In this chapter we argue that industrial food production, distribution and consumption play a central role in perpetuating the present intersecting crises of poor health, biodiversity loss, climate change and inequality. At the centre of our argument lies a contention that multiple rifts (e.g. between humans and nature, urban and rural, food and medicine) have been radically accelerated by industrial capitalism and the technocratic responses it produces, and that such rifts are the root causes of these crises. Fundamentally extractive in their commodification of labour, nature and knowledge, current food systems have cemented these deep metabolic, epistemic and social rifts, the roots of which reach back to at least the invention of the plough. The implications continue to shape health outcomes today. We argue that medicinal agroecology, existing in diverse forms but united by an understanding of food and nutrition as medicine, heals the rifts which separate us from the natural world and each other. Medicinal agroecology, as we conceive it, offers a pathway to planetary health by directly addressing the root causes of these crises rather than their symptoms, and thus constitutes a planetary medicine.