Sunday, September 2, 2018



People often ask me what sort of diet they should eat. Dr Samuel Hahnemann, the discoverer of homeopathy, had little to say on this matter. After all, considering how things were in the Eighteenth Century, just having enough food and clean water were significant enough issues. He hardly could have foreseen the glut of available food we have in the West today!

Florence Nightingale, founder of modern Nursing and head of the nursing staff at the field hospital at Scutari, Crimea during the Nineteenth Century, observed that food should be as fresh as was practical to obtain, and consist of good meat, starches, and the usual fruits or vegetables available at the time. Recovering soldiers who ate decent food recovered better.

When patients ask me about diet, I don't have a whole lot to say. Part of this is the practical matter of the visit: just taking a homeopathic case uses up the available time. But I suppose I could create a patient teaching tool about what constitutes a "good" or "healthy" diet. The problem with such an approach is that it's also important to know how a person eats now compared to what they think of as a goal diet. This is compounded by other issues.

What is their culture? Foods that may be culturally appropriate to one person clash with the culture of another. When I practiced HIV medicine in Reading, I had a lot of Puerto Rican patients, and I learned that the diet of Puerto Rico tends to be somewhat high in fats. That doesn't make it bad; it does present a different set of advisements about how to make such a diet healthier.

What comforts us? Doughnuts are not exactly health food, but once a week, on Sunday, I allow myself one, because I like doughnuts and they make me happy. Limiting my "doughnut happiness" to once a week has not harmed my mood, and has contributed to me maintaining a healthy weight. Foods we were raised on--back when the health of food consisted of just having what we thought was a "balanced diet"--nevertheless can evoke good memories and a good mood.

So for me, if a patient wants dietary advice, and depending on any existing medical conditions like diabetes or high blood pressure, I generally refer them to a registered dietician (insurance sometimes pays for this service) or a naturopath, if they want something more aggressively "alternative". The latter often involves avoiding certain things like gluten, whey protein or dairy, or a wholesale changeover to whole grains, raw vegetables and so on.

Having reviewed a lot of the scientific literature on this approach, I can safely say that...

1) Such radical dietary changes really work well for some people, and
2) They also don't seem to work well for everyone.

Part of the reason is purely practical. I often tell patients that "You've eaten a certain way your whole life. It's a hard thing to change when that is what you are are used to." And it's not just liking the food. It's finding it, preparing it--changing the very way you shop for and cook your food. It's a big change!

I've also run across countless specialty diets. Atkins, ketogenic, Zone, high-protein, Frances Lappe's Diet for a Small Planet--diets even come with political and social agendas! Such is the state of affairs in a society that has plenty of food (arguably too much food), and so much that is processed in factories, themselves fed by an industrial agriculture that relies on pesticides, herbicides, feedlot meat production, and genetic engineering.

What prompted this blog is an article I saw in The Atlantic about professor and speaker Jordan Peterson and his daughter's "all meat" diet, in which they eat literally nothing but beef and water. It's actually not the strangest thing I've ever heard of in that realm. Several years ago there was a fad of eating spoiled meat to relieve the symptoms of arthritis and other conditions. Spoiled meat stinks, so of course eating it indoors often posed a problem! An example is this report from Vice News. I gotta say, the guy doesn't look all that healthy to me, but if he feels it's working...

Anyway, I like the advice of author Michael Pollan: "Eat food. Not too much. Mostly plants." I don't follow it strictly, but it has guided me to reduce the kinds of things I was raised on and learned to love (burgers, doughnuts) and my diet has gradually become healthier. I'll add that it has taken years of little changes (and the help of my wife, whose diet is better than mine). Another author I like to emulate is Dr. Andrew Weil, whose advice generally points to a Mediterranean diet of more and varied grains, fruits and vegetables, smaller amounts of meat, and reduction of sugars, artificial fats, and foods that have been processed or raised with a lot of poisonous chemicals.

I've tried some of the "faddier" diets. Haven't stuck with a single one. I like the variety of a diet that borrows more from Mediterranean, Asian, and Central American cultures, who are less meat-focused. I've never tried a gluten free diet--I'm Southern Italian and the avoidance of really good artisanal breads and real Durham wheat pasta just doesn't fit. There's that "culture" thing again!

When patients tell me they feel better on a diet, especially avoidance diets (like gluten free, dairy free, etc.) I'm fine with it. In our society it's almost impossible to not have adequate nutrition if you supplement where needed with whatever's missing (vitamin D, vitamin C, etc.), so why criticize the diet if it makes people feel better. It's a trickier conversation whenever it is clear that the thing or things avoided are causing a person to feel unhappy, restricted, and afflicted though.

Take scallops, for example. For some reason they really make me ill. I avoid them. I can eat all other sorts of seafood like oysters, shrimp, and fish. Do I miss scallops? Maybe a little sometimes. Does it make me sad I can't eat them? Not really. But a nice loaf of handmade Italian bread? A hot, buttery croissant? A fresh baguette with goat cheese? If I started avoiding those things my life would feel like it's missing something. If I felt bad enough, I might reconsider, but I'd rather find another way to beat the problem.

Homeopathy takes another approach. Its theory and practice implies that we are, generally, genetically equipped to eat whatever we choose, and what we choose tends to be what we need--if we pay attention. Food allergies, food sensitivities, we propose, may owe more to regulatory imbalances that, in the absence of genetically-driven conditions like true lactose intolerance, if given the right homeopathic remedy, will resolve, leaving the person to eat as we were meant to.

Eating food. Not too much. And mostly plants.
Bon apetit!

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