Food as Medicine or Medicine as Food? Karol Chandler-Ezell (Washington U School of Medicine) http://www.nutritionalanthro.org/publications2005.

php While many know that nutritional anthropologists investigate ritual foods, conserve food gathering practices and explore cultural meanings of food, nutritional anthropologists are also ideal investigators for a far more extensive set of questions about what people eat and why, because the line between medicine, nutrition, and food is blurred - as are the boundaries between the investigational territories of medical anthropology, ethnobiology, and food studies. For instance, are nutraceuticals (nutritional supplements, vitamins, herbs, etc.) food or medicine? Does the form of consumption change the definition, cognitive category, and realm of investigation? While wild plants gathered for medicinal purposes are comfortably within the realm of ethnobotany, bottles of pre-packaged capsules containing the same plant extract stray into the realm of medical anthropology. For instance, vitamin C or folic acid 'pills' may be considered medicine while orange juice is a serving of fruit in a healthy diet. When does consuming citrus transition from more than 'healthy food' and become a remedy for preventing a cold or birth defects? When is comfort food a home remedy or treatment? Tonics are common to many medical and cultural systems, and are among the most prevalent remedies and foods used with the intent of preventing a variety of illnesses. Despite this, there are very few academic studies of tonics; they are often dismissed as 'old-time' folk remedies or superstitions (Vance 1947; Berman and Flannery 2001). In medical literature, they are dismissed as placebos or 'snake oil' sold by charlatans (Stage 1979; Blake, Tate et al. 1999). Ironically, these same arguments have been revived to dismiss popular herbal remedies and nutraceuticals. Tonics are important, however, as they raise two basic questions: 1) are they placebos, or are they biologically effective? and 2) even if they are mere placebos, what motivates people to use them? In my dissertation (Chandler-Ezell 2003), I found that 15.5% of my informants used tonics and 24.1% used preventive remedies (n=58). Herbal remedies were consumed to prevent possible future problems such as cancer, Alzheimer's, memory loss due to aging, stress, cardiovascular disease, and weakness. The form of these tonics ranged from capsules to power bars to 'food' products. (For example, soy occurred as a supplementary pill, an ingredient added to power-bars and diet products, and as soymilk and tofu; oat fiber was consumed both in fiber supplements and as a morning cereal). Interestingly, in another study, cross-cultural comparison using the Human Relations Area Files reveals not only that there are consistencies in tonic use in many cultures, but also that perceived threats leading to tonic use are often cued to environmental stressors such as seasonality, climate, and life history patterns. We have constructed a cross-cultural classification system which allows

the coding and comparison of different tonics and uses of tonics. Comparisons of the purposes and consumers for these tonics should reveal perceived risks and vulnerabilities within societies, as people take tonics for reasons, and these reasons reveal fears and perceived vulnerabilities. Our classification system could use tonics to tell us 'what people are afraid of' and how that compares to actual illness rates. Nutritional anthropologists can contribute to knowledge about tonic use as a part of food consumption with studies comparing epidemiological disease prevalence to perceived risk and use of preventive/tonic remedies. We can investigate how well tonics, perceived-risk and actual-risk-tohealth match. Nutritional Anthropology is the ideal theoretical medium for such investigation because it focuses on the blurry zones between medicine, nutrition, food, and traditional practices of consumption; it allows for an understanding of the 'thick' multiple meanings of such simple and yet infinitely complex actions as having a glass of orange juice. Berman, A. and M. A. Flannery (2001). America's Botanico-Medical Movements: Vox Populi. New York, Pharmaceutical Products Press. Blake, D., P. Tate, et al. (1999). "A patient requests an old-style tonic." Practitioner 243((1600)): 533-4, 539-40. Chandler-Ezell, K. (2003). The Modern Herbal Synthesis: An ethnobotanical investigation of the emergence and function of herbalism in the revitalization of American healthcare. Department of Anthropology. Columbia, MO, University of Missouri. Ph.D. Stage, S. (1979). Female Complaints: Lydia Pinkham and the Business of Women's Medicine. New York, W.W. Norton & Company. Vance, R. (1947). Ozark magic and folklore. New York, Dover Publications.