pre-2008, when they did not have the labeling guidelines we have now. So she was actually reading the whole label, versus now where I really am not reading the label. Honestly, before I started working at FEI, I would just read the bottom of the label, and it would say: contains peanuts. So, I’d be like, ‘Alright, cool, I'm not going to eat that.’ But now I've started actually reading it. I mean it's good that we have the separated allergen section, but it's not helping me read the label. So I guess that this is my way of segueing into talking about: How are some ways that we can really make nutrition education more accessible to people who aren't used to having to read labels? How do you know where to find them? And once you find them, what do you do with that information? What are some common tips? 

EM: So a quick and easy one is to familiarize yourself with a food packaging label. So typically on the back of the side, you'll find the list of ingredients as well as the nutrition information. In the nutrition information, it will include total fats, sugars, and added sugars… the quickest thing that you can do to start improving your diet at the next food purchase you make is to look at that added sugars line, and see if there are any added sugars. And if so, generally it's a good idea to put it down, and not eat that. 

SG: Something I've done since we've expanded out of the food allergy world and just into general nutrition, I've noticed I shop differently. I'm obviously still looking for my allergens, but now I'm also reading the ingredient list, and I'm trying to buy the items that have the shorter list of ingredients. And one thing that I've specifically changed in my shopping routine is my bread shopping. I didn't realize that they are adding sugars into bread. 

EM: A lot of breads will have sugar because it reacts with the yeast - and so you feed the yeast to help you get that rise. But looking at the ingredient label, there's another great start. They will often have a lot of ingredients you can't really pronounce, let alone know what they are. So starting to look for more whole foods, where they list ingredients you actually can understand what they are, those are going to be typically a little bit healthier and more nutritional for you. Some of the synthetic vitamins will have a little bit trickier names, and it can be harder to understand. Some people will have some issues with those, but a lot of the other different chemicals, as far as flavorings and things that they put in food to help with the processing and the manufacturing that can damage your body, and at a cellular level. The point of adding those elements is to ensure that it lasts longer on the shelf. So, the preservatives are doing that in your body in a way.

SG: Right, and I think that's also a cultural thing in America - we expect our food to last longer. Most people that I know go grocery shopping once a week, maybe once every two weeks. But I remember when I was living in Latvia, you'd go once a day. Also their fridges were a ton smaller, so you could only buy what could fit in your fridge, so it's kind of like you were always shopping. ‘Oh, I ran out of milk that today, I'll get it the next day, then the next day I'll run out of potatoes,’  which is impossible in Latvia!

EM: Yeah, we do have a different mentality around grocery shopping, and how often we purchase items. We even have the big box stores like Costco and Sam's Club, where you can bulk up and save, and it can change your shopping habits as well when you're purchasing that way. Then oftentimes what gets forgotten are those fresh foods, and what you are going to be your healthier foods. So trying to stock up, at least for a day or two to have that fresh produce last and then be able to restock is another habit that you can try and get into. 

SG: And I was definitely under the false impression that frozen vegetables weren't as good for you as fresh ones, but that's not the case, right?

EM: Right. Many frozen foods are picked at the height of their freshness, ripeness, and then are frozen quickly. And so those nutrients get saved, so they can be a healthier option. If you have the freezer space, that's a different thing. They do cook up sometimes a little bit differently than your fresh foods. But often now, our fresh foods are being trucked in from out of the country or several thousand miles away, and they're not picked up the height of freshness or taste or flavor or nutrients actually, so, having to maybe switch some of the foods over to frozen can be healthier. 

SG: Well, that's really cool, too, because it makes it more accessible than if you don't have that time to go grocery shopping every day, or you have trouble using fresh ingredients in time before they go bad. Having frozen food in your freezer is not a bad option, and it's not unhealthy or less healthy than buying fresh vegetables. 

EM: If you can get frozen over canned, that is the healthier option.

SG: To bring it all together, why is food medicine? Like we've been talking about, it's nutritious, but what's the easiest way that you can explain why you believe food is medicine? 

EM: Everything that we put into our bodies will affect our bodies typically at a cellular level. And so, when our bodies break down the foods that we eat, it can recognize the healthier parts of the foods, and then there's always the waste. The body will use those nutrients as building blocks for your muscles as building blocks for your nerves and all the different parts of your body to help regenerate the cells, and then your body is able to function the way that it was meant to, because it's getting those nutrients that it needs that it can't make on its own. And so, you're really feeding yourself so that you can regrow and survive. Your body knows how to break down those nutrients that it's programmed to be able to recognize - the more chemicals you put in that it doesn't recognize, it gets confused and you start having breakdown at a cellular level.

SG: So, you are what you eat.

EM: Yes. If you're eating in a healthier manner, you are preventing future problems. 

SG: Right. I think that's one of the main takeaways - the right food will make you healthier in the moment, but it also will make you healthier in the future.

EM: Eating healthy, whole food does help prevent additional chronic conditions. 

SG: So, in addition to providing access to nutritious foods and providing education about nutrition, what else is important in the food is medicine space?

EM: Policies need to change. We advocate for the underserved in this area, so that policies are changed, and there's more availability of access through federal programs. 

SG: And so that's why the conference at the White House this September is so important - it's a chance to actually change some of those policies, right? 

EM: It's a chance to start down that path. We know that it will take time, but that is our goal to see greater inclusion of food is medicine and greater coverage from insurance companies. We want to see more of a willingness to support the general community and their health. 

SG: You said earlier that one in two people either have diabetes or a pre diabetes. Is that just in America? 

EM: Yes.

SG: I was wondering, if that is the case, and we're asking insurance to cover it, like that's so many people! That's a huge problem, and will be a huge problem on our health care industry. We've seen that from the pandemic - if a bunch of people get sick at one time, it breaks. 

EM: Which is why our intervention and nutrition education is so vital - to start making those changes in childhood and educating the parents who are taking care of the children, educating the children so that they can lead healthier lives and really change the trajectory. 

SG: Yeah, it's so many systems that all have to work together - the school system, the farming agriculture system, the food manufacturing companies, the grocery stores. All of us need to be on board. Hopefully, we'll see more of that through the Conference. 

EM: I think that the US is really trying to take a step back, and recognizing that there is a health crisis, and that these current conditions are all conditions that we can change that should change, and that there is truly going to be an effort to improve lives through diet and exercise.