By Simon Martin
After a lifetime dedicated to pioneering nutrition and mental health, Patrick Holford—founder of the Institute for Optimum Nutrition (ION) and the visionary behind Food for the Brain—will be stepping down as CEO in 2025 (but will remain very much involved). Over the past 40 years, Patrick’s radical and impactful work has included establishing ION, writing 47 books translated into 30 languages, and building Food for the Brain into a global force for mental health support and prevention.
To mark this milestone, we’re delighted to share this exclusive interview with Patrick Holford by Simon Martin Editor of IHCAN magazine. From humble beginnings—selling self-published books from the back of a battered Skoda—Patrick’s mission has transformed into a fast growing, global research and education charity, changing lives by promoting prevention and optimal nutrition to address the increasing prevalence of mental health challenges.
Discover Patrick’s journey, his insights, and what’s next for his enduring legacy.
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SIMON MARTIN: Let’s start at the end, with your latest project – preventing Alzheimer’s. Did you get interested in Alzheimer’s because you’re worried about it yourself, or because you saw where things were going?
PATRICK HOLFORD: Some years ago, I realised we knew what to do to prevent all these chronic diseases, and it HAS to be prevention. And as much as I love the whole mission where I started from, creating the profession that could then theoretically work with doctors and lots of people, the issue is, “How do you do prevention on a big scale?”
I’ve pondered that for many years. And then I thought Alzheimer’s might be a very good place to start, although ten years ago, “Alzheimer’s is preventable” was a radical statement. But I figured it would become the number one fear and the number one killer and the number one health cost. Since it is, in essence, irreversible – once you’ve got holes in your brain – you’ve got to think about prevention.
I also rather loved the homocysteine research, which was pure functional medicine or optimum nutrition. In other words, we’re not all the same, sometimes you have to test. The use of nutrients to reverse a process is very clear in the world of homocysteine, and in fact arguing that case, which is also the case for B12, opens up the door for supplements, which, of course, is a bête noir for the medical establishment. They’re very happy to talk about a bit of diet and exercise, but the concept that one might actually have to take a supplement, and that it might in fact even work better than a drug, is a big paradigm shift. So I decided to focus on Alzheimer’s prevention. In truth, when you look at it, the eight drivers, as we organise the data, are just as applicable to diabetes or heart disease or anything else.
SM: I was reading the news this morning and the Daily Mail had two “health” stories. One was a “Probiotics will kill you” type headline on a complete mess of a case report where doctors had given a bacterial pill to someone who was seriously ill with a number of overlapping diagnostic labels, and he died. Then they decided to feature a new study that claims that everything from turmeric to ashwagandha can give you liver disease. I mean – it’s 2024, and they’re still at it.
So as we celebrate ION’s 40th, part of the history we should look at is how often we’ve been first with stuff, from supplements, to probiotics to junk food – or ultra-processed foods as they call them now – and orthodox medicine is still catching up. With Alzheimer’s, of course, we’re ahead again.
But let’s rewind to the start. I was upset to realise that I don’t have a picture of our first meeting, which was when I was editor of Here’s Health, so must have been around 1980. I think you were working for Green Farm at the time.
PH: My first awakening really was at Green Farm through Brian and Celia Wright, who had some very interesting ideas about nutrition.
I was studying psychology at York university, and even then I was very interested in consciousness and mental health. I didn’t really have nutrition on the map, and so I was really learning from them. When I left university, two things happened. One was I was introduced to the book by Dr Carl Pfeiffer called Mental and Elemental Nutrients…
SM: I still have a copy on my shelf.
PH:…which is really brilliant. And then I was introduced to the research of Dr Abram Hoffer. I didn’t realise at the time, but his double-blind trials on high-dose niacin in the ‘50s were
the first ever on a nutrient in the history of psychiatry. I’d already dabbled in various forms of psychotherapy and I was thinking of going in that direction and by whatever quirk of fate, York university was doing quite a lot of research into schizophrenia. I remember at the time saying, “Could we meet one please?” But that didn’t seem to be on the agenda.
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SM: What do you mean – “meet one”?
PH: Could we meet someone suffering from schizophrenia. Because I had got into construct theory, which is to do with the fact that when we talk about depression, for example, what you mean by depression and what I mean are very different things. They’re constructs. So in my holidays, I was volunteering in alcohol addiction centres. I joined a group for heroin addicts who had a choice of going to prison or going into this sort of reform school. So I went to work there, and I met schizophrenics; I just wanted to know the nature of the beast, so to speak. And around that time, I bumped into Brian and Celia, who I invited to give a talk for us. We were very into neurochemistry at York. I wasn’t so interested, but it gave me a good background in neurotransmitters and all that sort of thing. So it was that perfect storm of Carl Pfeiffer, Abram Hoffer, studying schizophrenia, learning neurochemistry, that got me excited.
Somewhere around about 1980 or so, I’d set up a health food shop in High Wycombe called the Better Health Shop, and a little room in the back called the Better Health Clinic.
I called myself a nutrition consultant and I had a three-month waiting list. I developed a questionnaire, which was sort of the beginning of the questionnaire that nutritionists or nutritional therapists use today. Then I had a few people approach me saying they’d like to study to do what I was doing.
Also around that time, I remember suddenly having this realisation – perhaps all these diseases, like diabetes and heart disease, mental illness and so on, maybe they’re all a function of sub- optimum nutrition!
Right then I decided to set up an institute, or a college or whatever.
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SM: Where were you getting your inspiration from at that point?
PH: I was well into the whole concept of orthomolecular medicine – the right molecules – which was really the creation of Prof Linus Pauling and Abraham Hoffer. Pauling had published the seminal paper in 1968, originally on orthomolecular psychiatry.
SM: The paper that starts: “The functioning of the brain is affected by the molecular concentrations of many substances that are normally present in the brain. The optimum concentrations of these substances for a person may differ greatly from the concentrations provided by his normal diet and genetic machinery”.
PH: I didn’t really realise it at the time, but this concept is totally in parallel with Darwin. In every edition of The Origin of Species he said that there were two driving forces for evolution: one was “conditions of existence”, and the other was natural selection. Of the two, he said, conditions of existence is the more important. If you think about it logically, natural selection doesn’t kick in until the conditions of existence change.
Prof Michael Crawford made me aware of that, with the simple question of how did we become human? Given that our genome is only 1.4% different from a chimp and that brain size in chimps and gorillas hasn’t changed at all, and ours did… the logic is it had to be a change in the conditions of existence.
He pointed out that in 1900 to get into the Army you only needed to be five foot tall. The Industrial Age diet with its refined flour and sugar and all the rest of it happened to ignore protein as we moved away from “standard” eating to man-made eating. But with the discovery of the importance of protein and going to work on a good British breakfast etc, effectively we go from five foot to six foot in a matter of 50 years.
The point that he was making is that conditions of existence, when they change – epigenetics, in effect – this works very, very fast.
The power of changing the conditions of existence is extraordinary. So whether you call it orthomolecular, or optimum nutrition or functional medicine – Jeff Bland also was a student of Linus Pauling – we’re talking the same language, and what we’ve learned is that when
you create that perfect “conditions of existence” – environment – and nutrition is a big part of that, it works fast, and you can see extraordinary recovery from disease processes.
In the early days, there I was with this questionnaire and I’m a Nutrition Consultant. I’ve trained in quite a few other things as well – massage, reflexology, Bach flower remedies, kinesiology and this and that, but I found the nutrition was really working, so I cut my hair, and I got a suit and a room somewhere off Harley Street.
This is pre-ION, about 1981, and I remember a woman coming in saying, “I have systemic lupus erythematosus and Sjögren disease”. I said, “How do you spell it? What is it?” I told her, “I don’t really know about your condition, but I know about optimum nutrition”. And she got better.
And then on the same day, somebody came in with post-epidemic myalgic encephalomyelitis. I said to myself, “You think you’ve got a problem? The last one had SLE and Sjögren’s!” And he got better as well! So I grew the confidence that if you create that, “conditions of existence”, things can get better.
SM: There’s a pattern here that I’ll explore later to do with both logical thinking and your ability to tap into expert advice that I think explains a lot of your success – and the success of ION.
But as an example, you had double Nobel Prize winner Prof Linus Pauling on board early on?
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PH: Yes, and another influential person around that time was Prof Derek Bryce-Smith at the University of Reading. He was a genius organic chemist, who effectively got lead out of petrol.
I worked with him on his campaign, and he had also got into trace elements, zinc, selenium, manganese and so on, in the context of women who were having miscarriages and deformed babies and so on.
At the time, you had to go through a formal process to be able to register an institute,
and Derek Bryce-Smith was one of the key signatories for that and was the first patron of the Institute for Optimum Nutrition. Prof Pauling was the second.
SM: Staying with the “origin story” for now…I well remember the 1980s, because obviously nutritional therapy as a profession didn’t exist. In the Here’s Health office we were regularly visited by Pearl Coleman, who lived nearby and was pushing us all to learn about the new field of allergy. At that time, there wasn’t a single specialist clinic in the NHS for allergy. Pearl championed Dr Richard Mackarness, who was single-handedly pioneering “clinical ecology” at Basingstoke Hospital until he was closed down.
[Mackarness, it’s worth saying, wrote Eat Fat and Grow Slim – a low-carb, keto, “Stone Age” program in, wait for it, 1958!]
The late great Leon Chaitow had just started writing for Here’s Health and was trying to introduce his naturopath-osteopath colleagues to supplements. In the magazine we railed against junk foods, promoted a wholefood diet and campaigned for organic gardening and farming. Our classified ads were the main source for people looking for a nutritional practitioner – and we vetted their qualifications. And that was the extent of what was going on with what we would now call nutritional therapy. There were just these oddball characters, with all due respect to Pearl, who were fanatical about this nutrition thing. It was very much a specialist, minority interest. So along you come and start an institute. Did you have from the start a big vision for what this would become?
PH: There was a big vision. And we had 73 students sign up for the Nutrition Consultants Diploma Course in the first year, so it didn’t start small!
Around then I had a very important meeting with Dr Stephen Davies and the journalist Geoffrey Cannon.
SM: Stephen Davies was amazing. He had a photographic memory and as a result his presentations on nutrition were mind-blowing. We did feature him and his colleague Dr Alan Stewart. They were “conventional” medics who had woken up! They came out with their book Nutritional Medicine in 1987.
PH: The essence of the conversation was, how do we make change happen? How do we bring this nutrition into existence in a significant way?
Geoffrey’s view was that nothing would change until you change the establishment, the major organisations. Stephen Davies said, “This is evidence-based medicine, and therefore it should be done by doctors”.
My view was it wasn’t going to happen like that. I thought that if we could create a profession of nutrition consultants who could work with doctors, doctors could refer to them, and then we might have a chance. So that was the function of the new profession, and I am so delighted that it’s taken off!
SM: I don’t remember you doing much marketing, but the thing just grew and grew.
PH: One thing that was important with the Institute is that rather than me teaching everything, I decided to get the best people I knew on each topic. Within a couple of years we would have, on average, five or six professors lecturing in a year. Prof Crawford came, and Dr Neil Ward, professor of analytical chemistry at the University of Surrey. The students rated every lecturer on content and delivery, and that was the basis of improving the education.
SM: And then you started writing…
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PH: Before I started ION I’d been selling supplements. I bought myself a cheap Skoda and whizzed around the land and sold Brian and Celia’s herbal and nutritional products. But when I asked if I could either buy in some shares or have a pay rise, they fired me.
I lived in a cottage in Burwash that I rented, and I didn’t have a phone, but there was a phone box. And I didn’t have a typewriter, but the neighbour had one. And the owner of the farmhouse wouldn’t let me use the address for a business, but the village greengrocer would.
Even though I’d been fired from Green Farm, they gave me a good wholesale distributor rate. So I wrote an advert ,which was incredibly successful, with the headline: “Don’t waste your money on vitamins”. And there were three action points: 1, “Read this book” – which didn’t exist; 2, “Ring the nutrition telephone service; and 3, “Buy these products”. So I thought I’d better write a book!
A friend did a drawing, and I went to a printer and said, “I’ve got £1,000. How much would it cost to print 10,000?” And he said, £3,000. And I said, “Well, if I give you £1,000 in 30 days and £1,000 in 60 days, 90 days, do we have a deal?” He said yes, so I had 10,000 books printed, jumped in my Skoda, and just drove around the UK. I’d knock on radio shows, and sometimes I’d give a talk – to six people, or maybe even 20 or 30 if I was lucky – and sold 8,000 copies. And then Thorson’s turned up and said they’d like to publish my Whole Health Manual, and they went on to sell a quarter of a million. So that provoked a lot of interest about the training, as well.
SM: Did you rename it as The Optimum Nutrition Bible, because that title gets mentioned most often in our In Practice section when we ask what book first inspired practitioners?
PH: The first one came out in 1981 and when Thorson’s republished it in ‘82 or ‘83 it did catalyse a bit of a revolution. And then in ‘85 or so I published Optimum Nutrition, and a few other books – The Fat Burner Diet was one of the early ones, one of the first on a low GI diet, and then The Optimum Nutrition Bible – which everyone remembers the most – in 1997. I wrote that when I left ION, which is when I went into a mad writing frenzy when I was released from running the Institute.
SM: So the growth of ION was really fuelled by you and your Skoda and selling books. People read the book and decided they wanted to know more.
PH: Yes, I remember getting an article in Cosmopolitan or an article here and there, and gradually the whole thing evolved – not without you know, “troubles”. There were troubles along the way. I’m sure we remember a few of them…
SM: And here we are with “the” book just translated into Chinese and about to hit a market of umpteen millions…but what’s your current book count?
PH: It’s 48 books in more than 30 languages.
SM: You always amaze me that you not only have great ideas, whether it’s ION, Food for the Brain or the Alzheimer’s campaign, but you’re incredibly productive. What’s the secret?
PH: I think it’s because I see where things are going. I’m not really a good manager, and
I get bored quite easily. But when I have a strong sense of where something is going, I get focused on that. I’m very bad at the past. I got 8% in my history exam, but I did well in maths and economics.
So yes, there’s a sort of perseverance. When an idea forms in my mind that I think has got arms and legs, I just keep going. What I’ve certainly learned in relation to books, and also in life, is to totally absorb myself in a subject. And work hard. So when I’m writing a book, I’m up at 5am and I’ll always do three hours before the day begins.
I wrote The Optimum Nutrition Bible in six weeks. Not many of my books have taken more than two months. The essence is – and we saw this recently with my latest book, Upgrade Your Brain,- also the campaign – it was a purposeful, two-month campaign, just do everything – conferences, lectures, interviews, just make as much noise as you possibly can in a very short period of time to get a quantum leap. You cannot get a shift in an organisation or in a concept just by working nine to five, hoping it will steadily change. There needs to be some sort of burst.
I remember the concept of “natural highs”: I was giving a lecture at a conference in LA and met Dr Hyla Cass, associate professor of psychiatry at UCLA. I was a bit bored, and so was she. And those words dropped out of the sky. I mean literally. What? Why do we humans like to be, sometimes stimulated, sometimes chilled, sometimes concentrating, sometimes connected?
What’s the nature of those different states and how do they relate to chemistry?
We worked on that book, and out of that came supplements – Brain Food, Chill Food, Mood Food, and so on. Conceptually this was very early on and a bit radical for the health food industry. No one wanted to run with it, so I did it myself and then later they caught on. And it just amazed me that we had to wait more than a decade until the idea that you could have supplements, nutrients, and actually support your brain function, caught on.
So yes, it’s having an idea that I think has merit, and doing it and sticking with it until eventually it starts to get traction.
SM: That sounds fine, and I can understand that for the odd book and the odd project: you get an idea, you intuit that something’s going to happen with it, and you devote this burst
of time to it, and just keep repeating that. But ION, 48 books and who knows how many other projects later and you’re still applying that same model. So why aren’t you a shrivelled husk of a human being by now?
PH: Well I am a bit more shrivelled! But I also I love that – and this has been so true with Food for the Brain and the charity – it’s the people that have come forward to get involved…
SM: So you get help?
PH: No question. If an idea is good.
In a sense, it’s all about raising consciousness. I should say that what’s always floated my boat is expanding my awareness, my consciousness of something. The effect of my lectures – and I think this is also true with most of the books – it’s not about the content, it’s about somehow inducing a big “Aha!” in someone that wakes them up to the idea that they are definitely the architects of their own brain’s destiny.
We’ve seen that so often in nutrition. For example, once somebody gets a cold or flu and takes a gram an hour of vitamin C, and experiences a different flight path, they never look back.
The other point in answer to that question is that I met Linus Pauling a couple of times in
the US, and had lots of interactions with him before he died. And it was a very seminal moment when he said, “Patrick, follow the logic; it’s the logic that counts”. He said to not worry about the randomised control trials – they come later. That was really important. So I trusted the logic of things, and I trusted conditions of existence, and I trusted the power of nutrients.
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SM: So people are attracted to what you’re doing and they step in. But explain this. you’ve got your psychology degree and you’ve invented yourself as a nutrition consultant, and then you decide to go and connect with a double Nobel Prize winner. How do you do that? Because you seem to have a capacity to not only reach out to people, but to get them interested in what you’re doing.
PH: Well we didn’t have emails, we had to write letters. I wrote to Linus Pauling, I wrote to Abram Hoffer. I said I’d like to visit, and I jumped on a plane, I went there, and we connected. That’s how I learned. I found someone whose ideas were excellent, like Prof Michael Crawford, for example, and I wrote to them, went to meet them, and so on. So many of these scientists are humanitarians – they want their work to be shared. And so many have been phenomenally patient with me, directing my ability to accurately turn their science into something that the public can understand.
But I think they often really enjoy the questions. And they’ve enjoyed the desire to put it in the public domain, because quite a few are not that good in the public domain, but they know it’s important. So it’s not a title that exists, but it’s a communicator role. You’re also very much there. And it’s perhaps easier to put the hat on you and say “journalist”, but it amazes me how these people, these scientists, spend decades of their life in minute details, struggling to get grants, often extremely badly paid, and hoping that it will make a difference. And the old belief was, if it’s published in a journal, it will make a difference, but we now know that that is not true. So yes, it’s not difficult to reach these people, if you’re on the same track and you ask decent questions.
SM: And you get them involved, how?
PH: Well now we have emails and it’s easier.
I just read a beautiful paper from a lovely professor at the University of Maryland on
two cases of severe autism, reversed – loved your report in IHCAN on that. So I dropped
him an email, and I explained the concept of everything we’re doing and said, “I’d love to talk”. He got back to me and said,“I adore what you’re doing. I’ve checked it out. It’s totally in alignment, let’s talk”. So he’s on board because we’re launching COGNITION for smart kids and teens next year.
SM: It’s telling that they don’t dismiss you because you’re some kind of popular nutrition guru – they take you seriously. Would you say that’s again down to the quality of the questions you ask? I’m plugging away at this because, as you mentioned, your career has not been without some pushback, to put it mildly, and this seems to indicate a new appreciation, not necessarily for you personally, but for nutritional therapy as a serious endeavour in general.
PH: Well it’s just bringing people together – they tolerate me! I do ask interesting questions sometimes, but we have these Zoom meetings, and people love them – and they disagree with each other. Recently I did a brain fat think tank and then an anti-antioxidant, anti-ageing brain think tank, and I get three scientists together, and I pose questions, and the best ones are quite “Vulcan”; they’re happy to say “I don’t know of any evidence for that” – unlike GPs, who seem to be trained to never say “I don’t know” – and they love the exchange.
It’s just about the science. It’s about the logic. It’s the old Linus Pauling line of “follow the logic”. It doesn’t really seem to be so relevant what my qualifications are as such. And you know, I’m not writing a letter to the Lancet.
I always thought professors talk to professors more, and doctors talk to doctors more, and so on. But no, it’s very rare that somebody doesn’t respond. And that’s what I also thought was so lovely about optimum nutrition, is that it isn’t a fixed thing. It can mutate, it can change as we learn more. It doesn’t have to be quite so static.
Sometimes supplements are my focus, but I think the important point is what Pauling and Hoffer did, to suggest the use of nutrients at amounts bigger than you can eat in order to reverse a disease process – that was a paradigm shift. And that’s why I can agree with many people who are big into diet and sugar and organic and this, that and the other, but it’s amazing how often people just shut down on the concept that a nutrient might be necessary to supplement.
The wonderful thing with Alzheimer’s and homocysteine and so on is, if your homocysteine is raised, you need 500mcg of B12 and it will come down. Well, you won’t do that with 10mcg. David Smith wrote a beautiful thing, which is the charity’s statement on supplements, that basically says the requirement is whatever corrects the disease.
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SM: With nutrigenomics and DNA tests and all the rest of it, we can now individualise our own diet and supplement regime. Or do you not buy into that?
PH: I’m not dismissing it, but polymorphism is like a weak light, which in the darkness of changing nothing, you can see as increased risk.
People are scared about ApoE4. The other obvious one is MTHFR C677T, so I thought I would just look at the big papers on changing diet, supplements, omegas or B vitamins, and of course they’ve all measured whether there was ApoE4, or not, and MTHFR or not, and then I looked up the results – and the results of the interventions were no different. I only found one study where the “positive” gene test was associated with a difference. We’re not denying that MTHFR C677T, if you have it, increases your risk of dementia, schizophrenia, depression. It increases your risk, but not that much. It’s 4-6%. Everyone gets a bit messed up with absolute and relative risk, and suddenly the headline says more like 30%.
So yes, knowing the genetics is useful. But don’t get too hung up on it. Change your diet, take some supplements etc – the significance fades away.
More interesting are situations like the DHFR polymorphism, which means you really can’t use folic acid. It doesn’t work. I’m only just learning that it’s very prevalent in Southeast Asians, but not prevalent in Europeans. And some of the folic acid studies have done better in Europeans and worse in Southeast Asians.
So I think there are, you know, there are some real merits, but I still think “conditions of existence”.
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SM: What about your own conditions of existence? What’s your own diet and supplement regime if you have one? Mine varies all the time…
PH: Sometimes I call myself a “pegan”, which is a pescatarian pagan vegan! I’m dairy allergic. I think a lot of people coming into nutrition will have had a health problem, and mine was terrible sinus trouble and ear trouble – embarrassing. So I learned that dairy didn’t work for me. I don’t really react to gluten. I don’t have much, but I don’t totally avoid it. And I was fascinated by the work on Kamut Korasan, with every study showing a massive reduction in inflammatory markers. Now that is highly glutinous wheat, right? So it’s not just gluten.
I didn’t eat any meat for 45 years, and now I’m not averse to some, but if I never ate meat, it wouldn’t bother me. I don’t salivate when I see a steak. But I worked out a long time ago, when I was exploring macrobiotics and then vegan, the evidence on omegas was so compelling that I did eat fish.
So I do make a conscious effort in that direction, whether it’s mackerel, or taramasalata, or salmon, but I’m quite fussy about where it comes from. I drink very little alcohol and I never had coffee until I met my lovely wife and she got me “addicted”. We grow our own vegetables and yes they’re organic, biodynamic, zero dig or whatever, but we’re working with a guy called Dan Kittredge of the Bio-Nutrient Research Institute, who has analysed thousands and thousands of plants, and the nutrient variation, for example, antioxidants in carrots, is 40-fold, and you can’t predict the antioxidant level from organic or biodynamic or zero dig.
SM: What about your supplement regime? Does that change?
PH: I always take a high-strength multi-vitamin, I always take extra vitamin C. I have these strips, because life’s too short to be rattling loads of boxes. Fortunately, the guys that make these make my 100% Health Pack. So I’ve got a high-strength multi, a gram of vitamin C, plus zinc, omegas…and those three I take twice a day, every day, getting that better utilisation over six hours. And in that pack is something called Brain Food, which is phospholipids and a few extra B vitamins. And then I take an AGE Antioxidant, which is alpha-lipoic acid and resveratrol and CoQ10 and all that good stuff.
But where it gets interesting is, we’ve now learned that the amount of vitamin D that’s optimal is whatever gets you at least above 75 nanomoles per litre, or probably 100; and now we learn very clearly that you’ve got to be about 8% on your omega-3 index…so if you’ve got the time and the money, you can check in and see what’s actually working on your body. And then when you start to look at the evidence for DHA, it’s at least 500mg per day, possibly 1000mg milligrams a day.
The other aspect of this optimisation thing – and it comes out of some of those very early concepts of genes interacting with environment – is looking at evolutionary models, such as humans not making vitamin C and so on.
They found this 40,000-year-old complete Homo sapiens remains in the Gower and worked out that at least 20% of his diet was seafood. It’s fair to assume that they were expending two or three times the calories that we do – no Ocado, no home delivery, no cars. Everything was walking, foraging, maybe hunting, collecting wood…and there’s nothing flat in Wales. So if 20% of their diet was marine food, and we imagine that we were coastal, living in estuaries, migrated out of Africa. So let’s assume that was normal, and that’s how our brains grow. We’re expending half of the calories that they were on, then 40% of my diet would have to be marine food to get what they were getting. When you work out how much phospholipids you would be getting, how much choline, how many omegas, how much B12, iodine, selenium…you’re getting to what the nutrient researchers show. So you can approach the question of optimum nutrition from a number of different directions – biochemistry and logic, evolution studies and so on.
SM: That is a great connection to make.
PH: I think that I’m just lucky, because I’m 66 and I’ve been studying since I was 18 or so, and a bit like you, there’s barely a day when you’re not reading some paper somewhere or learning something new. And also, because I’ve got my scientists on a network, they send me stuff.
Now you could have a 25-year-old, super bright, straight As and everything, and they have just not had the time to have absorbed all this material. That’s why I say I’m lucky. I’ve got “sensors” that ask “Does that really fit an evolutionary model? And this finding doesn’t really fit with this…”so when everything comes together, you feel very confident about it.
SM: One of the things that stops me writing more books is that I’m aware that as soon as I’ve written one, it’s out of date. You don’t seem to be bothered by that. You just do another book, I guess. Is that how you operate?
PH: The thought of going back and updating my books is a nightmare. Yes, I do it when
I’m really embarrassed! I did it with my book on arthritis, and I did it with Improve your Digestion, but there’s not a lot that is “wrong”, it’s just that we discover new things. I’m looking at my book Say No to Cancer. Now, there are some seriously good books out there on cancer, but if someone’s been diagnosed with cancer, they’re in a state of fear and disempowerment. That book is actually empowering. Later on they can get into ketones and whatever, but some of the brilliant, detailed books – if you’ve got hold of that in your first two months of cancer, unless you happen to be that sort of person, you’d just be completely overwhelmed.
I guess if you’re writing books as encyclopaedias, it’s a problem, or is it something that opens up an area? So I’m not so worried about it, but you’re right. I mean, there’s so much stuff coming through, and you must feel quite overwhelmed at times. You do an incredible job making it accessible. I don’t know how you do it.
SM: Well thank you and back at you. As you know, you can be inundated with new material and some of it just “sticks” and you know it’s important and needs a follow-up. You can let the rest go. From your VERY aged perspective then, from the beginnings in the back room to ION and kick-starting a whole profession into existence, where do you think it’s going? What are we doing right? What are we doing wrong? Where would you steer us?
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PH: Funnily enough, in the time since I left ION, there are times when I’ve been flavour of the month, and times when I haven’t been…
SM: Well, that’s a very restrained frame for what the media and certain academics have put you through…
PH: I’ve taken the flack a few times, I think, for the profession. And at that time, most people flee, so you don’t generally get much support. So yes, there’s been a sort of nervousness around ION – for example, in relation to supplements, because of potential attacks or whatever. And I would just say to everyone to, as I do, always follow the logic, follow the science, and be bold and brave, because nutrition is always amazing. The power of nutrition is always amazing.
I love the way that ION has been run over the last several years. It’s really tough to run a charity, and it’s done very, very well.
My intention was simply that people would be really good at what they were doing, and if they were and got really good results, then they would get more clients. They would be successful. But there is still this disempowerment, where we look to the establishment. We want to be recognised by some authority, thus have our degree status or whatever. My personal view is that although that’s a very good thing, it’s secondary.
I believe ION was four times at the point of getting degree status without achieving it (it has now), usually because there are vested interests who do not want nutritional therapy to become mainstream. So there’s a debate as to what extent you change what you’re teaching and learning in order to get some accolade from the establishment, so to speak. And I would say, whatever happens we have to stick to our guns. We have to do what works. We have to do what the science shows. Be like those Vulcans: don’t be persuaded just by opinion.
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SM: Fads and fashions rather than fundamentals?
PH: I’ve been a little bit shocked, because I have interviewed various people qualified in nutrition for various jobs, and everyone has something to say about the microbiome right now. Yet it’s extraordinary how many know very little about homocysteine and methylation.
And then one of the questions I always ask when I’m interviewing various nutrition therapists in mental health is about the very good work on high-dose chromium being an effective antidepressant. That was shown by a brilliant psychoanalyst professor who had a patient who got better taking chromium, and not from psychoanalysis. So he set up a randomised, placebo-controlled trial. In other words, there are some learnings along the way and some things that have just been forgotten in nutritional therapy and functional medicine.
For example, you’ll find that the homocysteine-methylation thing is quite ignored in America, but not in Scandinavia, and it’s a bit more known in the UK. So you get these geographic differences. And things go into fashion, and then they go out of fashion.
An early influence: the ground-breaking book by Dr Carl Pfeiffer, famous for Pfeiffer’ Law: “For every drug that benefits a patient, there is a natural substance that can achieve the same effect”.
Founder of the Brain Bio Centre, he was one of the first physician-scientists to investigate the biochemical basis of mental disease.
“If there’s a drug that can alter the brain’s biochemistry, there’s usually a combination of nutrients that can achieve the same thing without side-effects”, he wrote.
So yes, I just say stick with the science. Stick with being highly confident in the effectiveness of optimum nutrition.
But then, I watch how it has evolved. It’s fantastic. I mean, it’s an established profession. I think BANT has done an incredible job.
You know, it’s a very active, vibrant and alive community. But one has to know that there are companies who make money because they have products, and they need new products, and they need new tests, and sometimes they have the money for the marketing and all the rest of it, which is fine, because it helps to support the whole industry in one way or another. But you must always have your BS detector turned fully on. Antennae on, not to just get sucked into the latest fad. For example, the blood sugar issue is vital, however you deal with it. The whole methylation-homocysteine thing is vital: I mean, David Smith’s paper showed homocysteine is a marker for more than 100 diseases.
SM: Yes, thanks to you we got that covered in IHCAN – it is a staggering piece of work.
PH: “It’s bigger than you think” sort of thing, right? And then fats are not just omega-3s. And vitamin D – which is a weird one, really, because we put it in the “fat-soluble vitamin” zone.
SM: Even although we should actually be treating it as a hormone…
PH: And even with vitamin D’s effect on COVID, we don’t really know why. It’s got so many potential genetic switches and all the rest of it. But no, I’ve tried to fit it in with the others. It doesn’t fit. And then there are the antioxidants and polyphenols – we finally got the glutathione index test up and running all over the place. That’s really a nice measure, because, you know, people like Dr Tom Levy say, it’s all about oxidation and antioxidants.
SM: So, back to fundamentals, and I know you see the future as “digital” – what does that mean for us?
PH: I worked out quite a few years ago that the only way to affect major change was that it had to be digital, it had to be international, and it had to change people’s behavior. It took a few years for others to buy into that, but then we did this crazy project with the cognitive function test. But almost every day we have 150 people take the test. We’re up to 450,000 people now. My goal is to have data on a million people, which makes us bigger than anything, bigger than UK Biobank, by the end of next year.
SM: So by “digital”, you mean you’ve got to use the internet, apps and tech, rather than flogging books from the back of your Skoda?
PH: Rather than just a book, yes. And I think, also, nutritional therapists have learned that only doing one-on-one consulting is not the way to go. The successful ones tend to have different routes to them – so coaching and sessions and a package that you buy into. And that comes from the whole concept of, how do I change a person’s behavior? If I see them once, and then a month later I see them again, and a month later I see them again – it’s very hard. So what’s the method that creates that behavioural shift?
For myself, I started doing three-day residential workshops called Total Health Transformation, where I saturated people completely in an environment where it wasn’t just nutrition, but if we learned something about food, we then cooked it together, and we’d eat it together.
So it’s how to wake someone up to actually do that. This is all part of ION, too, because it’s also when you realise that it’s not just what you know, but it’s knowing how you actually change behaviour.
So in the time when I was running it, we were learning a lot of psychological techniques, also marketing techniques, knowing that 80% of it was psychological and 20% was about the knowledge about nutrition.
The truth is that for 80% of people, it’s about some very simple things – the fundamentals that we mentioned: blood sugar, antioxidants, fats, methylation. Most problems can be solved with something that we could probably learn in a month or two, and it’s just those extra, difficult cases where you really have to go to a whole, other layer.
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SM: You see things coming so what’s your prediction for the nutritional therapy profession? The NHS is permanently in crisis and yet many practitioners seem keen to get more involved with GPs and the whole system.
PH: My view is that the NHS-type, conventional medical system is beyond repair, and it will get worse and worse. It’s happening in every country. I also think that the pharmaceutical approach, although it still looks strong, is really, really weak. And we knew from ten years ago when Heather Stein of GSK said the only way they could sustain profits was not from blockbuster drugs, because they didn’t have any, but from vaccines.
Pharma holds up the whole broken system. And all our lovely doctors, like in the Public Health Collaboration, or all the fabulous GPs who are part of groups within the NHS trying to make change happen, say it’s like pulling teeth. It’s just so painful. So people are not getting better, so more and more people are going to look at “What’s my alternative?”, and our job is to provide that and make ourselves available in a way that is accessible, affordable and so on.
SM: What’s the best way to do that?
PH: The important thing is for us to be very good at what we’re doing. But again, I think practices need to go much more digital.
We are in a digital universe. 60% of access to everything is on a mobile device. And it’s no longer about what paper you read and what television program you watch. There’s much more influence these days through podcasts and YouTubes and social media. So it’s just simply understanding how to meet people’s needs – which they’re just not getting from their doctors.
Be available – whatever that means to you. With Zoom, for instance, we can reach people anywhere in the world, and with AI we can have instant translation, “speak” their language and understand them even if they don’t speak English.
We need to just stay on target: what is it we do that really works? What are people’s needs? How do we package what we are doing to be available to people? And people tell people.
The future is bright, because there’s no lack of supply of unhealthy people! It should be shrinking, but in most areas, it’s growing, and what treatment is available for them is less and less available. If we wind back 15 years, there were blockbuster drugs that were very sexy, and now there aren’t. So our area is getting very messy and no one wants to wait a month to see their GP and then get referred, and then have to wait again for something that’s probably not going to work anyway. Whatever they’re talking about doing with the NHS, it’s just so slow and it’s probably just not going to happen.
SM: So 1978, I’m at Here’s Health, you’re at Green Farm and what are we talking about? Get people to stop eating junk food. Fast forward 46 years and what’s the hot topic? Ultra-processed food. It’s bad for you, apparently. Who knew? It’s frustrating, isn’t it?
PH: I went to one of the Public Health Collaboration conferences, maybe three years ago, and they’d have patient cases up, and for everyone, the answer was a sort of low glycemic load and sort of keto diet. And that was the answer for everything they wanted. Very, very exciting. I was so glad to be hearing this, a bunch of fantastic doctors saying this. But the other side of this is that I was saying this in the 1980s.
SM: Exactly. And did you get credit for it? No.
PH: And the other thing is at this conference, there wasn’t a single mention of micronutrient supplements. Well, there was a talk about the need for “proper studies” where you get a drop in the HbA1C in randomised trials and meta- analyses. And I raised my hand and said, “You know, there have been 28 randomised control trials on chromium that have been meta-analysed, and lowered HbA1C by the amount you’re talking about. Is there any chance, maybe next year, we’ll chat about micronutrients?”
So more and more doctors waking up to low-carb, and in this first wave it’s also no
pills or fewer drugs, which is fantastic but the medical profession is still paranoid about nutrient supplementation. And we know that what actually works is to both change the diet and supplement the right nutrients. And that is orthomolecular medicine, that is optimum nutrition, that is functional medicine.
SM: So we have doctors turning on to diet and nutrition, but they won’t do supplements, so we are still about ten years ahead and able to provide science-based recommendations that the public just won’t get anywhere else.
PH: Yes, and this paranoia towards supplements is illustrated by the Lancet Commission totally ignoring homocysteine despite all the evidence because the solution is a supplement.
It also tells you that if you have a Prof Tim Spector or Dr Chris van Tulleken, anyone who comes through has got to nutrition through a medical route. They’ve had implanted in their DNA an anti-supplement bias. And you know, they’re just not processing science. That’s the point. So we have to stick to the science, be confident in the evolution of nutrition and conditions of existence, and just get good at changing people, which means coaching to facilitate behaviour change. We have to empower people because the only person who can change you is you.
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Thank you for reading!
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