A handful of forward-thinking physicians are helping patients get well by prescribing more than just pills.
We all know the tenets of a healthy, wholesome lifestyle: Plenty of exercise, a balanced diet, regular sleep, and some form of stress-reducing relaxation—like regular walks in nature. But too often, we’re gobbling less than nutritious food, working long hours, holed up in our houses, and living generally distracted, disrupted lives. And it's a growing health problem.
Chronic diseases affect approximately 40% of Americans, and doctors have long known that lifestyle changes can often have as big or an even bigger effect than simply taking the medications they prescribe.
This is why health care providers have begun to seek new methods of intervention—by actually prescribing certain diets and activities.
We’ve written previously about how doctors in Flint, Michigan are writing prescriptions for healthy food to combat obesity and level the nutrition playing field for children living in food deserts. In California, doctors are finding that free healthy meals prescribed to chronically ill Medicaid patients actually prevents more expensive treatments and interventions.
And on the South Side of Chicago, FoodRx—a partnership between health centers, a local university research team, a farmer’s market, and Walgreens—incentivizes healthy food choices through discounts and free food. One peer-reviewed study of the project concludes that programs like this, that address a variety of patient needs all at once, instead of one at a time, "may be essential to promoting the health of underserved communities and reducing disparities in diabetes outcomes."
Along the same lines, a recent article in The New York Times highlighted the work of Dr. Robert Zarr, a pediatrician and the founder of Park Rx America, a non-profit organization devoted to yup, you guessed it, facilitating prescription of outdoor activity. As the company states on their site: “Spending time in natural environments increases physical activity, hence decreasing the risk of developing chronic disease.” The organization works with health care providers to facilitate the prescribing of outdoor time and exercise. They even share an infographic poster explaining the medical benefits of spending time outdoors:
And there's an interactive map to help you find a park nearby, should you receive a prescription.
This new, more directive approach—coupled in some cases with financial incentives (such as free food) to take part—may be what’s getting a lot of spotlight in the news, but does it really work?
To find some answers about this, Cooking Light spoke with Dr. Joe Galati, a hepatologist, radio host, and author of the recent Eating Yourself Sick, which was published in May. The book is based on thousands of conversations and interventions that Galati has made over the course of his career. Galati is an enthusiastic home cook who seeks to share not only the benefits of a healthy diet, but his passion for cuisine. “In a sense,” says Galati, “food is medicine and you cannot neglect it.”
Galati noticed, over the years, that simply instructing patients to increase the amount of fruits and vegetables they ate didn’t work. “They’d nod their heads and say, ‘okay, Dr. Galati, more fruits and vegetables.’ But then they go shopping and they’d get to the produce area and they’d look around... and go back to the frozen section and select the wrong foods.”
So Galati and his staff started to take a much more granular approach. First, they’ll take a patient's food history, to gauge how many meals are eaten outside the home, as well as a patient’s comfort level in the kitchen.
If the patient likes green beans, for example, Galati asks three ways that they like to cook them. Often, he says, a person is simply steaming or boiling their food, and has no idea how to use healthy ingredients to kick up flavor or alleviate the monotony of week after week of boiled dinners.
To combat this, Galati started bringing bags of produce into the office. He laughs, “We’ll put [a vegetable] in a bag, attach a very simple recipe, and we’ll give it to them. The staff will educate them on the nutrients, on the fiber content and their favorite method to cook it and go from there—the response has been excellent.”
Asked if there has been any negative feedback, people bristling at the instructive nature of what Galati dubs “The Great American Produce Giveaway,” he laughs. “... People walk out with a bag like it’s their birthday or Christmas. So I tell everybody… I want you to get excited about cooking and shopping and experimenting. That’s one of the reasons I wrote my book, because that’s exactly what we’re doing and we have to turn ourselves around.”
Galati also “prescribes” physical activity on a similarly simple level. He’ll encourage patients to start with fifteen minutes of walking a day, increasing every week by a minute or two, until they build up to the ideal 10,000 steps per day and light resistance training.
We talk about the necessity of making patients see diet and exercise as medicine. Galati says, “After a 30-minute discussion about disease and what they need to do, and they’ll look at me and say, ‘Am I going to get a prescription for all of this? Am I going to get a pill?’ I talk about it as the ‘pill mentality.’ And I say ‘Yes, the prescription you’re going to get is one head of broccoli.’ And they look at me like, you’re gonna give me a prescription for broccoli? And I say, ‘I’m not gonna call it in to Walgreens. You have to eat better, that’s the prescription, or at least a very big part of it.’ ...When you look at it, the majority of chronic disease? The root of the problem is obesity and the food [people are] eating. If you don’t attack it, the prescriptions, the pills, the statins, are simply a band-aid for the elephant in the room.”
Education about healthy food and diet is critical, Galati says, “Because if mom and dad are not cooking, if they’re food illiterate, their kids are going to be food illiterate. You know the story on childhood obesity. We [could] lose an entire generation to disease.”