The Increasing Importance of Diet

On paper it doesn’t make sense to me. 

Thinking about it doesn’t make sense to me. 

But people [lots of people] maintain it works. 

When I was training over 20 years ago nutrition was one module in our degree course. Something that we acknowledged was a ‘useful’ addition to the complex mixes of medicinal herbs we would construct individually for our ill patients. 

Food was supportive, but peripheral. The real work happened in the tinctures, the decoctions, the carefully balanced phytochemical synergies… 

Two decades later, I have had a re-think. 

What once sat at the margins of clinical thinking has moved to the centre of some of the most compelling conversations in modern medicine. And not fringe conversations either, but the work of clinicians like Dr Chris Palmer1 and Dr Georgia Ede2, both Harvard‑trained psychiatrists, both deeply grounded in evidence, both willing to ask the question that has perhaps been ignored for far too long: 

What if diet is not just supportive, but foundational [ biologically, mechanistically, clinically]  to both physical and mental health? 

This shift didn’t happen because of ideology. It happened because of patients. 

Because people with chronic, treatment‑resistant conditions [depression, bipolar disorder, metabolic syndrome, autoimmune disease] began reporting improvements due to a change in diet that were too consistent and too physiologically plausible to ignore.  

Chris Palmer’s work reframed mental illness not as a purely psychological phenomenon but as a metabolic one. Talking about the ketogenic diet he says, 

“It also changes neurotransmitter levels, regulates calcium channels, decreases inflammation, improves the gut microbiome, increases overall metabolic rate, reduces insulin resistance…”1 

Palmer’s clinical observations showed that dietary interventions, particularly low-carbohydrate
and ketogenic patterns, could stabilise mood, reduce symptoms, and in some cases achieve remission where medications had failed.  Not because food is medicine in a vague holistic Hippocrates sense, but because food is the primary regulator of metabolic signalling. 

Georgia Ede took this further, mapping how specific dietary components [seed oils, refined carbohydrates, ultra‑processed foods] drive inflammation, oxidative stress, and neurotransmitter disruption. Her argument is simple but radical: the brain is an energy hungry organ, exquisitely sensitive to metabolic instability, and modern diets destabilise it. 

Once you see that, you can’t unsee it. 

This is where things get uncomfortable for conventional nutrition, and for me. The more meat-based diets, the ketogenic diets, starting infiltrating my cosy mind-set. These ‘extreme’ diets don’t make sense to me. 

Because on paper, a carnivore or ketogenic diet shouldn’t work, at least not for the long term. It is the antithesis of the plant‑rich, fibre‑heavy, whole‑grain‑centred models I was taught. It breaks every rule of balanced eating. They look extreme. 

And yet people with rheumatoid arthritis, Crohn’s disease, psoriasis, depression, anxiety, and chronic pain keep reporting improvements. Not subtle improvements, but life‑altering ones. For some individuals, particularly those with autoimmune or inflammatory conditions, the removal of plants appears to quiet the immune system in a way nothing else has. 

…the way we eat has a profound impact on brain development, neurotransmitters, stress hormones, inflammation, antioxidant capacity, brain energy production, brain aging, and brain healing.2 

So where does this leave me? 

Not with dogma. Not with a single dietary prescription for all humans. But with a clear, unavoidable truth: 

Diet is not an accessory to health. It is a primary driver of it. 

Twenty years ago, I was taught that nutrition was a helpful adjunct to herbal medicine. Today, I would invert that entirely. Herbs can support. Lifestyle can support. But diet is the daily metabolic input that shapes every cell, every hormone, every immune signal and is the foundation. And sometimes, the interventions that ‘don’t make sense on paper’ are the ones that force us to rewrite the paper. 

How does this affect me? 

I concentrate much more on dietary interventions and use herbs as the accessory. This, at least, does make sense while I finish reading Dr Ede’s book and get to grips with her research. Then I will let you know what I think of the carnivore diet. 

Whether I like it or not…