It is much easier to be critical than to be correct.
—BENJAMIN DISRAELI
At this point, you may be wondering: Why does the scientific establishment go along with these health-degrading schemes? Why do scientists in health-related fields produce work that supports the same strategies that have gotten us into this mess? The answer is that the goal of Truth to which academic science has always aspired has been replaced, in this distorted health system, by other goals: money, status, influence, and personal security, among others. The basis of a healthy information system is the quality of the information itself, and this industrial profit motive has distorted the very process by which the academic research that produces this information is carried out.
Recall the way information moves through the health-care system in an ideal society. The main input to that cycle is significant questions worthy of research. Scientists collectively address these questions through a healthy diversity of study designs, ranging from the extremely reductionist to the moderately wholistic and everything in between. This variety serves a couple of purposes. First, when they all more or less agree, we can be very confident in the results. Second, the reductionist studies provide new questions, parameters, and constraints for the wholistic studies, and vice versa. And third, conflicting results gained from different types of studies show us the areas in which we may need to reframe our assumptions and pursue paradigm breakthroughs in order to get closer to the truth. As in any ecosystem, diversity contributes to the complexity, resilience, and health of the production of scientific information.
In our profit-driven system, the value added by this diversity of research is sacrificed. Instead of resulting from myriad perspectives, the weight of evidence is built from only the data deemed credible by the current paradigm—data that are the product of some form of reductionist study design. This narrow range of acceptable study methodology and research data is used to create more profit-generating “solutions” that in turn produce more problems that require research and treatment.
The question we need to ask is why. The answer, as you’ll see, is that scientists are rewarded if they contribute out-of-context information that supports industry goals while contributing to our nation’s poor health, and penalized if they don’t.
THE IMPOVERISHMENT OF SCIENCE
At its best and most useful, science combines the arts of wholistic observation, reductionist observation, and experimentation in pursuit of human well-being. But today we almost completely disregard the art of observation of wholes, or systems, in favor of precise quantification and manipulation of minutiae. We mistakenly judge the quality of scientific investigation in the health disciplines by its precision and focus on tiny details—in other words, on how reductionist it is. “Real” scientists investigate parts, not wholes. But this diminishes the goals of true science. What most scientists are doing today really should be called technology, not science.
This distinction matters a lot. Technology refers to a means, a way of accomplishing some task. It’s the last step in applied science, whereby the results of free and imaginative inquiry inform the creation of new products and services. When the “free and imaginative inquiry” phase is eliminated from the scientific roadmap, as it is in far too much medical research, we no longer have genuine science. Science is defined by the scientific method; it’s an unbiased search for truth and a willingness to be proved wrong. Technology is defined by market potential; only those questions that can be answered with dollar signs are deemed worthy of investigation.
Modern techno-biologists are expected to look deeply into DNA and cellular metabolism, but cannot express a professional interest in a topic such as human well-being. A pursuit that broad just isn’t “scientific.” Because we limit the permissible scope of scientific inquiry to reductionist details, we have lost sight of the true meaning of human progress. We equate advancement with the development of new technologies, of new products and services, rather than human well-being and happiness.
This isn’t a new phenomenon. The subjugation of science to industrial profits has been going on for at least the past century, since capitalism devised the intellectual property protections that could fully reward those whose discoveries and inventions could be converted to products, sales, and capital. Once patent, trademark, and copyright instruments, among others, provided this protection, the engine of industrial capitalism could roar unhindered through society, using technological advancements to produce profits that were then plowed back into the system to fund more research and advancements. The system became self-replicating and self-perpetuating; initial market success provided the capital to fund subsequent market success.
The facts and information generated by science and used to create capital are the fuel that keeps the free-market engine running. The more useful the facts and information expected to be produced by a study—the better the fuel—the more likely the study is to get funded. If it won’t end up with a barcode on it, it’s probably not going to get funded.
As we’ve seen, a technological approach to nutrition—the kind that makes money for industry—includes drugs, supplements, and enriched and fortified foods. All of these are highly profitable and protected by intellectual property laws. There’s plenty of funding for this type of science, and so plenty of it gets done. By contrast, research into the nutritional effects of whole plant foods doesn’t really have market potential. You can’t patent a recommendation to eat lots of fruits, vegetables, nuts, seeds, and whole grains. So there’s no incentive for industry to invest in such research and no incentive for researchers to study and validate such claims.
Human health, happiness, and overall well-being cannot and will not be fully advanced by a corrupted free-market model manipulated by its most powerful participants. Instead of wholistic nutrition, the free-market engine gives us marketable fragments: supplements and nutraceuticals. When we get sick from lack of proper nutrition, the market engine obliges us with reductionist solutions: patented drugs and expensive surgeries. And through it all, the research community marches to the beat set by industry, masquerading as noble seekers of truth while churning out new ways to make money at the expense of our well-being.
FOLLOWING THE MONEY
Do you ever wonder who pays for medical research, the kind that investigates basic biological principles and lays the groundwork for later application? University professors—at least those who are tenured—are guaranteed a salary from their institutions,1 but that doesn’t cover the costs of dedicated lab equipment devoted to research, or the time of the graduate assistants and postdocs who do all the grunt work.
Just as politicians must spend much of their time raising funds for reelection, so must most research scientists devote many hours to applying for and maintaining grant funding. The main sources of research funding, aside from universities, are private industry and government. Since there are more researchers seeking funding than there is money to support their research, competition for dollars is fierce. Private companies and government agencies have to make decisions about what small percentage of research grants to approve.
What we call research ranges all the way from very basic, almost esoteric investigations, to very applied experiments that might more properly be called technology development (although the division between what is basic and what is applied is often vague and vigorously contested even within a single institution). While both types of research are useful, when it comes to funding, our system is biased toward the latter—even when the funding doesn’t come from industry.
The majority of total health research, basic and applied, is funded by the pharmaceutical industry or by agencies beholden to it (such as the U.S. National Institutes of Health). Because the pharmaceutical industry expects a profitable return on that investment, its decisions on funding understandably tend toward applied science; the chief criterion they use for evaluating research proposals is usually how much money can be made. However, even government funding, via agencies such as the NIH or the National Science Foundation (which is the primary source for basic research), imposes reductionist criteria, either directly or indirectly, on just about all research into health and nutrition.
Unfortunately, over the last few decades I have observed a gradual encroachment by the corporate sector and its priorities into the domain of basic research at universities and related research agencies. The effects of this encroachment can be seen at nearly every level, from individual study design (what gets studied and how) and the way scientists interpret their findings, to the directions their careers take.
HOW FUNDING INFLUENCES STUDY DESIGN
If an applicant for basic research hopes to get funding, he or she is virtually required to ensure that the proposed hypothesis be “focused”—a code word for reductionist. To successfully compete for funding for this kind of research, applicants should want to study the detailed biological effects of a single nutrient rather than the food from which it came, or to search for the key biochemical mechanism that explains an effect rather than survey an array of possible mechanisms. In the pejorative jargon of the research community, wholistic research is described as “going on a fishing expedition” or “using the shotgun approach.”
In basic research, each new reductionist finding usually leads to an obvious question: “What next?” The almost universal (and oftentimes legitimate) response from researchers is to recommend more research. (This certainly keeps our labs funded and running!) As a consequence, these researchers limit their ability to gain broader insight into the more fundamental phenomena that should be their mandate as basic research scientists. “What’s next” is almost always another reductionist question that gets the results of the previous study closer to the marketplace. It doesn’t matter whether or not we scientists give voice to our commercial interests in these research discussions; ultimately, research findings gain value and relevance when money can be made, and that affects how we think about our next steps. Whichever way these studies are designed and executed, they nonetheless represent steps on the pathway to commercial exploitation. Potential marketplace value has proven a powerful magnet toward which the research enterprise inexorably is pulled. In fact, as the years have passed, I have become more and more convinced that marketplace potential is the only goal of even the most basic, non-applied biomedical research.
I am not saying that individual researchers are even necessarily aware of these assumptions; they may be totally oblivious to this concern. Many researchers will be offended by these remarks and may deny that they are personally doing research for marketplace utility and possible financial return for themselves or their employer. But they are still working within a system whose primary motivation is a return on financial investment. Monetary return is the principal fuel that propels our biomedical system, and almost all professional biomedical researchers are part of and beholden to this system. The more a research investment is perceived as being able to yield a return, the more enthused and supportive the society at large becomes, from consumers and entrepreneurs to politicians and research-funding agencies.
HOW FUNDING COMPROMISES RESEARCH INTEGRITY
There’s some evidence that funding pressure induces researchers to commit fraud to keep their funders happy. I’m not talking about egregious research sins like falsification or fabrication of data, but much subtler stuff. According to the colorfully titled “Scientists Behaving Badly” from the June 2005 issue of Nature, which reported on a survey of over 3,000 U.S.-based researchers who received NIH funding, 15 percent admitted to “changing the design, methodology or results of a study in response to pressure from a funding source.”2 When we break out the data by career stage, things get even more interesting. While only 9.5 percent of researchers in the early part of their careers reported engaging in this behavior, that number skyrocketed to 20.6 percent for those in mid-career. It seems that industry is quite good at training scientists to comply with their market motives. As well, this increase suggests that the longer established researchers are immersed in the system, the less they want to disturb that system. They’ve invested too much time, energy, personal identity, and professional status into their labs to put their funding at risk.
Two other admissions from the same survey help us see how these questionable practices conspire to damage the entire field of health research. First, 15.3 percent of health researchers admitted to “dropping observations or data points from analyses based on a gut feeling that they were inaccurate.” Talk about seeing what you want to see and disregarding the rest! Even if an outlier bit of data managed to survive the reductionist study design, one-seventh of the researchers felt free to ignore it based on “gut feel,” or, in other words, prejudice. Second, 12.5 percent of the researchers said they would overlook “others’ use of flawed data or questionable interpretation of data” in informing their own research agenda and supporting their own conclusions. In other words, they would pretend that bad research that bolsters their own beliefs was actually good research, and quote it within their own papers to substantiate those beliefs. The sum total of all these admissions is a medical research engine that plays fast and loose with fundamental truths, picks and chooses data to support premeditated and prepaid conclusions, and is not very likely to contradict the sales and marketing agenda of the industries that sponsor its research.
I would argue for several reasons that the percentages in the previous paragraph are actually low. First, this behavior is so automatic that much of it is done unconsciously. Many researchers are literally unaware of the corrupting influence that their funders’ expectations and pressures have on the integrity of their research. Second, “bad” behaviors are routinely underreported by survey respondents, even when assured anonymity as they were in this instance. And third, the survey response rate was just under 42 percent. It’s probable that the 58 percent who declined to return the survey were even more susceptible to funding pressure than the respondents, as most voluntary surveys are completed and returned by those with the least to hide and who are least ashamed of their behavior.
The survey didn’t look at the nature of the design or methodological changes to the altered studies, but my long experience as both a recipient of funding and a member of peer-review boards that evaluate grant proposals tells me that the research was almost certainly shifted in the direction of heightened reductionism—toward more specificity, more assumptions about causality, and fewer “messy” observational designs.
HOW FUNDING IMPACTS CAREER TRAJECTORIES
Nutritional scientists are rewarded for creating and perpetuating a system that focuses on single nutrients out of context, and they are effectively punished for examining real foods and real populations in the real world. This makes a difference not only in the case of individual studies, but when it comes to researchers’ career choices. Take, for example, Chinese scientist Rui Hai Liu. Professor Liu, you may recall from chapter eleven, did early groundbreaking research demonstrating that the antioxidant activity of an apple is 263 times more powerful than the amount of vitamin C contained in the apple would suggest. Having learned this, Professor Liu was faced with a choice: what direction should his research take?
He could have chosen to demonstrate the same “the whole is greater than the sum of its parts” effect across a wide variety of plants and chemicals. His research, we now know from the research of others, could have discredited the misleading and often dangerous claims of the supplement and nutraceutical industries. He could have devoted his career to exploring the idea that eating plant-based foods is a superior option to the reductionist approach of consuming pills that contain only the “active ingredients” present in food.
But in academia, there is no funding for such a career trajectory. So, being the good researcher that he is (actually, he is outstanding), he chose the reductionist approach, his only option, because this is where the research money is. If he intended to advance in his profession and to secure tenure—if he wanted to afford the kind of equipment and assistance he needed to do any other research at all—this decision was a no-brainer.
Taking the reductionist path, Professor Liu was able to investigate many interesting ideas. He searched for other vitamin C–like compounds in apples that might account for the difference between the chemical and presumed biological activities of vitamin C. He confirmed their chemical structures, determined how they are absorbed and distributed after consumption, found out how they are metabolized, and learned how potent they are when doing these things. And in doing so, he has performed exceedingly well. Many would aspire to have his reputation and professional position. His are the kind of objectives that easily attract funding. He has had a relatively large group of graduate students whose research findings have been published in some excellent peer-reviewed journals.
The point is not that the reductionist approach is not interesting, or that it does not provide us with things that are valuable. I certainly loved the reductionist research I did; it was challenging and intellectually stimulating, and as long as I “focused” my proposed questions I always had plenty of public funding to be creative and to do the projects that seemed appealing. Graduate students use these studies to develop their critical thinking, experimental design, research, and writing skills—all highly useful to them, the scientific community, and society in general.
The problem is not that reductionist research is a career option. Rather, the problem is that it’s the only career option. Professor Liu’s career path is followed by thousands of newly minted young researchers every year, in areas ranging from very basic biology to the applied sciences. In one way or another, researchers are rewarded for following this conventional reductionist path. It’s much easier to acquire funding this way. It’s also a surer path to developing and enhancing one’s scientific reputation.
Had Professor Liu fully honored his wholistic roots in Chinese medicine within the Western academy, it is my opinion that he would be scrounging for funds, bereft of a decent lab or motivated graduate students, and nowhere near a tenure track. Once scientists start doing well in reductionist research, shifting to a wholistic track is nearly impossible. If they do, they risk losing everything they’ve spent their lives working for: funding, facilities, prestige, and influence. And so, once established in a well-funded research career like this, a researcher becomes ever more subservient to his or her own research findings—and to the reigning paradigm of the discipline.
I do not mean to question my friend and colleague’s choices, for I know and greatly value Professor Liu’s dedication, perseverance, and sincerity in his work. Rather, my concern is for the environment that surrounds him. His example is an excellent illustration of the choices all researchers face—a choice that, given our system, is not actually a choice at all.
HOW FUNDING DRIVES MYOPIC SPECIALIZATION
The reductionist agenda of research funders not only encourages reductionist study design, but also rewards narrower thinking about what is an important question. This has driven the development of more and more specialized areas of study.
Just as “human health” is too broad to be considered a real scientific discipline, so too has “biology” become a catch-all rather than a legitimate field of study. Instead of becoming a biologist, you become a biochemist, a geneticist, a microbiologist, a neurobiologist, a computational biologist, or a molecular biologist. There are no “naturalists” anymore. There are, however, animal physiologists, ecologists, evolutionary biologists, insect biologists, marine biologists, plant biologists, and biotic diversity biologists. And even these subdisciplines (which I copied from the list of concentrations on the Cornell University Biology Department website) sound quaintly general these days. Cornell’s Department of Molecular Biology and Genetics (a completely different department than Biology, by the way) offers the following graduate programs: Biochemistry, Molecular, and Cell Biology; Biophysics; Genetics, Genomics, and Development; and Comparative, Population, and Evolutionary Genomics.
To some extent, this division into more and more subdisciplines was inevitable, as biomedicine learned more about our infinitely complex biology. There’s so much to know that it’s natural and useful to separate that knowledge into subdisciplines, including biochemistry, genetics, pathology, nutrition, toxicology, pharmacology, and so forth. Intellectual discussion of ideas is easier when like-minded people are able to converse in a more precise common language.
The problem is, these divisions reinforce the illusion that each group is studying something completely different from all the others. Each of these subdisciplines takes on its own identity and, in doing so, begins to form intellectual boundaries that filter out others who may be able to constructively contribute to discussions of broader health topics. To be taken seriously by pathologists, you must be a pathologist. No geneticist thinks he or she has anything to learn from a nutritionist. And so on. In effect, these enclaves (I think of them as tiny caves) become not just narrowly focused, but exclusionary and isolated.
As a result, becoming a highly competent researcher in a biomedical discipline or subdiscipline, while still having a good understanding of the broad umbrella of biomedical research of which that subdiscipline is a part, is discouraged. In an attempt to avoid being considered a “jack of all trades and master of none,” biomedical researchers tend to focus exclusively on one trade. They may learn everything about how to hammer nails, but they often have no idea when a mortise and tenon joint, screwdriver, or a bottle of glue will do the job better.
Other writers have noted this problem many times before, and institutions have attempted to resolve it by developing cross-fertilizing and interdisciplinary programs to promote better communication among subdisciplines. But even within these interdisciplinary programs, group identities continue to exist. People still carry their labels with them. And here, as with research itself, expertise in individual disciplines is valued over a wholistic understanding of the relationships between them.
I accept and understand the ever-greater specialization of the biomedical research discipline. But it comes with a downside that is too often forgotten—and it is serious. Some of these specialized subdisciplines naturally produce more lucrative reductionist solutions than others, so they get a larger piece of available funding. And as they gain a larger share of research resources, they become ever more dominant within the broad community of researchers, thus giving them a platform to dominate public opinion as well. In short, without necessarily realizing it, they begin to control the conversation about the larger discipline of which they are a part. Instead of one perspective among many, theirs becomes the dominant one. And the reason for their dominance is not their perspective’s greater value for solving the issue at hand, but rather its greater ability to generate a return on investment.
The public needs to know about this highly fragmented environment because this fragmentation is an important source of public confusion. The first subdiscipline makes known their views on a particular topic, while the second and third subdisciplines, with different perspectives, weigh in with their own views—and sometimes these perspectives conflict. The public, untrained in these matters, is left to guess who is right, when the answer may actually be none of them. Remember the blind men and the elephant? Each of these inward-looking subdisciplines is severely limited in their knowledge of the “full” story.
When someone has the qualifications of a biomedical scientist, that just means he or she has command of a fraction of a portion of a specialized subdiscipline. It does not necessarily mean that he or she is any more qualified than a layperson to comment publically on the umbrella covering the whole of biomedicine. Indeed, because such research specialists become so narrowly focused, they may be less qualified to speak about the larger context. It’s a bit like a frog that has spent its entire life at the bottom of a silo telling us about the world outside.
Insofar as misguided scientific elitism is concerned, there is no better example in biomedical research than the individuals who call themselves geneticists—especially those within the subdiscipline of “molecular genetics.” They now receive an unusually large share of the total funding for biomedical research and, as a consequence, have successfully positioned themselves as a dominant voice within both the professional and lay public communities. They have the money to create and relate their findings in ways that favor their own interests and perspectives. They may extend their boundaries to include other disciplines at times, but only on their own terms. For example, geneticists only acknowledge nutrition as a discipline completely unrelated to their domain—if they bother to recognize nutrition as a scientific discipline at all! Where the two do intersect, nutrition is defined as a subdiscipline of genetics, as in areas like “nutritional genomics” or “epigenetics.” In this way, nutrition becomes secondary to genetics at best and completely irrelevant to health at worst. Geneticists control the conversation; this isn’t an exchange of information between two equal partners, but geneticists using nutrition, because it’s known to “play” well with the public, in a way that severely distorts and controls the vital importance of nutrition information to the public.
In addition, for-profit research funders benefit greatly from the fracturing and proliferation of the health sciences into more and more distinct disciplines. As in any free-market system, the more competitors there are for limited funds, the fiercer the competition—and the more the funding applicants are forced to exaggerate the importance of their research agendas and methodologies to please their deep-pocketed patrons.
HOW FUNDING DETERMINES SOCIETY’S RESEARCH PRIORITIES
The sometimes subliminal “make a profit” agenda that attaches reductionist, market-focused strings to almost all funded research also has implications for which disciplines get funding priority. Certain disciplines receive more funding than others. Genetics, as we’ve seen, is a much hotter topic than nutrition. The projected market potential of gene therapy to enhance the immune system drives much more funding than the possible market potential of broccoli. The money flows to genetics and drug testing not because these are the most promising or cost-effective ways to improve overall human health, but because they are the most profitable ways to address our need for human health—or, put another way, they are the best way to meet market demand.
Can you imagine the health gains in the U.S. population if the half-trillion dollars in annual Big Pharma revenue were allocated to educating the public about WFPB nutrition, and to making sure that fresh, organic, sustainably grown produce were available and affordable for all Americans? We can hardly imagine such an initiative; it seems utterly impossible within the current system. But why? Why, if the all-out promotion of WFPB would be such a positive thing, is it unthinkable that our society would coalesce around a nutritional Manhattan Project? Because we know that health research and programs reflect the priorities of for-profit industries, not science in the public interest. Such an initiative would pay dividends in health, not dollars (although in the long run, the results would pay off in dollars saved on health care, too!).
Here, too, the industry’s emphasis on marketable reductionism influences government funding, even though it is ostensibly not driven by the profit motive. Look, for example, at the NIH, a U.S. government agency that is also the most prestigious and wealthiest funder of health research in the world. The NIH comprises twenty-eight institutes and programs and centers, devoted to cancer, aging, eye health, alcohol abuse, and many other facets of human health and disease. But not one of them is solely devoted to nutrition! (Unless you facetiously count the Institute of Alcohol Abuse and Alcoholism, of course.) Of the meager research funding for nutrition at NIH (comprising only 2 to 3 percent of the heart- and cancer-specific institute budgets, and even less of other NIH institutes and programs), most of this money is being used to investigate the effects of isolated nutrients in randomized clinical trials, for optimal nutrition for patients who are taking specific pharmaceuticals, and/or for biochemical research on the function of individual nutrients. (Although a few of the NIH’s projects occasionally considered the wholistic basis of health research and clinical practice in the past—without using the weird word wholistic, of course!—these studies were largely ignored in policy debates about food and health, and mostly remain in the realm of academic literature.) Sadly, the public has become convinced that these research priorities are the best way of achieving our health goals, when they are just the best way of achieving greater profit.
AN INSIDER LOOK AT FUNDING AND RESEARCH
I know intimately how funding determines research priorities, both as a longtime applicant for research funding and as a peer reviewer for several research-funding agencies that determine which research grant applications receive funding and which do not. I know well both the frustration of having to force research questions into a form that research evaluation panels will find acceptable, and the pressure to find reductionist answers.
Over the years, my growing awareness of the limitations of reductionist research began to trouble me. I found it more and more difficult and disturbing to continue to teach the traditional (and reductionist) views of nutrition—the way I was taught—when my own views were changing. Even as I was chugging away in the reductionist paradigm, something within me knew there was something missing.
Then I began getting ominous warnings, such as the one I privately received from a former colleague, a member of an NIH research application review group (or “study section” in the jargon of NIHers) that was reviewing our latest (and in the end successful) grant application for renewed funding of our project in China. In the application, I had expressed enthusiasm for the biologically complex relationship of diet with cancer, and how our work in China might provide some unique opportunities to develop more complex disease causation models, perhaps reflecting the more wholistic nature of disease occurrence, instead of the linear mechanistic model. This apparently was a cause for deep concern on the peer-review panel. According to my colleague—who, by telling me this, ignored the code of silence generally imposed on reviewers—I had come perilously close in my proposal to a description of a wholistic research strategy, and he advised me that I should never again defend my research in reference to wholistic interpretation. I was being reminded that I was challenging a fundamental tenet of biomedical research and that, in doing so, I almost cost us the much-needed funding for the third and final three-year phase of this research project. I chose shortly thereafter to discontinue my very active experimental research program of thirty-plus years—a personally agonizing decision at the time because experimental research had long been my life’s work, and I loved working with students. I could no longer bring myself to write research grant applications for funding to investigate only highly focused hypotheses on minute details out of context.3
But that choice—to opt out of the system, or even just to challenge it—is one that not every researcher has. Our program was, at that time, the largest, best-funded research group in a large nutritional science department long regarded as the best in the country, which gave me the freedom to explore questions that, in subtle ways, defied the prevailing paradigm. Others, especially those just starting out in their career and seeking tenure, are under much more pressure to adhere to the research community’s industry-friendly expectations.
There is pressure on the other side of the table as well. From the late 1970s to the late 1980s, I was a member of a research grant review panel for the NIH’s National Cancer Institute (among other cancer research agencies), and there were several occasions when an enthusiastic applicant proposed an investigation of a biological effect by considering a relatively broad array of causal factors—in other words, to look at a problem wholistically. Without fail, such “shotgun approaches” and “fishing expeditions” were summarily rejected without further review for funding priority. I generally went along with these rejections because, too often, the applicants did indeed lack any sense of focus or purpose. But not always. Our panel’s knee-jerk rejections reflected something more, something that I find especially revealing, and troubling, in science: the belief that highly focused hypotheses—not fishing expeditions—were the only type that deserved to get funding.
Occasionally, I learn of more recent research that is being funded under a systems analysis model similar to our project in China. In earlier years, however, our work was the only such project that interpreted data in this way. What we learned in China, coupled with our laboratory work, has completely changed my understanding of nutrition; imagine what else we could learn if we funded a few more non-reductionist studies!
THE SOCIETAL COSTS OF PROFIT-SEEKING FUNDING
I know firsthand the personal passion and honest sincerity that the vast majority of biomedical researchers and practitioners bring to their work. But they are working in a system that, due to the pressure it puts on them to perform only reductionist research, makes it very difficult for that passion and sincerity to result in good, effective science.
As we discussed in Part II, reductionist research on its own is fundamentally inadequate. By definition, it lacks the understanding of the whole that is required to give meaning to its insights. Its solutions—as with a solution that works only for a spherical cow in a vacuum—do not hold up in the context of real life. But the profit motive doesn’t just limit researchers’ ability to do rigorous science through industry’s funding priorities; it also leads to serious negative consequences, such as industry’s push to translate questionable research findings into profit as quickly as possible.
Health products and services that arise from reductionist research are mostly delivered via syringes, pills, and potions, and their funders (or should I say “investors”?) rush these products and services to market very quickly, usually before the implications of the research on which they’re based can be fully explored and integrated. Of course, companies test new products and services; in fact they run up big bills doing so, betting on their randomized control trials to show positive health benefits. Sometimes they do. However, calling those positive results truly promising requires assuming that narrowly focused, short-term results actually bring long-term health. That’s a risky and generally unfounded assumption.
In short, the pressures of the market result in products that are based on unripe research insights and unpredictable in their long-term effects. It shouldn’t be much of a surprise that these products end up being of limited utility at best and actually harmful at worst.
Vitamin E, which we discussed in chapter eleven, is a good example. A prominent study suggested a correlation between vitamin E levels in the body and healthier hearts.4 Industry began marketing vitamin E as a heart healthy supplement and rushed it to market. Then evidence started mounting that vitamin E supplementation actually increased overall mortality through, among other things, more prostate cancer and secondary heart disease5—evidence that industry has ignored for as long as possible. Researchers’ responses to learning this new but damning information about vitamin E resulted in a consensus that the party must go on.6 Everyone wants to find a way to save the market for vitamin E, or to find a replacement if vitamin E is beyond salvation. There is clearly great incentive to produce evidence that will justify the continued marketing of such products.
It is truly not the individuals within my community that I decry (although some could show more creativity and courage!), but rather our world of research, greatly influenced by market forces that define what is expected of us. Most of us know that money talks, as the old saying goes. But few of my fellow researchers and medical practitioner allies really know how corrupting money has been and continues to be. It is so pervasive that it is difficult to see from the inside. When we’re in the belly of the beast, how can we know which beast our host is, or even that our host is a beast at all?
Too often, our research priorities are driven more by personal rewards than community good. But the public pays for this research and depends on its findings, and, in the current system, they are being penalized for it. Individuals within the research community may find personal success by adhering to the reductionist company line, but as a group, we are getting no closer to the goal of health.