Nutrition plays a key role in preventing and managing disease

After 5 years at medical school and 6 years as a hospital doctor, I started to question the quality of care I was able to provide for patients. Medical knowledge, understanding and healthcare facilities were much more basic than I had expected them to be. This was 40 years ago. 

Medical knowledge, understanding, and practice have evolved and improved since then, mainly thanks to the introduction of new imaging and laboratory technologies, but still fall far short of where they could be in terms of preventing and managing disease. 

I know this because over the past 40 years I have had the opportunity to work at the cutting edge of medical science listening to and reporting on the opinions of the best medical experts in the world. This unique experience has resulted from my work for 44 international publishing and medical communications clients as a medical publisher’s editor and as a medical writer marketing the products of pharmaceutical companies. During this time, I have contributed to hundreds of medical and health publications and communications and reported on over 50 international medical conferences and expert teleconferences.

The mission statements of all medical communication and drug companies include their role in improving the lives of patients — but like all corporations with a responsibility to maximise profits for their shareholders, maximising sales of pharmaceutical products is the highest priority. 

I have often felt conflicted about the work I have done in promoting drugs, but it has been a great way to find out why medicine is not where it should be. Some people say medicine is broken because pharmaceutical companies have played such a huge role in shaping where it is now. My interactions and work for pharmaceutical companies on many different levels demonstrated how their development and marketing strategies have adversely affected not only medical knowledge, understanding, and practice but also the lives of patients.

I have learned a lot. But the more I learned, the more I discovered that there is so much more that we don’t know. Over the years, research has shown that chronic inflammation plays a key role in many diseases, including most skin diseases, cardiovascular disease, a variety of cancers, type 2 diabetes, arthritis, Alzheimer’s disease, Parkinson’s disease, inflammatory bowel disease, asthma and chronic obstructive pulmonary disease (COPD). This suggests that inflammation-based diseases are linked — but how?

It is now known that each individual has a constantly changing reversible expression of the genes in their DNA in response to nutritional, behavioural, and external environmental factors. These so-called epigenetic processes play a role in determining an individual's health and disease profile. Identical twins are born with the same DNA and genes, but the expression of their genes varies depending on the lives they lead. So it appears we all have some ability to control our health and disease.

Understanding the exact mechanisms by which nutritional, behavioural, and external environmental factors alter gene expression is in its infancy, mainly because drug companies have been a main provider of research funding, which has been focused on their drugs. But increasingly funding is becoming available for research is into the nutritional, behavioural, and external environmental factors that impact health and disease. For example:

• the nutrients in a Mediterranean diet  have beneficial effects on the gut microbiome and metabolism, which play key roles in maintaining a healthy immune system to prevent harmful inflammation
• in contrast, ultra-processed foods (UPFs) have adverse effects on the gut microbiome, metabolism and the immune system and are associated with an increased risk of chronic inflammation and many physical and mental health illnesses.

This research is increasingly demonstrating that nutrition plays a key role in preventing and managing disease and that food is medicine.

Dr Lindy van den Berghe BMedSci BM BS

First Line Medical Communications Ltd

Dietary Guidelines for Americans 2025–2030  emphasize the role of nutrition in preventing chronic diseases. They highlight that  almost 90% of healthcare spending in the US is for chronic diseases, many of which result from an American Diet of highly processed foods associated with a sedentary lifestyle