Intended for healthcare professionals

Rapid response to:

Editor's Choice

“Let food be thy medicine…”

BMJ 2004; 328 doi: (Published 22 January 2004) Cite this as: BMJ 2004;328:0-g

Rapid Response:


“I speak the truth, not so much as I would, but as much as I dare;
and I dare a little more, as I grow older.”

Michel de Montaigne.

While it is impossible to say that a particular food is good for a
particular individual, one could reasonably argue that, for most healthy
people, the following guidelines would be good enough. I must hasten to
add that all scientific findings are true until proven otherwise. No man,
however great or learned, could write the last word on anything.
Everything is dynamic and changing. Man’s wisdom is only a small fraction
of the secrets that Nature keeps close to its bosom. In the case of foods
it is all the more complicated. Most of our modern reductionist research
gives us only a key hole view of the reality, while the ancient wisdom of
the Vedas (Ayurveda) is longitudinal research of observations and is,
therefore, more reliable. The following data are given from all those

There are three kinds of foods- thamasic, satvik and rajas. In short,
the type, the variety, as also the contents are different in the three
types. In addition, the seasons of the year and the ambient temperature,
the phases of the moon and humidity have a lot to do with what one eats
and how comfortable one feels. To give a quick example, let us take the
strong spices in Indian diet. While they feel good during the cold months,
especially in the heavy rainy season in India, they are not that pleasant
during very hot summer months. Human body’s need for heat generation also
changes with seasons. It is; therefore, better to eat fewer spices during
summer months.

Timing of food:

It is good to eat many times, at least, four to five times day, small
amounts of food rather than eat one, two, or three large meals. Multiple
small feeds keep the metabolism under a steady state without large
fluctuations in blood sugar levels. In addition, people who want to watch
their weight would also be helped by the absence of hunger if one takes
multiple meals. The long intervals between infrequent meals make dieting
difficult because of hunger. Another great advantage is that a large meal
directly strains the heart by forcing it to work almost 2.5 times its
normal. Hearty meal is derived from this scientific fact. Large meals
could be quite dangerous in the elderly, whose blood pressure could drop
after a heavy meal when they get up from the dining table, resulting
occasionally in a major stroke or a heart attack! Small frequent pleasing
meals should be the bija mantra. Heavy exertion after a large meal could
be dangerous at any age.

What to eat?

It is not what you eat that kills you, but it is what eats you that
kills you--your destructive emotions of anger, hatred, jealousy,
depression and hostility. This has now been proven even by the modern
medical methods. That said, I must hasten to add that man is what he eats.
Your moods, your enthusiasm to work hard, as also your capacity to work
hard depend on the healthy foods that you consume. Everything that one
eats and drinks gives one the calories for work and, for the younger ones,
the calories they need for growth as well. Pregnant mothers need special
diets. It is only in old age that one needs very little food for

Common man need not worry about balancing the calories. Body sends
out signals whether one should eat or not. Simple rule to follow would be
to eat very, very little or little when not hungry. Eat only when you feel
like eating. Drink when you are thirsty but do have a minimum quantity of
water daily. It is difficult to say how much water one has to take daily,
although the rough guide could be about 30 ml/Kg. body weight. Please
remember that one could get waterlogged if one drinks too much water even
though the normal kidneys could balance the water levels in the body.
Occasionally, people could have low sodium levels because of too much
water. Once again, the body is the best guide. You feel thirsty when you
need water and feel uncomfortable if you had too much and might even feel

How to eat?

If one is eating three large meals, the breakfast must be the
largest, as the whole day’s energy needs should be met. Lunch and dinner
must be smaller and the last the smallest of all. One should have, at
least, three (four) helpings of fresh fruit in between. Keep the total
food intake under control to see that you neither gain nor lose weight, if
you are normal weight. If one were over weight, the simple formula would
be to cut the intake by half and walk daily for one hour to lose around
350 calories daily. If one is underweight, one should try and see how
he/she could improve on that by adjusting the calories. Those who are ill
and are under medical care should follow their doctor’s advice strictly.

Should one take vitamins and minerals daily?

Never! They are dangerous in the long run. They are OK for a short
while, if you are ill. It is a very bad habit to ape the American dining
table with a centre spread of vitamin and aspirin tablets. If you are
healthy, taking even baby aspirin for the imaginary prevention of heart
attacks is fraught with danger! Any drug, including aspirin, if taken for
no good reason, could result in higher deaths in the long run, vitamins

How does one know that he/she is healthy? If one could sleep well,
has good appetite, good bowel motion, is full of enthusiasm to work hard
and keeps the mind filled with universal compassion, one can’t but be
healthy. Any sign of disease, any symptom for that matter, must
immediately be brought to the doctor’s attention without delay, since
disease is only an accident and life teems with ills.

Studies done on large cohort of women, comparing extra intake of
fruits and vegetables vis-à-vis added vitamins and minerals daily, have
clearly shown that the extra fresh fruit and vegetable eating group had
significantly less cancers and heart attacks in the following five years.

Is it healthy to have a small amount of alcohol daily?

This is one of the many myths in our noble profession of medicine.
There is no unequivocal scientific evidence to show that small amounts of
alcohol, whichever class it belongs to, do any good to human health,
although we do not know, for certain, that in small amounts alcohol harms
human health! If one understands statistics in medical research, one
quickly realises how easy it is to draw any conclusion that one wants from
the available data, seeing what you want to see, by either "sharp
shooting"-emptying all the bullets on to the wall and then drawing the
target in a convenient area-and/or "data dredging". Epidemiology is a
good science when applied to acute contagious diseases and is a miserable
failure in trying to predict the unpredictable outcome of chronic
degenerative diseases. One of the leading American epidemiologists, Steven
Milloy, in his well written book, Science without Sense, gives a graphic
description of how epidemiologists could produce epidemics of such
diseases in society by injecting fear into the common man’s psyche.

Are diary products good for health?

For an infant, and many children for as long as they get, mother’s
milk is the best food. After the child weans off from breast milk, the
child loses the milk-digesting enzyme. Milk from any other animal only
supplies foreign protein that is antigenic. Except pure ghee (clarified
butter) having only caprionic and butyric acids, which is free of animal
proteins, all other diary products obviously can not be that good for
human health. Vegetable protein, especially from germinating seeds gives
the best protein. Ghee is very good food but remember that it is fat!
Total fat intake in a healthy adult should not exceed 20% of total
calories. Fat in food is vital for human life, but the quality and
quantity do matter a lot. Anything deep fried in fat is bad as the fat
then gets hydroxylated and becomes dangerous to blood vessel health.

Cocoanut oil, when fresh, is another very good fat for human use. It
prevents cancers and protects the heart and keeps it healthy. Rancid
cocoanut oil is dangerous as the fatty acids in cocoanut oil get converted
into the deadly trans-fatty acids, normally found in many other preserved
oils, sold in the market as healthy food! Cocoanut oil does not contain
cholesterol. No vegetarian food can have cholesterol in it. The latter
comes from animal cell wall. We try and confuse people saying that
cocoanut oil is saturated fat and gets converted into bad blood fat.
Truth, however, is that the saturated fat in fresh cocoanut oil is mostly
medium chain and not long chain. Lauric acid, found only in cocoanut oil,
is the best fatty acid for humans.

New data has reinforced the truth that unsaturated fats, heavily
advertised and sold in the market, are, in fact, the villains in the
drama. Simple truth is that any food heavily advertised should be bad for
health. Anything good does not need advertisement. Cocoanut oil has stood
the test of time. In addition, as a bonus, it is a good germ killer.

Is Non-Vegetarian food bad for health?

Man is basically a vegetarian, physiologically but, meat, as such,
may not be poison. It is definitely not as good as vegetarian food. Once
cooked, the amino acids in raw meat fuse, losing what little good there
was. Large studies have shown that even the fish myth is an invention.
The fishy meal story of fish protecting against vessel diseases is
commercial bait. Fish, however, is a good and cheap source of protein for
the coastal people. Vegetarian diet is satvic, in addition. A diet based
mainly on fruits and vegetables, and is otherwise balanced, is the best
choice for good health and energy. The darker the outer colour of the ripe
fruit, the better it is for health. If people doubt the capacity of pure
vegetarian diet to give enough strength, they should think of fighting
with an elephant to verify the truth. Meat, in addition, contains added
hormones and anti-biotics in its edible avatar.

Are preserved Junk foods good for health?

This is a bad habit that we have inherited from others and is bound
to bring new epidemics of dangerous degenerative diseases in its wake. Any
food that is preserved is bad for health. The main preservative is common
salt. This is man’s enemy numero uno. The other preservatives in those
foods are equally bad. Most of them also contain heavy doses of fat and
sugar that are not good in the long run. The sugar equivalents in some of
the preserved foods and drinks are dangerous to the liver. Some of those
get converted into formic acid in the body, damaging the liver.


Eat what you want to eat in moderation, not bothering to worry about
the contents as long you do not over indulge in food. Try to be happy when
you eat. For routine use follow the tips given above. Worrying each time
you hit the dining table could kill faster than the food on the table.
None of the above suggestions would make you immortal. If you follow
sensible food habits you could expect to be healthy and active as long as
you live. Once in a blue moon even poison might not be that bad after all.

“Three things are good in little measure and evil in large: yeast,
salt and hesitation.”

…..The Talmud.

Competing interests:
None declared

Competing interests: No competing interests

25 January 2004
BM Hegde
Retired Vice Chancellor
Mangalore, India