You Are What You Eat

Sandra Steingard, M.D.

April 8, 2012

Earlier blogs have discussed the pros and cons of drugs, but food is the most important thing any of us ingests and it seems foolish to not pay careful attention to what we choose to eat.  In the past 12 years, three books have had a major influence on how I think about modern medicine: Marcia Angell’s, The Truth about the Drug Companies, Michael Pollan’s, Omnivore’s Dilemma, the Robert Whitaker’s Anatomy of an Epidemic. One might ask how books about pharmaceutical companies, industrial agriculture, and the long term effects of psychiatric medications might relate to one another and I will try to answer that in this blog.

As Whitaker notes, the discovery of the antibiotics changed medicine. It led to a hope that more effective drugs, “magic bullets,” would be found for other diseases.  I would argue that this optimism about our ability to solve and fix problems in medicine was part of a larger optimism that gripped western culture in the post World War II years.  Agriculture changed dramatically. Chemicals that were used in explosives were found to be powerful fertilizers and this contributed to the development of industrial agriculture. In the US, policy favored the development of large farms and the entire nature of our agricultural system was transformed.  Rather than have farms that grew a variety of crops and raised different kinds of livestock, farms became large and they focused on one product.  Animals and produce became commodities.

Whitaker pointed out in Anatomy of an Epidemic, that when one gives a drug that alters the action of a neurotransmitter, the body has ways of adapting and adjusting. This tendency is known as homeostasis.  He raises the concern that the body’s homeostatic response to psychiatric medications may cause problems over time that may be worse than the condition they were meant to help.  This plays out on a larger scale in nature.  We are part of an ecosystem. If one perturbs one part, it has ripple effects on the entire system.  Antibiotics may cure a particular infection in a particular individual. When an antibiotic is used over time, however, the organism the drug targets evolves and develops ways to survive exposure to the drug.  Animals on industrial farms are overcrowded and this makes them sick. In order to keep them alive until they can be slaughtered, they are fed antibiotics.  Pharmaceutical companies sell more drugs to farmers to use for livestock than they sell for use in humans.  This practice may be contributing to the development of extremely dangerous strains of bacteria.  Similarly, large monocultures of crops may develop sensitivity to parasites. Although pesticides might help to fight these infections, over time the parasites will develop resistance.  In contrast, as Pollan describes in his book, farms that have multiple crops develop ecosystems that are healthier for the crops and livestock and eliminate the need to use pesticides and antibiotics.  This is healthier for our environment and healthier for us.

As farmers became more effective at growing food, they needed to grow their markets.  This led to the growth of the food processing business.  If you go into a modern supermarket, there are food products – typically in the middle isles – that  have been around for less than 50 years.  These foods are mostly made of corn, an incredibly versatile  and cheap food.  High fructose corn syrup may not be an inherently  dangerous food – or at least no more dangerous than cane sugar – but it is so cheap and abundant that food processors can pack high quantities into many products and there by increase not only their appeal to us (more on that in another blog) but also the amount of calories we are consuming with very little effort.  This is likely a major contributor to the increase in obesity in our country.  Obesity has been a major factor for the increase in a number of chronic illnesses such as diabetes and high blood pressure.

This has been an extremely profitable venture for food processors.  The use of pharmaceuticals has been extremely profitable for the drug companies. This gives them enormous clout in the advertising and political  worlds.   We have a food and medical system that is geared towards making us sick and then treating those illnesses.  In future blogs, I will write more about food and behavior and ways we can reverse some of the cultural trends that promote diet related illness.

Note: I did not put references in the blog but the ideas derive largely from the books cited above. Any  flaws in the argument reflect on this author and not the authors of those books.
Sandra Steingard, M.D.

Anatomy of a Psychiatrist: Dr. Steingard chronicles how she is integrating information from Anatomy of an Epidemic into her community mental health practice. She also discusses changes in Vermont’s mental health system and the influence of pharmaceutical advertising on clinical practice.


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15 thoughts on “You Are What You Eat

  1. I am always skeptical about the food arguments, related to emotional problems, because 12 years ago, I moved to a hobby farm, and learned to garden and cook. About 70% of the food that I eat, my husband and I grow without pesticides, or are deer and fish that we shot or caught and processed ourselves. The change from frozen pizza and Campbell’s soup to homemade, homegrown meals made no difference in my emotional problems. In fact, growing all that food and then having to cook on a daily basis is a crushing burden for me during a depression.

    What DID help was getting off the psychiatric drugs, although I am still very depressed off and on. At least the agitation is gone, and I think sharper and I can do chores a bit better, because I am no longer fighting akathisia.

    There may be people who benefit from the change. I think a lot of the benefit is placebo effect, frankly. My husband and I made the changes in lifestyle in order to save money, and get more exercise, and get better tasting results, and never considered my emotional health when we did that. I notice when I stop off at the locally owned health food store, there are a lot of true believers shopping there, so they are a lot more likely to get a placebo boost than I would.

    Our bodies are probably a lot healthier, though. The cost savings are so significant that having less money stress offsets the stress of having to cook everyday, which is overwhelming for me a lot of the time.

    OK, so those are my 2 cents.

    • I will address this more later but basically I think that eating food, less processed and locally grown food is healthier from the perspective of the larger ecosystem in which we live. It is a separate albeit realted question as to whether certain foods can be beneficial for certain specific symtpoms.

    • Rabbit — I totally agree with you. I think it’s placebo effect combined with true-believerism. I too have seen my diet play absolutely no role in my mood or emotions (not “symptoms,” Sandy) while other things (social in nature) have made all the difference in the world.

  2. I just finished reading Patrick Holford’s Optimum Nutrition For The Mind. I highly recommend it!! Thank you do much for bringing my attention to Anatomy Of An Epidemic, Soteria House, and more holistic approaches to mental and physical health. I feel like my whole world view has changed in that last couple of months from these books. I am enjoying the MadInAmerica weekly newsletters and your blogs. Thanks for being a leader in this direction!

  3. Dr. Steingard:

    I am sure you have seen that I am a strong critic of biological psychiatry after doing much research on it for many years due to the fact that some of my loved ones were threatened with great harm by it due to life crises.

    However, I must say as I have read the many articles on this site, I do admire your hard efforts to engage with many of the people here in an attempt to learn new ideas, seek new ways to avoid harming patients with emotional distress or trauma given your reading of ANATOMY OF AN EPIDEMIC, and share new discoveries or thoughts of your own as in this latest post.

    I agree with you that healthy food can heal much damage in a person’s body and mind while toxic or junk food can do a great deal of harm. The book, THE OMNIVORE’S DILEMMA, that you cite is a classic among health food advocates as you probably know. I also highly recommend Dr. Joel Fuhrman’s EAT TO LIVE and EAT FOR HEALTH and his great web sites and other books/DVD’s since he is a renowned nutritionist and expert on preventing/healing chronic illnesses by natural means. He uses his expertise to heal both physcial and mental symptoms holistically without drugs or other medical interventions. His latest book is SUPERIMMUNITY. He has recently been on PBS.

    I realize that junk food has certanly contributed to the obesity epidemic, but so have psychiatric drugs, especially atypical antipsychotics. Although once one’s metabolism has been compromised by these toxic drugs, one may eat much much more junk food as a result, I know from personal observations that the drugs caused the problem in the first place for a huge number of people as doctors prescribing them have also observed. I say this because I wonder if you believe that the junk food more than antipsychotics are more to blame. I believe they are both to blame, but the drugs cause the problem for those not obese before the drugs and worsens it for those already obese, which makes the cause quite obvious to all and very dangerous.

    My main reason for writing, however, is that I recently saw Dr. Mark Hyman on PBS with his new program/book, THE BLOOD SUGAR SOLUTION, which led me to get the book and start reading/browsing through it. What I like about it is that he also takes a holistic approach and he sees three main culprits of BIG PHARMA, BIG AGRICULTURE and BIG FOOD businesses promoting toxic drugs and food that promote and maintain very unhealthy lifestyles that are ultimately deadly. I admit that I am not familiar with all of his science, but based on much reading about health issues, much of his advice makes great sense.

    In the book and on his web site of the same name, he advocates what he calls functional medicine whereby the emphasis is rooting out the cause of such chronic illnesses like diabetes such as toxic eating habits and other poor life style habits rather than treating it with the current treatments like insulin that make the diabetes worse and create far more dangerous health problems. He also shows how this approach can be applied to such symptoms/labels as ADHD by finding underlying nutritional, vitamin deficiencies and toxic junk food habits, allergies and other underlying physical problems contributing to the symptoms. Somebody recommended Safe Harbor to you that does something similar that you enthusiastically said you joined.

    Though I despise psychiatric labels for the huge harm they do, which I have certainly not hidden, I do applaud this approach to getting at the root cause of symptoms often falsely labled as mental illness to promote actual healing once and for all rather than merely masking symptoms with toxic drugs known to make the problems much worse in the long run whether it is diabetes, heart disease or ADHD. Of course, toxic relationships and/or isolation can also cause symptoms, which Dr. Human also addresses along with the need for exercise and stress reduction.

    I am wondering what your thoughts are on this and if you are familiar with the concept of functional medicine and/or Dr. Hyman’s book, THE BLOOD SUGAR SOLUTION.

    Again, I realize we disagree on several issues, but I have admired your willingness to consider new or better options, new methods and treatments and express your own concerns and reservations about some of the approaches of mainstream psychiatry.

    I would appreciate your consideration of the above.

    Donna

    • Thank you, Donna. I deeply appreciate this comment. I have not read Dr. Fuhrman’s or Hyman’s books. It does sound like Dr. Hyman is elaborting on the point that I was trying to make in the blog so I will look into that further. In future blogs, I will describe how I am approaching this topic with my patients (and with myself – this is a human issue and not attached to any particular label).
      Regarding the impact on many psychiatric medications on weight: this is a topic with which I am extremely familiar and deeply concerned. It was when I observed significant weight gain among my patients on second generation antipsychotics while promient psychiatrists and drug companies were minimizing this, that I realized there was a serious problem in psychiatry. This should be a link to a letter I wrote to the American Jounral of Psychiatry about this: ajp.psychiatryonline.org/cgi/content/short/166/8/934?rss=1
      I am glad that we have found some common ground.
      Sandy

  4. Started reading a book this weekend that a fellow gardener recommended “The Happiness Diet” : Graham/Ramsey writing on the mad diet and in it states a large study was published in British Journal of Psychiatry that “found that eating processed foods, such as refined carbohydrates, sweets, and processed meats, increased the risk of depression by about 60%. Eating a whole-food diet, on the other hand, decreased the risk of depression by about 26%”. Knowing my own experience, I looked this up more as a study reveals more to some than one’s story.

    There is a little summary and an opinion of the study here http://lifetwo.com/production/node/20091106-one-treatment-midlife-crisis-healthy-food

    The full study’s technical details are listed here http://hal.inria.fr/docs/00/43/20/97/PDF/Akbaraly_et_al_Diet_Depression_BJP.pdf

    I do wonder if we will ever have collectively have free salad refills instead of a free soda refill…or maybe even be able to purchase fruits and veggies with a discount with our ‘wellness card’ at the pharmacy checkout…instead, I do continue feel quite challenged combating my sadness that our society’s ways for the health of all humans here continue to promote foods that are “bad” for us. One day I hope to see a commercial or campaign on advertising fruits and veggies from the US Government or some grassroots organization, or maybe some processed foods company waking up to the health harms they have contributed to. I know there is no money in advertising fruits and veggies or methods of cooking whole foods, but there is a higher cost to not to get the message out there somehow…I continue to think on this issue somehow parallel to the cigarette companies and the hype with that…but somehow it is acceptable that we have convenience foods and one tiny ‘health food isle’ in our grocery stores yet many, many health issues are a direct result of lifestyle choices.

    My grandfather was a pharmacist and he would fill the individual capsules by hand. How can this be possible that the needs of people have changed so drastically to ‘need’ medicines as we do now…not that long ago…yet, would my grandmother recognize many of the “food” items people purchase in 2012? I doubt my great grandmother would! (a thought many books reflect upon today)

    “Let thy food be thy medicine and thy medicine be thy food.” 400BC Hippocrates

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