Medication and nutrition interact. What you eat can lead to your medication not working as intended. And your medication can cause your body to not absorb nutrients properly, or to cause side effect such as weight gain or fatigue. No matter how hard you try to live a healthy life, the interaction between food and medication can get in the way of your lifestyle goals.
A healthy lifestyle contributes to good health. Healthy diet and regular exercise are important. Sometimes medication is necessary to keep the body healthy. Yet medication can get in the way of a healthy lifestyle, for example when medication leads to weight gain while you want to lose weight, or to severe fatigue while you want to exercise more.
In addition, medication and nutrition can affect each other. What you eat can lead to your medication not working as intended. And your medication can cause your body to not absorb nutrients properly. No matter how hard you try to live a healthy life, the interaction between food and medication can get in the way of your lifestyle goals. More knowledge about this can help you to make different choices. Always consult with your health care provider.
Introduction
Oral medication
Most of the interaction between food and medication occurs with medication taken orally. Some foods and drinks affect how, to what extent, or how quickly medication is absorbed into the body and how the body responds to medication. Some examples:
- The effect of medication may be different when taken on an empty stomach compared to during a meal as with pain medication, diabetes medication or antihistamines.
- Some medication can only be properly absorbed into the body when taken during a meal, or specifically during a meal high in fat or high in carbohydrates.
- Foods, such as milk, can have a protective effect on the stomach while also slowing the absorption of medication.
- Stomach acid production is necessary to process foods, but can also affects the absorption of medication.
Health risks
The interaction between food and medication may be similar to the interaction between different types of medication. More is known about the interaction between different types of drugs than about the interaction between food and medication. Medication and their interaction are extensively studied and tested under rigorous scientific conditions. This is much less the case with nutrition, the effect of nutrition on the body, and the interaction between nutrition and medication. Even the effect of, for example, herbs and of over-the-counter pills such as vitamin pills and dietary supplements is often not thoroughly researched and tested.
The unknown interaction between nutrition, including over-the-counter dietary supplements, and medication can lead to potential health risks being underexposed. For example, when certain foods result in weakening or enhancing the effects of medication, or when certain medications prevent the absorption of nutrients or cause undesirable side effects such as weight gain or loss of energy. Understanding the interaction between nutrition and medication contributes to making safer lifestyle choices.
Extra attention in the elderly
The interaction between nutrition and medication is particularly relevant among the elderly. Physiological functions decline with age, and nutrition is less effectively absorbed and processed by the body. The health status of the body changes. In addition, there is often the presence of one or more medical conditions and the use of multiple types of medication. Furthermore, elderly people often have a reduced sense of hunger and satiety, and psychological and socio-economic factors also play a role in their eating patterns. Loneliness, for example, can cause the elderly to lose the desire to cook for themselves.
How food affects medication
Food can affect the effectiveness of medication directly and indirectly. Directly when food alters the effect of medication, and indirectly when food causes changes in the body's absorption or processing of the medication. Food and beverages can enhance the effect of medication and lead to more side effects, or they can actually weaken the effect of medication. Factors involved include the type of medication, the severity of the disease for which the medication is taken, the health condition of the user and the duration of use.
To give an impression of influence of nutrition on medication describe some common examples. Always discuss with your health care provider how medication should be taken and what you should consider, such as certain types of food, herbs or alcohol, supplements or vitamins that you consume.
High-fiber foods and fruits
High-fiber foods can slow the absorption of certain medications. For example, foods high in fiber and foods containing pectin, such as those found in apples, citrus fruits, blackberries and berries, can reduce the effect of cholesterol-lowering medications and increase the risk of unwanted side effects. In particular, grapefruit juice can affect the effect of medications such as aspirin and psychotropic substances. In some cases, grapefruit can quintuple the effect of medication and lead to unwanted side effects.
Fatty meals
Fatty foods can slow down the absorption of certain medications, or speed up the absorption of certain medications, as with certain medications for fungal infections. High-fat foods can enhance the effects of bronchodilators, while high-carbohydrate foods can actually weaken those medications.
High-protein foods
High-protein foods can affect the action of blood pressure medications. (This also goes for orange juice and products containing licorice).
Hot beverages
Hot beverages can reduce or even negate the effect of a drug.
Milk and milk products
Milk and milk products high in calcium and magnesium can affect the effect of medications such as antibiotics, including slowing down absorption.Even a small splash of milk in coffee can have an effect. Fruit juice can also affect the absorption of some antibiotics in the body. At the same time, milk can also act as a stomach protector for pain medication, for example.
Alcohol, caffeine, Coca Cola and grapefruit juice
Alcohol, caffeine, and grapefruit juice can increase the risk of side effects with certain medications. For example, alcohol can enhance the effects of NSAIDs and increase the risk of liver or stomach damage.Ibuprofen is better absorbed when combined with Coca Cola.
Herbs
Herbs can interfere with certain medications. For example, garlic and ginkgo biloba may increase the risk of bleeding when combined with blood thinners. Hawthorn may interfere with beta blockers and calcium channel blockers. St. John's wort is advised not to be taken in combination with blood thinners and cholesterol-lowering drugs, among others.
How medication affects food
Medication can affect food directly and indirectly. Some medications directly affect the way and extent to which food is processed in the body and nutrients are absorbed. For example, they can lead to reduced absorption of vitamins and minerals. Medication can also affect the metabolism of fats, carbohydrates and proteins; and affect, for example, the functioning of the stomach and the composition of the microbiome (Your poop tells it all)
In addition, medication can have an indirect influence on nutrition, for example, when it acts on the system that regulates hunger and satiety. Medication can alter nutritional status, body composition and body health-for example, when medication leads to changes in smell and taste and decreased appetite, resulting in malnutrition and underweight. Or when medication affects the rate of metabolism and thus affects body weight and body composition, such as the amount of fat mass and muscle mass.
To give an impression of influence of medication on nutrition describe some common examples.
Impaired nutrient absorption
Some medications accelerate the motility of the gastrointestinal system, causing food to pass through the gastrointestinal tract more quickly and impairing nutrient absorption. In contrast, other medications have a slowing effect. Food that stays too long in the gastrointestinal tract can have adverse health effects.
Reduced values of vitamins and minerals
Some medications affect the absorption and processing of vitamins and minerals in the body and therefore can increase the risk of malnutrition. Some examples:
- Retention of sodium and water, such as cortisol and corticosteroids
- Reducing potassium in the body, such as diuretics and laxatives
- Reducing the absorption of iodine, such as lithium
- Reducing absorption of iron and zinc, such as anti-biotics
- Increasing copper levels in the blood, such as penicillin
- Reducing the absorption of magnesium, such as antibacterial drugs
- Reduce vitamin B levels in the blood, such as diuretics, antacids, estrogens, and antidepressants
- Reducing vitamin C levels in the blood such as diuretics and birth control pills
- Reducing vitamin D levels in the blood such as cholesterol-lowering drugs
Changes in appetite
Medications can affect appetite, the extent and manner in which food is absorbed into the body and the metabolism of nutrients. For example, antihistamines, corticosteroids and insulin can increase appetite, while some antibiotics, glucagon and morphine decrease appetite. The influence of medication on appetite may be due in part to the medication's influence on the central nervous system and the regulation of hormones that regulate feelings of hunger and satiety.
Medication can cause weight reduction, for example, when medication causes a reduction in nutrient absorption. For example, Orlistat reduces the absorption of fat from food. A reduction in daily dietary intake, for example, when medication inhibits appetite, can also result in weight reduction. In addition, medications can affect metabolism, for example, thyroid hormones stimulate metabolism, and certain medications affect hormones that regulate the metabolism of carbohydrates, proteins and fats. When medication leads to decreased appetite or nausea, long-term malnutrition can result.
Medication can also lead to weight gain, for example, when it stimulates appetite; slows metabolism/combustion; or when medication leads to severe fatigue that causes the user to exercise less. Some examples of medications that can lead to weight gain:
- Insulin stimulates appetite and lead to increased fat storage in the body
- Some anti-psychotics slow metabolism and stimulate appetite
- Anti-inflammatories such as Prednisone can lead to more fat storage in the face and abdomen
- Corticosteroids stimulate both appetite and metabolism of body proteins, causing a decrease in muscle mass and an increase in fat mass.
- Corticosteroids can cause retention of fluid and salt in the body
- Estrogens can interfere with insulin sensitivity, increasing appetite and decreasing metabolism, while progesterone can have the opposite effect.
- Gastric acid inhibitors can cause weight gain
How medication affects physical performance
Some medications can negatively affect physical performance, such as because medication leads to fatigue; affects heart rate; or causes muscle and joint discomfort, making exercise more difficult. Some examples:
- Betablockers to treat high blood pressure and cardiac arrhythmias, and antidepressants can reduce physical performance because they fail to achieve a high heart rate and more fatigue is experienced
- Blood pressure medication can cause dizziness and fatigue
- Statins can cause muscle pain and stiffness
- Diuretics can cause muscle pain and stiffness
- Medication to treat osteoporosis can cause musculoskeletal problems
- Antibiotics can cause muscle and joint pain
- Antidepressants can cause muscle and joint pain
Break the chain
When medication and nutrition interact, an unfavorable chain reaction can occur, making it difficult to achieve lifestyle goals. For example, when medication inhibits appetite, it can lead to decreased energy to exercise and to malnutrition and underweight, which alters the body. This altered body then has implications for medication efficacy and nutrient absorption. Another example is when medication leads to severe fatigue and stimulates appetite, causing the user to exercise less and eat more. Body composition changes to the detriment of health, which in turn affects the effect of the medication and the absorption of nutrients in the body.
A healthy lifestyle contributes to good health. Healthy diet and regular exercise are important in this regard. Sometimes medication is necessary to keep the body healthy. Yet medication can get in the way of a healthy lifestyle: The adverse effect of drugs on lifestyle goals.
Knowledge about the interaction between medication, diet and exercise can help you make other healthier choices. Always consult with your health care provider and engage a medical dietitian or accredited lifestyle coach, as well as a fitness professional specialised in prevention (NL Actief Prevention Center) to guide you to find a good balance between healthy eating, exercise and medication, and to find a way, given your situation, to look at possibilities rather than limitations.
Create your own health!©
References
Ayo, J.A., Agu,H., Madaki, I. (2005). Food and drug interactions: its side effects. Nutrition& Food Science.
D'Alessandro C,Benedetti A, Di Paolo A, Giannese D, Cupisti A. Interactions between Food andDrugs, and Nutritional Status in Renal Patients: A Narrative Review. Nutrients.2022 Jan 4;14(1):212. doi: 10.3390/nu14010212. PMID: 35011087; PMCID:PMC8747252.
Bhupathiraju,Shilpa, N., Hu, Frank. (2023). Nutrient- Drug Interactions. MSD Manual. Professional version.
Bushra R, Aslam N, KhanAY. Food-drug interactions. Oman Med J. 2011 Mar;26(2):77-83.doi: 10.5001/omj.2011.21. PMID: 22043389; PMCID: PMC3191675.
Deng J, Zhu X, Chen Z, Fan CH, Kwan HS, Wong CH, Shek KY, ZuoZ, Lam TN. A Review of Food-DrugInteractions on Oral Drug Absorption. Drugs. 2017 Nov;77(17):1833-1855. doi:10.1007/s40265-017-0832-z. PMID: 29076109.
John Hopkins Medicine.Food drug interactions. What is a food- medicine interaction? Retrieved August2024 from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/fooddrug-interactions
National Academy of Sports Medicine. (2014). NASM Essentials of Personal Fitness Training.
