Starving for Information: The Importance of a Nutrient-rich Diet

Kathleen DiChiara

For months, health professionals have been scrambling to understand the new coronavirus (SARS-Cov2), which emerged in Wuhan, China, sparking a pandemic of acute respiratory syndrome in humans (COVID-19). During a time when a potential infection feels heightened, the idea of “boosting immunity” sounds enticing. But what is the magic formula for producing an ideal immune response to a novel virus? And should that even be the focus?

The immune system is a complex network including cells, tissues, bone marrow, antibodies, the spleen, the thymus and the lymphatic system. It is a “system” requiring balance and harmony to function well. Humans are constantly infected with multiple endogenous and exogenous viral agents, with an estimated generation of up to 1012 new virus particles per day. A healthy immune system functions around the clock to protect us from illness and even death.

Pre-existing chronic illnesses can lead to a higher risk of death and health complications from the novel coronavirus. However, those illnesses can be prevented and even reversed with nutritious food and a healthy lifestyle.

A Chronic, Ongoing Issue

One in two Americans struggle with chronic disease. A wide range of reasons and factors are involved, including food insecurity, smoking, excess alcohol intake, physical inactivity and the consumption of ultra-processed food. All of these issues can be compounded by racial disparities from decades of systematic inequality in American economic, housing, and health care systems.

It’s important to keep in mind that a significant portion of the population is diagnosed with autoimmune disease. So, while the concept of “immune boosting” sounds good, a more active immune system does not always correlate to better health outcomes. For example, a hyperactive immune response is responsible for allergic reactions to ordinary nontoxic substances.

More than 20 million Americans take various drugs that intentionally suppress the immune system, altering the way the body responds to viral and bacterial infections. When chronic diseases are treated with medications that are targeted to alleviate the symptoms without tending to the underlying causes, patients may be left in an even more vulnerable position.

Good health and immunity depend on a peaceful coexistence among the symbiotic bacteria in the gastrointestinal and respiratory tract. Those include the cells, tissues and other microorganisms that live there and have the ability to recognize dangerous intruders. Quality food nourishes the diversity of the body’s inner ecosystem by feeding gut microbes. These microbes are in constant communication with the immune system, working in partnership to protect us and reducing the susceptibility to a wide range of viral infections. This prompts an important question: What is disturbing this communication and making Americans so vulnerable?

Year after year, client health history questionnaires, as well as data gathered from group discussion forums, reflect the same obstacle —consumers are trying to make healthier choices, but they remain unaware of what’s hidden in the food they’re eating every day. The problem? There simply is no label for glyphosate.

The Enemy Hidden in Plain Sight

Glyphosate is the primary ingredient in Roundup herbicides and other generic equivalents, which are the most widely used weed killers in the United States and the world. More than 250 million pounds of glyphosate is sprayed annually on crops in the United States. It’s in the water supply, food, yards, the local parks and on conventional farms with treated fields. That quantity means the chemical ends up nearly everywhere.

A 2009 study, published in Toxicology, used human liver cells in vitro and showed that even in low doses, glyphosate is toxic to human cells and can cause genetic mutations and disrupts endocrine function. In 2003, Monsanto filed for a patent on glyphosate as an antibiotic. This patent was granted in 2010.

Glyphosate based herbicides may act as an antibiotic, preferentially killing many of the body’s good gut bacteria, including lactobacillus, which manufactures nutrients and neurotransmitters that keep the digestive and nervous systems healthy. When the commensal (“good”) microbes become compromised, harmful pathogens have the chance to overgrow, causing inflammation in the gut. Inflammation in the gut has been linked to many health issues, including autoimmune disease, allergies, irritable bowel diseases and even antibiotic resistance.

Studies and clinical data also show that nutrient deficiencies, which affect an estimated 3 billion people, may be linked to inflammation in the gut.

A new round of food testing commissioned by GMO Free USA (“Eating Out: A Date with Glyphosate”) found that glyphosate and its breakdown product or metabolite, aminomethylphosphonic acid (AMPA), are pervasive in foods served by major restaurants and fast food chains in the United States. Notably, the highest levels of glyphosate were detected in “whole grain” or “multigrain” items that consumers often perceive as a healthier choice. Studies have linked harmful health effects to the levels of glyphosate detected in a single serving of tested restaurant foods.

According to dining trend surveys, restaurants are aware that consumers are seeking healthy choices free from synthetic chemicals. Many restaurant chains are using terms like “natural,” and “clean food” to exploit the general public.

Glyphosate Linked to Health Issues

EFFECTIVE GLYPHOSATE levelGlyphosate has been linked to cancer by the World Health Organization’s International Agency for Research on Cancer (IARC). Recently, a California jury ordered Bayer-Monsanto to pay $289 million to DeWayne “Lee” Johnson, who is terminally ill with Non-Hodgkin’s Lymphoma. While the judge subsequently reduced the award to $78 million, the verdict stands. Currently, over 11,200 people diagnosed with Non-Hodgkin’s Lymphoma after environmental exposure to glyphosate-based herbicides are also suing Bayer-Monsanto.

It would be remiss to focus solely on the cancer risks associated with glyphosate. A nine-year study, published in Nature, involving 300 French volunteers revealed that a low genetic diversity of intestinal bacteria in participants translated into a tendency to gain weight. It also caused higher inflammation and greater insulin resistance.

Recently obesity was identified as a major risk factor for COVID-19 hospitalizations and ICU admissions. The chart (below) reflects the records from 5,700 people with COVID-19 who were admitted to hospitals in New York City. Ninety four percent of them had at least one co-morbidity, most commonly hypertension, obesity or diabetes.

Chronic conditions do not on their own increase a person’s chance of catching coronavirus. Underlying health conditions do, however, appear to increase the risk of serious illness and complications across all age groups. It should be alarming that more than half of U.S. adults have at least one condition that increases their risk of becoming seriously ill if infected.

Metabolic dysregulation can compromise the immune system to increase the risk of infections and chronic respiratory diseases. Studies show that excess adipose tissue promotes chronic inflammation, insulin resistance and many downstream chronic illnesses, including cardiovascular disease, diabetes, hypertension, liver and kidney disease and cancer.

Chronic disease prevention is not glamorous. People are not highly motivated to give their attention to solutions that prevent a disease they didn’t think they were susceptible to getting in the first place. We are currently experiencing an epidemic of a population that is undernourished — characterized by excessive intake of processed food, hidden pesticides in the food supply, and inadequate access to nutrient-dense foods.

While it seems simple to preach “food as medicine” as the solution, many people are not aware that glyphosate, hidden in so much of the food supply, is an acute threat that should not be ignored. Glyphosate makes other chemicals even more toxic by blocking the enzyme pathways in the liver that help the body detoxify. These enzymes are also used to make bile acids and when bile acids don’t flow, a cascade of health issues arise downstream, including mineral imbalance. Glyphosate was first patented in 1964 as a metal chelator that was used to clean or descale commercial boilers and pipes. Glyphosate binds to and removes minerals such as manganese, zinc, and cobalt that are vital to human health.

As more glyphosate is used on crops, there has been a 500% average increase over 23 years in the level of glyphosate found in human urine. A 2018 study published in Environmental Health found that higher urinary glyphosate levels in pregnant women were associated with a shortened gestational length, potentially reducing a child’s lifetime cognitive achievement. Another study, published in 2014, in the Journal of Environmental & Analytical Toxicology, observed that chronically-ill humans had significantly higher glyphosate residues in their urine than their healthy counterparts.

The graph below shows my glyphosate levels after switching to an organic diet. My test was taken one year after removing genetically modified foods and glyphosate from my diet.

Glyphosate goes hand-in-hand with “Roundup Ready” genetically modified crops such as corn, soy, canola, sugar beets and cotton (for cottonseed oil). The GMO crops are sprayed multiple times during the growing season to control weeds.

It is also used as a desiccant, a ripening or drying agent, on non-GMO grains and other crops including wheat, barley, oats and other grains, sugar cane, lentils, beans, edible peas and chickpeas, sunflowers, mint, potatoes and cantaloupe. One way to combat or forgo high exposure to this chemical is by choosing to support organic and regenerative farmers who do not spray glyphosate-based herbicides.

When it comes to infectious diseases, many people don’t realize that the overall health of a community matters greatly. Public health measures and policies that target lifestyle habits and aim to build resilience and longevity also fortify a collective immunity against any infectious disease.

A Vital Network vs. a Pandemic

Lasting change will require a deliberate and sustained effort to address social determinants of health, such as poverty, racial discrimination, and environmental degradation. Regenerating health will start when the burden of toxic chemicals begins to lift. Without addressing this underlying burden on the body, the effort to consume nutrient-rich food is simply a way to plug the holes of vitamin and mineral deficiencies caused by glyphosate.

When we look at the human body as an interconnected network of vital communication pathways, we understand that everything is connected. A breakdown in one system—immune, cardiovascular, endocrine, digestive, and so forth—will adversely affect the strength of the others.

A virus works by gaining access to the cells of its host and then hijacking a receptor on the cell. In the case of SARS-CoV-2, access is obtained via the ACE-2 receptor, which is why the virus gains access readily through the lungs and small intestine, where the tissues have ample amounts of ACE-2 receptors. The vascular system also abounds in these receptors, and they are upregulated (increased) in conditions such as hypertension. The lungs, digestive, vascular system, and heart can be vulnerable to the attack. The human body is like an interconnected network of vital communication pathways, where everything is connected.

Modifiable factors (like nutrition, movement, sleep and a connection to nature) can be used as powerful levers that influence the body’s resilience. The principles targeted to prevent and reverse chronic disease can also serve people well during an infectious disease pandemic.

Without minimizing the health and financial hardship that most are currently facing, quarantine has given many people time to re-examine their lives, both physically and mentally. For many, it has become clear where the blind spots are in the food system and the importance of local food and food quality.

In the near future, as the economy comes back online, people will need to choose what to bring back into their lives, what they are willing to accept and what they want to improve for themselves and for others. Some will get the luxury of deciding how to carry out most daily activities — how to source and cook food, spend time, educate children and prioritize work. Others will not experience this privilege. Now is the time to take a deep breath, honor this global pause and take inventory of what is and is not working for communities. This is a rare and sacred opportunity to recreate a new version and better version of “normal,” perhaps one that honors innate harmony and alignment with Nature.

Food Quality

The body depends on six groups of essential nutrients – vitamins, minerals, proteins, fats, carbohydrates and water – to maintain vitality and health. A truly healthy immune system depends on a balanced mix of these essential nutrients, plus normal sleep patterns and frequent bouts of movement throughout the day.

It’s been understood for some time that many foods have been getting less nutritious. Measurements of fruits and vegetables show that their minerals, vitamin and protein content has dropped measurably over the past 50 to 70 years. Researchers have generally assumed the reason is fairly straightforward: We’ve been breeding and choosing crops for higher yields, rather than nutrition, and higher-yielding crops—whether broccoli, tomatoes, or wheat—tend to be less nutrient-packed.

In 2004, a landmark study of 43 different vegetables and fruits found “reliable declines” in the amount of protein, calcium, phosphorus, iron, riboflavin (vitamin B2) and vitamin C across most garden crops since 1950. This team of researchers concluded that this decline could mostly be explained by the agricultural practices designed to change traits and varieties that grow. Although not studied, declines in other nutrients like magnesium, zinc and vitamins B-6 and E were also likely.

A 2002 experiment with zooplankton revealed other details about why nutrients levels may be declining. Irakli Loladze, while studying for his Ph.D., observed that rising CO2 levels rev up photosynthesis, the process that helps plants transform sunlight to food. It also, however, leads the plants to pack in more carbohydrates, like glucose, at the expense of other nutrients like protein, iron and zinc. Greater volume and better quality might be inversely linked.

Zinc is needed for normal growth in humans, development and sexual maturation, and helps regulate appetite, stress level and sense of taste and smell. It also has antioxidant properties and plays an essential role in the immune system. A 2017 review on zinc in Nutrients, summarized that: “Nearly 30% of the elderly population is considered to be zinc deficient. It went on to say that “since zinc homeostasis is known to be important in immunological reactions such as the inflammatory response, and the oxidative stress response, multiple chronic diseases observed in the elderly are probably related to zinc deficiency.” Dietary sources of zinc can be found in a variety of beans, nuts, seeds, oysters (including canned), crab, lobster, beef, pork chop, dark meat poultry and yogurt.

Iron, although needed in very small amounts, is crucial for normal body functions. Without enough iron, the body cannot make hemoglobin, the oxygen-carrying component of red blood cells, potentially leading to anemia.

Diets that are deficient in minerals (in particular zinc and iron) and other nutrients can cause malnutrition and lead to reduced growth in childhood, to a reduced ability to fight off infections, and to higher rates of maternal and child deaths. This type of malnutrition is common around the world because many people eat only a limited number of staple crops, without enough foods rich in minerals, such as fruits, vegetables, dairy and meats.

Researchers are finding that these changes might contribute to the rise in obesity as people eat increasingly starchy plant-based foods and eat more to compensate for the lower mineral levels found in crops.

Every part of the body functions better when reinforced by proper levels of protein and other key nutrients. There is a synergistic effect to consuming nutrients through a diverse diet of whole foods like fruits, vegetables, fish, poultry, beef, nuts, legumes and dairy. Those foods contain a wide range and balance of vitamins, minerals and phytochemicals that supplementation doesn’t provide.

Eating foods rich in vitamin C – like citrus fruits, leafy green vegetables, and bell peppers helps the body absorb iron. These foods also serve as “food” for the microbes in the gut which need to eat to thrive. Kiwifruit, for example, contains high amounts of pectic polysaccharides and fiber, which has been found to improve the immune system through its prebiotic effects on intestinal microbiota. Beneficial quantitative microbial changes were observed at the group level for bifidobacteria, bacteroides and lactic acid bacteria.

These friendly gut bacteria consume the fiber and produce butyric acid as a byproduct. Butyric acid is a short-chain fatty acid (SCFAs) that repairs the gut lining encouraging the production of feel-good neurotransmitters. SCFAs also influence another important immune cell — regulatory T cells. T cells tell the body how to respond to invading pathogens and germs.

Research on vitamin C has a long history, showing some protection against pneumonia and reducing the risk and severity of infections. A deficiency in vitamin C can lead to impaired immunity and higher susceptibility to infections because our bodies don’t produce it naturally.

However, healthy individuals need just adequate intake of vitamin C of 100 to 200 mg/day to support optimal cell and tissue levels. In contrast, treatment of established infections requires significantly higher doses of the vitamin to compensate for the increased inflammatory response and metabolic demand.

Maintaining adequate vitamin D levels is also important for immune health but most people are not getting sufficient amounts of the cofactors, like magnesium, in their diet. Supplementing with vitamin D became popular after some trials showed it helped lower the risk of contracting the cold and flu. But the effect is mainly seen in people who have very low or deficient levels and most people are not tracking their Vitamin D levels. Vitamin K2, as well as vitamin A and D, and most minerals, are best consumed through food. Vitamin K is fat soluble, so it should be eaten with fat for best absorption. Vitamins A and D are both activated by vitamin K2, allowing them to bind to calcium to do their jobs.

Vitamins A plays an important role in promoting proper immune function in response to viral exposures. Broad population studies suggest that people who eat foods rich in vitamin A and beta carotene (which converts to vitamin A in the body) are less likely to develop many types of cancer, especially lung cancer. However, when researchers tested beta carotene supplements in smokers, they found that people who took the supplements were more likely to develop lung cancer, while non-smokers presented neither benefit nor risk. Supplementation with vitamin A can be dangerous if not monitored, as this nutrient gets stored in the liver and can cause damage.

There is solid evidence that certain micronutrient deficiencies — for example, deficiencies of zinc, selenium, A, C, D, K2, and E — can alter immune responses but it’s important to focus on a diet that includes these key nutrients as much as possible, before attempting to take large doses of single vitamins and minerals which may carry risks for you.

Let Quality Food be thy Medicine

The importance of eating nutrient-rich food has been reinforced by the current pandemic, which is devastating to individuals with underlying health conditions that can be traced to nutrition and lifestyle habits. By consuming foods that are locally sourced, nutrient-rich, and devoid of pesticides and herbicides, people can shift healthcare in their communities from a disease-centered approach to one that reinforces health regeneration and disease prevention. Implementing immune resiliency at home is a critical step toward building resilient communities.

Kathleen DiChiara is a practitioner of Functional Nutrition, founder of Rhode to Health, Inc., and author of End Chronic Disease: The Healing Power of Beliefs, Behaviors, and Bacteria (2020). Her personal journey back to health was the main feature in the award-winning documentary film Secret Ingredients.



The Covid-19 virus pandemic has brought many people’s consciousness around to focus on their personal health. Some are looking to technology to protect themselves and their families – masks, distances beyond which droplets can’t be projected by human lungs, various pharmaceuticals, cleaning agents and other products already available, and one or more vaccines yet to be released. This is perfectly natural and to be expected.

But there are many who are focusing on Nature as well. This issue of The Natural Farmer had been a vague idea for a while, but the pandemic brought it into reality. It is an attempt to discuss the role of natural systems in sustaining human health. Natural systems can both impair and repair an organism’s health, of course. Animals can sometimes avoid predation or accidental injury by fight or flight mechanisms and physical strength. But to manage infectious agents, like the current pandemic, living creatures have developed some amazing capacities and systems. In most cases the strength of those capacities and systems is largely dependent on the nutrients that we have ingested.

This issue is devoted to examining that process for humans, examining what role food plays in our states of health. We have articles from a doctor, a professor, several scientists researching nutrient health, a couple of nutrition counselors, an organization committed to raising higher quality non-toxic foods, an animal feed specialist, and an advocate for the inclusion of good nutrition in health care insurance coverage. Not all these writers agree on everything, but we hope together they give you an idea of the power food plays in affecting your health.

Note that a few of these articles were longer and contained footnotes and references which we have omitted for space reasons. We have noted each article so shortened at its end. Anyone wishing the original version of one of these articles can get one. Just Email for a copy as noted at the end of the article.

A Sunny Boost For the Immune System In The Face Of a Pandemic

Vitamin D foodsThis paper is dedicated to the indelible spirit of my Grandmother Evelyn Clapperton.

Connecting vitamin D to respiratory health appears from all my research to be a no-brainer. Vitamin D deficiency is part of my family history. My grandfather and father were separately quarantined in a sanatorium in Ontario, Canada, in the late 1930s amid a continuing epidemic of tuberculosis (TB). Imagine a young boy separated from his family and not being able to see his father in the next building. There was no welfare, and with the sole provider for the family gone, and her only child locked away, my grandmother worked as many jobs as she could to make the mortgage payments. She was determined that her young son and husband would return to their home.

This was no small task for my 4 ft 10 in and 90 lb grandmother, who had suffered from rickets as a child (a severe deficiency of vitamin D). Her soft foot bones had been squashed into too-small hand-me-down shoes causing her toes to be permanently deformed. Her feet were always painful. Being hunched over a knitting machine, from the time she was eight years old until the family immigrated to Canada from England, gave her a hunched back. Happily, despite the naysayers, my tiny grandmother made all the mortgage payments, my father returned home after six months, and my grandfather about a year later.

I ask myself, why are there adults and children in this world today with rickets, and why is TB still considered an epidemic?

Historically speaking

In 1922, Elmer McCollum and his team at Johns Hopkins reported on a new factor from cod liver oil that cured rickets, which is a softening and then weakening of the bones primarily in children due to prolonged lack of vitamin D. They showed that an unidentified vitamin increased the amount of calcium (Ca) and phosphorus (P) deposited in bones. At the same time, a group of doctors in Austria and the UK reported that children with rickets could be cured by sunlight during summer. Then, in 1928, Windaus and Linsert announced the discovery of vitamin D.

Before this we had learned in the 1890s that sunshine could cure tuberculosis (TB) and rickets. In 1903, Dr. Neils Finsen won the Nobel Prize in Physiology or Medicine for the discovery that light therapy could cure the skin form of TB. There were large numbers of patients with consumption (TB) moving to Colorado in the late 1890s and early 1900s in hopes of being cured by the high altitude and clean dry air. None of them knew that living at high altitude also meant more exposure to UVB ( the part of the ultraviolet spectrum which causes sunburn), especially in summer, which in turn meant more vitamin D was manufactured in their skin.

Dr. Susan Anderson, a young physician from Michigan, went to the town of Fraser, Colorado just as winter hit the area in the early 1900’s to heal her consumption. She spent days sleeping next to an open sunny window, drinking hay-fed milk, and then started snowshoeing when she was strong enough. The village people remarked on her tanned face as she got stronger (Virginia Cornell, 1991). Doc Susie didn’t know about vitamins A and D but had realized that there was healing power in the high Colorado climate when combined with good nutrition. She was well known for lecturing her patients on the value of eating rhubarb and vegetables. Rhubarb is a good source of vitamins C and B, potassium (K) and manganese (Mn) and grew well in the area. Without social media and modern medicine we knew the value of nutrition and sunshine for maintaining optimum health.

I challenge all of us to use this low tech, practical, cheap, and common-sense wisdom in our high-tech world — To Be Well and Stay Well.

The science of vitamin D and respiratory wellness

Our lives have been turned upside down and inside out by a respiratory virus SARS-CoV-2 that causes COVID-19. Now we spend a lot of time thinking about ways to keep our immune system tuned-up. Many of you will know that vitamin D is used for keeping our skeletons strong. It helps bones to accumulate calcium (Ca), phosphorus (P) and magnesium (Mg) so they resist breaking and regenerate quickly.

Vitamin D has also been shown to protect against respiratory infections caused by bacteria and viruses. Getting enough vitamin D is one of the easiest and cheapest things we can all do to help our bodies stay well. Humans and animals on a sunny spring or summer day can produce all the vitamin D they need to stay healthy. The ultraviolet B (UVB) energy from sunlight transforms a universally present cholesterol (7-dihydrocholesterol) in the skin to previtamin D3, which is carried to the liver and then the kidneys to be converted into its active form we call vitamin D. Most dietary supplements are manufactured by exposing a plant sterol to ultraviolet energy, producing vitamin D2, which is almost identical to D3. Generally, both are lumped together and called vitamin D.

No one is immune to vitamin D deficiency. The biggest risk factor for vitamin D deficiency is insufficient sun exposure (Holick 2007; Holick and Chen, 2008). When the cold and flu season rolls around in late fall and winter, anyone living outside of the equator and tropics cannot eat or make sufficient Vitamin D. Your grandparents likely remember forcing down a teaspoon of the dreaded cod liver oil every day in winter. Aren’t you glad cod liver oil and vitamin D supplements are now in capsules!

I am not surprised there has been a renewed interest in the association between vitamin D and respiratory illness. Studies have recently shown significant, but in my mind tentative, correlations between low vitamin D levels and the numbers of deaths related to COVID-19 in Europe. Scandinavian countries have been among the nations with the lowest number of cases and deaths associated with COVID-19, and the highest average levels of vitamin D. There is a public health emphasis on foods fortified with vitamin D, supplements, and cod liver oil in northern Europe. In contrast, the countries of Italy and Spain have had more cases of COVID-19 and higher death rates, and on average have significantly lower levels of vitamin D, compared with the countries in northern Europe. People in the Mediterranean countries generally avoid strong sun, and their natural skin colour requires them to spend more time in the sun to make enough vitamin D.

What was also interesting for me was that people with COVID-19 in northern European countries generally recovered more quickly with fewer complications. Vitamin D dampens the proinflammatory response of our immune systems to viruses–called cytokine storm or acute respiratory distress syndrome. Of course, as a couple of studies were careful to point out, correlation does not mean causation (Ilie et al. 2020; Rhodes et al. 2020). Mitchell (2020) outlines a growing number of studies that have demonstrated strong circumstantial evidence that patients with COVID-19 are likely to have a better outcome if they are not vitamin D deficient. A common finding in almost all the studies I reviewed was that patients that entered a study deficient in vitamin D often had the worst outcomes, and responded the best to supplements.

There were a number of research and clinical studies that demonstrated a strong relationship between having adequate vitamin D and a lower risk of developing any kind of upper respiratory infection (Chang and Lee 2019, Daley et al, 2019; Rondanelli et al 2018; Martineau et al 2017; Bartley 2010). The take home message from my research is that vitamin D deficiency leads to worse health outcomes and prolonged recovery from respiratory infections. Although there is no direct evidence that vitamin D can reduce the risk of contracting COVID- 19, there is strong evidence that vitamin D reduces proinflammatory responses to diseases, and can temper cytokine storms. So, it is possible that having sufficient vitamin D could speed the recovery. This means it is imperative that we maintain adequate levels of vitamin D especially at the start of cold and flu season. Gombart et al (2020) concluded that the body needs optimal levels of micronutrients, including vitamin D, to lower the risk of infections. I can hear Doc Susie telling us all to eat well, and play outside.

How can I get enough vitamin D in winter?

It is estimated that 1 billion people worldwide have vitamin D deficiency (Holick 2007). The major cause of vitamin D deficiency is lack of moderate skin exposure to sun (Holick and Chen 2008; McCullough and Lehrer 2018). “Very few foods naturally contain vitamin D, and foods that are fortified with vitamin D are often inadequate to satisfy either a child’s or adult’s vitamin D requirement” (Holick and Chen 2008). Lifestyle changes have more and more people working indoors during the important sunlight hours (11 am until 3 pm), and midday outdoor activities for school children are often reduced. We wear sunscreen and cover up when we are in the sun. Together, this means that for most people today, vitamin D supplements will be essential to maintain wellness (Mitchell, 2020; Charoenngam et al. 2019). Pets and livestock can also suffer Vitamin D deficiency in winter leading to bone softening diseases and respiratory issues (Smith et al. 2018). They need vitamin D too.

In the Netherlands, Hochberg and Hochberg (2019) recommended children and adults leave their hands and head uncovered for 15–30 minutes daily to make a healthy dose of up to 25,000 IU (International Units) of vitamin D (Rondanelli et al 2018). People with darker skins need more sun exposure because the pigment in their skin filters the UVB. As humans moved north and south from the equator, we lost our skin tint. Only humans with light skin tones can make enough vitamin D naturally outside of the tropics (Holick 2007; Alex Bridgett 2019). Conversely, this means that light skinned people can easily get sunburn in the tropics. The risk of skin cancer from too much sun exposure is real. Health and happiness tend to be finding the balance. We need to get enough sun to make vitamin D, but not so much that we run the risk of skin cancer.

Other factors such as age, sex, diabetes, hypertension, religion, overall health, and genetics can also affect the amount of vitamin D required to maintain health. People with chronic diseases like cystic fibrosis, diabetes, obesity, and Crohn’s have compromised immune systems, an increased incidence of respiratory infections, and are known to have difficulty absorbing vitamin D (Danker et al 2019). Much of what we know about vitamin D and how it affects the immune system is from the study of chronic diseases (Tangpricha et al 2017). Both Deluca (2014) and McCullough and Lehrer (2019) have written historical reviews on the use of vitamin D to cure respiratory diseases, especially tuberculosis.

It is generally accepted that more than 30 ng/ml of vitamin D in your blood or plasma is sufficient for the maintenance of good health, while less than 20 ng/ml is considered deficient and the range in between 21 and 29 ng/ml is considered insufficient. Too much ranges from 100 and 150 ng/ml (Holick and Chen 2007; Chang and Lee 2019). The risk of too much vitamin D is greater in children than adults, and I discuss dosing levels of vitamin later on in this paper. There is some controversy over how vitamin D is measured, and when to measure, because levels can vary dramatically with medications, stress, trauma, hormones, and underlying disease (Reijen and Soeters 2020).

As you can see in Table 2, it is hard to eat your way to sufficient vitamin D, especially if you are a vegetarian or vegan. And not all variants of some foods are equal. For example, it has been shown that wild-caught salmon had on average 500 –1000 IU vitamin D in 100 g (3.5 ounces), whereas farmed salmon contained only 100 –250 IU vitamin D per 100 g serving (Holick 2007). The most likely reason is that vitamin D is plentiful in the food chain but is not as plentiful in the pelleted diet fed to the farmed salmon. Clearly diet matters.

Mushrooms and foods that are colonized by fungi – like fermented foods- can be a natural source of D2 (D2 still needs to go through the liver and the kidneys to be useful). Sun dried mushrooms are better sources of D2.

It is common to see staple foods fortified with vitamin D. These include non-dairy drinks or nut beverages, juices, flour, cereal, bread, and milk products. The amount of vitamin D may or may not be regulated or mandated depending on the country. Sun and supplements are still generally recommended to maintain a healthy immune system.

Vitamin D and how it works to maintain the body’s defence forces

The primary functions of the immune system are to protect the body against infection, contain and clear damaged tissues, and provide constant surveillance for invaders and malignant cells. The immune system has an acquired memory of the protein and chemical signatures from all the invaders it has fought and destroyed. It also has the ability to recognize and avoid attacking healthy tissue or harmless substances. We all have a different ability to fight invaders depending on genetics, environment, lifestyle and nutrition, and interactions between all these factors. It is well documented in the scientific and clinical literature that having good and adequate nutrition is closely associated with improved immunity and the ability of the body to fight infection. The European Food Safety Authority has recognized the health claims for vitamins D, C, E, and zinc (Zn) as positively affecting the immune system function for making us fit to fight.

The immune system as a whole is composed of an intricate network of highly specialized chemicals, cells, tissues and organs that are organized into three defense forces: physical barrier, innate immunity and adaptive immunity (Rondanelli et al 2018).

A barrier to entry

The first defense force is the physical barrier which includes the skin, mucus membranes, and mucus secretions (that can contain bacteria-killing peptides). Stomach acidity and the lowering of pH in body fluids can limit the growth of most bacteria. Vitamin D is important for protecting the integrity of the lining and mucus in the small intestines. People with deficient vitamin D level have leaky guts allowing for bacteria to infiltrate the mucus barrier and move freely within the intestines and sometimes into the blood. Changes in the microbial community structure within the gut can also cause leaks in the lining of the intestine allowing the deeper layers to become inflamed, which can lead to colitis, and can facilitate bacterial infections.

This process, if left unchecked, can lead to further inflammation from cytokines (proinflammatory molecules) and leave the intestines subject to deeper infections, food sensitivities and allergies, which spiral into even more and deeper inflammation. Restoring adequate levels of vitamin D stabilizes the pH balance, and Ca, P and Mg uptake, and stimulates anti-inflammatory activity reducing the incidence of Irritable Bowel Syndrome (IBS), Crohn’s disease, presence of pathogens, and bacterial infections in the colon (Kanhere et al. 2016; Dimitrov and White 2017; Rondanelli et al 2018; Malaguarnera 2020). A stable gut microbiome can help us be less susceptible to viral infections (Altman et al 2020)—maybe even COVID 19.

Vitamin D has a collaborator in the gut to dampen proinflammatory responses and alter cytokine production. Butyrate is produced in the gut from the microbial fermentation of carbohydrates, particularly resistant starch and dietary fiber such as inulin. It supplies all the energy to the cells that regenerate the surface of the colon (colonocytes). Vitamin D and the gut microbiota work together to reduce gut inflammation and uphold the integrity of the first defense force (Liu et al 2018; Dimitrov and White 2017). It has been suggested that vitamin D supplements might be an easy and inexpensive way to positively modify the gut microbiota.

There are specific communities of microbes — associated with our sinuses and upper respiratory tract — called the nasopharyngeal microbiome, that if maintained can reduce the risk of viral infections. Studies have suggested that there are specific bacteria that protect the airways from viruses and reduce the risk of getting a viral infection (Altman et al 2020). We need more research to understand how these microbiomes strengthen our barrier defense forces.

Attack Forces

Vitamin D has known direct effects on respiratory infections (Chang and Lee 2019; Daley et al 2019; Rondanelli et al 2018) mediated through the innate immune system, or the second defense force. Specialized cells work together with vitamin D to produce anti-bacterial proteins that kill invaders, as well as cells that then dampen the inflammatory response to the dead cells, allowing for a faster recovery (McCullough and Lehrer 2019). By mobilizing the innate antimicrobial defense force, vitamin D plays a critical role in eliminating invading bacteria, viruses, and fungi (Chirumbolo et al 2017; Wu et al. 2019). Clearly, with adequate sun and nutrition we do have a fighting chance against viral respiratory diseases.

Always On Guard

The specialized forces of the third or adaptive immune system patrol the body for known pathogens and invaders, including any signs of potential cancer-causing (malignant) cells. Allergies are generally a result of the inflammation caused by the third defense force. Vaccinations stimulate an adaptive immune response so the third defense force will instantly recognise the invader and mount a swift attack. Vitamin D activates anti-inflammatory, anti-oxidant and anti-fibrotic actions (Dankers et al 2017; Wessels and Rink 2020) within the adaptive immune system, reducing the inflammation, pain, and tissue damage caused by aggressive third defense force attacks. Having sufficient vitamin D is protective against developing a number of autoimmune diseases, and can reduce the tissue damage from thyroid disease (Murdaca et al 2019). Nutritional strategies are strongly advised as part of an integrated approach to decrease the incidence of autoimmune diseases (Malaguarnera, 2020; Wessels and Rink 2020) which are a consequence of the adaptive immune system attack forces.

Vitamin D is a simple and cost-effective health solution

Vitamin D cuts risk of COVID-19With our modern lifestyle we also entered the era of antibiotic-resistant diseases, and skyrocketing healthcare costs. Let’s use the COVID-19 pandemic to reboot, and set a goal to develop simple and cost-effective approaches that integrate nutritional outcomes with disease management strategies. Studies examining the interactions between chronic disease and vitamin D have shown over and over again that individuals with sufficient vitamin D have better health outcomes, and generally stay well. The lowest effective dose of vitamin D needed to maintain health, or in therapeutic use against disease, is still debated (McCullough and Lehrer, 2020). Most agencies have agreed that the daily supplement dose of vitamin D in the winter must be higher than 400 IU for children and 800 IU for adults to maintain health.

The scientific research consistently demonstrates that there is enough evidence from clinical and research trials to adequately determine safe vitamin D dosing levels. Intake of more than 50,000 IU can cause clinical signs of vitamin D toxicity, while experiments using prolonged doses of 40,000 IU reported no adverse health effects (Brower-Brosma et al 2013). However, it is generally recommended that routine prolonged adult doses of as much as 10,000 IU are safe to maintain health and the immune defense forces in winter months (Holick, 2007; McCullough and Lehrer 2019). Vitamin D supplements, cod liver oil, sunshine and phototherapy are proven and forgotten low tech, inexpensive treatments that have the potential to safely end global vitamin D deficiency and many of the associated diseases. The body needs optimum levels of micronutrients including vitamin D to support all three of the immune defense forces and keep them in fighting condition. The scientific and clinical evidence exists to support supplementing diet with combinations of multiple, specific, and immune system supportive micronutrients to optimize immune function and reduce the risk of infection (Gombart et al 2020).

Concluding remarks

There is no hard evidence that vitamin D has any effect on COVID-19, but there is a lot of evidence to show that people with sufficient levels of vitamin D have better overall health, and if they do get sick, they have less severe symptoms, and recover more quickly.

It is clear to me that micronutrients including vitamin D are fundamental to the fitness regime of our immune system defense forces. As I said at the beginning, I believe that all things are ultimately connected—even if we don’t know it yet. To me, the interaction between vitamin D, gut microflora, fiber intake, and our health reinforces the need to look at systems as a whole. Feeding yourself whole grains and fermented foods for the gut microbes, fruits and vegetables for the minerals, vitamins and enzymes, and adding some physical exercise in the sun can clearly help your immune system to fight a pandemic.

Jill Clapperton is Principal Scientist and Founder of Rhizoterra Inc. as well as being Chief Scientist to the Real Food Campaign. She is not a medical practitioner and the opinions and views expressed in this article are her own based on the research she has done. This series is co-sponsored by Rhizoterra Inc and the Bionutrient Food Association. The Real Food Campaign and Our Grounded Growth help us to get the message out. I thank Dr’s David Pearce, James Frame, and Curt Livesay for reviewing this paper.

We have omitted notes from this article for space reasons. Anyone wishing the original version of this article can get one by Emailing the editor for a copy. I will send it to you as a .docx attachment.
– Jack (TNF (at) nofa.org)

There Is Nothing In The World More Powerful In Its Effect On Human Health, Than Food!

Dr Natasha Campbell-McBrideWe live in a world of nutritional misinformation coming from commercial powers and funded by them as nutritional ‘science’. Using food as medicine requires real information, which the real science provides all the time. But the real science is too poor to spread their knowledge through the mainstream media, so the population only hears what somebody with a large wallet wants them to hear. So, what is the truth about food?

We eat at least three times a day, sometimes more often. Every morsel of food you eat changes your metabolism and your health. Western health systems are crumbling under the burden of chronic disease, physical and mental. The first and most important cause of these illnesses is consumption of processed foods.

When Mother Nature made our human bodies, she at the same time provided us with every food we need to stay healthy, active and full of energy. However, we have to eat these foods in the form that Nature made them. Industrial processing that we subject the food to changes its chemical and biological structure. Our bodies were not designed to have these changed foods! The more food is processed, the more nutrient depleted and chemically altered it becomes. Apart from losing its nutritional value, processed food loses most of its other properties: taste, flavour and colour. To compensate for that, various chemicals are added: flavour enhancers, colours, various E numbers (“European” numbers for food additives) and other additives, contributing to inflammation, cancer, memory loss, hyperactivity and learning disabilities, psychiatric disorders and other health problems.

Natural foods do not keep very long, so industry changes them into various chemical concoctions, which are then packaged nicely and presented to us as ‘food’. ‘Food’ that is made to suit commercial purposes where health considerations never enter the calculation. The manufacturers are obliged to list all the ingredients on the label. However, if the manufacturer uses an ingredient that has already been processed or is made from processed substances, this manufacturer is not obliged to list what that ingredient was made from. So, if you are trying to avoid something in particular, like sugar or gluten, for example, reading an ingredient list may not always help you.

If we look at supermarket shelves, we will see that the bulk of processed foods are carbohydrates. Breakfast cereals, crisps, soft drinks and beer, biscuits, crackers, breads, pastries, pastas, chocolates, sweets, jams, condiments, sugar, soft drinks, snacks, preserved fruit and vegetables and frozen precooked meals with starches and batter are all highly processed carbohydrates. When we eat them, they put the body in a fat-storing mode, which causes weight gain and obesity; our world obesity epidemic is caused by processed carbohydrates. They create chronic systemic inflammation in the body, leading to heart disease, diabetes, cancer, Alzheimer’s disease and many other chronic degenerative conditions. Processed carbohydrates feed pathogenic microbes in the gut, damaging your gut flora and making your immune system ineffective.

Sugar is the most addictive substance on the planet and a large percent of the Western population is addicted to it. Sugar addiction is the basis for developing all other addictions (drugs, alcohol, tobacco, dangerous behaviour, gambling, etc). In order to metabolise only one molecule of sugar, your body requires around 56 molecules of magnesium, dozens of molecules of vitamins, enzymes, minerals and other nutrients. When we analyse a piece of fresh sugar cane or sugar beet in their natural state in a laboratory, we find that every molecule of sugar in them is, indeed, equipped with 56 molecules of magnesium and all those other nutrients. So, when we eat natural sugar cane and sugar beet without processing them, the sugar in these plants gets used by the body well and brings us only health.

But we do not eat sugar beet or sugar cane in their natural form. We extract the sugar out of them and throw everything else away. That pure sugar comes into the body like a villain, like a highway robber pulling nutrients out of our bones, muscles, brain and other tissues in order to be metabolised. It needs those 56 molecules of magnesium! Where is all that magnesium going to come from? From your bones, your muscles and other organs. Consumption of sugar is a major reason for the widespread magnesium deficiency in our modern society, leading to high blood pressure, heart attacks, strokes, neurological, immune, behavioural and many other problems. Other nutrients will also be depleted in your body as a result of eating sugar, leading to disease.

Processed fats: margarines, butter replacements, spreadable butter, vegetable oils, cooking oils, hydrogenated oils, shortenings and many other are alien to our human physiology and must not be consumed. You will find processed fats in most processed foods and they are made from plant oils. All plant oils contain fragile polyunsaturated fatty acids, which are easily damaged by heat, light and oxygen. That is why Mother Nature has hidden them away very carefully in the cellular structure of plants – in their oily seeds, leaves, stems and roots. When we eat plants in their natural form, we get these oils in their pristine state and they are good for us. But when we take plants to our big factories and extract the oils from them, high temperatures, pressure and various chemicals are employed, which change the structure of fragile fatty acids in the plant matter creating a plethora of unnatural, chemically mutilated, harmful fats. These oils have conclusively been proven to cause cancer, heart disease, diabetes, neurological damage, infertility, immune abnormalities and other health problems.

More than 90% of all salt produced is used for industrial applications, which require pure sodium chloride. Salt in Nature contains more than 90 elements: in fact, natural crystal salt and whole sea salt contain all the minerals and trace elements that the human body is made of. Because the industry requires pure sodium chloride, all other elements and minerals are removed from the natural salt. It is sold under the name of ‘table salt’ and all our processed foods contain plenty of it. This kind of salt upsets our homeostasis on the most basic level. Natural salt is just as fundamental to our physiology as water is. We need to consume salt in its natural state: as a crystal salt from salt mines or as whole unprocessed sea salt. There are a number of companies around the world that can provide you with good quality natural salt.

Soya is very big business and a large percentage of the industry uses genetically modified soya. Soya can be found in many processed foods, margarines, salad dressings and sauces, breads, biscuits, pizza, baby food, children’s snacks, sweets, cakes, vegetarian products, dairy replacements, infant milk formulas, etc. In Japan and other eastern cultures soya is traditionally used as a whole bean or fermented as soy sauce, tofu, natto, miso and tempeh. The form in which soya is used in the West is called soy protein isolate – a tasteless powder, easy to use and add to any processed food. It is a highly processed substance with non-existent nutritional value and a lot of harmful qualities. It is linked to cancer, autism, inflammation, mental illness and other degenerative conditions in humans. It destroys your thyroid function, upsets the hormonal balance in your body and it is a powerful allergen.

These are just a few most common ingredients in processed foods. If good health is important to us, all processed ‘foods’ should be avoided.

What should we eat to be healthy and full of energy?

Let’s start with shopping. Buy your food in the shape and form that Nature has made it and prepare it yourself at home, using traditional methods of cooking: on the stove, the grill or in the oven. Avoid microwaves or induction stoves, as they destroy food and can make it carcinogenic.

  1. Buy meat and fish, fresh or frozen, including game, organ meats and shell fish.

Contrary to popular belief, it is meats, fish and other animal products that have the highest content of protein, vitamins, amino acids, nourishing fats, many minerals and other nutrients which we humans need on a daily basis. If we compare the amounts of vitamins in meat, fish or other animal products with plant foods, it is the animal products that are at the top of the list.

Vitamin B1 (thiamine): the richest sources are pork, liver, heart and kidneys.
Vitamin B2 (riboflavin): the richest sources are eggs, meat, milk, poultry and fish.
Vitamin B3 (niacin): the richest sources are meat and poultry.
Vitamin B5 (pantothenic acid): the richest sources are meat and liver.
Vitamin B6 (pyridoxine): the richest sources are meat, poultry, fish and eggs.
Vitamin B12 (cyanocobalamin): the richest sources are meat, poultry, fish, eggs and milk.
Biotin: the richest sources are liver and egg yolks.
Vitamin A: the richest sources are liver, fish, egg yolks and butter. We are talking about the real vitamin A, which is ready for the body to use. You will see in many publications that you can get your vitamin A from fruit and vegetables in the form of carotenoids. The problem is that carotenoids have to be converted into real vitamin A in the body, and a lot of us are unable to do this conversion, because we are too toxic or because we have an ongoing inflammation in the body. So, if you do not consume animal products with the real vitamin A, then you may develop a deficiency in this vital vitamin despite eating lots of carrots. Vitamin A deficiency will lead to impaired immunity and development of any chronic illness in the body, because without this vitamin and other fat-soluble vitamins the body cannot use protein, fats, minerals and all other nutrients.

Vitamin D: the richest food sources are fish liver oils, eggs and fish.

Vitamin K2 (menaquinone): the richest sources are organ meats, full-fat cheese, good quality butter and cream (yellow from grass-fed animals), animal fats and egg yolks. This vitamin is essential for our health, its deficiency leads to deposition of calcium in the soft tissues and initiation of inflammation. Apart from the high fat foods, an important source of this vitamin is our own gut flora: the probiotic bacteria in the gut produce and release vitamin K2. Fermented foods contain vitamin K2 as the bacteria produce it in the process of fermentation; natto (fermented soy beans) is one of the richest sources in Eastern culture while in the West well-aged natural full-fat cheese is a good source of this vitamin.

All these vitamins are absolutely essential for us. Three well-researched vitamins, which are generally thought to come from plants, are vitamin C, folate and vitamin K1 (phylloquinone). However, now we know that liver and other organ meats contain good amounts of both vitamin C and folate. I have a growing group of patients who have to stay on the No-Plant GAPS Diet, where nothing from the plant kingdom is consumed at all. These are children and adults with severe digestive problems, mental illness and autoimmune illness. This diet allows them to recover from their illnesses, come off all medication and feel well. There are no deficiencies of any nutrients that can be detected in these people, which shows that human beings can live perfectly well without plants at all! (the No-Plant GAPS Diet is described in my new book Gut And Physiology Syndrome).

Organ meats (liver, kidney, heart, brain, tongue, etc) have been considered to be a delicacy and the most valuable food in all traditional cultures. These foods contain concentrated amounts of nutrients. Liver is an absolute powerhouse of nutrition for our physiology and should be consumed on a regular basis, particularly by people with nutritional deficiencies. People with anaemia should have fresh liver and red meats daily (lamb, beef, game and organ meats in particular), because these foods are the best remedy for anaemia. The mainstream misinformation about meats, particularly red meats, has been driven by commercial powers, which profit from replacing these natural foods with their processed alternatives. Fresh, natural meats have nothing to do with heart disease, cancer or any other disease, and are important for us to eat in order to provide all the nutrients we, humans, need.

2. Buy fresh eggs from free-range pastured hens, preferably organic.

Eggs are a wonder food, full of easy-to-digest nutrition. A fresh, raw egg yolk is absorbed literally without needing digestion and provides you with almost every nutrient in the best biochemical form. Any person with memory loss must have at least three, preferably five to six, fresh eggs a day. It has been demonstrated in a number of clinical trials that eating fresh eggs improves memory and learning ability.

3. Buy natural organic dairy, preferably raw (unpasteurised).

Raw unprocessed milk, cream, butter, ghee, live yoghurt, kefir and natural cheeses, produced in a traditional way, are full of wonderful nutrition and are important for us to consume. Milk must come from native breeds of animals, not from commercial breeds. Many people cannot tolerate pasteurised milk products, because pasteurisation destroys the structure of milk. Unprocessed, unpasteurised, straight-from-the-animal milk is very easy to digest as it contains enzymes that digest the milk for you to some degree. Pasteurisation of milk is a major contributor to lactose intolerance in the population. Raw fresh milk contains an active enzyme, lactase, to digest the lactose for you, but this enzyme is destroyed by pasteurisation. Many lactose-intolerant people find that they can digest raw milk perfectly well.

4. Buy and use only natural fats.

The best fats for humans to consume and to cook with are animal fats! Plant oils are best consumed as part of the whole plant. Extracting them from plants damages them, making them harmful. On top of that a majority of plant oils are too rich in omega-6 fatty acids. Consuming vegetable cooking oils causes an excess of this substance in the body, leading to chronic inflammation, autoimmunity, infertility, cancer, heart disease and other problems. Cook with animal fats, such as lard, pork dripping, lamb fat, beef fat, goose fat, duck fat, etc. It is best to do what our grandmothers did: collect the fats yourself after cooking your meats; they will keep in a glass jar in your refrigerator for a long time and are excellent to use for cooking. Roasting a duck will provide you with a cup of excellent fat, which has been proven to be heart protective. Roasting a large goose will provide you with even more of an excellent cooking fat. You can buy some of these fats from a traditional butcher. You can also cook with butter, ghee and natural coconut oil. All these fats are healthy for us and very stable: they generally do not change their chemical structure when we cook with them, they can even be reused.

5. What about cholesterol and saturated fats?

When we talk about animal fats, a question about cholesterol and saturated fats invariably comes up, because everybody has heard about these substances ‘clogging up your arteries’ and ‘causing heart disease’. This idea came from the diet-heart hypothesis, first proposed in 1953. Since then this hypothesis has been proven to be completely wrong by many scientific studies. George Mann, eminent American physician and scientist, called the diet-heart hypothesis ‘the greatest scientific deception of this century, perhaps of any century’. Why? Because, while science was working on proving the hypothesis wrong, the medical, political and scientific establishments fully committed to it. To admit that they were wrong would do too much damage to their reputation, so they are not in a hurry to do that. In the meantime, their closed ranks give complete freedom to the commercial companies to exploit the diet-heart hypothesis to their advantage. Their relentless propaganda through the popular media ensures long life for the faulty diet-heart hypothesis.

Thanks to the promoters of the diet-heart hypothesis, everybody ‘knows’ that cholesterol and saturated fats are ‘evil’ and have to be fought at every turn. If you believe the popular media you would think that there is simply no level of cholesterol low enough.

The truth is that we humans cannot live without cholesterol and saturated fats. They are major structural elements of every cell, every tissue and organ in your body, particularly the brain. Our immune system, our hormonal balance, healing any damage do not work without an ample supply of these vital substances. To understand this subject fully, please read my book Put Your Heart In Your Mouth. What really causes heart disease and what we can do to prevent and even reverse it.

Buy only plants (vegetables, fruit, nuts, legumes, grains, etc), which have been grown on rich healthy soils without any chemicals.
There are two important points to understand about plant foods.

First: they are difficult for humans to digest! The only things in Nature that can truly digest plants are microbes, which have incredible abilities to ferment carbohydrates, break down proteins, starch and fibre, release vitamins, and generally turn the plant matter into a form that other creatures can benefit from. This is exactly what Mother Nature used to help the herbivorous animals to digest plants and extract nutrients from them. Mother Nature equipped them with a very special digestive system, called a rumen, full of plant-breaking microbes that digest the plants for the animal. Humans don’t have a rumen! We have one small stomach with virtually no microbes in it, and it is only able to break down meat, fish, milk and eggs effectively. Our stomach is designed perfectly to digest animal foods!

Plants, however, do not digest in our stomach to any degree; they have to wait to move out of the stomach into the intestines, where pancreatic enzymes and bile are added to the mix to break down the food further. But even there the plants don’t digest well. We can only break down a small part of cooked starch and absorb some juices, sugars and vitamins. The bulk of the plant – the fibre and most starch – is indigestible for the human gut. It goes through the intestines and then lands in the bowel, which is the equivalent of the rumen in the human body. This is where the majority of our gut flora resides: bacteria, fungi, protozoa, viruses, worms and other creatures work on the plant matter and extract from it what they can.

The difference between the herbivorous animals and us is that their rumen is at the beginning of their gut, while our ‘rumen’ – the bowel – is at the end. In herbivorous animals the plant matter is digested well in the rumen, before it moves down into the part of the gut where absorption of nutrients happens. In humans the bulk of our food absorption happens higher up in the intestines, where plants cannot be digested. So, the nutrients that we absorb in the intestines come largely from animal foods, which were digested well in the stomach. In short, the bulk of the nutrition that our bodies thrive on comes from animal foods! People knew this fact through experience for millennia. They knew that the most nourishing foods for them came from animals; they would eat plants as a supplement to meat or when animal foods were in short supply. To understand this subject in detail, please read my book Vegetarianism Explained. Making an Informed Decision.

Second: all plants, particularly their seeds (grains, legumes, nuts and seeds), must be properly prepared before consumption! They contain a plethora of chemicals, called antinutrients, which damage our digestive system and the rest of the human body and can trigger a chronic disease. Soaking, sprouting and fermentation prior to cooking are essential for all seeds. Vegetables and fruit digest best when fermented and cooked, particularly for people with a sensitive digestive system. If you have digestive problems please study the GAPS Diet in my book Gut And Psychology Syndrome.

In conclusion

When feeding yourself or your family please remember these simple rules: never economise on food and never compromise when it comes to food! Because if you do not eat well, you will not be healthy, and if you do not have your health, you will have no life!

Have you ever wondered what a ‘balanced meal’ means? Our mainstream will tell you that it is proportions of carbs to protein and fat. No, that is not what it means! It means that all your taste buds are singing praises to the meal you eat. Our taste buds are specialised: some perceive sweet, some sour, some perceive salty, some astringent, some perceive pungent and some perceive bitter. All of these tastes should be present in the meal. So, when you make a meal, add some sweet vegetables (carrots and beets for example), some bitter (celery leaves, dark-green leaves, aubergines, courgette, spices and herbs), some chillies, garlic, onion or herbs for a pungent taste, some natural salt or seaweed, broccoli, cauliflower, asparagus and turnip for an astringent taste, and some fermented vegetables, vinegar or lemon to satisfy the sour taste. These guidelines will produce very tasty and satisfying meals for you. But, of course, the most important parts of any meal are the meat and the fat! We can cook our vegetables without meat, but we must add good amounts of fat into it! It is the fat that will bring out all the tastes and extract beneficial nutrients from the vegetables. The best fat to cook your vegetables with comes from animals: bacon fat, pork dripping, lard, tallow, lamb fat, goose fat, butter and ghee. Fat is essential for our bodies to be able to use minerals, vitamins, protein and all other nutrients. The more animal fat you add to your meal the more nourishment your body will get out of it.

Eating out a lot is a very unhealthy habit (that includes takeaway meals), because you have no idea what kind of ingredients and cooking methods were used to make your meal. And you have no idea who cooked your meal and with what attitude.

Why is the attitude of the cook important? It is very important because cooking is alchemy. The most important part of any alchemy is the alchemist: the person who makes the meal. The most important actions of the alchemist in the process are his thoughts and attitudes – this is what creates the magic. We, humans, are powerful creatures! If a person who cooks your meal doesn’t like you and wishes you ill, this energy will permeate the meal they prepare for you. This meal will not bring you good health! The meals you eat must be produced by people who love you, who wish you to have the best health and happiness. This kind of meal will bring you good health and healing from any illness.

The person who cooks for the family holds the health of that family in her or his hands. This is power! The health of any nation is not in the hands of governments or the medical profession. It is in the hands of those who cook for that nation! If the nation consumes things cooked by some faceless factories, then that nation will have poor health – exactly what is happening in Western countries. In traditional societies people knew the value of food; they knew that there is nothing more powerful in its effect on human health than food. Women knew that, through cooking, they were holding the health of their families in their hands. They would never relinquish that power to anyone else! They knew what foods to use for what occasions: what is good for babies, what is good for pregnant women, what is good for a couple trying to conceive a baby, what is good for any illness or injury, and what is good for the elderly to eat. Women knew the herbs growing in their location and used them extensively in cooking. This sacred knowledge was passed through generations: from mother to daughter and from grandmother to granddaughter. From the dawn of the food industry, people started losing this knowledge. The food industry advertising lured them away from cooking and deceived them into relinquishing their God-given power – to hold the health of their loved ones in their own hands! The result is the misery of sickness in Western families, which is getting deeper with every generation.

Cooking is not difficult. Forget the recipe books. Cooking is a very creative activity, enjoy it and create your own unique meals every time you cook. Just keep in mind: you are cooking for good health (not convenience, not expediency or anything else). Do your shopping and cooking with this thought. As a result, you will lay a solid foundation for your own health and the health of your family. And a healthy family is usually a happy family!

Dr. Campbell-McBride graduated with Honours as a Medical Doctor in 1984 from Bashkir Medical University in Russia. After practising for five years as a Neurologist and three years as a Neurosurgeon, she started a family and moved to the UK. It was during this time that Dr. Campbell-McBride developed her theories on the relationship between neurological disorders and nutrition. She has specialised in using nutritional approach as a treatment, and has become recognised as one of the world’s leading experts in treating children and adults with learning disabilities and other mental disorders, as well as children and adults with digestive and immune disorders.

In her clinic Dr Campbell-McBride works with many patients with heart disease, high blood pressure, arrhythmia, stroke and other complications of atherosclerosis. She has become acutely aware of the existing confusion about nutrition and these conditions, which spurred an intensive study into this subject.

Dr Natasha is an organic regenerative farmer. In 2012 she and her family purchased a piece of land in East Anglia in the UK, which was commercially farmed for a long time. Since then they have transformed this land into an organic and biodynamic paradise with many animals, birds, bees, gardens and orchards.
She is involved with these websites:

Let Feed and Food be Our Medicine

Fred ProvenzaThe health of livestock, humans, and landscapes is linked with plant diversity. Human and environmental health is enhanced when livestock forage on phytochemically rich landscapes, but it is reduced when livestock forage on pastures with few species or eat high-grain rations in feedlots, and health is greatly reduced when people eat ultra-processed diets. The global shift away from eating phytochemically and biochemically rich foods to ultra-processed diets encouraged 2.1 billion people to become overweight or obese and ballooned the incidence of type II diabetes, heart disease, and cancer. We can reverse these trends by learning to grow and eat wholesome foods that nourish human and environmental health. To do so, producers and consumers must become mindful that the health and wellbeing of the plants and animals we eat to nourish our bodies ultimately determines the health and the wellbeing of our families and our species. We are members of nature’s communities. What we do to them, we do to ourselves.

Let Feed Be Thy Medicine: Plant Diversity and Herbivore Health

Plants turn dirt into soil and diverse mixtures of plants turn soil into homes for herbivores, omnivores, and carnivores below and above ground. Landscapes with complex assortments of grasses, forbs, shrubs, and trees are nutrition centers and pharmacies with vast arrays of phytochemicals. Nothing is more important for health through nutrition than landscapes with a variety of foods for herbivores, omnivores, and carnivores below and above ground.

The Gravelly Range in southwestern Montana is home to incredibly diverse plant communities. Walking in the meadows of the Gravelly Range, I’m struck by the fragrances emanating from the bouquet. Gazing upon those multi-colored meadows makes me keenly aware of how complex mixtures of plant species create homes for myriad communities of animals. The resulting diversity is a model for how to create health and resilience in human communities.

The health of humans is linked to the diets of livestock through the chemical characteristics of the plants they eat. That includes not only the energy, protein, minerals, and vitamins, but the tens of thousands of other compounds plants create, collectively termed phytochemicals. This rich pool of compounds—including terpenes, phenolics, and carotenoids—promotes health in herbivores and humans. Through their many biological properties—anti-microbial, anti-parasitic, anti-inflammatory, anti-carcinogenic, cardioprotective, and immunomodulatory—phytochemicals bolster health and protect livestock and humans against diseases and pathogens.

A palate attuned to a landscape enables animals including humans to meet needs for nutrients and self-medicate through three interrelated processes: 1) access to phytochemically and biochemically rich foods, 2) learning in the womb and early in life to eat wholesome foods, and 3) biochemically mediated flavor-feedback associations where cells and organ systems, including the microbiome, alter liking for foods as a function of their needs. While we typically think we like foods because they taste good, we aren’t aware, because flavor-feedback associations occur at a subconscious level, that foods taste good when they are good for us.

These processes converge in wholesome ways when livestock learn to eat complementary combinations of forages on phytochemically rich landscapes, but they are thwarted when livestock forage on pastures with few plant species or are fed high-grain rations in feedlots. They are utterly commandeered and undermined when people learn to eat ultra-processed diets.

Compared with simple plant mixtures or feedlot diets, nutritional (macro and micronutrients), physiological (blood parameters indicative of health), and immunological (immune function) status improves when livestock forage on diverse mixtures of plants. While 3 to 5 plants typically make up the bulk of the diet in our meals, animals often eat 50 to 75 plants in a meal. Historically, we did not appreciate that the nutritional and pharmacological properties of these minor components of the diet—best eaten in small doses—enable health. Livestock foraging on phytochemically rich landscapes do not require antiparasitic drugs and antibiotics, yet they have low levels of morbidity and mortality compared with animals forced to forage on pastures with few species or in feedlots. When mixtures of plants include tannin-containing legumes, cattle gain weight more efficiently and can reach slaughter weight as quickly as animals in feedlots.

Complex mixtures of plants also enhance environmental health. For example, synergistic effects among different kinds of phenolic compounds (tannins) in legumes such as sainfoin and birdsfoot trefoil reduce emissions of greenhouse gases—methane and nitrous oxide. Pastures with tannin-containing legumes also have less emissions of nitrous oxide from soils. Assortments of phytochemically rich plants create healthy communities with no need for mechanical, chemical, or biological inputs. Yet, rather than grow diverse mixes of plant species, industrial agriculture declared fossil-fuel-based warfare on land mechanically (ploughing soil), chemically (herbicides, pesticides, fertilizers), and biologically (GMO technology). We can reverse ecological damage—from tillage, fertilizers, herbicides, and pesticides used to grow and protect crops in monocultures—by integrating livestock back into mixed-farming systems that build fertility, organic matter, and water-holding capacity of soil and enhance biodiversity.

During the past 70 years, people have grown crops such as corn and soybeans in vast monocultures to feed livestock confined in feedlots under conditions that violate the five freedoms of animal welfare. Livestock are moved from familiar environments (home) to unfamiliar social and physical environments (feedlots), which violates their freedom from fear and distress. Animals in feedlots are daily fed the same total-mixed ration, so high in grain they experience nausea, which violates their freedom from discomfort. Like us, animals come to dislike foods eaten too often or in excess, which causes stress and food aversions. Like us, individuals vary in their food preferences due to experiences in the womb and early in life. In feedlots, they have no chance to self-select their own diets, which violates their freedom to express normal behavior, maintain individual health, reduce stress, and prevent disease.

Fine DiningTo counter the cumulative effects of grain-rich but phytochemically impoverished diets and unfamiliar, crowded conditions, animals are given antibiotics. Overuse of antibiotics in feedlots helped to create antibiotic resistance, a global health challenge. Our reliance on mass-produced meat also increases risk of pandemics. People in the U.S. now eat meat at nearly three times the global average. Reducing intake of meat from feedlots, while increasing intake of meat from livestock reared on phytochemically rich landscapes, could reduce what some consider excessive intake of meat and increase intake of biochemically rich meat, arguably of better quality.

Palates Link Plant Diversity, Herbivores and Humans

In Life in the Rocky Mountains, Warren Angus Ferris recounts his adventures along the headwaters of the Missouri, Columbia, and Colorado Rivers from 1830 to 1835. Back then, bison fed on diverse mixes of plants and Ferris’ crew fed on bison, as Indigenous people had done for ages. He notes bison in poor flesh were the worst diet imaginable, but as they became fat, no other meat could compare: “With it we require no seasoning; we boil, roast, or fry it, as we please, and live upon it solely, without bread or vegetables of any kind, and what seems most singular, we never tire of or disrelish it, which would be the case with almost any other meat.” His remarkable observations raise two questions: Why were bison in good flesh so nourishing? How is the flavor of bison affected by the phytochemical richness of their diets?

Human health is enhanced when livestock forage on phytochemically rich landscapes. The benefits to humans accrue as livestock directly assimilate some phytochemicals and convert others into metabolites that become muscle and fat, which in turn become biochemicals that can improve the health of humans. That is analogous to, but distinct from, benefits attained by eating phytochemically rich herbs, spices, vegetables, and fruits. This expanded pool of compounds—phytochemicals as well as metabolites produced by animals from plants—should be considered in attempts to understand health benefits to humans, such as dampening oxidative stress and inflammation linked with cancer, cardiovascular disease, and metabolic syndrome.

Diets influence the flavor and biochemical richness of meat. For instance, the flavor of blue grouse changes seasonally from early fall to winter as the birds switch from eating diets rich in grasses, forbs, and berries to diets higher in conifer needles, which give a subtle hint of terpene to the meat. Adding garlic or essential oils (terpenes) from juniper, rosemary, or clove to the diets of lambs and calves improves the flavor of their meat because each of these plant species contains a host of phytochemicals that benefit human health. Phenolic compounds (tannins) in herbivore diets improve the flavor of meat by reducing rumen bacteria that produce ‘off-flavors’ from skatole, a mildly toxic organic compound produced from tryptophan in the mammalian digestive tract. Among many other compounds, terpenes, phenolics, and carotenoids in herbivore diets can enhance the flavor and biochemical characteristics of meat and fat.

Herbivore diets also influence the flavors of milk and cheese. Phytochemically rich native pastures with diverse species of grasses, forbs, and shrubs produce complex combinations of terpenes and phenolics that positively influence the flavor of milk and dairy products. Plant diversity affects phenolics in cheeses such as L’Etivaz and Gruyere. Likewise, carotenoids in plants positively influence flavor and impart a yellow color to milk and cheese. Different compounds impart different flavors. Dairy cattle fed diets high in lipids produce milk with sweet, raspberry-flavors (γ-dodecalactone from oleic acid and γ-dodec-cis-6-enolactone from linoleic acid). Cattle fed diets low in lipids produce milk fat high in cheesy-flavored fatty acids and precursors of blue-cheese-flavors (methyl ketones) and coconut-peachy-flavors (δ-lactones).

herbs and. berriesWhen dairy cows dine on botanically diverse pastures, rather than a total-mixed ration of cultivated forages and grains, both the flavor and biochemical richness of their milk and cheese are greatly enhanced. Local people in Italy and France prefer the flavors of milk and cheese from dairy cows grazing on the botanically diverse swards. Consumers in those countries select cheeses based on season of production and the mix of plant species in particular landscapes, for example cheese made from high elevation summer pastures in the Alps. Their palates are linked —beginning in the womb and early in life—with soil, plant diversity, and herbivore diets.

People also prefer meat they are accustomed to eating. When Spanish milk/concentrate-fed lambs and British grassfed lambs were assessed by Spanish and British taste panels, both panels found British lamb had higher flavor intensity, but the Spanish panel preferred milk/concentrate-fed lambs, while the British panel preferred grassfed lambs. Families in Mediterranean and European countries—Greece, Italy, Spain, France, UK, and Iceland—also differ in preference for meat depending on whether they are familiar with lamb fattened on grain or pasture.

Most Americans are conceived and raised eating grain-fed beef, so taste panels of consumers, as well as experts trained to evaluate sensory features of meat, typically find grain-finished beef more palatable than grass-finished beef. Inconsistent ratings for grass-finished beef in studies reflect differing past experiences of consumers and differences in how animals are fattened. These studies show why the generic label “grassfed” tells a consumer little about how the phytochemical richness of an animal’s diet contributes to the flavor of meat or health, and they create an opportunity for producers to develop artisanal meats that link local soils, plant diversity, grazing practices, and environmental health with the palates of consumers.

Let Food Be Our Medicine: Plant Diversity, Livestock Diets and Human Health

Most humans are omnivores who satisfy their needs for nutrients with both plant and animal foods. Our needs for some nutrients are better met by plants, while our needs for other nutrients are better met by meat. Plant and animal foods thus function symbiotically to nurture human health. For example, plants can more readily meet needs for magnesium and plants are high in folate, manganese, thiamin, potassium, vitamin E, and a wide array of phytochemicals. On the other hand, meat provides high-quality protein (a balanced mix of all of the essential amino acids) and micronutrients such as iron, zinc, and vitamin B12. Eating 30 g of dry beef can meet daily needs of a healthy 70-kg adult human for taurine and carnosine and provide creatine, anserine, and 4-hydroxyproline to improve overall health of cells and organ systems.

While soy or pea proteins in plant-based faux meat alternatives have similar digestibilities to proteins in meat, they are not converted as efficiently into cells and organ systems. That is why, compared with plants, people need to eat less meat to meet needs for protein and some essential nutrients. That is also why, as Warren Angus Ferris experienced, meat obtained from bison fattened on phytochemically rich diets nourishes and satiates. That also helps to explain an apparent paradox: vegetarians report a lower desire to eat meat compared to omnivores, but brain scans of their neural activity reveal a craving for meat. Their verbal reports and neural scans highlight a conflict between inherent needs for nutrients in meat and acquired beliefs.

A common contention and belief is that eating too much red meat promotes oxidative stress and low-grade systemic inflammation—characterized by elevated plasma levels of pro-inflammatory markers such as C-reactive protein, serum amyloid A, tumor necrosis factor alpha, and interleukin 6—implicated in cancer, cardiovascular disease, metabolic syndrome, insulin resistance, and type 2 diabetes. These diseases allegedly are due to ingesting excesses of compounds such as heme iron in red meat and nitrate/nitrite in processed meat.

Inferring the health impacts of dietary patterns from associative (epidemiological) studies is problematical due to multiple confounding factors, many of which are not known or taken into account, including how the phytochemical diversity of herbivore diets affects the biochemical characteristics of meat and milk. Studies that find inverse associations between eating red meat and health do not distinguish between meat from livestock fed high-grain diets in feedlots and livestock foraging on phytochemically rich mixtures of plants. Nor do these studies address how herbs, spices, vegetables, and fruits eaten in a meal with meat can enhance health.

Eating any food causes a transient inflammatory response following the meal. When people eat meat and fat, protein oxidation and lipid peroxidation cause inflammation. Yet, when herbivores eat phytochemically rich diets, compounds in their diets protect meat and dairy from the protein oxidation and lipid peroxidation that cause inflammation. Phytochemical richness may be one reason why people have decidedly lower inflammatory responses following a meal of meat from kangaroos foraging on diverse mixtures of native plants (a traditional hunter-gatherer meat meal) compared with a meal of meat from wagyu cattle fed high-grain diets in feedlots (a modern meat meal). Despite the potential significance of these findings, no other studies have assessed how the phytochemical richness of forages herbivores eat affects the phytochemical and biochemical richness of meat and fat and how that affects inflammation.

Historically, Native Americans used wild berries—such as serviceberry (Amelanchier alnifolia), highbush cranberry (Viburnum trilobum), silver buffaloberry (Shepherdia argentea), and chokecherry (Prunus virginiana)—for food and medicine. They also combined berries with dried meat and fat to make pemmican. Eating wild berries (and some vegetables and fruits) can reduce risks of type 2 diabetes, cardiovascular disease, cancer, and all-cause mortality. Wild berries contain phytochemicals that protect against metabolic syndrome, diabetes, diabetic microvascular complications, hyperglycemia, and inflammation. Phenolic compounds in berries (proanthocyanidins, anthocyanins, and phenolic acids) can moderate high levels of glucose in blood (hyperglycemia) and inhibit chronic inflammation associated with disease. Carotenoids inhibit aldose reductase, an enzyme involved in diabetic microvascular complications.

Eating processed meats is associated with higher incidence of colorectal cancer, allegedly due to compounds such as nitrates used in processing. People who eat processed meats high in nitrates as well as large amounts of vegetables high in nitrates—beets, celery, lettuce, radishes, and spinach—may have greater risk of cancer, though some contend eating modest amounts of foods enriched with nitrate and nitrite provide health benefits with little risk. Yet, people who eat traditionally processed meats in Morocco do not have increased risks of colon cancer. One explanation is that the complex combinations of herbs and spices used to process meats, such as Kaddid in Morocco, promote health. Kaddid is ribs of beef, lamb, or camel cut in thin slices mixed with olive oil, herbs and spices such as cumin, garlic, coriander, salt, vinegar.

Cooking hamburger can generate reactive oxygen species that cause oxidative stress and inflammation associated with heart disease and cancer. However, adding polyphenol-rich antioxidant spices such as oregano and rosemary to hamburger enhances flavor and reduces levels in meat, plasma, and urine of malondialdehyde (MDA), a marker for oxidative stress. Likewise, drinking polyphenol-rich red wine while eating red meat cutlets reduces by 75% the levels of MDA, which can rise by 3-fold after a meal of cutlets alone. That is one reason why drinking a glass of red wine complements a meal with steak.

Grillin!Phytochemically rich herbs and spices added to foods enhance palatability, satiation (when a meal ends), and satiety (length of time between meals). Why? Because herbs and spices are good for the health of cells and organ systems. They can counter the seven hallmarks of cancer: selective growth and proliferative advantage, altered stress response favoring overall survival, vascularization, invasion and metastasis, metabolic rewiring, an abetting microenvironment, and immune modulation. Little wonder they complement meat and vegetable dishes and that people eat less of foods that provide greater sensory pleasure from added herbs and spices than they do of a blander version of the same food. These flavor-feedback relationships occur as cells and organ systems, including the microbiome, are nourished by phytochemicals in herbs and spices. Ironically, no research has assessed how palatability, satiation, and satiety are affected by the phytochemical and biochemical richness of meat or of meat with herbs and spices.

Rather than growing and eating wholesome combinations of phytochemically and biochemically rich foods, our ailing society (adults in the U.S.: 75% overweight or obese, 50% pre-diabetic or diabetic, only 12% metabolically healthy) succumbs to the allure of multimillion-dollar supplement industries that claim to be the foundations of health. We are captivated by the allure of their recommendations to take supplements alleged to improve our health—our single-nutrient obsession. Omega-3 fatty acids are an example. Human health is enhanced as the phytochemical and biochemical richness of our diets increases from individual omega-3 fatty acids, such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), to diverse mixtures of omega-3 fatty acids, to mixtures of wholesome foods such as oily fish, meat and milk, vegetables and fruits that contain tens of thousands of bio-active compounds in addition to omega-3 fatty acids. That is why increased intake of fish, as opposed to supplemental omega-3s, is more consistently associated with lower inflammatory responses in people with metabolic syndrome.

Our understanding of how diet affects health is limited to a mere 150 nutritional components, including energy, protein, minerals, and vitamins. These compounds are a fraction of the more than 26,000 biochemicals in the human foodome. Learning in the womb and early in life to eat phytochemically and biochemically rich combinations of foods, not single compounds, is foundational in health. Sadly, during the past century, we’ve extracted the culture from the landscape, the diet from the culture, the whole foods from the diet, and the compound from the food and we now have no notion whatsoever of how palates link peoples with landscapes.

During the past 70 years, we incentivized eating ultra-processed foods and disincentivized eating fruits and vegetables. To our detriment, the flavors of ultra-processed foods have become irresistible as the food industry learned to link familiar flavors with a blast of energy from refined carbohydrates to condition strong preferences for their products. On the other hand, the flavors of fruits and vegetables have become bland and unpalatable because their phytochemical richness has declined from 10% to 50% during that same time. We selected varieties for production, growth, appearance, and sweetness rather than phytochemical richness. By contrast, wild fruits and vegetables still contain complex mixture of different phytochemicals that nourish and satiate. In addition, we fertilize and irrigate crops, which often favors growth at the expense of phytochemical richness. For instance, phenolics and terpenes are typically higher in plants grown on drier sites than on wetter sites and higher in plants grown on less fertile sites than on highly fertile sites. Finally, fruit is picked green, shipped, and ripened with ethylene gas—the fruit-ripening hormone—rather than ripened to full phytochemical richness on the vine. These same issues apply to beef and chicken: we selected animals that grow quickly on feedlot diets that diminish favor because they are utterly lacking in phytochemical richness. Phytochemical richness also affects bees and honey as well as chickens and eggs.

The global shift away from eating phytochemically and biochemically wholesome diets to ultra-processed foods encouraged nearly one third (2.1 billion) of the human population to over-eat and become overweight or obese. This was illustrated in a study where people fed ultra-processed foods (white bread, sugary cereals, and reconstituted meats) ate an additional 500 calories daily compared with people offered wholesome foods (e.g., fresh fruits and vegetables, whole grains, and unprocessed meat), even though the two diets were matched for energy, protein, sugar, fat, sodium, and fiber. Compared with wholesome foods, ultra-processed foods do little to induce satiation (physical and biochemical processes that bring a meal to an end) or satiety (processes that inhibit eating between meals). Thus, people overeat and gain weight.

Steadily embedding ultra-processed foods in our diets for the past 70 years has been an experiment of sorts. Replicate this study over generations—in the womb, childhood, teen, and adult years—and we now have a pandemic of chronic diseases linked with excess weight. Given modern dietary trends, it is foolish to think that introducing more ultra-processed foods (faux meat) in our diets will reverse the burden of diet-related diseases. Our past experiences provide a good idea of the likely outcome: a sustained rise in intake of ultra-processed foods, which is now greater in young vegetarians and vegans than in meat eaters, and diet-related diseases. Ironically, champions of faux meat purport to address issues of human and environmental health, created in part by industrial agriculture, with more ultra-processed foods reliant on industrial agriculture.

Conversely, circumstantial evidence supports the hypothesis that plant diversity—manifest as plant diversity and phytochemical richness of landscapes—affects the biochemical richness of meat and dairy as well as human and environmental health. Future studies should enhance understanding of how plant diversity influences flavor and biochemical richness of meat and dairy; how phytochemically rich herbs, spices, vegetables, and fruits complement meals that contain meat; and how the aforementioned affect the health of people and the planet.
My colleagues (Stephen van Vliet, Scott Kronberg, Pablo Gregorini) and I are comparing faux meat, meat from feedlots, and meat from animals eating phytochemically rich diets. To do so, we are conducting: 1) metabolomic analyses that assess the phytochemical and biochemical richness of meat and dairy; 2) feeding trials to assess inflammatory responses of people, as researchers in Australia did when they compared postprandial inflammation in people fed meat from kangaroos and wagyu cattle; and 3) clinical trials to assess satiation, satiety, inflammation, and health.

Findings from these studies will achieve three ends. First, they will illustrate relationships among liking for the flavor of meat and dairy, the ability of phytochemically and biochemically rich meat and dairy to satiate, and the value to cells and organ systems, including the microbiome, of phytochemically and biochemically rich foods for humans. Second, they will underscore how we can create human and environmental health by growing and eating wholesome foods, rather than treating the symptoms of diet-related diseases. Finally, they will help people appreciate how palates link soil and plants with animals and environments.

Palates linked with wholesome foods would obviate the need for much modern nutrition and medicine. Health through nutrition was, of course, the point Hippocrates made roughly 2,400 years ago. That was also the point Roger Williams made in Biochemical Individuality, first published in 1956, when he discussed the implications of individuality for medicine and nutrition. He noted correctly that treatments (and diets) will need to be tailored to individuals and the importance of “body wisdoms” concluding “If this wisdom were universally possessed by all members of the human family, there would be no need to study nutrition and the only deficiency diseases would be those induced when suitable foods were not available.”

Unfortunately, nowadays most people are sick as a result of nutrition and medicine not appreciating the wisdom of the body and how that is linked with healthy soil, plant diversity, and the biodiversity of landscapes. These systems in conjunction with industrial agriculture have created the health crises whose symptoms medicine and pharmacy now treat at great expense.

During the past century, farmers and ranchers valiantly attempted, using the best intent and knowledge available during that time, to feed a human population that has burgeoned from 2 billion to nearly 8 billion people—a global population that is increasingly exceeding the carrying capacity of the planet. In the process, industrial agriculture and food processing have inadvertently wreaked havoc on soils, plant diversity, populations of animals below and above ground, and humans. We are now experiencing a pandemic of diet-related diseases from obesity at one extreme to malnutrition at the other end of the spectrum, all signs of societies detached from the landscapes that sustain our wellbeing. We can reverse these trends in part by integrating livestock back into mixed-farming systems that can provide wholesome meat and produce to nourish populations while building the health of the ecosystems that nurture us.

We made an art form of dining, but tabled the larger questions. Eating is participating in endless transformation as plants and animals are killed and eaten. As I eat, energy and matter in someone—plants and animals alike are conscious and sentient—becomes this entity I call “me” which will, in the flicker of a cosmic eye, return to Earth as soil, plants, and animals. In pondering this mystery, we may realize that all life is sacred. The wellbeing of the plants and animals we eat as food to nourish our bodies determines our health and that of the communities that sustain life on this planet. We’ve forgotten that we are members of nature’s communities: what we do to them, we do to ourselves. Only by nurturing them can we nurture ourselves. And we do that by declaring love—not war—on one another and the communities we inhabit.

Further Reading

This article is derived from the book Nourishment: What Animals Can Teach Us about Rediscovering Our Nutritional Wisdom and a subsequent article (also derived from Nourishment), which was published in March of 2019 in Frontiers in Nutrition titled Is Grassfed Meat and Dairy Better for Human and Environmental Health? That article is available for free online: https://www.frontiersin.org/articles/10.3389/fnut.2019.00026/full.

For additional details and a complete list of scientific references please refer to that book and article.

About the Author

Fred Provenza grew up in Salida, Colorado, working on a ranch and attending school in Wildlife Biology at Colorado State University. He is professor emeritus of Behavioral Ecology in the Department of Wildland Resources at Utah State University where he worked for 35 years, directing an award-winning research group that pioneered an understanding of how learning influences foraging behavior and how behavior links soil, plants, herbivores, and humans.

He is the author of three books, including Nourishment: What Animals Can Teach Us about Rediscovering Our Nutritional Wisdom; Foraging Behavior: Managing to Survive in a World of Change; and The Art & Science of Shepherding: Tapping the Wisdom of French Herders (co-authored with Michel Meuret). He has published over 300 research papers in a wide variety of scientific journals. He has been an invited speaker at over 500 conferences.

Mast Cell Activation Syndrome:

Ellen Kittredge in Peru

Ellen catching a few rays to bolster her immmune system at Machu Picchu

This article is both a personal story of a chronic health situation that I’ve been able to heal through food and lifestyle choices, and a story of the mismatch between how our immune system has evolved to function over countless eons and the very real challenges it faces in today’s day and age.

Immune dysregulation is an epidemic that is only beginning to come to light. I believe it will get much more attention over the coming years, and deservedly so. The ongoing COVID-19 pandemic has brought many things to the forefront of our awareness, one of the most obvious being that it is past time to look more deeply into our immune function, especially as it relates to pathogens and environmental pollutants, stress, poor diets and the other ills of our modern society.

When the immune system becomes dysregulated or hypervigilant it begins to display a pathological loss of tolerance.

While I have not had COVID-19, I have struggled with a pretty serious case of immune dysregulation, which started in the fall of 2018, and which has many factors that I think will be of interest to this readership.

I’d like to tell this story as part of this collective of articles on Food as Medicine because it’s a story of remarkable healing through appropriate dietary and lifestyle changes, from a condition which I thought was going to kill me at various points in the past year and a half.

My story is also connected to an early-life diagnosis with Lyme Disease and the way in which this disease causes immune dysregulation, apparently, for some of us, for life.

Additionally, the foods and natural supplements for the condition I realized I had which help to support the immune system to normalize from its dysregulated state are the same things that can be supportive in protecting against the symptoms connected to COVID-19!!

Finally, my story is a great example of the truth of bio-individuality, a really important concept when we discuss food as medicine: i,e, we need to listen deeply to our intuition and inner knowing about what foods/lifestyle choice and activities work for us.

Canary in cageIn the worst of the times, as my health was declining and I was searching for answers, which was much of 2019, I resolved to myself many times that once I figured out what was going on for me I would share it, in the hopes that my discovery might help others who struggle with unresolved chronic health issues, which don’t seem to be helped by much of anything, even by eating really clean and healthy foods and avoiding the common food allergens/toxic foods.

Luckily this aspiration I have had is now coming to fruition, as I’ve successfully peeled back the layers of a health condition that has its roots in both genetics and environment, but I would say is most linked to the many and increasing physiological stressors present in our increasingly toxic world.

Please note that as I am not a doctor, none of what I share in this article is intended to be medical advice or be a substitute for professional medical counsel, treatment or diagnosis. Please always consult with a health care professional when it comes to treatment options for any condition.

People like me, who are the “canaries in the coal mine” of modern day society often express health conditions before others do in response to changes in environment.

‘Like a canary in a coal mine’ is, according to Wiktionary: An allusion to caged canaries (birds) that miners would carry down into the mine tunnels with them. If dangerous gases such as carbon monoxide collected in the mine, the gases would kill the canary before killing the miners, thus providing a warning to exit the tunnels immediately.

And so, this allusion means: “Something whose sensitivity to adverse conditions makes it a useful early indicator of such conditions; something which warns of the coming of greater danger or trouble by a deterioration in its health or welfare.” – Wiktionary

Chemical sensitivity is one of the many symptoms of this condition.

And as I have discovered in my research, hyper-sensitivity to fresh paint, perfumes, scented candles, diesel exhaust, and other VOCs is a sure-fire indicator of this condition I have found myself dealing with.

Sensitivity to mold is another.

Reacting poorly to extremes of heat and cold is another, as is an inability to handle much exertion/exercise without turning red, flushing and feeling unwell after exercise.

In my home we have a “canary test” for any cleaning products, personal care products, etc brought into the home. If I sniff a cleaning product and pretend to keel over and die, it’s a no/no.

Many people who have this condition are the ones who’ve been told by their doctors, “It’s all in your head”, as their doctors have not been able to get to the root of the many symptoms presented to them, and have instead given up on their patients and sent them home without answers.

Mast CellI work with these sorts of clients, and I must say that while I wouldn’t wish the last year and a half of challenging symptoms on anyone, I am so glad to know that a pathway of healing is possible, as I have resolved the vast range of symptoms that I had; symptoms which are becoming increasingly common for many, and which I think will only become more well understood and diagnosed in the years to come.

So what is this condition I’ve found myself learning about in the most personal of ways this past year and a half?

It’s called Mast Cell Activation Syndrome, with a related condition of Histamine Intolerance

Mast Cell Activation Syndrome or MCAS involves a heightened response in the immune system, specifically in the mast cells of the immune system. When triggered by a wide range of irritants, mast cells will release various chemical components including histamine in reaction to something as simple as a small whiff of fragrance, exposure to mold, certain medications or any of the other many triggers listed below.

What then sets off in one’s body is a host of symptoms ranging from headaches to nausea, to vomiting, to anxiety, to full body pain, to coughing and wheezing, to skin rashes/flushing, to depression (and much more, the most severe symptom being anaphylaxis).

All of these symptoms have the same cause: An increase of histamine (and other chemical components) released by the mast cells of the immune system which are reacting to the irritant by sending out a cascade of chemicals into the tissues of the body as if the irritant was a virus or bacteria or other pathogen that needed to be immediately killed.

Basically, the mast cells over-react and then one feels a range of symptoms due to this over-reaction. What can happen for a person with MCAS is that there are virtually constant triggers of this release of histamine, because there are so many things that cause this release, and one ends up in a state of fairly constant inflammation.

Because the range of symptoms is so varied and seemingly unrelated, and can affect every major organ system of the body (because mast cells live all over the body) it can be very hard to understand what’s going on and is also difficult to diagnose.

“Some experts believe as many as 14 to 17 percent of the US population have MCAS, which is one out of every six to seven people. It’s also been estimated to take up to 10 years to reach a MCAS diagnosis. This is mostly due to the lack of awareness surrounding MCAS.” – Dr Bruce Hoffman

My symptoms have included:
– menstrual irregularities including extended periods of heavy menstrual flow
– long bouts of coughing and wheezing with my lungs filling with fluid
– chronic migraines
– full body pain
– joint pain in all the joints of my body
– digestive distress
– anxiety – seemingly appearing out of nowhere with no obvious trigger
– depression – happening quickly with no obvious trigger
– low energy (unrelenting fatigue is a very common symptom)
– skin rashes, rosacea and heat sensitivity
– cold sensitivity
– inability to handle exercise (i.e. exercise triggered worsening of symptoms)
– hair loss
– memory loss, inability to think clearly, difficulty with word retrieval

Throughout this past year and a half I have had very cyclical yet hard to track episodes of symptoms worsening and then getting better. Symptom cycling is another very common occurrence with MCAS and has to do with the range of triggers and also the histamine intolerance and the way that food plays a significant role with the expression of symptoms (more about that below).

Today, while writing this, I feel well and have felt well fairly consistently, with small bouts of recurrence of some symptoms, for the last three months. Symptoms worsen around my menstrual cycle because of the inflammatory nature of that process…and so I have to be extra careful with diet and stress management during that time. Consistency with what I am doing for myself with my diet, supplements, and lifestyle changes over the last 7 months has made all the difference.

In addition to what I’ve shared about my symptoms of this condition, Dr Hoffman shares a few more of the: Most Common General Symptoms:
“I’ve been sick for as long as I can remember”
“I overreact to bee stings, mosquito bites, penicillin and most medications”
“I can’t take a full breath”
Tinnitus/ringing in the ears from a young age
Vomiting as an infant
Dermatographism-a red line appearing on the skin when scratched with a blunt object
Frequent infections, cold, viruses, gut viruses as an infant, adolescent or adult
Frequent fevers
Edema-”water” accumulation in different parts of body
Food, drug, and chemical intolerances (especially fragrances). This is a very common symptom which may be exacerbated by phase 1 and phase II liver detoxification problems as identified by gene testing
Sense of being cold all the time
Decreased wound healing
Hypersensitivity to much in environment, including medications
Weight gain or loss
Heat intolerance
Frequent family history of cancer, especially intestinal or bone marrow (hematologic)
Generally feeling inflamed
Generalized lymphadenopathy (enlarged lymph nodes)

For those who are visual learners, below is a great visual from Dr Becky Campbell’s website, showing a few of the more common symptoms of MCAS.

For folks with this condition, often only some of these reactions will be present. Sometimes many or all will express.

I am still not sure what triggered the onset of this condition for me, though most likely it was stress, albeit “good stress”, resulting from a very packed international teaching and travel schedule in 2018, combined with a lot of travel in the previous couple years.

But this condition has a genetic component as well. The relatively common gene mutation known as MTHFR can make one more susceptible to developing MCAS.

And Lyme Disease is another factor as I also found out in my research. According to some doctors, a significant subset of Lyme Disease patients develop MCAS. Many people who’ve had Lyme end up never feeling fully well again in their lives. I had Lyme Disease when I was 10. My mom has said my health and vitality was never the same after that. Now I know why. Seems I’ve likely had MCAS to some extent, though mostly it’s been relatively mild, for perhaps the last 30 years, or maybe, like many with it, since birth.

In general it seems to worsen or become more obvious after age 40 or so, and seems to be slightly more common in women, though it can affect anyone of any gender and any age.

For me, chronic migraines (a very common symptom of MCAS) started at age 13, and I’ve never been able to get to the bottom of them, though now I am very hopeful and am seeing much progress in this area as well as every other areas of my health in the last couple months.

Many of the other symptoms of MCAS I’ve only struggled with in times of acute stress, which makes sense, because stress (specifically through the activation of corticotropin hormone) is a major trigger for MCAS.

Stress directly activates mast cells, causing them to release histamine and other chemical messengers. Adrenal stress/fatigue, a more recently named condition that has been linked, like MCAS, to lifestyle and environment triggers, has many of the same symptoms as MCAS.

I’ve become so aware of what a trigger stress is for the symptoms, that I’ve had to let go of a lot of commitments and really slow down in many ways this last year and a half in order to heal. Stress was literally killing me…

Also, looking back I can see now that it’s the times I’ve had mold exposure that have always triggered symptoms such as the ones listed above. If you have a strong sensitivity to mold you might want to look into MCAS.

Food can heal. Food can harm. With treatment of MCAS, food choices are really important, and the recommendations below may not be what you would expect!

Histamine Intolerance: How Food Plays A Role

Another very important part of the equation for this condition is something called histamine intolerance. The reason MCAS can be so difficult to diagnose is that one of the challenges folks with MCAS end up experiencing is that they become sensitive to any foods high in histamine, as well as foods that block the enzyme in the gut (DAO) that helps to break down dietary histamine.

Histamine is in many foods, and is actually found in some of the healthiest foods we might consider eating like spinach, fermented veggies (sauerkraut, kimchi, etc.), kefir, strawberries, peas, tomatoes and citrus fruits.

Being pretty health conscious and eating pretty well most of the time, I‘ve always fairly consistently eaten many of the healthy foods listed below, thus being unable to get off the merry-go-round of symptom cycling.

Below is one complete list of food to avoid if you are Histamine Intolerant.

Please note that treatment involves avoiding these foods for a period of time, but as the body heals, many of these foods can be brought back into the diet, as I am now starting to do after about 7 months of cutting these foods out of my diet.

Histamine intolerance is not a food allergy. It’s simply the inability to break down histamine in the gut. Because it’s not a food allergy, oftentimes testing for food allergies will not provide any helpful information, even though one is reacting to foods…just not in a way that can be picked up by food allergy testing!

Because folks with MCAS often have gut health imbalances due to the chronic inflammatory nature of the condition, over time one’s ability to break down histamine can lessen or disappear completely. Also, NSAIDs, some antibiotics and other medications can directly inhibit the DAO enzyme. This means that someone taking NSAIDS over time might start having reactions to high histamine foods, because the NSAIDS had been slowly destroying the body’s ability to break down histamine through damaging the gut and the bacteria that help to create DAO in the gut. It’s a vicious cycle, and can be hard to get off of without an act of Grace.

I am hoping that by writing this article today and by sharing this with you all, that this information might be the Grace that you’ve been waiting to experience, or that perhaps in sharing this information with a friend or family member whom you know has some of the symptoms above, that this might be the answer that they’ve been waiting for.

The odds are that 15% of you reading this have MCAS and possibly the related condition of histamine intolerance, and could benefit greatly from lifestyle changes, dietary changes and appropriate supplementation.

Because, now it’s time for the Good News!


While MCAS may not be something that is seen to ever be curable, it is something that can be lived with and managed and one can find that they can live a perfectly healthy, happy and normal life with perhaps just a certain amount of extra care and consideration in certain areas of one’s life.

I started treating my MCAS and histamine intolerance in early February of this year, after (through an act of Grace) a colleague and fellow health practitioner shared with me that she suspected this is what I had going on. The symptoms matched, so I started my research.

A combination of careful adherence to a low histamine diet, appropriate supplementation with certain vitamins that are mast cell stabilizers (i.e keep the mast cells in my immune system from going into overdrive mode and reacting to everything), and ridding myself of any and all sources of stress, seems to have done the trick! I am now able to eat a normal diet, and am finding myself much less sensitive to some of the more common triggers of MCAS like extremes of heat and cold, sun and insect bites. Sensitivity to perfumes, diesel, paint, and mold remains at a high level.

For a little more on this condition, below are some common conditions that may have MCAS as a factor in the expression of the condition/illness.

As you will see, there are MANY common dis-eases on this list!

So please keep reading…

This list also come from Dr, Hoffman, and the full article can be found here (https://hoffmancentre.com/mast-cell-activation-syndrome-histamine-immune-system-runs-rampant/)

Conditions Associated with Mast Cell Activation Syndrome

Because MCAS is a chronic, multisystem, multisymptom condition with an inflammatory theme, it’s been associated with a number of conditions and diseases, including (this is not an exhaustive list)
Irritable bowel syndrome and gut dysbiosis
Asthma and allergies
Autoimmune diseases (such as lupus, rheumatoid arthritis, and Hashimoto‘s)
Celiac disease
Parasite infections
Skin conditions such as eczema and psoriasis
Food intolerances and allergies
Gastroesophageal reflux (GERD)
Infertility and endometriosis
Chemical and medication sensitivities
Postural orthostatic hypotension (POTS)
Fungal infections
Multiple Sclerosis
“In general, inflammation accompanies MCAS and most of its coinciding or associated illnesses. If you are struggling to get one of these illnesses under control, there’s a possibility MCAS could be causing further complications.

It’s a good idea to check for MCAS if you have any of the above conditions and vice versa.”

Whew! That’s a lot. I know. It’s taken me the last 7 months to start to digest this material myself! For further reading, I recommend several websites below. Many of these are doctors or health practitioners that have struggled with and subsequently “healed” MCAS and histamine intolerance in themselves!

Please note that because of the varying nature of symptoms and the lack of full consensus in the medical community on which foods are high in histamine, you will find conflicting information listed on various websites. It’s really helpful to work with a qualified health care practitioner who can help to guide you step by step with appropriate treatments. Each person is different in their expression of symptoms, and their pathway to healing will look different.

A few of the nutrients that I have found invaluable for me are luckily the same things that are super supportive of a heathy immune system AND are great for stress reduction. Please don’t start taking supplements without consulting with a health care practitioner, especially if you are taking medications, as there are sometimes contraindications.

Some of the nutrients you will want to focus on increasing in your diet (and/or consider supplementing with with appropriate medical guidance) for MCAS include:
– Quercetin,
Vitamin C
Vitamin D
Liver supportive herbs and nutrients

In addition its incredibly important to be taking the correct probiotic. Some beneficial bacteria CREATE histamine in the gut. For a normal healthy person who can break down histamine, that’s not a problem! For someone who has an inability or lessened ability to break down histamine, it becomes a big problem. Seeking Health, created by Dr Ben Lynch, who suffered with MCAS himself for 35 years before diagnosis, has created some wonderful probiotic formulas for folks with MCAS/Histamine Intolerance.

Check out Dr. Ben Lynch’s website here: (https://www.seekinghealth.com) If you want to go the route of genetic testing, which can be very supportive for a clear diagnosis, I would recommend working with him in this arena as well.

Dr. Becky Campbell is another MCAS sufferer who was able to “heal” her condition after changing her diet and getting the right nutritional support. She also healed herself from a low thyroid condition, which is very linked to MCAS/Histamine Intolerance. She also helped me put the dots together around Interstitial Cystitis, which is a condition of inflammation in the bladder which causes pain and discomfort for many. IC is caused by mast cells releasing histamine. She has written a very simple and easy to follow guidebook and cookbook to support the healing of MCAS and histamine intolerance. Her focus is more Paleo, and so her book, with 50 recipes in it, is an invaluable resource, especially if you are keen on a paleo-type diet. More about her approach to healing this condition here: (https://drbeckycampbell.com/mast-cell-disorder/)

One of the earlier researchers of this condition is someone named Yasmina Ykelenstam. She suffered with MCAS/Histamine Intolerance for 20 years before getting a diagnosis, and then made it her life mission to help others with the condition. Sadly she died a couple years ago from cancer, which is more common with MCAS sufferers, and is another one of the reasons I feel so compelled to share this information in this article. Her website is full of great resources and she has a cookbook that you can purchase that is more vegetarian-friendly, if that’s a dietary approach you follow. Check out the extraordinary wealth and depth of her research and info here (https://healinghistamine.com)

Dr Hoffman, at the Hoffman Centre for Integrative Medicine is another wealth of resources and information about MCAS and histamine intolerance and is definitely on the leading edge of research into this condition. He shares about both the medicalized/medication route to take with treatment as well as the dietary/supplement route. You can access his resources here (https://hoffmancentre.com/treatments/mcas/).

I’ll leave you here with these websites of trusted practitioners, and my strong recommendation to do further research if anything in this article set off some lightbulbs for you in re: to health challenges you may have.

The good news is, this is not only treatable, but, as I mentioned, there are many who have recovered fully from this, and are living normal healthy lives again (some of them the doctors mentioned above).

I am well on my way to full recovery myself, and am thanking all the many factors that came together to allow for the Grace to descend into my life so that I can be sharing this success story in the making with you right now.

I hope that this article may have both inspired in you a renewed faith in the power of food as medicine, perhaps made you curious about which foods are YOUR medicine, and if you or someone you know has been struggling with a chronic unresolved health condition, that this article may have some answers. Let’s keep nourishing ourselves with the foods that heal, so we can live our lives as fully and joyfully as possible in this world!

Ellen Kittredge
Certified Health Coach, with additional certifications in Functional Nutrition

The Power of the Plate:

POTP Different Approaches“Let thy food be thy medicine and thy medicine be thy food.”
Hippocrates, 400 BC

“The health of soil, plant, animal and man is one and indivisible.”
Sir Albert Howard, 1947

“People are fed by the food industry, which pays no attention to health, and are treated by the health industry, which pays no attention to food.”
Wendell Berry

If you have touched food, you have been touched by soil. Soil is amazingly complex, and yet it’s simple. Most soil biota are one-celled creatures—simple—but they are present by the billions in just one teaspoon of topsoil and create complex networks and interactions to support life on earth. Yet with all the power of modern science, we still don’t completely understand how soil functions or the depths of its importance to our health and wellbeing.

We—a group of farmers, soil experts, doctors, and food service providers—have explored the connection from many angles. The scary truth is that we’re losing and degrading topsoil rapidly around the world at the same time that chronic disease rates are skyrocketing, and our children are predicted to live shorter lives than their parents. Though the connections between soil and human health are complex and often indirect, the two are linked. It doesn’t only matter what we eat, but how our food is produced. We can continue with an industrial food system dependent on toxic chemicals that harm soil and the environment and produces increasingly less nutrient-dense food. Or we can recognize the profound link between food and health, shift to less toxic, more regenerative farming practices, and finally connect our farming, food, and healthcare systems. How we take care of the soil is a reflection of how we take care of ourselves and mankind.

We propose a new vision, called Regenerative Healthcare, in which farming and healthcare work together to inform a prevention-based approach to human and environmental health. Rather than relying on toxic chemicals to solve agricultural issues and pharmaceutical intervention to manage disease, Regenerative Healthcare aims to prevent disease through an organic, whole-foods, plant-forward diet that begins on farms that work in harmony with nature. Conventional agriculture has been a critical tool in previous decades; however, the consequences of its hyper-focus on yields, the threat it poses to biodiversity, and its reliance on polluting, nonrenewable resources have limited its promises. The solution lies in a new way of farming—regenerative organic agriculture—that addresses the ecological and health challenges we face today, and a new type of healthcare—regenerative healthcare—that harnesses the power of nutritious food and lifestyle to suspend, reverse, and prevent disease.

Defining Regenerative Healthcare

A system in which farming and healthcare work together to inform a prevention-based approach to human and environmental health. Rather than relying on toxic chemicals to solve agricultural issues and pharmaceutical intervention to manage disease, Regenerative Healthcare aims to prevent disease through an organic, whole-foods, plant-forward diet that begins on farms that work in harmony with nature.

Our current food system is adept at producing cheap, hyperpalatable, nutrient-poor foods. We’re highly efficient at growing, processing, and distributing commodities like wheat, corn and soy, many of which end up as livestock feed, ethanol, and refined, processed foods. Agricultural intensification and consolidation have enabled the mass-scale production of inexpensive animal products through confined animal feeding operations (CAFO). Despite the fact that research overwhelmingly supports the adoption of whole-food diets high in nutrient-dense fruits and vegetables, only 0.9% of adolescents, 2.2% of adult men, and 3.5% of adult women met the daily recommended needs for fruits and vegetables in 2009. Sonny Ramaswamy, director of the USDA’s National Institute for Food and Agriculture from 2012-2018, stated that, “If Americans were to actually go ahead and jump into consuming the amount of fruits and vegetables recommended, we’d be hard-pressed to meet that demand.”

Simply put, our farming systems aren’t aligned with what science has identified as the best foods for proper health. By emphasizing a small number of crops for export and animal feed; subsidizing and insuring those crops; and providing only limited research funding and resources to fruit and vegetable production, our current farming system hinders effective dietary change and limits access to health-promoting food. Chemical-intensive, industrial farming has also contributed to declines in nutrient-density and threatens human health through exposure to toxic pollutants.

At the same time, our medical system is overburdened attempting to treat lifestyle-related diseases with pharmaceutical intervention rather than nutritional and lifestyle changes. As a nation, the United States spends approximately 18% of its Gross Domestic Product—$3.6 trillion—on healthcare, a number projected to reach nearly $6 trillion by 2027. That’s the highest per capita healthcare expenditure of any nation in the world, yet this massive investment hasn’t paid off in improved health outcomes or longevity. The United States ranks near the bottom on many health measures, including life expectancy, obesity, and prevalence of chronic disease when compared to similar high-income countries that spend significantly less per capita on healthcare services. If current trends continue, the Federal Congressional Budget Office predicts that Medicare and Medicaid alone will devour 20% of GDP by 2050. Although the benefits of nutrition for health and thus reduced healthcare costs are well-established, medical students receive fewer than 25 hours of nutrition education during their four years of medical school.

Now is the time for change. By integrating our food and healthcare systems, emphasizing nutrition and lifestyle choices that prevent disease, and transitioning to regenerative organic farming on more cropland, we could radically improve the future of human health.

The Current State Of Human Health

Today, six out of ten American adults have a chronic disease, and four of ten have more than one chronic disease. Globally, more than 71% of deaths annually are related to non-communicable, lifestyle-related diseases that include cancer, type 2 diabetes, chronic lung disease and cardiovascular disease. Based on current global trends, 6 of the top 7 causes of death in 2040 (including heart disease, stroke, Alzheimer’s and diabetes) will be directly related to our lifestyle choices and diet. And while total life expectancies have increased since 1950, healthy life expectancies and quality of life have not. Not only does that mean diminishing quality of life for citizens, it adds to the socioeconomic burden of caring for an ailing, aging population. In communities around the globe, an average of 10 years of total life expectancy are spent in poor health. The top three risk factors globally relating to years of life lost are high body mass index, hypertension and high blood sugar—all conditions related to diet.

Despite greater healthcare access and advanced technology, Americans are not exempt from these statistics. In the United States, the wealthiest country in the world, approximately 92 million Americans are living with coronary artery disease or the consequences of a stroke, illnesses that are largely preventable and reversible with optimal nutrition and healthy lifestyle choices. The prevalence of type 2 diabetes in the United States continues to rise each year. The U.S. adult obesity rate was 42.4% percent of the population in 2017-2018, and worldwide, more than 1.9 billion adults and 340 million children and adolescents are overweight or obese. The result is that our children are predicted to live shorter and less healthy lives than their parents.

The good news is that the most prevalent health issues of our time can be prevented by increased consumption of the foods necessary for optimal health, a change that will require modifying our mainstream agricultural model. The aim of modern agriculture should be to maintain and improve the health of the global human population, not simply to produce enough calories to feed the world. Regenerative organic agriculture supports that goal, with soil and biodiversity at the foundation of a healthy, chemical-free, nutrient-rich diet. The result is a more diverse, nontoxic, regional food supply that mitigates the harmful effects of industrial agriculture on both human health and the planet.

The first step in the Regenerative Health model is to adopt more regenerative organic farming practices that repair the soil and enhance natural ecosystems, removing toxic chemicals from our food, air and water while ensuring a healthy, secure food supply for generations to come. The second step in Regenerative Health is to improve diet through greater consumption of nutrient-dense, whole foods, a shift that will need to be accompanied by increased research and support for the production and distribution of those foods globally. The third step in Regenerative Health includes lifestyle changes, like reducing health-threatening habits such as smoking and increasing physical activity levels. Widespread adoption of these changes will result in a radical shift in human health and well-being and a reduction in chronic disease across the globe.

The Standard American Diet

Nitrate Ground Water Pollution

Risk of Nitrate Ground Water Pollution

Most Americans aren’t eating the kinds of foods that promote health. The Standard American Diet is characterized by the excessive consumption of calories from processed and industrialized foods; inadequate consumption of nutrient-dense fruits and vegetables; and excessive intake of sodium and chemical additives. The USDA estimates that the Standard American Diet derives more than half of total calories from highly processed foods. The Standard American Diet is now found far beyond America’s borders—22% of deaths worldwide are caused from poor diet; in particular, insufficient intake of unprocessed vegetables, fruits, nuts and seeds, and whole grains.

The Standard American Diet is intertwined with highly industrialized, chemical-intensive farming methods. Changes in farming supported by government policy especially over the last century have incentivized farmers to grow crops that are easy to ship, store, and process—namely cereal grains and sweeteners—ensuring these foods are inexpensive and widely available. These same farming methods rely on a suite of toxic fertilizers and biocides that today have proven to have devastating effects on the environment and hazardous implications for human health.

The Rise Of Industrial Agriculture

Beginning in the late 19th century, significant changes took place in American culture and global food and farming technologies. While Americans turned increasingly to convenience foods and meals outside the home (see Figure 2), farming shifted away from small, diversified operations based on feeding a family or community towards a more consolidated approach focused on maximizing yields of a few crops for storage and export.

Such yield intensification was aided by technological advances leading up to World War II. The Haber-Bosch process, a method of generating nitrogen fertilizer by synthesizing ammonia from hydrogen and nitrogen, was used to create munitions, the large-scale production of which led to surpluses then diverted to agriculture. For the first time, materials formulated to kill people were intentionally used for food production and a massive scaling of chemicals in agriculture was launched.

In the 1960s, the Green Revolution brought new, high-yielding crop varieties that worked in conjunction with the new chemicals and led to an explosion in food production, particularly in developing countries. New machinery combined with new cultivars and chemicals allowed for the increased mechanization of agriculture. Earl Butz, the Secretary of Agriculture under President Nixon, urged farmers to “get big or get out,” further driving the consolidation of American agriculture.

The result has been an accelerated loss of diversity on American farms, especially in the last 30 years. In previous generations, more farms grew crops and raised livestock simultaneously. The advantage to such a system is a closed-loop nutrient cycle: animals deposit manure, which provides nutrients for crops, reducing or eliminating the need for synthetic fertilizer. Today, 88% of farms specialize in either crops or livestock (a growing percentage of the latter represented by concentrated animal feeding lots), and only 8% of farms produce more than four crops. Monocultures, or the growing of a single crop on a large acreage year after year, results in the need for greater chemical inputs. Such lack of diversity and reliance on outside inputs leads to greater risk of pest and disease outbreaks, and degraded soils keep farmers on a treadmill on which each year more inputs or new technologies are required to maintain production. The result is a system highly specialized in a few commodities—largely destined for processed food, ethanol, and animal feed—that is dependent on synthetic fertilizers, insecticides, and herbicides.

With the rise of industrial agriculture also came an increase in research dollars and resources funneled to commodity cereal crops; the result is that we’re now much better at growing corn and soybeans than tomatoes and spinach. To this day, “specialty crops” including fruits, vegetables, and nuts are grown on just 3% of cropland. In the United States as of 2007, there were 8.5 million acres of specialty crops amongst more than 300 million acres of everything else, and the USDA spends only $400 million studying specialty crops out of a total $3 billion invested in agricultural research. Even less is dedicated to studying organic agriculture, which has only been a formal branch of the USDA since the Organic Program was first conceptualized in 1990. Most recently, the 2018 Farm Bill promised to modestly increase current investments in organic research from $20 million (less than 1% total research budget) to $50 million per year by 2023. Our food system is skewed to support the processed, nutrient-poor foods that are fueling today’s epidemics of obesity and chronic disease.

The Direct Impacts Of Industrial Agriculture On Human Health

Glyphosate Use by Year and Crop

Glyphosate Use by Year and Crop

Toxic exposure from pesticides
The EPA reports that “More than a billion pounds of pesticides are used in the U.S. each year to control weeds, insects, and other organisms that threaten or undermine human activities. Some of these compounds can be harmful to humans if ingested, inhaled, or otherwise contacted in sufficient quantities.”
Studies show that exposure to pesticides may increase the risk of dementia, Alzheimer’s, cancer, and other chronic conditions that are more prevalent today than ever before.Exposure to glyphosate, the most commonly and intensively used herbicide worldwide and the active ingredient in Bayer’s Roundup formulation, has also been hypothesized to contribute to conditions including immune system damage, kidney and liver damage, and Hodgkin’s Lymphoma.

Glyphosate was classified by the World Health Organization’s International Agency for Research on Cancer as a probable carcinogen in 2015. More than 250 million pounds of glyphosate are applied on crops each year. Glyphosate has become ubiquitous in our food supply; one study found glyphosate residue in 39 out of 44 restaurant food samples.

Air pollution
– Air pollution is a major concern for public health and has been linked to endothelial cell dysfunction, oxidative lung damage, vascular inflammation and exacerbations of asthmatic conditions. According to the WHO, worldwide ambient air pollution causes 16% of lung cancer deaths, 25% of COPD deaths, 17% of deaths from ischemic heart disease and stroke, and 26% of respiratory infection deaths.
– Agriculture and factory farming practices are top contributors to global emissions and ambient air pollution: Bauer et al state that “In the past 70 years, global ammonia [nitrate] emissions have more than doubled, from 23 Tg/yr to 60 Tg/yr. This increase is entirely attributed to NH3 emissions from agriculture, with N fertilizer use contributing 33% and livestock production 66%.”

Antibiotic resistance
– The spread of antibiotic resistance through conventional agriculture represents a significant threat to the future of human disease control
Of all antibiotics sold in the United States, 80% are sold for use in animal agriculture. 58% of those are excreted into the environment and more than half end up in the soil.
– 70% of those drugs are “medically important,” meaning they overlap with drug classes important to human medicine

Water pollution
– Fertilizers, herbicides, insecticides and fungicides pollute waterways when they are washed off fields during rain events or through groundwater leaching.
– In a study of four American agricultural watersheds, the herbicides atrazine and metolachlor were found in every single rainfall sample; dacthal, acetochlor, simazine, alachlor, and pendimethalin were detected in more than 50% of the samples.
– Research from Rodale Institute has shown that conventional farming practices leach atrazine, a known endocrine-disruptor in amphibians, at a rate of nearly 3ppb into the water table (see Figure 4).
– Neonicotinoids, the most widely used insecticides in the world, are commonly found in surface waters across North America; common water treatment processes like chlorination interact with neonicotinoid metabolites, creating potentially even more potent and harmful compounds in drinking water.
– Nitrate pollution in groundwater can cause restriction of oxygen to the bloodstream, leading to methemoglobinemia, or “blue baby” disease. Infants are most vulnerable.
– Chemical nitrogen fertilizers and animal manure are the primary sources of nitrogen and phosphorus pollution of surface and groundwater, according to the EPA.
– USGS surveys of surface water, well water, soil, and rain find over 70% of samples are contaminated with glyphosate or its derivative, AMPA.

Secondary Effects Of Industrial Agriculture On Human Health

The effects of industrial farming on soil
– Conventional practices including monocropping (planting the same crop on the same plot of land year after year), repetitive deep tillage, the application of synthetic fertilizers and pesticides, and the absence of living ground cover or cover crops all contribute to the destruction of biodiversity below ground.
– Fewer microorganisms in the soil compromise nutrient delivery to plants, resulting in weaker plants that are more susceptible to infections and pests, requiring the use of synthetic fertilizers to grow to maturity. The result is increasing dependence on synthetic inputs that require the burning of fossil fuels to create and apply, increased emissions from the soil, reduced soil carbon stores, and the destruction of soil life, leading to reduced soil structure and exacerbating erosion.
– Soluble, salt-based fertilizer use leads to increased soil mineralization and loss of soil carbon over time. 30% of the world’s arable land has become unproductive in the past 40 years due to soil erosion.
– Soil is being lost 10 to 40 times faster than its being replaced.
– By 2050, soil erosion may reduce up to 10% of crop yields, the equivalent of removing millions of hectares of land from production.
– It takes at least 100 years to build an inch of topsoil, and much less time to lose it. Conventional agriculture, on average, erodes soil by about 1 mm/yr, a rate 1.3-1,000x greater than natural erosion under native vegetation, and can erode soil at much faster rates under some conditions.
– Soil is the source of more than 95% of our food and much of our clothing, building material, and antibiotics (about 78% of antibacterial agents and 60% of new cancer drugs approved between 1983 and 1994 had their origins in the soil, as did about 60% of all newly approved drugs between 1989 and 1995).
– Some hypothesize that a decrease in the diversity of microorganisms in the soil driven by industrial farming methods could also contribute to loss of diversity in the human gut microbiome, decreasing immunity and contributing to chronic conditions.

The effects of industrial farming on biodiversity
– The application of biocides can directly deplete populations of beneficial insects, including honeybees—one teaspoon of a neonicotinoid, commonly used in conventional applications, is enough to deliver a lethal dose to 1.25 billion honeybees.
– It is now estimated that 40% of the world’s insect species face extinction over the next several decades, and land conversion for the production of food is the single most important driver of biodiversity loss now, presaging mass species extinctions across the world.
– Threats to biodiversity are then a threat to the economy, since biodiversity is crucial to the ecosystems on which humans depend, including farming and forestry—the annual economic and environmental benefits of biodiversity in the United States total approximately $300 billion.
– A significant decline in insect populations would severely affect humankind’s ability to feed ourselves, as one third of the world’s food crops are dependent on insects (and to a lesser extent birds and bats, which are also in decline) for pollination.

Industrial Agriculture And Nutrient-Density

More than half of the world today suffers from “hidden hunger,” a condition defined by malnourishment despite adequate daily caloric intake. Such “hidden hunger” may be partly responsible for the rise in chronic diseases in the U.S., since we rely on the vitamins, minerals, protein, and bioactive compounds in our food—not calories—to prevent disease. Agricultural production goals focused mainly on maximizing crop yields have led to a significant decline in nutrient concentrations over the last 50-70 years. An assessment of the nutritional concentrations of 43 crops, mostly fruits and vegetables, from 1950 to 1999 revealed a decline in most nutrients. Six key nutrients—protein, Ca, P, Fe, riboflavin, and vitamin C—significantly declined between 6% to 38%. The same study also revealed higher water and carbohydrate concentrations in our food.

While grain yields have more than doubled in this time period, grain protein concentrations have declined significantly—wheat, rice and barley as much as 30%, 18% and 50% respectively. This suggests a “dilution effect,” an inverse relationship between yields and a measured nutrient. Such an effect is reason for concern, as more than half of the world population suffers from undernourishment of nutrients critical for maintaining proper health, and grain products constitute a significant portion of many diets.

More recently, climate change—driven, in part, by emissions from the production and use of agricultural fertilizers, herbicides, and pesticides—has been implicated in driving crop nutritional declines. Macrocosm studies that control carbon dioxide levels over rice fields found that increased atmospheric CO2 levels reduced the concentration of protein, iron, zinc, and B vitamins. Considering the health implications of a continued decline in crop nutritional density, agricultural production goals will need to shift from a sole emphasis on yield to a more integrated emphasis on crop quality. Regenerative organic agriculture and its emphasis on soil health supports this shift.

Perhaps the greatest factory of bioactive compounds critical for human health lies in the soil and the plants that grow in that soil. Soil bacteria and fungi synthesize medically important compounds. Some of these compounds can be extracted from the soil and used directly—78% of antibacterial agents and 60% of new cancer drugs approved between 1983 and 1994 had their origins in the soil, as did about 60% of all newly approved drugs between 1989 and 1995. Some of the compounds synthesized in soil are transported to plants, where they can be consumed by humans—ergothioneine, for example. Other compounds interact with plants in other ways, increasing plant production of bioactive phytochemicals that, when consumed, have been implicated in the prevention and reversal of cancers, diabetes, hypertension, heart disease, neurodegenerative disease. These phytochemicals also play a critical role in immune function. Organically managed soils contain higher levels of microbial diversity and organically produced foods possess higher levels of bioactive phytochemicals than conventionally managed soils and foods. This link between soil health and human health is largely unexplored and must be advanced.

Two long-term studies that measured bioactive compounds in vegetables grown using organic and conventional management have yielded interesting results. A six-year study at the Teagasc Field Research Center in Dublin, Ireland found higher levels of flavonoids, anthocyanin, and antioxidant activity in two onion varieties grown organically. At the University of California, ten years of comparing organic and conventional systems showed that organic tomatoes had higher anti-cancer flavonoids and immune-boosting alpha-tomatine content than conventional, and these markers tended to increase over time, suggesting that as the soil improved with organic management, bioactive compound levels increased.

At Rodale Institute in Pennsylvania, two long-term trials exist. The Farming Systems Trial, begun in 1981 and active today, is a side-by-side comparison of two organic systems and one conventional system, all growing common cereal crops. Preliminary assessment of the nutrient concentrations in oats grown in the trial have found that 7 of 13 minerals measured were significantly greater in organic legume, no-till systems compared to conventional. The Vegetable Systems Trial, 2017-present, is specifically designed to test nutrient concentrations in leaf, root, and fruit vegetables grown in the different systems for twenty years or more. While there is no refuting that organic foods pose lower human health risks than conventionally grown foods due to reduced pesticide residues, heavy metals, and nitrates, more peer-reviewed research is needed to verify and quantify the link between soil health and human health. These trials, along with other controlled field trials, are the starting point to begin discussing how soil health and production methods impact nutrient-density and human health.

In the meantime, there are actions we can take proven to improve health outcomes for both people and the planet.

Solution 1: The Power Of The Plate

The composition of our plates matters, and the global crisis of non-communicable, lifestyle related disease is solvable with the right dietary intervention. Shifting to a predominantly organic, whole foods, plant-forward plate can:
1. Provide the body with all necessary vitamins, minerals, fiber, macronutrients and antioxidants to maintain health, build immunity, and prevent, suspend and often reverse lifestyle-related diseases.
2. Reverse the epidemic of chronic, non-communicable disease. Research from the Imperial College of London found that approximately 7.8 million premature deaths around the world could be prevented if people consumed 10 servings of vegetables and fruits every day.
3. Prevent, suspend and potentially reverse cardiovascular disease, the number one cause of death globally. Randomized trials utilizing a whole-food, plant-based lifestyle treatment intervention have demonstrated dramatic 91% reductions in chest pain. Between 82% and 91% of patients showed a trend toward regression in artery narrowing, and reperfusion of heart muscle was seen in three weeks. Participants with the greatest adherence saw the greatest degree of improvement; participants who had adherence of 50% or less did not see any significant changes.
4. Prevent, suspend and reverse the epidemic of type 2 Diabetes. Type 2 diabetes improves rapidly with diet changes, and in many cases, goes into remission. Studies have demonstrated that in just 4 weeks on a whole food plant-based diet, 44% of patients on insulin and 74% maintained on oral medications were able to discontinue the medications.
5. Powerfully reduce inflammation, help heal IBS/IBD, more effectively reduce weight than any other dietary lifestyle, improve autoimmune diseases like rheumatoid arthritis, prevent acne, enhance mood, reduce and resolve allergies, prevent constipation, reduce asthma, improve PCOS, prevent dementia, reduce arthritic pain, dramatically improve kidney and chronic kidney disease impairment, and significantly reduce the risk of colon and other cancers.1 2
6. Cultivate a diverse microbiome. Healthy soil and the human gut are comprised of a diverse population of trillions of bacteria that optimize growth, protection, and health. Diets comprised of a wide variety of organic plants support a healthy microbiome and promote the growth of a variety of microbial species through the digestion of fiber and the unique biomes of fresh fruits and vegetables. Optimized populations of bacteria have been shown to prevent weight gain, reduce inflammation, improve gut tight junctions, and reduce the risk of disease. Living in relationship with organic ecosystems enhances microbiome diversity and has been associated with improved immune function.
7. Optimize immune function. The Covid-19 pandemic galvanized the need for a healthy immune system. Dietary patterns that are plant-predominant have been shown to enhance immune function and lower systemic inflammatory levels. Polyphenols, a group of more than 8000 bioactive compounds in plants, promote improved immunity to a variety of pathogens and activate important signaling pathways to initiate immune responses. Some polyphenols like curcurmin and EGCG can induce epigenetic changes that enhance immune function. Further, the fiber in plants enhances the growth of synergistic bacterial populations in the microbiome that epigenetically “turn on” key immune cells and “turn off” key inflammatory switches, thus improving the overall health of the immune system.
8. Provide the greatest opportunity for rapid change globally. The global population consumes 11.5 million calories per minute. If enough people made a significant shift in their daily purchasing and consumption habits towards a predominantly organic, whole-foods, plant-forward plate, we would experience a regenerative revolution of health for the soil, people, and the planet.

Solution 2: Regenerative Organic Agriculture

Regenerative organic agriculture is more than a set of agronomic principles—it is a holistic approach to farming that encourages continuous innovation and improvement of environmental, social, and economic measures. Regenerative organic farming necessarily includes the welfare and health of animals and mankind.

Regenerative organic agriculture aims to improve ecosystem and human health through several basic principles:
1. Eliminate the use of toxic, synthetic inputs like fertilizers and herbicides, thus eliminating the potential harm caused through exposure via diet, air, water, and occupational exposure.
2. Diversify crop rotations, promote on-farm biological diversity, and institute strategies to manage insect, disease, and weed pressures that reduce or eliminate the need for chemical inputs.
3.Maximize soil coverage and biodiversity through cover cropping, permanent perennial agriculture and integrated livestock systems to maintain and improve soil health, thereby ensuring our ability to feed a growing population long into the future.
4. Increase soil organic carbon levels, resulting in greater soil structure and water-holding capacity to maintain crop production during periods of climate uncertainty. Measurements of crop yields and soil/water relationships over more than ten years at the Rodale Institute Farming Systems Trial report between 35% to 96% higher corn and soybean yields in the organic systems than the conventional comparison during periods of drought. This was attributed to greater water capture during rainfall events (less runoff and erosion) and increased soil water holding capacity.
5. Support the growth of diverse microbial populations in the soil through natural soil fertility measures such as compost and green manures, reducing pest pressure and boosting plant bioactive compounds known to provide substantial health benefits and help combat chronic disease.
6. Integrate animals into farming systems to improve nutrient cycling and allow innate animal behavior and grazing on living grass and forage, leading to less animal stress and more nutritious animal products.
7. Use productive farmland to grow food and fiber for people and not for inefficient bio-fuel production, which diverts nutrients into combustible engines and ultimately greenhouse gases.
8. Promote and establish conservation practices to protect vulnerable waterways and the aquatic and terrestrial life that depend on those bodies of water. Regenerative organic agriculture places inherent value on wildlife and habitat management as measures to mitigate pest outbreaks, provide ecosystem services such as carbon storage and air pollution mitigation, and support sources of highly nutritious food.
Provide a meaningful source of income for farmers and support rural and urban communities.

We have omitted notes from this article for space reasons. Anyone wishing the original version of this article can get one by Emailing the editor for a copy. I will send it to you as a .docx attachment.
– Jack (TNF@nofa.org)

EcoHealth: A Paradigm for a Pandemic

Pierre Weill

Pierre Weill

Epidemiological studies and diet composition

The link between nutrition and health is supported by different kinds of studies:

Epidemiological studies provide so-called “ecological correlation” or a correlation between traditional food habits and health events at the population level. These “ecological correlation” studies describe a link between a geographical situation, a food tradition there, and the health of the population practicing that tradition.

For instance, the famous “seven countries study” in the sixties compared cardiovascular outcomes in comparable populations of 5 European countries, from Greece to Finland, plus Japan and the USA. Results emphasized the cardiovascular benefits of the “Mediterranean Diet” characterized by a high level of fruits, cheese, vegetables, fish, olive oil and wine.

Following these “ecological correlation” study results (a negative correlation between “all cause mortality” and vegetable consumption, or between fish and “cardiovascular mortality”, for instance), nutrition scientists raise hypotheses, try to demonstrate them with new trials, and describe more precisely the role of various nutrients.

The Mediterranean diet study, for instance, revealed the role of antioxidants and fibers from vegetables and the role of Omega 3 Fatty acids from fish and terrestrial sources like purslane and grass fed animals (rabbits, geese, sheep, goats, snails all typical of Mediterranean diet) in maintaining human health.

Today more than 50.000 scientific peer reviewed articles are dedicated to the link between immunity, inflammation and nutrition. A wealth of mechanistic and clinical data show that vitamins, including vitamins A, B6, B9, folate, B12, C, D, and E, trace elements, including zinc, iron, selenium, magnesium, and copper and the omega-3 fatty acids play important and complementary roles in supporting the immune system.

Epidemiological studies and “civilization diseases”

Modern epidemiology also describes a lot of “non-transmissible but epidemic” diseases such as obesity, diabetes, cancer, depression or neuro-degenerative and cardiovascular diseases. This group is called “civilization diseases”, or more precisely “low grade inflammatory diseases”.

“Food is our first Medicine” said Hippocrates, the Greek ancestor of all physicians, 2600 years ago. But food quality is not only based on the particular foods in our diet. It is also based on how that food is produced. That very much affects its nutritional composition.
Indeed, the quantity of immunity-affecting nutrients per amount of food product varies considerably according the way plants and animals are produced.

For instance, compliance with the main components of the Mediterranean diet (such as fruits & vegetables) is always positively associated with longevity, whereas the consumption of dairy products is negatively associated with longevity in some countries like Holland, but positively in Switzerland and some other mountain countries.

Epidemiologist call it “the Alpine paradox” and explain it with the fact that cheeses come from cows eating grass leaves (rich in Omega 3, see below) in mountain countries, and grain diets (rich in Omega 6) in lowlands areas with intensive crop production methods.

In the Mediterranean diet, vegetables and fruits are especially important because they provide the vitamins and antioxidants for approximately half of our dietary needs. But the variation in antioxidant content among those foods can vary from 1 to 100 for the same plant.

Antioxidants, omega 3s and other vitamins are nutrients necessary to our immunity. We need them, but their presence in basic food is linked to the way farmers produce the plants and animals from which we derive these nutrients.

The most impressive example is probably the impact of the Omega 6 – Omega 3 ratio in feed and food for our health.

Omega 3 and Omega 6: A documented and important example of the “Ecological correlation”

In the last half century, the physiological and biochemical effects of polyunsaturated fatty acids (PUFAs) Omega 6 and Omega 3 have been thoroughly investigated and are now better understood.

PUFAs are divided in two big families, Omega 6s and Omega 3s, that play antagonist roles in the inflammation process. And inflammation is the first step of the innate immunity process.Numerous biochemical explanations describe the biological pathways of inflammation. Inflammation is a biological defence response against physical, biological or infectious trauma to the body’s cells. It involves a whole series of processes whose purpose is:
– amplification or “promotion” phase,
– then to restore the affected tissues and homeostasis (equilibrium) in its reduction or “resolution” phase.

Omega 6s are involved in the pro-inflammatory process (promotion) while Omega 3s are involved in anti-inflammatory process (resolution). The recommended ratio between Omega 6s and Omega 3s on our plates for this purpose is 4. That is, four times as much Omega 6 as Omega 3.

Biochemistry means “Chemistry of Life” and sometimes the chemistry of life tells stories full of meaning. Omega 3 and Omega 6 precursors are only synthesized by plants, for example. Without plant synthesis, we would have no Omega 3s and no Omega 6s. But plants produce them primarily as short chain molecules, and animals have the enzymes to link them up and produce more long chain Omega 3s and long chain Omega 6s, which are very active and essential to our metabolism.

Omega 6s come mainly from grain or seeds, like corn or soybeans, while Omega 3s come primarily from leaves (together with B-9) such as grass, clover and alfalfa, as well as from algae and also from unusual and minor seeds like Flax or Chia.

So the Omega 6 and Omega 3 balance in the food chain is not only necessary to avoid inflammation dysfunction, is not only a biochemical ratio, but also a sum of good balances from the soil (crop rotation, diversity) to the animals’ diet and our plates (vegetal – animal balance).

Vegetable oils like corn oil, sunflower oil or soybean oil provide mostly Omega 6s. Palm oil provides mainly saturated fat, but also Omega 6. While olive oil and rapeseed (canola) oil provide mainly mono-unsaturated fatty acids.

The majority of the lipids consumed by humans in the western diet come from animals. If animals are fed with the universal corn-soy system, then milk, eggs, meats, cold cuts and even fish will become sources of (pro-inflammatory) Omega 6.

If animals are fed with grass, alfalfa and flax in soil, or on an algae based food chain in the ocean, then they will provide a lot of anti-inflammatory Omega 3.

This link between nutrition and health is key. The optimum recommended ratio is 4:1, or four Omega 6 for one Omega 3 in the diet.

Omega 6 / Omega 3 balance to resolve “low inflammatory civilization diseases”

– In Cardio Vascular (CV) diseases, Omega 6 favors platelet agregation, which is good for scarring but bad for fluid blood circulation, instead of Omega 3 action that favors blood fluidity, an important factor to prevent stroke and other vascular events.
– Omega 3s are the main component of brain and prevent neurologic troubles.
– Omega 6s favour cell development, including cancer cells, while Omega 3s limit them.
– Omega 6s favour inflammation, while Omega 3s limit them. (NB: Inflammation is a very important and positive function, but too much inflammation can be deleterious.)
– And Omega 6s help producing adipose cells to store energy as fat. (NB: This was an important function at the first stages of human evolution, but has become deleterious nowadays.)

Sources of Omega 6 (Corn/soy system) versus Omega 3 (rich plants)

What are Omega 3 and Omega 6?
They were discovered in the 1920s when scientists found that fat-free diets had adverse effects on rats. Initially, the scientists suspected the rats were deficient in a new vitamin they called vitamin F. It turned out that vitamin F was composed of two fats — alpha-linolenic acid (ALA) and linoleic acid (LA). ALA is a member of the omega-3 fat family, while LA belongs to the omega-6 family. They are called “Essential” and “Indispensable” Poly Unsaturated Fatty Acids. They are essential because we need them for the essential needs of our organism, the human body, to properly function. They are indispensable because we cannot synthesize them internally, we have to get them from outside our bodies, in our diets. They are fatty acids because they belong to the “fat” (lipids) family.
A fatty acid is saturated if there are no double carbon bonds in its molecular chain. A fatty acid is unsaturated when there is at least one double bond in its chain, and it is polyunsaturated if it has more than one double bond. Unsaturated fats are considered beneficial fats for human health, but they are liquid at room temperature and can oxidize (go rancid) more easily than saturated fats. Thus in many processed foods the fats have been saturated to prolong shelf life.
For those interested in molecular structure, each fatty acid double carbon bond causes a curvature. Each carbon of the fatty acid chain has its number from Carbon 1 or Alpha Carbon to Carbon n (terminal) or Omega Carbon. Omega 3 is a group of fatty acids. All of them have the unsaturation on the n-3 carbon, but they differ in the length of the carbon chain and the number of unsaturations. Omega 3 fatty acids with more than 18 carbons are called Long Chain (LC) Omega 3 PUFAs and have particularly interesting biological properties. Omega 6 fatty acids always have their first curvature on the n-6 carbon. Only plants synthesize the first member of Omega 3 and Omega 6 families. They do it mainly in the leaves for Omega 3 and mainly in the seeds for Omega 6.

Omega 3s (because of their particular multiple curvatures that play a role in the mobility of the cell’s membrane) are a massive component of the choroplasts in the plant leaves. Omega 6s are part of the energy storage of the seeds for germination.

So Omega 3s are abundant in spring, when leaves absorb solar enregy in the chloroplast. And Omege 6s are abundant at the end of summer, when plants put energy in the seed for the survival of the species. Only a very few plants (like flax and chia) have Omega 3s in their seeds.

From these facts, we can suggest:
– That Omega 3s present in all chroropyllic leaves are “spring and summer fatty acids”, the seasons of reproduction and birth while Omega 6s are “autumn fatty acids”, interesting to stimulate ingestion, store grain energy (lipogenesis) before winter times, and face various aggressions through the inflammation promotion process.
– The Meditarrenan area is an area of mountains and hills where leafy plants to feed men and animals are more abundant than grain. (See Mediterranean diet and its ecological positive correlation above)

Ailhaud & al. in 2006 showed that the breast milk balance for the Omega 6/Omega 3 ratio dropped from 5 to 22 between 1960 and 2000 due to changes in oil consumption in western countries, as well as changes in animal diets.

Hibbeln calculated the increase in soybean consumption and its consequences for Omega 6 (LA) in the USA in the 20th century. It is an impressive figure.

Figure 1: Soy consumption and LA (linoleic acid, main Omega 6 FA) consumption during the 20th century, USA

Disappearance is calculated from production data (here from various oleaginous seeds in the food chain) through both food and feed. Here we see that LA Omega 6 increased from 1.5% of the energy intake in the sixties, up to 8% of the total energy intake in 2000. LA is the precursor of all the Omega 6 family. This cannot be without consequences when we know the role of Omega 6 in inflammatory process.

Omega 6, Omega 3 and “Healthy eco-food barrier” during COVID-19 pandemic.

Covid-19 – The viral epidemic named Coronavirus-2019 disease (Covid-19) is responsible for symptomatic cases with fever, cough and sneezing. In most recent data, 10-15% of these symptomatic cases are complicated by severe pneumonia requiring hospitalization with a high risk of developing an Acute Respiratory Distress Syndrome (ARDS) that can lead the patient to the intensive care unit (ICU). Covid-19 general mortality rate is about 2% amongst symptomatic patients.

Up until now there has been no proven effective treatment/vaccine to heal/prevent the disease or to prevent its progression to a serious condition. The global burden of infection being high and worldwide, all kind of approaches deserve to be tested. Nutrition is of course one of the most promising approaches. It is interesting to emphasize that victims suffer from complications of inflammation. Specialists speak of an excessive “cytokine storm”. But, surprisingly, usual anti-inflammatory drugs are generally prohibited for the Covid-19 patients.

What happens when the coronavirus SARS-CoV-2 arrives ?

As soon as the virus enters the lung cell (pneumocyte), the mechanisms of innate immunity begin. Inflammation is the first step of the immune response. As seen above, the first phase of inflammation is called promotion phase and is driven by the Omega 6 Fatty-Acid (FA).

One of the Omega 6 FA family, called AA (Arachidonic Acid), stored in the cell membrane is then liberated (thanks to an enzyme named PLA2) and the inflammation process starts with oxygenase enzymes (like COX 1 and COX 2) which produce Omega 6 issued pro-inflammation mediators that lead to cytokine (protein of inflammation) production.

Omega 3 Fatty acids are also stored in the cell’s membrane (mainly EPA (EicosaPentaenoic Acid) and DHA (DocosaHexaenoic Acid), but, once they are liberated from the membrane (with the same PLA2 enzyme activity) they initiate, on the contrary (but through the same COX and LOX enzymes), an anti-inflammatory natural pathway.

In Figure 2 we see the two phases of inflammation. Dolor (Pain), Rubor (Redness) Calor (Heat) and Tumor (Swelling) were already described in the old Latin language by Roman Doctors twenty centuries ago. They are characteristic of the promotion phase. The body fight against aggressors, Promotion phase must happen very quickly: a question of seconds, minutes where Omega 6 stored in the attacked cell’s membrane are at the frontline as the first soldiers against aggression.

Then comes the resolution phase, after hours or sometimes days (when the battle is over and the aggressors killed), Omega 3s are active.

Too much promotion or not enough resolution and problems due to excess of inflammation appear. The tissues are repaired and they find their normal structure and role.

To have the good balance between promotion and resolution phases, the good ratio inside the membrane is supposed to be 4 Omega 6 for 1 Omega 3, or even less (3 to 1 ratio is sometimes recommended).

Anti-inflammatory drugs inactivate inflammation enzymes (PLA2, COX, LOX), so they inhibit pro-inflammatory processes (and leave the cell without defence against the virus) as well as anti-inflammatory pathways that stop or limit cytokine production.

So it is very important to have a good (low) Omega 6 / Omega 3 balance in each cell of our body. Omega 6 increased in the USA from 1.5% to 8% of total energy intake when Omega 3 remains stable or decreased. The changes in the fields (mainly due to the predominant corn-soy system) influence diet composition and unbalance the inflammation process. Harmony in the body is related with harmony and diversity in the fields.

From each piece of soil to each cell of our body

soy oil consumption chart

Figure 1

As mentioned above, Omega 6 and Omega 3 precursors are only synthesized by plants. If fields are full of Omega 6 rich plants like corn, sunflower, soybean, palm at the first step of the food chain, then our cells membrane will have a pro-inflammatory composition. On the contrary, if grass, alfalfa, clover, and other plants with leaves full of chloroplast (and some minor unusual seeds like flax), have their part, then the diversity in the soils will help to maintain a healthy membrane with less chemical input while our cells will have the good balance to regulate the pro- and anti- inflammatory pathways in our bodies.

Some pieces of the puzzle, (sometimes the link between science and health is like a police investigation, we need evidence from a lot of data)

ARDS (Acute Respiratory Distress Syndrome) and its lung oedema (build-up of fluid) are the worst consequences of the pro-inflammatory process that follows the viral Covid-19 infection.

phases of invlammation process

Figure 2: The Two phases of the inflammation process.

A lot of human studies focused on the Omega 3 impact on ARDS. In these trials, fish oil rich in Omega 3s was used in enteral nutrition (passing through the intestine) as a treatment at high doses of Omega 3 (approximately 10 grams a day, which is 5 to 10 times more that the nutritional long term recommendation. In recent meta-analyses, it was found that this Omega 3 supplementation significantly reduced patients’ mortality by 36% as well as shortening duration of stay in the ICU and other data.

In animal studies, researchers used mice infested with bacteria and virus that were fed with standard diets or Omega 3 rich diets. The studies reported that dietary supplementation of Omega 3 PUFAs exert an overall beneficial effect. The survival rate increased significantly in the Omega 3 diet’s group and the microbial burden decreased. It was possible to measure in Omega 3-fed animals’ tissues a significant decrease of levels of pro-inflammatory cytokines.

Epidemiological data on Covid-19 are still to be discussed. Very preliminary observation comparing countries show that those with high fatty fish consumption have an optimal intake of omega-3 long chain PUFA of over 400 mg a day: Portugal (420), South Korea (450), Finland (470), Norway (500), Malaysia (700), Japan ( 760 ) and Iceland (900 ). These countries also have a very low number of victims related to the population: more than 4 times lower than the average of the other countries of the study (36 versus 175 deaths per million in June 2020).

Note that Omega 3 long chain PUFA consumption is estimated at 190 mg a day in the USA. Of course, no definitive conclusion can be drawn from this observation alone due to the large number of biases (linked to the varieties of social measures, the percentage of elderly people, the date of virus arrival, etc.) It is only a piece of the puzzle without any significance alone.

But… more than anything, in all western countries, the average consumption of Omega 3 is far below the recommendation of official guidelines when Omega 6 consumption is sufficient or excessive. Omega 3 consumption is often 3 to 4 times lower that the official recommendations. The breast milk Omega 6/Omega 3 ratio gives a value from 15 to 20 in western countries.

Co-morbidity factors for Covid-19 are always related to low-grade inflammatory diseases like obesity. Lack of Omega 3s is also linked to dysbiosis (imbalance) of gut microbiota. Gut microbiota influence health in protecting against pathogens and maintain gastrointestinal tract barrier integrity.

So, Human and Animal trials + consumption data + epidemiological data + Co-morbidity factors all together suggest that in case of an aggression such as a viral attack, the imbalance of our food chain fatty acids will be a very probable cause of an imbalance in our cells’ membrane composition that will cause an imbalance between pro- and anti- inflammatory pathways that can lead to cytokine storm, ARDS and even death.

May Omega 3 reduce COVID- 19 induced ARDS and save lives?

To move from hypothesis to evidence, we need dedicated human trials. Because there is a lot of scientific data to support this hypothesis about Omega 3s and COVID-19, trials are scheduled with the French research team to which I belong, including University biochemists and a University hospital physician for 2 trials: One with Covid-19 infected patients (secondary prevention) and another one with healthy but weak old people (primary prevention).

Conclusion and hopes…

For a new agriculture providing healthy foods with a good nutrient density: Back to “ecological correlation” and “Eco-Health”

We started with the so-called “ecological correlation” of the epidemiologists from last century. They found a relation between diet and health, then between diet, nutrients and health. It’s time now for a new paradigm, measuring the link between human health and the environment.

From diversity in the fields to balance in the cell’s membranes to prevent diseases because of an excess of inflammation, there is a connection that I discovered during my 45 year-long professional life. I started with concern about the soil’s health, promoting grass, lupine, horse beans, peas and flax. Then we measured that high Omega 3 (grass and flax) animal diets improve a cow’s fertility and reproductive data. Then we checked the impact of these Omega 3 diets on methane (a major ruminant Green House Gas) emission and we measured a large improvement. We measured also the nutritional value of animal products related to the quality of their feed, that led to my first clinical study, where we measured the impact of animal diets on human health.

Providing nutritious food that helps us through strengthening our immunity is a noble goal. Healthy food can protect us (as Hippocrates said). Microbial growth is absolutely dependent of their playing field, which is inside us.

This “One Health” or “Eco-Health” way is a narrow one, but it is also a beautiful one. Our human health is absolutely linked to animal health, planet health and soils health, mainly through a microbial link. Microbial life in the soils has an impact on animals and through them on food. It is not a marketing claim, it’s a patiently constructed scientific truth, and further research continues to make it stronger.

If you look at my publication list, you’ll find a lot of different topics about human health of course, but also animal health and the environment. We proved the impact of animal diet on human health. If farmers change from a corn-soy system to a grass fed + variety of seeds, we measured the impact on man’s insulin-resistance for instance, but also on a cow’s fertility, a soil’s organic matter, methane emission, etc.

For 25 years I was in the middle of a research movement with the other authors of those papers. Some had an interest in nutrition, others on the environment. It was not easy. If you say: “when animals are well fed, men will be healthier” everybody thinks it is evident. But the facts are sometimes difficult; the best is sometimes the enemy of the good. But when you find a measurable connection between a soil, an animal’s health and man’s health, it is fantastic. This is what I call “Eco-Health”.

Pierre Weill worked as a technical advisor for dairy farmers in Brittany, France. With some friends in 1992 he created and later became president of Valorex, a feed company that conducted trials linking animal feed with the nutritional quality of the resulting animal products. Their findings led to the founding in 2000 of the non-profit Bleu-Blanc-Coeur (BBC) to apply science to animal nutrition and sell high quality feed. Today BBC is active in 12 countries and represents 10% of French pigs, 7% of the country’s eggs and 5% of its milk.

We have omitted notes from this article for space reasons. Anyone wishing the original version of this article can get one by Emailing the editor for a copy. I will send it to you as a .docx attachment.
– Jack (TNF@nofa.org)

Let Food be Thy Medicine

Teen volunteers in Ceres kitchen preparing meals

Teen volunteers in Ceres kitchen preparing meals

A revolution is taking place in community health centers, hospitals and community benefit organizations across the country. It has the potential to create an integrated, equitable and regenerative food and health care system – but only if we pay attention, raise our voices, and make it so. The goal is the full integration of healthy, sustainably raised food into our approach to preventing and treating illness, and into our health care system. The motivation comes from the abysmal state of American’s health and the epidemic of diet-related chronic disease.

At Ceres Community Project we’re working to create a food as medicine solution that layers positive impact throughout the community and our food system. We provide medically tailored meals for primarily very low-income people who are struggling because of an acute or chronic health condition. Our meals are made with 100% organic ingredients, sourced as much as we can from local farmers and food producers. We integrate a Youth Development program where hundreds of young people each year volunteer as gardeners and chefs, learning how to grow, prepare and eat healthy and organic food. We work to educate all our stakeholders about the link between healthy whole foods, a healthy food system, and our own health and well-being. And we work to change policy so that all people have access to affordable, healthy, sustainably raised and culturally relevant foods to support a thriving life.

This article provides an overview of why food as medicine is so critical for health, the basic food as medicine strategies or interventions that are gaining acceptance, and key policy approaches for scaling food as medicine to reach as many people as possible. We start with an overview of the state of America’s diet.

The State of America’s Diet

Impact of Providing Food on HealthPoor diet quality is now a leading risk factor associated with death and disability in the United States, contributing to approximately 678,000 deaths each year from illnesses such as heart disease, cancer, and type 2 diabetes. In the last 30 years, obesity rates have doubled in adults, tripled in children, and quadrupled in adolescents.From 100 years ago when food was primarily whole and always raised without pesticides, the typical American diet today suffers from cheap and readily available processed foods. As a result, it’s too high in calories, saturated fat, sodium, and added sugars, and lacks enough fruits, vegetables, whole grains, calcium, and fiber. The CDC reported in their 2018 State Indicator Report on Fruits and Vegetables that only 12.2% of adults were eating the recommended 1.5 to 2.0 cups per day of fruits, and just 9.3% of adults were eating the recommended 2.0 to 3.0 cups per day of vegetables. This eating pattern increases the risk of numerous diseases, including heart disease, diabetes, obesity, high blood pressure, stroke, osteoporosis; and many types of cancers, including cervical, colon, gallbladder, kidney, liver, ovarian, uterine, and postmenopausal breast cancers; leukemia; and esophageal cancer (after researchers took smoking into account).Millions of Americans are now living with one or more of these nutrition-related chronic diseases, and it’s costing hundreds of billions of dollars a year in health care spending:

Rethinking the Role of the Doctor’s Office

Illness table copyAlong with rising rates of nutrition-related chronic disease and the associated health care costs, there is another factor driving change in the health care sector – the realization that most of what impacts our health happens outside of the health care system. Some researchers believe that only 20% of our health outcomes are related to what happens in the doctor’s office. Thirty percent are related to health behaviors – choices that we make – such as diet and exercise, smoking, alcohol use, and sexual activity. We could probably add good sleep and stress management to the list. But what’s really important is the other 50% of the equation. These are the things out of our control – our physical environment and what are called the “social determinants of health”. The saying “your zip code is more important than your genetic code,” refers to this. The circumstances into which you are born provide either supports or barriers that have a significant impact on your health. This includes poverty, access to a quality education, the safety of our neighborhoods, and our likelihood of graduating from high school or college and therefore our ability to get and keep a good job. All of that is impacted by systemic racism.

As health care providers and, more importantly, insurers, began to study this information, they realized that they have to look outside the health care system if they want to improve health outcomes and manage health care costs. It’s not going to make any difference for a doctor to provide a prescription if the patient can’t afford it. A doctor can lecture all they want about getting exercise, but patients won’t comply if it’s not safe to walk in their neighborhood. It’s hard to prevent obesity and diabetes when patients can’t afford a healthy diet or there’s no grocery store within miles of their home.

The understanding of the role that social determinants of health play in patients’ health and well-being – and thus their health care costs – is driving health care providers and insurers to think in new ways about how to support patients’ health. Many health care providers are now implementing social determinants of health screening tools to assess patients’ social needs. New roles, including patient navigators and community health workers, are being added to help connect patients to community resources. Community referral websites are being developed that include the ability for health care providers to send referrals directly to community-based organizations. And health care organizations and insurers are experimenting with providing services that have traditionally been excluded from health care coverage. Even Medicare and Medicaid, the public health insurance programs, have recently allowed some flexibility to cover certain food and nutrition interventions. Because food insecurity is common, and addressing it is relatively cost effective compared to challenges such as housing or the physical environment, efforts by health care providers and insurers to improve food and nutrition security have soared.

Food as Medicine Starts with Food and Nutrition Security

In the broadest sense, food as medicine refers to the vital role that access to healthy food plays in overall health and well-being. This includes basic food and nutrition security as well as how we can use food to both prevent and treat chronic disease. The United Nations definition of food security makes this connection between food and “an active and healthy life” and in its definition assumes that by food security we mean nutrition security – not just enough food, but enough of the right kinds of food. The UN defines food security as: “all people, at all times, have physical, social, and economic access to sufficient, safe, and nutritious food that meets their food preferences and dietary needs for an active and healthy life.”

Prior to the pandemic, 11.1% of US households experienced food insecurity with research indicating that this was responsible for $52.9 billion annually in direct health care costs. Food insecurity is not limited to low-income households. There is consistent data linking food insecurity and poorer health outcomes even after controlling for factors like income, race, and education. Those at similar income levels with increased consistent access to healthy foods (whether because of access to food supports like SNAP, food pantries, or the ease and availability of nearby grocery stores) have better health outcomes than those who have less consistent access to healthy foods. And there is also a dose-dependent relationship with food insecurity and health: those who are more severely food insecure are more likely to have a chronic disease.

In children, food insecurity is associated with behavioral issues, poorer academic performance, worse health and higher rates of hospitalization. Among adults, the impacts include higher rates of obesity, diabetes, hypertension, depression and hospitalization. Improved food security, on the other hand, is associated with decreased A1c, blood pressure, BMI, pre-term birth and depression, and increased medication adherence and heart failure symptom control.

Research on the SNAP program shows important benefits for both children and older adults. Children with access to SNAP are more likely to graduate from high school – which carries its own benefit for lifetime well-being, and are less likely to suffer from obesity, heart disease and stunted growth. Among seniors, receiving SNAP benefits increases the likelihood of adhering to medication – including taking it every day, taking the prescribed dose, and not delaying filling the prescription.

Food as medicine starts with meeting basic nutrition security needs and includes important federally supported programs like SNAP (Supplemental Nutrition Assistance Program), WIC (Special Supplemental Nutrition Program for Women, Infants, and Children), school lunch and meals provided to seniors. These are interventions that can help prevent chronic disease by increasing nutrition security.

While all the clients we serve at Ceres Community Project are dealing with a health challenge that requires medically tailored meals, we also screen every client for food insecurity. For clients who screen positive, we provide either a double portion of prepared meals (14 per week) or 7 prepared meals plus a grocery bag of simple-to-prepare medically tailored items equal to about 8 meals.

Food as Medicine as a Medical Intervention

Food as medicine also describes specific kinds of nutrition interventions that can be offered by a health provider or insurer to address or treat specific chronic illnesses. Healthy food prescriptions, medically tailored groceries and medically tailored meals are all examples of food as medicine interventions that are being offered within a traditional health care context. In these situations, health care providers or insurers identify specific nutrition needs based on a patient’s diagnosis, acuity, income or other factors; refer the patient to receive the service; and in some cases also pay for the service. Below we’ll review broader policy efforts underway. Here are a few specific examples of how various food as medicine interventions are being researched or applied:

Medically Tailored Meals

Medically tailored meals (MTM) are delivered to individuals living with serious illness through a referral from a medical professional or healthcare plan. Meal plans are tailored to the medical needs of the recipient by a Registered Dietitian Nutritionist (RDN), and are designed to improve health outcomes, lower cost of care and increase patient satisfaction. MTM have the most robust research base of any food as medicine intervention (see chart below) with studies consistently demonstrating a net savings of at least 16% in health care costs and a wide range of additional benefits.

– California’s Nutrition Intervention Pilot for Medicaid members with Congestive Heart Failure: In 2017, the California legislature approved $6 million for the first statewide pilot of a MTM intervention. Ceres Community Project is one of the six non-profit nutrition service providers involved in this pilot. Together we cover 7 counties and 48% of the state’s Medicaid population. Eligible patients receive 12 weeks of full nutrition (21 meals/week) and up to 3 visits with a registered dietitian nutritionist. Meals are fully tailored to meet evidence-based guidelines for patients with congestive heart failure. A full evaluation is being done by a national health evaluator and will include an assessment of health care utilization and costs among patients receiving the intervention compared to similar patients who do not. Early self-reported data is showing dramatically lower 30-day hospital readmission rates for patients in the intervention compared to the state’s average, indicating that this program will likely provide cost savings to the state consistent with the research on medically tailored meal interventions. Full results will be available in 2022.

– A wide range of health care organizations are currently providing MTM to specific eligible patients/members through contracts with MTM providers or conducting pilots to evaluate the benefit of the intervention. Ceres Community Project is currently working with Kaiser Permanente on a large-scale randomized control trial providing 10 weeks of meals for patients being discharged with congestive heart failure, diabetes and/or chronic kidney disease. Other examples include Medicaid patients with any condition at discharge from the hospital; patients with uncontrolled diabetes either alone or in combination with diabetes self-management programs; women with high risk pregnancies including gestational diabetes; end stage cancer; food insecure patients at discharge from the hospital, and more.

Healthy Food Prescriptions/Medically Tailored Groceries

In these programs, physicians identify at-risk patients—either by a diagnosed diet-related health condition (such as diabetes, obesity, or heart disease), a screening for food insecurity or a qualifying income level, or both—and write prescriptions for the consumption of subsidized nutrient-rich foods, most often fruits and vegetables.

– Gus Schumacher Nutrition Incentive Program (GusNIP): Supported by approximately $50 million in grant funding annually through US Department of Agriculture, GusNIP provides grants of up to $500,000 over three years to pilot produce prescription programs where community health centers or other health providers partner with community-based organizations. Eligible participants must be low-income patients who are eligible for SNAP or Medicaid, and be suffering from or at risk of developing diet-related health conditions. At least 50% of the funds must go directly to the patients being served and a wide range of program models are allowed. Eligible patients receive a “prescription” for the produce from the health provider, and you must track and evaluate the impact of the intervention on dietary health, food security, health care use and costs.

Feeding America’s Diabetes Wellness Boxes

Food as MedicineSeveral years ago, Feeding America conducted a multi-year pilot with several food banks around the country to test the value of an appropriately tailored food box for food bank clients with diabetes. Patients were referred by their health provider and received a monthly box with perishable and non-perishable foods tailored to meet nutritional requirements for diabetes. While funding for the pilot ended, some food banks have maintained the program through grant funding and Feeding America provides a Resource Guide on their website.

In 2018, Ceres piloted a program that combined access to healthy food, medically tailored prepared meals and nutrition education. The goal was to improve healthy eating behaviors and health status among low-income patients who were at risk of developing heart disease. Patients and their families attended a Saturday morning nutrition education class at a local elementary school. Extended family members were welcome, child-care was included, and the classes were taught in Spanish with simultaneous translation. Each week, the families went home with several already prepared meals that met diabetic and heart healthy standards, recipes and the groceries needed to prepare them. Patients reported significant reductions in food insecurity, and improvements in healthy eating behaviors, attitudes about healthy eating, and confidence in healthy eating. All health metrics that we tracked remained stable or improved.

While not connected directly to health care referrals, California’s Market Match Program is another example of efforts to increase fruit and vegetable consumption among low-income community members while also supporting local farmers. Funded initially by $3.7 million in federal grants through the Food Insecurity Nutrition Incentive (FINI) Program matched with state funds, Market Match doubles the spending of food stamp recipients when spent at more than 300 farmer’s markets across the state. Research by the University of Southern California found that 75% of Market Match shoppers reported eating more fresh fruits and vegetables and 71% said their family’s health had improved.

Food Pharmacies

What we know - how medically tailored meals can helpOn their own or sometimes in coordination with produce prescription programs, community health centers, hospitals and others are developing Food Pharmacies. Most often, patients receive a prescription from their health provider to visit the Food Pharmacy either weekly or monthly. Sometimes patients participate as part of a cohort and also receive nutrition education and/or cooking demonstrations at each visit. The Pharmacies are small food pantries that contain only food choices that are healthy for the patient population being referred. Boston Medical Center launched their Preventive Food Pantry in 2001. Today, they distribute 50,000 pounds of healthy food a month to about 1,800 families with 40% of recipients being children. Participants receive a referral from their primary care physician and can visit the pantry twice each month. Their food options are pre-selected based on their family’s dietary restrictions and each visit is recorded in the patient’s medical record so their physician knows whether or not they are accessing the benefit.Boston Medical Center’s program also includes a Teaching Kitchen that was built at the same time as the Food Pantry to educate patients about how to cook nutritional meals at home. A Registered Dietician and nurse provides tips on how to cook healthy recipes and runs classes for people with diabetic, cardiac, and hypertension issues, as well as pregnant women and those fighting obesity.

The Opportunity of Food as Medicine

Faced with the epidemic of nutrition-related chronic disease outlined above, and the increased health care costs that are associated, health care providers and insurers, including CMS (Centers for Medicare and Medicaid Services), are innovating to connect patients to a wide-range of food as medicine interventions. While there is still a long way to go to fully integrate healthy food as a covered medical benefit, most national insurers have at least a toe in the water and progress is being made in federal and state-level health care programs. Here is an overview of the most promising efforts to scale food as medicine.

– Ryan White, the federal program for AIDS/HIV support approved in 1990, was the first time home delivered meals were funded for a population with a specific illness. The program, which provides a wide range of services for people living with AIDS/HIV, has been extremely successful. Ryan White Program patients have achieved retention in care rates (80%) and viral suppression rates (81%) that far exceed national averages. Ryan White was the first federal program to recognize and fund vital structural interventions like housing support, transportation, and most critically, food and nutrition services. Dozens of community-based organizations around the country continue to receive annual funding from Ryan White to provide MTM and medically tailored groceries to people living with AIDS/HIV,

– As of 2020, Medicare Advantage, the Medicare program used by about 33% of Medicare members, can include coverage of food and nutrition interventions for Medicare members who meet certain criteria. Medicare Advantage plans must choose to offer the benefit and receive approval from CMS to do so. While uptake of the benefit was slow in the first year, many plans are expected to begin some food and nutrition interventions like medically tailored or home delivered meals in 2021.

– To address the equity issues with nutrition benefits being available to only 1/3 of Medicare members, Congressman Roger Marshall (R-KS), Congressman Jim McGovern (D-MA), Congresswoman Jackie Walorski (R-IN) and Congresswoman Chellie Pingree (D-ME) have introduced H.R. 6774. The Medically Tailored Home-Delivered Meals Demonstration Pilot Act of 2020 would establish a Medicare MTM pilot program in at least 10 states to address the critical link between diet, chronic illness, and senior health. The goal is to evaluate the impact of a MTM benefit on health outcomes and costs. If the pilot is successful, the meal benefit could be expanded to every Medicare beneficiary who qualifies based on health status.

– While the traditional Medicaid program does not cover food as a benefit, several states have requested permission (through program waivers) to cover or pilot food as medicine interventions in their Medicaid programs. For example, both Massachusetts and North Carolina have received permission to provide a range of food and nutrition interventions, such as meals or transportation to a grocery store, to Medicaid beneficiaries who meet certain criteria. A number of state Medicaid programs also pay for home-delivered meals in order to keep people in their homes as opposed to nursing homes. Moreover, in light of the research that shows a reduction in health care utilization and therefore cost with participation in certain food as medicine programs, private insurers that participate in the Medicaid program are also offering meals with non-benefit funding.

– Private Funding – hundreds of private health care organizations and insurers, along with philanthropic funders, are conducting research studies, piloting interventions for different populations, or simply acting on the basis of the existing research and paying for food as medicine interventions for their patients and members.

Food as Medicine Challenges

While we’re seeing tremendous momentum in the food as medicine space, significant challenges exist to fully integrate food as a covered medical benefit. Our health care system is simply not designed to partner with non-clinical food providers, or to prescribe or refer to non-clinical food services. Here are just a few of the issues that must be addressed at a systems level if we’re going to recognize the full benefits of the food as medicine revolution.

Health care providers have not historically been set up to identify patients who might need a food as medicine referral. Often such referrals are based on a combination of a diagnosis and clinical data along with information about food insecurity, mobility issues, or other factors. Someone has to gather this data, make it available in the patient’s electronic medical record (EMR), and then someone at the health care provider needs to reach out to the identified patients, talk with them about the referral, and then follow through by making the referral. A wide range of strategies are being implemented to address these issues.

Health care organizations are implementing various social determinants of health screening tools to assess patients’ need for food, housing assistance, transportation, and other services. On-line Community Resource Guides are being set up that allow individual patients or patient navigators to find resources that best match a patient’s needs or that are available near a patient’s home. Many of these include the ability for “closed-loop” referrals – a health provider can refer a patient to a community-based organization and receive confirmation back that the patient has been enrolled in the service. And health care organizations and communities are investing in community health workers to serve as patient navigators, helping patients connect with community-based services like food programs that can help them better manage their health conditions.

Linking to Sustainable Food Systems

Planting beets in the Ceres garden, Sebastopol

Planting beets in the Ceres garden, Sebastopol

While food as medicine is gaining momentum, these efforts are not necessarily aligned with the movement to build a healthy, sustainable and just food system. In our own work across a range of coalitions, we are often asked why we choose to spend money on organic food. For those working to address hunger as an immediate condition, it seems an almost frivolous cost. Colleagues providing medically tailored meals lean on the nutritional tailoring of their meals without looking more deeply at food quality. Even for those who are beginning to acknowledge the superior nutritional quality of organically and regeneratively grown foods, cost continues to be a barrier.

Our challenge is to help our peers working across the food space – all of whom are doing critically important work – to understand the connection between what they do and two important issues: the health of the people they serve, and the health of the planet. And to understand that the two are inextricably linked.

To reap the full benefit of the food is medicine revolution, we need to articulate and adopt food guidelines that go beyond the nutritional components needed by an individual patient. We also need to establish guidelines for how that food was produced and processed. Thinking only about how food will impact an individual misses the broader impact that our food system has on the health of food and farm workers, communities and the environment. If the food we provide to a patient as part of a food as medicine intervention is produced in a way that increases cancer rates among farm workers or pollutes local drinking water, we’ve negated the value of our investment. By merging these two movements – the movement for a better food system with the movement for nutrition security and health equity – we can leverage the value of our food is medicine investments and create win-wins for our communities.

Health Care without Harm’s Environmental Nutrition Framework is a valuable starting point for this work:

Client enjoying Ceres meal

Client enjoying Ceres meal

“Healthy food cannot be defined by nutritional quality alone. It is the end result of a food system that conserves and renews natural resources, advances social justice and animal welfare, builds community wealth, and fulfills the food and nutrition needs of all eaters now and into the future. [We must expand] the definition of healthy food beyond measurable food components such as calories, vitamins, and fats, to include the public health impacts of social, economic, and environmental factors related to the entire food system.”Ceres Community Project published a white paper in 2016 called The Power of our Food Choices that summarizes research on organic and conventional food systems, pasture-raised vs factory farmed meats, and several other parts of our food system. Finally, in 2019 California Certified Organic Farmers (CCOF) produced the Roadmap to an Organic California Benefits Reports summarizing more than 330 studies on the value of organic agriculture, many of which tie directly to health and health equity.

Using the information in these three documents we can educate those providing and paying for food as medicine interventions; we can urge them to establish and meet food sustainability guidelines, to give preference to providers who include organic and sustainably raised products, and to be willing to pay more for food that meets higher standards. In 2019, we used these documents to help create a food quality pledge for organizations providing emergency food in Marin County.

The reality is that our health depends on a healthy and sustainable food system, a healthy environment, healthy community connections, equitable access to health care, and wide range of other issues. Connecting the dots between our food system and our health care system is a first step in building a more holistic approach to health. If we’re thoughtful and intentional, we can use the food as medicine movement to make that connection. By doing so, we’ll improve health for individuals and improve chronic disease while also fostering a healthier and more just food system for all.

Where do We Go from Here?

All of us can play a role in moving the food as medicine movement forward. While major work needs to – and is – moving forward to integrate food as a covered benefit as part of federal health care programs and among major insurers, there are many opportunities to advance this work at a local level. Here are a few suggestions:

– Share what you’ve learned with key decision makers – local legislators, leaders of health care organizations, farmers market managers and others

– Advocate for increased access to healthy food:

  • Have local farmers markets offer Market Match or double up bucks for SNAP recipients using local philanthropic dollars or funding from your local health department
  • Work with a nutritionist to offer free cooking demos and nutrition information at the farmers market
  • Work with community health centers to offer a weekly on-site farmer’s market – offer produce at a lower rate or get a local funder to subsidize the produce

– Create a Food as Medicine Coalition that brings together representatives of key health providers and key food providers (food banks, senior meal providers, farmers market managers) to create joint strategies for improving access to healthy food while also strengthening your local food system

– Work with a local meal provider like a Meals on Wheels program to have them improve the quality of the food they source. Connect them to local farmers and help them raise local philanthropic dollars to purchase local food.

Reframing our mindset that investments in food and nutrition security are investments in the health and wellbeing of our society as a whole, rather than investments only in those who receive the benefits directly, helps to build the connection between food and health. Continuing to integrate healthy food as a credible intervention paid for by health care dollars will dramatically increase funding for food at critical times for those who need it most.

NOTE: The author wishes to thank Dr. Rita Nguyen, Chronic Disease Physician Specialist at San Francisco Department of Public Health and Assistant Clinical Professor, UCSF, for the use of several slides that were part of our join presentation at the Eco Farm Conference in January 2020.

Author Bio
Cathryn Couch is the founder and CEO for Ceres Community Project, a non-profit working to foster health by connecting people to one another and to a healthier food system. Ceres provides 120,000 organic medically tailored meals annually to primarily low-income people struggling because of a health challenge. Youth volunteers grow food and prepare the meals as part of a youth development and culinary and food system education program. Ceres has trained a dozen communities across the United States and in Denmark to replicate their model and the organization supports 8 Affiliate Programs. Couch is the 2020 chair for the California Food is Medicine Coalition, a six agency collaboration conducting the first statewide medically tailored meal pilot for Medicaid members. Ceres is also one of four agencies currently conducting large-scale randomized control trials for medically tailored meals at Kaiser Permanente. Couch is as advisor to the Aspen Institute’s Food & Society initiative; sits on the leadership team for Hearts of Sonoma County – a collaborative working to reduce heart attacks and strokes; and participates in Marin Food Policy Council, California Food & Farming Network, and the Food Lab at Google. Couch was finalist for The Robert Wood Johnson Foundation’s Community Health Leaders Award, a finalist for the James Irvine Leadership Award, a Red Cross Adult Humanitarian Hero for Northern California and a CNN Hero. She holds an MBA from the University of Michigan.

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– Jack (TNF@nofa.org)