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The real food issue

Re-imagining healthcare

holistichealthcare

J O U R N A L O F

•Nourishing a small planet

• Eating for individual, public and planetaryhealth

• The real food campaignsustainability food andpower

• Food, imagination and reality

• Is EAT-Lancet wrong?

• Eating nose to tail

• Eating old-style

• Making health infectious

• Measuring food vitality

• A local community foodsystem

•Wildlife-friendly farming

• Seeds of survival

• Inspirational communityprojects

Plus• Research• Reviews

Volume 16 Issue 3 Autumn 2019

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ISSN 1743-9493

Published byBritish Holistic Medical AssociationWest Barn, Chewton KeynshamBRISTOL BS31 [email protected]

Reg. Charity No. 289459

Editor-in-chiefDavid [email protected]

Editorial BoardDr William House (Chair)Professor David PetersDr Thuli WhitehouseDr Antonia Wrigley

Production editorEdwina [email protected]

Advertising The journal of holistic healthcare has astrong online circulation both nationallyand internationally with thousands ofpage views every month. The journal isavailable in hard copy and online.To advertise [email protected]

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Designwww.karenhobden.com

Cover illustrationBen Peters [email protected]

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Contents

Volume 16 � Issue 3Autumn 2019

holistichealthcare

J O U R N A L O F

Unless otherwise stated, material is copyright BHMA and reproduction for educational, non-profit purposes is welcomed. However we do ask that you credit the journal. With thisexception no part of this publication may be reproduced in any form or by any other means –graphically, electronically, or mechanically, including photocopying, recording, taping or informationstorage and retrieval systems – without the prior written permission from the British HolisticMedical Association.

Every effort is made to ensure the accuracy of material published in the Journal of Holistic Healthcare. However, the publishers will not be liable for any inaccuracies. The views expressed by contributors are not necessarily those of the editor or publisher. 1

Editorial . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2Eating for individual, public and planetary health . . . . . . . . . . . . . . 3Mike DixonThe Real Food campaign . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4For a healthy, sustainable and affordable British dietAntonia WrigleySitopia: the power of thinking through food . . . . . . . . . . . . . . . . . . . . 5Carolyn SteelFood: emotion, imagination and reality . . . . . . . . . . . . . . . . . . . . . . . . . 10Andrew MorriceEAT-Lancet – is there such a thing as ‘one-size-fits-all’ sustainability?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15Robert VerkerkNose to tail nutrition and evolution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23Heather RosaFood for health: Putting traditional foods back on the table . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27Izabella NatrinsMaking health infectious: from organic principles to wholehealth agriculture. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32Lawrence Woodward OBEFood quality and its relevance to optimum health . . . . . . . . . . . . . 37David ThomasBuilding a local community food system . . . . . . . . . . . . . . . . . . . . . . . 41Phillip SharrattWilder labels, better farming . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45Tim MartinSeeds of survival . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49Fred GroomWellington’s inspirational community projects. . . . . . . . . . . . . . . . . 51Helen Gillingham‘Let food be thy medicine, and let medicine be thy food’ . . . . . 54Is food the foundation for good health?Jessica FrostPrescribing lifestyle medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57Mohanpal Singh Chandan and Asfia AftabWilliam House . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59Research . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60Reviews . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61

© Journal of holistic healthcare � Volume 16 Issue 3 Autumn 20192

David PetersEditor-in-ChiefEditorial

dairy fats were demonised for decades, until we learnedabout the trans fats in the non-dairy spreads we switchedto in the 1980s. Now it’s margarine we have to avoid andbutter is back on the table.

So what is a healthy diet? Eat food; not much, mostlyplants said Michael Pollan. Good advice you might think,yet Masai herders lived well on the blood, meat and milkof their cattle and not much else. Until the 1960s mosttraditional Alaskan Inuit people had a semi-nomadic lifehunting and catching fish, marine mammals and birds. Butin the 1960s after access to processed foods boostedrefined carbohydrate intake by 50% (Fodor et al, 2014),the Alaskans, who were still eating a traditional low-carbo-hydrate, high-fat/protein diet, had a much lower incidenceof atherosclerosis, hypertension and dental caries. Thependulum is swinging away from fat-avoidance towardssugar-fear. In WWII, when sugar was rationed and breadwas once again brown, the nation’s health improved,despite wartime stress and austerity. After the battlesended in Europe, something like a war began on the farmas industrial agriculture took to chemical fertilisers andchased ever greater yields. But in time Big Farmingdamaged the soil structure, stripped out its essentialminerals and microbes and poisoned our rivers with run-off. Now the nutrient supplement industry sells us backwhat’s been taken out, while Big Food sells us fake foodthat make us ill and Big Pharma sells the NHS its cures.

Some say science is giving meat a bad reputation, thatwe are fundamentally carnivorous, that only processedand smoked meats are a cancer risk. Big Meat would liketo convince us of this, and indeed many a small mixedfarmer lovingly caring for her land would be in a fix if itweren’t for manure from her cows. Still we have to bearthe realities of global overheating in mind, and in a year acow can release 70 to 120kg of methane, whose climateimpact is 23 times greater than the effect of CO2. It takes1,800 gallons of water to produce one pound of beef, andthere’s no counting the ecological cost of clearing Amazoniato grow soy beans for non-pasture-fed beef cattle.

It’s no longer a question simply of a diet that’s goodfor individuals: we need a healthy diet for a small planet.Food is so much more than a mix of nutritional chemicals.In this issue of JHH we look at the power of food to affectsoil, soul and society, and shine a light on some inspirationfood-based community-building and sustainability projects.Nor have we shied away from the vexed question of foodvitality and some radical dietary ideas. Food for thought.

Reference Fodor JG, Helis E, Yazdekhasti N et al. ‘Fishing’ for the origins of the‘Eskimos and heart disease’ story: facts or wishful thinking? Can JCardiol 30:864–8.

We need a healthy diet for asmall planetFor most of us food just appears as if by magic, like moneydispensed at the ATM. It arrives, often embalmed inplastic, whatever the season, so the realities of its plantingand harvest are hidden from us. We are spared a hungrywinter, but are detached from the natural world and lessbothered about what suffered for the sake of our sausage,or the fungicidal mayhem spreading from the fish farm, orthe ancient hedgerows torn up as wheat fields spread out,or calves dying so we can drinka pinta milka day. Yetethics aside, it’s now impossible to think about foodwithout running up against every aspect of our profligateand unsustainable ways of life.

In the days before flight-guilt, on an economy flight tosomewhere warm, my companion was gazing balefully ather airline lunch-tray. Set before her, anaemic microwavedchicken, reconstituted mash, some wilted hydroponiclettuce, a foil pack of Flora, plastic straws of milk andsugar. ‘It’s real’ she said ‘because it exists… it’s foodbecause you eat it’. This is the problem in a nutshell; that we feel confused about what’s real. In hangar-sizedsupermarkets we are dazzled by cabinets of tasty lookingfood-like substances – plant-based only in the sense thatthey were made in food factories: produced in plantsrather than grown on plants. We pop the ready meal intothe microwave oblivious to how it got from soil to shelf,shelves that would be empty but for precarious and short-horizon global supply lines.

A manufactured food-like product may be technicallyspeaking nourishing: its packaging will tell you about itsfat, protein and carb content; its warning flags will alertyou to high salt, sugar and unsaturated fat. So far sobiochemical, for this is what it usually meant by ‘you arewhat you eat’: food builds bodies. But nothing goes intothe mouth without also going through the imagination,which is why what you eat reveals a lot about who youbelieve you are. Our dietary habits reinforce these unconscious assumptions, ensnaring us in illusions aboutour relationship to the natural world, for instance in theway white bread and white sugar used to signal pure andposh, while brown bread was for the poor and the peasantry. Perhaps too it satisfied a wish to detach fromhuman messiness. Then came the wholefood revolutionof the 1980s. Initially driven by concerns about fibre andfertilisers, it was accompanied by a widespread preoccupation with ‘naturalness’. Since those heady times,when we only had feelings and opinions to guide ourchoices, science has given us evidence-based lifestyles,evidence-based diets, even evidence-based contemplativepractices. But the sands of expert opinion shift over time:

© Journal of holistic healthcare � Volume 16 Issue 3 Autumn 2019 3

Food is the most important factor in preventing disease.The right diet can also enable and speed recovery whenwe are ill. Yet diet seems to come bottom of the list whenit comes to medical education or providing medical advicein the consultation. Our patients meanwhile – whether athome or in hospital – continue to eat relatively unhealthydiets and are spending a lower proportion of their incomeon food than ever.

Part of the reason for this may be because we medicsdon’t seem to agree on what is a healthy diet. There aresome generally agreed truths such as eat more fruit andvegetables, eat less fatty meat; and the protective effects ofa Mediterranean or anti-inflammatory diet are well proven.Some diets have shown to be particularly helpful in areassuch as heart disease and prostate cancer. Nevertheless,‘experts’ and the media continue to confuse the generalpublic with foods that are claimed to be superfoods oneday and demons the next. One minute we need to eat lessfat, the next it is less sugar. No wonder then if doctors arealmost as confused as their patients about what we shouldbe eating.

Meat is a case in point. There is little doubt that fattyprocessed meat is bad for you. Yet we know that a pasture-fed Angus steak is much healthier (eg higher omega 3content) than the cheaper and more widely available meatfrom cattle grain-fed in barns. What we don’t know is thepossible health-positive effects of meat from sheep or cattlegrazed in natural pasture, perhaps containing plentifulherbs such as wild thyme and St John’s wort which mightmake such meat healthier still. Then there are wider issuessuch as how, without animal manure (and without importingchemicals from abroad), we would fertilise our fields. Andwhen it comes to carbon footprint, let’s not ignore theability of the pasture plants themselves to sequestercarbon; an effect that is reversed by bare ploughed fields.

A further element of complexity comes from thediscovery of the importance of the trillion bugs that makeup our intestinal biome. We know that they matter andthat their effects range from bowel problems to obesityand disorders of mood and emotion. We also know thatthis inner world of gut bacteria prefers a wide range ofdiet, and that some probiotics and even faecal transplantscan restore a healthy microbiome. And though it is still as

yet a far from an exact science, it is becoming clearer thatthe individuality of our biomes and genotypes mean therecan be no precise one-size-fits-all ‘good diet’.

We are currently faced with an institutional and politicalunwillingness to reverse all the factors that stop us usingthe evidence available to help us lead more nutritionalhealthy lives. Healthy foods are, on the whole, moreexpensive than unhealthy foods. Supermarkets blametheir offering unhealthy foods on the customers, whowant to buy them. Farmers are encouraged to providecheap food by the least friendly farming methods and,having bought all this cheap food, we throw away 40% ofit. If politicians, food outlets, food producers, farmers andfood academics could group together, surely there mustbe some means of reversing a system that currently ensuresthat those most in need of a healthy diet are least likely tobe able to afford it or be sufficiently motivated to do so.

These are some of the issues that will be part of thisyear’s College of Medicine conference Food onPrescription at the Royal Society of Medicine on 24 October. With social prescription now national policysurely it is time to make access to healthy food part ofgovernmental policy, and a programme to make genuinechange instead of just tinkering around the edges.

The solution will have to deal with the current silo-thinking and political apathy. We are saddled with asystem that competes to make ‘cheap’ food available, andconsequently favours commercial interests that encouragefarmers and food processors to produce less healthy food.It will also involve a united front among the medicalprofession – some of whom have too often put their egosand pockets before the common good. The College ofMedicine established a Food Forum of all interestedparties after our last conference Food: The FutureMedicine. This did not succeed in its aims because ofthose conflicting interests and because it will take morethan a few motivated people to unsettle the system: it willrequire a social movement. The College of Medicine isworking with the BHMA to create a movement that willconnect farming, food and health and arouse the energyof change required so that we all can live more fulfilledand healthy lives in a system that nourishes us andsustains the health of our planet.

Eating for individual, publicand planetary health

Mike DixonChair, College of Medicine

LEADER

CAMPAIGNING


While practicing as a GP my passion in nutrition was rekindled a few years ago by coming into contact with agrowing number of medical practitioners using low carbdiets to reverse diabetes and metabolic syndrome. This ledme to further study and a better understanding of thecomplexity of the relationship between food and health.Through conversations with patients, colleagues andpotential collaborators the necessity of focusing on ‘realfood’ crystalised and the idea for a campaign took shape.

My definition: real food is food that promotes health,both personal and planetary. It is nutrient dense, safe,whole food, which has been raised or grown in ways thatregenerate our soils, and restores natural biodiversity.

The birth of the Real FoodCampaignThe first spark came from Professor David Peters afterreading about the collaboration in the US of the RodaleInstitute and the Plantrician Project. He wanted to ‘fire upa coalition of parties to promote the life-giving and over-lapping areas of sustainable agriculture, lifestyle and diet.And, in addition, to tell a story about the healing power ofrelationship, with the soil, with one another and with thelarger community’.

This vision inspired me to plan a small gathering as the first step in a collaborative venture. The Real FoodGathering took place on a very windy weekend at the endof April 2019 and, despite the weather and some technicaldifficulties, was a huge success. We had 18 speakers andabout 30 other participants with different areas of interestand expertise. Together we started a conversation andforged relationships, which are becoming the foundationand inspiration for future campaigning. Read more aboutthe gathering in this blog by one of our collaborators:www.anhinternational.org/news/from-unreal-to-real-food.

In the process of planning the gathering, through themany conversations I had and my ongoing exploration of

the field of food, farming and health, the inspiration for acampaign slowly developed and a twitter page/feed wasstarted @Food_campaignUK.

I see the need for educating both the general publicand the medical profession about the importance of realfood. From my discussions with patients and otherdoctors it is clear there is a great deal of confusion aboutwhat constitutes a healthy diet; there is also a lot of differing opinion and debate about diet which is likely tobe ongoing. However focusing on real food could be anarea of agreement and seems intuitively sensible. Whilethe main focus for the Real Food Campaign will be onhealth we are also concerned about the environment.Happily, on the whole, food which is grown in ways which support nature tend also to be the healthiest.

Over the next few months we plan to have morediscussions with organisations sharing a similar ethos andaim to collaborate on various agendas including:

• getting real food principles into medical education and public health guidelines

• improving access to real food in local communities and institutions.

There will also be a website which aims to give trustworthyand practical information to the general public and themedical profession which will be supportive of anyonewith an interest in producing and sourcing real food. Wehope to have blogs and other resources and be a hub forshowcasing examples of inspiring local and communityprojects.

We need to start fundraising to support our aims soplease donate via our website (which currently redirects tothe BHMA site) realfoodcampaign.org.uk. Over time, withthe help of local real food ambassadors (sign up online),we hope to build local networks that bring together localproducers of real food with consumers, patients andhealthcare providers for sustainable community health.

Antonia Wrigley GP; Vice chair BHMA and founder of The Real Food Campaign

FOODTHE

CAMPAIGN

REAL

MY FOOD • MY HEALTH • OUR FUTURE

For a healthy, sustainable and affordable British diet


Sitopia: the power ofthinking through foodCarolyn SteelArchitect

In 2008, I published a book called Hungry City: How Food Shapes Our Lives, in which Iexplored how the feeding of cities through history had shaped civilisations. As a practicing architect and lecturer, I had been looking for ways to expand the discourseabout cities to include the everyday lives of those who lived in them. I had the idea ofdescribing a city through food, and invented the word ‘Sitopia’, about which I now writeand lecture all over the world.

Talking breakfastWhat did you eat for breakfast? Thisseemingly simple question – whichmost of us can answer without thinking– captures the unique quality of thegreatest unseen process shaping ourplanet. Eating is as natural to us asbreathing, so we rarely stop to wonderhow the bread, milk, cereals, fruit,bacon or eggs on our plate happenedto get there. Yet, when you come tothink of it, the fact that most of us inthe industrialised world get to eatthree meals a day with very little efforton our own parts is something of amiracle; the greatest achievement, onemight say, of industrialisation. What isincreasingly clear, however, is that the‘miracle’ has been achieved at a heavycost: climate change, deforestation,soil erosion, water depletion, pollution,mass extinction, slavery and diet-related disease are just some of theside-effects of the way we eat.

The ‘miracle’, it turns out, isnothing of the sort: rather, it is theresult of the systematic externalisationof the true costs of food productionand the obscuring of the effort that itreally takes to feed us. However greatthe breakthroughs that have given usindustrial food – mechanisation,monocultural production, chemicalfertilisers, factory farming, chill-chains,efficiencies of scale, just-in-time logistics – they have all had negativecorollaries whose true effects have

been systematically ignored. In thisway, the illusion of ‘cheap food’(something that can never exist) cameinto being, a fantasy upon whichmodern economies, political systemsand urban civilisation itself have cometo depend. As EF Schumacher notedat the start of his seminal 1973 bookSmall is Beautiful, ‘One of the mostfateful errors of our age is the beliefthat the problem of production hasbeen solved’. Living in a Western city, it would be easy to imagine that we’vesolved the problem of how to feedourselves, yet the very opposite istrue: the way we eat is now the greatest threat to us and our planet.

How did we get here – and whatare we going to do about it? In orderto answer such questions, we need toreturn to the breakfast with which westarted. Next time you sit down to eat,take a moment to stare at the foodyou are about to consume and try toimagine where it came from. Wherewere the oats in your cereal grown?Did they come from a vast mono -cultural field, or from a small, mixed-use farm? Were they grown chemically– ie with large doses of artificialfertiliser or pesticides – or organically,in nutritionally rich, living soil? Andwhat of the milk you poured on? Didthat come from grass-fed cows grazingin open fields, or animals kept permanently indoors and fed on grainthat we ourselves could have eaten?

Food is one of the greatestforces shaping our lives andworld, yet its effects can betoo big to see. Food shapesour bodies, homes, habits,cities and landscapes, yetsince we don’t value it, it doesso in ways that threaten ourhealth and planet, from diet-related disease to climatechange. By recognising that welive in a world shaped by food,in ‘Sitopia’ (from Greek sitos,food + topos, place) and byvaluing food once again, wecan redress these ills in aholistic, practical way.

SUSTAINABIL ITY


Or perhaps you used almond milk, in which case, did itcome from the desertified plantations of California? Andwhat of the sweetener you used? Was it honey from localhives, or sugar from vast refineries made from cane grownin the tropics? Do you know if the people who producedit were paid a living wage?

As such an exercise soon makes clear, there is nothingsimple about food, even an innocent-looking bowl ofporridge. Every bite has vast implications for the shapingof landscapes, ecologies, societies, economies, tradingpatterns, living standards, power structures and culturalattitudes. We live in a world shaped by food: a place I havecalled sitopia (from the Greek sitos, food + topos, place).Yet by failing to value food – expecting it to be cheap – wehave created a bad sitopia: one so bad that it threatensour very future.

The morsels of food on our plates are emissaries fromother worlds, each bearing signs of the value we place onthem. Did the production of the plate of food in front ofus make the world better or worse? Eating is an inherentlypolitical act, as well as an ecological and ethical one: thereis no such thing as amoral food, any more than there is afree lunch. Once we have realised this, eating becomes avery different activity: one that we can no longer dowithout thinking. This new awareness is one we canharness for good, since most of us choose how we eat.Food, we realise, represents power.

Food and powerAlthough hunter-gatherer societies revolved around

food, its related tasks were so embedded as to be indistinguishable from the rest of life: one reason why the concept of work is virtually unknown in such commu-nities. Urban-agrarian societies, on the other hand,required new structures and processes to deal with thecomplexities of farming and the seasonal tasks of sowing,growing, reaping, processing and storing their new staple,grain. Writing and money were two crucial outcomes ofthis development, as were social hierarchies that distinguished for the first time between feeders and fed,farmers and consumers, rural and urban.

Although farming was far harder work than hunter-gathering (earning it the universal status of divine

punishment), its one great advantage was the ability toproduce a food surplus that could be stored through theyear and so used to feed large non-food producing populations. Cities and agriculture co-evolved for thisreason, and the world’s first urban settlements – theSumerian Ur, Uruk, Kish and Nippur, situated on thebanks of the Tigris and Euphrates – were effectively city-states: compact urban centres surrounded by dedicatedfarmland. Although they grew rich by exporting grain,such cities remained small enough to feed themselves,forging an urban blueprint that, for many, remains theideal.

Most pre-industrial settlements followed this basicpattern. Towns and cities were generally small and allroads led to the central market square, which was theheart of all commercial and public life. Most cities werebuilt on rivers, which provided them with fresh water, fishand a handy waste disposal facility. Grain was grown out inthe countryside, yet close enough to the city to make thetransport of the relatively bulky, low-value food economic,while sheep and cattle, which could walk to market, wereoften grazed further away. Most households kept pigs,chickens or goats, which could be usefully fed on house-hold scraps. Fruit and vegetables were grown in the cityfringes, where they could benefit from ‘night-soil’ (animaland human waste) that was carefully conserved to be usedas manure. Most cities, in short, had largely local, circularfood economies.

The city that bucked the trend was, of course, ancientRome. The world’s first ‘consumer city’, its vastness – withsome million citizens by the first century AD – meant thatit had to do things differently. At its height, Rome wasimporting grain, oil, wine, ham, salt, honey and liquamen(a popular fermented fish sauce) from all over theMediterranean, North Atlantic and Black Sea. Rome, inshort, fed itself via what we would now call ‘food miles’:

Sitopia: the power of thinking through food

SUSTAINABILITY

The Fertile Crescent, where farming and cities began (drawn by author)

City 1.0: Map of the City of Ur, circa 2000 BCE (drawn by author from a map bySir Leonard Woolley)


a strategy made possible by its command of the sea, overwhich it was far easier (and about 40 times cheaper) totransport food than it was overland. With such staplespouring in from abroad, local farmers were able toconcentrate on producing luxury foods for the city: everything from fruit and vegetables, poultry and game to songbirds, pond fish and nut-stuffed dormice. This so-called pastio villatica (villa farming) made farmers afortune, yet was ridiculed by Pliny and others, for whom itmerely symbolised the capital’s decadence.

It’s not hard to recognise ourselves in the mirror ofancient Rome. While the city sucked up the nutrition fromdistant lands, rich citizens worried about eating too much,yet as their appetites expanded, the capital increasinglystruggled to feed itself, eventuallysuccumbing to collapse as the soils ofits North African breadbasket failed.Rome ended up eating itself to death,as we are in danger of doing.

Goodbye geographyThe nineteenth-century advent of rail-ways transformed the way cities werefed. By making it possible to transportfood quickly and cheaply over longdistances, railways emancipated citiesfrom geography, allowing them to growany size, shape or place for the firsttime. As the metro politan carpet startedto roll out, a matching agricultural onebegan spreading in the New World, aspreviously inaccessible territories suchas America’s Great West were openedup to grain production. When some USstockmen had the bright idea of feeding

the excess grain to cows, the feedlot systemwas born, creating a previously unthinkablecommodity, cheap meat. Chicago became themeatpacking centre of the world, and when apacker by the name of Gustavus Swift workedout how to get his beef to the East Coast inan edible state (by using refrigerated railcars,the start of the modern chill chain), all theessentials of our current food system were inplace. Henceforth, cities would be fed, not byintricate networks of small producers, but bya small number of powerful companies withthe scale to take vertical control of the foodchain and the logistical capacities to match.

Today, the global food system is moreconsolidated than ever, with a handful ofcompanies such as Nestlé, Walmart andBayer-Monsanto commanding profits biggerthan many national GDPs and just three suchcorporations controlling 60% of the world’sseeds and 70% of its fertilisers and pesticides.As such statistics suggest, the methods

employed by such companies are overwhelmingly industrial,meaning that crops are grown monoculturally with the use of chemical fertilisers and pesticides, rather thanorganically on mixed farms. Our quest for cheap food hasturned us against nature, with disastrous consequences forthe natural ecosystems without which we couldn’t exist.

Sitopian economicsThe way we eat is killing us and our planet – so what canwe do about it? The most obvious first step would be toacknowledge that cheap food doesn’t exist. Food, afterall, consists of living things – plants and animals – that we


SUSTAINABILITY

Ancient food miles: the food supply routes of Ancient Rome (drawn by author)

George Scharf, A Cowkeeper’s Shop in Golden Lane; 1825 watercolour: fresh milk in the pre-industrial city


kill in order to live: to treat it as cheap is thus to devaluelife itself. If we were to value food properly again – whichis to say, to internalise its true costs – it would transformour lives, landscapes and societies. Industrial farming in its current form would immediately become unaffordable,which, in reality, it already is. The true cost of good food –which is to say, food produced in ethical, ecologicallyfriendly ways – isn’t cheap. In societies where food isvalued, feeding people is a hugely rewarding way of life.This is a win-win scenario since, if we want to work withnature instead of against it in order to feed ourselves –as, indeed, we must – we will need far more farmersworking and looking after the land, not fewer. Contraryto those who insist we can’t feed ourselves organically,the latest research suggests not only that we could, butthat we could do so without increasing the amount offarmland needed. In order to do that, however, wewould need to eat rather differently – much less meat anddairy and wasting far less – yet such aims are surely notbeyond our grasp. We might adopt what the British farmerand journalist Simon Fairlie has called a ‘default livestock’approach, raising only the animals we could sustain on

food waste, grass and crop residues, much asthey were raised in the past. Althoughorganic veganism is the most low-impact waywe can eat, we do need animals in our foodsystem if we are to farm organically since, asthe British ‘father of compost’ Sir AlbertHoward pointed out, they make a vitalcontribution to the circulation of nutrients and to soil fertility.

There are some who say that, in order tosave nature, we should intensify agricultureand build vertical farms in cities in order torelease as much countryside as possible backto wilderness. First proposed by US epidemi-ologist Dickson Despommier early in thiscentury, vertical farms already exist inSingapore, New York and London, plying abrisk trade in micro-greens sold to high-endstores and restaurants. Yet, as verticalfarmers themselves admit, such farms arenot the answer to feeding cities in the future,since, apart from the vast amount of spaceneeded to build them, the cost of growingstaples like grain in towers simply doesn’tstack up. Vertical farms may be part of thesolution, but they can’t escape the urbanparadox which states that, however much weimagine ourselves to be urban, our need forfood means that, in a greater sense, we allstill dwell in nature and depend on it.Vertical farms are, in essence a luxury item,the pastio villatica of our day.

Could lab-made alternatives to meat anddairy be part of the answer? This latest trendfrom Silicon Valley is already big in the US,with start-ups like Just and ImpossibleFoods attracting billions in investment from

the likes of Sergei Brin and Bill Gates. Impossible Burgers,which mimic meat juices using a vegetable compoundcalled haem (which also exists in animal blood and gives


SUSTAINABILITY

Growing Underground, London’s subterranean ‘vertical farm’: part of the answer?Credit: Richard Ballard, Growing Underground

Chicago Union Stockyards: the invention of cheap meat

Ogilby map of London in 1676, shaded to show food markets and supply routes (annoted by author)


haemoglobin its name), are already popularin the US and went on sale in the UK in2018. Google, meanwhile, is funding a Dutchinitiative to grow meat protein in a lab, usingbovine foetal serum to replicate muscletissue to produce so-called cultured beef.Whatever your view of such projects, thequestion is whether we really want ourfuture food to be made and owned by thelikes of Google and Amazon. Control of food,as our ancestors knew, is power.

Perhaps the greatest lesson we can learnfrom our past is that big cities are hard tofeed. Plato and Aristotle believed that thepolis (Greek city-state) should stay small inorder to remain self-sufficient, while ThomasMore’s 1516 Utopia, Ebenezer Howard’s1902 Garden Cities and PatrickAbercrombie’s 1944 London Green Belt allshared the same idea: that cities should belimited in size and surrounded by countrysideto satisfy our human needs both for societyand nature.

In a rapidly urbanising world in which megacities suchas Tokyo, Delhi and Shanghai have populations upwardsof 24 million, such ideas arguably have more relevancethan ever. Uncontrolled urban growth is predicated on thefalse premise that cities are easy to feed. The fact that weknow this not to be true should urge us to rethink how

we live in future. Using the lens of food, we need toconsider what a landscape for human flourishing mightlook like in the mid twenty-first century, by which time lifewill necessarily be ordered as something like a no-growth,steady-state economy. If such a way of life requires that weweave city and country closer together, future cities willhave to be planned with farming in mind. Existing onescould be retro-fitted, as André Viljoen and Katrin Bohn

have proposed with their concept theirContinuous Productive Urban Landscapes(CPULs). As Patrick Geddes once said, we should ‘make the field gain on the street, notmerely the street gain on the field’.

How we eat means more than simplywhether our food tastes nice and makes ushealthy: it is critical to the way we shape ourlives and those of the other living creatures withwhom we share the planet. Food is the greatconnector: the substance that ties us directly tothe world’s living ecosystems, as well as to oneanother. By thinking more clearly about whatand how we eat, and acting accordingly, solutionsto our core human needs for sustenance andsociety will emerge. Because food and feedingare so fundamental, if we can get them rightdespite the many complexities of our times,humans may yet thrive in an ever more crowded,overheating world. Indeed by valuing food (andinterrogating our porridge) we can worktogether to build a better sitopia.

ReferenceSchumacher EF (1973) Small is beautiful. New York, NY:Vintage, p2.


SUSTAINABILITY

Ebenzer Howard’s Garden City: an unrealised utopia

Bohn and Viljoen’s Continuous Productive Urban Landscapes (CPULs): post-fitting the city with countryside. Credit: Bohn and Viljoen Architects.


Why are we in thissituation?The answer lies in the way our embodied minds work, which is ofcourse not in the reasonable, rationalway imagined by lawyers, logicians and (when we know we are right)ourselves. What is going on is far moreinteresting, far less ‘cognitive’ and agreat deal more emotional. Rationalobjectivity is a state we can hope toachieve, and it requires special conditions, of which the key component is calm. Calm, good qualityinformation, and a willingness toconsider many perspectives. This, andother similarly helpful tools for under-standing our human world, came forme primarily through my long reflection on the human givens (HG)approach (Griffin and Tyrrell, 2003).

The HG model starts with theobservation that human beings areorganisms, and like any other organismwe survive and thrive by deploying aset of innate resources to meet ourinnate needs in the environment.It goes on to describe health as arisingfrom a situation in which needs can bemet in balance, through properlydeveloped and deployed resourceswithin an environment that will

support this process. Though developed originally to describemental and emotional health, thissimple biological idea works well forhealth overall: the key to creating andrestoring health is work out how tomeet our needs in balance. Cruciallythis means we must distinguish clearlybetween our needs and desires, asurprisingly difficult task particularly inthe area of food and nutrition.

Our emotional guidance systemOne resource, which we share withthe other vertebrates, is vital to under-standing many of our difficulties: the‘emotional guidance system’. What dowe mean by this? Animals typicallyoperate through movement andbehaviour, an approach that requireslarge-scale information processingequipment – brains and nervoussystems – to integrate information and guide action aimed at meetingneeds such as nutrition, safety andreproduction. The fundamental questions for a moving organism areto move or rest and, if movingwhether towards or away. Fear anddisgust prepare us to move away,anger and desire to move towards –

FOOD AND IMAGINATION

Food: emotion, imagination and realityAndrew MorriceGP, psychotherapist, educator

I became interested in diet and health and what was then called ‘alternative medicine’while still at school and went on to study medicine. I have been a member of the BHMA for 32 years and co-led the London Medical Students Group from 1988–1991. I work mainly in general practice, and I was a member of the clinical team at BristolHomeopathic Hospital for eight years and taught at Bristol University on the WholePerson Care course for 15 years. I am a registered human givens (HG) therapist, andteach regularly for HG College. In 2018 I set up JoinedUpHealth to develop and delivereducation for GPs (and perhaps the public) about how the HG model applies not justto mental but overall health. In terms of diet and health I have experienced a numberof approaches including classic whole-food vegetarianism, blood-type, Atkins, low-carbohydrate, raw diet, and veganism. Things have settled down completely sincemoving to a blue-zone diet about eight years ago. www.joineduphealth.net

There is a real urgency tosolve the extinction andclimate disasters that we havecollectively created, and foodproduction is a massive partof the problem and solution.There is nevertheless a division of well-meaningopinion on what exactly weshould do, with at least twoquite different dietaryapproaches proposed totackle the rising tide ofchronic disease and theclimate emergency. Rationalobjectivity requires calmness,good quality information, anda willingness to consider many perspectives. If ‘a humanbeing is an animal thatbelieves the stories it tellsabout itself ’, surely our task is to work out what is thetruest story.


though in quite different ways. Emotions guide the actionsof the entire organism and one of the fundamental tasksof this system is to find food.

It has transpired that these emotional (or morecorrectly, affective) states are built into the fundamentalsof brain function, into everything it perceives and predicts,though we only tend to notice them as a feeling oremotion when the intensity is strong enough. Back in the1990s the concept of emotional hijack was popularised,but this idea – that strong emotional arousal hijacks cognitive processes – has been replaced by a morenuanced model (LeDoux and Brown, 2017) in which affectand emotion are continuously focusing our attention andframing our perceptions (Feldman Barrett, 2017).

The totality of sensory information available througheyes, ears, nose, skin, joints, muscles, tongue and internalorgans would if processed raw require what DouglasAdams memorably described as ‘a brain the size of aplanet’. Instead our brain is constantly jumping to conclusions – usually with remarkable accuracy – by creating a simulation of the world from a series ofsummaries of past experience learnt from infancy onward.What we experience, what we see, hear, touch and smell is a set of constructions, a simulation which our brain hascreated on the basis of prediction. This is the basis ofmany well-known phenomena, includng th fct that yu canrd the rst of ths sentnce wth sme of th lttrs missng. It is avery efficient way of dealing with all the data to hand, andis balanced by an ongoing ‘error checking’ process.

The mirage-making brainCrucially this whole process is influenced by affect; andgenerally the more intense the affective-emotional statewe are in, the less interested our brain becomes in checkingout whether what we perceive is true. Lisa FeldmanBarrett expresses this memorably by comparing the highlyemotionally aroused brain to ‘like a bad scientist’ who isunable to acknowledge data that contradicts their theory.This suggests that confirmation bias is in fact a manifestationof the way we perceive the world. It also warns us thatpassionately held views are likely to be held even in thepresence of information that clearly contradicts them.

Furthermore, human beings have taken this ‘mirage-making’ capacity of the brain to extraordinary lengths. The human brain, perhaps uniquely, is not just dealingwith real-time information coming from the outside worldand from our biological interior, but also with dreams,visions, memories and anticipations, fantasies, inventions,symbols, and stories. Our brains can create not only acurrent reality but can create images and hear sounds ofthings past, things future, things as yet undreamt of. Werun simulations of that argument we had last week, orwatch an internal movie of ourselves performing well in an interview, or dream up a new recipe. Not only this, wehave created language to symbolise ideas, objects andactions. So when we read a book we may hear the voicesdescribed, when we listen to someone speak we may see

what they talk about, and these sights and sounds are(almost) as real to our brains as reality itself. And all ofthese are, in important respects, as real to the brain asanything else. Our mind might much more usefully bedescribed as a ‘reality simulator’, or as our ‘imagination’.And the basic stuff of emotions – affect – is woven rightinto the fabric of this amazing human resource. One lovely way of summing all this up is, ‘A human being is ananimal that believes the stories it tells about itself ’(Rowlands, 2010).

But why is any of this pertinent to food?The finding and consuming of food is of central importanceto any animal, so the role of affect in our perception ofnourishment is extraordinarily ancient and well-developed.There are few areas of life as emotive as food. We are fedby those we love and who love us when we are at ourmost small and vulnerable. The simple act of eating incompany – with family or friends – is profoundly bonding,creating trust and love. Because eating is such a strongstimulator of our relaxation and connection responses wecan learn to associate comfort with anything from a tub ofice-cream to a steak. Refugees and exiles always dream ofthe food of their homeland, the taste of a loved recipefrom childhood is, as Nigel Slater noted in his book Toast(2003), a powerful gateway to a world of memory andfeeling. Regardless of the environmental or health costs of a particular food eaten in childhood, each of us willperceive it through a powerful and very personal lens ofemotion and feeling.

This is one of the ways in which food becomes identity. This is the hidden payload in the often repeatedand seldom examined phrase ‘we are what we eat’.Indeed. The French are (apparently) ‘frogs’, the English‘les ros-bifs’, the Dutch ‘kaaskoppen’ (cheese-heads), andthe Germans ‘krauts’. In this way we can understand thatanyone who has not grown up eating a diet that will optimally preserve their health and wellbeing mayencounter a profound sense of threat to their identitywhen a suggestion is made that they might change theireating patterns. There are people who would rather diethan change what they eat: and history is full of examplesof people who have chosen death rather than give up acore aspect of identity. And not just because of identity:the social aspects of shared food are enormously powerful, as anyone who has changed their diet from theprevailing pattern in their family and social network knowsto their cost. Anyone who has decided not to eat meat, forexample, may find themselves as pressured and mocked as a teetotaller in the company of drinkers.

Pleasure and addictionThe human givens model has a neat way of understandingaddiction – when our emotional needs are not met inbalance we can easily form an addiction to any activity that

Food: emotion, imagination and reality


can generate a feeling of pleasure. Obviously this happensmost readily when there is an element of pharmacologicalaction as with tobacco, caffeine, alcohol and opiates. Andthe food industry understands all too well that there is asimple recipe for creating addicting foods: fat, salt andsugar. The foods most problematic in terms of addictingbehaviour consistently have these features, or at least twoin combination. The fat-and-salt combination in bacon orcheese is as hard to deal with as more regularlydemonised sugary foods such as breakfast cereals andsodas (Schulte et al, 2015), which is a concern as bacon isin the same carcinogen category as asbestos and plutonium(IARC, 2018). And if you are now undergoing a strongemotional reaction – do look up the references! What isinteresting is that although there is a clear sugar–salt–fatpredisposition to addicting foods, which are associatedwith all the brain changes seen with classic addictions(Wiss et al, 2018), there is also evidence that individualconditioning is important – anything pleasant can beaddicting (Burger and Stice, 2012). This is all very relevantbecause the language of resistance around dietaryimprovement is at times identical to that around tacklingaddiction. For example: ‘you’ve got to live’, or ‘lifewouldn’t be worth living’ or ‘it’s my only pleasure in life’.

Safety also plays a partWe all have an innate need to stay as safe as possible(while meeting our other needs), and a perceived threatto safety puts us in a highly focused emotional state.Decades of marketing specific foods on the basis that theycontain specific essential nutrients has created a situationwhere people fear doing without foods that are simply notessential, in order to obtain nutrients that are found in anenormous variety of foods. A good example is the marketing of milk as containing vitamin D which began inthe 1920s and soon shifted to calcium. Milk is not an essential food for any adult mammal. Perhaps you now arefeeling cross, and perhaps tempted to put this articleaside? Bear with it. It may be worthwhile. If I mentionspinach and iron (another early example), does that help?Notice how powerful these reactions can be.

Seafood is another good example here. Nowadays weare advised to eat oily fish regularly. One wonders howmany of those giving this advice notice or care that theoceans are now dying toxic waste dumps with dwindlingpopulations of oily fish concentrating ever larger quantitiesof persistent organic pollutants and heavy metals, or thatwild fresh-water fish also contain the long chain omega-3fatty acids (William et al, 2017) we believe we need to getfrom seafood, but which most of us (but not all) can,along with our microbiomes (Wall et al, 2009), producefor ourselves (Domenichiello et al, 2015) from abundantlyavailable alpha-linolenic acid, or obtain direct from algae(Sarter et al, 2015). No. We tumble straight from magicalingredient to over-specific terminology into a collaborationin the destruction of marine ecosystems.

Returning to safety and fear, these show up again inthe issue of familiarity. It is an essential protective instinctfor small children to be disgusted by unfamiliar andstrong-tasting foods, and they learn by imitation (and now also through advertising) what is safe, desirable andpalatable. This distrust of the unfamiliar remains, albeit insomewhat diminished form into adulthood. At the FoodGathering we heard a wonderful story about an old ladywho refused to try the ‘organic’ potatoes until they wereoffered as a free sample. She had distrusted these strangenew-fangled and doubtless hallucinogenic objects, untilshe ate them and found that ‘they were real potatoes, likethe ones you used to get’.

Black and white thinkingJust as the animal fundamentally needs to distinguish whatto approach and what to avoid, in the area of food wehave a profound tendency to divide foods into ‘good’ and‘bad’, ‘healthy’ and ‘unhealthy’. And often all that isneeded to flick a food from one category to another (aprocess usually accompanied by fear or desire) is a word,an ingredient, a nutrient or an idea. This is the wholemagic of food labelling and marketing. Yet in reality foodsare varied in their quality, content and provenance in verymany ways, some are better in many or all ways thanothers. It is more helpful to think of better and worse,than good and bad, in colour, rather than plain black and white. Yet day by day we are faced with a series ofeffectively binary choices – to eat or not to eat specificfoods – and we are easily swayed by ‘low-fat’ ‘protein’‘natural’ or ‘vegan’ to makes choices that could easily havebeen improved on. The use of self-declared standards inthis area is of concern. We may support the idea ofpasture-feeding livestock, but there is no currently bindingdefinition of this, and a ‘pasture-fed’ designation that is onthe wrong side of the threshold required to either conferproven overall health, and overall climate benefit is simplygreenlighting a product that could be construed asharmful.

The power of languageWe are so accustomed to our trick of substituting soundsfor objects, processes, perceived qualities and abstractconcepts that we forget how powerful and potentiallymisleading our language can be. ‘Milk’ is a noun that canbe used to describe both a skimmed homogenised cartonand the liquid of yesteryear which could be found on ourdoorsteps, consisting of several layers: milk, cream, air,foil, and bluetit. ‘Bread’ can describe a pizza base and awholemeal spelt loaf. Which means that terms like ‘bread’and ‘milk’ can hide as much as they reveal.

But at least milk and bread – variable as they are – are as tangible as tables and carburettors. Our difficultybecomes more obvious with abstract terms like ‘natural’,‘goodness’, ‘healthy’ and – paradoxically – ‘real’. Theseterms can be useful, but only when we can agree on what







they mean. Politicians love such words because they canbe used to manipulate us. ‘The people of Britain wantchange’ – yes, but different people want different things tochange. ‘Change’ is an example of a nominalisation – aword that denotes an abstraction, action or quality, butwhich is used like a noun. It is an essential task oflanguage to summarise sometimes complex concepts, butour problems start when we are left filling in the blankourselves: in the politician’s audience we are all obligedon hearing the word ‘change’ to imagine our own idea ofdesirable change. ‘Sustainable’ is another example,because one person’s sustainable is another person’s environmentally damaging. We all have a slightly differentidea about what ‘real food’ might be. It is a useful way ofstarting a discussion, but we need to move beyond thisconcept to something we can see or touch, test or otherwise agree on.

Us-and-them thinkingLanguage is often used to create categories, whichhowever arbitrary, can acquire an apparent solidity(through the same fundamental process as the examplesabove) causing many difficulties. It is not unusual forpeople to describe themselves as vegetarian or vegan orpaleo or low-carb. The tragedy is that these are all arbitraryartificial concepts, which are then used as the basis of ‘us and them’ thinking, promoting conflict, sometimesbetween people who actually agree on a great deal morethan they disagree on. But a moment’s thought can oftenrelease us from these traps. After all, how often does aperson need to eat meat to be an omnivore? And if youhave porridge for breakfast are you a vegetarian? It ispointless if vegans assume that nothing about their dietcan harm the environment or that no animals died orsuffered in the process of producing their food. Similarly itis quite daft to think that anyone now can eat a paleolithicdiet without being a traditional hunter-gatherer in one ofthe few remaining wild places on our planet.

Collective self-deceptionBoth are examples of linguistic spell-casting, forms ofcollective self-deception. Another place in which this isparticularly problematic is in the description of foods asmacronutrients. The habit of discussing food primarily interms of protein, carbohydrate and fat is quite novel, andreally only took off in the 1970s. There are two huge problems with this approach. The first is that the over-whelming majority of food is made of living things, andliving things are built of cells, and cells are made of lipids,water, carbohydrates, proteins, nucleic acids, and myriadother compounds. Unless the food has been refined into a pure compound – like white sugar, corn oil, or wheypowder – it is usually unhelpful to label it primarily as oneor other macronutrient. The second, related problemconcerns research (above and beyond the well-knownissues with industry funding, which is widespread in

nutrition research). There is no agreed definition of highor low carbohydrate, fat or protein diets. Yet these termsare routinely used. It is hard to think of another area ofscience where such a lack of clarity would be tolerated for an instant, let alone decades. For example it is notuncommon for the ‘low fat’ group in a diet study to beeating 30% calories from fat (Shai et al, 2008). Since mostof us don’t read the actual scientific papers (often they arebehind a paywall), we (or the journalist writing about thestudy) who believe the abstract and the title are misled.This misapprehension about macronutrients has alsoprovided ample material for storytellers, and humanbeings do love to believe the stories they tell.

What are we to believe?A recent story goes like this: on the basis of cherry-pickeddata in Ancel Keys’ Seven Countries Study, the scientificcommunity went on a 50-year publicly-funded wild goosechase blaming saturated fat for heart disease, and gave thepublic the misleading advice in the 1970s that what wasneeded was a shift to a low-fat diet. This low-fat diet adviceled to the avoidance of dietary fats and an upswing in theconsumption of sugary and starchy foods leading thecurrent obesity epidemic (Taubes, 2009). A great story, anddebatable at every point (Guyanet, 2017; Astrup et al,2000; Pett et al, 2017) the most striking evidence beingfrom the US government data that shows that Americansoverall didn’t ever eat a low-fat diet during this period,they just kept right on eating more and more of every-thing (USDA, online).

Perhaps you’ve also heard another: that from the turnof the millennium the meat and dairy industry fundedstudies that appear to have been designed to neutralisethe scientific consensus on dietary fat. Examples includethat you can eat beef and lower your cholesterol, byhalving the overall saturated fat in the ‘beef ’ diet (Roussellet al, 2012); not controlling for known confounders (Guoet al, 2017); apparently comparing high fat and high carbdiets, while actually carefully matching fatty acid intakes(Thorning et al, 2015). They were able to rely on ourmodern press and commentariat to over-interpret thestudies and overlook the fine print. I like this story too butI know enough now to hold it lightly. The truth is going tobe in one way more complicated (Forouhi et al, 2018),and less of a stark contrast to the past (Sacks Frank et al,2017). The truth is much easier to apprehend when wetalk about foods, rather than macronutrients, and if wegive due emphasis to studies that can robustly showcausation and that focus on meaningful outcomes.

We can ask ourselves, could this situation have arisenwithout the particularly problematic interaction betweenhuman imagination and emotion when it comes to food?

What are we to do?‘Let us not talk falsely now: the hour is getting late’, sangBob Dylan in All Along the Watchtower.

The hour is indeed getting late and, regardless of our intentions, to avoid ‘talking falsely’ we need calmattentiveness and the ability to hear clearly what otherpeople are saying. We do well to notice that mostinformed proponents of different dietary approachesagree on many elements of healthy diet and mostthoughtful food producers can find ample commonground. We need therefore, to open ourselves to information that might disprove our ideas, and beprepared to be wrong at times. We need to urgently agree guiding principles that are maximally consistent with the reliable information we have to hand, not just our favourite data. We urgently need robust terminologyand concepts to describe the actions we need to take. Ourplanet will remorselessly respond, not to what we imaginewe are doing, but to what we actually do. Even our bodiescan only do so much: clinical experience suggests theremust be a limit to the food-placebo effect. We are with afew enlightened exceptions, emotional creatures, livinglargely in our imaginations, believing the stories we tellabout ourselves, using words that we take for reality. Givenall this, surely our task is to work out what is the trueststory.

Perhaps we can start by noticing the basic dietarypattern that the longest lived and healthiest populationsaround the world eat (Buettner, 2012) is neither low-carb,nor vegan, nor paleo, and is probably consistent with allthe aims and objectives of those who met at the Real FoodGathering in April. And it might just see us through.

Blue zonesWith their strikingly high concentrations of individuals who live to be over 100-years-old, blue zones include thefollowing regions: Ikaria, Greece; Okinawa, Japan; theprovince of Ogliastra in Sardinia, Italy; the community ofSeventh-Day Adventists in Loma Linda, California; andCosta Rica’s Nicoya Peninsula. Although food choices varyfrom region to region, blue zone diets are primarily plant-based, with as much as 95% of daily food intake comingfrom vegetables, fruits, grains, and legumes. People in bluezones typically avoid meat and dairy, as well as sugary foods and beverages. They also steer clear of processedfoods. A wholesome diet isn’t the only factor thought tolead to longevity for those living in blue zones, however.Such individuals also have high levels of physical activity, low stress levels, robust social connections, and a strongsense of purpose.www.verywellhealth.com/blue-zone-diet-foods-4159314

ReferencesAstrup A, Grunwald GK, Melanson EL, Saris WH, Hill JO (2000) Therole of low-fat diets in body weight control: a meta-analysis of adlibitum dietary intervention studies. Int Jour Obes Relat. Metab Disord24, 1545–1552.

Buettner D (2012) The blue zones. 2nd Edition: 9 lessons for livinglonger from the people who’ve lived the longest. New York, NY:National Geographic.

Burger KS, Stice E (2012) Frequent ice cream consumption is associated with reduced striatal response to receipt of an ice cream–

based milkshake. The American Journal of Clinical Nutrition, 95(4)810–17.

Domenichiello AF, Kitson AP, Bazinet RP (2015) Is docosahexaenoicacid synthesis from �-linolenic acid sufficient to supply the adult brain?Progress in Lipid Research, 59, 54–66.

Feldman BL (2017) How emotions are made: The secret life of thebrain. Stuttgart: Pan Macmillan.

Forouhi NG, Krauss RM, Taubes G, Willett W (2018) Dietary fat andcardiometabolic health: evidence, controversies, and consensus forguidance. BMJ 361, k2139.

Griffin J, Tyrrell I (2003) Human givens: A new approach to emotionalhealth and clear thinking. Chalvington: Human Givens.

Guo J, Astrup A, Lovegrove JA, Gijsbers L, Givens DI, Soedamah-MuthuSS (2017) Milk and dairy consumption and risk of cardiovasculardiseases and all-cause mortality: dose–response meta-analysis ofprospective cohort studies. Eur J Epidemiol 32, 269–287.

Guyenet S (2017) Did the US dietary guidelines cause the obesityepidemic? [Online]. Available at: www.stephanguyenet.com/did-the-us-dietary-guidelines-cause-the-obesity-epidemic (accessed 24 July 2019].

IARC (2018) Red meat and processed meat. IARC monographs on theevaluaton of carcinogenic risks to humans, volume 14. Geneva:WHO Press.

LeDoux JE, Brown R (2017) A higher-order theory of emotionalconsciousness’. Proceedings of the National Academy of Sciences,114(10) E2016–25.

Pett KD, Willett WC, Vartiainen E, Katz DL (2017) The Seven CountriesStudy. Eur Heart J 38, 3119–3121.

Roussell MA, Hill AM, Gaugler TL et al (2012) Beef in an optimal leandiet study: effects on lipids, lipoproteins, and apolipoproteins. Am JClin Nutr 95, 9–16.

Rowlands M (2010) The philosopher and the wolf: Lessons from thewild on love, death, and happiness. New York, NY: Pegasus Books.

Sacks FM, Lichtenstein AH, Wu J HY, et al (2017) Dietary fats andcardiovascular disease: a presidential advisory from the AmericanHeart Association. Circulation 136, e1–e23.

Sarter B, Kelsey KS, Schwartz TA, Harris WS (2015) Blood docosahexaenoic acid and eicosapentaenoic acid in vegans:Associations with age and gender and effects of an algal-derivedomega-3 fatty acid supplement. Clinical Nutrition 34, 212–218.

Schulte EM, Avena NM, Gearhardt AN (2015) Which foods may beaddictive? The roles of processing, fat content, and glycaemic load.PLOS ONE, 10(2) e0117959.

Shai I, Schwarzfuchs D, Henkin Y et al (2008) Dietary InterventionRandomized Controlled Trial (DIRECT) Group, 2008. Weight loss witha low-carbohydrate, Mediterranean, or low-fat diet. N Engl J Med 359,229–241.

Slater N (2003) Toast. London: Fourth Estate.

Taubes G (2009) The diet delusion. London: Vermilion.

Thorning TK, Raziani F, Bendsen NT et al (2015) Diets with high-fatcheese, high-fat meat, or carbohydrate on cardiovascular risk markersin overweight postmenopausal women: a randomized crossover trial.Am J Clin Nutr 102, 573–581.

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EAT-LANCET

EAT-Lancet – is theresuch a thing as ‘one-size-fits-all’ sustainability?Robert VerkerkFounder, executive and scientific director,Alliance for Natural Health International

It was an honour to present on this subject at the inaugural Real Food Gathering inApril 2019, in a marquee on an organic farm in the wilds of the Glastonbury Valley inSomerset, in the midst of howling gales gifted by Storm Hannah. Over the last fourdecades, as both an academic and a campaigner, I have explored sustainability as appliedto the environment, food production systems and human health. I have worked indiverse settings in Europe, sub-Saharan Africa, Central Asia, South-East Asia, Australiaand the US. Insights from this work make me deeply concerned about the centralised,integrated approach proposed by EAT-Lancet that has the potential to benefit the world’slargest agrifood businesses more than either the natural environment or human health.

IntroductionJanuary 2019 saw the publication of a Lancet Commission study thatattempted to provide a global solutionfor dietary and planetary sustainability(Willett et al, 2019). The 47-page, 357-reference article, Food in theAnthropocene: the EAT-LancetCommission on healthy diets fromsustainable food systems, was aproduct of more than two years ofdeliberation by a Lancet Commissionled by Harvard’s Professor WalterWillett and Stockholm ResilienceCentre’s Professor Johan Rockström.They were supported by 17 scientificexperts and 20 co-authors. The workwas carried out in conjunction withthe Norway-based EAT Forum (2019a),a non-governmental organisation‘dedicated to transforming our globalfood system through sound science,impatient disruption and novel partnerships’ (EAT Forum, 2019b).

The EAT-Lancet Commissionproposes a global transformation offood systems that set boundaries,limits and estimates for foods humansshould eat and what foods should becultivated in order to nurture bothhuman health and the environment.

The proposal is deemed fit for theexpected 10 billion populationexpected by 2050. The EAT-Lancetreport sought to provide an integratedframework, a series of scientifictargets, and a battery of soft and hardlevers that should be used by policy-makers, the food industry, agriculturalproducers and the global public tohelp catalyse a transition towardsustainable food consumption andproduction patterns.

While the report was widelyacclaimed by the world’s media, criticisms have subsequently emerged,including by the Sustainable FoodTrust (2019), through my own critique(Verkerk, 2019), and by a subsequentdecision by the World HealthOrganization to withdraw its support(Torjesen, 2019).

While there are many aspects ofthe EAT-Lancet report that are widelyagreed, the primary purpose of thispaper is to focus on areas of uncertainty, weakness, controversy ordisagreement. Ultimately, the goal is to encourage debate so that rational,proportionate, individualised and location-specific ways forward can beestablished for both producers andconsumers in different parts of theworld.

The EAT-Lancet Commissionwas formed with the recognition that food systemshave the potential to nurtureboth human health and theenvironment, yet are currentlynegatively impacting both. This paper is a critique of theEAT-Lancet report, published inJanuary 2019, which proposesa global 50% cut in consumption of red meat andsugar, and a doubling ofconsumption of nuts, fruits,vegetables and legumes. The critique emphasises theweaknesses of any one-size-fits-all approach based onevaluation of published literature, its clash with traditional eating cultures and production systems, and,ultimately, its potential to failto deliver on its promises.


The planetary health diet andhuman health implicationsThe EAT-Lancet Commission proposes a universally-applicable daily reference diet, referred to by the EATForum as the ‘planetary health diet’, that includes targetintakes as well as ranges for eight distinct food groups(Table 1, opposite).

Among the reference diet’s most notable features are:

• Average proposed daily intakes for adults are given foreight food groups (incorrectly referred to as ‘macro -nutrients’) along with wider intake ranges to take intoaccount social and cultural differences and diversity.�

• Zero to relatively small amounts of meat are proposed(an average of 43g of beef, lamb, pork and poultry,comprising 3.7% of daily energy). This contrasts withpresent levels of meat consumption in the US of 128g a day (Daniel, 2011).

• The reference diet proposes a greater energy ‘allowance’for sugar (120 kcal) than for beef, lamb, pork, chicken,other poultry, and eggs combined (111kcal energy).

• The proposed ‘added sugars’ allowance is the equivalentto more than seven teaspoons of added sugar every day(about 5% of daily energy intake).�

• The reference diet proposes limited intakes of starchyvegetables, contrary to most current government guidelines. �

• Very limited intake of saturated fats (added animal fatslimited to 5g a day, equivalent to 1.4% of daily energy)are advised.�

• The report proposes that palm oil, currently the secondmost commonly consumed dietary fat worldwide,should be limited to a maximum of just 6.8g a day (2.4% of daily energy). �

• The proposed substitution of plant oils for animal fatswill probably lead to n-6 to n-3 polyunsaturated fattyacid (PUFA) ratio that is strongly n-6 dominant given thelack of stipulated n-3 sources and the high n-6 contentof unsaturated plant oils. �

• The reference diet proposes a surprisingly low averageratio of vegetables to fruit (fresh weight) of 3:2,although a maximum of 6:1 is possible if the maximumintake of vegetables and the minimum of fruit shown inthe ranges is consumed.�

• It recommends a 32% contribution of daily energy fromwhole grains (34% from all starchy carbohydrates).�

• It proposes only 8% of the daily energy contributionfrom all vegetables and fruit.

• The report proposes the addition of an average of250ml a day of whole milk or derivative equivalents ofdairy products (equivalent to about 25–40g of cheese),although it also allows for zero intake for those who aredairy intolerant.

While the EAT-Lancet report proposes significant reductionsin consumption of red meat, sugars and highly refinedcarbohydrates, the proposed high intakes of n-6 relative to n-3 PUFAs, grains and starchy carbohydrates are notsubstantially dissimilar from current eating patterns inindustrialised countries such as the UK (NDNS, 2018).

Furthermore, the presentation of the reference diet bythe EAT Forum (EAT Forum, 2019c) is misleading. In itsdiagrammatic representation (Figure 1A), fruit and vegetables are denoted by fresh weight, and in the samefigure, the remaining seven food groups are shown byenergy contribution, the mixing of units in the same figure being misleading. Figures 1B and 1C represent theEAT-Lancet reference diet by fresh weight and energycontribution, respectively. These latter diagrams show thatthe reference diet is relatively close to current governmentguidelines, that are described by Harcombe (2017) asbeing designed more for food industry wealth than forpublic health. As shown by the latest data on adultconsumption patterns (NDNS, 2018), compliance with theguidelines has also improved significantly since 2012(Harland et al, 2012), yet obesity, type 2 diabetes andrelated conditions have continued to soar.

Taken together, it is unlikely that the escalating rates of non-communicable diseases, particularly in relation toheart disease, obesity and type 2 diabetes, could bereversed with the proposed dietary pattern which couldhardly be described as ‘anti-inflammatory’ (Biobaku et al,2019).

Furthermore, the reference diet is based on 2,500 kcal(10,460 kJ) daily intakes, which does not take into accountcaloric restriction which has been linked to reduced incidence of preventable chronic diseases (Lee and Longo,2016). The EAT-Lancet report also avoids any considerationof food frequency or intermittent fasting, the ‘how’ we eathaving been shown to be at least as important as ‘what’ we eat (Miller et al, 2018; Templeman et al, 2019).Furthermore, with carbohydrate intakes, maintained ataround 35% of total energy intake, the EAT-Lancet referencediet ignores extensive clinical evidence and emergingpublished evidence for the benefits of carbohydrate-restricted diets, especially among overweight, obese, type2 diabetic or prediabetic individuals (Zafar et al, 2019).

However, many of these assumptions are based on the average values proposed, and not the ranges. It istherefore important to evaluate the potential health implications of different interpretations of the referencediet, based on the flexibility offered by the ranges. It alsoworth pointing out that widespread public adoption ofdietary patterns at the limits of these ranges may alterquite dramatically the relevance of the EAT-LancetCommission’s findings as well as its recommendations.Examples include widespread consumption of theminimum amount (200g per capita) of all types of vegetables per day, or maximum consumption of animalprotein sources (211g per capita daily from beef, lamb,pork, chicken and other poultry, eggs and fish).

EAT-Lancet – is there such a thing as ‘one-size-fits-all’ sustainability?

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Table 1. EAT-Lancet reference diet/planetary health diet by food group and recommended daily intake (grams fresh weightand by energy [kcal])



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�1 As used here, a ‘flexitarian’ diet focuses on healthy plant proteins and other whole, minimally processed plant-based foods with the inclusionof low to moderate amounts of animal-derived products.

Exploring the flexibility of the planetary health dietWe conducted a detailed scenario analysis in which thenutrient composition of three types of ‘flexitarian’1 andvegan diets for which specific foods were selected inamounts compliant with the reference diet were compared(Verkerk, 2019). Nutrient contents were determined fromdata in the USDA National Nutrient Database for StandardReference (https://ndb.nal.usda.gov). The three types werecharacterised as ‘basic’ (assuming typical interpretations,using average amounts), ‘lower carb’ (common andpopular among those with metabolic issues and seekingweight reduction) and ‘higher protein, physically active’(given that the average protein stipulation in the referencediet is inadequate and has not been optimised for physically active individuals (Slater and Phillips, 2011;Stellingwerff et al, 2011).

The following conclusions could be drawn from thescenario analysis:

• Protein intakes ranged from a minimum of 8.7% of totalenergy for the ‘higher protein, physically active’ vegandiet to 11.3% of total energy for the ‘lower carb’ ‘flexitarian’ diet.

• The protein intakes for all three vegan scenarios (basedon a 70kg adult) were below the consensus levels set for adult humans established by an international expertgroup in 2007 (Joint WHO/FAO/UNU Expert Consultation2007).�

A

B

C

Figure 1. Three different representations of the recommended daily intake of different food groups as proposed in the EAT-Lancet reference(planetary health diet), based on a daily energyintake of 2,500 kcal (10,460 kJ)

EAT Forum representation that conflates freshweight and energy contribution values for differentfood groups in the same pie chart

EAT-Lancet reference dietary compositionrepresented by fresh weight only

EAT-Lancet reference dietary compositionrepresented by energy contribution only

• Despite including the minimum amounts proposed inthe reference diet, the protein intake in one of thevegan scenarios (‘lower carb’) was below the levelconsidered adequate even by the EAT-Lancet authors.

• The amino acid profiles in the vegan scenarios may beincomplete for some individuals, particularly those whoare immunologically challenged, with a higher argininerequirement (Daly et al, 1990).

• Total energy intake from carbohydrates could be variedby different dietary compositions from 33% (‘flexitarian’‘higher protein, physically active’) to 52% of total energy(vegan, ‘basic’).�

• The contribution of daily energy from whole grainscould be varied from 20% (flexitarian ‘higher protein,physically active’) to 35% (flexitarian, ‘basic’), the latter,not the former, being close to the EAT-Lancet target of 32%. �



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• Given the relatively large intakes of plant foods, dietaryfibre intakes in all scenarios readily met the 30g per daytarget (range: 35–53g) set in the landmark study by(Reynolds et al, 2019).

• The vegan diets are likely to be deficient in a wide range of micronutrients, including vitamin A (retinol)(Kristensen et al, 2015), haem iron (Miller, 2013),vitamin B12 (Gilsing et al, 2010) and long-chain omega-3 fatty acids (notably eicosapentaenoic acid (EPA), anddocosahexaenoic acid (DHA) (Burdge et al, 2017).

• High levels of phytic acid may prevent adequate absorption of zinc, copper and iron (Lim et al, 2013).

• Replacing animal-based foods with vegan ones may illicit adverse reactions in sensitive individuals, owing toincreased intakes of gluten (Schnedl et al, 2018), anti-nutritional factors such as lectins (Miyake et al, 2007),phytate (Schlemmer et al, 2009), goitrogens (Felker et al, 2016) and oxalates (Prezioso et al, 2015).�

• The EAT-Lancet recommendations do not adequatelytake into account adaptations of specific sub-populationsto particular diets and the potential impacts on themicrobiome, especially of the gut (Gupta et al, 2017)that can be associated with dietary transformation.

• The Lancet-Commission authors continue to maintainan anti-saturated fat stance, contradicting the recentchanges in the scientific consensus on the subject(Fattore and Massa, 2018; Zhu et al, 2019). The authorsalso do not adequately address the evidence for the pro-inflammatory nature of diets in which a high dietary n-6:n-3 polyunsaturated fatty acid (PUFA) ratio contribute tometabolic diseases (Torres-Castillo et al, 2018).�

• The EAT-Lancet authors make a strong case forincreased use of oilseed rape (canola) because of itsprovision of essential fatty acid alpha-linolenic acid(ALA). Twenty-five per cent of the world’s oilseed rape is genetically modified, the vast majority of this beinggrown in Canada, the US and Australia (Belter, 2016),with a consequent increase in herbicide-resistant weeds(Fernando et al, 2016).

• The data that the EAT-Lancet Commission has relied onto draw its conclusions are based on long-term studiesinvolving mortality (not morbidities or comorbidities),many of which are based on consumption patterns thatprecede the era of widely available globalised, ultra-processed foods. Additionally, there are major, ongoingdietary transitions associated with increasingly urbanisedpopulations, such as the consumption of increasingamounts of food outside of the home, which generallyhas been shown to be detrimental to health comparedwith food preparation in the home (Nago et al, 2014).Accordingly, the findings may not be relevant toconsumption patterns required to reduce morbiditiesand mortalities in the current or future eras. �

Greening agriculture?The EAT-Lancet’s environmental protection and agricultural sustainability goals are laudable. They includeclimate change mitigation, conversion of agriculturalsystems from net carbon emitters to net carbon sinks,water conservation, improved nutrient recycling, andenhancement of biodiversity. All of this, says the EAT-Lancet Commission, is to be achieved through great stridesin efficiency in the use of fertilisers and land – with noadditional land use over that presently used for agriculture.

Despite growing awareness about the health of plant-based diets and adverse impacts of factory farming ofanimals over the last decade or more, there has been noslowing in demand for livestock products, a trend that isstrongly linked to growing affluence. The World HealthOrganization (WHO) projects that annual meat productionwill increase to 376 million tonnes by 2030, a 72% increasefrom 1999 (WHO, 2019).

The proposal to halve meat consumption globally met with an expected negative reaction from the meatindustry. However, the EAT-Lancet authors – as is often thecase with desk-based research projects reliant on macrodata – have failed to take into account the profound differences that livestock production systems can havedepending on whether they operate as part of industrialfarming or agroecological systems.

Marginal landsParts of the USA, Russia and Australia, for example, haverelatively large amounts of marginal land that is suitablefor grazing, but not for arable or horticultural production.In fact, the concept of ‘marginal land’, in which land isconsidered marginal for agriculture, but vital for grazing, is integral to any large-scale, holistic, sustainable agro -ecosystems model (Shahid and Shankiti, 2013). Dry land,much of it viewed as marginal, represents 45% of theworld’s land area and the role of livestock to aid the ‘upcycling’ of such land is viewed as increasinglyimportant for the future of food, people and planet.Ironically, as the Global Dry Land Alliance (GDLA)member countries are only too well aware, the trendtowards salinisation and desertification of dry lands is actually reducing available arable land, and increasing landsuitable for grazing and restoration for mixed uses.

Maintaining ideology, avoidingrealityThe EAT-Lancet report avoids some of the most thornyquestions around intensification of agriculture productionsystems, including the centralisation of agriculturalresources (eg seeds, fertilisers), increased use of geneticallymodified (GM) crops and associated pesticides (egglyphosate), and the impacts of pesticides on non-targetorganisms including pollinators and humans. These wereamong the issues considered as crucially significant in thefive-year, seminal findings of the International Assessment

of Agricultural Knowledge, Science and Technology forDevelopment (IAASTD, 2009) which, based on five yearsof research by 400 scientists from 60 countries, favouredtransition towards decentralised, locally-adapted, agro -ecological models.

There remains considerable confusion over the extent of agriculture’s contribution to greenhouse gasemissions, the EAT-Lancet report authors relying onVermeulen et al’s (2012) estimate of ‘up to 30%’ contribution to greenhouse gas emissions. By contrast, the US Environmental Protection Agency (EPA, 2018) estimates the contribution at just 9% of the total amount,with 28% linked to transportation, 22% to industry and28% to electricity generation. The contribution from live-stock is estimated at just 4.2%, comprising 2.2% from beef,1.4% dairy, 0.5% swine and 0.1% from poultry.

By contrast, New Zealand, with just 4.6 million humanpopulation and more than twice that many cattle, is estimated to produce 46% of its greenhouse gases fromagriculture, with electricity production contributing nearly the same amount, at 42% (NZ Ministry for theEnvironment, 2014). So while per capita greenhouse gasemissions are a stunning 16 times over the global sustainable rate of 1 ton of CO2-equivalent per person,New Zealand, by virtue of its small population, is welloutside the top 20 greenhouse gas emitting countries. In order to reaffirm the need for prioritisation, NewZealand’s emissions represent just 1.7% those of Chinaand 3.4% those of the US.

Global versus localGiven that a central tenet of EAT-Lancet is to reduce global consumption of red meat by over 50% ostensibly to reduce greenhouse gas emissions, we calculated, usingFAO data, the relative impact of animal protein intake percountry, taking into account per capita animal proteinintake and population sizes (Verkerk, 2019). This analysisshowed that just three countries (China, the US and India)contributed to 67% of the global impact, assuming equivalence of impact per gram of animal proteinconsumed. This emphasises the need to focus on regionaland local solutions, as opposed to global ones thatinevitably encourage further globalisation and centralisation of resources, a trend being widely considered as counter to environmental, cultural andsocial diversity and sustainability (der Ploeg, 2012).

Concluding remarksViews about the most sustainable nutritional and agricultural practices are increasingly being informed bydesk-based researchers and policymakers with strongbelief systems and ideologies, but who have little practicalexperience either of nutrition or sustainable agriculture in diverse ecotypes.

Data on which views are based is often derived frommeta-analyses or systematic reviews, whose original data

may be many decades old and so no longer relevant tocurrent or future scenarios. During the analysis and interpretation of results, association is often incorrectlytaken to imply causation. When the results are published,media channels that support the ideologies spin the findings further – and the public does its best to pick upthe pieces and integrate them with its own knowledge,experience and belief systems.

The EAT-Lancet project is, in our opinion, a case inpoint. The much-publicised research paper by Poore andNemecek (2018), which has been used as a justification tovilify animal-based foods, is another. With an ideology inplace, it is very easy to look past the full range of factorsthat require consideration if truly sustainable approachesare to be found. That might include, for example, theconsideration of biodiversity loss (eg small mammals,birds, soil organisms) attributable to soil degradation,herbicide, fertiliser and pesticide use, as well as thedestruction of hedgerows and borders, all in the name ofexpanding large-scale arable monocultures intended forhuman consumption.

Another major issue with the big picture, globalisedapproach that occurs when scientists and policy makersget together in the manner of this Lancet Commission, isthat they work with averages. In doing so, the subtleties,vagaries, mysteries and wonders of outliers are omittedfrom their analyses. Their lack of practical experience ofsuch examples – whether it is the resolution of auto -immune conditions through the removal of certain typesof plant food from the diet, or the restoration of marginalgrasslands through the re-introduction of livestock –means they remain invisible.

Once an ideology takes hold – as is the case withconcepts such as peak livestock and the perceived need to globally transition from animal to plant-sourcedproteins (Harwatt, 2018) – momentum can gather quickly. If policy measures including taxes on foods deemedunhealthy or bad for the environment are imposed, theprocess of transition is likely to accelerate. In this case, it is essential that the approach – and the evidence thatunderpins it – is sound. In many cases, contrary to thebold assertions made by the EAT-Lancet authors, the dataare far from certain.

The EAT-Lancet report, in effect, vilifies meat consumption. However, even accepting the argumentsmade, meat eating is not the problem per se – it is excessively cheap meat that is the problem, where thecost of the meat does not adequately take into accountthe true cost of its production in environmental terms.This includes how different types of animal productionsystems act as sources or sinks for greenhouse gases, orwhether their net carbon footprints and the ecosystemservices offered, including that related to the forage cropsor feed that helped create the animals, have beenadequately factored in. �

If agro-ecological systems were to be valued for theirreduced impacts on climate change, their contribution tobiodiversity and reduced pollution, and in which livestock



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were accepted as a necessary part of these systems, adegree of meat-eating, probably significantly over thelevels contemplated in the planetary health diet, wouldprobably be tolerable. But such approaches are completelycounter to the kind of industrialised animal productionmethods that have become de rigeur through much ofthe world.�

The westernisation, simplification and globalisation ofdiets is a massive issue for both people and planet. Thisprocess, that has swept across the world ever more rapidlyover the last three or so decades, is being driven as muchby industry and government, as it is by consumer demand.As emphasised by research on the five blue zone regionsof the world, long, healthy lives are not associated withtechnological advancement either of food production orhealthcare systems (Buettner and Skemp, 2016). Thecorollary is also true. Obesity, type 2 diabetes and theprimary health burdens of the 21st century, are all associated with technological advancement. Traditionaldiets and agricultural practices are being forgotten at anastonishing rate as adoption of technology and urbanisationgathers pace in the so-called developing nations. �

For the sake of people and planet, a major internationaleffort is urgently required to compare the net harms andbenefits of different strategies relating to food productionsystems and consumption patterns in different regionsand countries. This should include comparisons betweenhigh-input, industrial-scale farming systems for plants andanimals, against low-input, sustainable systems, based onagro-ecological, nutrient-cycling principles.

As suggested by Christine King (2008), these agro-ecological systems are about reconnecting peopleand food, and people with people – as well as helping tocreate community and health resilience. Fundamental tothe viability and stability of these systems is their adaptationto local environments and cultures, and their resilience inthe face of climatic, social and political instability.�

Such considerations are of key importance given thedeficiencies of the EAT-Lancet report and the rise of thecorporatocracy (Vanbergen, 2016). Equally, full accountneeds to be taken of the social, environmental, economicand cultural impacts of current trend tendency for controlof agricultural, food production and healthcare resourcesinto the hands of a small number of transnational corporations (George, 2015; Hendrikson et al, 2017).

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IntroductionWhat do we mean when we speak of‘real food’? The simplest of food iscomplex. We eat combinations of food– more complexity. We are complexand the environment in which we eatand live is complex. The impact onhealth of what and when we eat isinfluenced by individuality, belief,community, environment, access, politics etc. We no longer eat tosurvive. The diversity of food eaten inthe UK has diminished. Now place allthis complexity and lack of diversityover a lifespan of continual changeand challenge. This complexity oftenappears insurmountable, for there areso many confounders on the foodjourney from soil/sea to self. Researchunderpinning current public advicesits on shaky foundations, poormethodology, and bias, both personaland commercial. For the public thisleads to confusing messages and reversals… welcome back to butter!

Where nutritional considerationscollide with concerns about environmental sustainability, ill-advisedfuture diets (EAT-Lancet, 2019) maybe proposed. Research methodsincluding randomised controlled trialsare inadequate in the face of suchcomplexity, but new research paradigms and methodologies areemerging – genome, epigenome,

microbiome and exposome research.However we cannot wait, we need aconsensus on a definition for ‘realfood’ that takes into account at leastgenetic adaptations, human physiologyand biochemistry and health status.

There are no simple messages innutrition, however an ideal food/dietshould both sustain reproduction andhealth throughout the lifespan and beregenerative for the environment. Wecan apply principles of holism, fooddiversity and evolutionary theory, andtake into consideration currentadvances in genomics, epigenomicsand our understanding of the micro-biome, while remaining open to challenging these frameworks as wediscover more through new researchand experience.

Food is medicine –nutrigenomics and themicrobiomeWhat is ‘real food’? One answer is that‘food is information that tells yourentire biology what to do and when todo it, but junk food is like malware onyour computer: scrambled informationthat leads to a major hardware crash’(Frank Lipman, 2019)

The substances in food change theenvironment in the gut. Food speaksto our gut microbiome which in turn

DO WE NEED MEAT?

Nose to tail nutritionand evolutionHeather RosaDean, Institute for Optimum Nutrition

Food was the key to my recovery from illness and my inspiration for studying nutritionaltherapy. It has since kept at bay Barker’s baby trajectory1 and helped me survive 30years in academia. Having surmounted the usual zeal to find the perfect diet I now havesleepless nights pondering complexity! I’m endlessly fascinated by the web-like interconnections between health, dis-ease, food, beliefs, movement, evolution, genes,microbiota, individuality, community, environment, politics... As Dean of the Institute forOptimum Nutrition my goal is to educate nutrition scholar-practitioners, instilling criticalthinking, evidence informed and collaborative practice. I’m half Italian, grow organically,forage, and eat chicken feet!

This article is an abridgedversion of a presentation givenby the author at the BHMA’sApril 2019 Real FoodGathering, a two-day debateon the nature of ‘real food’and just what we mean by ahealth-enhancing human diet.The scientific evidence is onlypartially helpful, for instancethe benefits and hazards ofmeat in our diet is particularlyconflicted, though according topaleontologists, our earliestancestors were meat-eaters,who would have eaten all theedible parts of the animals,including fish and shell fish aswell as insects and spiders.

1 Babies born premature or with poor inutero nutrition succumb to western diseases10 years earlier than the general populationaccording to Barker (1997)


speaks to the whole body. Food influences the expressionof genes. Microbes, for example, train the immune systemvia conversations with Regulatory T cells (Treg cells) whichby restraining inappropriate immune responses in thehealthy gut have a central role in the maintenance of intestinal homeostasis (Spector, 2016). Not eating reducesmicrobial diversity however, yet short-term fasting can bebeneficial as long as non-fast days contains a diversity ofnutrients dense foods.

Nutrient-dense foods contain vitamins, minerals, complexcarbohydrates, lean protein, and healthy fats. Examples ofnutrient-dense foods include fruits and vegetables, wholegrains, low-fat or fat-free milk products, seafood, lean meats, eggs, peas, beans and nuts.

We now understand that it is not just vitamins and mineralsconversing with our genes and microbes. There aremyriad other substances in food that also communicate,such as phytochemicals (think rainbow), nucleotides(found in organ meat), short chain fatty acids (eg butter,coconut), fibre, hormones, bacteria and bacterial fragments (fermented foods), fungi, viruses and as yetunknown beneficial factors as well as xenobiotics introduced in the growing, processing and preserving offood. The context in which food is eaten, lifestyle andenvironment, are also important. So, we could add to our‘real food’ definition foods that speak beneficially to bothour microbiome and to our genes. There is still much tolearn about these interactions. However, generallyresearch shows a rich diversity of whole, nutrient dense(important if a person is intermittent fasting), minimallyproceeded food, low in xenobiotics keeps these conversations healthy (Spector, 2015).

Evolution: an ancestral approachDiet, and the use of fire for cooking, has been cited as adriving force in human evolution (Cornelio et al, 2016).Associated physical changes included increased brain size,a reduction in gut length and blunter teeth. For our pre-agricultural, hominin ancestors’ nose to tail consumptionof fish, seafood, animal foods and insects became thedominant sources of energy, protein, long chain fattyacids, iodine, vitamin B12, taurine, haem iron and zinc.Brain development occurred alongside an abundance ofessential fatty acids (EFAs) from aquatic, and animal fattytissues (brain, bone marrow etc). Humans are inefficientin the conversation of plant rich 18-carbon fatty acids(seeds, nuts) into the 20- and 22-carbon polyunsaturatedfatty acids (EPA and DHA) essential for cell membranefunction and brain tissue. This conversion is furtherhampered by high n-3 and sugar intakes, type 2 diabetesand subclinical deficiencies in B6 and zinc co-factors in the conversation pathway.

What are humans adapted to eat?Necessitated by migration, biological adaptations over timehave expanded dietary patterns for some populations: egmilk (lactase) and grain (amylase). However, there are noknown non-animal food civilisations perhaps because such a diet would provide inadequate energy return forsurvival. It has been argued that divergence from ourevolutionary dietary pattern involving high meat intake(fat and protein) to a more grain and processed food-based diet, forms the basis of lifestyle-related chronicdiseases (Mann, 2018).

We can’t go back in time and eat the foods our ancestors ate, nor know fully the extent of their dietaryintake and patterns of eating. However, we evolved withcertain nutrient needs. Could we define a ‘real food’ dietas one that meets intra-individual requirements for physiological, psychological and anatomical needs acrossthe lifespan, without the need to supplement (eg B12) or fortify the food?

Quality, as well as diversity and quantity, is anotherimportant factor to consider in defining ‘real food’. Qualityof food is impacted at multiple points along the journeyfrom soil/sea to self. For example what we feed animalsbecomes us: something worth remembering when advocating nose to tail eating. Soil nutrient content andwhether to supplement micronutrients is another significant topic.

Expanding the diversity of ‘realfoods’ in the diet Dietary diversity and quality Today we eat fewer than 20 separate food items a day,from just four main ingredients wheat, corn, soya or meat,mostly processed, and with high glycaemic potential toelevate blood sugar. The fossil records and observations ofmodern hunter-gather tribes, suggest a broader diet couldcontain over 150 foods a week, mostly animal with plantsplaying an important supplementary role (the Hadza ofTanzania have access to around 600 plants and animalspecies [mostly birds] [Spector, 2017] and insects). These foods came whole, not as juices and certainly not fractionated (eg high-glucose corn syrup) or highly-processed. Foods were seasonal, local and fresh, eaten raw and cooked (meat and starchy tubers). Preparationmethods (increasing in diversity and complexity overtime) included cutting, chopping, soaking, cooking andpreserving (air, sun or with naturally occurring materialsand later fermenting).

It is not only ultra-processed food that we need tobeware of in defining what real ‘real food’ is or isn’t. Wealso need to understand that many of the fruits andvegetable we eat today bear little resemblance to thoseeaten by our ancestors. Selective breeding has increasedtheir sweetness and reduced numbers of seeds, phyto -nutrients and fibre content making these foods relativelyeasy to consume in large amounts.

Nose to tail nutrition and evolution

DO WE NEED MEAT?



DO WE NEED MEAT?

Tim Spector who lived three days with the Hadzareported: ‘My next snacks were wild berries on many ofthe trees surrounding the camp – the commonest weresmall Kongorobi berries. These refreshing and slightly sweet berries have 20 times the fibre and polyphenolscompared with cultivated berries – powerful fuel for mygut microbiome.

The low glycaemic index of ancient/wild/bush carbohydratefoods places a relatively low demand for insulin secretionpotentially protecting from a genetic predisposition toinsulin resistance and the consequences for developingchronic diseases (Brand-Miller and Holt, 1998). So canmodern plant varieties be classed as ‘real food’? Would the public be prepared to eat wild/bush varieties?

InsectivoryAnalysis of fossilised faeces suggests our early ancestorsroutinely consumed a wide diversity of insect species —ants, beetle larvae, lice, ticks, mites, and spiders wellbefore we early hominids began to hunt or farm. Whenthe Hadza eat honey they also eat fat and protein fromlarvae, pupa and insect parts (Marlowe et al, 2014)

It is estimated that as much as 80% of the world’scurrent population eats insects intentionally. Whether wildand collected or farmed, this extends to over 1,555 speciesof insects and spiders. However 100% of humans eat themunintentionally according to Srivasta et al (2009). Do youlike chocolate? Chocolate averages 60 to 90 or more insectfragments per 100 grams. The food colouring cochineal ismade from the eggs of pregnant beetles. Honey is the by-product of insect activity. For those of you who likesmoothies, up to 60 per cent of frozen berries can bemouldy, with an average of four or more larvae, or ten ormore whole insects, per 500 grams. I like to forage so I’mlucky I’m getting more! Can any plant-based diet be trulyvegan?

Humans eat two classes of invertebrates: mollusca(shellfish), and arthropoda (insects, crustaceans, scorpions,spiders etc) (McGrew, 2014). Somewhere back in timeinsects became the enemy, probably when farminginvested in livestock (Gordon, 2013). Prawns are generallyeaten without a second thought, although this was notalways the case. Witchetty grubs can be thought of as landprawns, but our distaste for them is an issue, since insectsare nutrient dense, and proportional to their macronutrientcomposition, they could serve as equivalents not only ofwild meat, but of a range of other foods including someshellfish, nuts, pulses, vegetables and potentially fruits(McGrew, 2014). As a solution for food and feed security,they contain 60% protein per 100g. Compared withproducing meat, where 100 gallons of water creates 6g ofcow protein, or 18g of chicken protein, the same amountof water can turn into 238g of cricket protein (FAO.org).Utilising insect powders, pastes, liquids and oils may be away to surmount barriers to diversifying our diets withinsects, a rational argument – but without a sustainedchange in attitudes and habits, we will need many morecreative solutions.

Insect farming is a massive industry in the far east.European production is small, producing niche costlyproducts (Dossey et al, 2016). Environmentally there arequestions about the cost of energy needed to maintaingrowing temperatures. Grain and high-quality meat areused as feed. In the UK EU laws regulating animal feeddon’t allow the use of food waste to be used as animalfeed. In short there is no such thing as a free lunch!

Quality is an issue. As with salmon when insects arefarmed and fed a cereal-based diet their n-6/n-3 ratioincreases significantly and are not considered supportiveof human health (Oonincx, 2019). Current consumptionof n-6 is already considered excessive and potentially detrimental creating a pro-inflammatory state in the body.The optimal ratio may vary with the severity of a diseaseresulting from the genetic predisposition (Simopoulos,2008). A more desirable n-6/n-3 ratio can be obtained byenriching standard insect diets with 1%–2% of flaxseed oilor chia seed oil (Oonincx et al, 2019.) Fat is in the form ofALA and not EPA. DHA is not retained in insects. Humanconversion of ALA to EPA is inefficient and reduced furtherin type 2 diabetes.

Hadza eating honey-plus (National Geographic, 2017)

Seed content and size of a wild and cultivated banana

Insects provide natural nutrient dense, minimallyprocessed food sources for humans but is this ‘real food’ if the insects are not fed their natural diet? While insectscan provide lower energy and resource intense sources ofprotein, fish and shellfish remain the better sources ofEPD and DHA in the human diet.

ConclusionIt is not just the quantity but the quality of food weconsume that confers health. Humans can tolerate a widediversity of foods, but it appears we have not evolved tothrive on a diet high in ultra-processed foods, sugar anddamaged seed oils nor are we likely to. Avoiding thesefoods is an easier message. More problematic is what weadvise on foods that are perceived as healthy yet may,through hybridisation, breeding and other insults on thejourney from soil/sea to self, have a low nutrient densityand less fibre, are higher in sugar and whose essential fattyacid profile is skewed.

Eating nose to tail is to be applauded for providingincreased nutrient density and the benefits of non-nutritivehealth-giving compounds. While including insects in thediet could improve available nutrient density, it might notprovide the touted solution to future world food supplyunless insect farming practices embrace sustainable andregenerative principles.

The frameworks briefly explored here provide reasonable starting points for defining ‘real food’. Still,individuality (eg of the genome and microbiome) andfood’s biological and cultural complexity will mean that no simple universal nutrition message is possible, andespecially so for those with chronic ill health.Nevertheless, any diet that encourages eating a diversity of nutrient-dense wholefoods both animal and plant, minimally processed to enhance nutrient availability, hasto be the basis for any real food project to begin with.

ReferencesBarker D (1997) Maternal nutrition,fetal nutrition, and disease in later life.Nutrition 13(9) 807–813.

Bland JS (2014) The disease delusion:conquering the causes of chronicillness for a healthier, longer andhappier life. New York, NY:HarperCollins.

Brand-Miller JC, Holt SHA (1998)Australian Aboriginal plant foods: A consideration of their nutritionalcomposition and health implications.Nutrition Research Reviews 11(1)5–23.

Buck Louis GM, Sundaram R (2012)Exposome: Time for transformativeresearch. Stat Med, 31(22) 2569–75.

Cornélio AM, de Bittencourt-NavarreteRE,3 de Bittencourt Brum R, QueirozCM, Costa MR (2016) Human brainexpansion during evolution is independent of fire control andcooking. Front Neurosci, 10: 167.

Dossey AT (2016) Modern insect-basedfood industry: current status, insect processing technology, and recommendations moving forward. In: Dossey AT, Morales-Ramos J,Guadalupe Rojas M (eds) (2016) Insects as sustainable food ingredients:production, processing and food applications. London: Academic Press.

Gordon DG (2013) The eat-a-bug cookbook. Revised: 40 ways to cookcrickets, grasshoppers, ants, water bugs, spiders, centipedes, and theirkin. Available at: http://davidgeorgegordon.com (accessed 21 August2019).

Iowa State University (2000) Available at: www.ent.iastate.edu/misc/insectnutrition.html (accessed 21 August 2019).

Lipman F (2019) Twitter: @DrFrankLipman, 0:15 am, 31 July 31.https://twitter.com/DrFrankLipman/status/1156342500048740355?s=03)

Mann NJ (2018) Meat in the human diet: an anthropological perspective.Available at: www.thefreelibrary.com/Meat+in+the+human+diet%3a+an+anthropological+perspective.-a0169311689 (accessed 21 August2019).

Marlowe FW, Berbesque JC, Wood B, Crittenden A, Porter C, Mabulla A(2014) Honey, Hadza, hunter-gatherers, and human evolution. Journalof Human Evolution, 71, 119–128.

Oonincx DGAB, Laurent S, Veenenbos ME, van Loon JJA (2019) Dietaryenrichment of edible insects with omega 3 fatty acids [online]. InsectScience. Available at: https://hal.archives-ouvertes.fr/hal-02173580/ docu-ment (accessed 24 August 2019).

O’Malley R, McGrew B (2014) The other faunivory: the significance ofinsects & insect resources for nonhuman primates, modern humans, &extinct hominins. Journal of Human Evolution, 71, 119–128.

Simopoulos AP (2008) The importance of the omega-6/omega-3 fattyacid ratio in cardiovascular disease and other chronic diseases.Experimental Biology and Medicine 233(6) 674–88.

Spector T (2017) I spent three days as a hunter-gatherer to see if itwould improve my gut health. Meldical X press. Available at: https://medicalxpress.com/news/2017-06-spent-days-hunter-gatherer-gut-health.html (accessed 21 August 2019).

Spector T (2015) The diet myth: the real science behind what we eat.London: Orion Books.

Srivasta SK, Babu N, Pandey H (2009) Traditional insect bioprospecting –as human food and medicine. Indian Journal of Traditional Knowledge,8(4), 485–494.

Stull V, Patz J (2019) Research and policy priorities for edible insects.[Online] Sustainability Science. Available at: https://link.springer.com/article/10.1007/s11625-019-00709-5 (accessed 24 August 2019).



DO WE NEED MEAT?

Table 1: Nutritional value of various insects Insect Protein (g) Fat (g) Carbohydrate Calcium (mg) Iron (mg)

Giant Water Beetle 19.8 8.3 2.1 43.5 13.6Red Ant 13.9 3.5 2.9 47.8 5.7Silk Worm Pupae 9.6 5.6 2.3 41.7 1.8Dung Beetle 17.2 4.3 .2 30.9 7.7Cricket 12.9 5.5 5.1 75.8 9.5Grasshopper 20.6 6.1 3.9 35.2 5.0Grasshopper 14.3 3.3 2.2 27.5 3.0June Beetle 13.4 1.4 2.9 22.6 6.0Caterpillar 28.2 N/A N/A N/A 35.5Caterpillar 9.7 N/A N/A N/A 1.9Termite 14.2 N/A N/A N/A 35.5Weevil 6.7 N/A N/A N/A 13.1Beef (Lean Ground) 27.4 N/A N/A N/A 3.5Fish (Broiled Cod) 28.5 N/A N/A N/A 1.0

Iowa State University (2000)


EATING OLD-STYLE

Food for health:Putting traditional foodsback on the tableIzabella Natrins Nutrition and lifestyle health coach; nutritional chef

Food-and-lifestyle-as-medicine is my passion. I write, educate and teach on regainingtraditional food wisdom, engaging with sound science and learning the forgotten skillsthat restore energy, vitality and true health. As a former health research psychologist,my training at the organic Ballymaloe Cookery School in Ireland introduced me totraditional farming, food production and preparation methods, from soil to plate. Aftercreating IzabellaNatrins.com to promote holistic wellbeing, I trained as a nutrition andlifestyle health coach with the Institute of Health Sciences (Dublin). I became a PublicHealth Collaboration Ambassador and joined the Real Food Campaign UK to play apart in joining up thinking across all parts of farming, food and medicine for better health.

Diet controversies are ongoingacross a spectrum thatstretches from the strictlyvegan to eating patterns low in carbs and high in flesh; controversies made all the morecomplex by environmentalconcerns. However, few doubtthat cheap manufactured‘food-like’ substances, with littleor no nutritional value, aresabotaging health and qualityof life. ‘Deep nutrition’ kept ourancestors free from the chronicdiseases that plague today’sworld: the meat, eggs, butter,milk and cheese of grass-fedanimals; bones and broths;organic fruit and vegetables,seafood and fermented foods.The author makes suggestionsfor how to source real foodaffordably.

‘Dis-moi ce que tu manges, je tedirai ce que tu es’Tell me what you eat, and I will tell you what you are…Anthelème Brillat-Savarin, 1826

A race to the bottomThis article is based on the presentationI gave at the 2019 Real FoodGathering, where I had been asked toprovide an overview of foods oncecommon in the traditional westerndiet. The content, which reflects myexperience as a nutrition and lifestylehealth coach and chef, is based on theextensive research I carried out inorder to write my book Once Upon aCook – Food Wisdom, Better Living:Reclaim your kitchen. In the book I examine each category of the traditional foods highlighted in thisarticle in detail over the course of 14chapters, two appendices and citingover 500 references.

As a nutrition and lifestyle healthexpert, coach and a nutritional chef, Icare deeply that the traditional, time-honoured foods, the powerful medicinethat kept generations before us fit andfree of chronic disease, are no longer

on our tables. In the UK, perhapslargely because of our increasedconsumption of ultra-processed foods,we are now leading a global race tothe bottom of international leaguetables for health and disease. Thisarticle expresses my belief that thecrisis in healthcare won’t be solved bymoney, but only by going back to real,nutrient-dense food.

Granny’s larderIf we are to halt the present nutritionalrace to the bottom, the time-honoured, traditional foods our grandparents (and theirs) enjoyedmust find their way back on to ourdining tables. For instance the sorts of bone broth ‘grannies’ in diversecultures around the world have beenmaking for generations. The basis of a Polish granny’s great chicken soup‘rosol z kury’ would have been a slow-cooked chicken broth. If she was Jewish she would have served up‘goldene yoich’. Her Italian counter-part cooked ‘fedelini in brodo’ and inRomania ‘ciorba de pui’. In Mexicothey spice theirs up in ‘zopa difideros’, while Peruvians enjoy a ‘caldo


de gallina’. Traditional Chinese medicine has long prizedhealing ‘congee’ – a well cooked rice-based porridge –which could be made with a chicken feet stock. In Indiavarious versions of ‘kitchari’ (a well-cooked broth of rice,mung beans, vegetables and spices often on a meat/bone-based stock) have been prescribed to countlessgenerations for restoring a weak digestion. All over theworld, foods like these are part and parcel of time-honoured healing traditions.

Eggs – the humble egg – organic, genuinely free-range or pasture-fed – is an all-round superfood withproteins, fats, vitamins A, B, D, E and K and other keymicronutrients. Our grandparents’ encouragement to ‘Go to work on an egg!’ was sound advice.

Seafood – although oily fish like salmon have beenvery much in vogue, the deep nutrition in the humblesardine, white fish and seafood such as mussels, crab andoysters that granny enjoyed are once again coming intotheir own.

Dairy – dairy and its products have been prizedthroughout history and were widely used as a medicinebefore industrialised, pasteurised dairy products camealong. We are witnessing a renaissance of organic, non-homogenised milk; grass-fed, free-range milk; full-fat rawmilk from certified producers; full-fat and raw cheeses,supporting our gut health and immune system function.Raw dairy is rich in fat-soluble vitamins A, K and E – 50%

more than in pasteurised – and in vitamin C which is notpresent at all in pasteurised dairy products.

Bone broths – straight out of granny’s kitchen comebone broths and stocks. Chicken and beef bone brothsand stocks from pasture-fed animals are a nutritionalpowerhouse. Incredibly healing for the digestive tract,broths aid liver detoxification and support the immunesystem and heart health. Among many other nutrients,bone broths contain a magical ingredient: gelatin…

Gelatin – is not just for jelly! Gelatin is a good sourceof protein, containing important amino acids not found inlean muscle meat. It supports skin, hair and nail growth; is good for joints and can help joint recovery; can helptighten loose skin and improve digestion since it naturallybinds to water; and helps food move more easily thoughthe digestive tract.

Gelatin is the ultimate ‘beauty’ food, as it’s not onlyrumoured to help improve cellulite but is a great source ofdietary collagen. (Forget collagen creams and make brothinstead!)

Bone-in and ‘slow-cook’ cuts from grass-fedanimals – back in the day, lean meat was cast aside infavour of what we now call ‘cheap’ cuts. But very leanmeat is tough on our digestion and lacks important nutrients like gelatin. Granny’s slow-cooked casseroles andbraises make use of old-fashioned cheaper cuts on thebone, with rich connective tissue that melds down itsprecious gelatin into the gravy, greatly helping digestion.

Organ meats – chicken liver pâté with bacon, pâté decampagne, pork and herb terrine, meatloaf, steak andkidney casserole – all delicious, nutritious organ foods. Allliver is beneficial, especially liver from pasture-fed animals;good for all vitamins and packed with minerals. Beef liver,although strong in taste, is particularly nutritious.Thankfully, ‘nose-to-tail’ eating trends are encouragingmore of us to enjoy these organ meats.

Cultured and fermented foods – every civilisationthroughout history has understood the power of cultureddairy: home-made yoghurts, labneh, raw-milk kefir,cultured butter and fermented vegetables such as kimchi,sauerkraut, carrots. These foods are incredibly efficientchelators (detoxifiers) and contain more nutrients thanbefore fermentation.

Grains – organically-grown wheat, spelt, oats, barley,cornmeal, rice and grain-based products like flour and

Food for health: Putting traditional foods back on the table

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cereals, can play a part in a varied, nutrient-dense diet. Butthey are problematic for our digestive systems. Grains andtheir products are complex carbohydrates which releasetheir energy slowly, but they need to be well broken downinto simpler sugars in our digestive tract before they canenter the blood stream. Granny’s grains were prepared bytraditional, time-honoured methods – like soaking, sprouting or fermentation, for better digestion and toavoid potential mineral deficiencies.

Colourful roots, shoots, tubers and squashes –these starchy carbs ultimately get broken down to glucosein the digestive system to deliver energy efficiently to ourcells. Although starchy carbs have become demonisedlately, for many of us these undervalued, below-the-ground vegetables – carrots, beetroot, parsnips, swedes,celeriac, squashes and potatoes – are much easier todigest (and therefore can meet our energy needs) thanthe fibrous and very difficult to digest leafy greens that weobsessively whizz into those healthy green smoothiesevery morning.

Leafy green and sulphur-rich vegetables – we eatfirst with our eyes, so green vegetables are an appealingaddition to any meal. Organically-grown kale, spinach,broccoli, cabbage, cauliflower, brussels sprouts andsulphur-rich onions and garlic all graced granny’s larder.They supply much-needed fibre in our diet, but they canbe a problem for many of us if eaten to excess, and grannyknew that they need to be cooked well – and served withbutter or olive oil – to support digestion and nutrientabsorption.

Fruit – evolutionarily, we’re hard-wired for sweetfoods. For our ancestors, colourful, ripe fruit was an indicator for, and important source of, vitamins. Althoughmodern fruit has been hybridised to be sweeter than thesharper fruits our ancestors enjoyed, it still plays an important part in a traditional, nutrient-dense diet. Grannyknew that eating whole fruit rich in fibre slows down theabsorption of the fruit sugars.

A word about carbohydrates – grains and theirproducts, starchy and green vegetables and fruits are allcarbohydrates and ultimately are all…sugars. There’s nodenying that as a food group, carbohydrates have becomecontroversial… and whether we even need to eat carbs atall is currently at the centre of a huge nutritional debate.

Despite the current backlash, these dietary carbohydratesprovide our bodies with energy to use and to store forfuelling our cells. They provide structure, feed beneficialgut bacteria and bulk out our stools, as well as supportingour immune, digestive and cardiovascular systems.

But excess consumption of highly refined andprocessed carbohydrates has skewed a proper dietarybalance of other macronutrients – proteins and fats, forexample spawning ‘carb-phobia’ (fast replacing fat-phobia) and demonising them as the new dietarydemon on the block.

All carbohydrates break down into sugars and there is no doubt that the developed world now consumeshorrifying amounts of excess and highly refined isolated,added and synthetic sugars all hidden in ultra-processedfoods. But natural, simple sugars in the form of honey,maple syrup, molasses, and fresh, ripe fruits had anhonest place in granny’s larder, supporting a well-balanced, metabolically-positive diet.

Fat – is our healthy friend, but for decades, fat-phobiahas ruled the day. Thankfully, both forgotten and emergingscience is now proving what granny always knew: saturated fats like coconut oil and animal fats like butterand cream (grass-fed, raw if possible) or beef tallow (frompastured and grass-fed and finished animals), are all high in fat-soluble vitamins A, D and E. Mainly mono-unsaturated fats like lard (from pastured pigs), avocado oil and extra virgin olive oil are highly beneficial too.These healthful fats need to be back on the table.

Salt – is most definitely the victim of misplaced blameand takes the rap for a variety of serious health conditions.However, salt plays a complex role in the body and weneed it to keep our metabolism high and manage ourbody’s stress response – anything that chronically stressesour system will lead to a health issue. But not all salt iscreated equal. We need to understand the differencebetween healthful, unrefined salts like Maldon or Cornishsea salt or Himalayan salt and the free-flowing, refined,industrial-grade salt that appears on our tables and inprocessed foods. It’s worth remembering that MotherNature has given us a taste for salt and every chef worththeir salt knows that what separates good food from greatfood is salt!

Not in granny’s larderGranny would have shuddered at the prospect of ultra-processed and convenience foods, full of excessive andcarefully hidden amounts of sugar, far more than wewould ever use in our own kitchen. Although we tend tothink that ‘added’ sugar is only found in desserts, cakes,biscuits and other sweet treats, it’s widely found insavoury processed foods, such as bread, pasta and pastasauce. To make matters worse, many foods promoted as‘natural’ or ‘healthy’ are laden with these added sugars.The food industry uses a dizzying array of names toconceal the frightening amounts of added sugar containedin these super-sweet foods.

Neither would granny have given any shelf space tothe cheap, highly processed, damaged and rancid poly -unsaturated fats such as ‘vegetable’, sunflower, soya andrapeseed oils which are found everywhere in today’sprocessed, junk and fast foods… and in our kitchens.Studies are clearly showing us these oils are detrimental to our health and should be banished from our kitchensand from our plates.

Real food – affordablyWith over 80% of food retail in the UK controlled by four supermarket chains, we’ve been seduced withconvenience, open-all-hours-one-stop-shopping, bewildering choice, bargain-buys, and… a parking space.Along the line, we’ve been brainwashed into believing that real food is an expensive luxury.

Shifting mindsets toward real food shoppingWhen I speak to groups and get people to stop to thinkabout the nature and quality (or lack of it) of the foodthey’re putting into their supermarket shopping trolliesand their bodies, one comment comes up again and again:‘Where can I shop, if not at the supermarket?’ People aregenuinely surprised to learn that a wide variety of veryaccessible and affordable options are available… all it takesis a mindset shift, a little planning time and a consultationwith Google.

How to shop for affordable real food

Visit the high street Town centre parking is always a problem, but traditionalbutchers, fishmongers and greengrocers on the highstreet know where their produce comes from and aremore likely to offer fresher, locally sourced produce.They’ll also carry a much wider range of traditional cuts(much cheaper and more nutrient-dense) than thosefound at the supermarket and they offer advice on how to prepare and cook their products. Buying local alsosupports the local economy, not anonymous corporateprofits.

Visit a local farm shop, pick-your-own operator, or farmers’ marketBuying direct from the producer has all the benefits ofhigh street shopping and is easily the best and mosteconomical way to eat seasonally and source fresh, localproducts. While farmers’ markets can be expensive (think overhead costs of stall rents, transport, staff andopportunity costs), farm shops tend to offer better valuefor money and pick-your-own schemes are a seasonal, fun,money-saver. Again, buying local supports the localeconomy.

Support a CSA schemeNewer on the UK scene, Community SupportedAgriculture (CSA) emerged to repair the local food linksdamaged by the anonymity of intensive large-scale farmingand supermarket dominance, to promote sustainable foodproduction and encourage reconnection with real food.For an upfront contribution, members receive a share ofthe food produced by the CSA: most commonly vegetables,but also poultry, bread, fruit, pork, lamb, beef and dairyproduce.

It’s a win-win model: a CSA farmer has cashflow forlong-term planning and members get fresh, nutritious andaffordable products, support their local economy and haveopportunities to get involved at practical, environmentaland often social level.

Order a meat box or bulk-buy direct for full traceabilityMost high-quality farmers do their own butchery and canoffer a wide range of traditional, inexpensive cuts likeblade and skirt and offer discounts for bulk purchases,half-a-carcass deals and free delivery with a minimumspend. Check out the Pasture for Life website for producers with mail order delivery schemes.

An increasing number of farms now deliver 100%grass-fed and organic meat nationwide (my personal go-tois Fordhall Organic Farm, a community land initiative witha commitment to education, youth projects and carefarming).

Another well supported favourite is Green PastureFarms, a collective of traditional family farms with 100%grass-fed beef and lamb, and Eversfield Organic Farm,which supply meat from farms that are certified by thePasture Fed Livestock Association and the Soil Association,or Organic Farmers and Growers.

Buy truly free range and organic poultryTruly free-range (and organic) poultry is beyond delicious.Springfield Poultry offers national delivery for both freerange and organic naturally reared, succulent birds amillion miles away from anything you’ll find in a super -market – at any price – and a whole bird will go much,much further than you think. And you’ll have the carcassleft for nutritious stock.



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EATING OLD-STYLE

Order a fish box, or bulk buy online for sustainable sourcingIf you don’t have a local wet-fishmonger and aren’tprepared to travel (I regularly travel 12 miles each way tomine) then sourcing sustainable fish online, direct from afleet or retail fishmonger, is definitely the way to go.

My tried and tested suppliers are all in Cornwall: FishFor Thought, The Cornish Fishmonger, Stevenson’s Fish,Trelawny’s Fish and Deli, and W. Harvey & Sons (for hand-picked shellfish). All offer variety, great value and the less‘fashionable’ but never-the-less delicious species likewhiting, pollack and megrim sole and deliver spanking-fresh fish nationally. Visit their websites to be educatedand inspired.

Use BigBarnFifth-generation farmer Anthony Davison developed thisonline portal connecting farmers with customers, afterdiscovering his onions were being sold in a supermarketfor eight times their wholesale price. Anthony’s mission isto reconnect people with local food and the Big Barnportal offers over 7,500 shopping outlets, information,education and even recipes and cooking videos.

Open Food Network UK The Open Food Network (OFN) UK is an online websitebringing shoppers and food producers together. It’s madeup of a community of independent producers, retailersand distributors, dedicated to building a stronger, fairerfood system in the UK. Customers can shop by UK post-code for the freshest, seasonal produce at affordableprices and can define a preferred delivery service (drop-offor pick-up). Shoppers may have to order a week inadvance and wait until their order is harvested/produced.

Join (or start) a local buying groupGetting together with family, friends and neighbours tostart a buying group and bulk-buy store-cupboard staples(like coffee, grains, rice, beans) brings substantial savingson wholesale prices. Collective orders placed with wholefood suppliers, such as Suma, are dispatched to thewholesaler, which then delivers to a drop-off point such as

a private house, where members can pick up their order.Splitting items, like a case of organic processed tomatoesor baked beans, can mean substantial savings. Sustain: the alliance for better food and farming, has a variety ofresources and toolkits to help a buying group get started.

Search online for natural and organic productsGoodness Direct is an online retail shop selling natural,free-from, organic and Fairtrade food products, frozen,chilled and bulk whole foods, natural toiletries and eco-friendly household products. Substantial savings can bemade on products and delivery charges by bulk ordering.

Shop one-stop-online with national box schemesRiverford (now in employee-ownership) and Abel & Coleare the longest established and biggest box deliveryschemes in the country, both offering a wide range oforganic vegetables, fruit, eggs, dairy, bread and meats and other products like recipe boxes with measured ingredients. There are also many local schemes with fewer food miles and supporting the local economy.

Grow your own and/or barter with neighboursFinally, nothing is better for health or community than the satisfaction of harvesting, preparing and eating (andsharing) your own organically grown produce. Be it veg,fruit, or eggs, home-grown produce from one’s own or aneighbour’s garden, or from a local allotment-holder willnot get fresher, tastier, or more nutritious.

Is real food affordable? This granny says yes.

Try one of Izabella’s delicious recipes for yourself atIzabellaNatrins.com

Further reading Doulliard J. Proving ancient wisdom with modern science: naturalhealth & ayurveda. http://lifespa.com (accessed 29.07.2019).

Fallon S (2000) Ancient dietary wisdom for tomorrow’s children.Weston A. Price Foundation. www.westonaprice.org/health-topics/traditional-diets/ancient-dietary-wisdom-for-tomorrows-children(accessed 29.07.2019).

Fallon S, Enig M (2009) Nourishing traditions – the cookbook thatchallenges politically correct nutrition & the diet dictocrats. NewTrends Publishing.

Jaminet P, Jaminet S-C (2013) The perfect health diet. Scribner.http://perfecthealthdiet.com (accessed 29.07.2019).

Natrins I (2019) Once upon a cook – food wisdom, better living:reclaim your kitchen. Take back your health. Better Living Press.

Price Pottenger Nutritional Foundation. https://price-pottenger.org(accessed 29.07.2019).

Price Weston A (1997) Nutrition and physical degeneration. KeatsPub Inc.

Professor Tim Spector. http://britishgut.org (accessed 29.07.2019).

Shanahan C (2017) Why your genes need traditional foods. St Martin’sPress.

Weston A. Price Foundation www.westonaprice.org (accessed29.07.2019).


Creating and managingpositive healthGenerally in the conventional medicalworld, it seems health is seen in termsof absence of disease rather than as apositive state. There is an alternativeview though, notably promulgated bythe Peckham Experiment and itsPioneer Health Centre (ScottWilliamson and Pearse, 1980) thatthere is such a thing as positive healthand that this is a dynamic process withits own pattern of behaviour, andwhich can be as infectious in its way as disease. This example of holisticthinking leads to the idea that thehealth of soil, plant, animal, man andplanet is one and indivisible. Thisprovides a conceptual basis for organicfood and farming.

However, few farmers – organic or conventional – farm for health.Knowledge and understanding abouthow to manage a farm for health islimited. Nor do they know how it canbe made to be infectious and how itcan be transmitted. Yet we can experience some farms or crops oranimals where ‘health smacks you inthe face’. But why that is or whyothers don’t is largely unknown.

What is known is that organic agriculture is the only farming systemconsciously built on a concept ofhealth (IFOAM, 2005). Whatever their merits, approaches such as agro-ecology, ‘agricology’, precisionfarming, low-input farming, regenerative farming, pasture-fedfarming or any of the other buzzwordfarming approaches, are not conceptually or systemically buildaround health in the way organicfarming is – and certainly none ofthem have been going for as long.

There are clear differences,between organic and other farmingsystems in a range of ‘beneficialparameters’ of food quality (FiBL andORC, 2015). But apart from pesticideresidues these differences are not asgreat as organic protagonists claim.Moreover they are statistically andvisibly variable. It is clear that soil, farmtype, season and major managementdifferences in such things as rotations,cultivations, variety selection, manureand other input management, stockingrates etc are significant factors in thisvariability. What is unknown is how,why and if these factors affect theprocess of positive health and its transmission.

Making health infectious:from organic principles towhole health agricultureLawrence WoodwardOBE

The question, ‘How do we feed ourselves when oil and other finite resources run out?’led in 1975 to my farming organically. It was still pressing when I co-founded and beganto direct the UK’s leading organic research and development centre in 1980. But overthe 30 plus years in that role I became obsessed by health questions; what makes a‘healthy’ farm? What qualities does it have? How are these passed on in its food andenvironment to people and animals? These are the unanswered questions of my professional life.

The health of individuals andcommunities cannot be separated from the health ofecosystems. Health is thewholeness and integrity ofliving systems, not simply theabsence of illness, but themaintenance of physical,mental, social and ecologicalwellbeing. Immunity, resilienceand regeneration are keycharacteristics of health. Theorganic farmer sees the farmas a living organism whose‘living soil’ can transmit healththrough the food chain toplants, animals and humans,and through careful, organichusbandry seeks over time toenhance this vitality.

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Organic farming is based on aconcept of healthThe genesis of organic agriculture is arguably to be foundin three schools of thought, which originated in the firstthree decades of the twentieth century: the biodynamic oranthroposophical school of Rudolf Steiner; the organic-biological school of Muller and Rusch; and the organicschool of Howard and Balfour. Also important is the workof Schuphan and Voisin who promulgated the idea of the‘biological value’ of soil, plant and food in the early 1960s(Woodward, 2002)

Though there are some highly significant differencesbetween them (for example the anthroposophical perception of ‘ethereal and astral forces’ is unique to the biodynamic school), there is an essential core of agreement on three aspects:

• the concept of the farm as a living organism, tendingtowards a closed system in respect to nutrient flows but responsive and adapted to its own environment

• the concept of soil fertility through a ‘living soil’ whichhas the capacity to influence and transmit healththrough the food chain to plants, animals and humans,and that this can be enhanced over time

• the notion that these linkages constitute a whole systemwithin which there is a dynamic yet to be understood.

These core agreements underpin the principles of organicagriculture as health, ecology, care and fairness, as setout by the International Federation of Organic AgricultureMovements (IFOAM, 2005). Although they are all linkedtogether it is the first two which are most relevant to thisdiscussion.

The organic principle of health declares that ‘thehealth of individuals and communities cannot be separatedfrom the health of ecosystems: healthy soils producehealthy crops that foster the health of animals and people.Health is the wholeness and integrity of living systems. Itis not simply the absence of illness, but the maintenanceof physical, mental, social and ecological wellbeing.Immunity, resilience and regeneration are key characteristics of health.

‘The role of organic agriculture, whether in farming,processing, distribution, or consumption, is to sustain andenhance the health of ecosystems and organisms – fromthe smallest in the soil to human beings. In particular,organic agriculture is intended to produce high quality,nutritious food that contributes to preventive healthcareand wellbeing. In view of this, it should avoid the use offertilisers, pesticides, animal drugs and food additives thatmay have adverse health effects.’

The organic principle of ecology ‘roots organicagriculture within living ecological systems’. It states thatproduction is to be based on ecological processes, andrecycling. Nourishment and wellbeing are achievedthrough the ecology of the particular environment. Forexample, in the case of crops this is the living soil; foranimals it is the farm ecosystem; for fish and marineorganisms, the aquatic environment.

Organic farming, pastoral and wild harvest systemsshould fit with the cycles and ecological balances innature. These cycles are universal but their operation issite-specific, so organic management must be adapted tolocal conditions, local ecology, local culture and scale.Inputs should be reduced by reuse, recycling and efficientmanagement of materials and energy to maintain andimprove environmental quality and conserve resources.‘Organic agriculture should attain ecological balancethrough the design of farming systems, establishment ofhabitats and maintenance of genetic and agricultural diversity.’

In 1981 the United States Department of Agriculture(USDA) produced a definition of organic agriculture whichis arguably more accessible to farmers (Woodward, 2002):‘Organic farming is a production system which avoids orlargely excludes the use of synthetically compoundedfertilisers, pesticides, growth regulators and livestock feedadditives. To the maximum extent feasible, organicsystems rely on crop rotations, crop residues, animalmanures, legumes, green manures, off-farm organicwastes, and aspects of biological pest control to maintainsoil productivity and tilth, to supply plant nutrients and tocontrol insects, weeds and other pests. The concept of thesoil as a living system...that develops...the activities ofbeneficial organisms… is central to this definition.’

Here we can see what organic farmers do not do, what positive things they do instead and the context inwhich they work; ie the living soil. Here is the key tounderstanding what organic farm management looks like– or should look like – wherever it is. It concentratesprimarily on adjustments within the farm and farmingsystem, in particular rotations and appropriate manuremanagement and cultivations, to achieve an acceptablelevel of output. External inputs are generally adjuncts orsupplements to this management of internal features.Wherever it is found in the world, the common basis oforganic agriculture is practical, clear and coherent enoughfor all but the dullest or most obstructive to understand.

The health of soil, plant, animal,man (and the planet) is one andindivisible

‘Health can be as infectious as disease, growingand spreading under the right conditions.’

Establishing that organic farming is built on a concept ofhealth with management practices based on ecologicalsystems is important but it does not go far enough in

Health is the wholeness andintegrity of living systems. It is notsimply the absence of illness

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Making health infectious: from organic principles to whole health agriculture

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explaining the perceived holistic nature of health, farmingand food. For this, a consideration of the ideas of Lady EveBalfour isneeded(Woodward,2006). In herseminal bookThe LivingSoil, firstpublished inOctober1943, EveBalfourargued thatthe health ofthe soil is thesame as thehealth of theplants that grow in it, of the animals that eat those plants,and the health of the humans that eat both.

Eve Balfour (1898–1990) co-founded The SoilAssociation in 1946 following publication of what becamethe founding text of organic agriculture, The Living Soil.At an earlier stage of her work, she thought of soil, plant,animals and man as separate entities that were somehowlinked together. Her concern – and that of a number ofleading mainstream scientific thinkers – was to find ‘themissing link’; the crucial component that made this vitallink.

However, influenced by the doctors Scott Williamsonand Innes Pearce of the Pioneer Health Centre and thePeckham Experiment, she came to the conclusion thatthey are not separate and linked but are one and indivisible.

Core concepts of ‘the living soil’Eve Balfour’s thinking revolved around four notions,which she discussed in varying depths in her book. These were:

• A biologically active, living soil is an essential prerequisite for soil fertility and the role of soil micro-organisms (especially fungi) is particularly important – as had been highlighted in MC Rayner’searlier research on mycorrhizae.

• This natural soil fertility is maintained and enhanced by the return and addition of organic material in theform of compost – Sir Albert Howard was the leadingproponent of this ‘compost-farming’.

• The third concept came from the nutritional studies ofSir Robert McCarrison, who found that the diets of thehealthiest peoples he studied were ‘for the most part,fresh from its source, little altered by preparation andcomplete; and in the case of those based on agriculture,the natural cycle – (wastes to soil to plants toanimals/man) is complete’.

• Fourth, that all living things are whole entities with theirown integrity but they function in ‘mutuality of action’with all the other entities in their environment, so thatwhile they are independent, only a functional relation-ship between them can sustain the health of the whole.This holistic perspective was primarily provided byGeorge Scott Williamson and Innes Pearse.

Lady Eve was more of a ‘doer’ than a ‘thinker’ and shequickly began to focus on what could be done practicallyto improve health. She came up with five propositions:

1 The primary factor in health (or lack of it) is nutrition.

2 Fresh unprocessed natural whole foods (such as wholewheat bread, and raw vegetables and salads) havea greater nutritive value than the same foods when stale,or from which vital parts have been removed byprocessing, or which have been destroyed by faultypreparation.

3 Fresh foods are more health-promoting than preservedfoods (dried, canned, or bottled).

4 The nutritive value of food is vitally affected by the wayin which it is grown.

5 An essential link in the nutrition cycle is provided by theactivities of soil fungi, and for this and other reasons thebiological aspects of soil fertility are more importantthan the chemical.

She felt that the first two of these propositions ‘have been pretty conclusively proved’, but that although theevidence to support the other three was strong, they hadnot been proven and ‘it has become a matter of theutmost national urgency to submit them, without delay, toa final and conclusive test’. It was this process that mostintrigued sympathisers from the scientific establishmentsuch as Viscount Bledisloe, a Parliamentary Secretary tothe Ministry of Agriculture and Chairman of the LawesAgricultural Trust, which ran Rothamsted, the country’sleading agricultural research station.

Bledisloe readily accepted McCarrison’s argument that‘immunity from degenerative human disease followed theingestion of a fresh, well-balanced diet of unprocessednatural foods’. He also accepted Howard’s work oncompost and how it engendered resistance to disease inotherwise susceptible crops. Yet, does this mean thatthere is a ‘consequential relation between humus andhuman health’? Bledisloe believed that ‘viewed from astrictly scientific standpoint, there is, it would appear, asmall but important “missing link” in the chain of contact’and he welcomed the idea of a ‘perhaps epoch-making

The diets of the healthiest peopleshe studied were for the most part,fresh from its source, little alteredby preparation and complete

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experiment’ which would investigate the possibility ofsuch a link (Woodward, 2006).

Transmitting health and makinghealth infectiousThe process by which health can be transmitted is theweakest element, although arguably the most important,of the whole Living Soil argument. It was not adequatelydefined nor even described in any of the early editions ofthe book. Its existence is alluded to through an associationof the words ‘vitality’, ‘living’ and ‘quality’. At variouspoints Lady Eve uses the terms ‘soil fertility’ and ‘soil vitality’ interchangeably. She then makes a theoretical linkwith the quality of food and health by what is, in essence,a linguistic or textual association.

In the 1976 edition published in the United States asThe Living Soil and the Haughley Experiment, shemakes a rather more precise effort to describe the processand picks up on the Scott Williamson and Innes Pearseidea that: ‘health is not a state but a dynamic process….The early pioneers believed that its course is identicalwith the flow of the nutrition cycle, and that to promote itone must, therefore, keep open all the living channels ofthis flow, though no one yet knows what they all are, oreven the true nature of the flow itself. That land is a greatstorehouse for it, however, seems clear. What then is land?Let me give the late Aldo Leopold’s definition: “Land…isnot merely soil: it is a fountain of energy flowing through acircuit of soils, plants and animals. Food chains are theliving channels which conduct energy upward: death anddecay return it to the soil”. Soil fertility he defined as “‘thecapacity of soil to receive, store and transmit energy”’.Lady Eve then continued: ‘The concept that the nutritioncycle is not merely a transfer of nutrient materials fromone form of life to another, but also a circuit of energy,though even now not universally accepted, is no longerconsidered revolutionary, and under the name of ecologyhas become an acceptable subject for research’.

There is a touch of revisionism here about the thinking of the early pioneers and many would think thatshe is stretching the definition of ecology and it is a mootpoint as to whether this gets any nearer to describing whatthe ‘consequential relationship’ between soil and healthmight be. Depending on taste, one might see Leopold’simagery as poetic and powerful, or as fanciful and obscure,but certainly it adds nothing from a scientific perspectiveand only serves to reinforce the lack of evidence.

However Lady Eve was determined to find thatevidence and to understand the ‘functional relationships’of organic entities – ‘man, animal, plant along with…theliving inhabitants of the soil’, because she had concludedthat between these entities there is no ‘missing link’, thereis a ‘mutuality of action’.

Drawing on the work of Scott Williamson and InnesPearse at the Pioneer Health Centre in Peckham shehypothesised that ‘all disease might be a symptom ofunbalance between a living organism and its total environment, and that the key to health would not befound through the fragmentary approach of seeking thecause of specific diseases, but in studying living functionbetween organisms and their environment as a dynamicwhole’.”

She therefore resolved to establish the HaughleyExperiment to be ‘a type of comparative research differentfrom any existing agricultural research’. And the inclusionof a more or less closed system – fundamentally at oddswith Howard’s Law of Return – ensured that it was(Woodward, 2006)

The Haughley experimentWork on the Haughley experiment got under way in 1947 and from the beginning was beset by managementdifficulties, methodological problems and lack of funding.It was a stop and start, debilitating experience but in establishing three comparative working ‘farmlet’ systemson one sizeable area of land with the same soil type, it wasinnovative and groundbreaking.

Three systems were established: a linear input/outputsystem using only synthetic agri-chemicals (called thestockless section) ; a mixed cropping and livestock systemrecycling nutrients from within the system supplementedby bought in feed and fertilisation (called the mixedsection); and a closed system with livestock and croppingwith no outside inputs (misleadingly called the organicsection).

For the most part data collected from the experimentwas not analysed (and of course analytical methods of thetime would be considered inadequate today) and in mostcases (but not all) the published results were not peerreviewed. However there are some notable findings:

• plant growth patterns between the sections were significantly different

• nitrogen levels in cereals and aphid numbers weresignificantly higher on the stockless section

• humus levels in the organic (closed) system over timewere significantly higher than the mixed system despiteno fertiliser or external organic manure input and bothwere significantly higher than those in the stocklesssection

• milk yields were comparable between the closed andmixed sections despite significantly lower feed intake

Land … is not merely soil: it is afountain of energy flowingthrough a circuit of soils, plantsand animals

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• there wassignificantlygreaterlongevity andfertility ofcows inclosedsection.

The differencesbetween thestockless andthe mixed andclosed sectionsare not surprising.However, thedifferencesbetween themixed andclosed sectionsare and are at odds with the conventional scientific knowledge of the time and, for the most part, of todayalso.

The major limitations of the Haughley experiment interms of resources, management and metho dology meanthat we can draw no conclusions as to whether these differences tell us anything about Innes Pearse’s hypothesisthat there is a ‘mutuality of actions’ of whole organisms orthe transmission mechanism of health whereby ‘eachtaking what it needs and rejecting what it has had no usefor, thereby sustaining the needs of others (within theirmutual inhabitation of the ecosphere). As a shift occursthrough the action of one, so all shift within the functionalorganisation of the whole’. But more than this: ‘What eachutilises in building up its own substance and carrying outits proper function, it stamps with its own specificity – its own “individuality”, or uniqueness. In the traffic ofexchange there are then to be sought different types ofcontribution within the whole. There is that which is ofspecific pattern; and that, too, which is “anonymous” andin use common to all. Heat for example, generated in anytransaction passes “unlabelled” in its going, while there isthat which having passed through the living organism,when ejected into the traffic stream, is imprinted with itsspecific identity, and leaving there its imprint on the scenefor us to find – if we care to look!’ (Woodward, 2006).

Research evidence since HaughleySince the The Haughley experiment ended a reasonableamount of research has been completed by a wide rangeof institutions from different countries revealing a cleartrend that organic produce (in appropriate crops) containsmore desirable components (vitamins, dry matter, protein,phytochemicals (including antioxidants and phenols) andfewer undesirable substances (pesticide residues, nitrates,sodium and some heavy metals) than conventional

produce. In livestock trials, animals fed on organicallygrown feed generally show greater fertility and longevity,higher healthy fatty acids and a better omega 3 to omega 6ratio than those on conventionally produced feed (FiBLand ORC, 2015).

Most of this work has been carried out using main-stream methods and statistical analysis. However, some so-called ‘novel or complementary methods’ of analysishave been used in some of the trials. Picture-developingmethods, bio-crystallisation, fluoresence-stimulation spectroscopy and forced-storage tests have been used tomeasure factors that are not revealed by chemical analysis.As most of these methods have now been validated underthe International Organisation for Standardisation (ISO)we can have confidence in their findings.

The factors revealed have been called vitality and structural energy. Clear differences have been shownbetween organic and conventional systems; between fertilisation regimes; between plant and seed varieties; and between growing conditions. It is postulated thatthese differences might be important for health. Furtherwork is needed on these approaches but they mightprovide the evidence of a positive health dynamic andhelp identify how we can farm to optimise health.

Towards whole health agricultureWe cannot be definitive on how to farm for health norhow to make health infectious. We do not know what theimportant transmission factors are or how the ‘mutualityof actions’ work – whether through micro-organisms,bacteria, energy, vitality, self-organisation or somethingelse.

However we do know some things that are likely to be important and which farmers should pay attention to.These revolve around managing the soil and above- andbelow-ground livestock through biological system management and not through inputs whether these aresynthetic or organic.

Whole health agriculture as an organisation is under-taking case studies of farmers to understand what worksand what doesn’t, how and why. We welcome farmers andgrowers who wish to join us in the vital exploration.

www.wholehealthag.org

References Fibl (Research Institute for Organic Agriculture Switzerland) and ORC(Organic Research Centre) (2015) Sustainability and quality of organicfood. [Online]. Available at: https://shop.fibl.org/chen/mwdownloads/download/link/id/335 (accessed 25 August 2019).

IFOAM (2005) Principles of organic agriculture. [Online]. Available at:www.ifoam.bio/sites/default/files/poa_english_web.pdf (accessed 25August 2019).

Williamson G Scott, Pearse IH (1980); Science, synthesis and sanity.Edinburgh: Scottish Academic Press.

Woodward (2006) Introduction to The Living Soil in: Balfour E, TheLiving Soil. Soil Association Organic Classics. Bristol: Soil Association.

Woodward (2002) Science and research in organic farming. Availableat: http://orgprints.org/3835 (accessed 22 August 2019).



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In the mid 1990s I wrote a report thatreflected a mantra evident at that timewithin the naturopathic fraternity –that the foods we eat today are not as nutritious as they once were. Itsimplications for the general health ofthe UK population were of coursenegative. The report was eventuallypicked up by a wider audience andthis resulted in its being expanded andpublished in 2002 in the journal,Nutrition and Health (Thomas, 2003)The report used as a historicalcomparison food analysis data firstpublished by the Medical ControlAgency in 1940 (McCance andWiddowson, 1940) with subsequentpublications under similar reputablegovernment agencies through to 1991(McCance & Widdowson, 1991). Thefirst publication was initiated because,in the 1930s, it was hypothesised thatthe rising incidence of diabetes was insome way connected to diet. At thattime there was no quantitative datarelating to the chemical compositionof foods.

The current awareness of micro -nutrient content of foods is of coursefar more substantial. We are nowaware that foods contain carbo -hydrates, minerals, trace elements,essential fatty acids, vitamins, amino

acids, phytonutrients, probiotic material, and the list constantly beingadded to as we find out more aboutthe essential roles of certain foodcomponents to health and wellbeing:the microbiome being the latest tocome into the spotlight

Historically, food compositionswere categorised into far fewer subdivisions. The ChemicalComposition of Foods, published in1940, identified fats, proteins, availablecarbohydrate (as glucose) and mineralsas the main subdivisions. Of thoseminerals, the only trace mineral (otherthan Iron) was copper – which wasfound to be essential in 1928.Consequently, my report could onlyrecord the mineral content of thosefoods analysed – sodium, potassium,phosphorous, calcium, magnesium,iron, copper and sulphur. Since thattime many other trace minerals havebeen named as essential – theseinclude zinc, cobalt, manganese,molybdenum, boron, iodine, seleniumand chromium.

Table 1 summarises the results ofmy subsequent study (Thomas, 2007)which demonstrated that over a 62-year period across 72 different foodsthe mean average copper content inthose foods was reduced by 62%.

FOOD QUALITY

Food quality and its relevance tooptimum healthDavid ThomasFounder Member, Register of NutritionalTherapists

It seems I’ve been banging on about the dangers to general health of mineral deficienciesin foods for over 25 years and at long last the significance of the micronutrient contentof foods has begun to find traction. Now, in addition to the physical composition offoods, I have become more aware of less quantitative, more qualitative aspects of foods. I feel there’s need to conduct future research work into their significance – and maybethis can ultimately lead to a more inclusive less reductionist scientific paradigm than iscurrently in vogue.

Most food science focuses onthe chemical content of whatwe eat. Only a few decadesago, little was known aboutthe presence and importanceof trace elements. The authorpresents evidence that theseminerals though present intiny amounts are less availablein our foods than they were50 years ago. If, as somesuspect ‘food vitality’ is alsodeclining, do we need to revisitthe notion of ‘vital force’, nowviewed as an emergent bio-physical informational ‘quality’.The article touches on waysof visualising food-vitality.


To put the significance of these findings into perspective, let’s consider the european nutrient referencevalues (NRV) for magnesium (375mg), zinc (10mg) andchromium (40µg), which many nutritionists consider to bethe minimums below which deficiency diseases begin tomanifest. How much is this actually per day? Given that alevel teaspoon represents 5mg, 1/13th of a level teaspoonwould represent the magnesium quota; 1/500th is therequirement for zinc; while approximately a 1/125,000th of a teaspoon is all that is required for chromium. In relationship to the amount of food we eat each day, theseare minuscule amounts: yet deficiencies do indeed occur.Consequently, micronutrient content can be consideredone fundamental signifier of a food’s nutritional quality.

Deficiencies of micronutrient content in food has beenlinked in part to declining soil quality. The UKEnvironment Agency recently published a report(Environment Agency, 2019) on poor soil quality in theUK, which although it doesn’t directly link to reduction innutrients within our food, can be used to draw conclusionsbetween the two. There is a growing awareness of thesignificance of soil health to the health and welfare of notjust commercial crops but of the neighbouring ecosystem.Jim Porterfield, an independent researcher in the US, hasalerted me to how the low mineral content of vegetablesand grains can be positively improved by following guide-lines given in the publication Ideal Soil (Astera, 2014).

With these facts in mind the reader can make theirown judgement as to the relevance of my findings – but Icontend that the loss of minerals in our food – directly orin association with other factors for which these levels area surrogate marker – will have a fundamental bearing onthe prevalence of chronic disease. Similar studies havealso been published (Davis, 2004; Davis, 2009; Bergner,1997). Since 2000, as the incidence worldwide of chronicnon-communicable disease conditions has increased, theevidence supporting the importance of micronutrientcontent of foods in relationship to health and wellbeinghas grown.

Is there more to the quality offoods than their micronutrientcontent?This thought was inspired by the 1940 publication The Chemical Composition of Foods (McCance andWiddowson, 1940), which implied that there is more tofoods than their chemistry. This is in contrast to a subsequent edition (McCance and Widdowson, 1991)which implied that chemistry is all we need consider whenassessing food quality. However, the current debates aboutfood quality must include the food production methods oforganic and bio-dynamic farming, methods that certainlyguarantee that no toxic chemical residues of pesticides,insecticides, fungicides, etc so often used in conventionalfarming practices. will be present. This emphasis on‘absence of ’ detracts from the positive qualities that resultfrom excellent husbandry and stewardship of the land byfarmers committed to these methods. These aspects,humanly and humanely important though they are, do not according to accepted ways of measuring nutritionalquality add any value. Were this ‘vitality’ or ‘vibrancy’quality to be scientifically demonstrable, organic and bio-dynamic practices would gain a very valuable uniqueselling point, but more than this, the awareness of ‘vitality’and food quality would have important consequences forindividual, communal and planetary health.

The scientific model bequeathed to us in the 1600s has at its centre a dualism that separates qualities fromquantities, and a reductionism that assumes we can understand the whole by measuring the parts. However, instriving to grasp at ever smaller components, have we as asociety lost sight of the whole? I was reminded of the fableof Sir Isaac Newton who, sitting under a tree, when theapple fell on his head suddenly understood the law ofgravity. Has science, in its endeavours to discover evermore about the material world (and despites the many‘gifts’ that research has provided) been less curious than itought to have been about how the apple got up there?

Consequently, suspecting this worldview was incomplete, I started to look at what else could give someindications of food quality. And indeed I found plenty of

1940 to 1991 1940 to 1991 1940 to 2002 1940 to 2002 1940 to 2002

Vegetables Fruit Meat Cheeses Dairy Weighted (n = 28) (n = 17) (n = 14) (n = 9) (n = 4) Average (n = 72 Sodium -49% -29% -24% -9% -47% -34%Potassium -16% -19% -9% -19% -7% -15%Phosphorous 9% 2% -21% -8% 34% 1%Magnesium -24% -16% -15% -26% -1% -19%Calcium -46% -16% -29% -15% 4% -29%Iron -27% -24% -50% -53% -83% -37%Copper -76% -20% -55% -91% -97% -62%

Table 1: Historical essential mineral depletion changes in five categories of food products

Food quality and its relevance to optimum health

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indicative research which, although currently consideredtoo subjective and qualitative, nevertheless could suggestmethods for researchers interested in ‘measuring’ the‘vitality’ of foods; and not only through subjective attributes of sight, taste, aroma, touch – the senses weinstinctively use to judge what to eat and what to avoid.The true scope of food quality suddenly weaves an intricateweb of components, some physical (its farming, storing,shipping, processing and manufacturing practices), somemental and emotional (that shape individual choice),some cultural (that influence preparation, and whom wecan and cannot eat with) and possibly even the spiritual(expressing appreciation and gratitude through the sayingof Grace and giving thanks for the food that nourishes usand the web of life). All these dimensions have their ownvalidity, but within today’s scientific paradigm only one, its chemical composition, is readily accepted as credible.Though we all recognise the quality of aliveness (after all,a person who has just died physically has all we have,except ‘life’) this isn’t something to be quantified, ieweighed and measured. And that’s the difficulty. Yet maybethis paradox could be the motivation for establishing somescientifically viable parameters that represent food’s livingqualities.

Picturing nutritional forces within foodsBiophotonics is a branch of quantum biology dealing with interactions between photons and living tissues, fromwhich very low levels of biophoton emission have beenwidely reported. Extensive research by Dr Fritz-AlbertPopp has explored the function of biophotons as takingpart in an information system signalling within and betweencells. Some who have speculated that this system facilitates physical healing hypothesise that levels of biophotonemission may correlate with thevitality of biologicaltissues. If this wereshown to be the caseit would provide uswith a much neededquantitive measure of food quality(www.biontologyari-zona.com/dr-fritz-albert-popp).

An earlier attempt to reveal thenutritional forcespresent within foodswas EhrenfriedPfeiffer’s sensitivecrystallisationmethod, which wasdeveloped on thebasis of indications by

Rudolf Steiner, who was concerned about a decline infood’s nutritional properties. Steiner believed a loss ofvitality was a direct consequence of introducing mineralfertilisers into agricultural practice. Pfeiffer – who developed the bio-dynamic farming method – found a10% solution of copper chloride when it crystalisedshowed patterns that correlated with the ‘quality of thefood substance used’. The problem associated with thismethod though, is the amount of training required tointerpret the complex crystalisation patterns and form ajudgement on the quality of the product.

Sensitive crystalisation has been further developed by the Bio-Dynamic Association, which in 2016 held aconference on the theme Vitality and Quality as SeenThrough Picture Forming Methods (Lia, 2016). A more

The beautiful crystallisation image above (of biodynamic wine) has been createdusing the sensitive crystallisation method developed by Pfeiffer

Walter Danzer’s photos: left: extract from an organic apple; right: non-organic extract

recent pictorial development has beenachieved by WalterDanzer. He has investigated more than50 foods, both organicand non-organic, in hisown specially designedlaboratory andpublished a book of hisresults (Danzer, 2016).In it, the author says: ‘I have discovered thatorganic foods possessan amazingly beautifullife-energy or orderforce (life design principle), whereasthe life-energy of non-organic foods isgenerally weakened, disrupted or destroyed. Since I findthis important I wanted to share it with you, so that youcan make informed decisions’.

These investigations point to the possibility of anemergent informational quality in living tissues, and therefore that the food we eat is more than just its materialmolecules. The hypothesis is that in the process of organising itself into life a new property emerges, of asubtle but literally vital and necessary informationalcontent which contributes to the physical material chemicalbody’s ability to self-organise. Danzer’s work implies thatwe need food that can nourish this vital information bodythrough its abundance of order force (life design principle), which represent in a sense the informationalmemories and experiences of the food’s growth. If this isso then there is a significant value to the way our food isgrown and prepared. A parallel research area, whichseems to support Danzer’s hypothesis involves empathicfood testing whose aim is to evaluate scientifically theemotional and physical impacts of food, and how the‘emotional properties’ of food products influence ourwell-being and performance (www.wirksensorik.de/en).

ConclusionThe gut prevents products of digestion and other ‘foreign’substances from leaking into the circulation. When thesystem fails to do so and foreign proteins get into thebody fluids undigested they can have toxic effects in theshort and longer term. Ought medicine therefore be more curious about how the more subtle food qualitiespreviously alluded to are absorbed and assimilated, andhow they affect health and wellbeing? I’m reminded of the scenario where a group of blind people attempt todescribe an elephant. With each holding and describing apart, all are correct in their own way, but none ‘see’ thewhole elephant. In terms of food quality the big picture ishuge and its study, even leaving aside biological and

chemical content, would entail a nested hierarchy of disciplines that include geology, climate science, soilstudies, agricultural history and anthropology, the logisticsand economics of storage, transport, processing andmanufacturing. Each layer will have had an effect on thechemical composition and the informational ‘life’ forcequalities of the emerging food product, and the culturalbackground and individual circumstances in which thesefoods are prepared and ultimately eaten.

ReferencesAstera M (2014) Soilminerals.com (accessed 25 August 2019).

Bergner P (1997) The healing power of minerals. Roseville, CA: PrimaPublishing.

Davis D (2009) Declining fruit and vegetable nutrient composition:What Is the evidence? HortScience 44(1).

Davis D (2004) Changes in USDA Food Composition Data for 43Garden Crops, 1950 to 1999. Journal of the American College of Nutr,23(6).

Environment Agency (2019) The state of the environment: soil.Available at: www.gov.uk/government/publications/state-of-the-environment/summary-state-of-the-environment-soil (accessed 25August 2019).

Lia B (2016) Vitality and quality as seen through picture formingmethods. Available at: hwww.biodynamics.com/research/vitality-and-quality-seen-through-picture-forming-methods (accessed 25 August2019).

McCance and Widdowson (1991) The composition of foods, 5thedition. London: Royal Society of Chemistry/Ministry of AgricultureFisheries and Food.

McCance and Widdowson (1940) The chemical composition of foods,1st edition, special report series no 235. London: Medical ResearchCouncil.

Thomas DE (2007) The mineral depletion of foods available to us as anation over the period 1940 to 2002, Nutrition and Health, 19, 21–55.

Thomas DE (2003) A study of the mineral depletion of foods availableto us as a nation over the period 1940 to 1991. Nutrition and Health,17, 85–115.



FOOD QUALITY

Extract from a grain of rice, magnified x 400; left: organic; right: non-organic.


The big challengeThe global food sector accounts forbetween 14% and 30% of global greenhouse gas emissions (Vermeulenet al, 20912) with around 50% of those emissions attributable to transportation, refrigeration, packagingand waste on a scale not previouslyexperienced. Over-production andcommoditisation of an abundance ofprocessed food is making food a lessvalued, cheap and disposablecommodity, And the well documentedvisual quality requirements for freshproduce is forcing farmers to disposeof unattractive yet perfectly ediblefood. These requirements havereduced consumer choice to anhomogenised range of fresh producegrown for appearance and yield, andcaused a loss of ancient heritage varieties whose unexplored geneticproperties may well prove crucial towithstanding the impact of climatechange.

‘Food is the most importantthing to our health and to ourlife, yet we degrade it and don’tvalue it properly. At the end of

the day, farmers will onlyproduce to what the consumerwants. It’s about everybodytaking responsibility, takingmore interest in their food andwhere it’s produced.’ (Walrond, 2019)

‘Good food’ is a term coined by theBristol Food Policy Council to describethe broader value of real food. ‘As wellas being tasty, safe, healthy and affordable, the food we eat should begood for nature, good for workers,good for local businesses and good for animal welfare.’ And yet even thisdefinition misses the true power ofgood food to bring people together, to build community, and reconnectpeople with nature and each other,and thereby mitigate the health andwellbeing challenges we all face in anincreasingly fast, disjointed and isolating society.

Somerset Local Food We launched as an online food retailerin 2002 in the early days of slow dial-up internet. An existing network offarmers markets in Somerset brought

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Building a local community foodsystem Phillip SharrattChief Executive, Somerset Local Food Limited

With 30 years’ experience of working as a business and management consultant, Iarrived in Somerset in 2005 to deliver a project that supported small businesses tobecome more successful. Since then I have delivered numerous economic and community development projects with a strong social purpose, including tacklingpoverty by helping people to set up their own business, working with constructionbusinesses across the south west to adopt environmental technologies, and introducingcomputer coding into primary schools to help give children new skills and possiblysupport them to achieve their future potential. I joined Somerset Local Food two years ago and have led the transition of the business from a commercial model to acommunity-owned not-for profit Community Benefit Society.

The globalised food chain ismoving food productionfurther away from thecommunities it serves, at thesame time creating wide-spread health problems andcontributing to ruination of thenatural environment throughsoil degradation, change ofland use and loss of habitat.It’s becoming clear that foodproduction will demand innovation if we are to stemwhat appears to be anunstoppable and increasinglydetrimental decline in thequality of what we grow andeat. A Somerset-based socialenterprise project is showingthe value of bringing togethercommunity engagement, withsustainable growing, andaccess to good food.


together the market gardeners, family-owned farms andsmall-scale food producers which didn’t have outletsthrough supermarkets or large retail chains. By broadeningtheir consumer base – selling produce online and deliveringorders across a much larger area that included the cities of Bristol and Bath – small local growers stood a betterchance of achieving traditional business developmenttargets of increased turnover and job creation.

Initially Somerset Local Food was a roaring success,and achieved it’s purpose of ‘supporting small-scale foodproducers’. Then, as supermarkets started retailing online,sales volumes went into a decline, and growers tried tocompete on price by reducing their own margins.Inevitably the next 10 years saw waning numbers of

market gardeners and small-scale family-owned farms, and a large turnover of local micro-food producers.

The initial organisation had failed because it treatedfood as a commodity: a tool for creating financial wealthand jobs. So another approach was needed, one thatrecognised the broader social impact for ‘good food’ toboost community engagement and increase social capital.An understanding of these vital added values wouldremind potential consumers that in reality there can onlybe one price for food, a price that reflects the true cost tosociety and the environment. Buying ‘cheap food’ in factcreates a debt that our children and grandchildren willhave to pay for an overburdened health system, soil degradation, declining biodiversity, continued destructionof natural habitat, and our inability to curb the impacts ofclimate change on food systems. In addition, all thesefactors will have an enormous impact on rural communities.

Two years ago Somerset Local Food received significantsocial investment to transform into a not-for-profit socialenterprise. With new branding and website and a committedpurpose it is now thriving and once again growingcommunities through food, and supporting local small-scale, community food growers, farmers and producerswho are passionate about healthy food, and about protecting and enhancing the natural environment. We arehelping build networks among those food producers toshare knowledge and experiences, and encourage them tocollaborate to develop plans for extending access to goodfood for local communities using limited growing space.

The Community Farm at Chew Valley in Somerset is anexample of an engaged community grower. It was startedby a group of volunteers in April 2011. Initial start-upfunds came from 419 people investing in a communityshare offer, creating a group of consumers with sharedvalues for good food, for the environment, and to belongto a community of like-minded people. Today, the farmgrows market garden-scale organic vegetables and fruit on a 14-acre rented site that supplies an organic veg boxservice and wholesale delivery hub supplying SomersetLocal Food and other wholesale customers. Expanding to be more inclusive of the local communitythe farm now welcomes people to ‘get on our land’ forlearning, work, recreation and wellbeing. The staff teamhas grown to around 15 full-time equivalent people withan annual turnover approaching £1 million. The site, whichat the start had nothing but one cold water tap, now hasfour polytunnels, a warehouse and cold store for thepacking operation, a yurt and roundhouse for classrooms,and a learning area where children and wellbeing groupsturn their hand to growing. There are accessible composting toilets, mature apple trees, owl boxes, and apond. The operation delivers around 500 veg boxes each week in Bristol, Bath and the Chew Valley. A small farmshop runs in Bath, and a weekly fresh produce stall atSouthmead Hospital in Bristol serves NHS staff and visitors. The farm also supplies some wholesale

Food variety tree

Community cohesion

Community resilience

Health and wellbeing

Natural environment

Somerset Local Food social impact model

Local food system

Ruralheritageand art

Building a local community food system

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consumers. By working directly with other producers,both at home and abroad, the farm pays a fair price forproduce that goes directly to the grower. The Get onOur Land programme welcomes weekday volunteers allyear round and on 15 community farmer Saturdays eachyear. In growing season, schools bring 60 children eachweek for a learning day run by partner organisationEarthwise. Diverse groups come for learning, team daysand wildlife activities. Partnerships with Bristol DrugsProject, Bath Wellbeing College, and Ecowild enable well-being courses, and therapeutic and rehabilitation activities.More than 1,200 people spend at least a day on the farmeach year and numbers are continuing to grow. In addition to the impact of a 14-acre site converted toorganic farming, and routes to market for many moreorganic acres, the major impact is on people; boxconsumers say they love the produce, eat far more fruitand veg because it is always there, and are healthier as aresult. Volunteers and visitors say that for them the farm isa lifeline, a meaningful project that they love being part of.It gives them outdoor activity, friendship, purpose, joy,structure, new skills, confidence, routes to employment,connections in the local community, learning aboutfarming and wildlife, and leads to lasting change in healthyeating. In short they describe it as ‘rehab in a mad world’.

Somerset Local Food Limited also supports therapeuticand social growing projects through the sale of its surplusproduce.

Seed of Hope CIC (SoH) was started in 2014 over a pintof cider in the local pub. Jayne Alcock, the grounds andgardens supervisor of the Walled Gardens of Cannington,and Kris Scotting realised they both had interest andexperience of using horticulture as a tool to bring peopletogether in a therapeutic environment. Jayne had previously worked as a mental health social workerbefore moving into horticulture, and Kris had trained as amental health nurse, and worked in health and social carefor over 30 years, several of these years in therapeutichorticulture projects. They approached Bridgewater andTaunton College for permission to start a weekly group at the Walled Gardens of Cannington for people withmental health issues, and the initial SoH project was born.Subsequently groups in Watchet and Glastonbury havestarted and a pilot gardening project launched with a localhousing association to help tenants who can’t cope withtheir gardens. The vision of Seed of Hope CIC is to growmental health recovery throughout the south west ofEngland using therapeutic horticulture. Like the Big Issue,they believe that people with mental health needs need a hand up rather than a handout, and are challengingsociety’s assumptions about the abilities of people withmental health problems. SoH has supplied fresh herbs and wild flower seeds andwe are looking forward to a regular supply of mushroomsgrown at their Glastonbury site.

Root Connections CIC links homelessness and community through inter-agency involvement. It operatesa successful outreach service for rough sleepers, offering a safe place where people can seek help and advice, andassistance to start their journey of recovery. The ethos isone of hope, finding meaning and strength together, givingsupport and by showing ways towards a more sustainablefuture.The Root Connections plot is based on a beautiful Duchyfarm in Somerset, occupied by farmer Rob Addicott andwife Suzanne, who both have a heart for community andpeople on the fringes of society. The garden sits alongsidethe Dairy House, a six-bed hostel offering residentialaccommodation to the homeless, rough sleepers andisolated individuals with (sometimes complex) mentalhealth issues and needs. Initially the garden was a patch ofland Rob offered to the residents but a volunteer quicklysaw the benefits of residents working together outdoors,with the local community getting involved as well, whichresulted in improved health, sleep and general wellbeing.The Dairy House residents are encouraged to volunteerin the garden as often as they feel they’re able to, wherewe offer structured activities, encourage soft horticulturallearning and support with social re-integration by workingalongside our team of volunteers. We also have volunteerland days two mornings each week, where people fromthe local community join us and work alongside the DairyHouse residents and volunteers, and each Friday wecome together for a shared lunch of fresh, local produce.The garden is now sufficiently productive that theproduce can be sold through a network of local churches,farmers markets, other community events and onlinethrough Somerset Local Food.

Volunteers at the community farm

Root Connections collect a polytunnel from Charles Dowding, the Somerset-based leading authority on no-dig gardening

Our community of consumers identify and recommendnew suppliers and suggest which growers and producersthey would like to meet through visits to farms. Thesegatherings for enjoying local produce always generateconversation and new friendships. There is also a growingrecognition among community food producers that theyare not competing with each other; that through collaboration we can grow the market for good food andimprove its nutritional value, while building stronger,more resilient and coherentcommunities passionate about goodfood and their natural environment.Together we can offer a broaderchoice including heritage varietiesof fresh produce, more traditionalcuts of meat no longer offered bysupermarkets, and we are seeing agrowing appreciation of local foods,such as the amazing choice ofcheeses and dairy produce.

The Good FoodNetworkThrough the Good Food Network –lately established with the supportof Resonance, a social impactinvestment company – we arealready beginning to deliver

projects. A pilot distribution networkwill be aiming to move seasonalproduce gluts between local distribution hubs, and enable improvedcrop planning across the entire sub-region, with Bristol to the north and all of Devon to the south.

Bristol is a former Green Capitaland currently a Sustainable Food City.Its well-established and productivecommunity food system, led by FeedBristol, incorporates not only a networkof community farms and small-scaleproducers, but also independent foodretailers, catering and hospitality businesses. To the south in Devonthere are many established communityfarms, producers and retailers, so itmakes sense to link all these local foodsystems and so increase efficienciesthrough collaboration and create a

bigger social impact through knowledge-transfer and bysharing assets and produce.

We are now eagerly anticipating the roll-out of socialprescribing so we can engage with GPs and primary careagencies for mutual benefit. By bringing good food tomany more people we can improve local health and well-being, while building social capital and at the same timeprotecting and enhancing our local natural environment.By working together like this to join up the dots, theGood Food Network’s impacts could be felt far beyondthe south west of England.

ReferencesVermeulen SJ, Campbell BM, Ingram J (2012) Climate change and foodsystems. Annual Review of Environment and Resources, 37, 195–222.

Walrond R (2019) Positive News [online]. Available at: www.positivenews/environment/agriculture/farming-in-somerset-in-an-era-of-climate-change (accessed 23 August 2019).



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Seeds of Hope erecting a garden shed at their Watchet site

Somerset Local Food team

We are now eagerly anticipatingthe roll-out of social prescribing sowe can engage with GPs andprimary care agencies

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WILDLIFE

Wilder labels, betterfarmingTim MartinFounder, Farm Wilder

My whole life has been shaped by wildlife. As a child I was a keen naturalist and wildlifephotographer, and this led to a zoology degree and over 20 wonderful years as a director then executive producer in the BBC Natural History Unit. But against a backdrop of rapidly declining biodiversity I felt that just filming wildlife wasn’t enough –I wanted to get more directly involved in the fight to protect and restore nature. Andthat’s meant immersing myself in the world of farming.

Last year I was delighted to finally see a Marsh Fritillary, a very rare andstunningly beautiful butterfly. Oncewidespread, it is one of our fastestdeclining species, and for me it’sbecome symbolic of the biodiversitywe have lost as farming has intensified.I was in the middle of a dampDartmoor meadow, known as a Rhospasture, and looking out past theorchids, buttercups and forget-me-notsI could see dozens of these exquisitelittle orange and black checkered creatures flitting from flower to flower, energised by the strong Junesunshine. I’d come for the butterflies,but my senses were being bombardedwith natural wonders in the way thatnormally only happens in a rainforest.A cuckoo called higher up the valley,

soaring buzzards mewed, and from the hedgerows came the constantbubbling song of willow warblers andblackcaps. As I crossed the meadow Iinhaled scores of scents – wild mint,the coconut aroma of warm gorseflowers and the herby compost ofmarsh soil. It was a poignant reminderof just how bursting with life ourcountryside can be.

Sadly, very little of our farmland islike this now. We might survey thepatchwork of fields full of crops andlivestock and remark on how greenand beautiful it looks – but up closemost of it is a green desert. Birdsongand the buzz of insects has given wayto eerily quiet monocultures of ryegrass, wheat, barley, oats and oil-seedrape. A whole generation has grown

Intensive farming is failing usall, through loss of biodiversity,falling nutritional quality offood, depletion of soil and highgreenhouse gas emissions.Farm Wilder is a social enterprise promoting a newway of labelling food that forthe first time gives consumersthe choice to support farmerswho are leading the way to abetter future, through regenerative and wildlifefriendly farming.

The Marsh Fritillary butterfly – an endangered species which Farm Wilder farmers are working to protect


up deprived of the joy of experiencing ahealthy vibrant countryside. I’ve watchedthis impoverishing of our land unfold inslow motion over several decades. As a BBCwildlife film-maker I’ve been fortunate tovisit some of the world’s great wildlife hotspots, but I’ve also been aware of the sadirony that wildlife has been rapidly dying outin my own back yard. It’s been abundantlyclear that the root of the problem is intensive farming. Over 70% of Britain isfarmed, so most of our wildlife relies onfarmland for its survival. The widespread useof chemicals, along with the loss of flowermeadows, hedges, ponds and scrub hasbeen catastrophic. Once common creatureslike hedgehogs, turtle doves and tree sparrows have declined by 95%, and Britainis now one of the least biodiverse countries in the world.The situation had become so desperate that I decided tofind out for myself what was going so wrong, and what Icould do to help put it right.

What I found out was shocking – Britain’s wholefarming system is utterly broken. It isn’t just failing wildlife,it’s failing human health through the declining nutrientquality and chemical residues in intensively producedfood; it’s failing farmers, many of whom struggle to makeends meet; it’s threatening our homes by increasing flooding; it’s poisoning waterways through the runoff oftoxic chemicals; and it’s gambling with all our futuresthrough high emissions of greenhouse gases, and becauseof the way soil is being mistreated. Not only has thecarbon content of soil declined, but the soil itself is beingdepleted at an alarming rate – farmers are effectivelymining it rather than nurturing and replenishing it, withthe result that some of our best land could be unfarmablein a few decades. Most of our farming is about as sustainable as a coal-fired power station. But it’s wrong toblame farmers for this – they’ve been led down this route

by government and EU policy, and by us consumerswanting to buy the cheapest food we can. The good newsis that many farmers desperately want to change course,they just need our support in doing so.

So how do we help farmers to farm more sustainably?The problem is that as consumers we have very littlepower to influence how our food is being produced.There’s so little information on the labels that when weshop we can’t separate food that’s been farmed in awildlife friendly and sustainable way, from intensivelyproduced food from green desert. The only widely

available labelling option is organic, butdoes that mean rare wildlife is beingsupported? Sadly not – organic farms mayhave more worms and bugs, and more ofthe most common wildlife, but there’s noguarantee of anything with more specializedneeds like a Marsh Fritillary or a Cuckoo. Atleast I thought that organic would guaranteebetter soil, but even that’s not always thecase. Organic farms have to plough tocontrol weeds, and ploughing is bad for soilhealth: a poorly managed organic farm canactually end up with less carbon stored inthe soil than a well-run conventional min-tillor no-till farm that uses a small amount ofherbicide so they don’t have to plough. Toadd to the confusion, there are plenty ofconventional farms that are very wildlifefriendly, thanks to special measures to

There are plenty of conventionalfarms that are very wildlife friendlythanks to special measures toprotect habitat

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Wilder labels, better farming

WILDLIFE

Filming Lost Land of the Jaguar

The cuckoo – one of Britain’s fastest declining birds.Dartmoor is one of its strongholds.



WILDLIFE

protect habitat, while some organic farmscan be surprisingly devoid of life. It was clearthat we needed much better labelling tosupport wildlife-friendly regenerativefarming, and to educate consumers aboutwhy it’s so badly needed. So I left my job atthe BBC and set out to try and create it.

In January I launched a social enterprise,Farm Wilder CIC, together with journalistand Farming and Wildlife Advisory Group(FWAG) farm and policy advisor Luke Dale-Harris. We select food exclusively from groups of farms who are farmingregeneratively, and who look after rarewildlife. We’ve started with beef and lamb,because many of our most endangeredspecies need sensitively grazed meadows tosurvive, although in the longer term we arealso looking into cheese, beer and cereals. We’ve namedthe meat after the Dartmoor wildlife that’s being nurturedby our farmers: Cuckoo Beef, Cuckoo Lamb and FritillaryButterfly Beef. Beautifully illustrated and informative labelstell the story of the wonderful work these farmers aredoing, and the meat is now on sale in several butchers inBristol and Totnes, and online across England and Walesfrom ethical retailer www.fresh-range.com. Currently weare funded by grants, donations and a lot of goodwill, butover the next couple of years, as our sales volume grows,we will be increasingly self-sufficient through a small levyon the meat sold.

By buying our meat, consumers are helping farmers do two things – conserve rare wildlife and farm in a moreholistic and regenerative manner. We work with charitiesincluding Butterfly Conservation, RSPB, FWAG and DevonWildlife Trust to provide advice on managing habitat forMarsh Fritillaries and Cuckoos. And we partner with thePasture for Life certification scheme, encouraging andtraining farmers to transition to their more regenerative100% pasture-fed system, where artificial inputs are

massively reduced or eliminated, animal health and well-being is improved, and biodiversity boosted. It’s moreprofitable for farmers, even before we pay farmers theFarm Wilder premium of an extra 45p per kilogram. Just asimportant is that this system produces extremely tasty andhealthy meat from native breeds that thrive on relativelypoor upland pastures: beef connoisseurs say you can actually taste the herbs from the flower-rich meadows, andresearch points to an improved nutrient density comparedto grain-fed meat, including up to five times more omega-3s, and twice as much conjugated linoleic acid (CLA).

The most critical aspect of this pasture-fed system is that it radically improves soilhealth – and there are few things moreimportant to human health than the futureof our soil. Shallow rooted rye-grass isreplaced by a mix of over a dozen grasses,herbs and legumes, all of which have adifferent role to play. Some fix nitrogen fromthe air (instead of applying expensive fossilfuel-derived fertilisers), while others bringup different minerals from deep under-ground. The greater mass and length ofroots adds organic matter and carbon to thesoil, building soil rather than depleting it,and sequestering carbon which helps tocombat climate change. This healthier soil ismore permeable, so that water soaks in andis retained, rather than running off intorivers taking the soil with it. It’s a beautifulsystem, making farms much more resilient

Marsh Fritillary sheltering ingrass tussock, Dartmoor

Farm Wilder labels highlight the wildlife that our farmers are looking after

The greater mass and length ofroots adds organic matter andcarbon to the soil, building soilrather than depleting it

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WILDLIFE

in the face of floods and droughts, and it has the built-inbenefit that the greater variety of flowers and grassesprovides food for many more insects than ryegrass canever sustain.

It’s an interesting time to be promoting meat, as moreand more people turn vegan, but that makes FarmWilder’s educational work all the more important, as we

try to inject some reality into an oftenconfused debate about the rights andwrongs of meat-eating. It’s all too easy tolabel all meat eating as bad – but that’snonsense. Just as electricity can be fromsustainable or unsustainable sources, so canmeat. Our message is simple – eat less meat,but when you do buy our high quality FarmWilder meat that helps protect endangeredwildlife as well as restoring soil and regener-ating the countryside.

The past 18 months have been anextraordinary voyage of discovery for aformer TV producer who knew little aboutfarming – but I don’t think there’s ever beena more exciting or important time to be

involved in British agriculture. Farming holdsa special role in the future of humanity, farbeyond just providing food. It is both amajor cause of the greatest problems of our time, collapsing biodiversity and mushrooming greenhouse gasses; but it also has the potential to provide solutions, if only we can fully embrace farming thatregenerates the soil, sequesters carbon, andrestores lost biodiversity. The scale of thischallenge can be daunting, but I’m moreoptimistic than ever that we will make thischange, and I’m pleased that in its own smallway Farm Wilder’s innovative labellingscheme is already starting to contributetowards this transformation.

Ryegrass monoculture

Wildlife-friendly Rhos pasture, Dartmoor

Farming … has the potential toprovide solutions, if only we canfully embrace farming that regenerates the soil, sequesterscarbon, and restores lost biodiversity

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Tim with his daughter


SEED SAVING

Seeds of survivalFred Groom Co-founder, Vital Seeds

I have a background in ecology, horticulture and human ecology, and have been workingwith seed in various capacities for five years. For a long time it has been my dream tostart a small organic seed company, and in 2018 the time seemed right; Vital Seeds wasborn. Vital Seeds produces and sells organic vegetable, herb, and flower seeds of open-pollinated varieties to home gardeners and small-scale growers. A core part of ourmission is to re-skill people in the art and craft of seed saving. My growing journey hastaken me from urban rooftops through Spanish deserts to the lush green hills ofDevon, where I and Vital Seeds now reside.

Nine out of ten mouthfuls of food startwith a seed, and that is not going tochange any time soon. These smalland unassuming objects hold withinthem the key to our survival as aspecies. They are essentially littlepackets of information, containinginstructions on how to produce sugar,starch, protein and many other life-giving molecules from soil, sunlightand water. They also contain theinstructions on how to create almostidentical replicas of themselves ensuring that this information can bedisseminated year after year. The workthey perform is no less than alchemy.

It is a disturbing fact that in the last 100 years, more than 90% of thediversity within food crops has beenlost. This is in large part as a result ofthe industrialisation of global foodproduction, and the dangerous shift incontrol of the global seed supply fromgardeners, growers, and small regionalseed companies, to large multinationalchemical giants, who now controlmore than two-thirds of the world’sseed. The shift from naturally breeding, open-pollinated varieties tohigh-tech F1 hybrids means that evenif gardeners and growers wished tosave their own seed, they cannot,because any seed produced by F1plants will be genetically unstable. You can save the seed of an F1 hybrid,but you won’t get the same plantwhen you try to grow it next year. Sogardeners who use F1 hybrid plantvarieties must buy new seed everyyear.

In the UK the majority of organicfood is actually grown using non-organic seed, as the supply of organicseed is so poor. On top of that nearlyall of the vegetable seed (organic andnon-organic) planted on UK farms isproduced in other countries, withdryer climates and cheaper labour. Somost of the ‘local’ food we endeavourto eat actually comes from seedproduced on the other side of theworld.

In response to this situation, we started Vital Seeds, a small independent seed company based inDevon, producing and selling organicvegetable, herb and flower seeds. Ourvision – lofty as it may sound – is tocreate a world where all farming isecological and all crop varieties areperfectly suited to their environments.We want to breed new crop varieties

Vital Seeds co-founders Fred Groom and RonjaSchlumberger offer a sustainable and local alternative to most seeds thatare planted in the UK, manyof which are grown thousandsof miles away in countrieswith a dryer climate andcheaper labour. They arebased at Westford farm, onthe north edge of Dartmoor.Here in their converted barn,they process seed and test itsgermination quality in aspecialist ‘germination oven’. It is here that they test theirseed twice a year to check itis still top quality. Part of VitalSeed’s mission is to re-skillgardeners and growers in howto save their own seed, and torevive this ancient and fascinating craft.

Peas


and improve existing ones. All our varieties are open-pollinated, so you can save seed from them year after year.

What do we mean by ‘open-pollinated’ I hear you ask?Open-pollination is the natural way that plants breed,whereby they exist in populations and each generation issimilar to the last. There is genetic diversity within thepopulations which means that they can evolve and adaptto changing climatic conditions. Conversely, F1 hybrid varieties of crops do not have this genetic diversity; all theindividuals of a given variety are essentially geneticallyidentical; not quite clones of each other but almost. Notonly do they have very limited genetic diversity, but theseeds which they produce will not produce plants similarto their parents, due to a genetic phenomenon calledsegregation which there is not the space here to go into.As it is not possible to save good seed from hybrids, itmeans that seed companies have total ownership of

varieties, and people wanting to grow the varieties mustgo back to the company every year to buy more seed.Another result of hybrids producing bad seed is that theyare unable to adapt to changing conditions, making themessentially an evolutionary dead end.

Some say we are approaching an eco-crisis; I personallythink that it is already in full swing. If we are going tocome out the other side of it with any hope of producingnourishing food from freely accessible plants, then wemust start to take seeds more seriously. We need excellentseeds of well-adapted and resilient varieties to give us thebest chance of moving towards a future we want our children to live in. To make this happen it is imperativethat individuals and communities are re-skilled in the artand craft of saving seeds. This humble activity would oncehave been one of the most important elements of ourseasonal land-based existence. Without good seed to plantin the spring, the harvest – and therefore our health –would have suffered greatly. This is still as true today as ithas ever been.

There are gene banks and some seed companies whoare stewarding varieties which may be of use in the future.However, it would be no less than foolish to depend on afew ‘Noah’s Arks’ to save the day. The real ark is in everygrower and gardener who saves seed year after year andswaps seeds with their neighbours and friends, andteaches them to save their own seed. This is the option fortrue resilience. In this scenario not only are we keepingvaluable varieties alive and evolving, but we are alsoenabling the flow of genetic and cultural material betweencommunities in a truly organic form.

As well as producing and selling top-quality seed, partof our mission at Vital Seeds is to educate gardeners andgrowers in seed-saving skills, through workshops andonline content. We are passionate (borderline obsessive)about seeds and want to share this with others. Seedsreally are little miracles waiting to happen.

What can you do today?

• Learn to save seed – start with self-pollinating, annualcrops as they are easy (eg French beans, peas, lettuce,tomatoes)

• Join the Heritage Seed Library (few £s a month) – theirraison d’etre is to keep alive old varieties which mightotherwise go extinct

• Support small regional organic seed companies (likeVital Seeds).

Seeds of survival

SEED SAVING

We need excellent seeds of well-adapted and resilient varieties togive us the best chance of movingtowards a future we want our children to live in

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Carrot root selection

Kale seed drying


TRANSITION TOWN

Wellington’s inspirationalcommunity projectsHelen GillinghamTransition Town Wellington (TTW)

The miracles of nature never cease to amaze me. I was taught to treat the body as awhole by my homeopath from an early age, which led me to pursue a career in holisticmassage and skincare. Permaculture seemed to perfectly suit my holistic approach tolife, and I have been involved with the transition town movement for about 10 years.Being part of of TTW’s Sustainable Food Group has brought me a lot of joy, so I hopereaders will be inspired to join their own local group to take positive steps towards agreener, kinder, and healthier future.

The transition townmovementRob Hopkins, the permaculturalist andaddiction counsellor who founded thefirst transition town group in Totnes in2005, pointed out that our society isaddicted to fossil fuels – and will doalmost anything to avoid facing thefact that we need to change. Somedeny that there is a problem; othersadopt survivalist strategies and build a bunker, or pin their hopes onoutlandish technical solutions –perhaps we can move to anotherplanet? The real answer is much closerto home: to work together as acommunity to transition away fromfossil fuels – and fast. For if we carryon consuming the earth’s resources atthe current rate, as well as warmingthe climate and damaging the environment, shortages and price risesare likely to cause war and conflict.But if we use the remaining resourceswisely to build infrastructure such assolar farms, hydro dams and windfarms, we could have a future that’snot just viable but actually more desirable, within closer-knit and mutually supportive communities.

The transition strapline is: ‘If wewait for the governments, it’ll be toolittle, too late; if we act as individualsit’ll be too little; but if we act ascommunities, it might be just enough,just in time.’

If we were to show, as I believe weare now starting to, that the ‘electorate’

really care about the environment,climate change, and the destruction ofhabitat, politicians will have to respond.

Hearing about too many of theworld’s problems, on our ever increasingly depressing and negativenews, can leave us feeling powerless.This feeling can lead to a sense ofhopelessness. The problems are sovast and complex, it feels like nothingwe can do will make the slightestdifference. But this is what the transition movement is all about.Whatever local community group youchoose to join, or create, you can bepart of the solution. We all have theability to influence and change thesmall patch of earth we call home.

The transition movement aims toreskill people with the arts we arelosing – learning from our elders howto sew, bottle food, mend our bikes –the kind of life we led before ourthrowaway and consumerist societystarted to wreak havoc on our climateand environment. This could buildconnections in our community andhelp us become a more cohesivesociety. If we can take the best frommodern life – the technology thatmakes life easy – and combine thatwith some of the skills and values fromthe past, the Earth and us humanswould be happier for it. Repair cafés –closely allied to the transition movement – are a wonderful wayforward, as we saw in practice whenwe started our own in Wellingtonearlier this year.

People have an affinity withthe natural world, and manystudies have shown that whenwe get in touch with nature,we are happier and healthierfor it. But many of us living incities, surrounded by concreteand steel, have become sodisconnected, our heads toofull of our jobs or relationshipsto allow space for anythingelse.


Growing our ownOne of the first regular events we set up in TransitionTown Wellington were talks on how to grow organicvegetables. This was a chance for both experienced andnovice gardeners to get together and share knowledge.Unlike the town’s regular gardening club, which invited‘experts’ to give talks on their special area with the audience sitting and listening, we decided to run themeetings more as a knowledge-sharing platform, wherenovices and more experienced gardeners could learn from each other. The notes are available from our websitettw.org.uk. They have been revised and added to over theyears, to provide a valuable resource for us in the future –and for others too.

Growing plants to eat is a complete joy. I would like toencourage anyone reading this who doesn’t already growto give it a go. It will help you discover a fundamentalconnection to the earth, and this connection will growstronger over time, even if you live in a city, and will have a positive impact on your mental health. Until relativelyrecently, in evolutionary terms we, like all other animalson our planet, spent our lives in pursuit of food.Becoming more self-reliant and reconnecting with thisprimal drive will give you more confidence and satisfaction.

As well as encouraging people to grow their own fruitand vegetables, TTW also wanted to encourage homecooking. The emergence of convenience food, fridges andfreezers in the 1960s, drew many people away fromcooking from scratch. Then, as the busyness of our livesincreased and more women started to work full-time inthe 1970s, cooking skills took a back seat. Chef-ledprogrammes may encourage a few to have complicatedfood and cooking as a hobby, but as a group, we want toreskill normal people with basic cooking skills. We organised chutney-, soup- and bread-making afternoons,where we would get together in a church kitchen andmake a variety of recipes from mainly home grownproduce.

Low carbon farmingLooking at the bigger world picture, 26% of the world’scarbon emissions come from food production(www.bbc.com/news/science-environment-46459714) sogrowing food locally is a good place to start when it comesto reducing our carbon footprint. At the start of the Digfor Victory campaign in the Second World War, Britain onlyproduced around a third of its food. There was a massivegovernment drive to increase yield, until in the early 1980swe had the ridiculous situation of phenomena like ‘grainmountains’, although we did produce 82% of our food.But now we have slipped back to 61% self-sufficiency(www.countryfile.com/news/can-the-uk-feed-itself-after-brexit/). But if we are going to rely less on fossil fuels andminimise the destruction of our natural environment, we need to move away from a highly mechanised and artificially fertilised agriculture. We can influence how agriculture works by campaigning for government policy

change, and as individuals aim to increase the amount oforganically produced food we buy, and reduce our intakeof meat products. In time, more farmers will change theirpractices to meet consumer demand.

Meanwhile, as a community, we can help our urbanlandscape provide food, and wildlife to thrive there. Wecan choose what we grow in our own gardens, but we can influence what gets planted in our communal spaces.Wellington local council has been co-operating with transition town efforts for planting and maintainingunused public spaces for the overall good of the town.TTW has been planting fruit trees, bushes, and herbs,around the town for five years now. We are workingtowards a vision that there could be food to forage neareveryone’s home, to provide an opportunity for everyone,through gardening, to connect to the earth, and to theirneighbours, even if they have no garden nor time tocommit to their own allotment.

Community orchards and woodland We started by helping to expand and develop a communityorchard on a new housing estate, on a spare bit of greenspace that had to be preserved due to the presence of apond with greater crested newts and 10 veteran appletrees. This sizeable orchard has the most productivecommunity trees in town. We have added 29 more appletrees and four plums and pears to the original heritageorchard, plus a range of soft fruit bushes and hazels. In2013, we planted a new orchard on an old church site.This is now known as Trinity Orchard, and contains 14apple trees, a plum and a pear tree. In 2015, we plantedsome fruit bushes and rhubarb on council land by theWellington Bowling Club. In 2016, we got a grant from thecouncil to plant suitable fruit trees and bushes in a dampfield dubbed a ‘community woodland’, and morello cherries along the shady edge of a rugby pitch. As theprojects have grown, awareness of our activities hasspread, and residents have started to ask if we can plantup small patches near their houses. By December 2018,we had planted plum, apple, cherry and pear trees near alocal primary school, which in time will provide fruit forthe children to pick on their way home from school.

These sites are shown on our foraging map drawnusing the artistic skills of volunteers, and reproduced withsponsorship from local businesses; again using theresource of our community. Our foraging map got usnoticed and together with our other projects led us to win a Green Heart Hero award in March 2019, as an ‘inspirational community project’.

Gaining momentumThe Free Community Food Map (https://ttw.org.uk/free-community-food-map) has helped raise awareness of whatwe are doing as a group, as families are using the foragingsites more and more. It’s lovely to see young children

Wellington’s inspirational community projects

TRANSITION TOWN


discovering picking fresh food forthe first time, as well as spendingtime with their families. New peopleare learning when different fruitsbecome ripe, not from someonetelling them, but from practical experience. As the most bountifulharvest so far in the town are theapples at the original communityorchard, we have been runningapple-juicing days for around fiveyears now. As more people join thegroup, we may run an elderflowercordial event, or jam-makingsessions, and share more recipes touse the foraged fruit by one of themany social media platforms.

This year we are embarking onour biggest project yet – a newcommunity garden of around an acrenext to a railway line. This site wasbrought to our attention at the same time as the community woodland, in 2016. The energy and enthusiasmof local volunteers has transformed the idea into some-thing much greater than our original vision, with wildlifeand nature now as its main focus.

The picture below shows the plan for the site. Thecouncil’s ecologists are using our developing sites as casestudies for the Pollinator Action Plan, adopted bySomerset County Council in 2018, to help provide insect-friendly habitats which are in desperately short supply.Hopefully in the future, this once bramble-covered fieldwill be not just a bountiful resource for foraging, but also ahaven for wildlife and a place for people to come togetherand enjoy picnics in a beautiful semi-wild garden.

The future is really bright for Transition TownWellington. People seem to be waking up to the urgencyof the situation – especially climate change and speciesloss – and realising more than ever that we all play a partin the global picture. Perhaps the success of our mostrecent projects is an indicator that more people aresearching for something they can do to make a change. It feels like we are involved in the right movement at theright time.

Coming together for changeI would really encourage anyone reading this to join aproject or start one. What is it that bugs you, that you’dlike to change? If we can do it in Wellington, then you can.You don’t need to be an expert, or have any particularqualifications. All it needs is the willingness to spare sometime, some patience to deal with different people, andenergy and enthusiasm to have a go. It doesn’t need to beperfect, and you don’t need to know everything – societyjust needs someone to volunteer, especially if no one elseis doing it already. It might be a bit of hard work, but thatis totally outweighed by the great feeling you get of beingpart of the solution. Member Andrea says: ‘I was feeling abit low one day with my job on the computer, wonderingif my life was worth anything, but the following day, usinga mattock to dig up bramble roots to create a footpath atLongacre, I felt my life had purpose and meaning, becauseI was helping the community’. Maybe you can join us inplanting fruit trees and bushes in your town, or creating acommunity veg patch, or a wildflower meadow, joiningmany other similar projects in the country, until all ofBritain’s urban spaces are greener and more beautiful,providing hope for our future and our food security.

Wellington’s inspirational community projects

TRANSITION TOWN


‘Let food be thymedicine, and letmedicine be thy food’: Is food the foundation for good health?

Jessica FrostFinal year student, Birmingham Medical School

Throughout university, I have become increasingly passionate about lifestyle medicine,plant-based nutrition and fitness, with an insatiable love of dance, martial arts, runningand weightlifting. I am eager to educate others about the monumentally positive impacteven small changes in lifestyle can have on both mental and physical health and, as atrainee doctor, feel it is my duty to practise what I preach. I also believe it is imperativethat patients are made to feel engaged and empowered by their healthcare providers,hence why I aspire to pursue a career in general practice, where I can provide otherswith evidence-based lifestyle advice and further develop my interests in this exciting,up-and-coming field.

Food has played a fundamental rolewithin healthcare for centuries, and its use in both preventative and therapeutic medicine has been documented in medical texts dating asfar back as the Hippocratic epoch. The quote attributed to Hippocrateshimself, ‘let food be thy medicine, and let medicine be thy food’, furtherreiterates how nutrition and dieteticshave been viewed persistently as keyto the optimisation of health sinceancient times. Health is a dynamicstate, described by The World HealthOrganization as one ‘of completephysical, mental and social wellbeing,and not merely the absence of diseaseor infirmity’ (WHO, 2006). This definition provides the individualfacets through which this essay willexplore the age-old link between dietand wellness, to ultimately decidewhether food today still provides thefoundation for good health, orwhether such a narrative oversimplifieswhat is actually a hugely compositehealthcare issue.

The foods people consume ultimately define a population’s health,with dietary risk factors one of thebiggest contributors to the globalburden of disease and responsible forone in five deaths worldwide (GBD2017 Diet Collaborators. 2017; Afshinet al, 2019). Although the health benefits reaped by following a plant-based, Mediterranean diet have longbeen documented, the obesogenicWestern diet has precipitated animpressive peak in chronic diseaserates and poses a similarly dire threatto the planet (Sofi et al, 2014).Research published by the BMJreiterates these dangers: consumptionof more than four servings of ultra-processed foods per day was associatedwith a 62% higher all-cause mortalityrate than consumers of less than twoportions per day, plus significantlyhigher rates of cardiovascular andcerebrovascular disease (Rico-Campàet al, 2019). Thus, although diet isirrefutably intertwined with physicalhealth, a comprehensive change in

The title for the 13th annualBHMA student essay competition was Is food thefoundation for good health?Our winner, Jessica Frost,impressed the judges particularly with her referencesto two topical issues – junk/processed/ultraprocessed foodsand the Eat-Lancet report onsustainability. They were alsoimpressed by the fact that shetook it beyond diet to food’srole in lifestyle medicine. Theessay is particularly relevant as the Real Food Campaign is launched (see page 4) focusing on food thatpromotes health, both personal and planetary.

STUDENT ESSAY


culture and mentality is required before this relationshipbecomes symbiotic, including a shift away from the patientas a passive participant to an active advocate for their own healthcare. However, statistics are discouraging andcompliance to health-promoting national dietary guide-lines remains poor: for instance, although fibre is essentialfor reducing incidence of and mortality from non-communicable diseases such as diverticular disease,ischaemic heart disease, stroke, type 2 diabetes and coloncancer, only 9% of people in the UK currently achieverecommended levels of the macronutrient per day(Reynolds et al, 2019).

A recent study by the GBD 2017 Diet Collaborators(2017), which evaluates dietary factors and non-communicable diseases in 195 countries, further quantifiesthe terrifying implications of modern food patterns onhuman health. It declares 11 million deaths in 2017 weredue to poor diet: 10 million as a result of cardiovasculardisease, the remainder from cancer deaths and type 2diabetes. Food has thus become undeniably importantwithin preventative medicine. The EAT-Lancet Commissionargue that it is, in fact, ‘the single strongest lever to optimise human health and environmental sustainabilityon Earth’ (EAT-Lancet Commission, 2019). In contrast topharmacotherapy alone, a balanced, whole-foods dietwields the power to not only prevent and treat, but alsoreverse, myriad chronic illnesses including diabetes andhigh blood pressure. Even simple changes, such as reducing saturated fat, cholesterol and salt intake, andincreasing dietary fibre, can have a huge impact on overallhealth and wellbeing, as well as the prevention of obesity-related disease (WHO, 2003). The emergence of thePlanetary Health Diet earlier this year, a global initiativewhich proposes a plant-based diet as a sustainable meansof feeding a population of 10 billion, is a powerful move in the right direction and promises huge health and environmental benefits. By pushing food to the healthcarefrontline, its potential as a tool to prevent disease andsimultaneously maintain both human and environmentalwellbeing can be properly utilised.

The influence of food on health, however, extendsmuch further than our physical state. Research is emergingthat highlights the negative corollaries of consuming nutrient-poor, energy dense foods on brain health. Diet,among other lifestyle components, has been repeatedlyunderlined as contributing to the genesis of mental illness,yet largely ignored in therapeutic approaches. Just ascardio-metabolic diseases depend heavily on diet forprimary and secondary prevention, the same may be truefor psychiatric disorders. Unsurprisingly, the mostcommon deficiencies occurring in patients with mentaldisorders are of precursors to neurotransmitters, includingB vitamins, omega-3-fatty acids and amino acids (Rao et al,2008). Furthermore, diets low in carbohydrates have beenshown to precipitate depression in susceptible individuals,given that the production of serotonin and tryptophan aretriggered by carbohydrate consumption (Ghoch et al,2016). Evidence thus suggests a high-carbohydrate,

low-GI, plant-based diet, centred around wholegrains, fruitand vegetables, results in long-lasting improvements in themood and energy-levels of patients with mental ill-health(Rao et al, 2008; Lassale et al, 2019).

Other studies assessing the impact of diet as anadjunct to pharmacological and psychological treatment ofdepression echo the suggestion that dietary changes maybe an efficacious means of managing the condition andassociated with positive mental health outcomes (Parlettaet al, 2019; Jacka et al, 2017; Psaltopoulou et al, 2013;Sanchez-Villegas and Martinez-Gonzalez, 2013). The closecorrelation evident between the extent of dietary changeand the extent of improvement in depressive symptomsreiterates the need for further studies to assess nutrition’spotential in the prevention and treatment of mental disorders, especially given the rising rates of mental illnessin the UK and the stigma which continues to surroundantidepressant use. Furthermore, depression incurs thegreatest societal costs in Europe at present, and is aleading cause of disability worldwide (Lassale et al, 2019).Thus, it is essential that we begin to accept nutritionalmedicine as ‘a mainstream element of psychiatric practice’(Sarris et al, 2015) as it constitutes such an accessible,affordable, efficacious and side-effect free treatment strategy for the general population.

However, despite the unequivocal benefits of food onour health, its limitations must also be considered. AsHippocrates once said, ‘in food excellent medicine can befound, in food bad medicine can be found; good and badare relative’. Like all aspects of clinical practice, if utilisedpoorly, food can be equally as damaging as it can be remedial. Carb-restriction, juice ‘cleanses’, ‘detoxes’, ketogenic and alkaline diets, spuriously promising quick-fixes and dramatic weight loss, are the result of society’ssimultaneous demonisation and moralisation of food. No single food can cause or cure disease; the key is inmoderation, balance, and viewing lifestyle medicine as acollective. However, the obscured view of food as medicine – which unabashedly over-emphasises thehealth-properties of certain food types – and disregard forthe wider panorama of lifestyle medicine – has perpetuatedthe UK’s damaging diet culture. This elusive pursuit of the‘thin ideal’ has not only resulted in macro-and-micro -nutrient deficient dietary patterns, especially among young people, but has also contributed to the growinganorexia crisis and recent surge in hospital admissions fordisordered eating (Marsh, 2019). Hence, an effort must bemade to distinguish between food and medicine, and toappreciate them as separate yet synergistic entities, as

‘Let food be thy medicine, and let medicine be thy food’: Is food the foundation for good health?

STUDENT ESSAY

No single food can cause or curedisease; the key is in moderation,balance, and viewing lifestyle medicine as a collective

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opposed to relying on food as medicine, or as an alternative to it.

Hippocrates also declared that ‘eating alone will notkeep a man well’, reiterating that while a balanced dietirrefutably forms the scaffolding of good health, it is notthe only player in a comprehensive lifestyle approach togood health (Berryman, 2012). Exercise is another keymodifiable risk factor for chronic diseases such asischaemic heart disease, stroke and diabetes, and onewhich has been proven to wield a similar efficacy to pharmacotherapy (Naci and Loannidis 2013). With itsability to reduce the risk of dementia, shrink mortality ofdepressive disorders, as well as overall risk for the condition, and lower risk of several cancer types, especiallycolon and breast, it offers a seemingly simple solution tothe UK’s growing disease burden (Larson et al, 2006;Murri et al, 2018; Rezende et al, 2018). However, despitegovernment recommendations currently suggesting thatthe most beneficial ‘dose’ is 150 minutes of moderateintensity physical activity, current figures suggest that 34%of men and 42% of women do not meet these targets(NHS Digital, 2017). This lack of physical activity isthought to result in at least one in ten premature deathsin the UK, with a direct economic corollary of more than£1 billion (Lee et al, 2012). Furthermore, we cannot omitstress reduction, good sleep hygiene, minimisation ofalcohol consumption and tobacco avoidance from thehealth equation, as only when all of these factors areconsidered together can diet be utilised as part of an efficacious method to maximise physical, mental andsocial wellbeing.

Ultimately, while food in isolation is not a panacea forachieving health and longevity, together with exercise itforms the foundation for good health and constitutes oneof our greatest weapons against the global epidemic ofpreventable chronic disease. Given that most doctors aremore comfortable prescribing pharmaceutics than ahealthy lifestyle, undergraduate medical training inevidence-based nutrition and lifestyle interventionsdeserves much more attention than it currently receives.Lifestyle medicine and ‘fitness prescriptions’ have thepotential to slash our burden of chronic disease andballooning NHS costs, hence why it is paramount thatpatients are made to feel engaged and empowered bytheir healthcare providers. A balanced diet may not be asprescriptive as a pill, or as easy to dispense, with dosesand formulations for every eventuality, but it is arguablythe most powerful, accessible and affordable driver ofglobal wellbeing we currently have at our disposal. Wetherefore need to use it.

ReferencesAfshin A, Sur PJ, Fay KA et al (2019) Health effects of dietary risks in195 countries, 1990–2017: a systematic analysis for the Global Burdenof Disease Study 2017. The Lancet, 393: 1958.

Berryman J (2012) Motion and rest: Galen on exercise and health. The Lancet, 380: 210–211.

GBD 2017 Diet Collaborators (2019) Health effects of dietary risks in195 countries, 1990–2017: a systematic analysis for the Global Burdenof Disease Study 2017. The Lancet, 393:1958–1972.

Ghoch M, Calugi S, Grave R (2016) The effects of low-carbohydratediets on psychosocial outcomes in obesity/overweight: a systematicreview of randomised, controlled studies. Nutrients, 8:402.

Jacka F, O’Neil A, Opie R, Itsiopoulos C et al (2017) A randomisedcontrolled trial of dietary improvement for adults with major depression (the ‘SMILES’ trial). BMC Medicine, 15: 23.

Larson E, Wang L, Bowen J, McCormick W et al (2006) Exercise is associated with a reduced risk for incident dementia among persons65 years of age and older. Annals of Internal Medicine, 144: 73–81.

Lassale C, Batty GD, Baghdadli A, Jacka F et al (2019) Healthy dietaryindices and risk of depressive outcomes: a systematic review and meta-analysis of observational studies. Molecular Psychiatry, 24(7):9 65–986.

Lee I, Shiroma E, Lobelo F, Puska P, Blair S (2012) Effect of physicalinactivity on major non-communicable diseases worldwide: an analysisof burden of disease and life expectancy. The Lancet, 380: 219–29.

Marsh S (2019) Hospital admissions for eating disorders surge to thehighest in eight years. The Guardian. [online] Available at:www.theguardian.com/society/2019/feb/15/hospital-admissions-for-eating-disorders-surge-to-highest-in-eight-years (accessed 24 May 2019).

Murri M, Ekkekakis P, Magagnoli M, Zampogna D et al (2018) Physicalexercise in major depression: reducing the mortality gap while improving clinical outcomes. Front Psychiatry, 9:762.

Naci H, Loannidis J (2013) Comparative effectiveness of exercise anddrug interventions on mortality outcomes: meta epidemiological study.BMJ, 347: 5577.

NHS Digital (2017) Health Survey for England 2016: Physical Activity inAdults. [Online]. Available at: http://healthsurvey.hscic.gov.uk/media/63730/HSE16-Adult-phy-act.pdf (accessed 24 May 2019).

Parletta N, Zarnowiecki D, Cho J, Wilson A, Bogomolova S et al (2019)A Mediterranean-style dietary intervention supplemented with fish oilimproves diet quality and mental health in people with depression: arandomized controlled trial (HELFIMED). Nutritional Neuroscience,22: 474–487.

Psaltopoulou T, Sergentanis T, Panagiotakos D, Sergentanis I et al(2013) Mediterranean diet, stroke, cognitive impairment, and depression: a meta-analysis. Annals of Neurology, 74: 580–91.

Rao TS, Asha MR, Ramesh BN, Rao KS (2008) Understanding nutrition,depression and mental illnesses. Indian Journal Psychiatry, 50: 77–82.

Reynolds A, Mann J, Cummings J et al (2019) Carbohydrate quality andhuman health: a series of systematic reviews and meta-analyses. TheLancet, 393:434–445.

Rezende L, Sá T, Markozannes G, Rey-López J, Lee I et al (2018)Physical activity and cancer: an umbrella review of the literature including 22 major anatomical sites and 770,000 cancer cases. BritishJournal of Sports Medicine, 52: 826–833.

Rico-Campà A, Martínez-González M, Alvarez-Alvarez I, Medonça R,Fuente-Arrillaga C, Gomez-Donoso C et al (2019) Association betweenconsumption of ultra-processed foods and all cause mortality: SUNprospective cohort study. BMJ, 365: 1949.

Sanchez-Villegas A, Martinez-Gonzalez M (2013) Diet, a new target toprevent depression? BMC Medicine, 11:3.

Sarris J, Logan A, Akbaraly T, Amminger G et al (2015) Nutritionalmedicine as mainstream in psychiatry. Lancet Psychiatry, 2: 271–274.

Sofi F, Macchi C, Abbate R, Gensini GF, Casini A (2014) Mediterraneandiet and health status: an updated meta-analysis and a proposal for aliterature-based adherence score. Public Health Nutrition, 17:2769–82.

The EAT-Lancet Commission (2019) Summary Report of the EAT-Lancet Commission: Healthy Diets From Sustainable Food Systems.[Online] Available at: https://eatforum.org/content/uploads/2019/04/EAT-Lancet_Commission_Summary_Report.pdf (accessed: 24 May 2019).

WHO (2006) Constitution of the World Health Organization. [Onlinet]2006. Available at: www.who.int/governance/eb/who_constitution_en.pdf(accessed 23 April 2019).

WHO Technical Report Series (2003) Diet, nutrition and the preventionof chronic disease: report of a Joint WHO/FAO Expert Consultation.Geneva: WHO.

‘Let food be thy medicine, and let medicine be thy food’: Is food the foundation for good health?

STUDENT ESSAY


L IFESTYLE MEDICINE

and motive represented by BigPharma.

In came the Farmacy, five-minute workouts, amber glassesand 345 Breathing, digital detoxand natural living and environments in healthycommunities.

No more auto pilot for thepatient or for us.

We stopped.

We took note.

We took a deep breath and we created a 1:1 lifestyle cliniccalled Healthy Lives, practice-based small group lifestylelessons and large communitybased group health events, affectionately termed theSmartcare Be Happy Hub (offering lifestyle medicine andsocial prescribing to 80,000patients in the West Midlands).

True 4 Pillar plans/IFM Lifestyleaficionados fervently flocked tothese newly drawn frontlines.

Not just GPs, but consultants:Rheumatologists,Gastroenterologists,

Mohanpal Singh ChandanGP

Asfia AftabGP

Endocrinologists, NutritionTherapists, osteopaths, healthcoaches, chefs, artists, horticulturists, tai chi, meditationand mindfulness instructors,social workers, psychologists,social prescribers, pharmacists,nurses, physios, physicians associates, dieticians, charity societies, volunteers medicalstudents, GP trainees and eventeenage work experiencestudents… learning together,peer-peer support, presentingtogether, eating nutritious foodtogether with patients… and somuch more.

Eminent guests (including thefounders of the PLM JeremyHawkey, Rangan Chatterjee, Mike Ash, CCG officials, HealthEducation England, and founderof the international FunctionalMedicine forum, James Maskell,were all genuinely in awe of what has been achieved in such a short space of time and allinspired by one book and onecourse. Support came from bigand small organisations, local andnational: Action for Happiness,Permission to Smile, British LungFoundation, MIND…

Take two frontline GPs inBirmingham and bring themtogether at an NHSLeadership for ChangeImprovement course andwhat do you get?

You get them both attending the RCGP approved PrescribingLifestyle Medicine course, andthen embedding its principles ininnovative ways in clinical careand possibly leading to a changein the NHS which may revolutionise how medicine ispracticed in the UK.

It really is that cataclysmic.

Out went the biomedical model, paternalistic medicine,downstream sticky plasters formetaphorical gaping wounds…And in came ‘root cause’ medicine, whole person medicine, personalised medicineas well as group medicine andlifestyle solutions for lifestyleproblems.

System-based thinking ratherthan organ-based. Preventionrather than shortsightedsymptom-driven decisions withoffending, questionable evidence

P R E S C R I B I N G

58 © Journal of holistic healthcare � Volume 16 Issue 3 Autumn 2019

From small acorns...

Patients revelled in finally feelingas if their problems were reallybeing addressed in a truly holistic,progressive and mindful way.

HCP felt free of the stifling ‘pill for every ill’ tinnitus-likewhisperings. And finally felt theywere making a real difference…finding their passion for theirvocation, working alongside eachother, watching relationships andconfidence grow, stories beingshared by the figurative tribalcampfires, sourdough beingbrought in for newly formedfriends as learnings developed, ofconnections and gut brain axes.

The clinics and the hubsbrimmed with gleeful positivity but what did thefigures show…

The 1:1 Healthy Lives clinicshowed that even 12 monthsafter a single lifestyle medicineappointment, patients attendedtheir own GP surgery 30% lessoften. From this it appears thatwhen a person is empowered to create health rather thanmanage disease, skills developthat are sustainable and do notdecay with time. Prescribingcosts went down by 7% acrossthe 220 patients seen in theclinic and this was sustained fora whole year. For people withtype 2 diabetes who attendedthe clinic, there was an averageof 7 points reduction in HbA1c,and 14 patients brought theirHbA1c reading into the non-diabetic range. A health costsanalysis showed that for every£1 spent on the service, £3 wassaved for the NHS.

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RCGP AccreditedMeets the professionalism, expertise and commitment requirements to the highest possible standards of general practice.

Evidence Based TrainingThe course has been developed from the latest available evidence from research, clinical outcomes and patient experience.

Join Our CommunityWe have a thriving online community which use the Prescribing Lifestyle Medicine framework every day.

#Increased Job Satisfaction100% of attendees would recommend the course. Feedback has shown increased job satisfaction.

Reduce Follow-Ups & MedicationBy getting to the root of a patient’s symptoms, follow-ups and prescriptions can be reduced long term.

Created for NHS GPsOur framework allows GPs to provide lifestyle advice and interventions in ten-minute appointments.

www.prescribinglifestylemedicine.org

EDUCATE INSPIRE TRANSFORM

The group sessions impactedgreatly on wellbeing scores in allareas as well as physical scores.Every patient attending type 2diabetes group sessions hasreduced their HbA1c readings.There was a 74% drop in GPappointments. Weight, BP,cholesterol all went down. Painscores went down. Prescriptioncosts went down.

The only humming we hear nowis of the deep inhalations andeven longer exhalations wetake, as we learn to breatheagain while we truly take care ofpatients as we had dreamed wewould.

Welcome to a new dawn. Thefuture looks bright. The futurelooks holistic. We urge you topick up the baton and encouragewhat nature intended. To eatsleep, relax and move in a betterenvironment for you.


very interesting things emerged.Firstly, about her consultations withthe haematology team she said:

‘I didn’t want to take on any information beyond what I hadto accept: that is what was seendown the microscope. I rejectedmedical dogma about curability –I viewed it as an unhelpful story – and I made up my own storyand I’m sticking to it through thick and thin! … I just knew Ihad to build a protective ringaround my immune system.’

Jenny’s ‘own story’ was inspired by avisit to a Reiki practitioner before herchemo started. He said the body’sfrontline defences are very importantand ‘we call them “Mum”, and mumgoes around sweeping up messes’. ‘Of course!’, Jenny thought, ‘mum hasslipped up and I must help her, thenshe may be able to cope on her own.This became her empowering story,which ultimately expressed itselfmainly in the planning and preparationof meals – surely a crucial role for a‘mum’! She was (and still is) veryexcited about this. Healthy, nourishingfood along with some other healthylifestyle changes would become the‘protective ring’ around her immunesystem. She began reading widelyespecially about diet and health. Oneparticular recipe book, good goodfood by ex-medic Sarah Raven, focuseson food and health in a very practicalway. This became Jenny’s key referencework. She showed it to me. I counted43 bookmarks in it!

So what is going on here? It iscertainly a striking story. The impact ofa single dose of chemotherapy wastruly remarkable and we are allimmensely grateful for that. But the

medical specialists’ preoccupationwith the disease and its technical treat-ment at the expense of engagementwith the wider human self-healingpotential of the patient is surely amissed opportunity. For Jenny, it is notso much the details of her new dietthat became so important in herrecovery, but rather the inspirationand positive empowerment that hascome with it. The creation of an inspiring story leading to positiveaction has been her route towards that empowerment and healing. Shebelieves that the medical professiontoo often misunderstands what helpspatients most: they focus on thedisease at the expense of the patient.

Interestingly, Jenny told me that at one of her subsequent hospitalcheck-ups the haematologist admitted,when pressed, that they had seen afew long-term ‘remissions’ of follicularlymphoma. But he was reluctant tospeak of these ‘remissions’ as cures, asif it was inconceivable that the will andempowerment of the patient couldpossibly complete the job that themedical treatment left not quitefinished.

Of course, we are in the territoryof holistic medicine, or rather, the lackof it. We are looking for what DavidReilly calls ‘creative consulting’ seekingto liberate ‘the healing response’(Reilly, 2001, 2002). It is a great creditto Jenny’s imagination and strength of character, and also to the Reiki practitioner’s inspiring story, that they were able to enhance the haema-tologists’ remarkable medicine. Surelythis should be a lesson for the future.Reilly D (2002) The Healing Shift Enquiry. Video.Available at: www.davidreilly.net/HealingShift/About.html (accessed 3 September 2019).

Reilly D (2001) Creative consulting: why aim for it?BMJ, 323. Available at: www.bmj.com/content/323/Suppl_S4/0110364 (accessed 3 September 2019).

Food for thought andthe power of a storyWilliam House Retired GP; Chair of the BHMA

Food hardly featured at all in themedical curriculum when I trained inmedicine. That was in the late 1960s. I hope it’s better now, but have werecognised the true breadth of food’simportance to us humans? Here is astory about the perhaps unexpectedhealing power of food.

Jenny (not her real name) wasdiagnosed three years ago with follicular (non-Hodgkin) lymphoma.She is a determined woman, a force tobe reckoned with! But the disease wasgrowing fast with widespread enlargedlymph nodes, swollen stomach andlegs, weakness and tiredness. Thehaematologist told her they can helpto control the condition, but not cureit. For her, this was a red rag to a bull,but she could see she needed helpand agreed to chemotherapy. Theproposed treatment was planned in acycle of four doses by intravenousinfusion at monthly intervals. Duringthe weeks following the first dose itwas obvious to Jenny that the diseasewas melting away and when shereturned the next month for a checkprior to the second dose she was verywell and the disease was clearlyretreating, but further treatment wasdelayed because of a low white cellcount. At the next month’s check-up,there were no traces of the diseaseand the white cell count remainedslightly low. The rest of the treatmentcycle was cancelled. This happenedbetween December and February2016–2017. Today (September 2019)she remains very well and free fromdisease without having any furthermedical treatment. This is extremelyunusual.

So where is the connection withfood here? Jenny and I recently reminisced about her illness and some


We need to talk about meatSo what is a healthy amount of red or processed meat? It’slooking increasingly like the answer, for both the planet and theindividual, is very little. Saying this is one thing. Getting the worldto a place where we have the ability to balance the desire toeat whatever we want with our need to preserve the ecosystemwe rely on to sustain ourselves is quite another. The conversationhas to start soon.Editorial, The Lancet (2018) 392(10161).DOI:https://doi.org/10.1016/S0140-6736(18)32971-4

Plant-based diets tied to 23%lower diabetes riskOne of the main risk factors for type 2 diabetes is diet. Manystudies have suggested that plant-based diets significantly reducediabetes risk. A recent review and meta-analysis of nine largestudies showed that a predominantly plant-based diet of anykind is associated with reduced diabetes risk. ‘Predominantlyplant-based’ could mean either a diet of healthful plant foods, orless healthful ones such as potatoes and sugars. Both diets couldinclude some animal products. Participants who adhered morestrictly to plant-based diets had a 23% lower risk of type 2diabetes than those who adhered less strictly. Reduction of riskwas even stronger in those who adhered to strictly plant-baseddiets featuring a large amount of fruit, vegetables, legumes, wholegrains, and nuts. The team noted that healthful plant-based foodscan improve insulin sensitivity and blood pressure, reduce weightgain and low-grade inflammation, both of which contribute to aperson’s risk of diabetes. Some of the authors have disclosedpotential conflicts of interest: one co-author received individualresearch support from the California Walnut Commission, andhonoraria from two dietary supplement companies. Qian F et al (2019). Association between plant-based dietary patternsand risk of type 2 Diabetes. JAMA Intern Med.www.ncbi.nlm.nih.gov/pubmed/31329220

So how much meat is it safe to eat?Not much it seems. Members of the Seventh-day AdventistChurch tend towards a plant-based diet rich in whole foods andlow in most animal products, alcohol, and caffeinated drinks.However, some followers eat some low-fat dairy products, eggs,and low amounts of certain ‘clean’ meats or fish. A study involvingmore than 72,000 Seventh-day Adventist men and womenrecruited between 2002 and 2007 aimed to find out whetherthose who did eat red and processed meat had shorter lives. Infact processed meat alone was not significantly associated withgreater risk of mortality, but there was a greater all-cause andcardiovascular disease mortality in those with a bigger intake of

red and processed meat. These findings suggest moderatelyhigher risks of all-cause and cardiovascular disease mortalityassociated with red and processed meat in a low meat intakepopulation. Alshahrani S et al (2019) Red and processed meat and mortality in a lowmeat intake population. Nutrients, 11(3): 622. DOI:10.3390/nu11030622

Ultra-processed foods andcancer risk?Are people who eat a lot of ultra-processed food more likely toget breast, prostate, and colorectal cancer? In a population-basedEuropean study 104,980 participants aged at least 18 completeda series of 24-hour dietary e-records, that categorised 3,300different food items and their degree of processing (by theNOVA food classification). In this large prospective study, a 10%increase in the proportion of ultra-processed foods in the dietwas associated with a significant increase of greater than 10% inrisks of overall and breast cancer. Further studies are needed tobetter understand the relative effect of the various dimensionsof processing (nutritional composition, food additives, contactmaterials, and neo-formed contaminants) in these associations.Fiiolet T et al (2018) Consumption of ultra-processed foods andcancer risk: results from NutriNet-Santé prospective cohort. BMJ, 360.DOI: https://doi.org/10.1136/bmj.k322.

How much cancer is diet-related? Diet is an important risk factor for cancer that is amenable tointervention. An American study estimated the annual numberand proportion of new cancer cases attributable to sub-optimalintakes of seven dietary factors among US adults aged 20 yearsor older, and by population sub-groups. An estimated 80,110 newcancer cases were attributable to sub-optimal diet, accounting forjust over 5% of all new cancer cases in 2015. Of these most,67,488 (= about 4% of US total) were attributable to directassociations and 12,589 (= 0.82% of US total), to obesity-mediated associations. Colorectal cancer had the highestnumber and proportion of directly diet-related cases (52,225).Low consumption of wholegrains and dairy products, and a highintake of processed meats contributed to the highest burden.Men, middle-aged (45–64 years) and racial/ethnic minorities(non-Hispanic blacks, Hispanics, and others) had the highestproportion of diet-associated cancer burden than other age,gender, and race/ethnicity groups. More than 80,000 new cancercases were estimated to be associated with sub-optimal dietamong US adults in 2015, with middle-aged men and racial/ethnic minorities experiencing the largest proportion of diet-associated cancer burden in the United States.Zhang FF et al (2019) Preventable Cancer Burden Associated WithPoor Diet in the United States. JNCI Cancer Spectr. 3(2):pkz034. doi:10.1093/jncics/pkz034.

Research summariesThanks to James Hawkins http://goodmedicine.org.uk/goodknowledge


The Uninhabitable Earth: A Story of the FutureDavid Wallace-WellsAllen Lane, 2019ISBN 978-0241355213

I am approaching my 75th birthday. As I look back, I see my life hasbeen overshadowed by the gatheringecological catastrophe. I have a childhoodmemory, strangely both clear and hazy,that was an intimation of things to come.As a small boy in the 1950s I am sitting atthe kitchen table turning the pages of a weekly magazine –possibly Life or Picture Post. I come to a double-page spreadfeaturing a dramatic black and white photo of a filthy smoke-stack, illustrating an article predicting a future environmentalcrisis. I ask my mother about it, and her reply brushes myconcerns aside as if forbidding even the thought behind thequestion, ‘You don’t want to think about that, dear’. But clearlythe notion that life on Earth was precarious lodged in my mind.Throughout my adult life this early intimation was reinforced: I was just 18 in 1962 when Rachel Carson’s Silent Spring waspublished; I recall having the weird image of a mother birdcrushing her eggs as she sat to incubate them because the shellswere so thin. This was followed in 1968 by Buckminster Fuller’schallenging proposal that we live on ‘Spaceship Earth’; in 1972 by the Club of Rome’s Limits to Growth report pointing to overshoot and collapse; in the 1990s by Al Gore’s movie AnInconvenient Truth; in the new century by the series of increasinglyalarming reports from the Intergovernmental Panel on ClimateChange (IPCC); and now daily reports of rapidly melting icecaps,record temperatures, violent storms, the bleaching of coral reefs,chemical and plastic pollution, all indicating that ecological catastrophe is on us faster even than the pessimists thought.

As professor at the University of Bath, I taught andresearched ‘sustainable business practice’ – a phrase the nowseems rather archaic. I remember conversations with colleaguesback in the 1990s, agreeing, ‘We have another 10 years toaddress this, then it will be too late’. Yet here we are now, overhalfway through the second decade of the new millennium,when little has really changed. Is it still nearly too late, as thelatest IPPC report argues; or has the moment, if indeed itexisted, actually slipped from our collective grasp? And is italarmist to talk about the possibility of ecological and socialcollapse? Or is that a taboo that needs breaking? All these issuesare raised by David Wallace-Wells’ The Uninhabitable Earth.

In 2017 Wallace-Wells published an article in New YorkMagazine ‘peering beyond scientific reticence’ to argue that theclimate catastrophe is ‘I promise you, worse than you think.’ Itwas a punchy piece that attracted considerable criticism forbeing alarmist and for selecting evidence to suit his argument.When I read it myself, having watched humanity fail to respond

to the gathering crisis for so many years, I thought his majortheme was uncontrovertibly true. The book is a development of that article.

It is a shocking book, shocking in several ways. First, in itsappearance. From the moment my review copy arrived in thepost, I tried to keep it out of view. The stark cover – the title set in plain black letters on a light cover, with a small dead beeunderneath – is a brilliant piece of typographical design. But it isnot the kind of image you want to have at your bedside – Ifound myself constantly putting the book out of sight on a highshelf. It was as if I myself was hiding from confronting the issue.

The second way in which this book is shocking is the mostimportant: its content. For the book details the many ways inwhich climate change is impacting life on Earth far faster andmore profoundly than public discourse accepts. It has becomethe all-encompassing stage on which life in conducted – and willcontinue to be so into the distant future. We brought this uponourselves. Humankind impacted the Earth system since huntingwith spears cause the extinction of megafauna way back inprehistory, as Elizabeth Kolbert brilliantly details in The SixthExtinction. But most of the damage to climate stability has takenplace since the Second World War in what has been called the‘great acceleration’, the exponential growth of resource use andpollution, mainly in developed Western economies. Indeed,Wallace-Wells tells us that a full half of the carbon dioxideexhaled into the atmosphere by burning fossil fuels has takenplace in the last three decades – since Al Gore, then USSenator, published his book Earth in Balance: ‘we have now engineered as much ruin knowingly as we ever managed in ignorance… we wouldn’t, or couldn’t, or anyway didn’t looksquarely in the face of the science’.

The first main section of the book details the ‘Elements ofChaos’, the many ways in which climate change will have anapocalyptic impact of life on Earth. It must, at the very least,mean the end of the way of life that we in the developed West take for granted, let alone the impact on the global southand other creatures: heat death, hunger, drowning, wildfire,unbreathable air, plagues, economic collapse and conflict. Eachchapter is packed with statistics gleaned through research articles and interviews that makes horrifying reading. To pick justone example: as Arctic ice melts and reflective albedo is lost,additional warmth is absorbed by the dark sea; this results in asmuch additional heating as 25 years of global carbon emissions.Parts of Earth will become too hot for human survival; sea willrise of up to two metres by 2100, inundating coastal cities andchanging coastlines; crops will fail – cereal crops in particulardon’t do well in higher temperatures; storms will be increasinglyviolent and damaging; and on and on. We have to move fast inreducing carbon emissions, not to stop, but just to limit thewarming that is already in the climate system.

This book doesn’t definitely claim, despite its title, that Earthwill become uninhabitable within current lifetimes; that dependson the choices we make and fail to make. But ‘the fact that we

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have brought that nightmare eventuality into play at all isperhaps the overwhelming cultural and historical fact of themodern era’. What we face is ‘the end of normal’, the end of the environmental conditions that enabled the human animal toevolve and develop its range of cultures and civilisations. Theimpact of climate change is more extensive and faster thancertainly conventional science imagined. The IPCC report thatglobal society has just twelve years to take effective action isalarming enough, but it is important to note that the IPCC isnecessarily conservative, only admitting new research that haspassed the threshold of unarguability. For example, the lastreport did not account for the kind of feedback effects of lossof albedo, or the potential release of methane from thawingpermafrost. And in the past two years since that report, theEarth has had record-breaking temperatures, and new evidencethat ancient ice is melting far faster than expected in both Arcticand Antarctic.

This leads to the third way in which I find this book shocking:it is shocking that we find it shocking. There is an apocryphalstory of the leading professor of climate science who asks allprospective PhD students to name the major theoreticaladvances in climate science since the 1970s. The correct answeris, of course, that there have not been any: there are new empirical findings and new methods of assessment, but thetheory has been confirmed time and again; indeed, scientists firstpredicted the impact of greenhouse gases in the nineteenthcentury. But the scientific community has generally been reticentabout setting out the threats clearly; and despite the best effortsof many activists, we have not found the language, the stories,the rhetorical forms to encompass the threats. We continue todiscuss climate change within the conventions of today’s world,rather than in terms of a world ‘deformed and defaced beyondrecognition’. We pick up on one issue for a while – plastic pollution is the current favourite – but fail to understand thesystemic implications, the ‘cascade effects’ as Wallace-Wells callsthem. Maybe the current wave of schoolchildren’s strikes andmovements like Extinction Rebellion will contribute to the emergence of a new narrative: there certainly does seems to besome fledgling new urgency in public discourse, although notfrom government circles.

I also find the book shocking in that it is entirely anthro-pocentric. The author makes clear he has never been an ‘environmentalist’ or a ‘nature person’. He writes ‘I may be aloneon the environmental left in feeling that the world could losemuch of what we think of as ‘nature’ as far as I cared, so long aswe could go on living as we have in the world left behind. Theproblem is we can’t’. Apart from his failure of empathy for othercreatures, he appears to have no clue that humans are part of aweb of life, totally dependent on a flourishing ecology for oursurvival.

The book has been generally welcomed in the mainstreammedia, described as ‘lively’, as ‘relentless, angry journalism of thehighest order’. But I found it not really very well written; assembled rather than composed. Here I agree with JohnGibbons in the Irish Times, who sees Wallace-Wells as a ‘skilledessayist’, but finds the book doesn’t advance his original arguments, feels rushed, and needing better editing to free thenarrative from a tangle of statistics and extraneous details.

I often found myself stumbling on long sentences full ofsubclauses, having to go over them a second or third time tograsp his meaning. The first major section of the book, detailing

the elements of chaos, has a certain dynamism to it, driven bythe information he lays out. The later part of the book, ‘TheClimate Kaleidoscope’, explores significant themes – Storytelling,Capitalism, Technology and others – in short and rather insubstantial chapters. Wallace-Wells draws on major and minorcontemporary commentators but all too briefly and superficially.There is no unifying perspective or narrative through thissecond part. Overall, I found the book a struggle to read.

This book is important because it contributes to breakingthe taboo against discussing the seriousness of our predicament:to repeat, it is ‘worse, much worse, than most of us think’. It is acontribution to the emerging debate about the profound existential threat posed by climate change and by our collectivefailure to make anything like an adequate response; a debate wemust learn to have. For to accept this does not mean we mustlapse into fatalism; as Jan Zwicky writes in Learning to Die, thefirst requirement of a moral human is to ‘look the truth of oursituation in the eye’. And beyond that, there remains much wecan do for ourselves and for the community of life on Earth –adopting the kind of New Green Deal proposed by the Greensin the Europe and the radical Democrats in the US would be agood start. Above all we need imagination and courage todream new futures.

I suspect this is a book that will be more bought anddiscussed than actually read. I would certain recommend readingthe original article in the New York Magazine before buying it. Iwould also consider other books and media sources that makethe same argument: Elizabeth Kolbert’s The Sixth Extinction iswell researched and much better written; Naomi Klein a muchstronger polemicist; academic and Green Party campaignerRupert Read sets out the climate catastrophe in his talk onYouTube; management professor Jem Bendell covers similarground in his paper on Deep Adaption; there is a very clear essayFacing Extinction by Catherine Ingram, an Australian writer andBuddhist teacher.

I must give the last word to David Wallace-Wells, who endshis book asserting: ‘climate change… calls the world, as one, toaction. At least I hope it does.’

Peter Reason is a writer and sailor whose work links the traditionof nature writing with the ecological crisis of our times

Root to StemAlex Laird Penguin Life, 2019ISBN: 978-0241371213

Growing up in the Kent countryside and on the banks of Loch Lomond in Scotland,medical herbalist Alex Laird was in tune with the natural worldfrom the start. She spent her childhood and teens surroundedby hills, rivers and beaches but itwasn't until age 12 that she had anepiphany and started to appreciatenature’s power.

‘Standing on the Loch bank one day before school I wassuddenly overwhelmed by the great beauty of my surroundings,’says Alex whose life’s work has been to get us to reconnect

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with nature. ‘ I was knocked out by this great feeling of calm andknew it was an important moment but didn't know why,’ sheadds. But time would tell.

Moving on to study philosophy and politics at BristolUniversity followed by a decade in television, Alex found herselfbecoming increasingly fascinated by health, alternative economics,sustainability and green issues and decided to train as anaromatherapist. This led her to working with HIV patients atTurning Point as well as in clinics at the Chelsea andWestminster Hospital in London. Then came a second epiphany.

‘While recovering from ME I picked up a copy of TheEssential Book of Herbal Medicine by Simon Mills and realisedwhat that moment on the loch banks all those years ago wastrying to tell me – that plants and herbs have amazing healingpowers. It became my mission to find out more.’

‘I trained as a medical herbalist and started practising at theBreast Cancer Haven in Fulham and at Whipps Cross Hospital inLeytonstone, but wanted to share the knowledge I had gainedover the years. And her new book Roots to Stem does just that.

These beautifully illustrated pages set out the benefits ofconsuming whole foods in their natural state, which meanseating the skin, pith, and seeds of vegetables and fruit. Why?Because as Alex explains this is where the plant’s defence chemicals are found, which we and other animals can use asmedicine. Roots to Stem goes on to show us the foods andherbs that are the best to eat and grow for optimum health,season by season. There are also simple, delicious recipes andeasy-to-make herbal remedies to try.

With details on how to use a slew of plants and herbs forcommon ailments ranging from allergies to infections, there isalso a wealth of invaluable information on how to boost immunity. There are some surprises along the way too, such ashow, in spring, nettles, sorrel and cleavers can help to cleanseyour system, how, in summer, eating raw foods will help to beatthe heat, while, in autumn, mushrooms are key to beating infections thanks to their antiviral and antibacterial properties.Meanwhile, in winter, red berries, purple potatoes and rosehipsare an essential weapon in the fight against colds and flu.

And that’s not all. Throughout the book you will learn howliving and eating in sync with natural rhythms can make a realdifference to your health and that of the planet. As Alex explains,‘ We are all part of one unique and complex ecosystem’. Sofollowing a root-to-stem approach to living is not only good for us but good for the planet too, because we are all inter -dependent. This is a must-read for anyone wanting to eat withthe seasons and learn more about the intriguing links betweennature and ourselves. Don’t miss it.

Jane Garton, health writer and Chelsea Physic Garden guide

Grass-fed nation: getting backthe food we deserveGraham HarveyIcon Books, 2016ISBN 978-1785780769

Why do we have such a seemingly illogical food system? This is the question at the heart of Graham Harvey’s recentlypublished book, Grass-Fed Nation, a manifesto for grazing livestock and the extensive benefits of mixed farming.

Peppered with case studies,the book convincingly assertshow mixed farms are essentialfor improving soil fertility, increasing yield and reducingpests. How do mixed farmsstrengthen local communities andrural economies by providing jobsand using a diverse range of local services? And how do theyimprove the long-term health of theplanet by converting arable landback to pasture, thus improving thesoil’s ability to store carbon?

Harvey, renowned food and farming journalist and agricultural advisor for The Archers, is a long-standing championof grazing animals and mixed farming. This latest book is adamning criticism of the rise of industrial arable agriculture and a detailed perspective on the positive human health and environmental impact of a return to grass-based farmingsystems.

When the water in his local river turned murky brownfollowing heavy rainfall, Harvey knew something was wrong. Like the canary down the mine, he cautions that, ‘Milky brownwaters are a warning we ignore at our peril’. What it signifiedwas a fundamental problem in our farm systems causing soil tobecome eroded and washed away. The decline of pasture andthe rise of intensive arable cropping has mined the nutrientsfrom the soil and left bare earth exposed and vulnerable toweather.

But the impact of this is not solely environmental, it carriesequally worrying implications for our health. Harvey claims weneed to join the dots, offering the river as a perfect example.‘What happens to our rivers – and more precisely, whathappens to the land they flow through – is connected with thelevel of disease in society.’

Integrated thinking combining food, farming, health and theenvironment has been in short supply for many years. Butrecently there appears to be a shift, away from thinking in siloes,and towards a more systemic approach. This informs one of thestrongest messages in Harvey’s book, that the way we farmimpacts our diet and our health, and vice versa – our diet andconcerns about health affect the way we farm.

Meat consumption is one of the clearest examples of this.Despite evidence to the contrary, which is intelligently exploredthroughout the book, the myth that saturated fat is bad hasbeen perpetuated by dieticians and manufacturers of low-fatfoods. This has contributed to a decline in pasture and encouraged the shift to ever more intensive crop production asthe demand for plant-based foods and vegetable-based oils hasincreased.

Harvey also points out how our diets have changed dramatically throughout human existence. We shifted from ahunter-gatherer lifestyle to reliance on starchy, sugary refinedfoods within a relatively short period of time. So it’s littlewonder that society is now suffering from multiple dietary-related diseases, such as heart disease and type 2 diabetes. This,he claims, is directly related to the shift to industrial agriculture.

Grass-fed meat is a nutrient-dense food containing farhigher levels of beneficial fatty acids. Milk too is much healthier

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when produced in a grass-fed system. Far from being a cause ofdisease and obesity, Grass-Fed Nation contends that meat anddairy produced from pasture-reared animals should form a keypart of healthy diets.

But industrial agriculture has not only waged war on ourhealth, it has also waged war on our environment. Monoculturecropping reliant on chemicals poses an ‘existential threat’ to ourcountryside, according to Harvey. With subsidies that encouragedfarmers to plough up pasture and sow wheat instead, the UKhas seen the staggering loss of 97% of its wildflower meadowssince the 1940s. An evocative description about the destructionof one particular meadow in Wiltshire, portrays it ‘As an act ofsheer vandalism’ continuing, ‘it was like taking half a dozen ofTurner’s masterpieces out of the National Gallery and torchingthem on the pavement of Trafalgar Square.’

Intensive arable cropping has led to the decline of half ofplant species, one third of insect species and four fifths of birdspecies. Harvey details the astounding number of chemicals thatgo into a typical growing season for a wheat crop, including fourdifferent weed killers, an insecticide, five plant-growth hormonesand no fewer than twelve disease-killing fungicide chemicals.Traces of these chemicals not only end up in our soils andrivers, but also in the food on our plates.

There are, as Harvey points out, those who argue thatintensive crop production is necessary to feed a growing worldpopulation. But this is far from the case. A major study in 2008found that industrial crop growing would not be capable offeeding the global population and was unfit for purpose. Withsmallholder farmers still producing 70% of the world’s food, achange of direction is evidently needed to ensure sustainable,small-scale farming is given protection and support.

According to Harvey, the way to enable this is through areturn to mixed farm systems in which pasture and grazing livestock form a central part.

He also explores the role that mob stocking might play, asystem inspired by Allan Savory in which the natural pattern ofgrazing animals is emulated by intensively grazing pasture in arotation. This prevents pasture being overgrazed and damagedthrough re-grazing too quickly and adds an even spread ofmanure and the trampling that’s needed to improve soil andplant growth.

Grass-Fed Nation is far more than a book about grass.Encompassing everything from human health to the future ofour planet, Harvey shows just how important it is to get ourfarming systems right.

Megan Perry, Sustainable Food Trust Communications and Policy Officer

Real food for pregnancy: The science and wisdom ofoptimal prenatal nutrition Lily Nichols

Lily Nichols, 2018

ISBN 978-0986295041

In Real Food for Pregnancy, LilyNichols explores the confusingand often contradictory topic of prenatal nutrition. Taking anevidence-based approach, Nicholsconcludes that many conventionalrecommendations for eatingduring pregnancy do not correspond to what researchsuggests is best for optimal prenatalnutrition. Nichols then brings the research down to anapproachable level, making concrete and manageable suggestionsfor modifying your diet during pregnancy.

My reaction: I love reading books that gather and workthrough the research, and Nichols certainly does that in thisbook. She also nicely includes highlighted statements andsummary sections, so if you are more interested in her conclusions than how she gets there, you can get a nice handleon the material in a short amount of time. I especially enjoyedChapter 4 where Nichols works through recommendations onlunch meat, alcohol and more. I also appreciated the balancedapproach she takes when she notes that first-trimester nauseamay make a diet overhaul unrealistic, but that it is something youcan work toward as you feel able. And, she also shares thateating ‘real food’ doesn’t have to be all or nothing. As with somuch in pregnancy and parenting, having the information youneed to make the best choices for your family – even if thosechoices include small-scale changes in prenatal nutrition ratherthan following her advice to the letter – is what truly matters.

Some quotes of note:‘Part of listening to your body is recognizing when your foodchoices don't leave you feeling well and making a mindful choiceto opt for a more nutritionally balanced option the next time youeat. Your body deserves nourishing foods and you deserve to enjoyyour food. There is a place for these two things to coexist.’

‘Calorie and macronutrient needs vary widely and therefore there’s not a single meal plan that will work for all women.’

‘When you ignore your hunger cues, you tend to ignore your fullness cues as well.’

My takeaway:Real Food for Pregnancy gives you all the research with

practical ways to apply it to your eating during pregnancy. While some nutrition books can load you with pressure, thisone incorporates mindfulness and emphasises that we are alldifferent, making plenty of room for you to take what you needfrom the book without feeling completely overwhelmed. I’drecommend this book to anyone looking to troubleshoot theirpregnancy nutrition or make changes preconception.

Johanna Tomlinson, postpartum doulaThis review first appeared on www.nestedmama.com

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About the BHMAIn the heady days of 1983 while the Greenham CommonWomen’s Camp was being born, a group of doctors formedthe British Holistic Medical Association (BHMA). They toowere full of idealism. They wanted to halt the relentless slide ofmainstream healthcare towards industrialised monoculture.They wanted medicine to understand the world in all its fuzzycomplexity, and to embrace health and healing; healing that involves body, mind and spirit. They wanted to free medicinefrom the grip of old institutions, from over-reliance on drugsand to explore the potential of other therapies. They wantedpractitioners to care for themselves, understanding that practitioners who cannot care for their own bodies and feelings will be so much less able to care for others.

The motto, ‘Physician heal thyself ’ is a rallying call for thehealing of individuals and communities; a reminder to all humankind that we cannot rely on those in power to solve allour problems. And this motto is even more relevant now thanit was in 1983. Since then, the BHMA has worked to promoteholism in medicine, evolving to embrace new challenges, particularly the over-arching issue of sustainability of vital NHShuman and social capital, as well as ecological and economicsystems, and to understand how they are intertwined.

The BHMA now stands for five linked and overlapping dimensions of holistic healthcare:

Whole person medicine Whole person healthcare seeks to understand the complex influences – from the genome to the ozone layer – that buildup or break down the body–mind: what promotes vitalityadaptation and repair, what undermines them? Practitionersare interested not just in the biochemistry and pathology of disease but in the lived body, emotions and beliefs, experiences and relationships, the impact of the family, community and the physical environment. As well as treatingillness and disease, whole person medicine aims to create resilience and wellbeing. Its practitioners strive to work compassionately while recognising that they too have limitations and vulnerabilities of their own.

Self-careAll practitioners need to be aware that the medical and nursing professions are at higher risk of poor mental healthand burnout. Difficult and demanding work, sometimes in toxicorganisations, can foster defensive cynicism, ‘presenteeism’ orburnout. Healthcare workers have to understand the origins ofhealth, and must learn to attend to their wellbeing. Certaincore skills can help us, yet our resilience will often dependgreatly on support from family and colleagues, and on the culture of the organisations in which we work.

Humane care Compassion must become a core value for healthcare and beaffirmed and fully supported as an essential marker of goodpractice through policy, training and good management. Wehave a historical duty to pay special attention to deprived andexcluded groups, especially those who are poor, mentally ill,disabled and elderly. Planning compassionate healthcare organisations calls for social and economic creativity. More literally, the wider use of the arts and artistic therapies canhelp create more humane healing spaces and may elevate theclinical encounter so that the art of healthcare can take itsplace alongside appropriately applied medical science.

Integrating complementary therapiesBecause holistic healthcare is patient-centred and concernedabout patient choice, it must be open to the possibility thatforms of treatment other than conventional medicine mightbenefit a patient. It is not unscientific to consider that certaincomplementary therapies might be integrated into mainstreampractice. There is already some evidence to support its use inthe care and management of relapsing long-term illness andchronic disease where pharmaceutics have relatively little tooffer. A collaborative approach based on mutual respect informed by critical openness and honest evaluation of outcomes should encourage more widespread co-operationbetween ‘orthodox’ and complementary clinicians.

SustainabilityClimate change is the biggest threat to the health of humanand the other-than-human species on planet Earth. The scienceis clear enough: what builds health and wellbeing is better diet,more exercise, less loneliness, more access to green spaces,breathing clean air and drinking uncontaminated water. If theseeds of mental ill-health are often planted in an over-stressedchildhood, this is less likely in supportive communities wherelife feels meaningful. Wars are bad for people, and disastrousfor the biosphere. In so many ways what is good for the planetis good for people too.

Medical science now has very effective ways of rescuingpeople from end-stage disease. But if healthcare is to becomesustainable it must begin to do more than just repair bodiesand minds damaged by an unsustainable culture. Holistichealthcare practitioners can help people lead healthier lives,and take the lead in developing more sustainable communities,creating more appropriate models of healthcare, and living more sustainable ways of life. If the earth is to sustain us, inaction is not a choice.

Journal of Holistic Healthcare

“The Journal of Holistic Healthcare…a great resource for the integration-minded, and what a bargain!” Dr Michael Dixon

Want to contribute to the journal? Find our guidelines at:http://bhma.org/wp-content/uploads/2016/07/JHH-Essential-author-information.pdf

Standard BHMA membership of £30 a year gives unlimitedaccess to online journal. Print copy subscription +£20

Re-imagining healthcare

holistichealthcare

J O U R N A L O F

Finished with your journal? Please donate it to your local GP surgery, community centre, library etc so others can read about holistichealthcare and the importance of looking after the whole person, notjust their immediate symptoms.

Editorial BoardDr William House (Chair)

Professor David Peters

Dr Thuli Whitehouse

Dr Antonia Wrigley

PROMOTING HOLISTIC PRACTICE IN UK HEALTHCARE

Join the BHMA to get the journal and other benefits

The Journal of Holistic Healthcare is free to all BHMA members. For just£30 a year members get unlimited access online, regular email newsletters,discounts on events and access to a closed Facebook group (optional). The concessionary rate (students/unemployed/receiving state benefits orstate pension) is £15. If you prefer to have a printed copy of the journalwhich is published three time a year, membership is just £50 a year.

In collaboration with The College of Medicinewww.collegeofmedicine.org.uk

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