Baking as Lifestyle Medicine BALM Protocol

Baking Eating & Sharing Bread as Lifestyle Medicine, The BALM Protocol is an evolutionary approach that transforms bread from an ultra-processed food into a source of nourishment, supporting both physical and mental health

BALM Protocol provides the framework for creating bread that supports nutritional psychiatry. It changes the way we understand our most basic food to support mental health.

Professor David Veale, Kings College London

BALM is used as a framework to create change so people can bake, eat and share bread that nourishes

Dr. Kimbell’s key findings from dietary intervention studies on diversity bread showed positive impact on the gut microbiome & mental health from her doctorate research. BALM underpins personalised bread and is the framework for baking therapeutically, to support both physical and mental health within the NHS, and for bakers who want to improve the health of their community.

Why was BALM developed?

When Dr Kimbell started teaching about healthy bread what became clear was that there was no definition of what healthy bread is. Most bread is ultra processed and contributes to poor health, however made well bread can support high levels of fibre and fermented it can be easily digested; coupled with diversity and eaten as part of a healthy diet bread, is an affordable delicious way to support health. With no clear definition of what healthy bread is Dr Kimbell determined to create an evidence framework that would serve as a guide to make bread that nourishes. BALM is this framework.

What is The BALM™  protocol?

BALM™  is an acronym for Baking as Lifestyle Medicine Protocol, is a framework for the way we bake bread and the way we bake, eat and share the bread that optimises nourishment to the gut microbiome to support health and well-being and empowers others to approach bread to improve social equality and environmentalism, fostering a more balanced relationship between us and the food we consume.

BALM is a holistic approach

1. BALM is a holistic approach to baking as preventative health. It is an approach that uses evidence-based behavioural interventions to prevent, treat and manage chronic disease. BALM stands for Baking, as Lifestyle Medicine. The BALM ™ protocol is the official procedure or system of rules governing Baking and is underpinned by The 6 pillars of Lifestyle Medicine. 
2. By extension, the protocol covers baking, eating, and sharing bread. The BALM™  Protocol and the seven principles underpin everything that we do at The Sourdough School, and the Sourdough Club, and in the books and communications.
3. Recognising that fermentation alone is not enough to nourish. With an Italian mother growing up in Southwest France, Vanessa recognised that the benefits of wholegrain sourdough were wider than just the fermentation.  The embedded knowledge from growing up eating a Mediterranean diet and living a Mediterranean life with bread a the heart of the community gave Vanessa a uniquely holistic view of bread which can be seen in Principle no 1 of the protocol includes the practices of

• Symbiotic eating,
• Sequenced eating
• Baking as activism

There are 7 Principles to Baking as Lifestyle Medicine.

How BALM™  protocol was used by GP’s as a self-funding empowerment Model for social prescribing.

BALM (Baking As a Lifestyle Medicine) is an empowerment model that connects bakers to the principles of regenerative agriculture, supporting farmers and promoting diversity in both gut health and the environment. It has been developed over many years with the vision of bakers playing a key role in systems change. The Sourdough School operates as a social enterprise. It utilizes the profits generated from the sales of courses to run an awards programme to train healthcare providers and bakers, and they have created botanical blend flour to support and empower graduates from The Sourdough School itself. This funding from the profit of the flour is a unique approach that enables graduates to continue their journey as ambassadors of BALM (Baking As a Lifestyle Medicine) and extend its principles to their communities providing education, flour and baking equipment as a circle system. The more bakers connect, the more change is generated.

Empowering healthcare providers

Healthcare providers utilize BALM™  as an empowerment model for their patients, prescribing it as lifestyle medicine. This empowers individuals to take control of their health through conscious baking choices and incorporating nutrient-dense grains into their diets. By doing so, they can improve their gut health, overall well-being and reduce the risk of chronic diseases. BALM provides a framework for patients and bakers to challenge the dominance of processed and unhealthy foods by championing whole, nourishing ingredients in baking. Rejecting the industrialized food system and embracing natural, unadulterated grains, bakers actively participate in a movement that promotes better health outcomes and environmental stewardship.

BALM ™ transforms bakers into activists, empowering them to make conscious choices that support regenerative agriculture, enhance gut health, and promote environmental diversity. By embracing BALM, bakers challenge the prevailing industrialized food system, advocate for whole ingredients, and contribute to better health outcomes. It not only receives endorsement from healthcare providers but also empowers them to support their patients in making positive lifestyle changes. The social enterprise aspect of The Sourdough School further empowers graduates by providing resources and support to extend the reach of BALM initiatives to those in need. By taking a stand against powerful brands that produce ultra-processed foods detrimental to health and the environment, The Sourdough School actively supports positive change.

The principles of sourdough and understanding the microbial connection to the soil, the starter, and the gut microbiome are crucial in BALM. It empowers bakers to create positive change through everyday baking practices. By consciously choosing flour and supporting diversity with regeneratively grown ingredients, bakers contribute to soil health, biodiversity, and sustainable farming practices. This not only supports farmers but also fosters a greater diversity of beneficial microorganisms in the gut, essential for overall health and well-being.

Through The Sourdough School’s social enterprise approach, profits generated from the botanical blend flour are used to empower graduates. This support includes providing baking equipment and flour to projects that deliver baking initiatives to those in need. By enabling graduates to teach and bake using BALM principles, The Sourdough School nurtures a network of empowered individuals who can spread the positive impact of BALM in their communities.

In summary, BALM™  serves as an empowering model that connects bakers to regenerative agriculture, and promotes gut health and environmental diversity. It is prescribed as a lifestyle medicine by healthcare providers and enables patients to make conscious baking choices for improved health outcomes. BALM ™ transforms bakers into activists, challenging the industrialized food system and supporting positive change. The Sourdough School’s social enterprise aspect empowers graduates and extends the reach of BALM initiatives to those in need.

Why is a Protocol needed?

Bread is our staple food, and we evolved to eat bread that nourished us. The industrialisation of bread over the past century has perpetuated the damage to public health and the planet. Each disconnect between the agricultural, baking, and eating systems has further fuelled the damage to health and the environment. BALM™  is a framework that reconnects each part of baking, eating, and sharing bread to positively impact physical and mental health and supports the environment. Creating an approach grounded in evidence of how to bake, eat and share bread that can prevent, treat, or modify non-communicable chronic disease brings synergy, and this empowers positive change in each of the systems.

The BALM Protocol can be used at many levels by individuals, such as the prescription courses, by GPs, and by bakeries and it can also be used to influence Population Health Management through an industrial application.

An example of Balm Protocol

In the photo above, you can see a wholegrain, long slow fermented bread made with a botanical blend of flour that increases diversity. The sourdough fermentation process damages the gluten, breaks down the anti-nutrients and predigests the sugars resulting in the bread having a more moderate impact on blood sugar. The sequenced eating principle of consuming soup before eating bread further reduces the impact of carbohydrates on blood sugar balance. This lunch is typical of symbiotic eating, with local probiotic-rich cheese, seasonal cauliflower is high in glucosinolates and isothiocyanate, and the cannelloni beans are sourced from Hodmedods. Eating legumes supports fair prices to farmers to implement low-input farming practices as the legumes fix nitrogen in the soil and reduce dependence on agrochemicals. The soup also further increases the sociable fibre and as you might see, this is a lunch to be shared.

How is the BALM™  Protocol used?

The application of BALM is to:

1. Bakers – to bake bread, eat and share the bread that nourishes, connecting the people they bake for to the soil, farmers, millers, their own physical and mental health and the wider community.
2. Healthcare professionals can socially prescribe BALM to patients a social prescribing through the Sourdough Club Prescription Level Memberships
3. Development of Industrial food systems to support bakeries, food producers and supermarkets to provide baked goods and related products, such as sandwiches, that nourish.

How was the BALM™ Protocol developed?

The Protocol has been developed over many years and evolved from the personal journey of Vanessa Kimbell, as a baker, who in the early 1980s began working in Baker in South West France. Vanessa trained and began working as a baker in the 1980’s and early 90’s ‘s.  After a particularly strong course of antibiotics, Vanessa was unable to eat bread in the UK.  In the late 1990’s returning to France after a number of years of eating. gluten-free diet, Vanessa discovered she was able to tolerate the French long slow fermented bread she had grown up baking and eating.

In 1998 returning to the UK, she presented this information to her GP, along with symptoms of NCGS, IBS, depression, weight gain, loss of appetite control and brain fog associated with inflammation.  When the Doctor was unable to explain the reason that she could eat the French country bread, Vanessa described a seminal moment as she determined to discover why she had become poorly and why she could tolerate the bread in France but not the UK.

As a trained baker, Vanessa’s embedded knowledge of baking provided her with the tools needed to recognise that it was the fermentation that changed the structure of the bread. In the late 1990s and early 2000, there was very little information on sourdough or the impact of antibiotics on the Gut Microbiome.

In 2002 as Vanessa taught her first sourdough class, she noted that almost all of the students who attended reported digestive issues.  Vanessa taught sporadically, each time retreating back to developing techniques and recipes of baking healthy bread.

In 2010 The first Sourdough School class was taught, and the beginnings of a structure of what is not the BALM Protocol appeared.  Vanessa called the courses Baking for Health.  The principles included eating and sharing bread, acknowledging that baking for health and connecting to the soil, the farmers and fermenting bread is food activism. In 2015 Vanessa was interviewed on the Food Programme about her approach to baking, heritage grains and preventative health on The BBC Food Programme. The result was an unprecedented interest in baking as preventative health, and as a result, many of the students who booked into the courses were from the healthcare profession. It was this programme that connected Vanessa to Tim Spector via Dan Saladino. As a result of this introduction in 2016, it was discovered as part of Tim Spector’s work that Vanessa’s  Gut Microbial analysis showed less than 2% Diversity. The knowledge and encouragement from Tim Spector focused the Protocol on the role of fibre in bread and the relationship between health and the gut microbiome.

In 2017 participating in a clinical study by Glenn Taylor Vanessa received 12 FMT ( Microbial) transplants.

The BALM protocol was further developed as Lifestyle Medicine as the foundation of  The Nutrition and Digestibility of bread course in 2018/19. Encouraged by  Vanessa began teaching an RCGP Accredited course at The Sourdough School, and forms the structure underpinning the public works of Vanessa’s Doctorate in Lifestyle Medicine: baking, eating, and sharing bread as preventative healthcare & applied as a social prescription solution through social enterprise ( expected to be completed by Spring 2023)

Defining nourishment and why the BALM™  Protocol is activism

” Bread is our most basic food. We evolved by eating bread, and when you understand that the microbes in the soil impact the levels of nourishment of the grain, you begin to connect to agroeconomic systems. And as you realised that these same families of microbes in the starter damage the gluten, breaks down the anti-nutrients and predigest the sugars and make the bread easier to digest and more nutritious, you will rethink the way you bake.  As you learn that the microbes in our guts manufacture the metabolites that our brains need to function from the fibre in the grains, then you will make the link and realise that we are symbiotic.  A true understanding of the BALM Protocol is when you realise that there is no such thing as individual nourishment because we are all connected. The bread we eat is part of a system, and to be truly nourished, every part of the way we bake, eat and share bread needs to be in sync. When you bake according to BALM, you are actively synchronising the system, and the positive impact of avoiding ultra-processed bread, eating more fibre, connecting to the people in your community, and living a more Mediterranean Lifestyle has positive impacts on both your physical and mental health and on the people you feed, so being a baker, you are actually disrupting the conventional food system where the majority of bread and baked goods damage our health, and the health of the planet.  So we consider that engaging with the BALM Protocol and Baking as Lifestyle Medicine as preventative health is activism.”

Evidence-based

As an evidence-based approach to baking to improve physical and mental health and as part of a belief in social justice, our research library is open for anyone to read and use the knowledge.  BALM™  protocol is underpinned by The 6 pillars of Lifestyle Medicine,

Seven core principles underpin BALM™ , and how to bake and eat healthy bread.  There is a specific focus on Bread and fermentation as a delivery system of fibre and breakdown of flour through fermentation that facilitates easier digestion ( reduction of FODMAPS) and that supports the gut microbiome through delivering more fibre and diversity of fibre through the approach of Diversity Bread ™, using Botanical Blend Flour ™ and Symbiotic eating principles.