This book imagines a meeting between Charles Darwin and Hippocrates, the ancient Greek father of medicine, supposing that any dialogue between these two great thinkers should be quite sensational. Each chapter is introduced by a short dialogue between the two great men and the book covers some of the main areas of this large subject including controversial issues such as the use of nutritional supplements, probiotics and junk food.
John Nichols graduated from Liverpool Medical School in 1967 and entered General Practice in Guildford in 1971. He spent six months as research assistant to Ian Watson at the Shere GP practice in Surrey working on various projects including a trial of revaccination against measles 5-10 years after primary immunisation which showed a decline in immunity that was boosted by revaccination. In 1973 he joined The Fairlands GP Practice near Guildford where he was able to collaborate with university colleagues on a number of research projects. He was also a GP trainer for 20 years. He graduated the MSc Nutritional Medicine in 2005 and was subsequently appointed as a Visiting Research Fellow in 2011. He has published research on zinc status and postnatal depression, trace elements and female infertility, smoking cessation, diverticular disease and the use of probiotics in primary care. Published books include two books on Nutritional Medicine and three works of fiction. One science fiction novel has been published as a paperback and two are currently only available as e-books; all available through Amazon books.
The busy GP (family doctor) may dismiss any discussion on vitamin and mineral supplements or food allergy with these brief comments such as the myth of the well balanced diet. The whole subject is much more complicated as explained here. For instance a well balanced diet cannot compensate for the lack of sunshine during the winter months in Northerly climes causing vitamin D deficiency and this is just one example. In this book I have attempted to deal with such issues comprehensively and I have recruited Charles Darwin and Hippocrates to help me with this task.
An Introduction to Nutritional Medicine
Late 20th Century medicine supplied two easy answers to patient’s questions about nutritional supplements – too easy, unfortunately, to be adequate:
If it’s a natural substance, it might not do you much good but it can’t do you any harm. Although there is some truth in this when referring to a modest dose of a vitamin, for instance, we now have evidence that higher “pharmacological” doses of vitamins like vitamins E, A and B6 might be harmful in some circumstances, but the evidence is inconclusive. Since herbal remedies are sometimes referred to as supplements, every GP will realise that herbs like St John’s Wort are more like drugs, with side effects and the potential for interaction with other drugs.
You don’t need to take extra vitamins and minerals if you eat a well-balanced diet. This is a gross oversimplification. We now know that even the best, most varied, Western diet is not the same as the stone-age diet that we are adapted to as a result of millions of years of evolution. This is especially true of the low vegetable fibre content of modern diets. Added to this, many of our patients have psychological and money problems that prevent them from eating well. Nearly all food surveys show that 20-30% of people in the UK never eat fish,and some will tell you that they find the very thought of it disgusting
Another easy answer is to tell patients with normal IgE blood test (immune globulin E) and the related allergy tests that “….food allergy is all in the mind”. We now know that this is not necessarily the case. For instance, some patients with irritable bowel syndrome (IBS) can tell you exactly which foods exacerbate their symptoms although they do not test positive on any standard type of allergy testing. The balance of evidence from dietary studies suggests a rule of halves:
Half the patients who think they have a “food allergy” but have normal IgE and RAST (radioallergosorbent test) will have a genuine food intolerance and half will be imagining it.
Half the patients with a genuine food intolerance will have some idea what foods are problematic and, with minimal help and understanding, they will be able to control their symptoms.