Food- Our Most Powerful Medicine

Tasty Food Abundance in Healthy Europe

The food we eat is well known to be the number one cause of many of the preventable diseases we struggle with today. Despite this doctors everywhere are spending little or no time reviewing what patients eat and what they should be eating. Nutritionists are spending their time concentrating on fat, protein, and carbohydrates often times ignoring the other and likely more important aspects of food such as phytochemicals, vitamins, fiber and the medicinal effects of food.

Our relation to food in our modern society is amazingly messed up from the soil to our plate. We seem to have forgotten that we are just as reliant on the nutrients from the soil and energy from the sun to survive as plants are. We just get these things from the food we eat rather than directly.

Modern agriculture practices abuse plants and by proxy abuse ourselves as well. Through planting huge monocultures of plants we have eliminated the synergy between plants that allows nutrients in the soil to be constantly repleted. These large groups of one single crop completely deplete the soil of nutrients and are a huge advantage for any pest that feeds on that crop. Add to this that the depletion of nutrients compromises the immune system of the plants and their ability to fight off pests. This leads to the widespread use of pesticides and fertilizers. The problem with fertilizers is that it only repletes what is absolutely necessary for plant survival and growth but does not replete the wide array of nutrients that help make the plant truly healthy, making us unhealthy as well. As for the pesticides, we are all told to believe they are not harmful and no study has shown them to be harmful. However, all we have proven is that they are not fatal. They may very well be harmful to us as long term studies have never been done. We can all remember cases before when we were told chemicals were safe until they were proven harmful (DDT, BPA, asbestos). Our current system is set up to say chemicals are safe until proven harmful, not the other way around as it should be. Not to mention that the harm may not be to us directly but to other organisms in the environment. There is new research showing that the dying out of bees in massive numbers in a disorder coined colony collapse may likely be due to a fungicide that was presumed to be safe for bees but is now found to compromise the bees’ immune system leaving it vulnerable to parasites. Bee pollen has been tested and usually shows on average 9 to 21 different pesticides in it. This chemical stew’s effect on the environment and our bodies has never been tested. Also these chemicals take away the job of fighting off pests from the plant as this is done for them. Therefore the plant no longer needs to make these naturally occurring pest deterrents which happen to be many of the same chemicals that make plants so healthy for us.

Then after we harvest these sickly, nutritionally depleted, chemical laden plants rarely do we eat it in its whole form which is the most nutritious way for us to take it in. In fact this is the only way our digestive system has evolved to eat. Millions of years of evolution adapted us to be hunter gatherers. Gathering up wild fruits, vegetables and nuts and eating them and occasionally supplementing this with wild animal meat which is far more lean and has more omega 3 fats. Instead we take this food from the earth and often times ship it thousands of miles from where it was farmed giving it more time to nutritionally deteriorate. Or, even worse, the food may be sent for processing, separating it into isolated parts depleting it of almost all phytochemicals and vitamins and is made into some food product that has almost no similarities to anything our ancestors would have eaten. In fact there have been theories put forth that overeating is due to the body craving nutrients it still in deficient in despite eating a lot of calories. The body continues to send hunger signals despite lots of fat and having taken in plenty of calories in an effort to get the person to eat the nutrients it is lacking. So far there is only some observational data supporting this and to the best of my knowledge it has never been tested but it does make logical sense and may explain the failure of many other attempts to treat weight gain such as using leptin. Lastly, and possibly even worse than processing food, we feed it to livestock to fatten it up and eat it. The problem is that these animals never evolved to eat corn, soybeans or whatever cheap crop we choose to feed them. Corn is far to high in sugars for cows and is the main reason their intestines are now filled with dangerous E. coli bacteria that lead to gastrointestinal infections in humans as food borne illnesses and why we have to treat our meat like it is radioactive in the kitchen to avoid getting sick. Feed a cow only grass as it was evolved to do and the E. coli in its gut disappears and its meat becomes leaner and has far higher omega 3 fats making it much healthier. But this is not what we do. We abuse our livestock just like we abuse our plants, damning them lives to overcrowded, sedentary, nutritional deprived lives leading to sick animals that when eaten by us lead to sick people.

We have forgotten our connection to the soil, plants and animals. We spend less time than any other culture in history obtaining and preparing our food. Just a few hundred years ago most of our day was spent in these efforts. It is a huge luxury and advancement that we no longer have to devote so much time to meeting our basic needs. But there seems to be an inner desire that is fulfilled when we obtain this food ourselves. So much technology and industrialization of the food process has been set up to allow us more free time. And what do we do with that free time? We go fishing, or hunting, or we garden. We clearly have an evolved drive to cultivate and obtain food, and it brings us satisfaction to do so. So many of our psychological and health related problems could be helped by simply having a garden to grow some of our own nutritional food. Sharing that experience of growing food with our children and showing them first hand our connection to the soil and sun, and to our planet. Or spending time hunting, sitting in nature and admiring animals first hand and seeing their sacrifice for our nutrition up close. Many animal rights activists may criticize hunting and I certainly do as well if it is hunting only for sport and not for food. I have no moral objection to hunting a deer and eating it if it substitutes for the meat of a cow or pig that was raised on a livestock yard in inhumane conditions. The deer at least was able to survive and thrive in the wild for its whole life until it was killed for food. This seems far more humane and natural. And the meat obtained from the deer is much leaner and has far more omega 3 fats and likely many more nutritional aspects to it that we have yet to understand that make it far healthier than a farm raised cow or pig.

After all this food is planted, raised, harvested, processed, fed to livestock we then often eat it in solitude as fast as possible and in far too much quantity. The sit down family meal is slowly being replaced by the solitary meal in front of the television or the fast food behind the wheel of a car. We used to leisurely eat at a table with others giving our stomachs time to know it is full and allowing us to respond more to internal queues telling us how much and what to eat rather than external queues. When watching television the queue to stop eating is often the end of the show as your attention is drawn away from the food itself.

Diet experts and nutritionists are constantly tweaking the ratio of fats, protein, and carbohydrates to make for the perfect diet that will allow for optimal health and weight loss. However food is far more complicated than these three macronutrients. Very VERY slowly science is respecting the importance of vitamins and other micronutrients. Initially they were only considered to be important to prevent extreme deficiencies as seen in rickets, scurvy, or beriberi. Now slowly science is understanding that less severe deficiencies may also play are role in disease such as low vitamin D leading to osteoporosis or increasing risk for cancer. However this science is still in its early stages and there is still far too little of it. And we are just beginning to understand the importance of the 10,000 other phytochemicals in plants that may have a potential effect on the human body such as lycopene or selenium. Our understanding of food is in its infancy and to think we know enough to mess around with the soil, pest killing chemicals, and the diet of the animals we eat is not only arrogant, it is completely wrong. The safest thing to do when there is such a huge lack of knowledge would be to keep our diets as close to what we found in nature as we evolved. Our bodies have had millions of years to not only survive but to thrive on this diet. Our genetics are set up to be at our best on a diet of wild nuts, berries, and vegetables with the occasional lean meat.

Due to this organic fruits and vegetables not only have the advantage of exposing us to less chemicals. It also makes for plants that are under more stress producing more nutrients that our body needs including many more of those 10,000 phytochemicals that our body needs than their nonorganic counterparts. This is already well known in the wine industry. Grapes that are put under some stress as they grow make far better wine than grapes that had everything they needed and were grown under perfect conditions. The stress makes the grape make a far greater array of phytochemicals to ward off pests and resist draught. This makes for a richer, fuller taste that our palate enjoys. We crave this taste of the earth.

Our idea of nutrition has to change dramatically. Food is not merely a conduit for calories in a ratio of protein, carbohydrates and fats. They are also the delivery system for vitamins and thousands of other phytochemicals that we need. One day in the far off future we may have a full understanding of food and be able to get all the vitamins, nutrients, and phytochemicals we need from supplements, but that day is no where near. For now our best path to health is to match the diet as closely as possible that we have evolved to thrive on. The diet should consist predominantly of fresh, whole fruits and vegetables with minimal cooking or processing (none if possible). This should be supplemented with a small amount of animal meat or fish that are raised in as close to wild type settings as possible. Grass fed cows, wild fish, free range chickens and eggs. It may seem like this would be far too expensive for anyone to sustain but keep in mind you should be eating FAR less meat than you do. Meat is not only the most expensive part of our diet, it is also the least efficient use of our energy. Plants give us far more bang for our buck. And if everyone were eating far less meat we could afford to pay more for it and devote sufficient amount of land to allow them to be pasture raised. Our plants need to be not only organic but grown in close proximity to different types of plants. Monocultures are not found in nature and for good reason. They deplete the soil and make for a perfect environment for pests. Our plants need to be able to naturally struggle with pests in a sustainable diverse environment.

We all need to reconnect with the soil and our ecosystem. We need to grow some of our own food even if it is only some herbs in a window box. Our children need to understand that our current system is not sustainable and is poisoning us. With this approach much of the modern day diseases would be far less frequent and we could all feel much more healthy while enjoying our food more at the same time.

Advertisements

An Internist’s Defense of Traditional Medicine

TEAMWORK WINS - NARA - 515550

UA-43701379-1

As an internist with an open mind to natural medicine I often have to defend my views of it to my colleagues. However, I also have to defend my field against many of those who devoutly believe in natural medicine alone. They often feel traditional medicine is nothing more than a profit driven industry geared towards symptom relief and no interest in cure or true wellness. Although there is a grain of truth to this criticism it misses the bigger picture by leaps and bounds.

Traditional medicine has for ages concentrated more on symptoms or treating disease after it has already progressed to late stages because these are the patients who present themselves for treatment to a physician. Those without symptoms rarely suffer the cost or inconvenience of seeking physician care merely in the interest of staving off a possible future disease. Due to this selection bias in our patient population this has been the focus of our attention, and we have become quite good at treating these maladies. I have made my support of natural medicine well-known and documented in this blog, however if you have an acute onset of chest pain, shortness of breath, or find a mass on your body somewhere I would argue that the place for you is the local urgent care clinic or hospital and NOT the office of a natural medicine practitioner (and a vast majority of natural medicine practitioners would agree).

We in traditional medicine have made immense progress in opening up acutely occluded blood vessels in the heart or brain, cutting out cancers before they have metastasized, treating overwhelming infections that have progressed to the point of sepsis. Natural medicine in all its millennia of experience and broad focus on overall health has little to offer is such situations.

With treatments such as the cardiac catheterization for heart attack, TPA for strokes, surgery for localized solid tumors, chemotherapy for leukemia, lymphoma or testicular cancer, antibiotics for overwhelming infections, modern traditional medicine has taken diagnoses that were certain death sentences just a few decades ago to being very curable disease. No herbal medicine, vitamin supplement, or mindfulness practice could ever come close to replacing these remedies.

It is true that traditional medicine in the chronic disease phase all too often concentrates on the symptoms of the disease and not the underlying cause of the disease. You have high blood glucose? We have medicine to decrease the glucose. You have high blood pressure? We have medicine to decrease your blood pressure. You have a rash? We have a cream to suppress the rash. Your body’s immune-system is attacking your body? we have a medicine to suppress the immune system so it will stop. Granted we are treating many of these because we have recognized them as risk factors for other diseases such as vascular disease that lead to heart attacks and strokes. However, we have stopped at the risk factors and have not asked enough questions as to what causes the high blood pressure, cholesterol and glucose. We have not marched it back a step further to truly find out what causes these imbalances in the body and instead have resigned ourselves to treating these secondary manifestations.

However, I know of no natural remedy that can bring a blood pressure over 200 into the normal range. I know of no vitamin supplement that can bring a glucose of over 400 down to less than 200. This is where traditional medicine thrives, in the acute and the extreme. Natural medicine spends so much more time and energy toward prevention, understanding of underlying issues, and long-term goals where traditional medicine is so often lacking. But natural medicine lacks the arsenal needed to deal with acute, extreme disease.

As for the profit driven nature of traditional medicine in the United States, this is not an entirely bad thing. The free market capitalist system has been shown over centuries and through countless national experiments with socialism to be the best system for prosperity and innovation. Without the continuous feedback to supply and demand the need for medicines and medical care would certainly be either in overabundance and the waste of countless tax dollars or, more likely, in extreme short supply such as in every industrialized country that has socialized medicine. The allowance of capitalism in our medical system has given us a quite delicate balance of supply and demand. We may have slightly too much demand and therefore too much supply to those with money and too little supply due to too little demand with those who lack the resources to afford medical care but this is more a fault of legislative issues and not a direct result of the profit driven nature of our medical system per se. Also, the profit driven capitalist nature of our current medical system allows for the only proven driver of innovation, creative destruction. Without creative destruction as created by the capitalist system there is no way medical care could keep up with the ever changing and developing research and breakthroughs. This is certainly who so many of the world’s medical breakthroughs and innovations are developed here in the United States. However, as I have agued throughout my blog, this needs to be supplemented in areas either by the government or by private business that has a financial interest in decreasing the cost of medical care by researching non-patentable herbal medicines, vitamin supplements, or dietary changes which do not hold enough profit incentive to warrant vast amounts of money being put in to the necessary research.

If we can only we could get the two sides to talk to each other in order to come together at some middle ground. Let natural medicine practitioners teach traditional medicine about true preventative care and treating the underlying causes of disease instead of concentrating on its manifestations and suppressing them. And let traditional medicine teach natural practitioners how to approach acute illness and see where herbs and supplements may fit in to the goals of acute care management

For far too long we have struggled in the “either or” world where we are treated as if we cannot have both. Patients, doctors and society as a whole would be best served by a collaboration of both fields. It is time we start talking and join the same team.

An Internist’s Defense of Natural Medicine

Choice is always yours

As an Internal Medicine physician many of my colleagues are less than open minded about natural medicine. Some of them view it as lacking any evidence and likely of no benefit. Some are much more hostile toward the field and view it as nothing more than snake oil peddling in the seek of profiting off poor trusting patients. There is some validity to both of these claims but neither is a full explanation of reality.

Yes it is true that there is little evidence for many of the treatments used by naturopathic physicians and other natural medicine practitioners. This blog lays out many examples of where some evidence is present and points towards a likely benefit but is never followed up with any large good quality studies like the ones seen for pharmaceutical drugs due to madate by the FDA. Unfortunately this is merely the reality that any natural medicine practitioner has to deal with. There are thousands of herbs, vitamins and minerals that have been used for hundreds and sometimes thousands of years for a particular illness or symptom. Through generations of experimentation people found these natural remedies to work, not unlike finding out which foods were good to eat and how to prepare them. However, our reductionist science has refused to merely study the whole herb or food to see if that would work towards treating the illness. Instead our universities and pharmaceutical companies have labored tirelessly to isolate single chemicals that they hope explain the complete effect of the herb and then patent these for mass production. This is not some profit making conspiracy but is merely a result of the limitations our our limited technology and understanding of the extremely complex chemical composition of herbs and foods. Also it results from the incentives set up by the fact that one cannot patent herbs but can patent synthetic chemicals. However, it is not always (and most often is not) true that one isolated chemical can explain the effect an entire herb has on the body. One simple herb like thyme or elderberry has many chemicals in them. Each of them interact with the others, and untangling this interaction is impossible with current technology. And yes, you may find one chemical that is primarily responsible for the effect on the body you are looking for, but there is no guarantee that in isolation it will be as bioavailable and active without the other chemicals in the herb. Not to mention the other chemicals may offset side effects from the chemical in isolation. Almost all pharmaceutical drugs have some very serious side effects yet many of the herbs used in natural medicine have little to no side effects. The simplest way to find this out would be to compare any drug that is isolated from a plant, food or herb head to head in clinical trials to the herb itself to make sure it is as safe and effective. Preferably you would want it to be more safe and more effective as any patented pharmaceutical drug will be more expensive than its un-patented herbal source, unless the herb is extremely rare.

As for the claim that natural medicine is deceitful snake oil peddling, this also has a grain of truth. Given that it is an unregulated field with no FDA or medial boards to oversee it, there are a lot of unscrupulous natural medicine practitioners out there giving out remedies that likely do not work in pursuit of profit. Some may only sell one product and therefore will claim that this one product can cure anything and everything in the interest of increasing their client base to sell more product. However, deceitful profit seeking individuals are not unique to the natural medicine field and can be found in any area of industry where anything is being sold. This is not a reason to discard the field as a whole and give up on potentially less toxic and cheaper treatment alternatives. In fact more research and information can only make this situation better allowing good scientific research to guide people’s consumption of natural remedies. Also we need to come up with innovative ways to have this industry regulated in some way. Naturopathic physicians are a great step in the right direction as they practice natural medicine, but only after a 4 year postgraduate training program and are subject to licensing and medical board oversight. An insurance company or employer sponsored oversight body may also be a good option.

One particular aspect to natural medicine that I thinks is far too rare in traditional medicine practice is supporting the body’s own ability to fight disease. Our body is amazingly capable of fighting cancer and infection and balancing hormone and electrolyte levels and yet all too often these abilitites and many others of the body are ignored completely in traditional medicine. For infections we give antibiotics (which are amazing life saving drugs) but we do nothing to support the body’s own infection fighting mechanisms. When people have cancer we cut it out or try to poison it with chemotherapy (which has saved millions of lives and has changed the death sentence from Hodgkin’s disease and testicular cancer in to greater than 90% cure rates) but we do nothing to support the body’s myriad of mechanisms to fight cancer. Natural medicine has much more respect for the body’s ability to fight disease and find balance that I feel traditional medicine is lacking.

Natural medicine practitioners also place much more emphasis on nutrition which has been almost completely abandoned by traditional medicine. When is the last time your doctor asked you what you are eating, went over a diet diary, or gave you specific dietary instruction? I know even I do not do it much in my daily practice despite how important I know that it is. It is time consuming, frustrating given the lack of change by the patients, and we as traditional physicians merely do not have much training in it. But I strongly feel the importance of what we take into our bodies every single day multiple times a day cannot be understated. What we eat is the underlying cause or at least a contributing factor in almost all chronic disease and could likely far more often be the cure if we spent more time on it and devoted more research to it. Natural medicine gives nutrition much more of the attention it deserves.

Irregardless of what we do, the public will continue seeking out natural treatments to their ailments for a variety of reasons. Many feel in there gut that there must be some herbs that can do some good. Many believe that natural medicines are less toxic and safer than pharmaceutical drugs. Other may desire a doctor who pays more attention to their body’s natural ability to heal itself and to nutrition. And many more are merely unsatisfied or frustrated by traditional medicine’s inability to make them feel any better. We need to start taking natural remedies seriously and give them the solid scientific research they deserve so we can honestly tell our patients what the evidence shows rather than merely reply that there is no research supporting it. No research indeed.