A slightly more personal message than usual as drbriffa.com reaches the 500 mark

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Today’s blog is actually drbriffa.com’s 500th article. Right from the outset, my aim with drbriffa.com has been to use it as a portal for giving trustworthy and accurate advice about a broad range of topics that relate to health and wellbeing. In order to do this, I try and mix what can be learned from published research with the experience I have been fortunate enough to gain over the years through working with real people with real problems. I actually think this clinical experience has been invaluable in informing me about what tends to work (and what doesn’t). I bring this experience into my writing whenever I can.

I reckon part of the value in blogging comes from being able to develop a more intimate relationship with the reader than is generally possible with other media. It’s a format that allows the sharing of professional experience. It also allows, I think, some sharing of personal experience too.

Some of you may have noticed that I will, from time to time, write about issues I have experienced in my own life. This has included really quite intimate issues including having an unhealthy disrespect for my parents for many years (as discussed in my book Ultimate Health), and my ability for many years to go through relationships like a knife through butter (as detailed in the book Soul Secrets). I’ve also shared details of my own personal lifestyle habits including my past issues with ‘addictions’ to cigarettes and crap TV.

The sharing of this sort of information may seem to some as self-indulgent, but is actually based in my recognition that I am no different to and am prone to the same issues as anyone else. As I mentioned in my blog last Monday, I don’t believe I have the whole of life sussed, and I’m certainly not magically immune to life’s challenges. Why hide this? And there’s always the chance that sharing my experiences may help others deal with their own issues.

So, when thinking about what I’d like to share with the 500th piece on the site I came to the conclusion that I’d like to give a more personal insight into my background, motivations, beliefs and philosophies than you can get from reading my rather turgid CV/resume. With that in mind, I’ve added here a piece I used to announce my column in the Observer Magazine in the UK which ran from 2002 to 2006. It gives a potted history of my life, my work and how it is I came to be doing the job that I do. Every word of it is as true now as it was when I wrote it.

I’d also like to take this opportunity to thank those of you who visit drbriffa.com regularly for your support. And a special thank you goes out to those of you who have posted insightful and thoughtful comments on the site – I don’t always have time to respond or comment further, but this input is genuinely appreciated.

Doctor in the House

As a doctor specialising in the nutritional management of health and disease, you might imagine that food assumed an important influence in my life from an early age. Actually, nothing could be further from the truth. I am the youngest of five children, and both my parents worked full time. With no hired help in the home, my mother simply did not have the time to concoct tasty and nutritious meals for the family. Quantity, not quality, was the order of the day.

Accordingly, my poor mum amassed a repertoire of about half a dozen rapid-fire but uninspiring dishes that were circulated on a rota system throughout the week. Affectionate piss-taking was the main form of communication among us children, and my mother’s culinary efforts were duly renamed Briffa-style. Shepherd’s pie, lamb curry and Irish stew became shepherd’s penis, lamb slurry and Irish spew respectively. A flan my mother often made comprising the residue from other meals was referred to as ‘phlegm’. We always had a catering sized jar of piccalilli on hand to camouflage the taste of anything truly awful. This we referred to as ‘the antidote’.

When I left home to go to medical school my dietary habits slid further downhill. I subsisted mainly on pizzas, kebabs, and Kentucky Fried Chicken. For most of my training I shared a dilapidated Victorian House in Finsbury Park with four friends. Occasionally, I ventured into the kitchen to prepare a meal for me and the boys. I cooked pasta, which I only did one way. In our house, my tomatoey, bacony, mushroomy sauce became as infamous as my own mother’s fare. Maybe it is true what they say about children turning into their parents.

Another area where I just might have been influenced by my parents is in my choice of career. Both my parents are doctors, yet neither of them encouraged me to follow the same path. In fact, they very rarely talked about medicine at all. If my parents did steer my course in some way, they were subtle about it. Whether subliminally influenced or not, by the age of eleven I was pretty much set on being a doctor. I went straight from school to start my training at University College London Medical School.

Starting medical school turned out to be a bit of a culture shock for me. The product of a state-education in suburban Essex, I had spent my school years feeling like I could hold my own academically. Overnight, I morphed into an intellectual minnow in a sea full of able-minded sharks. Rather than attempt to compete, my reaction was to opt out. I failed my first year exams, coming a spectacularly dismal 139th out of 140 in anatomy. I was not entirely deterred however, and got through on the re-takes.

After two years studying basic sciences such as biochemistry, neurophysiology, genetics and microbiology (all of which I found as dull as dishwater), I enrolled on a one-year BSc degree programme in Immunology. This duly completed, it was time to progress to the hospital wards. For the whole of my time at medical school, I wore my hair long. I suppose this would have been fine if I had been a brilliant student. But in truth I found studying medicine an immense chore, and never really applied myself to the task. My patchy knowledge, coupled with my ponytail, meant that I was generally viewed as canon-fodder at ward rounds and tutorials. During one particularly excruciating cross-examination, the Professor of Medicine at my teaching hospital described me as the most inept medical student he had ever taught.

The medical establishment did not warm to me, but to be honest, there was no love lost here. I was never comfortable with what I saw as the rather autocratic and egocentric approach of many of the doctors responsible for my education. I had major reservations about the largely symptom-suppressive approach orthodox medicine takes. And while conventional medicine clearly has its place, it did seem to me that much of it was pretty ineffective and sometimes downright dangerous. The thought of practising conventional medicine for the rest of my working life turned me cold. Now almost six years into my training, I decided I didn’t want to be a ‘medic’ after all.

Through a concerted effort in the last few months of my training I gained a degree in medicine. The medical school recognised my efforts on the stage (I was a keen actor in those days) and in the bar by awarding me the prize for contributions to extra-curricular activities. By some strange and rather ironic twist of fate I managed to scoop a couple of academic prizes too. In an odd way my last gasp academic success, rather than causing me to question my decision to leave medicine, just cemented it. I served my one-year apprenticeship in hospital medicine as a junior doctor, and started to do locums while I contemplated my next move.

On one such posting, I admitted an elderly man who had come in for a hernia repair. Although he was in his seventies, he didn’t look older than sixty. He was fit and robust, and, unusually for his age, had never been in hospital before. The icing on the cake for me was when he told me he and his wife were still ‘getting plenty’. I was agog and fascinated with how this man had managed to keep himself in such good health. When I asked him about this, he told me that he’d always eaten a simple healthy diet, which now included organic vegetables which he grew on an allotment. He cycled several miles each day, and also confessed to taking nutritional supplements.

Intrigued by this man’s approach to life, I began to buy books about diet and nutrition, initially with a personal interest in shedding about a stone in excess baggage and transforming the rather grey sense of well-being that had plagued me for years. For some months I read voraciously about nutrition and natural health. On the strength of this new-found knowledge, I decided to experiment, using my own body as the guinea pig. I made a few basic dietary and lifestyle changes, and quite quickly came down to my fighting weight. Not only that, but I also felt healthier than I had done in ages. Propelled by this early success, I resolved to make nutritional medicine my career.

Naïve and somewhat blinkered by my experience of life, I did not know that a sizeable natural health industry was in full swing in the UK. I started work in a diet clinic, imagining this was where nutritionally-oriented doctors plied their trade. As it happened, prescribing a high-protein diet and dolling out appetite suppressants was not to be my destiny. I ended up starting a practice in nutritional medicine in the City of London, and about three years ago migrated to rooms and a private hospital in North London.

I love my work. I thrive on variety and freedom in my life and being self-employed suits me down to the ground. My work is split pretty much equally between clinical practice, researching and writing, and lecturing. In my practices I see a wide range of health issues, both physical and emotional. My writing encompasses books, newspapers and magazines. Speaking engagements take me to some far-flung places, and my audience might be practitioners, the general public or corporations. Boredom rarely features in my life, but it’s not all plain sailing either. Juggling a number of different commitments is and art in itself, and sometimes things can get pretty fraught. Fortunately, I am blessed with a fabulous personal assistant who is terribly organised and efficient, and whose irreverent wit makes me laugh out loud every time we speak.

Most of my patients suffer from long-standing symptoms or conditions that have yet to be explained, or the treatment for which has proved ineffective. Usually, a fair proportion of my approach is geared to finding the right diet for the individual. For me, using the diet to heal illness makes sense because so many symptoms or conditions are nutritionally related. Headaches and migraine, for example, are often related to factors such as dehydration, caffeine withdrawal, sensitivity to specific foods, magnesium deficiency and instability in the level of sugar in the blood stream. By working nutritionally, we at least have the potential to identify and correct the true underlying cause of an individual’s headaches, or whatever else happens to be ailing them. Conventional medicine, on the other hand, rarely treats illness at its root. Headaches, after all, are not caused by a paracetamol deficiency.

I often use food supplements and medicinal herbs as an adjunct to dietary change or manipulation. There is now a wealth of research which shows taking nutrients or medicinal herbs in supplement form can be effective in preventing or treating medical conditions. For instance, overwhelming evidence supports the use of glucosamine sulphate in the treatment of osteoarthritis, and the herb St John’s Wort has been proven to be effective for depression.

I like to keep abreast of the research in natural health and medicine, and will sometimes draw on this in my column. Sometimes, I may also present ideas or concepts that have not been formally studied and are therefore not thought to be ‘scientifically validated’. However, let us not lose sight of the fact that just because an approach has not been studied, does not necessarily mean it is ineffective. Absence of proof does not mean proof of absence.

Despite my scientific background, I am alive to the fact that science can sometimes be a pretty blunt tool with which to dissect reality. The closer I look at medical and nutritional research, the more I realise it is filled with inconsistencies and anomalies. It is not uncommon for similar studies to show quite contradictory results. And it’s amazing what a bit of nifty statistical manipulation can do to the apparent findings of a study. Lies, damned lies and statistics I think they call it. Opinion is generally based on the ‘balance of evidence’. However, much research is never published because it did not yield the expected or desired result. This means that the balance of evidence may not be very balanced at all. Worse still, fraud and misconduct is known to occur in research, which means that even in scientific and medical journals, we cannot always believe what we read.

So, why I recognise that science can sometimes provide us with useful pointers about how best to overcome illness and improve health, I’m no slave to it. Many of the concepts and approaches I use in my work are based on common sense and what has been found to work in practice. I will work nutritionally with almost all patients, but I often also explore with them other physiologically based factors in health, such as breathing, and the function of important organs such as the thyroid and adrenal glands. While getting the physical body going is important, as the Barefoot Doctor I suspect will agree, it’s not the whole story either. For this reason, we’ll often sneak a peak at the emotions too, and look at ways to resolve issues here.

While we are often advised to eat a ‘healthy, balanced diet’, it’s amazing how little agreement there is on what this actually means. There does not even seem to be a consensus on whether foods such as pasta or bread are healthy or not, or if margarine really is better than butter. In the World of nutrition, it seems that confusion reigns. My belief is that the place specific foods have in the diet needs to be taken in the context of our diet as a whole. For instance, broccoli may be a healthy food, but eating nothing but broccoli does not make for a healthy diet. By the same token, the odd crème brûlée or bottle of Merlot is not necessarily a problem, as long as the broad base of the diet is sound. As with most things in life, eating healthily is about balance.

If we are going to look at specific foods, however, my belief is that the diet should based on the foods we evolved on, because it stands to reason that these are the foods we are best adapted to. The bulk of the evidence suggests that a diet rich in foods such as fruits, vegetables, beans, pulses, nuts, seeds and fish (all as unadulterated as possible) is the best for us. Even moderate amounts of meat and eggs appear to be compatible with a healthy diet: a close look at the evidence reveals that the link between saturated fat and disease is not nearly as clear or as strong as we have been led to believe.

There is emerging evidence that the real dietary spectres for many of us come in the form of foods rich in refined sugars and starches such as many pastas, breads, breakfast cereals, confectionery, soft drinks and snack foods. Other food components that appear to be giving cause for concern are the ‘partially hydrogenated’ or ‘trans’ fats that have only been in our diet in appreciable quantities in the last few decades. These fats lace more and more of the foods we eat including most margarines and many processed, baked and take-away foods.

To my mind, many of the health problems we face in the 21st century come, at least in part, from eating a diet that is light years away from the one we evolved on. It’s easy to imagine hunter-gatherers subsisting on a diet of fruit, vegetables, nuts, seeds, beans, pulses and eggs, interspersed with the odd meat or fish supper. On the other hand, can you really see early man sitting around the campfire tucking into plates of pasta Neopolitana? I don’t think so. Study after study shows that when populations switch from an indigenous diet to a more ‘Westernised’ style of eating, the risk of problems such as obesity and degenerative conditions rises accordingly. Nutritional thinking, it appears, is coming full circle. There is now a compelling argument for our return to a diet based on basic ingredients that are innate to the human diet. Irish spew, anyone?

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Walking versus running

I recently read an interesting editorial in the Journal of American College of Cardiology about the relative benefits of walking and running [1]. The editorial

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