Can integrative medicine be evidence based? With Dr. Matthew Nagra

Dr. Matthew Nagra is a naturopathic doctor who's become well-known on social media for his evidence-based approach to health and nutrition. We dive deep into some of the most controversial topics in wellness today, from seed oils to soy, and discuss what it means to practice evidence-based naturopathic medicine.

The Journey to Evidence-Based Practice

Both Dr. Nagra and I found our way to naturopathic medicine through personal health struggles, but our paths led us to similar conclusions about the importance of evidence-based practice. As Dr. Nagra shared, his transformation began in his teens: "I struggled with some health issues. I had asthma that was quite serious at one point.  I struggled with my weight despite playing every sport, imaginable."

It was through dietary changes recommended by a personal trainer that he first noticed improvements: "I started noticing right away my skin was clearing up my, I was losing some weight ,breathing easier even. And it was from that that I thought, well, okay, maybe there's more to this nutrition piece than I otherwise, believed."

My journey was similar, I realized, "the piece that I was missing in my health was that I had undiagnosed anxiety that was not being treated." This experience taught me that sometimes the answer isn't more complex testing or alternative approaches—sometimes it's addressing fundamental issues that have been overlooked.

The Appeal to Nature Fallacy

One of the biggest misconceptions in wellness culture is what's known as the Appeal to Nature Fallacy.

He illustrates this perfectly: "We can talk about fox glove. Uh, you start eating that, you're gonna have some problems. You go into the forest and pick whatever berries you see, you might have some problems." The point is clear—natural doesn't automatically mean safe or beneficial.

The fallacy becomes even more apparent when we consider everyday examples. As I pointed out, "the population that usually talks about we should just do natural" often have no problem "taking things like creatine and whey protein, which there's no creatine tree out there, right? Like we are making creatine."

The Seed Oil Controversy: What Does the Evidence Actually Say?

Perhaps no topic generates more heated debate in wellness circles than seed oils. Dr. Nagra considers this "the seed oil fear" to be "like the biggest one there" among unsupported wellness trends.

The fear stems from omega-6 content: "The Omega six fat linoleic acid is prevalent in these seed oils" and "theoretically that linoleic acid could be converted into another omega six called arachidonic acid in our bodies, which could then theoretically be pro-inflammatory."

But here's where theory meets reality: "We can test that and we have run multiple, not we as in me partaking, but humans have run multiple randomized controlled trials on human subjects where they feed them these seed oils and they do not increase in, uh, markers of inflammation."

In fact, the research consistently shows the opposite. Dr. Nagra explains: "Both randomized controlled trials and observational studies, and actually within the observational studies, not just those looking at dietary intake, but actually blood levels so you can measure the amounts of certain fats in the blood" show "benefit for the, or, um, a benefit if you're replacing saturated fats with these seed oils."

The Soy Myth: Separating Science from Fearmongering

Another area where misinformation runs rampant is soy consumption, particularly among men who fear hormonal effects. Dr. Nagra breaks down the science: "These soy products, they do contain isoflavones, or better known as phytoestrogens, which are not estrogen, but they have some structural similarities so they can interact with estrogen receptors in our bodies."

The research is reassuring. A comprehensive meta-analysis

"looked at 41 clinical trials and across the board, there were no significant impacts on hormone levels, whether it's testosterone or estrogen."

For women, the evidence is even more positive: "These phytoestrogens, they specifically bind to certain types of estrogen receptors. These are called ER beta or estrogen receptor beta, and in breast tissue, those have antiestrogenic effects.

"This is why "higher soy consumption actually is associated with a lower risk of breast cancer."

The Problem with Unvalidated Testing

One of the most concerning trends in integrative medicine is the proliferation of expensive, unvalidated tests. As I explained to Dr. Nagra: "There's this pocket of testing that's being done. And it's not little, like you said before, like some of these tests are hundreds and hundreds of dollars and they're usually gonna be kits that are shipped to a person's house."

The fundamental problem is statistical: "If you test a hundred markers, the chances of some of them being out of range are gonna go up and up. The more things that you test."

Dr. Nagra agrees that this leads to problematic outcomes: "You have people in this, this complimentary or integrative space who sort of promote a single answer to everything... everything is caused by that, whether it's cardiovascular disease, whether it's diabetes, whether it's cancer, whether it's the gut problems, whether it's, um, your hair falling out."

What We Really Know About Gut Health

Speaking of gut health, it's worth addressing the elephant in the room. As Dr. Nagra bluntly states: "Gut health. We know nothing. Okay, let's just make that clear. We know very little about like the gut microbiome, how it impacts our health, if it impacts our health, um, beyond just the gut."

This doesn't mean the gut microbiome isn't important—it means we're not yet at the point where expensive testing can provide actionable answers. The correlations we see in research might be explained by other factors: "People who eat more fruits, veggies, whole grains, et cetera, are gonna have a certain type of microbiome" and "that... diet is going to be associated with better outcomes. We can't say it's because of the microbial makeup."

A Sensible Approach to Supplements

When it comes to supplements, Dr. Nagra takes a measured approach: "For nutritional supplements, um, maybe it's just my experience at this point with, with that, that I, I find it pretty simple. Like I'll review someone's diet, I'll review if they are taking any current supplements."

His criteria are clear: "If we simply have animal data, I will pretty much never be suggesting that" but "if we have some, uh, I think an interesting area is actually with migraines. We have some clinical trials, randomized controlled trials on, on a few different supplements."

The key is having "at least having some human data before I'm going to make a suggestion around something."

Practical Dietary Recommendations

For those seeking the healthiest dietary approach, Dr. Nagra's recommendations are straightforward: "The foundations of a healthy diet being again, whole grains, fruits, veggies, uh, nuts and seeds, legumes, uh, if you're having animal protein, uh, seafood or fish, um, that data is very, very clear."

Regarding meat consumption, the research shows: "Where we consistently see risk is a serving a day" but "if you're having it once or so a week, uh, again, not really a big deal."

For protein needs, his recommendations align with current research: "1.2 grams per kilogram of body weight is a really good target for the vast majority of people" for general health, or "1.6 grams per kilogram of body weight" for those looking to optimize muscle gains.

The Future of Naturopathic Medicine

When I asked Dr. Nagra about his vision for the profession, his response was telling: "I'd like to see us, move more towards, or I'd like to see us have more rigorous standards of practice around whether they're in the form of like clinical practice guidelines or what have you, but having some standard of evidence that we need to meet in order to recommend something."

He also emphasized the importance of collaboration: "I would like to see more collaboration with medical doctors as well" because building these bridges benefits "not just for me, but for the profession as a whole."

Key Takeaways

• Natural doesn't equal safe or effective—the appeal to nature fallacy leads to poor health decisions

• Seed oils aren't inflammatory—research consistently shows cardiovascular benefits when replacing saturated fats

• Soy is safe and potentially beneficial—multiple meta-analyses show no hormonal concerns and possible cancer protection

• Expensive unvalidated tests often provide false answers—we simply don't know enough about gut microbiome to make most testing meaningful

• Evidence-based supplement recommendations require human data—animal studies aren't sufficient for clinical recommendations

• A predominantly plant-based diet with minimal processed meat offers the strongest evidence for long-term health

• The future of naturopathic medicine should include rigorous evidence standards and collaboration with conventional medicine

The path forward for naturopathic medicine isn't about choosing between natural and conventional—it's about choosing what works based on the best available evidence.

For more evidence-based health insights subscribe to the Modrn Wellness podcast and follow @dr.marypardee on Instagram.

Follow Dr. Matthew Nagra

Instagram: @dr.matthewnagra

Website: https://drmatthewnagra.com/

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