Patients in her San Francisco family practice call her Dr. Daphne. It’s a fitting moniker for an upbeat M.D. — a picture of health herself — known to prescribe soup recipes for cold-symptom relief.
Daphne Miller was educated at Harvard Medical School and teaches medicine at the University of California, but her views of health break through convention. Raised by Peace Corps volunteers and back-to-the-landers, this dedicated gardener and friend of Michael Pollan firmly believes that food is potent medicine.
In her first book, The Jungle Effect, Miller ventured to regions of the world where the modern pandemics of heart disease, diabetes, and cancer are rare. Her travelogue illuminates the nutritional wisdom of indigenous cultures, distilled with modern-day research, to detail diets for wellness.
Intrigued by the relationship between agriculture and health, she then arranged seven farmstays around the country. Her newest book, Farmacology: What Innovative Family Farming Can Teach Us About Health and Healing, interprets the lessons she learned from sustainable agriculture and applies them to holistic medicine. Each chapter extracts insights on treating cancer, stress, aging, and other ailments within an enlightening framework she calls the “farm-to-body connection.”
In your book, you describe some surprising parallels between soil ecology and the human body.
As a doctor, I wanted to practice in a more ecological way, to think of my patients and my patients’ environment more as a complex organism and less as a series of specific diagnoses. That was one of the first things that attracted me to farmers: their ecological mindset.
Then I realized it wasn’t just that they thought like doctors; they had very similar patients. A cross-section of soil looks surprisingly like a cross-section of our skin, or a cross-section of our intestines, or of our lung tissue. It has the same kind of layers; it has these microorganisms that are harvesting nutrients and passing them on to plants, just as microbiota on our skin or in our intestine pass on nutrients to us.
It has similar pH to our bodies, a similar carbon-to-nitrogen ratio. This makes sense, because all of the carbohydrates, fats, and proteins in our body actually come from soil. In fact, we are soil.
In Farmacology, your prescription is for medical practitioners to become medical ecologists. What do you mean by this?
I propose that we stop thinking so much in a reductionist way and think more about how all the parts of our body relate to each other, all our organs and organ systems. Also, to think about how we as individuals relate to our larger environment.
What is the “farm-to-body connection”?
A great example of this is a chapter in Farmacology that takes place on an egg farm in Arkansas. On this farm there are two different farming systems. There is one that is more of an intensive, high-density laying system, and then there is a pastured egg system. As I spend time there comparing these two ways of producing eggs, I begin to learn interesting differences between good stress and bad.
The hens on the pastured system are experiencing stress — they are experiencing thunderstorms and hawks and so on — but it’s a very different kind of stress than the hens who are shoved 15,000 to an indoor house and have no room to move around and no access to pasture.
These lessons are ones I can apply to my patients in helping them create a lifestyle which is not stress-free, but has a beneficial type of stress rather than a detrimental type of stress.
On another level, I learned that the eggs produced in the pastured environment have greater value than the eggs produced in the high-density environment. In fact, there are nutrients in those pastured eggs, such as vitamin D and vitamin A and omega-3 fats, that might specifically help protect us from illnesses related to stress.
So, the bottom line is that food produced in these healthier models is also healthier for us. What is good for the farm is good for us.
How are the strategies for integrated pest management (IPM) you learned about from a winemaker in Sonoma applicable to cancer treatment today?
In IPM, an invasive pest is controlled not through eradication but by gentle manipulation of the environment. This includes intercropping with plants that attract beneficials — bugs that are natural predators for that pest. It also includes managing water levels, dust levels, and so on, so that these are not optimal conditions for the pest.
This model can be readily applied to management of invasive cancers. In the past half-century, oncologists have done surprisingly little to bend the curve on cancer mortality rates. In Farmacology, I write about a handful of researchers who are changing the paradigm for cancer and focusing less on eradication and more on ecological containment of the disease, just like farmers do with pests. These oncologists are using IPM as their model.
You visit an urban garden in the Bronx. Can you talk about the benefits of gardening from the perspective of integrative medicine?
What I discovered is that urban farming has all kinds of health benefits beyond simply producing healthy vegetables. When you get a community working together to grow vegetables and create these centralized garden plots, you start to build a sense of efficacy, a sense that they can really do a lot of other things together.
What the research has shown is that this kind of behavior has surprising trickle-down effects: decreasing crime rates in that community, decreasing alcoholism rates, improving fitness for seniors, improving school performance for kids. It’s a great public-health intervention.
From a physician’s perspective, how do you see your role in all of this?
I like to think what I am doing is practicing real family medicine. It’s not that I have taken on another role as an agronomist, or an ecologist or a sociologist. Indeed, what I am advocating for is a true community-based health practice.
I don’t just rely on the limited tools of antibiotics and surgeries and whatever I was given in medical school. I try to have an eco-mind and a community mind and look at what patients truly need, not just what I have to offer.
What has been the reaction from your medical colleagues?
What a lot of people say is, “Sure, that’s fine. But we have a medical shortage, we need more doctors.” I think what they don’t understand is that if we can support people’s health, then we‘ll need fewer doctors.
Because these problems of not having access to fresh vegetables and communities we can exercise in and not having places where we can connect with other people are much further upstream from diabetes and heart disease or depression and stress. If we can start to work on those, we won’t have to sit in our clinics and deal with these pandemics of modern disease.
In Farmacology, you compare drinking raw milk to having unprotected sex. What is your perspective on raw milk and how do you advise your patients?
There are clearly some health benefits to drinking raw milk. The question is whether the benefits outweigh the risks. The milk is going to be much safer if you are getting it from a farmer who is taking really good care of his cows, keeping them on pasture, milking them in a very mindful way, and keeping their immune systems healthy. And when the milk is drunk very quickly by the consumer, there is less opportunity for unwanted bugs to grow.
But buying raw milk off the supermarket shelf, not knowing how long it’s been there and not knowing the particulars of the farm, is more concerning, and I certainly don’t advocate it for my patients. It’s exactly like unprotected sex. You really need to know who you’re doing it with and check them out very thoroughly.
On one of the farms you visited, you were served a big steak. In your view, what’s the appropriate place of milk, cheese, and pastured meats in a holistic diet?
That really depends on the individual, where they live on the planet, what their resources are, and what their health issues are. It’s hard to come up with a hard-and-fast rule for the perfect diet.
When I asked Cody Holmes, who is a rancher in Missouri, “How can you ethically be raising beef when you could use that same acreage to raise something lower on the food chain, like vegetables?” he laughed and said, “Have you checked out our soil here? I do a great job with cattle, but my carrots are stunted.”
He has this very shallow soil that’s really good for rotating cattle through his paddocks. He felt that his land was good for animals and wouldn’t have done so well for vegetables. That was an interesting concept for me.
I tend to recommend that animal products be eaten with a lot of vegetables and legumes and grains — a little bit more as a spice, not so much as a big slab in the middle of the plate.
Many people, including Dr. Oz, have wondered whether buying organics is worth it. You have a detailed section in your book defining organics. What’s your reply to the question “Why organics?”
“Organics” is the best label that we have for finding healthier food at the store. But it’s a really imperfect label. You can grow food organically, but not take care of the soil at all. You can dump a lot of fertilizer and nutrients and even organic pesticides into that soil, and kind of keep it going on life support.
On the other side, you have lots of farmers who farm in an incredibly sustainable way, who keep very healthy soils and vegetables, but who are not certified organic. A., because they can’t afford the certification or the paperwork associated with the paperwork, because it’s loads of paperwork, or B., because the label organic does not represent all they put into their farm and is therefore not worth doing. We need something better.
Personally, the way I find food that is the most delicious and nutritious is I get to know the farmers or at least the story of the farm. I always like to know that the farmer lives on that farm. The other way is that I look at the fruits and vegetables. We all intuitively know when these are coming from healthy soils. They don’t look like they are on steroids or just had plastic surgery to make them look all exactly the same.
Fermented foods are big right now. What are the benefits from eating fermented foods?
Fermentation is just controlled rotting. If you think about it, we’ve eaten fermented foods for thousands and thousands of years. Our intestinal systems and all our body systems have co-evolved with this rotten food and figured out a way to survive and even thrive on them.
Before refrigeration, we were interacting with a lot more microbes than we are now. The microbes in fermentation originally come from the soil, and there is a lot of data to suggest that they are augmenting and supporting our internal biota.
I learned about combining beans with rice from Frances Moore Lappé. I’ve also read about other combinations, such as lemon juice on greens, that offer more nutritional benefit from what you’re already eating. Do you have any other magical food combinations to share?
Another great example is traditional Mexican cooking, where you have your beans, your corn tortillas, and your squash. It’s interesting because corn tortillas have a fairly high glycemic index, meaning that they put a lot of sugar all at once into our bloodstream. But when you eat them with beans, it actually lowers the glycemic index, so the sugar isn’t absorbed so fast. If you look at traditional recipes from around the world, so many of them already have prescriptions for these healing food combinations. They are perfect prescriptions.
What learning, from your any of your farmstays, most challenged your own ideas about maintaining good health?
On a personal level, I would say that my discoveries about sustainable beauty and graceful aging were profound. I had never contemplated how many messages we exchange with plants and what an important role they could play in changing our outlook on ourselves and on each other.
I had always thought of botanicals as simply being natural drugs, but now I look at them as having a much broader and more amazing function. They affect the way we perceive ourselves and, in many ways, they are the glue that binds us to each other and to our natural world.
Lynne Curry is a writer based in Joseph, Oregon. She is the author of Pure Beef: An Essential Guide to Artisan Meat with Recipes for Every Cut, and she blogs at Rural Eating.
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