AI Caramba!

When Gemini, Claude or DeepSeek screen this blog they conclude that the science is reasonable and the writing adequate, but the conclusions are a bridge too far.

They like it when I recommend eating a better diet, even though everybody knows that dietary education programs don’t work (ie 1-3). They can’t find it in their silicon hearts, however, to concede my claims about pharmaconutrition, because I have commercial ties and because I advocate rationally designed nutrient programs as a strategic addition or alternative to whole foods. They confirm my commercial nature by pointing out that I recommend omega 3’s, polyphenols, prebiotic fibers and 1-3, 1-6 beta glucans, all of which are contained in products I designed. And they don’t like the fact that I cite my own articles.

These are substantial arguments, which I will try to counter.

Their criticism of my involvement in the sordid world of commerce is moot, or at least arguable; show me a scientist who labors for free. Are my counterparts who work for the pharmaceutical industry less compromised than I am (4-7)? Given that the numbers of biomedical papers being retracted has quadrupled in the last 20 years (8, 9), are academics less questionable than their commercial counterparts?

The ‘publish or perish’ academic culture has fed into this latter issue, as have the paper mills, a desperately overloaded and sometimes compromised peer-review system, and more recently, generative AI. Improved vigilance by the various research integrity watchdogs is an additional but positive factor.

The AI’s second argument, against pharmaconutrition, is thin. The idea that fruits and vegetables have magical properties over and above their increasingly well-defined phytochemistry is science infused with the last gasp of vitalism, a concept largely discredited in 1828 (10); although it has recently been re-imagined in a very interesting way as teleonomy, or evolved purposiveness (11).

In a related claim, Gemini insists that pharmaconutrition is unnecessary because humans can obtain all the nutrients they need in food. This reflects the standard position taken by many nutritionists (ie 12) – but I don’t accept this either.

The idea that someone living at the modern (post-industrial) rate of 2000 kilocalories/day can obtain all the nutrients they need within 2000 kilocalories of food, especially when so many of the calories in ultraprocessed foods are empty ones, is absurd (13-16). It is almost possible if you focus on nutrient-dense produce (17), but the ultraprocessed, calorie-dense and generally nutrient-lite food juggernaut has ruined that scenario (17, 18).

Let’s consider argument No. 3, the lack of evidence for pharmaconutrition.

The modern diet and lifestyle is very obviously harming public health (19), and a large part of the machinery that links diet to disease has been elucidated. Chronic inflammation, dysbiosis, multiple micro- and phytonutrient depletion and glycemic overload are implicated in almost all the many chronic diseases which currently fill our hospitals and funeral parlors (20-23). Countering these drivers of disease would therefore be expected to slow, stabilize or reverse at least the earlier and reversible aspects of all these conditions.

Sodium excess is another substantial factor, addressed here: https://drpaulclayton.eu/blog/dietary-sodium-intake-and-morality/

The formulations in the Health Protocol were specifically deigned to counter chronic inflammation, dysbiosis and Type B malnutrition. In addition, I have long advocated for lifestyle changes (less carbs, more exercise) to counter glycemic overload. Exercise mimetics are a potential alterative, and until the regulators start to engage honestly with the science the herb Gynostemma pentaphyllum can be grown at home (24).

Such a program should logically go a long way to restoring pre-transitional health, and my colleagues and I see this in our clients and patients on a daily basis. From my background as a pharmacologist, it is hard to make a case that they wouldn’t do so. The lack of prospective clinical trials to prove that case is due to the fact that natural products cannot be adequately patented, and so the price points to justify trials cannot be achieved.

Moreover, the current regulatory system makes such trials almost impossible; the consistently positive results we see would produce medicinal claims, which necessitate pharmaceutical licensing.

Classically trained doctors find it difficult to accept this idea, as the current medical model focuses on specificity, and therefore synthetic (and patentable) chemistry. This reflects the historical origins of the pharmaceutical model (25-28), and does not fully address the health problems that are important today; hence our declining public health.

Doctors and other health practitioners trained in functional and integrative medicine take to the HP like highly qualified ducks to water, and combine it with pharmaceutical medicine to elicit better and safer outcomes for their patients.

The AIs’ last criticism refers to excessive self-citation, and here I concede that Gemini, Claude et al have a point. I often cite previous posts, but there is a reason for this. Each post uses multiple citations to build an argument, typically between 40 and 100, and it is easier to provide the post as a single composite reference rather than include the much larger number of original references. If I did that, each post would carry several hundred citations. I’m simply trying to be efficient.

A carbon-based intelligence I respect had a rather different angle. She argued that my posts generated anxiety, and catered to hypochondriacs (somatoforms) and the morbidly self-obsessed, who appear to be over-represented among medical students (29-32). Hypochondria is indeed bad for your health (29), but the articles I post here are designed to inform and empower consumers by showing that many health conditions are self-manageable. Whether my writing achieves this, I leave my readers to decide.

A reasonably powered Swedish study found that individuals with a history of hypochondria had a substantially increased risk of death from both natural and unnatural causes, specifically suicide (33). The likely connection is chronic stress, leading to physical maladaptive responses that cause real harm over time. They do this by triggering chronic inflammation (34), dysbiosis (35-37) – which then feeds back to cause increased stress (38) – and degraded glycemic control (39).

The HP may be useful here. It counters the first two mechanisms, and diet plus exercise (or an exercise mimetic) counters the third. The anxiety component in hypochondria correlates with neuroinflammation (40), so the HP will likely act here also; together with a saffron extract standardized to crocinolides (41), if further help is needed. Cognitive behavioral therapy is an acceptable alternative.

I fed the above text though Gemini and received the following summary:

‘The author makes strong, pragmatic points regarding the systemic flaws of modern nutrition, the commercial food landscape, and the financial impossibility of patenting natural health trials. However, he appears to prioritize pharmaconutrition over proven clinical interventions, his defense against his own commercial conflicts of interest relies on logical fallacies, and his dismissal of whole-food nutrition as “vitalism” mischaracterizes modern nutritional science.

Pointing out the problems with academic science does not exonerate my commercial ties, and is indeed a logical fallacy. All I can say is that I strive to for the truth in my work, and would never promote something I knew was ineffective. This plea is not proof, however, so I must concede the first part of Gemini’s case.

I do emphasize pharmaconutrition, because it is under-appreciated and under-utilized. It has little place in acute and emergency medicine, but should be used in tandem with those drugs used to treat (not cure) chronic conditions. By rectifying the pathology underlying those symptoms that drugs largely treat it enables gradual dose reduction, reducing cumulative drug burden and the risk of iatrogenic disease.

I discussed this in a previous post (42) in which I challenged my colleagues to try this approach in a few patients, hopefully culminating in a testable and falsifiable hypothesis.

The ‘Dismissing whole-food nutrition as vitalism’ argument isn’t entirely correct, in my view, because it rests on the alleged importance of food matrices. An interesting topic (43), but although the adverse effects of accelerated glucose uptake from rapid release matrices are well documented (44), this is far from a general case.

Omega 3’s ingested as fish oil are absorbed no faster than fats from butter or any edible oil. Vitamin C in a tablet will cure scurvy just as well as in a lemon or lime, and polyphenols in a supplement are absorbed no more rapidly than polyphenols in fruit juice, although polyphenols bound to plant fiber do show different pharmacokinetic and hence possibly clinical properties (45).

Against that, adding prebiotic fiber promotes microbial diversity in the colon and protects against infection (46) whether consumed in food or a supplement, because most other elements in food matrices are absorbed in the small intestine.

Different food matrices may alter gut transit time and satiety signaling, but does this matter if key absorption rates remain unaffected? In any case, supplement users also consume food; so if the synergy of nutrients in food matrices is in some way significant, this will still apply.

I believe, therefore, that the AI arguments reflect bias built into the rag by the prevailing voices in this area of research, whose baseline positions reflect a traditional and increasingly obsolescent medical model. Claude sees it differently.

‘The article is an example of sophisticated pseudoscientific writing. It uses real science to validate a reader’s legitimate frustrations with modern junk food and medical systems, but then uses that trust to pivot to an unproven alternative: replacing whole-food nutrition with a proprietary supplement line. Eating a nutrient-dense, whole-food diet is still the undisputed gold standard of nutritional science. Supplements can bridge gaps, but they aren’t a “strategic alternative” to a real plate of food.’

At least my pseudoscientific writing is sophisticated!

More seriously, Claude is wrong here. I do not advocate replacing a good diet with supplements but I am aware, apparently more so than Claude, that the numbers of people willing and able to eat a nutrient-dense diet are small and diminishing (47, 48). Given our reduced calorie intakes and ultraprocessed nutrient-lite diet, I believe that well-designed supplements and/or functional foods are now essential additions if we are to salvage our declining public health.

It has been calculated that 75% of the world’s population are deficient in the omega 3 fatty acids alone (49); and it is quite obvious that our intakes of polyphenols (50-52) and prebiotic fibers (53-57) are far lower than levels consumed in groups not exposed to the modern diet.

Claude, educate yourself.

Individuals who do eat well, and do not require supplementation, should not be medicalized. Because a test-based approach makes it easy to inform such persons that they do not require support, and identify those who do, test-based pharmaconutrition is becoming the standard. I promote this approach, and will continue to do so.

In the final analysis, were Claude, Gemini and DeepSeek correct in their judgements about my take on healthcare? I think they were right in some areas, less so in others – but in the end what I think may not matter much, because it’s not just medicine. AI is moving into every area of decision making.

In 2006 the Zichuan District People’s Court in Zibo, Shandong Province, introduced computer-based sentencing software into their law courts (58). AI is now embedded throughout the Chinese legal system (58), and their AI judge is claimed to have a 97% accuracy record after listening to verbal arguments.

In India and Brazil, the judiciary is testing AI tools to assist human judges in processing minor or routine cases such as traffic violations and land disputes (ie 59). A pilot program in Estonia allows litigants in small claims court to submit their disputes to a computer program (60).

As Western civilization declines, governments with shrinking resources and fewer morals will extend cheaper AI systems into ever more legal areas. Human judgment will become marginalized.

All rise. The court of last appeals is now in session.

References:

1. Raine K, MacIntyre L. The failure of charitable school-and community-based nutrition programmes to feed hungry children Critical Public Health June 2003, 13(2).
2. Yearley S, Miller V, Cudhea F, Shi P, Sharib JR, Lara-Castor L, Essel K, Micha R, Zhang J, Mozaffarian D; Global Dietary Database. Global, regional and national intake of plant-based foods among youth in 185 countries (1990-2018): findings from the Global Dietary Database. BMJ Glob Health. 2026 Jul 8;11(7):e021543. 
3. Vanstone M, Giacomini M, Smith A, Brundisini F, DeJean D, Winsor S. How diet modification challenges are magnified in vulnerable or marginalized people with diabetes and heart disease: a systematic review and qualitative meta-synthesis. Ont Health Technol Assess Ser. 2013 Sep 1;13(14):1-40.
4. https://www.youtube.com/watch?v=ZYgiCALEdpE
5. https://www.justice.gov/opa/pr/glaxosmithkline-plead-guilty-and-pay-3-billion-resolve-fraud-allegations-and-failure-report
6. https://affiliates.legalexaminer.com/health/massive-fraud-in-merck-mmr-vaccine-testing/
7. https://www.pharmaceutical-technology.com/features/biggest-pharmaceutical-lawsuits/
8. Else H. Biomedical paper retractions have quadrupled in 20 years – why? Nature. 2024 Jun;630(8016):280-281.
9. Steen RG, Casadevall A, Fang FC. Why has the number of scientific retractions increased? PLoS One. 2013 Jul 8;8(7):e68397.
10. Kinne-Saffran E, Kinne RK. Vitalism and synthesis of urea. From Friedrich Wöhler to Hans A. Krebs. Am J Nephrol. 1999;19(2):290-4.
11. https://direct.mit.edu/books/oa-edited-volume/5634/Evolution-On-Purpose-Teleonomy-in-Living-Systems
12. https://newsinhealth.nih.gov/2021/12/do-you-need-dietary-supplements
13. Fulgoni VL 3rd, Keast DR, Bailey RL, Dwyer J. Foods, fortificants, and supplements: Where do Americans get their nutrients? J Nutr. 2011 Oct;141(10):1847-54.
14. Wallace TC, Frankenfeld CL, Frei B, Shah AV, Yu CR, van Klinken BJ, Adeleke M. Multivitamin/Multimineral Supplement Use is Associated with Increased Micronutrient Intakes and Biomarkers and Decreased Prevalence of Inadequacies and Deficiencies in Middle-Aged and Older Adults in the United States. J Nutr Gerontol Geriatr. 2019 Oct-Dec;38(4):307-328.
15. Reider CA, Chung RY, Devarshi PP, Grant RW, Hazels Mitmesser S. Inadequacy of Immune Health Nutrients: Intakes in US Adults, the 2005-2016 NHANES. Nutrients. 2020 Jun 10;12(6):1735.
16. Blumberg JB, Frei BB, Fulgoni VL, Weaver CM, Zeisel SH. Impact of Frequency of Multi-Vitamin/Multi-Mineral Supplement Intake on Nutritional Adequacy and Nutrient Deficiencies in U.S. Adults. Nutrients. 2017 Aug 9;9(8):849.
17. Gupta S, Hawk T, Aggarwal A, Drewnowski A. Characterizing Ultra-Processed Foods by Energy Density, Nutrient Density, and Cost. Front Nutr. 2019 May 28;6:70.
18. Aceves-Martins M, Bates RL, Craig LCA, Chalmers N, Horgan G, Boskamp B, de Roos B. Nutritional Quality, Environmental Impact and Cost of Ultra-Processed Foods: A UK Food-Based Analysis. Int J Environ Res Public Health. 2022 Mar 8;19(6):3191.
19. GBD 2017 Diet Collaborators. Health effects of dietary risks in 195 countries, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2019 May 11;393(10184):1958-1972. 
20. Phillips CM, Chen LW, Heude B, Bernard JY, Harvey NC, Duijts L, Mensink-Bout SM, Polanska K, Mancano G, Suderman M, Shivappa N, Hébert JR. Dietary Inflammatory Index and Non-Communicable Disease Risk: A Narrative Review. Nutrients. 2019 Aug 12;11(8):1873.
21. Shelton CD, Byndloss MX. Gut Epithelial Metabolism as a Key Driver of Intestinal Dysbiosis Associated with Noncommunicable Diseases. Infect Immun. 2020 Jun 22;88(7):e00939-19.
22. Brown KH, Hess SY, Moore SE, Combs GF Jr, Cashman KD, McNulty H, Allen LH, Krebs NF, Pfeiffer CM, Rybak ME, Osendarp SJ. Neglected micronutrients-considering a broader set of vitamins and minerals in public health nutrition programs worldwide: a narrative review. Am J Clin Nutr. 2025 Sep;122(3):680-694.
23. Villegas R, Liu S, Gao YT, Yang G, Li H, Zheng W, Shu XO. Prospective study of dietary carbohydrates, glycemic index, glycemic load, and incidence of type 2 diabetes mellitus in middle-aged Chinese women. Arch Intern Med. 2007 Nov 26;167(21):2310-6.
24.  https://drpaulclayton.eu/blog/an-exercise-in-bureaucracy/
25. https://drpaulclayton.eu/blog/the-doctor-is-out/
26. https://drpaulclayton.eu/blog/the-doctor-is-out-pt-2-the-bugs-are-back-in-town/
27. https://drpaulclayton.eu/blog/rustic-wrap-and-hickams-dictum/
28. https://drpaulclayton.eu/blog/the-drugs-dont-work/
29. Meng J, Gao C, Tang C, Wang H, Tao Z. Prevalence of hypochondriac symptoms among health science students in China: A systematic review and meta-analysis. PLoS One. 2019 Sep 17;14(9):e0222663.
30. Abdulghani HM, Marwa K, Alghamdi NA, Almasoud RN, Faraj AT, Alshuraimi AF, Mohamed KM, Alnafisah OS, Ahmad T, Ahmed MZ, Khalil MS. Prevalence of the medical student syndrome among health professions students and its effects on their academic performance. Medicine (Baltimore). 2023 Oct 27;102(43):e35594.
31. Szczurek K, Furgał N, Szczepanek D, Zaman R, Krysta K, Krzystanek M. “Medical Student Syndrome”-A Myth or a Real Disease Entity? Cross-Sectional Study of Medical Students of the Medical University of Silesia in Katowice, Poland. Int J Environ Res Public Health. 2021 Sep 19;18(18):9884.
32. Papadopoulou A, Koureas M, Farmakis A, Sirakouli A, Papathanasiou IV, Gourgoulianis KI. Increased Frequency of Health Anxiety in Health Science Students: a Cross Sectional Study in a Greek University. Med Arch. 2021 Jun;75(3):221-228. 
33. Mataix-Cols D, Isomura K, Sidorchuk A, Rautio D, Ivanov VZ, Rück C, Österman S, Lichtenstein P, Larsson H, Kuja-Halkola R, Chang Z, Brickell I, Hedman-Lagerlöf E, Fernández de la Cruz L. All-Cause and Cause-Specific Mortality Among Individuals With Hypochondriasis. JAMA Psychiatry. 2023 Dec 13:e234744. 
34. Liu YZ, Wang YX, Jiang CL. Inflammation: The Common Pathway of Stress-Related Diseases. Front Hum Neurosci. 2017 Jun 20;11:316.
35. Madison A, Kiecolt-Glaser JK. Stress, depression, diet, and the gut microbiota: human-bacteria interactions at the core of psychoneuroimmunology and nutrition. Curr Opin Behav Sci. 2019 Aug;28:105-110.
36. Zhang Y, Li X, Lu S, Guo H, Zhang Z, Zheng H, Zhang C, Zhang J, Wang K, Pei F, Duan L. Stress triggers gut dysbiosis via CRH-CRHR1-mitochondria pathway. NPJ Biofilms Microbiomes. 2024 Sep 30;10(1):93.
37. Butler, M.I., Bastiaanssen, T.F.S., Long-Smith, C, Morkl S, Berding K, Ritz NL, Strain C, Patangia D, Patel S, Stanton C, O’Mahony SM, Cryan JF, Clarke G, Dinan TG. The gut microbiome in social anxiety disorder: evidence of altered composition and function. Transl Psychiatry 13, 95 (2023).
38. Ritz NL, Brocka M, Butler MI, Cowan CSM, Barrera-Bugueño C, Turkington CJR, Draper LA, Bastiaanssen TFS, Turpin V, Morales L, Campos D, Gheorghe CE, Ratsika A, Sharma V, Golubeva AV, Aburto MR, Shkoporov AN, Moloney GM, Hill C, Clarke G, Slattery DA, Dinan TG, Cryan JF. Social anxiety disorder-associated gut microbiota increases social fear. Proc Natl Acad Sci U S A. 2024 Jan 2;121(1):e2308706120. 
39. Sharma K, Akre S, Chakole S, Wanjari MB. Stress-Induced Diabetes: A Review. Cureus. 2022 Sep 13;14(9):e29142.
40. Won E, Kim YK. Neuroinflammation-Associated Alterations of the Brain as Potential Neural Biomarkers in Anxiety Disorders. Int J Mol Sci. 2020 Sep 7;21(18):6546.
41. Shafiee A, Jafarabady K, Seighali N, Mohammadi I, Rajai Firouz Abadi S, Abhari FS, Bakhtiyari M. Effect of Saffron Versus Selective Serotonin Reuptake Inhibitors (SSRIs) in Treatment of Depression and Anxiety: A Meta-analysis of Randomized Controlled Trials. Nutr Rev. 2025 Mar 1;83(3):e751-e761.
42. https://drpaulclayton.eu/blog/polly-wants-a-steroid-a-small-clinical-observation/
43. https://drpaulclayton.eu/blog/unsafe-at-any-speed/
44. https://drpaulclayton.eu/blog/i-want-candy/
45. Fernandes A, Mateus N, de Freitas V. Polyphenol-Dietary Fiber Conjugates from Fruits and Vegetables: Nature and Biological Fate in a Food and Nutrition Perspective. Foods. 2023 Mar 1;12(5):1052.
46. Spragge F, Bakkeren E, Jahn MT, B N Araujo E, Pearson CF, Wang X, Pankhurst L, Cunrath O, Foster KR. Microbiome diversity protects against pathogens by nutrient blocking. Science. 2023 Dec 15;382(6676):eadj3502. 
47. Juul F, Parekh N, Martinez-Steele E, Monteiro CA, Chang VW. Ultra-processed food consumption among US adults from 2001 to 2018. Am J Clin Nutr. 2022 Jan 11;115(1):211-221.
48. Yi L, Wu J, Li Z, Yang J. The rapid rise of ultra-processed foods brings up human health concerns. J Future Foods, https://doi.org/10.1016/j.jfutfo.2025.08.013
49. Calder PC, Cawood AL, James C, Page F, Putnam S, Minihane AM. An overview of national and international long chain omega-3 polyunsaturated fatty acid intake recommendations for healthy populations. Nutr Res Rev. 2025 Nov 24;39:e6. 
50. Jew S, AbuMweis SS, Jones PJ. Evolution of the human diet: linking our ancestral diet to modern functional foods as a means of chronic disease prevention. J Med Food. 2009 Oct;12(5):925-34.
51. Restani P, Colombo F, Biella S, Bani C, Mercogliano F, Di Lorezo C. Diet, Polyphenols, and Human Evolution. Appl. Sci. 2022, 12(15), 7805;
52. Clayton P, Rowbotham J. How the mid-Victorians worked, ate and died. Int J Environ Res Public Health. 2009 Mar;6(3):1235-53.
53. Zizumbo-Villarreal D, Flores-Silver A, Marin P C-G. The Archaic Diet in Mesoamerica: Incentive for Milpa Development and Species Domestication. Econ Bot 66, 328–343 (2012).
54. Leach JD, Sobolik KD. High dietary intake of prebiotic inulin-type fructans in the prehistoric Chihuahuan Desert. British Journal of Nutrition, 103(11), 1558-1561.
55. Clemens R, Kranz S, Mobley AR, Nicklas TA, Raimondi MP, Rodriguez JC, Slavin JL, Warshaw H. Filling America’s Fiber Intake Gap. J Nutr 142(7), 1390S-1401S
56. Moshfegh AJ, Friday JE, Goldman JP, Ahuja JKC. Presence of Inulin and Oligofructose in the Diets of Americans. J Nutr 129 (7), 1407S-1411S, ‘99.
57. Murphy MM, Douglass JS, Birkett A. Resistant starch intakes in the United States. J Am Diet Assoc. 2008 Jan;108(1):67-78.
58. https://www.techandjustice.bsg.ox.ac.uk/research/china#:~:text=AI%2Drelated%20crimes.-,USE,with%20a%20high%2Dtech%20company.
59. https://www.news18.com/india/robo-judges-for-routine-verdicts-india-to-infuse-ai-in-justice-delivery-for-petty-crime-land-cases-ws-el-9542620.html
60. Newman WH. JudgeGPT: The Benefits and Challenges of an AI Judiciary. NAPCO (National Association for Presiding Judges and Court Executive Officers.). December 2025