I recently spent some time at a hospital with a family member who had a heart attack. And I’m shocked to be reminded of the mainstream medical establishment’s attitude toward food.

This is what a cardiologist said about his patient at one of New England’s “finest” hospitals:

He certainly seems to enjoy his food! [Snicker.] Well, I think we know what caused this heart attack, don’t we? [Wink, wink.] Probably not much chance of a heart-healthy diet for him, is there? All that fat…. [Shaking his head.] Well, we’ll just make sure he takes lots—and I mean lots—of lipitor. [Smiling as he moves on to the next patient-victim.]

Wow.

Classic food puritanism mixed with backward nutritional advice. What a doctor.

His first mistake: Assuming that the enjoyment of food is inherently unhealthy. (After all, pleasure is a sin, isn’t it?)

His second mistake: Defining a “heart-healthy” diet as low in fat but not necessarily low in sugar. (None of the hospital’s nutritional literature mentioned the relationship between blood sugar and heart disease.)

His third mistake: Declaring that there’s no use bothering with a patient’s diet when you can prescribe medications instead. (Especially medications with dangerous side effects.)

Absolutely infuriating, this cardiologist.

My boyfriend says I “shouted him down.” Not quite, though I might have been a little sharp. After all, he was a condescending twit.

I’m not going to go into all the details of why the conventional “heart-healthy” low-fat diet is wrongheaded. For that, you might check out Nina Planck’s Real Food: What to Eat and Why.

But I will say this: Doctors seem to be most comfortable condemning and blessing foods in categories: butter is bad, olive oil is good; beef is bad, fish is good. But really it’s not like that at all. It’s a question of what kind of butter or olive oil, beef or fish. Conventional feedlot beef and butter are straight-out poisonous, it’s true. But grassfed beef and butter contain Omega-3s and CLA—truly “heart-healthy” fats. Likewise organic extra virgin olive oil and wild-caught fish are great for your heart, but solvent and pesticide-laden “pure” olive oil and antibiotic-laced farmed fish are not.

So the challenge for this family member of mine is not to eliminate all fat from his diet, but to learn the difference between butter and butter, between fish and fish, between olive oil and olive oil—to learn the difference between modern industrial foods (refined sugar and flour, hydrogenated oils, fake sweeteners) and real, nutritious foods (traditional fats, grassfed meat, fermented whole grains).

(Oh, yeah, I can’t even begin to write about the food they fed him in the hospital. Are they trying to murder people, or what?)

(This is the third post in a series on my herbal philosophy. The first two posts were The body is an ecosystem and The body is not a war zone.)

Conventional medicine tends to think of the body as a battleground rather than an ecosystem. It takes a divide-and-conquer approach, dissecting the body into little pieces and forgetting how to put them together again.

I have a feeling that a lot of doctors and researchers fall into this trap because they’re drowning in a sea of microbiological information—they aren’t given the time or space or training to think about “macrobiology” or body ecology. So we have a proliferation of gastroenterologists and neurologists and dermatologists and fewer and fewer general practitioners. There really is an immense amount to know about the details of the human body, and specialization makes sense as a way to process those details. But the thing is, health problems are not specialized.

Take Irritable Bowel Syndrome (IBS)—a common diagnosis these days. It’s a condition that usually involves a person’s nutritional status, digestive system, nervous system, immune system and psyche. Say an IBS patient gets violent diarrhea when she eats foods that have wheat in them. Her doctor says “Your allergy tests came back negative. You’re not allergic to wheat.” And she leaves her doctor’s office with a prescription for a drug with serious side effects.

Luckily, there are still doctors out there with enough common sense to say “Okay, if wheat makes you feel bad, just don’t eat it,” regardless of test results. But it’s all too common for doctors to rush in with invasive battleground-style treatments where simple ecological changes—lifestyle, diet, stress reduction—would be enough.

And doctors don’t have a monopoly on the body-as-battleground theory of disease either. There are plenty of herbalists and herbal salespeople out there who use plants with the same mindset. (Don’t get me started on people who tout echinacea and goldenseal as “herbal antibiotics.”)

As an herbalist, I work on the assumption that the body is a vital, resilient ecosystem. Everything I suggest to people is intended to support and revitalize the ecology of their bodies. So the disclosure statement my clients sign that says I work with them to “support health” rather than “treat disease”? It’s not some legal word game to avoid practicing medicine without a license—it’s absolutely true.

I do not cure anything. Herbs as I use them do not cure anything.

Human ecosystems heal themselves.

Next in this series: Why I’m not a big fan of the body-as-temple theory of health.

Difficulty sleeping comes in many forms.

Trouble Falling Asleep can be associated with tension, excess nervous energy (“heat”) or a depleted nervous system (“cold”). My favorite herbs for falling asleep are kava (Piper methysticum) for tension, hops (Humulus lupulus) for heat and valerian (Valeriana officinalis) for cold. (Detailed indications for these herbs.)

Trouble Staying Asleep is usually associated with tension or excess nervous energy (heat), but it can sometimes be related to depletion (cold) as well. My favorite herbs for staying asleep are passionflower (Passiflora incarnata) for tension, peach leaf (Prunus persica) for heat and holy basil (Ocimum tenuiflorum) for cold. (Detailed indications for these herbs.)

Trouble Waking Up (aka waking up with that run-over-by-a-truck feeling) is common in people whose bodies are sluggish or depleted overall. Lymphatic and liver-supporting herbs are the thing to use here. Some of my favorites are cleavers (Galium aparine) and all heal (Prunella vulgaris) for sluggishness and rosemary (Rosmarinus officinalis) and oats (Avena sativa) for depletion. (I haven’t posted detailed indications for these herbs yet. Some of them are in Matt Wood’s book, listed below.)

Basic sleep hygiene applies in every case of sleep trouble: Dark and quiet bedroom (no TV), no caffeine/stimulants in the afternoon (or at all), good exercise (but not in the evening), good relaxing and good food.

Important: It is always best to choose herbs carefully, based on an individual’s constitution. Don’t think “valerian is good for insomnia.” Ask “Is valerian good for this person?” There is no insomnia, only a person. (If you give valerian to someone who has a hot constitution, it can have a stimulant effect; if you give hops to someone with a cold constitution, it can be depressing.) I never like to recommend herbs for anyone without seeing them and talking to them first. Again: herbs are for people, not for conditions.

N.B.: Heat/Cold and Tension/Sluggishness are part of a system of “energetics” that many herbalists use to understand human bodies and match them with appropriate herbs. Someday I will blog about energetics, but in the meantime the best introductory discussion of western-style herbal energetics that I know of is in Matthew Wood’s book The Practice of Traditional Western Herbalism.

One of the most common questions people ask me as an herbalist is “What can I take to help me sleep?” Since the underlying cause of insomnia is usually stress, working with the appropriate calming and comforting herbs is a good place to start.

In my post on comforting herbs, I mentioned that hops can be taken as tea or tincture to help with stress and insomnia—but my favorite way to use hops to encourage sleep is with hop pillows. The aroma of good quality hops is a gentle, effective soporific (so effective that people who pick hops all day sometimes get sleepy on the job).

Here’s how to make a hop pillow:

Make or find a small cloth bag. I generally make mine out of two 3×5 inch pieces of quilting cotton, but a large muslin teabag works well.

Fill the bag with good quality hops. Good hops should be fresh, more green than brown, and very aromatic. If you have trouble finding good hops, try a brewing supply store. Most bulk dried hops you find in herb stores are old and sad. (Herb stores often don’t take very good care of their bulk dried herbs, but that’s a topic for another post.)

After you’ve filled the bag with hops, sew or fasten it closed—tight enough so that if you roll over on it at night, you won’t wake up to a bed full of hops.

Sleep with the pillow close enough to smell it. (I like to give mine a few good squeezes to release the aroma when I get in bed.)

Sweet dreams!

(N.B. Most herbalists consider hops to be contraindicated in cases of depression. I think this is less of an issue with hop pillows, but it’s definitely something to consider. Always pay close attention to your reactions to any herb—if your instinct says something isn’t good for you, don’t use it!)

Most of us are ready for some comfort right about now. Holiday chaos is behind us, we’ve more or less survived, and it’s time to get quiet and cozy and rebuild our reserves.

Here are indications or “symptom pictures” for some calming and comforting herbs. A symptom picture is a great way to get to know an herb better—it describes the characteristics of a person who fits a particular herb. All of these herbs could be considered nervines that are good for “stress,” but you get the best results with plants if you pay close attention to details.

Bee Balm (Monarda didyma or M. fistulosa): Nervous stomach, “Irritable Bowel Syndrome,” someone who is passionate and intense but holding back. [Tincture or tea.]

California Poppy (Eschscholzia californica): Agitation and insomnia with pain. [Tincture or tea.]

Catnip (Nepeta cataria): Stress stomachaches, cold headaches, overstimulation and colic in children. [Tincture or tea.]

Chamomile (Matricaria recutita or Chamaemelum nobile): Irritability, petulance, complaining, impatience, “acting like a baby.” [Tea.]

Holy Basil (Ocimum tenuiflorum and O. gratissimum): Tension with fear underneath, running on adrenaline, trying to control things. [Tincture or tea.]

Hops (Humulus lupulus): Anxiety, muscle twitching, muscle and digestive tension, insomnia. [Tincture or tea.]

Kava (Piper methysticum): Muscle pain and tension, worry, “wrapped up in knots.” [Tincture.]

Lavender (Lavandula angustifolia): Nervous excitement, giddiness, headache. Culpeper says: “tremblings and passions of the heart.” [Tea.]

Lemon Balm (Melissa officinalis): Speedy feeling, racing heart, can’t calm down. [Tincture or tea.]

Linden (Tilia x europaea or T. americana): Heartache, sadness, palpitations, nervous nausea and vomiting. [Tea.]

Milky Oats (Avena sativa): Run down and weak, drained nerves and body. Hildegard suggests oat water in a sauna for “a divided mind and crazy thoughts.” [Tincture or tea.]

Motherwort (Leonurus cardiaca): Heartbreak, grief, emotions feel out of control. [Tincture or tea.]

Mullein (Verbascum thapsus): Raw, in need of soothing. Hildegard: “one whose heart is weak and sad.” [Tincture or tea.]

Passionflower (Passiflora incarnata): Racing thoughts, tremors, irritation. Tommie Bass used it to restore peace in relationships where people get irritated with each other over little things. [Tincture or tea.]

Peach Leaf (Prunus persica): Sensitivity, overstimulation, overheated, nervous nausea and vomiting. [Tincture or tea.]

Scullcap (Scutellaria lateriflora): Fear, anger, nightmares, physical spasms. [Tincture or tea.]

Sweet Violet (Viola odorata): Anger, headache from heat. Hildegard: “a discontented mind.” [Tincture.]

Valerian (Valeriana officinalis): Pale, cold, weak, spacy, agitated, can’t sleep, can’t catch breath. [Tincture.]

Vervain (Verbena officinalis and V. hastata): Driven, perfectionist, striving, tense neck muscles. [Tincture.]

Wild Lettuce (Lactuca virosa and L. canadensis): Been through trauma, deadened, cold, feel numb, stiff muscles. [Tincture.]

If you’re interested in learning to relate to herbs in terms of symptom pictures, Matthew Wood’s books are a great place to start. But really it’s just a question of getting to know the plants personally.

More notes on allergies and sensitivities:

1. We’re all sensitive to the barrage of toxic crap we breathe, eat and drink.

2. Dealing with the barrage of toxic crap increases our sensitivity to potential allergens and irritants.

3. Allergy and sensitivity are directly related to overall health and stress levels.

Some people seem to think that immune reactions are as fundamental and unchanging as eye or skin color. Not so. Our bodies are much more interesting than that. Our immune reactions are often mediated by stress—psychological or physical.

It’s possible to be allergic to something only when you’re stressed out. I see this often in people who have been diagnosed with “Irritable Bowel Syndrome.”
They can eat a trigger food with no problem most of the time, but if they’re tired or stressed out, the food triggers an IBS attack. So the real trigger is the interaction between the food and the stress. Knowing this, people can learn their triggers and take care of their health much more easily. They can say “I’ve had a long day, and wheat is a stress-related trigger for me, so let’s have rice for dinner instead of pasta.”

It makes sense to me that our nervous systems and our immune systems are so closely connected. If we’re feeling threatened in one sphere, why shouldn’t all our systems be up in arms?

Here’s a funny, geeky bit about stress and immune reactions:

“Psychological stress may be conceptualized as a social pollutant that, when ‘breathed’ into the body, may disrupt biological systems related to inflammation through mechanisms potentially overlapping with those altered by physical pollutants and toxicants.” From The impact of stress on the development and expression of atopy. Current Opinion in Allergy & Clinical Immunology. 5(1):23-29, February 2005. Wright, Rosalind J a; Cohen, Robyn T b; Cohen, Sheldon c

Food sensitivities are in style now. Gluten/wheat and casein/dairy are the most commonly cited offenders. I have a suspicion about this: most people feel better when they eliminate wheat and dairy from their diets because most wheat and dairy products people eat are just plain bad food.

I don’t doubt the existence of food sensitivities. I have several herbal clients who have clear negative reactions to gluten and/or casein in any form. For them, scrupulous avoidance is the only choice. But I think there’s a difference between a true food sensitivity and the universal sensitivity to bad food. And to help determine that difference, I’ve added some elements to the tried-and-true elimination diet.

The old-time common-sense approach is: if a food makes you feel bad, don’t eat it. An elimination diet is just a fine-tuning of that sensible bit of advice. These are the elements of a traditional elimination diet:

For at least 3 weeks, avoid all potential trigger foods. (I like to develop a list of potential trigger foods based on an individual’s health status, ancestry and dietary history. The most common trigger foods are: dairy, wheat and other gluten grains, corn, soy, rice, eggs, citrus, fish and nuts.)

At the end of the month, reintroduce the foods one at a time, carefully observing possible reactions. (Each food needs to be eaten in quantity on two occasions, separated by 2-3 days in order to “prime” the immune system for a potential reaction.)

To this sensible system, I add the following:

In addition to avoiding potential trigger foods during the elimination and testing period, avoid all foods on the bad or sketchy food lists. And when you reintroduce the suspected trigger food, reintroduce it in the healthiest form available (e.g., if you suspect wheat, reintroduce it as long-fermented sourdough or levain-type bread rather than pasta or quick bread).

I suspect that using this system, quite a few people who feel they’re sensitive to all wheat (or dairy, or corn, etc., etc.) might find they’re only sensitive to the bad or sketchy forms of the food in question.