ROBERT VERKERK PhD
Scientific Director, Bite The Sun
Executive & Scientific Director, Alliance for Natural Health International
When did you first become interested in nutrition and health?
I’ve always been interested in nutrition really. Growing up in East and West Africa, I was exposed to many forms of cuisine from a very early age. I was sent to boarding schools in Britain and was exposed to large amounts of dairy for the first time and that triggered a number of health issues for me.
You have faced many medical challenges yourself over the years. How have these shaped your approach to health and nutrition?
I suffered from secondary lactose intolerance that went undiagnosed for 10 years. My health deteriorated, my immune system hit the floor and I became hypersensitive to chemicals and pesticides. I had severe digestive problems, I had to undergo intestinal biopsies and peristalsis had broken down. This called for a complete diet change and I had to switch to organic foods
Having improved your health during your 30s, you were diagnosed with Metabolic Syndrome in your 40s, which made you highly predisposed to insulin sensitivity, obesity and detoxification challenges. How did you deal with this second health crisis?
It gave me a bit of a wake-up call because, although I was eating healthily, I was not getting enough exercise. My weight was ballooning and I was pre-diabetic. I was aware of so much research and the mainstream views of dieticians, who focused hugely on diet and not so much on the physical side of things.
I started eating less and eating different types of food. I introduced more protein and good fats and cut out carbs. I started doing short bouts of High-intensity Interval Training (HIIT), which uses the energy that gives you a “fight or flight” response and I literally changed the way my body stores energy.
Tell us a bit about your educational background.
I studied agriculture and got a primary degree in ecology from University of Westminster, London. I worked in Australia for 10 years in the area of sustainable environmental management. I was interested in creating agro-ecosystems that don’t rely on high amounts of pesticides and I found it strange that even though food and water are vital in all of our lives, the people who manage health and those who manage agriculture have almost no connection with each other.
I returned from Australia and continued my education, with a Masters and a PhD in sustainable agriculture from Imperial College, London. I stayed on for a further 7 years as a postdoctoral research fellow. I was offered a permanent position, which was almost unheard of, and I initially jumped at the chance but then I thought about it and turned it down.
In 2002 The World Health Organisation had said that the primary burden to global health was inappropriate behaviour related to diet and lifestyle. I realised that I could continue adding articles to journals or I could actually do something about the situation.
When someone said to me that I’d be mad to miss out on the “kudos” of the position, I knew I’d made the right decision because that’s not what it was all about for me. It was all about the fact that we largely already knew the solutions for altering the global food supply. We didn’t need any more research. What we did need was education, information and political change.
You founded the NGO, Alliance for Natural Health International (ANH-I), in 2002. What were your motivations for setting up this organisation?
I already had a track record of volunteering with NGOs around the world. While working in sustainable environmental management, I had led many environmental campaigns with the Total Environment Centre, Sydney.
I’d always found it interesting that the word “sustainability” while being used in an increasingly wide variety of contexts, was rarely used with respect to healthcare, which was ironic because it was one of the main areas of a country’s GDP that could be set to bust the economy.
The world is in a chronic disease crisis and we are all at risk of cancer, heart disease, diabetes, obesity and dementia. I think that we need to move away from the “pill for an ill model” and try to put people on a path that steers them away from these diseases at an early stage, rather than treating them as they arise. There is no silver bullet – chronic diseases are complex by their very nature and there is a very little consensus as to the causes. There are multiple different possible causes, that vary from person to person and there is also an epigenetic basis, which relates to the interaction between the environment and our genes.
This suggests that “personalised medicine”, with medical decisions and interventions tailored to each individual patient, might be the way to go but this is very slow to develop. The area that’s growing most rapidly at the moment is the area where each individual exerts control of their own health and is monitored. The role of the doctor in this model changes from being “God” to being “guide”.
The director of longterm chronic disease in the UK is now taking on this model, which is a positive sign. I think that the government and the health service need to change their entire emphasis. We need to change what children are doing and change what their parents are doing. We need to look at our individual genetic predispositions and look at our environment. Your genetics effectively loads the gun but it’s your environment that pulls the trigger. We need to roll out genetic tests for the masses. That way you can be tested and get the information you need at the same time, while you still have a chance to do something about it.
What kind of issues does the ANH campaign on?
The ANH is a non-profit NGO that operates worldwide promoting natural and sustainable approaches to healthcare. We campaign on issues like promoting the use of natural products in healthcare, ending mass fluoridation of water supplies, ending the use of GM foods and the safety of vaccinations.
The ANH has 3 distinct divisions. There’s the main non-profit NGO division. We also have a consultancy division, which provides services to support natural healthcare practitioners and then there’s Bite The Sun, which is a separate organisation with a shared ethos and this is the consumer empowerment arm.
We want to promote the use of micronutrients and herbal products in healthcare and ensure that they are not blocked by too many regulatory constraints. Many natural health products are being subjected to the same licensing laws as pharmaceutical products, which cost millions and this can block entry to some very useful products. The legislation is not black and white. There are many grey areas, especially when it comes to these products, and there can be a fine line between what is considered a drug or what is considered a food supplement. Much of our work involves trying to get products “unbanned”. A good example is “milk thistle”, which we worked to get unbanned in Ireland. Milk thistle protects the liver and the Irish legislators were reluctant to change their minds. The compromise was that up to 200mg can be sold as a food supplement as opposed to a drug so it was about setting a threshold.
It’s about striking a balance between “good science” and “good law”. Sometimes the science gets twisted and there are cowboys too, as there are in any industry, and we do need to police them but it is essential that we don’t throw the baby out with the bath water. The products and practitioners in the natural health industry are predominantly good and have a very important role to play in society.
I also work as an advisor to the Irish Association of Health Stores and they have the highest code of conduct of anywhere in Europe. They have some very important information to impart and products to offer and these can significantly lessen the burden on the health service. If we can deal with health and lifestyle issues early on in a natural and holistic way, we can prevent them from becoming serious problems and save the key resource for those who really need it.
GPs are not very good at early detection of diseases and they often treat the symptoms, not the underlying causes. Nutritional therapists, on the other hand, are good at prevention and their advice and treatment can reduce the risk of chronic disease. Their advice is also transferrable to younger members of a household and so it puts the responsibility for health back into the community and onto the individual.
A recent BBC show “Doctor in the House” took a doctor trained in functional medicine, Dr Rangan Chatterjee, and placed him in a home with a family, where he could observe every aspect of their lives, including diet, exercise, sleep. He was not allowed to administer drugs, so his treatment included advice, a range of alternative therapies, vitamins and supplements, but he had very positive results.
At the ANH we believe that primary health care can be changed without any significant financial investment, simply by changing the way in which things are traditionally done. Doctors have lots of patients to see and very little time to do it in. By adopting a “practice management approach” they could group patients with certain problems (like metabolic diseases affected by diet and lifestyle) together and hold a group session where, instead of seeing each patient individually for 10 minutes, the doctor could spend an hour educating the group on diet and lifestyle changes, make recommendations and meet them again later to assess the results. The patients would also benefit from interaction with people with similar health problems to themselves and from the support of the group.
Another issue that’s top of our agenda is governmental food and dietary advice. Much of the dietary advice being given to us by our governments is simply wrong. Take the UK Eatwell Plate, for example, and its over-reliance on starchy carbohydrates from bread, rice and pasta. The US Plate has changed so many times over the years that it’s impossible to believe that this latest version has finally got it right. Why don’t governments look to independent doctors and scientists to design the plate?
At the ANH we have developed our own version of the plate, called the ANH Food4Health plate and it’s a very different looking plate of food. Ours is gluten-free, for starters. We recommend 3 meals a day, with no snacking in between. We don’t advocate the “eating little and often” approach traditionally recommended by dieticians because it causes spikes in blood-glucose levels that can create problems in the long-term by causing people to become insulin-resistant.
Our genome has changed very little over the last 20,000 years. Wheat only entered the equation 12,500 years ago. A diet with intermittent fasting and caloric restriction is much closer to our evolutionary base. Years ago most of our food was won, hunted or trapped in a fasting state. Our protein kinase C (PKC) signalling system, which controls how we store and use energy, is well adapted to infrequent and regular bouts of famine and feast. An imbalance in this is due to the wrong input from your environment. Problems like obesity and Type 2 Diabetes are due to a messing up of this system. We need to reinstate our ancestral pattern. Programs that use caloric restriction and High-intensity Interval Training (HIIT) are based on this.
You set up Bite The Sun (BTS), an online health and nutrition programme, which helps people to get fit and healthy through a combination of diet, activity and rest. How did Bite The Sun come about?
Concerned by the fact that much of the government advice about food and nutrition is incorrect, BTS was partly born out of our desire to redesign the British Plate for Health as part of the ANH’s Food for Health campaign. We wanted to help the public to understand that diet alone is not enough; it is just one component or one subsection of a much bigger picture. When you combine diet with physical activity and rest you can achieve a synergy that’s much more than the sum of its parts.
Government advice is often distorted by vested interests in various industry sectors, which is why the advice we’re giving is slightly different. BTS takes the fundamental research and information and delivers it in a format that allows each participant to become empowered. We take the very latest scientific research and convert it into layperson speak, making the information more accessible.
We recommend 12-16 hour fasts overnight, high-intensity interval training sessions and the removal of white bread, white rice and white pasta from the diet in most cases. For people with a rapid metabolic rate, these carbs can be helpful, as they burn quickly before they have a chance to be stored as fat. We refer to these people as “the skinny fat” – they look thin but they carry a lot of visceral fat, which won’t be detected unless the GP has a body composition monitor. The physical exam has almost disappeared but the technology to do these kinds of tests is available and is not very expensive.
How does Bite The Sun work?
We have identified 3 equally important parts of people’s lives that they need to give equal attention to and we call these the 3 “rays of health”. The first ray is diet and we provide tried and tested dietary advice from globally recognised practitioners. The second ray is activity and we recommend 1 hour of moderate physical activity per day. We include an app for monitoring and tracking your progress, which is very useful. The third ray is rest.
“Rest” is an integral part of your programme and is given the same weight as diet and exercise. Why do you consider rest to be such an important element?
The benefits of exercise are widely acknowledged but the benefit of rest is often underestimated. In fact, the real benefits of exercise don’t come during the exercise itself, they come during the rest period. While exercising you damage muscle but it’s in the righting of that damage that all the benefits are incurred. Similarly, if we engage in an emotionally stressful behaviour, we need to have time to recover. The WHO has identified anxiety and depression as the leading burden on the world’s healthcare systems, overtaking cancer and heart disease, but there is not a very uniform approach for people to follow when dealing with these issues. The link between emotion and diet and lifestyle is hugely important; if we don’t eat right we can’t establish dopamine and serotonin responses and if we don’t get enough quality sleep in a dark room, our bodies don’t produce enough melatonin. These are all critical parts of living.
The first thing we do when someone joins BTS is built a profile. You need to understand where you are in terms of your overall health and determine your metabolic risk category. We use biometric data (chest, waist, hips and height) to assess this. BMI, which is widely used by healthcare professionals, has been widely discredited. For example, using this measurement, a professional rugby player would be categorized as morbidly obese. The best measure uses the circumference around your middle. If it’s less than ½ your height (less than 0.5%) it’s in the healthy range.
We have identified 4 body shapes for women and 5 for men, which are symbolised by fruit or vegetables. We assess where you are now and set goals. Some people may want to stay the same shape while leading a healthier life, while others might want to “shape-shift”.
We advocate that you eat no more than 3 meals a day and don’t snack in between. You need to make sure that the food you eat over the course of the day has all the colours of the rainbow within it (red, orange, green, blue, purple-black and white-tan-brown). Make sure that your main carbohydrate comes from vegetables and lay your protein source on a bed of vegetables, rather than rice or potato.
You need to reduce carbs and rely more on protein and fat for your energy. You need to train your body to “shape-shift” effectively into fat burning mode, a process which, in many people, has gone to sleep. You need to switch to a more ketogenic approach, where you’re burning fat and using that for your energy source for some of the time.
Exercise plays an important part in the program. We prioritise eating and we need to sleep but we often don’t prioritize the need to exercise. We should get pleasure from exercise but for many people that have gone. If you get diet and rest right people begin to find their desire to exercise again. You do need to pick the right time to exercise though – exercise after 7.30 at night is not very useful but Yoga at this time is helpful.
How do you teach kids to be healthy?
To teach kids how to be healthy you just need to show them how to do it and involve them in the process. I’ve had all my kids cooking in the kitchen with me from the age of 3 or 4. My kids had quite different foods in their lunchboxes to the other kids, with salad and meat, as opposed to ham and cheese and bread. Other kids made fun of them from time to time and when they came to me I said that they could have the same food as everyone else if they wanted but they chose to stick with healthy lunches because they knew why they didn’t want to eat the other food. Processed meats are carcinogenic and it doesn’t have to be this way. The traditional ways of curing meat that are still used by local butchers are fine and suppliers of processed meats could learn a lot from that if they wanted it but it wouldn’t fit in with their agenda of a long shelf life.
What advice would you give to someone who is trying to live a healthier life?
Eat 3 meals a day and don’t snack in between.
What advice would you give to someone who is interested in pursuing a career in the area of health or nutrition?
Think carefully about where you get your education from. There is such a mixture of courses out there, some of which are stuck in a time-warp. You need one that’s current. Richard’s course at the IINH is right up to the minute and that’s one that I would recommend. Dietetic training is very out of date and that’s where doctors are still looking for their advice. Nutritional therapists are way ahead in terms of understanding the science.