Nutrition: a doctor’s approach to food, digestion and chronic symptoms

Physician-led, integrative and personalised nutrition for chronic, unresolved symptoms. I use food alongside conventional medicine, Ayurveda and Traditional Chinese Medicine to support the pattern behind your symptoms. This page explains who it is for, how it works, and what to expect.

Who this is for

Most people who reach me feel confused by conflicting advice, frustrated by approaches that have not worked, or simply want to understand their body more clearly. Many are already eating well by any conventional or social-media standard. Whole foods, good protein, the right snacks, the trending supplements. And they still do not feel right. They are doing everything correctly, and the problem has not moved.

This page is for people here, expats and locals alike, with chronic, unresolved symptoms where food seems involved but meal plans, calorie targets and elimination diets have not resolved the wider picture. Persistent bloating or gut symptoms, fatigue, anxiety, inflammation or chronic pain, and food reactions that do not add up. Many of the people I see are getting worse rather than better, which is often what finally prompts them to look for a different kind of help.

If you are facing a medical emergency, contact emergency services. Where you need specialist treatment for an eating disorder, or specialist dietetic care, that is the right route, and this works alongside it.

What it can help with

Nutrition is a meaningful lever, as part of a wider plan, for:

Persistent gut symptoms, bloating and IBS-type patterns. See IBS: when food rules keep growing but the symptoms do not stop.
Fatigue and low energy, where the body struggles to extract and use energy from food. See chronic fatigue when sleep does not fix it.
Anxiety and a nervous system held in a stressed state, where food is one part of settling the physiology. See when anxiety is more than anxiety.
Inflammation and chronic pain patterns, including fibromyalgia. See fibromyalgia: what causes the pattern.
Nutrient deficiencies, including the vitamin D shortfall that is common even in sunny Malta. See my Malta vitamin D audit.

In complex chronic illness, nutrition is rarely the whole answer. It is one foundation, used in the right order alongside everything else.

In the Maltese context

Many of the people I see already take their health seriously. The practical challenge here is sourcing, because good guidance only helps if you can actually find and buy the food locally. The fundamentals I start from are set out in what actually makes food nourishing. I also keep a practical guide to where to buy good quality food and water in Malta.

Why standard nutrition advice often falls short

Most nutrition advice answers a single question, what to eat, which is enough for someone broadly well. When symptoms are chronic and run across several systems, the more useful question is why your body is responding the way it is.

The pattern I see most often is not someone eating badly. It is someone following the advice carefully: the trending foods, the right macros, the supplements recommended online, doing what is considered healthy by both conventional nutrition and social media, and still not feeling well. The missing piece is what is right for their body, in their constitution, their season of life and their current state. Public advice also genuinely conflicts, partly because nutrition research is harder to do relably than it looks,¹ and industry funding can skew published conclusions toward the sponsor.² People also respond differently to the same food.^3–5 And poor diet is among the largest single contributors to chronic disease worldwide.^{6, 7} The principles that actually hold are older and steadier than any trend. What I do is combine those timeless principles with personalisation, which is why the guidance tends to fit when generic plans have not.

How a doctor’s approach to nutrition is different

Before I change anything about your diet, I review your history, medication, previous investigations and any red flags. Some symptoms need conventional investigation or referral first. Some supplements and high-dose nutrients interact with prescription medication, including antidepressants, anticoagulants, blood pressure, diabetes and thyroid medication. That comes first.

Conventional medicine is the foundation: blood panels, deficiencies, ruling out pathology, and evidence-based reasoning so I am addressing the right problem. This is why I do not treat nutrition as a food list.

I also work to get the nutrients you need from food first, through the meals and the practical shopping guidance I give. Supplements and IV support come second, when there is a clear reason, not as a default list of twenty products.

Where nutrition sits in your plan depends on your case. For gut-driven problems it often leads. For others, such as anxiety, the nervous-system and mental-health work tends to come first, and nutrition supports the longer-term change. When a detailed dietary plan is the right step, it is thorough and genuinely personalised: the foods, the shopping list, and breakfasts, lunches and dinners built around what you will realistically eat, because compliance matters as much as theory. It is sequenced and adjusted as your body responds, a process rather than a one-off handout.

How personalisation works: your body is not an average

Your body is not an average. The foundation is the same for everyone, whole food, clean and mineralised water, and a sensible structure. Personalisation builds on it, to support your biology in the most practical and measurable way possible. This matters most in people whose gut, microbiome or immune sensitivity is already strained, where the same healthy food can produce very different results from one person to the next.

At the most basic level, food has to provide the right building blocks, and your body has to be able to use them. Vitamins, minerals and micronutrients are needed for energy, repair, detoxification and cellular communication. But that does not happen in isolation. How well those nutrients are used depends on your digestion, your nervous system, your sleep, your stress and your level of inflammation. This is why the same diet can work for one person and not another.

When your blood tests are clear but your symptoms remain

When people investigate these symptoms through standard testing, results often come back normal even when they clearly do not feel well. Conventional blood tests are excellent, even life-saving, in acute medicine, and allergy testing is reliable for true IgE-mediated allergies. In chronic, complex cases these tools have limits. Blood values are a snapshot in time and do not always reflect what is happening inside tissues over months, or how nutrients interact as a system. Many food reactions are not classic allergies but intolerances shaped by digestion, gut barrier integrity, the microbiome and the nervous system, where current testing remains imperfect. This is why so many people end up guessing. I write about that gap more fully in why normal results can miss the pattern. I use certain tools to generate targeted hypotheses about digestion, metabolic patterns, mineral status and likely food sensitivities. We then validate those hypotheses against your history, your symptoms and your real-world response over time. They are starting points, not diagnoses in themselves.

How Ayurveda and Chinese medicine fit in

I also draw on older clinical systems that have spent thousands of years observing how the body responds to food, season, routine and environment. Principally Ayurveda, alongside Chinese medicine pattern diagnosis, which genuinely shapes the plan. A concrete example makes it practical: when digestion is weak, the cold raw salads and smoothies marketed as healthy can, in that person, drive the very bloating they were meant to fix. The remedy is warmer, well-cooked, grounding food, matched to the person and the season. I combine that thinking with modern nutritional science and physiology. There is more on it on my Ayurveda page.

Food as medicine, and where I stay transparent

The idea that food is medicine is ancient. I have also completed Monash University’s Food as Medicine and Deakin’s Food and Mood programmes (full qualifications →). Where older traditions described vitality and flow as qi or prana, modern science describes overlapping territory through neurophysiology, the microbiome and the stress response. In my reading, this is often different language for the same underlying reality: how the body produces energy, regulates stress, coordinates immunity and repairs itself. When regulation improves, the body tends to heal more effectively. For a concrete example of a traditional idea explained through measurable physiology, see how acupuncture actually works.

Some of what I draw on sits at the edge of current evidence, where the science is not yet strong enough to make universal claims. Where that is the case, I say so, and I use it as one optional layer within a broader, evidence-aware approach, to make food trials more informed and track your responses more clearly. I encourage curiosity and questioning, of the material, of prevailing health narratives, and of me. That openness is one of the strongest foundations for genuine, long-term health.

How this differs from a nutritionist or dietitian

If you are searching for a nutritionist, the distinction is worth understanding. Dietitians and nutritionists in Malta are separate registered professions, and where you need specialist dietetic care you should see one. My work is a medical doctor’s: clinical nutrition inside a physician-led integrative assessment, drawing on conventional medicine, Ayurveda and Chinese medicine together, for chronic symptoms that diet alone has not explained. It is designed to sit alongside your GP, your dietitian and any specialist.

Where nutrition fits in your plan

Nutrition is one pillar of my wider integrative medicine practice. It works alongside medical assessment, acupuncture where appropriate, lifestyle medicine, and an understanding of your nervous system, sleep, stress and energy. The aim is to understand the pattern clearly enough to give your body the right support in the right order.

For some people that includes the Integrative Reset, an intensive, physician-led programme over two weeks. For others, nutrition runs through the longer arc of care rather than a single programme. Either way, it is matched to where it fits in your plan, which I set out in my method.

Explore the Integrative Reset Send a brief enquiry

Via WhatsApp. A short message to check fit and safety first.

Frequently asked questions

How is seeing a doctor for nutrition different from a nutritionist or dietitian?

Dietitians and nutritionists in Malta are separate registered professions; where you need specialist dietetic care, see one. My work is a medical doctor’s, using clinical nutrition within a physician-led integrative assessment alongside conventional medicine, Ayurveda and Chinese medicine, for chronic symptoms that diet alone has not resolved. It complements that care.

I already eat healthily and take supplements. Can this still help?

Often, yes. The people I see are frequently already eating well and following good advice, and still do not feel right. The issue is usually not effort or willpower, it is that the plan is not matched to their body, constitution and current state. The work is refining what you already do so it fits you, not adding more rules.

Do you give long supplement lists?

No. I work to get the nutrients you need from food first, through the meals and shopping guidance in your plan. Supplements and IV support come second, when there is a clear reason for them.

Do you provide weight loss or meal plans?

I do not provide slimming plans or calorie-counting spreadsheets. When a detailed dietary plan is the right step, it is fully personalised and built around what you will realistically eat, and it is often introduced once the wider pattern is settling rather than on day one.

Do you use blood tests?

Yes. Reviewing recent blood panels is part of a conventional medical approach, used to rule out pathology and identify nutrient deficiencies before any significant dietary change.

Is this suitable if I already have a GP or specialist?

Yes. The approach works alongside your existing medical care and adds a whole-person perspective on chronic symptoms.

Where can I buy better quality food and water in Malta?

I keep a practical, non-commercial guide: where to buy good quality food and water in Malta.

Medical disclaimer: This page is for educational purposes and describes a clinical approach. It is not a substitute for individual medical assessment, diagnosis, or treatment, or for personalised nutrition advice for your condition. Do not alter or stop medication, or begin new treatment, based on this page alone. Consult a qualified clinician who can evaluate your specific situation.

Dr Shehan Wijesingha, MD, M.TCM, DipAP, BMedSci, CPT, practises at Serenity Holistic Medical Clinic, Malta. He is Vice President of the Association of Ayurvedic Professionals UK.

References