I want to go into a bit more detail about some of the stuff in this post – both to clarify what I’m saying, and to help assimilate in my own brain what I’m learning and what I’m experiencing. So, if this is the magic bullet of perfect health, why isn’t it mainstream?
I think there are a lot of reasons, but here are a few of the top ones:
It’s too new
There’s a knowledge lag of 17 years before new treatments become standard practice.
In the case of experimental surgeries or pharmaceutical drugs, this might be a good thing – but if there’s no risk of harm, why wait?
It’s too hard to standardise
The “gold standard” of scientific research is the randomised controlled trial. By definition, such a trial needs to be testing one intervention, with all the other variables held constant. A few of these have been done, but the results aren’t conclusive, because they can’t be.
If you trial 100 people on a gluten-free diet, 10 of them might feel better. For those 10, that result could be life-changing, but overall, your trial is a failure because everyone didn’t get better. But the point is that everyone isn’t meant to because everyone is different.
Five of those 10 might improve further on a dairy-free diet too, or if they eat more plant foods, or heal their gut. Some of the other 90 might have issues with candida, or mould exposure, or their blood sugar.
There’s no single lifestyle intervention that will help everyone… beyond the obvious ones that we’ve already accepted because they really are universal, like stopping smoking, exercising, getting more sleep and eating less sugar.
Unfortunately, instead of the medical community as a whole saying “hey, these things help some people, they’re worth a try”, they tend to say “there’s no evidence for that, so don’t bother”.
(The funny part is that the efficacy of drug treatments are on the whole also pretty crap… for example, people with high cholesterol who may be at risk of a heart attack are prescribed a statin – a drug that lowers the level of “bad” cholesterol in your blood. Usually, you need to then stay on this drug forever.
But the “number needed to treat” (NNT) for statins taken over five years is 104 – which means that for every 104 people put on a statin for five years, one heart attack will be prevented. But the number needed to harm (NNH) is only 50 – “one in 50 people on statins develops diabetes and one in ten experiences muscle damage as defined as rhabdomyolysis”.
On the other hand, switching to the Mediterranean diet for five years has an NNT of 61, with no harms found.)
No one wants to fund the research anyway
Who’s going to put up the money for the kind of massive, intensive trial that would show results in this kind of stuff… Big Broccoli? This is not me digressing into Big Pharma conspiracies – just me saying that research costs a lot of money, and it’s generally funded by those who can make that money back from positive results of the research (like drug companies).
No one organisation is going to make billions from everyone eating a better diet and reducing their stress.
We think about things in boxes
The way we think about and classify disease is also working against us. We’ve built a system of specialists, classifications and interventions. We think about our bodies as a series of separate boxes rather than an interconnected whole. If you have a problem with your teeth, you see a dentist. If you have a problem with diarrhea and stomach cramps, you see a gastroenterologist. No one ever connects your bad teeth to your irritable bowel.
We’ve made medicine into an assembly line – you get 15 minutes to outline your symptoms, we check them against the way we’ve classified diseases, assign a name to whatever is wrong with you, and then give you the “standard of care” solution. Which is usually a drug, and may have loads of side effects or not even be particularly effective (see the statin example above).
The dentist might remove your sore tooth, or give you a root canal so you can’t feel the pain anymore. The gastroenterologist might put you on an anti inflammatory or give you painkillers. But if both problems were caused by an imbalance in your microbiome, you might end up in a different doctor’s office six months later, being treated for depression or candida or joint pain.
We see what we want to see
In functional nutrition, if you discover an intolerance to dairy or soy or corn and remove it from your diet for a period of time, while also working on improving your digestion and the quality of your diet, supporting your liver or other organs, and rebuilding your microbiome, you may eventually be able to start eating those foods again. This could be because you’ve healed your leaky gut, calmed your immune system, and/or reduced inflammation. Being able to resume eating a food you were intolerant to is evidence of success.
But to the medical establishment, that’s often seen as proof that the intervention didn’t work, or was all in your head. See! You can eat the thing again – that means you were never really intolerant to it! The fact that you also got better is just a coincidence.
To me, there’s a real cognitive dissonance to this view. It’s not like we don’t know how crucial vitamins, minerals, fats and proteins are to our health. We also know that 60% of the average (American) diet is now made up of processed sugar, white flour and vegetable oil – substances which have plenty of calories, but basically no nutritional value*.
Both of the doctors I saw personally about my lichen sclerosus decided to think of my recovery as “spontaneous remission” rather than accept that changing my diet had anything to do with it. Like, when the science they’d been taught didn’t match with the results they saw, they preferred to believe it had just happened by magic rather than consider new information. It still boggles my mind.
We like to believe the system is the best system
I think we really hold onto the idea that whatever the “usual” way of doing things must be the best way. I can see why – any deeper interrogation of modern society is a one-way rabbit hole that leads straight to an existential crisis. (She says, from inside the hole.)
But… the way we do school isn’t the best way of educating children. The way we farm is definitely not the best way of growing food. The way we work is absolutely not the best way to achieve a healthy, productive society. Most of our systems seem to be at best a series of accidents that built over time until they turned into reinforcing loops. Modern life is now a perpetual motion machine that we can’t figure out how to slow down, let alone point in a new direction.
Mainstream isn’t necessarily mainstream, anyway
I’d like to add one more point here, that’s becoming more and more apparent to me the longer I’m out in the world talking to people about my own health journey. Being a hardheaded, super-skeptical member of Team Science, readjusting my world view to accept that there was this whole field of health I’d never heard about, and that all these chronic diseases and mental health issues we’re suffering from are not only abnormal but also highly likely to be fixable, felt like I had to rewire my entire perspective on the world. It sounds dramatic, but I felt like everything I’d thought was true and solid was revealed to be – at best – some really mushy jelly, and I had to re-learn how to live on suddenly shaky ground.
So I’d assumed that the process of talking about this with anyone else would be similar – I’d either become an instant pariah, or I’d have to provide a full dissertation with footnotes and references in every conversation. But it turns out that just because my doctors don’t believe me doesn’t mean that everyone else agrees with them.
Every day I seem to talk to someone else who’s experimenting with this diet or that intervention because their doctor couldn’t help them, or they just know in their gut that they should feel better than they do. The problem is that most of them are doing it on their own, without help, in a scattershot trial-and-error way based on anecdotes or Instagram ads.
I feel like I’m still integrating this new model of the world into my brain. I still hold my breath every time I recommend someone makes a dietary change to try and help a health issue, and I’m still gobsmacked every time that change works. Recently I suggested a relative could try a gluten and dairy free diet to see if it helped his ulcerative colitis. I was not only still slightly shocked when his symptoms promptly resolved, but equally shocked (and amazed) that when he later tried a gluten challenge, the bleeding resumed the next day.
It’s not that it works, because the more I learn, the more the science and the theories make so much sense to me – it’s that any medical professional (let alone basically all of them) would leave fixing the fucking problem out of their arsenal when it’s readily available as an option.
This stuff should not be fringe – but to make it mainstream, we’re not only going to need to change the information we teach to our health professionals, we’re going to have to rethink our entire food system, as well as the way we work, play, interact, sleep, clean ourselves, and more. It’s terrifying, and overwhelming – but also so freaking exciting.
I’ve read dozens and dozens of books in the last year or two that expand on these ideas – what will speak to you will probably depend on what you’re personally dealing with. I reckon podcasts are the best way in – you can find what you’re interested in and choose to dig further from there.
That said, some of my favourites are:
*I’d go further and say they have negative nutritional value – not only are they not helping you get all the things your body needs to work properly, but they’re actively making you sick. More on that another time!