July 6, 2016
One doesn’t have to look far to notice that, when it comes to the health of either people or the planet, food is Topic #1 these days. Whether the goal is reversing obesity, diabetes, depression, heart disease, or any combination of the “new” childhood epidemics of chronic illness, including asthma, ADHD, autism, and allergies – especially the anaphylactic food allergies that are ubiquitous nowadays – everyone seems to be seeking the magic formula that will result in true health and wellness. This is unsurprising to me as, mainstream medicine notwithstanding, I find that anyone who has even put a toe in the water of diet and nutrition modification has proven for themselves that nutrition can have a powerful effect on health and well-being – so much so, in fact, that the ancient Hippocrates saying “Let food be thy medicine and medicine be thy food” is a staple on health-related websites these days.
As much as everyone seems to acknowledge the primary importance of nutritious food, however, it can be really hard to determine exactly what that means when it comes to growing, purchasing, and preparing it. Many parents are having difficulty figuring out what, if anything, is safe to feed their children their children these days. Buzzwords abound, and every new “expert” seems to disagree with the last one on fundamental points – to the extent that some parents have thrown up their hands and given up trying to navigate the overgrown thicket of nutritional and dietary advice. A dizzying array of options are available: Paleo, Body Ecology, GAPS, Specific Carbohydrate, ketogenic, Atkins, Zone, etc., all of which are touted by someone you know as the answer for everyone. Nutritional supplements get the same treatment: organic sulfur, vitamin B12 , “proper copper,” probiotics, vitamin D3, etc. How is one even to begin to sort through all this information to find what will really help? It ain’t easy, that’s for sure.
One thing that I find as I get older is that no one has the right answer for everyone. No one. Over the years I’ve seen people – even close relatives – do very well on very-low-carb diets, while they invariably make me feel faint and cranky. There’s little worse for a naturally active person than having zero zip throughout the day. As my blood type is O, all the folks who have blossomed by following Dr. Peter D’Adamo’s blood-type diets join the Paleo folks in telling me “Very low carb is the way you should be eating!” They say, “You’re just not doing it right,” or “You haven’t been doing it long enough,” but, unlike them, the longer I do it, the worse it makes me feel. Fortunately for my health, not to mention sanity, I gave up following fads long ago and began listening to what my body tells me with respect to the foods I feed it.
With all the conflicting information out there, we at TMR have decided to do a blog series on food to help people (including ourselves) sort through all the many issues surrounding nourishment in order to figure out ways to eat (and feed our children) that keep us sane and provide a foundation for optimal health. I can’t think of a better way to inaugurate this series than with a review of the book The Dirt Cure by Dr. Maya Shetreat-Klein, a well-known pediatric neurologist in New York City and mother of three.
I have to begin with a confession. When Dr. Shetreat-Klein was presenting at the AutismOne Conference in 2015, I was there, but I saw the name The Dirt Cure, and I’m embarrassed to say that I thought she was basically advocating eating dirt – along the lines of Jordan Rubin’s endorsement of soil-based organisms (SBOs), perhaps. And while I’m sure there’s some validity to that, I’d heard it before and I didn’t feel the need to hear it again. So I avoided her and her talk.
I’m kicking myself for that now because that meant that I didn’t actually meet her till this past winter after she spoke at the Functional Forum in New York. While everything she said that night made sense, I don’t think her talk begins to hint at the value of her book. The Dirt Cure is, simply put, the best guide to food – how to grow, buy, and prepare it in ways that promote good health and how to avoid those that will make you sick – that I’ve ever encountered. When you consider that I’ve been reading books, articles, and studies on nutrition since I was in high school in the ‘70s (Adele Davis’s Let’s Get Well, Let’s Eat Right to Keep Fit, and Let’s Cook It Right), that’s really saying something. You can trust me when I say that this is the reference book you’ve been looking for. The Dirt Cure is the first truly holistic treatment of a topic that cries out for holistic treatment.
To begin with, Shetreat-Klein’s style is eminently readable with easily “digested,” if you will, chapters on everything you really want to know about, from how to recognize and treat food allergies and sensitivities to how to differentiate all the different labels on dairy products and the pros and cons of water filtration systems. Most chapters include valuable “Tips” and a “Take Home” at the end, summarizing the main points. The reason I say that this is a truly holistic guide is that each topic is covered from every conceivable angle, from the historical perspective to the medical, economic, and moral implications of our choices, while weaving in juicy tidbits of information that taken together convey a real sense of where each topic fits in the bigger picture.
Part I is an overview of how food does – or does not – support health. Shetreat-Klein starts by identifying what we mean by “a healthy child.” One would think that should be unnecessary; don’t we intuitively know what “healthy” is? Perhaps not. In modern times, chronic illness has become the norm. As it gets harder and harder to find children who are truly healthy, we forget what health really is. Many people will declare that their children are healthy, but upon further questioning reveal that the kids are on asthma and ADHD medications, have multiple food allergies, and suffer from chronic diarrhea or constipation. Shetreat-Klein emphatically states that this is not what she means by “healthy.” She gives a list of the characteristics of truly healthy children that make it clear just how far we have strayed from the mark. There is hope, however. Not only does Shetreat-Klein explain how chronic illness occurs, she offers a plan to remediate it by removing the things that are causing illnesses and adding back in the things that truly nourish.
Shetreat-Klein uses a simple basin and drain analogy to explain in clear and concise prose how a child’s system can be overwhelmed by environmental intoxicants. The basin represents the child’s reservoir. To function optimally, the reservoir must be kept clean and not overflow. The drain is the child’s ability to get rid of these intoxicants. A child’s overall level of health will be determined by the size of their basin (how much crap a child’s body can hold before showing ill effects), how clean the basin is at any particular time (how much crap the child’s body is currently holding), and how quickly the basin can be drained. These factors vary dramatically from child to child due to different genetic tendencies and environmental exposures that alter the epigenetic expression of those genes. This explains why the same exposure can tip one child into a debilitating neurological state, while another remains relatively unaffected. It also explains why there can be no one diet or eating plan that works for every child. A child’s return to health begins with cleaning out the basin by removing anything that disturbs the child’s mitochondrial and cellular health. As someone with an avid interest in nutrition and children’s health, I’ve been familiar with many of the individual points Shetreat-Klein makes in this section of the book, but had never seen or heard them put together in such an elegant and understandable way before.
The importance of the gut and microbiome in achieving and maintaining health is underscored by Shetreat-Klein’s repeated emphasis on the “terrain” of the body (as originally described by Louis Pasteur’s rival, Claude Bernard) and is mirrored by her emphasis on maintaining the health and balance of the literal terrain of the earth in which we grow our food. The basic construct of the book is truly basic: If we grow our food in a healthy external terrain, that food will in turn nourish and promote an internal terrain that gets and keeps our children healthy. Simple, intuitive, logical – and very far away from our current practices as a society. Paradoxically, “cleaning out” children’s basins involves an intimate association with literal terrain in the form of dirt, playing in it, growing in it, even eating some of it. After clearing out the things that are making our children sick, the next step is to add in things that support health, and Shetreat-Klein makes a compelling case that the best way to do that is with whole, nutrient-dense foods grown in rich, nutrient-dense soil. In addition to the logical arguments she presents, Shetreat-Klein provides so much scientific evidence for each of her points that it’s hard to argue.
As I said, Shetreat-Klein covers her topic from every angle, making the “Nourish” section of The Dirt Cure a comprehensive compilation of the most important things we now know about each topic she discusses, including fruits and vegetables, seeds (including grains, nuts, and legumes), meat, dairy, eggs, fish, and water. Along the way, she covers macronutrient issues (composition and type of carbohydrate, fat, and protein), as well as micronutrient issues (such as the most important vitamins we get from a particular food and how to identify the most nutritious forms). She discusses the history of each food, indicating where and how “science” crossed over into PR and advertising. Every other author I’ve ever read on this subject leaves out whole categories of information that are crucial for our overall understanding of where we are now, almost invariably viewing the subject through a narrow lens that ignores large chunks of history, political currents that affected the public’s perception of a particular food, or the millions of people who consume a particular food without ill effects, eventually providing an at least slightly distorted view of the overall picture.
If you’ve read anything about the Paleo craze, you may have the idea that human beings cannot be healthy if they eat anything that was not available to cavemen. Many will eschew all grains, legumes, fruits, and dairy products because they were not part of the original human diet. Shetreat-Klein gently disagrees with this approach and points out the ways that grains, nuts, and legumes can be very supportive of overall health, while explaining why most grains that are conventionally grown today are not. In addition, she tells us how to get the biggest nutritional bang out of our fruits. She provides support for her views by giving a brief history of the ways we have depleted the soil of the very things that make food nutritious, and mentions that, as Paleo enthusiasts correctly point out, while human genes cannot evolve quickly, the huge number of commensal single-celled organisms that we carry around can. Many of those organisms inhabit our guts and perform a variety of functions that greatly affect the nutrition that gets into our bloodstream. These organisms have been evolving with us, and we are as dependent upon them as they are on us. Supporting a highly diverse internal microbiome is probably the most important thing we can do for our health. Eliminating whole categories of traditional foods (in the absence of allergies and sensitivities) isn’t likely to be the best or only way to achieve that.
If you talk to militant vegans, on the other hand, you will be given the impression that eating meat is a sure path to every bad health outcome imaginable. I have been following all the back and forth between vegans and Paleo enthusiasts, feeling that while both have valid points, neither has captured the whole truth. You may have noticed that the official word on fat has changed, slowly and subtly, but most definitely, to the point where a 2014 TIME Magazine cover proclaimed “Eat Butter.” If you’re old enough, you know that that is a complete and utter reversal of the conventional wisdom of the 1960s and ‘70s. Commercials of that era touted high percentages of polyunsaturated fats contained in margarines as the ultimate in fat composition. And later we were informed that we should keep total fat in our diets to an absolute minimum, which resulted in the low-fat craze that we can still see remnants of in many products that line the shelves of our grocery stores. But as each new scientific study on fat’s effects in the body has come out, it has slowly dawned on the scientific community that virtually everything we thought we knew about fat in 1970 or ’80 was dead wrong. People who diligently followed old guidelines got fatter and developed type 2 diabetes and heart disease in higher percentages than ever before. Shetreat-Klein presents all the scientific and political history on fat, making it clear that the demonization of animal fats has been misguided at best, while also presenting some sensible and practical arguments for how to include meat in a way that supports the health of both individuals and the planet. As a vegetarian for the past 25 years, I particularly appreciate her comments on raising and butchering animals ethically and honoring the animal’s sacrifice by using all the parts.
I remember in my youth, smack in the middle of the low-cholesterol nadir, my father (who used to eat Egg Beaters) told me that when he was a kid they were told to eat eggs because they had cholesterol. That should have been my tip-off to how little anyone really knew about how the body uses the food we feed it. Or, perhaps more accurately, how seldom anyone looked at the whole picture. You see, what they knew back in the early 1900s, which is still true, is that cholesterol is required for many processes in the body, including the production of sex hormones and the myelination of our nerves, an extremely important process required for optimal functioning of the neurological system. Cholesterol acts as an anti-inflammatory and is manufactured by the body to combat high levels of inflammation. If we artificially drop cholesterol levels with statin drugs but don’t bring down the inflammation, we are setting ourselves up for disaster. Cholesterol used to be the single biggest reason why nutrition “experts” would advise drastic limitations in the consumption of eggs and milk fat. Shetreat-Klein makes short work of that argument as well as the more current argument that milk should not be consumed by anyone other than baby cows. As she points out, humans have used cow’s milk and goat’s milk throughout history without ill effects. The negative effects we notice today are more about the way cow’s milk is produced for mass consumption than the nature of the food itself. Shetreat-Klein provides a thorough overview of current farming and processing practices and how they have undermined the basic healthfulness of both dairy products and eggs, in the process giving us all the information we need to choose the best possible products.
One of the things I love about The Dirt Cure is that Shetreat-Klein practices what she preaches, and her love for her subject lights up every page. She’s a gardening enthusiast who keeps eight chickens — who lay up to 55 eggs per week in the summer time — in her own New York City yard. No holistic food guide would be complete without some how-to-do-it-yourself instruction, and Shetreat-Klein’s enthusiasm for enriching soil and producing fabulously nutritious foods is infectious. Her eggs sound so good that she’s even got me thinking about getting some chickens for my own backyard.
An odd touchstone I’ve always had in the back of my mind when reading recent diatribes against the very ideas of dairy products and breads made from grains is my warm memories of reading Heidi as a child. If you’re not familiar with it, Heidi, written by Johanna Spyri and published in 1881, is a book about a Swiss girl who grows up on a mountain in the Alps. She moves briefly to the city of Frankfurt, Germany where her health suffers greatly. When she moves back to her beloved mountain, she eats nothing but warm goat’s milk, straight from the goat, and thick peasant bread toasted with a layer of goat cheese. On this diet, which should be the kiss of death according to most nutritionists today, Heidi thrives. Then she invites her sickly-but-rich friend Clara Sesemann from Frankfort to visit, and she begins to thrive as well. This picture of an incredibly healthy child (no allergies, no asthma, no drugs, no sensory issues, and no neurological issues) growing up on a simple diet of milk, cheese, and bread doesn’t jive with much of today’s conventional wisdom on food. Yes, Heidi is a work of fiction, but folklore often contains a kernel of truth, and if Swiss children could not have bloomed with health on a diet like that, it just doesn’t make sense that the book would ever have been so well-loved. Now, having read Shetreat-Klein’s loving descriptions of how eating a rich and varied diet on a mountain pasture can make for very healthy animals, who in turn produce very nutritious milk teeming with active probiotic cultures, I finally understand how the milk from Heidi’s beloved goats could indeed be the super food that Johanna Spyri described so long ago.
I have a feeling that Shetreat-Klein is onto something big here. Maybe health really is as simple as keeping our internal terrain as healthy as possible by growing our food in as rich and nutrient-dense an external terrain as possible.
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