I’m reading a book right now that was recommended by one of my favorite doctors. I’ve really enjoyed and learned a lot from 95% of this book but there was one section that really stood out to me in a bad way. The chapter is talking about autoimmune conditions and all the factors that can trigger or worsen these conditions. In one chapter the author cites 133 different medical studies/scholarly papers. That’s pretty impressive. But then the last few pages of the chapter are very different.
In the last few pages the chapter shifts from talking about factors that trigger or worsen autoimmune conditions to prescribing treatment plans that all autoimmune patients should follow. The first is trying medication, the second is to quit smoking (if you do). Pretty straight forward stuff. But then we get to the section on diet.
The diet section starts out pretty inoffensively. The advice is to eat more whole foods; plants, animals, herbs, fish, etc… But then it quickly pivots to describing the things that you should under no circumstances put into your mouth. The list includes anything with a chemical name (regardless of what it is), preservatives, additives, GMOs, gluten, sugar, and saturated fats.
Even if we agree with the assertion that all those things are categorically bad for a person (which in many cases is murky at best) that’s still a pretty impossible way for a chronically ill patient to eat. In order to eat this way a person would need to cook 100% of their own food from scratch. And I mean totally from scratch. No premade sauces or frozen foods. As an example, soy sauce almost always has preservatives in it. Should we be fermenting our own soy sauce at home to avoid this? If we cut out gluten then we will probably end up eating more corn products since corn is a gluten free grain. The problem is that corn is very often a GMO and in this country labeling GMO foods is not required so you couldn’t even know. Even if you were to grow your own corn it would be hit and miss to get seeds that aren’t GMO.
I would guess that in order to follow those dietary guidelines a person would need to spend 5 or more hours a day cooking or working on food related projects. But the people being prescribed this diet are often extremely ill, sometimes completely bed bound. In order to pay for food of this caliber you would need to hire a personal chef since eating out is out of the question with those requirements.
The next section of the book encourages patients to detoxify their lives by avoiding all contact with all chemicals. Again, this is not a reasonable thing to expect anyone to be able to do. If we want to regulate chemicals that’s a job for national governments and the UN to tackle. As an individual I can’t control if my neighbors use roundup. Even buying food from local farmers wouldn’t be a guarantee that no chemicals were used at any part of the food growing process. That’s not even getting into cleaning products. You can choose the cleaning products you use in your own home but what about when you have to go to a store or a hospital? And then there’s mold, which we are told to avoid as if we are regularly sticking our faces into bags of moldy bread and taking a big whiff.
The problem with telling chronic illness patients to make these types of sweeping and life altering changes is that no one can actually achieve this. You are basing the treatment plan on actions that cannot possibly be accomplished. What this means is that when the patient comes back and is still sick the doctor can wash their hands of them and say they just didn’t try hard enough. It lays the onus and eventually the blame on the sick person for not being superhuman.
But then as I was reading these totally undoable lifestyle changes I noticed something else. Neither the section on diet nor the section on toxins had any cited sources. Not a single one. In a chapter with 133 cited sources. The author made a decision to prescribe these treatments without any scientific backing at all.
If I had to guess I would say that there’s a good bit of science about what things can go wrong in a body under attack from an autoimmune disease but not a lot of good science about how to fix those problems. The right thing to do in that scenario would be to admit that we just don’t know enough yet about how to fix these types of problems. Perhaps put out a call for more research. Instead this author asks sick patients to do impossible things. It’s just putting up another barrier to care for chronically ill patients.
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