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“The Tomato Effect”: Why Nutritional Therapies Are Rejected By Mainstream Medicine—And What We’re Doing About It

The medical community has been slow to adopt targeted nutritional supplementation for mental health and healing—a form of rejection and resistance dubbed “The Tomato Effect.” But a new paradigm—a “redefined” perspective—is slowly but surely gaining ground.

For decades, I’ve struggled to understand the tragically slow pace that medicine adopts  to the role of diet and nutrition on brain health. This article in the Journal of the American Medical Association (JAMA) from 1984 has given me insight on why and it may be illuminating for you too. Please let me know your thoughts.

In the article I’m referring to, titled “The Tomato Effect,” the team of Dr. James Goodwin (internal medicine) and Dr. Jean Goodwin (psychiatry) wrote:

“The tomato effect in medicine occurs when an efficacious treatment for a certain disease is ignored or rejected because it does not ‘make sense’ in light of the accepted theories of disease mechanism and drug interaction.”

How exactly did the tomato effect get its name?

From the 1600s to the early nineteenth century, Americans truly believed that tomatoes were the equivalent of cyanide. Take one bite, and you’d be sick in minutes. Eat an entire tomato, and you’d probably be dead.

It’s not that fear of the so-called “poison apple” (native to Peru; imported to Spain; and quickly spreading in the 16th century to Italy and France) was wholly without basis. Tomatoes are nightshades, a family of plants that includes potatoes, eggplants, and bell peppers. It also includes very toxic plants, like belladonna, henbane, and mandrake.

But while Americans were avoiding tomatoes like the plague, Europeans were happily consuming the rosy vegetable—in pizza, sauces, soups, and other dishes. And here’s the strangest part of the story…

New World Americans knew that their Old World brethren had been chowing down on tomatoes for centuries without any ill effects…but they refused to believe the vegetable was safe for human consumption!

That situation changed in 1820, when a brave soul named Robert Gibbon Johnson—a historian and horticulturist—publicly ate a basket of tomatoes on the steps of the Old Salem County Courthouse in New Jersey. And lived to tell the tale.

Over the next century, tomatoes were cultivated in more and more American farms and backyards—and became a standard of the American diet. Americans now eat about 30 pounds per year of the vegetable, second only to the humble spud.

Rejecting Effective Therapies

I’m telling you this story because it perfectly illustrates a medical frame of mind that has been aptly dubbed “The Tomato Effect”—the rejection of highly effective therapies.

Later in the editorial, the Goodwin doctors make a point that I think is particularly relevant to targeted nutritional supplementation for mental illness:

“In this atmosphere we are at risk for rejecting a safe, inexpensive, effective therapy in favor of a treatment perhaps less efficacious and more toxic.”

Isn’t that exactly what has happened with nutritional supplementation for mental illness?

Participating in the Paradigm Shift

Understanding this human tendency to reject a treatment outside of one’s frame of reference—even in the presence of contradictory evidence—helps us identify why the medical profession has resisted the importance of nutritional deficiencies and imbalances in brain function.

However, that resistance is softening—and even melting—one mental health professional at a time. Psychiatry is being redefined. Right now. By you. By me. And by this community of knowledge and practice that we’re creating. The old medical model is giving way to a new model.

This “paradigm shift”—a term coined by historian of science Thomas Kuhn, PhD, in his influential book The Structure of Scientific Revolutions—is happening because of several factors. Here are  three specified by Kuhn…

  • Evidence to the contrary: There is an accumulation of evidence showing that nutritional deficiency and imbalance is a leading factor in mental illness and health. In fact, the literature is vast—with thousands of studies demonstrating that deficiencies in nutrients like omega-3 fatty acids, B vitamins, vitamin D, and zinc (to name a few) are linked to mental health disorders. Because of this research, more and more professionals—like yourself—are questioning the validity of the current paradigm, and exploring new avenues of treatment.
  • Education: The training of clinicians and researchers with a fresh perspective and approach can contribute to a paradigm shift. (I’m guessing you didn’t start reading this newsletter today thinking you were shifting the paradigm—but you are!)
  • Social and cultural factors: Your patients and clients—the society and culture of those with mental disorders—are leading the way, too. They are literally sick and tired of an ineffective medical paradigm for treating mental illness. They are fed up with a theory and practice that doesn’t work. They are weary of an approach to mental disorders that ignores the imbalanced biology underlying the disorder, and instead focuses on treating symptoms. They want change. They want healing. And my hope is that Psychiatry Redefined can help provide that change, improving the mental health and wellbeing of thousands of patients. And the professional satisfaction of thousands of people like yourself.

In other words, we can all start eating and enjoying “tomatoes”—targeted nutritional supplementation for personalized mental health treatment. To learn how to accurately diagnose underlying causes of mental illness and gain science-backed treatments and interventions, sign up for our Annual Fellowship in Functional & Integrative Psychiatry program.

The inspiring community of clinicians engaged in Psychiatry Redefined have enriched my life and career. Psychiatry Redefined is a fellowship in the true sense of the word “fellowship.” You will learn from colleagues and be supported in pursuing your goals of improved mental health care for all.

Please reach out to discuss how Psychiatry Redefined can help broaden your tools and strategies when treating mental health patients. We are offering a limited number of scholarships for our Fellowship, and you can schedule a 1:1 call with me to determine if you qualify.

Our unique 360-degree, personalized approach leverages evidence-based protocols that you will learn during the Fellowship to result in vastly improved patient outcomes and practice transformations.

Designed specifically for mental health providers (psychiatrists, nurse practitioners, physicians, PAs, psychologists, and naturopaths), our flexible program includes 300+ hours of research-backed curriculum, unparalleled faculty mentorship, and invaluable community support.

Our past Fellows have reported incredible outcome statistics: 
  • 90% of Fellows report improved patient outcomes after enrolling in the Fellowship
  • 95% report that patients are more satisfied with care since applying interventions from the Fellowship
  • 95% report that the Fellowship has made them more confident providers

I truly hope you’ll join me in our Fellowship program.

In health,

James Greenblatt, MD
Founder & CMO
Psychiatry Redefined