SINGAPORE - 12 per cent of people here will have some kind of mental disorder in their lifetime, and for most, mental illness will hit by the time they are 29 years old.
While doctors commonly prescribe drugs such as antidepressants to treat severe depressive disorders - one of the most common mental issues Singaporeans face - few consider the possibility that a patient's diet may be both cause and solution to their health woes.
According to nutritionist Patrick Holford, one of Britain's leading nutrition experts and a proponent of using food as medicine, drugs are not the solution.
We swallow what the drug industry tells us to, and thousands of people suffer adverse reactions to prescription drugs each year, he says.
Drugs for arthritis can cause heart problems, while drugs for depression can cause suicide.
In his book Food is better medicine than drugs, he argues that the foods we eat affect our mood, behaviour and brain functions, and that most diseases are not caused by a deficiency of drugs.
AsiaOne Health finds out more from the controversial advocate of nutritional therapy.
1. You say that people would be better off changing their diets and taking supplements to treat chronic conditions instead of taking drugs. These conditions include high blood pressure, diabetes, and more controversial, mental health conditions such as depression, ADHD and autism. Why and how can diet replace drugs?
The first point to make is that most diseases are not caused by a deficiency of drugs.
Conditions such as diabetes and high blood pressure are caused largely by poor diet, lack of exercise and stress. It makes much more sense to address these causes rather than take drugs for the rest of your life.
For example, the mineral chromium is refined out of food in making white sugar, flour or rice, and is further depleted by drinking lots of sweetened or caffeinated drinks or being stressed.
It is an essential nutrient required to make insulin work properly and, in high doses, has been proven in many trials to work better than any diabetes drug. The diabetes specialists I work with prescribe chromium plus a low GL diet. In most cases patients come off medication within a few months.
The same winning formula applies for diabetes, heart disease and weight loss.
Many people are prescribed anti-depressants for low mood, supposedly because they boost the brain's serotonin activity. This is our natural 'feel good' chemical.
But anti-depressants aren't that effective and have some pretty nasty side-effects, including a doubling of suicide risk.
A recent review concluded that "The magnitude of benefit of medication compared with placebo (...) may be minimal or nonexistent, on average, in patients with mild or moderate symptoms."
The natural alternative is to get more sunlight, exercise more and supplement a form of tryptophan called 5-HTP, an amino acid from which the brain makes serotonin.
There have been 27 studies that show that it works, without any significant side effects.
Make the right changes
2. Can relying on nutrition without medical supervision be dangerous? Are there cases where people should take drugs, rather than just rely on a nutrition plan alone?
If you are sick, you need to see your doctor and get diagnosed. Without question there are times when drugs and surgery are necessary. If you have a serious infection antibiotics can save your live. If you have an operable cancer it makes total sense to remove it.
However, if you don't change any of the known factors, including diet, why would the cancer not return?
Many doctors complain that their patients would rather take a drug than make changes to their diet. My job, and that of nutritional therapists, is to inspire and encourage people to make the right changes.
If a person is willing to make the right changes then the need for medication becomes less. This has to be a good thing. With no disrespect, medical training doesn't include nutritional medicine, and is heavily biased towards a pharmaceutical approach.
Unless a doctor has undergone specialised training in nutrition, they are unlikely to know a great deal about the evidence, or use of supplements for restoring health.
Many doctors come to my seminars and are often amazed at the level of evidence that exists for this kind of approach. I believe that nutritional therapists working alongside doctors is a marriage made in heaven.
In the 30 years that I've been in practice I haven't seen or heard of any significant adverse reaction to a vitamin supplement. There's a lot of fear-mongering about supplements but, in reality, nutritional medicine is a very safe approach.
I think there is a lot people can do for themselves without any real risk of harm.
3. In your professional opinion, what tweaks you would advise for a typical Singaporean's diet?
I always say that when you eat out it's best to eat in a restaurant from a country where the people are thinnest.
Thailand has very low rates of obesity and western diseases. The same would be true for those eating traditional Asian food, with plenty of fish, vegetables and spices.
The trouble for many people in Singapore is adopting American style habits - sweetened fizzy drinks, coffee, croissants, muffins and other carbohydrate snacks, sweetened cereals and toast.
Traditional Singapore food has a lot going for it. The choice is there if you make the right choices.
One the hardest, but most obvious changes is to have unrefined grains - brown rice instead of white rice, for example. For Asians, milk products are a bad choice.
Many people are unknowingly allergic and get more sinus problems, IBS, headaches and asthma as a result.
Patrick Holford's own regime
4. What is your own health regime like?
I usually start writing at about 6am, then do a 15 minute exercise regime called Psychocalisthenics at 8.30am, followed by a low GL breakfast. This is either oats with berries and chia seeds high in omega 3, or free-range scrambled eggs with smoked salmon, and rye bread, or a Get Up and Go shake, made with berries.
Twice a day I take my supplements - a high strength multivitamin and mineral, vitamin C with zinc, an essential omega supplement with omega 3 fish oils and some omega 6, and something called Brain Bood containing phospholipids. The brain is made from essential fats and phospholipids.
In the winter I take a couple of drops of vitamin D. I have lunch and dinner and two snacks a day. I always eat protein with carbohydrates so, if I have an apple I'll have a few almonds.
I don't eat meat and have fish about four times a week. I'll eat at least six eggs a week, plenty of beans, lentils and lots of fruit and vegetables.
I cook with a lot of herbs and spices - chilli, turmeric, cumin, oregano, cinnamon, ginger - these are all high in anti-inflammatory and antioxidant nutrients. I have a shot of Cherry Active, a Montmorency cherry concentrate, exceptionally high in antioxidants.
I am allergic to dairy and, anyway, don't think it's a good idea to have too much milk or wheat which I keep to a minimum.
I like dark chocolate and think it's good for you in moderation. I do drink alcohol, but not that much, and am careful to choose organic wines or champagne method, which is yeast-free, or something like a marguerita, with free lime and tequila.
I guess I'll have two or three drinks a week on average. I work very intensively, but then like to take time off in nature, climbing mountains if possible. I am doing my best to get out of England in the winter. Sun exposure makes a big difference.
5. Some critics say you exaggerate the benefits of nutrition for financial gains (selling supplements and books) and you are unqualified to make these claims. How would you answer to this?
I am an honorary fellow of the British Association of Nutritional Therapy, as well as a registered member of the Nutrition Therapy Council and the Complementary and Natural Healthcare Council. I am also Patron of the Irish and South African Association of Nutritional Therapy.
I've been researching, teaching and practicing nutritional therapy for thirty years. If I am not qualified to have opinions about the role of nutritional therapy in healthcare I am not sure who is.
My job is to study the research and piece it all together in my books in a way that people can put into practice. I present the best possible nutritional approach to various diseases.
My books are not about all forms of medicine, they are about nutritional medicine. Nutrition is so powerful in both preventing and reversing disease processes that some might think the statements I make are exaggerated, but in truth this is what we see in our patients.
My books contain hundreds of scientific references to back up the claims for those who wish to dig deeper. Even these studies on this or that nutrient or dietary approach are an underestimate of what happens when you put all the pieces together, which is what I recommend.
I would never make a recommendation to take a supplement that is not supported by evidence and that I would not take myself.
6. What do you think can be done to help the nutritional approach gain traction in mainstream health care?
The fundamental point of resistance is the power of the trillion dollar pharmaceutical industry.
It has perverted medical training and continues to undermine the role of non-drug approaches, such as nutrition, exercise and psychological approaches, which don't have the big profit margin of a patentable drug.
In addition, we have the food multi-nationals that have, quite frankly, got most people addicted to sugar.
This is driving the diabetes epidemic, as well as heart disease and the ever-increasing incidence of breast cancer and ADHD. All these are linked to too much sugar and refined carbohydrates.
By 2030 there will be half a billion people in the world with diabetes. That is a totally avoidable tragedy, yet most people continue to dig their own graves with a knife and fork.
If optimum nutrition was taught in schools, and in medical schools, that would make a big difference. Until then, we have to educate ourselves.
9. Your books and tours have covered the role of nutrition in conditions ranging from weight issues to balancing hormones for feminine health. Any new ground you are planning to cover?
My next book, out in April, is called Ten Secrets of Healthy Ageing.
Despite the fact that we are living longer, we have less healthy years and more years of unnecessary suffering. In Europe the average woman spends 9.8 years disabled, meaning she is unable to climb 10 stairs.
There's a big increase in the number of older people, fuelled by the "baby boomers", and it's going to be an economic and healthcare nightmare.
Many people think that how you age is down to your genes but the exciting thing is that new research shows you can actually reprogramme your genes for anti-ageing by changing what you eat.
Also, the older you get the more of certain nutrients you need, such as B12, vitamin D and magnesium.
We believe that learning how to age well is an essential life skill.
About Patrick Holford
Patrick Holford is a leading British nutritionist who has over 30 books to his name in 24 languages, and appears regularly on television and radio to speak on nutrition as an alternative medicinal approach.
Holford started off in the field of psychology, and holds a BSc in experimental psychology. He later chanced upon some research on the benefits of vitamins for the treatment of mental illness, which sparked his passion in exploring the underestimated power of nutrition.
Patrick Holford will be holding a Singapore tour from Nov 29 to Dec 3, 2011. The tour will include talks covering a range of subjects from Alzheimer's, pregnancy and balancing your hormones, the GL diet and general health workshop. For more information, go to http://www.patrickholford.com/.