This is my 10th attempt at writing this introduction. I hope take 10 gets
- My point across, and
- Gives you some entertainment value.
I am, for all intents and purposes, a health researcher. I am a trained scientist: PhD, lab coat, publication, grants, boring conferences… I check all those boxes.
But whenever I set out to write articles like these I always like to get a lay of the land in the “non-peer-reviewed” world. I like to get a sense of what is being talked about outside of my tiny PubMed bubble.
And oh god…. If you want to spend about 40 hours in the dark corners of the internet where absolute garbage information lives, just google, “diseases that can be cured through diet and exercise”.
After I got stuck down that rabbit hole I had to peel off my outer layer of skin, disinfect my eyeballs, burn the clothes I was wearing, and microwave my laptop to delete my browser history.
Ok, it wasn’t that bad. I might have amplified that a bit to make a point, which is that there is a lot of misinformation about the role diet and exercise play in preventing, and/or curing, disease.
You know that really popular saying “Let medicine be thy food and food be thy medicine”. It’s very poetic… but a little off the mark.
There is another popular saying, “Exercise is Medicine”. Again, very poetic, but also off the mark.
Here is the real deal. Food is food. Exercise is exercise. Medicine is medicine.
Sometimes both food and exercise can be medicine for certain diseases.
Over the last several decades it has become abundantly clear that both our diets and our exercise habits can shape our health and can modify our risk of disease and also help us combat some diseases.
That is what I want to get into today. Here are 3 disease that can be substantially impacted by diet and exercise.
Get your Jimmies unrustled.
The American Medical Association has defined obesity as a disease1. And yes, there are arguments for and against it, and we can noodle on it all we want, it is safe to say that obesity is a health problem2 that needs being addressed, regardless of how it is defined.
For the sake of this article we will do the prudent thing and go with the American Medical Association and let obesity be a disease for now.
Diet and exercise play a substantial role in the development of obesity.
When one considers the full body of evidence it is crystal clear that higher levels of physical activity can help prevent obesity3,4,5. How much is considered a therapeutic dose? Well, that is really hard to get a solid handle on but most guidelines suggest somewhere in the neighborhood of 30-60 minutes of moderate physical activity a day4,5.
In an analysis of 34 countries, rates of obesity were inversely related with levels of physical activity6, indicating that as people exercise less and less their likelihood of developing obesity increases pretty drastically.
Now that we know that exercise matters for prevention what about “reversing”? How much of a role does exercise play in weight loss? Contrary to what some internet memes say, exercise is actually a pretty big deal in the weight loss process for the large majority of people.
In a study from the Annals of Internal Medicine, exercise was highly effective for weight loss, with an average 3-month weight loss of ~7.6 kg (or ~16.5 pounds)7. In fact, it was as effective as the diet group in this study.
Which brings me to my next point...
Your diet has a substantial impact on both your progression to, and reversal from obesity. As unsexy as it is, caloric intake can tell us a lot about your likelihood of developing obesity. In fact, a recent study suggested that diet alone explains most of the rise in obesity8. Furthermore, it has been shown repeatedly that almost every diet that reduces calories can in fact reduce body weight or “reverse” obesity9.
So diet and exercise are indeed powerful tools for aiding in the prevention and reversal of obesity.
Diabetes is very close to home for me, I research diabetes and its effect on organs for a living. I spend about 60 hours a week thinking about diabetes.
One of the more difficult things to communicate is the role diet and exercise have in preventing and “curing” diabetes. Let’s tackle the prevention aspect first since it is much easier to discuss.
Obesity is the leading risk factor for type 2 diabetes, and we demonstrated above that exercise and diet are critical tools in the prevention of obesity. That is super cut and dry, so we can just take that to the bank and get into the more difficult topic: “curing” diabetes.
As far as we (professional scientists) know, there is no cure to diabetes. You can put it into remission, but it is never fully cured and there are lingering effects of having diabetes at any point in your life10.
Diet and exercise, either alone or together, have been shown repeatedly to be powerful enough interventions to put diabetes into remission11,12.
One important point to note here is that diet and exercise work to put diabetes in remission at least in part via weight loss, so maintaining a structured exercise and diet over the course of your life is essential for maintaining this “remission” state of diabetes.
3. Celiac Disease
While the recent pandemonium surrounding gluten has been overblown, the idea of gluten-free diets being used to help prevent or “cure” a disease holds some merit. However there is a small caveat, in this case it isn’t so much a specific diet can offer a prevention or cure, as the disease is at bottom genetic, but more so a diet offers robust symptom management.
In people with diagnosed celiac disease, following a gluten free diet can alleviate symptoms and actual histologic changes (read: structural) in the gut. However, this is not universal or complete. Some people see virtually full recovery while others see partial or no remission13. This suggests that gluten free diets can help stop the “insult” but not completely reverse all the potential damage done by early stages of the disease.
However, another recent study has indicated that some of the reasons that gluten-free diets don’t work is that you are still being exposed to a substantial amount of gluten. Researchers found that on average, people with celiac who consumed a gluten free diet were still exposed to ~150-400 mg of gluten per day14. So it may be that gluten free diets are more effective than we think, but completely removing gluten is incredibly difficult.
A List of Diseases that Cannot be “Cure” by Diet or Exercise Alone
Look, I am so far on the “diet and exercise your way to health” bandwagon that I can’t even see outside the stupid wagon anymore. Like I steer almost all my personal clients to lifestyle modifications before medication.
However, I am also very pragmatic and understand that diet and exercise alone can’t cure a lot of disease and I think we need to acknowledge that. Now that we have planted that flag, here are a short list of diseases that do not have adequate evidence to indicate that diet or exercise alone can “cure”.
- Type 1 Diabetes
- Monogenic diseases such as cystic fibrosis
- Multiple Sclerosis
- Heart disease*
*There is some evidence of reversal of many markers of disease but this is not well documented and it cannot be said that it has been “cured”.
The Wrap Up
We live in a world where acute illness is claiming the lives of fewer and fewer people each year, while the death toll due to chronic disease is rising. These chronic diseases are often the result of lifestyle choices and environment influences and as such, lifestyle choices can help prevent and “reverse” some of these disease states.
Obesity and diabetes are two lifestyle diseases that can be prevented by diet and exercise. Celiac disease, a disease that arises from a mismatch between genetics and environment, can also be substantially “managed” or even prevented by diet if the genetic markers are caught early.
It is also important to note that not all diseases can be treated, managed, prevented, or cured by diet or exercise alone and medical intervention is needed in many cases.
- Is Obesity a Disease?
- Did the American Medical Association make the correct decision classifying obesity as a disease?
- Physical activity and good nutrition: essential elements to prevent chronic diseases and obesity 2003.
- How much physical activity is enough to prevent unhealthy weight gain? Outcome of the IASO 1st Stock Conference and consensus statement
- Physical Activity and Public Health: A Recommendation From the Centers for Disease Control and Prevention and the American College of Sports Medicine
- Comparison of overweight and obesity prevalence in school‐aged youth from 34 countries and their relationships with physical activity and dietary patterns
- Reduction in Obesity and Related Comorbid Conditions after Diet-Induced Weight Loss or Exercise-Induced Weight Loss in Men: A Randomized, Controlled Trial
- Increased food energy supply is more than sufficient to explain the US epidemic of obesity.
- International society of sports nutrition position stand: diets and body composition
- A review of therapies and lifestyle changes for diabetes
- Remission of Recently Diagnosed Type 2 Diabetes Mellitus with Weight Loss and Exercise
- Piloting a Remission Strategy in Type 2 Diabetes: Results of a Randomized Controlled Trial
- Histologic Follow-up of People With Celiac Disease on a Gluten-Free Diet: Slow and Incomplete Recovery
- Determination of gluten consumption in celiac disease patients on a gluten-free diet