The Total Food Effect: Exploring Placebo Analogies in Diet and Food Culture

Abstract

Food and medicine share an inseparable history with essential evolutionary underpinnings. In addition to nutritional, medicinal or toxic components, the tastes, colours, shapes, names and labels of foods elicit emotions, expectations, associations and conditioned responses rooted within both public consciousness and individual experience. This combination of chemical-driven bottom-up and meaning-driven top-down influences provides a fertile framework through which to explore metaphors of placebos and placebo-like effects. As reviewed, elements of placebo are widespread in food culture, appearing in numerous forms and with varying degrees of resemblance to those observed in medicine. We first adapt a model of placebo from the medical literature for application to the subject of food, diet and nutrition. Exploring the intricate interactions between drug or food, patient or consumer, and doctor or food source within different settings and contexts, we then demonstrate that the total effect of any food, meal or diet is seldom, if ever, strictly a function of nutritional composition or chemically-driven bottom-up effects. In closing, we summarize and integrate our observations relative to current understandings of placebo effects in medicine.