All you can eat!
A Conversation with Matthias Riedl
It’s curious how we’ve become unconscious of those things that crucially shape our lives to such an extent that they’ve become habits. The ancient Greek word díaita refers not only to our caloric diet but to what we consume to sustain our lifestyles in general – of which the diets of deliberative political assemblies are reflexions. Conversely, the notion that we can decouple our lifestyle from our diet as a special sphere amounts to repression. Consumeism may be to blame insofar as the large food companies have taken advantage of it by supplying consumers with flavor-enhanced, over-sweetened, cheaply produced, thoroughly commoditized foods. What’s more surprising is how Medicine, which must deal with the fatal effects of our daily junk food consumption, has also lost sight of its patients' lifestyles. Certainly one reason for this is certainly specialization that amounts to a strange kind of autism – which prompted the philosopher of science Nicholas Murray Butler to make the apt observation, that here the Blind are leading the Blind.1
Thus, doctors lose sight of the patient as a holistic being; they don't know what to do about the spread of tertiary lifestyle diseases or, as may be more accurately put, diseases of consumerism. And because these increasingly affect not only advanced age cohorts but also the younger ones, it isn't uncommon for children to suffer from rheumatism, diabetes, and high blood pressure. In response, diabetologist Matthias Riedl founded the medicum Hamburg in the 90s and later launched a popular television program that shows patients their daily consumption and the fatal effects of this cozy consumerism on their health. Transferring the hero's journey of C.G. Jung to the consumer in marketing, Matthias Riedl and his Nutrition Doctors” use ›kitchen psychology‹ to encourage people to take their lives back into their own hands by eating healthily and consciously. Whether you call it self-efficacy or species-appropriate nutrition, as Matthias Riedl does, this lifestyle change has been the goal of all Enlightenment since Kant: the liberation of the individual from his »self-imposed immaturity« [Unmündigkeit]. And is that so difficult? Perhaps, and while it may very well be a misunderstanding of a person's happiness, this liberation doesn't begin with getting lost in ideologies—the first step into maturity is leading the person into their own kitchen. So, bon appetit as you read the English transcription of our recent conversation with the good Doctor!
Matthias Riedl began his career as a journalist, eventually changing direction to become an Internal Medicine Physician focusing on Diabetes. He then pioneered work in Nutritional Medicine, including founding the medicum Hamburg. He became known to a broader public through the TV series Die Ernährungs-Docs [The Nutrition Docs], which implemented the insights gained from his clinical practice into a successful television format. He’s also part of the EatSmarter! Team.
Martin Burckhardt: Dr. Riedl, I'm looking forward to our conversation today—especially since it’s about a field that’s generally ignored in our media-saturated society. Your television presence describes you as a Nutrition Doctor, but you started as a journalist. What led the young journalist from the Pinneberg district of Germany into medicine?
Matthias Riedl: As a child, I had horrible allergies. In the 1960s, physician’s training wasn’t as advanced as today. People thought it was just a weakness, that you just had to eat raw liver and be shipped off to live in the country...it was a real shipping industry back then as many children were shipped off to either the coast or the mountains, which is a bit nonsensical—even though there’s less pollen by the sea or at high altitudes. But in the end, that wasn’t about prescribing specific allergy therapy, as many doctors weren't even able to diagnose an allergy back then. I was very annoyed at the time, and it was only at age eleven when I was finally diagnosed with allergic hay fever, that I was able to get effective therapy. This made me see the work of doctors from a very personal point of view, which spurred me to see medicine as often tackling the problem from the wrong angle. I couldn’t let up on it, so I started writing about the medical profession’s educational deficits. My inner impulse is if there’s a problem, we must fix it in all fairness to society because people have a right to receive medical care of the highest standard … this isn’t the only problem in Germany currently, as it’s the symptom of something...you could say that we are in a movement of degrowth. That's how it is.
MB: After completing your specialist training as an internist, you turned to Diabetology and founded a center for inpatient diabetes care and training. Where did this interest in diabetes come from? Is it somewhere in your history?
MR: No, I don't have diabetes, and it doesn't run in my family either, but there was an analogy of treating a child with hay fever getting short of breath to young people getting diabetes in the hospital back then. In my mid-20s, it was standard practice to talk to a diabetic patient for five minutes, hand them a guidebook and send them home. I got my initial spark when I was sent to see an 18-year-old girl with new-onset diabetes. After speaking with her for five minutes, I thought this was wrong! I'm discharging a young woman with a chronic illness that she wasn’t prepared to deal with at home! It was just too dramatic, so I founded this center for diabetes2...I was relatively young at the time.
MB: Let’s look at the ancient Greek word diaita, which in the broadest sense means the way of life. This isn’t just linked to food; it also reflects the parliamentary assembly diets of our political representatives. We could justifiably call this a holistic view, but when we combine this view with conventional medicine, we somehow encounter a huge blind spot. Where does this blindness come from?
MR: This blindness stems from profound neglect in Western society towards our natural basic biological needs and ecological principles. It goes as far as not knowing the principles of our species-appropriate nutrition, just as there are species-appropriate diets for all animals–we do it for domestic cats and dogs. However, incorrectly, as we keep them overweight. This also applies to humans; even though we take ourselves out of this story by saying ›This may still apply to animals, but Man is the crown of creation; please put a question mark behind that! This doesn’t apply to us, as we can eat everything available!‹ But that’s wrong, as we have a role in the ecosystem of which we’re part. We’re mixed food eaters, not as carnivores as is currently highly popular in America, where there’s a counter-movement to veganism. That’s an extreme direction, of course, but veganism is a different extreme and unhealthy direction in contrast to vegetarianism. That’s precisely the problem...how and what we eat has become a general negotiation between public opinion influencers. ›What the aunt says, what the uncle says, what I once experienced myself.‹
It's as if everyone could define a species-appropriate diet for themselves, which doesn’t exist from a biological point of view because it denies all basic biological needs. We have an ecosystem within us with particular needs, such as the intestinal flora – and if it doesn't work, we become ill.
These connections between humans as a system within multiple systems interacting with the nutritional needs of our entire lives haven’t been recognized in society. This is evident in how we’re constantly trying some »new diet« that a celebrity brings back into the marketplace–which isn’t anything new–just to make a lot of money, such as Paleo and all the other trendy diets. They're always just excesses that never get to the heart of the matter.
MB: The American philosopher of science, Nicholas Murray Butler, wrote this remarkable sentence. ›An expert is someone who knows more and more about less and less until he knows everything about nothing.‹ This Bon Mot describes the dilemma of today's medicine. We may know more and more about less and less, but we lose sight of the person we should be concerned with the Patient. I saw this with my son, who, as a data scientist, collected medical data from a self-help forum for kidney patients who all complained about the same thing. Namely, the nephrologist doesn’t communicate with the cardiologist, who, in turn, doesn’t communicate with the nutritionist. In short, the patient is never being considered as a whole. How has this insight, which inspired your medical work, influenced your relationship with the Medical profession?
MR: The discipline’s autism, which you rightly point out, is a critically significant shortcoming, not only in German Medicine but in Modern Medicine throughout the world—you’re absolutely right! Specialties are becoming increasingly sophisticated and autistic in their thinking—and they don’t exchange ideas with each other. That's why I founded Medicum-Hamburg as an interdisciplinary center for Diabetology, Nutritional Medicine, Cardiology, Ophthalmology, Geriatric and Family medicine, and psychotherapy because people are more than just a psyche, a body, an organ – and these specialties have to exchange ideas. But it’s not like conventional medicine to exchange ideas because its specialization in a specific field is at the expense of ignoring the rest. That's what patients criticize about medicine in Germany - but what they find here is different. It’s not something they can articulate; they just say, ›Here, I'll go to the ophthalmologist, the cardiologist, the diabetologist and do some nutritional therapy, and it’s great because everything comes from one file. It’s one-stop shopping!‹ And that's what Social Physicians3 also demand from Modern Medicine.
However, as in Germany, this practice is penalized in most medical systems where we receive little support and less money—the exact thing we need to provide good medical care.
Even a classic specialty, like diabetology, is cross-sectional because of how the disease entity affects the kidneys, the eyes, the cardiovascular system, and the nervous system—and Nutritional Medicine is such a broad subject that it affects all the specialties in the world from Ophthalmology to Dentistry.
So, we’re involved in virtually all specialties. That's why Nutritional Medicine is a specialty belonging in every major medical center. According to the figures for Germany, almost 90 percent of our diseases are dietary or behavioral.
MB: In 2012, you and your colleagues Anne Fleck and Jörn Klaassen conceived the television format of The Nutrition Docs [Die Ernährungs-Docs] for the world. I must admit that because my wife is a big fan of this program, I’ve become a regular viewer. Tell me, how was this program conceived internally, and how did you convince the NDR [Nordeutscher Rundfunk4] executives that such a format could find a large audience?
MR: I already had a lot of contacts with NDR at the time, and we’d already produced many interviews here at Medicum-Hamburg. The idea came about because this elaborately designed British program called The Food Hospital was already in production in the inpatient setting. So, the idea was to do it on an outpatient basis in Germany, where Nutritional Medicine is an outpatient specialty that still isn’t taught at most universities. There’s the Culinary Medicine Program in America, but it’s taking a very long time for this idea to catch on here. So we found specific clinical cases where we knew we could make a difference with nutrition and worked them into this pilot program using a before and after principle of ›What changes after six months of the proper nutritional therapy?‹ It was so successful that today, it’s the most-watched program on NDR, and it’s developed an online presence—and we’re now celebrating our tenth anniversary. I think it was easy to convince patients because they already understand that what’s been happening in Western nations in recent decades naturally has something to do with nutrition. Unfortunately, the political caste ignores it because they don't experience it, perhaps because they eat in the political canteen or because they have more money and can go to better restaurants – although the majority of German politicians are also too fat for whatever reason, they don’t understand it. But the people on the street feel it. Ninety percent of the referrals to our center–Europe's largest center for Nutritional Medicine and Diabetology–come from the patients themselves.
MB: I think that's unusual for a new specialty.
MR: The patients also apply to NDR, saying ›Help me, I'm desperate!‹ They really are very, very desperate people.
MB: I must admit that everything I know about medicine, which is very little, is from my surgeon friend. And it quickly boils down to a few basic pearls of wisdom. For example, he who heals is right. I think that perhaps the biggest secret here is television. You see people who come in with classic symptoms of severe illnesses who all feel abandoned by the doctors by the medical system in general. But after six months of being mentored and encouraged by your team to take control of their lives, or more specifically, to cook for themselves and develop a nutritional plan, these people return to you almost transformed. How convinced were you at the beginning that this miraculous transformation would succeed?
MR: We’ve been treating diabetic patients with nutritional therapy and optimizing their weight—contrary to the general professional opinion—at our center for 20 or 30 years. During this time, we’ve noticed that high blood pressure goes down, hypo and hyperuricemia go away, and blood lipid levels improve, as does mood, physical performance, and fatty liver disease. I already saw these successes and knew we’d succeed—that was clear. That's why I wasn't worried that we’d embarrass ourselves. Based on this experience, I knew the combination of Nutritional Science and Medicine would be the successful guarantor of this series.
MB: You could extract the blueprint of a medical hero's journey by analyzing your TV show structurally and thinking of Joseph Campbell's The Hero’s Journey—which has kept a whole generation of Hollywood scriptwriters busy. A person comes to you with an unpleasant illness or a whole cluster of ailments. You carry out a suite of medical tests while assessing what this person eats. You then show the person in question how they’ve been stuffing themselves with everything imaginable that the supermarket has in the way of convenience food. This is the Hero's Journey moment of waking up from a slumber and saying ›I have to change my life!‹ This leads to the question of their personal sense of mission. Where does this desire come from to set these people on a new path and drive them forward? We’re in their childhood, right?
MR: Yes, exactly. On the one hand, we’re back in their childhood, while on the other, it’s about justice and, let's say, equal opportunities—I'm talking about real equal opportunities, not the »equal opportunities« we’re always discussing in Germany about certain people being disadvantaged because they have less money. But, there is less money, which is seen differently in America. Less money doesn’t necessarily equal less opportunity because you can give people more money, and then they buy even more convenience foods because they don’t know better, which offends us. But for me, equal opportunities are all about having the right food—having the education to understand what food is suitable to eat, what exercises are needed to keep your body healthy, and the opportunity to access it.
We know that children who come to term and then grow up with a mother who’s eaten convenience food have a 90 percent incidence of lower birth rate, poorer language development in infancy, smaller body size, and poorer brain development overall. In other words, we're talking about a D in math versus a B – and we also know educational success naturally impacts professional and economic success and health. The better-nourished someone is, the better their chances in society.
This injustice is a significant focus as in Germany, 50 percent of pregnant women are overweight, and they don't even know they’re passing on this epigenetic potential to their children, damaging them not just here but in America and the world over. Consequently, we’re getting more and more overweight people from generation to generation. For me, the whole thing amounts to a catastrophe because the disease burden of being overweight means developing secondary diseases we won’t be able to cope with economically because we know that obesity promotes depression or anxiety.
We also know that, in German primary schools, teachers are noticing children are becoming increasingly anxious. While it might be related to coronavirus or helicopter parents, it is also concerned with nutrition. According to health insurance surveys, one in three Germans in Germany are mentally ill, which also has something to do with diet. We can improve depression, anxiety, and many mental illnesses by up to 30 percent with the proper diet – a potential that hasn’t been tapped. Instead, we’re having an all-time high in sick leave use and drug consumption, leading to higher drug expenditure every quarter, and we’ll have double-digit increases in health insurance premiums next year. At some point, this will no longer be manageable, meaning the next generation will no longer have healthcare resources because the money will run out. This is the short-sighted thinking of society and politics.
MB: Yes, yes, of course. That corresponds to what goes back to C.G. Jung when he spoke of psychic inflation. And this psychic inflation naturally manifests itself massively in the way we live. Let's stop for a moment with the figure of the consumer. There’s a signature in the form of an unconscious where consumers express something fundamental in the question of their lifestyle. And thus, about the responsibility for their own lives. Every one of your patients knows when you show them what they've stuffed down their throats in a week with it spread out on a big table—it results in a shake of the head, embarrassment, and diffusion, saying ›Well, I've always known that it's unhealthy.‹ And then all it takes is this small gesture of taking back responsibility for your own life. How has this form of care, which is not medical but psychological, if not philosophical, affected how you see yourself as a doctor?
MR: In Germany, I grew up and trained in an authoritarian hospital system where we talked about service chiefs and senior physicians. Everything is still organized like a paramilitary, and the team concept of Healthcare is only slowly taking hold. The one essential thing in our center is that we have a very flat hierarchy. I want to hear all opinions as we always want the best for the patient. We don't like the Chief who says ›I’m the boss here.‹ Of course, it’d be nice if everyone always did what I said (laughing). But I know that's not always good for the patient, so I want to hear other opinions.
The other thing is if I want my child to tidy up their room, and everyone knows this from talking to their child, the wrong approach is to say ›Tidy your room! That's that!‹ That doesn't work with children, and it certainly doesn't work with adults either. So, I first have to learn what the inner motives are. When I care for chronically ill people, I can't promise I can cure them with one, two, or three pills—that's a construct, which is only the case with acute illnesses that nobody asks about anymore. ›I have pneumonia; give me an antibiotic. I take the pills; I'll be well again in a week.‹ No questions; I don't have to talk with the patient for long.
But with a chronic illness that’s also affecting a patient’s lifestyle, then I need to know what kind of person he is. ›What drives him? What are his obstacles? What does he want? What is he prepared to do?‹ In Diabetes, I am a practitioner of chronic diseases, and what I don't know about the patient may be obstacles to therapy.
So, to find out, I need a flat hierarchy that connects with the patients and is also in connection with the patient – which means we’ve moved away from Dr. Knows Best to a patient-centered decision. The patient decides, I advise.
MB: Cooperatively.
MR: That's right, cooperatively. You see, wait, what's that called? Agile. Many decision-making processes are also agile—shared decision-making is a technical term. Additionally, this is very important; if I bring a patient in and say, ›You have to ride a bike‹, or ›You have to do sports‹, then the people back away. But if I say, ›Could you imagine riding your bike to work once or twice a week?‹ Then something completely different happens. The patients immediately fall silent and imagine it: this is a step in the right direction. He imagines it and then tells me honestly, ›No, I don't feel like doing that.‹ Then I have to make another suggestion. Or they say, ›Yes, I could give it a try‹, and then we'll talk about it again next time. It's the same with food. That's why we must confront people with the reality of their diet on this plate. ›This is what you've eaten.‹ And it's often sheer horror. And when I ask the patients, ›Did you eat the vegetables during the week?‹ Then they say ›Yes, of course!‹ And then I say it’s not just an apple on the table. People see that. And that confronts them with their own lives and makes them think...that changes a lot. That's how a conversation works, and then it goes back and forth. What is our path? Deciding together.
MB: This disarmament of the feudal system is probably one of the big dilemmas. We had a conversation with Jeff Sutherland on Ex nihilo. He founded the SCRUM method, which is the Agile Management in software development. There, you can actually see the removal of the expert as a god-like figure, which is a conditio sine qua non of actually building this kind of collaborative logic. As a structural element in your program, you have the food diary, where candidates are asked to write down what they eat daily. This form of psychological accounting is the starting point of your therapy. As a doctor, you can see candidates’ eating habits from the food diary and how they contribute to the clinical picture. For example, how a diet high in sugar drives latent inflammation, which foods are missing: omega-3, fatty acids, and the like. Comparing this to a visit to my doctor, there is a world of difference, and I've never experienced anything like that.
MR: It's just what you've just described in Germany as the demigod-in-white, which is this hierarchization of the doctor as the decision-maker. We have to get to the point where the doctor is the consultant, the expert you ask for advice from, and who doesn't tell you what to do in an authoritarian manner. To do that, I have to get to know the patient. The food diary is really a diagnostic tool. It's not just a compulsory exercise; I first need to know how people eat. When I ask a patient ›What are you eating?‹ They say ›I don't remember everything...‹ and they remember it wrong. Their recall isn’t accurate. That’s why I have them document it so I can use it as an analysis tool. That way, I can tell you how much sugar, protein, and convenience foods you’ve eaten and see if it correlates with your symptoms. And what can we do about it? What are the options? It's a bit like the cardiologist using an ECG, echocardiogram, and a nutrition log. We’re missing one of the necessary analysis tools without a dietary protocol, making it a basic requirement for planning the first steps – and then I must list all the mistakes. And then it's like a company restructuring. I present the entrepreneur, in this case the patient, with all the things that aren’t going right in his company, in his body.
He can then decide whether he wants to take care of the sugar consumption, the low fiber content of his diet, the low amount of vegetables, overeating meat, or whatever. However, this is the decision of the company owner, who, in this case, is the patient deciding if they want to ruin their quality of life because a ruined quality of life also ruins nutritional therapy. This kitchen psychology leads the patient into the kitchen.
That is probably the significant advantage, which I believe is a key factor in the success stories of their patients. I've seen it myself, and it's always a pleasure.
MB: This is because they first feel seen as a whole for the first time. And the camera certainly contributes to this effect. This sense of wholeness is not part of our medical system. This becomes clear again and again in your program when you invite a specialist who remarks with some astonishment that changing the patient's diet produces much better results than decades of medication. What would you want to tell them if you were to hold a training course for your specialist colleagues? How do they need to change their system to make it patient-friendly?
MR: Listening to patients is the first principle; the patient is right, and I must listen to what they say. Many doctors say this isn't always true when they hear patient complaints. But that’s not the case because complaints and their constellations can be symptomatic of something rare. So, if the patient tells me something, I must first take it as the truth and work my diagnostic process around it. I have to take patient complaints and suspected correlations seriously and examine, question, and process them academically and intellectually so I can either verify or refute them. But I have to do this based on facts. I have to do that for the patient and not bring out the old Dr. Knows Best because that puts patients off; we can make mistakes, and I lose them that way.
Communication is essential in taking things seriously and asking questions. ›What complaints do you have? What is your goal? How can I best support you?‹
This no longer happens in modern conventional medicine. Instead, devices are used, laboratory and imaging studies are performed, and sometimes, the doctor neglects the importance of asking the patient about their symptoms, wishes, and health goals, even though that ultimately matters.
If the patient doesn't do what the doctor expects...I often have patients say, ›My GP has thrown me out because I haven't lost weight, and now I’m stranded. Oh my God, what am I to do?‹ And then they start crying, and I say, ›It’s ok, I’ll take care of you...‹ and they feel supported again.
MB: I can understand that, in all the wonderful stories on your show, the camera is, as you say, the psychological confessor. A question my wife often asks me is: ›What happens in cases where people have left your practice three, four, or five years later? Do they stick it out?‹
MR: Some people also fail in this phase of change. But that's not a problem because managing change is difficult when we want to get out of our own skin...it's tough.
Failure is allowed, and it's not bad that we fail. You know we have problems with that in Germany; the Americans fail better because they say, ›I fell down, but then I got up and tried again. I make my experience one where I re-evaluate what led to the failure and try again.‹
Sometimes they’re overwhelmed, sometimes it's the whole family, and there are economic problems. If that's the case, I say, ›Okay, if you feel overwhelmed now, it's not the right time to change anything. Let's wait until we can. Let's wait until you have the time and your head is freed up enough to change your life.‹ That's important because there are people who have healed afterward. That's just how it works. Some initially pull through, others have slight relapses, and others have more severe relapses. But in the end, in at least half of the cases, we have significant improvements resulting in optimal results.
And it’s also rewarding when I stand at an airport counter, and people come up to me saying I’ve saved their life...or ›Look at me, I now weigh 30 kilos less. Thank you for that!‹ Some have seen the TV show, but some have also bought one of my books describing the 20-80 principle of our work, which they can do on their own at home. What I keep getting back from my practice is that you don't necessarily have to have been on the TV show; you don't necessarily have to have been a patient in our practice.
For me, the best case was a wheelchair-bound man weighing 260 kilos who had diabetes...with a bad attitude and all the diseases of civilization you can imagine. Then, he saw how to improve his life on the Nutrition Docs for the first time. Maybe it has already been suggested to him...I hope it’d been suggested to him – but the show gave him the spark to initiate his self-healing, and then he thought about how to do it.
He asked himself the crucial question: ›What would it be like if I did the same thing for myself now?‹ That set a process in motion for him. He bought the 20-80 weight loss program and emailed me two years later with before and after pictures—260 kilos in a wheelchair, 90 kilos without a wheelchair, without diabetes, without the diseases of civilization. That I'm reaching millions of people is an even greater driving force...
MB: To come back to the question of what we call agency. We talked with Dickson Despommier on Ex nihilo, the godfather of vertical farming. This is a movement to remind people of their primary needs. When you see lettuce suddenly starting to grow in your apartment in Berlin, there is something very touching about it, and it inspired me—who is anything but a nature fanatic—to meditate on the growth of lettuce. In a specific case, there’s this school in Harlem, what you’d call a hotspot school, which had a lot of absenteeism. The management of this school decided to try doing a vertical farming project on its premises. They learned that after implementing it, absenteeism suddenly went down, and the children, who had been fed junk food at home, developed pride in their farming activities and began to prefer to eat their own produce. If I look at this sociologically, I’d say that the outsourcing of food is a profound privation, degrading people to consumers—that over time gives them all kinds of civilization diseases, which already affect young people today. So, what educational program would you like to see for children? And what would prevent them from growing up to be overweight consumers who suffer from diabetes, gout, and high blood pressure?
MR: You’re describing alienation from nature and our natural resources, that we forget we’re part of an ecological togetherness, that plants have been our primary source of nourishment, and it should still be so today. This alienation goes so deep that when I was at an organic farm last month, the farmer told me that when the children come from the city, they shake the organic cattle's horns because they think they are glued on. For many children, it's their first time seeing where food actually comes from. And that's precisely what we need...we need organic farming in every school, vertical cultivation of vegetables, whatever. There should always be a spot in every kindergarten where children are responsible for growing vegetables.
I also favor offering parenting courses in nutrition because parents help determine their child’s nutrition in the womb and during the first two years of life—or they help ruin it. Nutritional education has to continue in kindergarten after that. Shouldn’t a Nutritionist be involved in providing education on the relationship between nature and children's healthy eating habits again? Society needs to understand that. We need to restore people as part of an ecosystem. As long as we remain alienated and people continue littering their gardens with stones and pollutants in an environment contaminated with chemicals, as long we continue living on land where there’s no nature at all, where we’re as far away from nature as possible, then we don’t understand we’re also animals. As Homo sapiens, we’re a mammal, a primate...
MB: I liked that you’ve written a cookbook with celebrity chef Johann Lafer - indeed, you’ve approached these questions wonderfully non-ideologically. Not the health apostle, but the one who appreciates cuisine's lively, civilizing aspects. But tell us: what was it like working with Johann Lafer? Two very different perspectives and interests come together here.
MR: Many chefs take a critical view of nutrition. When I used to meet chefs, I always felt like I was competing with someone from the other side who wanted to spoil the food. That's all wrong. I met Johann Lafer; he said he’s tired of making these expensive high-production dishes, cutting food up with manicure scissors and applying gold leaf to it with tweezers, and all of those things because it isn’t economically viable – and it’s not an honest meal. I met him during an interview for my magazine, ISS DICH GESUND [It’s Your Health], and I said ›Let's do it together. I want to show people that healthy food isn’t dull but can taste great, and you make healthy food an absolute culinary delight.‹ We've joined forces and are already making a fourth production about, for example, curing diabetes with Medical Cuisine. We sit down in a kitchen doing a cooking workshop together where we design dishes...that’s how we do it for every book.
As a Nutritional Doctor, I know I've lost the patient if what I recommend doesn’t taste good because we’re all hedonists. I can't fight against human nature, and I don't want to. Medicine has been doing this for decades by coming up with bans and diets that many doctors are still trying to prescribe. And when they don’t work, they say ›We have to make their stomachs smaller because diets haven't helped by stapling or removing a part of it.‹
So I say, ›Dear doctors, diets don't help. Please stop advising people to diet. We must find a way of working with the patient – and making the food tasty. We need to find ways of slowly pulling the patient into being responsible for their own well-being rather than shrinking stomachs, and we need to start as early as possible.‹ The critical thing is tackling the quality of life issues medically...
MB: If I come back to the hero's journey, which is the actual dramaturgy of your TV show, I think that all the psychological processes you go through using the example of nutrition can also be transferred to other areas—including work on symbols and creative activities. Here, too, overconsumption of canned food is harmful - indeed, it prevents people from achieving what they actually want to achieve. Do you agree with this argument?
MR: Exactly! People are currently denied access to a healthy diet because our supermarkets are 80 percent canned or other things you shouldn't eat regularly, and you have to go to great lengths to find what is edible. We’re trapped in this nutritionally hostile environment of preventing people from accessing healthy food unless they know what they should or shouldn’t eat and what’s available in the supermarket that they should buy...you need an introductory supermarket course. Nobody can be expected to do that because we want to buy what we like. That’s why I always say people who are overweight and have diet-related illnesses are victims of the situation; they are not to blame.
Politicians like to say ›It's the patient's fault!‹, but fundamentally, it’s a political and social decision whether I sell unsuitable food and allow – or even worse, encourage people to eat lots of it. It’s about dealing with what’s blocking our access to what’s good for us…what enables or prevents us from living a species-appropriate life. Ultimately, we all need peace and quiet to think and reflect, and, of course, for food and social companionship as Homo sapiens to remain or become happy. That’s an entirely different social perspective...
MB: How has your work affected the Riedl family life? Do you bake your own sourdough bread? Have you switched to making your own sourdough? Do you find that you’ve become socially isolated because of your views in your own private life?
MR: Yesterday, I was invited to a friend's house on the Elbe who owns a company supplying cruise ships with exquisite meat. He served these small portions of some exceptional cuts from his warehouse, which we celebrated as something special. Although I mainly eat vegetarian food throughout the week and rarely eat meat, sometimes we do...yesterday we had a small sausage. But generally, we eat a lot of pulses because it makes me feel better, and when I feel better, I'm more productive. Some of my children are vegetarian and vegan. But nobody is dogmatic. In other words, we eat meat if we’ve been invited to someone’s home...and we order it from time to time, but it’s kept in a species-appropriate way. Usually, I share a main course with my wife, and we add a salad because the meat portions are far too big. So we take the rest home because it’s enough for a few days.
MB: So, as we slowly approach the end, tell us, put yourself in the position of a science fiction author thinking about how to feed a small Martian colony – and the food philosophy behind it. What would this future scenario look like for you?
MR: Vertical Farming, of course, because I don’t know how else to plant and grow vegetables on Mars. But you’re asking what we should eat, isn’t it? What would we eat in a new society? Well, the truth is that we should eat 80 percent plant-based food. So I’d include vegetables that are often separated from legumes—that’s important! Mushrooms and nuts are also part of this 70-80 percent base. That's important because it's how we cover our need for fiber, phytochemicals, and vitamins.
We’d also need seeds, not just nuts. Otherwise, we wouldn't be able to manage without whole grains to get the necessary amount of supplementary fiber that primitive peoples did, which was about 50 grams a day. The Americans eat 11 grams daily, the Germans just under 20 grams, and, according to the American Society of Nutritionists, we need 30 grams a day, and getting over 40 grams, almost nobody can do that. That’d be the basics. Then we’d talk about the side dishes, which brings us to dairy products, meat, eggs, chicken, and, of course, a bit of fish...maybe snails, or whatever else, sometimes crabs, seafood. That would be the ideal diet if we stick to it. We’d gain a lot healthwise, and we’d be saving billions in healthcare expenditure...
Thus, doctors lose sight of the patient as a holistic being; they don't know what to do about the spread of tertiary lifestyle diseases or, as may be more accurately put, diseases of consumerism. And because these increasingly affect not only advanced age cohorts but also the younger ones, it isn't uncommon for children to suffer from rheumatism, diabetes, and high blood pressure. In response, diabetologist Matthias Riedl founded the medicum Hamburg in the 90s and later launched a popular television program that shows patients their daily consumption and the fatal effects of this cozy consumerism on their health. Transferring the hero's journey of C.G. Jung to the consumer in marketing, Matthias Riedl and his Nutrition Doctors” use ›kitchen psychology‹ to encourage people to take their lives back into their own hands by eating healthily and consciously. Whether you call it self-efficacy or species-appropriate nutrition, as Matthias Riedl does, this lifestyle change has been the goal of all Enlightenment since Kant: the liberation of the individual from his »self-imposed immaturity« [Unmündigkeit]. And is that so difficult? Perhaps, and while it may very well be a misunderstanding of a person's happiness, this liberation doesn't begin with getting lost in ideologies—the first step into maturity is leading the person into their own kitchen. So, bon appetit as you read the English transcription of our recent conversation with the good Doctor!
Matthias Riedl began his career as a journalist, eventually changing direction to become an Internal Medicine Physician focusing on Diabetes. He then pioneered work in Nutritional Medicine, including founding the medicum Hamburg. He became known to a broader public through the TV series Die Ernährungs-Docs [The Nutrition Docs], which implemented the insights gained from his clinical practice into a successful television format. He’s also part of the EatSmarter! Team.
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The elaborate training which they have so often received is a sorry substitute for education. They are high-minded, eager and devoted specialists and illustrate to the full the definition, marked as much by truth as by wit, that the specialist is one who knows more and more about less and less. For whatever other purposes this trait may be useful, it is quite futile as an instrument of education. Butler, Nicholas M. – Annual Report of the President of Columbia University, in the 1928 Annual Report of the President and Treasurer to the Trustees with Accompanying Documents for the Year Ending June 30, 1927, Columbia University, November 7, 1927, Page 18 (Blind leading the Blind).
Founded as part of the German State Medical Service, Hamburg’s Diabetic Center had managing diabetics since 1943 until Dr. Riedl began converting it into a full-fledged diabetic practice in 1999, which, by 2007, he’d changed into an interdisciplinary Medical Center focused on Diabetology and Nutritional Medicine. Today, the Medicum Hamburg is the largest center in Europe focused on the interdisciplinary in- and outpatient healthcare needs of diabetic and nutritionally compromised patients using a shared-practice model with the patient.
Social Medicine, per Merriam-Webster, is the »organized investigation of social, genetic, and environmental factors influencing human disease and disability and promotion of methods of prevention of disease and health measures protective of individual and community.« There are organizations like Physicians for Social Responsibility and a movement to establish it as a part of the core part of medical care and its curriculum that Dr. Riedl has made the focus of his career.
The Norddeutscher Rundfunk [Northern German Broadcasting], or NDR, is a part of the Arbeitsgemeinschaft – der öffentlich-rechtlichen Rundfunkanstalten – der Bundesrepublik Deutschland [ADR] which is Germany’s public-law broadcasting system and is the largest public service broadcasting system in the world.