By Meleni Aldridge, executive coordinator

What do soft nose monkeys, fruit bats and guinea pigs have in common with us humans? Are skin tags part of the body’s early warning system? What do margarine and plastic have in common? How does fruit shift from health food to silent metabolic assassin?

The answers to these questions (and so many more!) were to be found amongst the line-up of informative and clinically-relevant presentations at the British Society for Ecological Medicine’s (BSEM) 13^th training day on Friday 4^th November 2022. The training day, entitled Beyond the Metabolism, was laced liberally with clinical pearls given the audience was entirely medical doctors and other practitioners. With everyone as ‘zoomed-out’ as we all are, it was a delight that Rob Verkerk and I could attend the event in person at the Hallam Conference Centre in Central London.

In what follows, I hope to pass on to you some of the pearls we found most memorable or relevant for people's health and wellbeing.

From snake oil to systems medicine - health approaches that work.

Dr Damien Downing – Applying the principles of ecological medicine to metabolic health

Dr Damien Downing’s (also the BSEM president) opening presentation, Applying the principles of ecological medicine to metabolic health, was a cogent reminder of how tough a journey it has been for those few medical doctors in the UK who chose to transition from a conventional path, for example as a NHS general practitioner, to an holistic, functional, systems-based, ecological approach to healthcare. Damien, a long-time friend and previous Medical Director of ANH, was among the first to make this transition in the UK some half a century ago - and has been practicing ecological medicine and evolving the way he practices ever since.  

Thankfully the world has moved on a little and we hear less about snake oil than we used to in the 80’s and 90’s. For any newcomers, ‘selling snake oil’ was (and still is at times) the term used to smear natural medicine as fraudulent and its practitioners as charlatans. The detractors were so vociferous in the 80’s that Dr Richard Kunin, a giant in the field of nutrition and orthomolecular medicine, and author of 15 Principles that Identify Orthomolecular Medicine, actually wrote a paper on the benefits of snake oil. Surprise, surprise, it’s rich in anti-inflammatory omega 3s!  

Dr Downing reminded us that medicine and the art of healing is not a horse race. A systems approach is about assessing the interaction of many factors together. There’s no prize for picking the best treatment approach, which is usually multi-faceted to deal with the multiple interactions of the real world we inhabit. In his inimitable style, Damien highlighted the point that systems-based, practitioners of ecological medicine are required to engage in heuristics (“Making fast efficient decisions”) rather than just following guidelines ("Something we do instead of thinking!”). 

Ecological medicine is a genuine new frontier in medicine and almost the polar opposite of conventional, mainstream, drug-based ‘pill for an ill’ primary care. To assist other medics wishing to make the transition, the BSEM offers excellent training for doctors, especially those wishing to expand their conventional horizons with its online Foundation Course. This course is the entry-point for GPs and other healthcare professionals wanting to learn about nutritional and environmental (ecological) medicine. It’s been created in collaboration with the Australasian College for Nutritional and Environmental Medicine (ACNEM), with which the BSEM has had a long relationship.

>>> Find out more about BSEM’s training and upcoming events

Dr David Jehring – Metabolic syndrome

Dr Jehring (also the organiser of the training day) gave an excellent presentation on metabolic syndrome which ticked so many boxes for me. It was packed full of clinical pearls as well as being firmly rooted in evolutionary biology. Hence the reference at the beginning to soft nose monkeys, fruit bats and guinea pigs. The answer to that question, by the way, is that we all share a genetic mutation from around 60 million years ago that means we lost the ability to make vitamin C in our bodies in order to enable us to put on more fat and combat starvation. Everything in biology, throughout evolution, comes down to survival of the species, which is why mutations are generally a trade-off between risk and benefit. Evolution may cause you to lose something, but in the process you gain survival benefits.

Another key take-home that we at ANH have often trumpeted is that we are built for famine and not for feast. That means the vast majority of us are living in environments - surrounded by bursting refrigerators and food shops on every street corner - that we’re not designed for.

The result is an ongoing pandemic of metabolic syndrome that is driving every health system in the Western world into bankruptcy. Metabolic syndrome is the direct result of living in an environment with a lifestyle that doesn’t match our evolutionary heritage. Dr Jehring’s presentation began with the dire warning that if we don’t do something about this now, our children and grandchildren are not going to be able to afford healthcare. Worse, they’re likely to be so sick as to have no quality of life either. The fabric of our societies is literally unravelling before our eyes as populations get fatter, sicker, less active and less able.

It’s why we wrote our book, RESET EATING, which shows you step-by-step how to turn your food into powerful medicine that creates health rather than taking you deeper into the pandemic of metabolic dysfunction and disease. 

Such is the current prevalence of metabolic dysfunction in our society that many GPs, when faced with impaired liver function, think they have a drinker in front of them. If the patient doesn’t admit to it, they think they’re lying, and the patient is left paranoid about the few drinks they might have while being left to devour refined carbs without any warning!

Not all GPs, let alone members of the public, realise it's not only alcohol that can cause an enlarged, fatty liver. The bigger culprit in today's world is non-alcoholic fatty liver disease (NAFELD) triggered by an excess of sugars, starchy and refined carbs. That includes all those potatoes (in their many fast food or processed guises), honey and fruit! Simple carbs break down to sugars rapidly in the body and regardless of how it gets there, sugar is sugar, as far as our bodies are concerned.

Clinical pearl on its way: If you’re someone who has, or is developing, skin tags and the skin condition, acanthosis nigricans (dark patches often in body folds), it’s worth having a health MOT as both are indicative of metabolic dysfunction related to high insulin levels driving abnormal build-up of skin cells (hypertrophy).

Another reason why fruit can be a silent health assassin is because fructose (fruit sugar) uses up a huge amount of energy (ATP) to break it down in the liver and the by-product of this process is uric acid. High levels of uric acid in the body are extremely damaging, but it also stop you burning fat, reduce the clean-up operation in your cells (autophagy – like the bin men going on strike), destroy the beta cells of your pancreas over time (risk for type 2 diabetes), inhibits the production of nitric oxide (NO), which amongst multiple major health benefits, keeps your blood vessels open and healthy, and so much more! I highly recommend reading Dr David Perlmutter’s new book, Drop Acid, for the complete lowdown on uric acid and its ramifications for our health.

If you’re a woman of a certain age and are despairing about the weight you seem to be gaining out of the blue, Dr Jehring may just have the answer. He shared that as we get older, the fructose pathway intensifies. As oestrogen partially blocks this pathway, when it becomes scarce during menopause, the net result is weight gain. Unfortunately, key drivers of this pathway are fruit, refined sugars, high-fructose corn syrup, alcohol, and, wait for it: polyol sweeteners like erythritol, mannitol and sorbitol – all pushed on us by Big Food as healthy alternatives to sugar. You might like to revisit our recent article on menopause for more helpful information to ensure a smooth transition.

Dr Aseem Malhotra – Can heart disease be reversed?

Dr Malhotra delved into the latest research in cardio-metabolic health. Quoting Prof John Ioannidis, his key messages were that most medical research today is unreliable or biased, few doctors realise it, and most are unequipped to evaluate it.

“The greater the financial and other interests and prejudices in a scientific field, the less likely it is that the research is true.” - Prof John Ioannidis, Stanford Prevention Research Center

Bearing this out, Dr Malhotra reminded us that statins are now a 3 trillion dollar industry being prescribed to an estimated 1 billion people worldwide. Ka ching! However, in terms of reducing cardiac risk, it amounts to around a 4-day gain over 19 years in primary prevention trials. I’d rather take my chances with diet and lifestyle changes that can reverse metabolic syndrome in around 4 weeks with full compliance. I can attest to this personally having completely turned my health around, including reversing markers for metabolic syndrome, in under 3 months back in 2011. I’ve never looked back.

Dr Malhotra then proceeded to share some of his client testimonials who had triumphed over their heart disease using the ‘Malhotra Method’. You won’t be surprised to find out that poor diet, psychological stress, poor sleep and a sedentary lifestyle are key factors in cardiovascular disease. It was good to hear that he’s even had success reversing arterial blockages using a natural diet and lifestyle mediated approach.

Rachel Nicoll PhD – Cancer metabolism and how to outsmart it

Dr Nicoll treated us to a consummate review of the research related to cancer metabolism after revealing that cancer is set to displace heart disease as the No1 killer in the Western world, where it hasn't already. US president, Richard Nixon, signed the National Cancer Act in 1971 and declared a ‘war on cancer’ whilst much of America focused on another particularly challenging war, in Vietnam. Sixty years on, it's clearly not a war that's been won, and where progress has been made, gains have generally been, despite the media headlines, more 'marginal' than 'breakthrough'. Despite all this, the oncological drug market, in particular, has been an incredibly lucrative cash cow for Big Pharma. As always, Dr Nicoll’s presentation was thorough and contained a broad selection of useful references to add to our personal reference libraries.

She enlightened us that the physiological role for the BRCA1 mutation - that's been widely linked to breast cancer risk - (remember what I said earlier about genetic trade-offs?) is that it’s in part responsible for the repair of DNA damage and the creation of new mitochondria (mitochondrial biogenesis) - not creating cancer. Mitochondria are of course the organelles that are the energy producing factories in our cells. In fact, the research shows that 50% of the women with the BRCA1 mutation never go on to develop cancer. Nearly all cancer cells have one thing in common – abnormal mitochondrial function, which is why addressing the early signs of metabolic dysfunction, and its downstream effects, should be the number one priority in healthcare.

Despite the US National Institutes of Health spending over $1 trillion USD trying to find a cure for cancer, gene-target therapies have been a huge disappointment. Dr Nicoll revealed that the American Cancer Society has now admitted that genes contribute no more than 5% of our cancer risk – the remaining 95% are caused by modifiable epigenetic factors. That’s things like diet, smoking, environmental pollutants, drugs, infections, stress, obesity, physical inactivity – you get the picture. Almost all of which are under our own control, if we have the education and the will to make the necessary changes. The paper in the previous link was published in 2008. That’s 14 years ago and still nothing has changed in conventional approaches to cancer. Makes the concept of recommending women to have their breasts removed if they have the BRCA1 mutation (remember Angela Jolie?) look like medical heresy or just plain butchery.

I’ve picked another 4 key take-homes from Dr Nicoll’s excellent presentation to mention:

1. Cancer cells utilise fructose to support growth and rapid development;
2. Healthy adults generally have several million cancer cells in our body every moment of the day, yet most of us only rarely, if ever, in our life times, develop malignant, cancerous masses (be grateful for, and nurture, a well primed, healthy immune system);
3. Insomnia itself is a risk factor for cancer, but those who were in the upper third of frequency for taking prescription sleeping pills, had a 35% increased risk of developing cancer; and
4. Antioxidants, whilst effective in preventing DNA damage can also inhibit some necessary steps in the immune response that keeps cancer in check. This is why we always recommend a food-first approach with targeted, rather than indiscriminate, supplementation.

Patrick Holford – What’s driving Alzheimer’s and is it preventable?

The final keynote speaker for the day was internationally renowned nutritional therapist and teacher, Patrick Holford, representing the Food for the Brain Foundation to talk about what’s driving Alzheimer’s disease and is it preventable.

Here’s a link to our very recent interview and article with Patrick on the launch of the ‘Alzheimer’s is Preventable’ campaign.

I really recommend you visiting the Food for the Brain website, not just to take the validated Cognitive Function test, but to access the wealth of information and materials to help you and your loved ones avoid the misery of dementia. More importantly, if your cognitive and homocysteine tests indicate you're at risk of Alzheimer's owing to your raised homocysteine (which represents around half of all cases), you should follow Food for the Brain's supplementation advice and take high dose B6, B12 and folate along with omega-3s.   

The day finished with doctors David Unwin and Shideh Pouria sharing case studies. In Dr Unwin’s case, it was how he’s managed to reverse over 120 type 2 diabetic patients at his practice in north of England (Southport) after offering them a choice between medication or lifestyle changes. Good to know that most choose the lifestyle option. But I believe his huge success also reflects his proper doctoring skills in the old-fashioned sense – he really cares about people, he listens to what makes them tick and he walks his talk. In fact, out of 9 doctors and nurses, 95% of the practice are low carb and the only snacks you’ll see are almonds and walnuts!

"I’m making up for 25 years of abrogating my responsibilities. I medicated people. Now I know there’s another way to do it. I’ve not referred a single diabetic person to a vascular surgeon for 7 years."- Dr David Unwin

If you've reached this far, you might be wondering if you've missed the answer to the margarine and plastic question. You haven't, I've just left it till last as I wanted to put it to Rob Verkerk PhD as the common response is that margarine and plastic are only one atom apart. As you'd expect from a scientist, here's a bit more detail. 

Certain kinds of plastic like polythene are polymers made from carbon and hydrogen. Margarine is a hydrogenated fatty acid containing carbon, hydrogen and oxygen. But PET and perspex also contain carbon, hydrogen and oxygen and they're also considered plastics.

The bottom line - avoid margarine. It's not good for you despite what Big Food likes to say.

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