Welcome to our Certificate Program in Plant-‐Based Nutrition, an online course offered in collaboration with our partner, eCornell Incorporated. This is the first lecture in the very first of three courses—501—and it will be focused on an overview of health statistics to sort of ground us in the connections between nutrition, health, and the practice of medicine.
In the course, we’ve had both non-‐professionals and professionals participating together, and we’re rather pleased with this approach. There might be the thought that it might be useful to separate these two groups. But, in reality, what we have found is that the interchange and the interactions between professionals and non-‐professionals—doctors and their patients, if you will—has been both really quite informative and productive. And so, we’re kind of proud of this approach.
This course is being offered for continuing education credit for professionals—we’re really quite excited about what we have here, and I think we offer a unique program. The professional credits awarded, among others, include continuing medical education credits for physicians, nurses, and pharmacists.
Chapter 2: Ten Leading Causes of Death
I want to start out in this first lecture, in the overview of the health conditions that exist in our country, by simply listing the 10 leading causes of death.1 [See slide number 4.] This particular list has actually stood pretty fast for quite a number of years, maybe shifting here and there a little bit, but basically heart disease is the most prominent of these diseases, cancers aren’t too far behind, and of course, as you can see, the rest of them are listed.
And I’ve starred the diseases that have a strong nutrition linkage, and what you will see here is that we have seven for which there is really good evidence to suggest that they have a strong link to diet and nutrition. These diseases we oftentimes call chronic degenerative diseases, indicating of course the fact that they tend to progress over a fairly long period of time, thus being chronic, and they also tend to be degenerative in the sense that normal tissue is gradually degenerating as one would tend to see with age. And in fact, most of these diseases tend to occur and increase with age.
Chapter 3: Other Chronic Diseases
But besides these, there are also the other chronic conditions and chronic diseases that we should take into consideration. Diseases that don’t necessarily cause death, but nonetheless are problematic. No discussion of health today would be complete without first starting to talk about obesity, the obesity epidemic that exists in our country these days. And even though obesity per se doesn’t necessarily cause death, it nonetheless is indicative of diseases to come. And so, about
1 Anderson RN. “Deaths: leading causes for 2000.” National Vital Statistics Reports 50(16) (2002)
TCC501: State of Health two-‐thirds of adults now are overweight—that’s a lot of people.2 One-‐third of adults are obese, this meaning that their body mass index exceeds 30. 3 Being overweight, their body mass index would exceed 25. The young people are especially vulnerable to this, and what we’ve seen during the last 30 years is an increase in the obesity of teenagers in particular, and even younger people. In fact, obesity incidence in young people has increased about three-‐fold during the last three decades, which is a remarkable increase, and of course it suggests that there are going to be problems to come if we don’t bring this under some control. 4
About 80% of young people who are obese may turn out to be obese when they’re adults.5 That’s at least what the current records would tend to suggest. Then those people are going to experience the kind of chronic degenerative disease that was listed in the previous slide.
Osteoporosis is another condition that we talk a lot about in the present day. It’s usually not necessarily a cause of death, but it turns out that amongst older women, upwards of half of these women have evidence of osteopenia, which is a precursor to osteoporosis.6 So, this tends to occur of course with the onset of the menopause years and that’s a very costly condition.
Chronic pain is another condition that is experienced by a lot of people. It is not listed as a specific disease, but chronic pain includes a variety of conditions such as lower back pain and arthritic pains of various and sundry kinds. Bursitis is yet another one in this sort of class. Headaches—the more serious being the migraine headaches that people experience. And chronic pain really interestingly does respond to changes in diet in a favorable direction, and it’s quite fascinating.
Hypertension is another common ailment like some of these others, although hypertension is not necessarily a cause of death, but it certainly is indicative of problems to come, especially in the cardiovascular disease category.
Chapter 4: The Cost of Care
Here are a couple of ideas that I think most of us know but may need emphasis—it can’t be overemphasized too much: namely, that the health problems that we now experience turn into medical care costs. [See slide number 6.] And as far as per capita medical care costs in the United
2 Cynthia L. Ogden, P. D., and Margaret D. Carroll, M.S.P.H. Prevalence of Overweight, Obesity, and Extreme Obesity Among Adults:
United States, Trends 1960–1962 Through 2007–2008. (National Center for Health Statistics -‐ Division of Health and Nutrition Examination Surveys, 2010). 3 Cynthia L. Ogden, P. D., and Margaret D. Carroll, M.S.P.H. Prevalence of Overweight, Obesity, and Extreme Obesity Among Adults: United States, Trends 1960–1962 Through 2007–2008. (National Center for Health Statistics -‐ Division of Health and Nutrition Examination Surveys, 2010). 4 Cynthia Ogden, P. D., and Margaret Carroll, M.S.P.H. Prevalence of Obesity Among Children and Adolescents: United States, Trends 1963–1965 Through 2007–2008. (National Center for Health Statistics -‐ Division of Health and Nutrition Examination Surveys, 2010). 5 Whitaker RC, Wright JA, Pepe MS, Seidel KD, Dietz WH. Predicting obesity in young adulthood from childhood and parental obesity. N Engl J Med. 1997 Sep 25;337(13):869-‐73. 6 Looker, A. C., Melton, L. J., 3rd, Harris, T. B., Borrud, L. G. & Shepherd, J. A. Prevalence and trends in low femur bone density among older US adults: NHANES 2005-‐2006 compared with NHANES III. J Bone Miner Res 25, 64-‐71, doi:10.1359/jbmr.090706 (2010).
TCC501: State of Health States are concerned, we are #1 in the world, about twice as high as the second country,7 8 but yet when attempts have been made to rank us in respect to quality of healthcare compared to other Western industrialized countries, we rank somewhere between 35th and 40th, depending on the criteria being used to rank us.910
So, the question that obviously arises is how can we be spending so much money and getting so little in return?
The cost of healthcare is looming large, and we’ve all heard a great deal about this in recent years—to be specific, the cost [for] companies that tend to have self-‐insured employee populations. As the cost goes up, it becomes ever more difficult for the companies to continue operating and supporting their workers. And so as a result, it has led in some cases to companies’ going overseas and using cheaper labor, because there they usually don’t have to pay for healthcare costs. So that’s one of the consequences. And the cost of healthcare among public agencies is in a similar category. You either lay people off or cut back on programs, as is the case with schools.
Schools have a particular burden in the sense that the retirees, as they get older, their health costs are covered by the program. As that tends to go up—and healthcare costs are rising rapidly in the last two or three decades in this country—as healthcare costs go up, costs go up amongst the school teacher retiree pool that have to be covered because it is an entitlement program. And when a larger percentage of the total budget available to schools is going to support that kind of activity, what it tends to mean is to cut back on the education programs in the school itself. Really quite a serious problem.
Chapter 5: State of Heath Statistics
In the next slide, I would like to touch on a problem that people tend to be generally aware of, but perhaps without knowledge of some of the specific numbers. [See slide number 7.] There now are something like 24,000 prescription over-‐the-‐counter medicines that are registered in the United States. 11 24,000—that is a huge number. We seem to have drugs for virtually every kind of condition.
Another figure that just sort of illustrates the problem: about 74% of the American population uses at least one prescription per year.12 That’s 3 out of 4 of us. And amongst seniors, generally meaning people 65 years of age and older, somewhere between 85% and 93% of seniors are
7 World Health Organization. Technical Report Series No. 425. “International Drug Monitoring: the Role of the Hospital.” Geneva,
Switzerland: World Health Organization, 1966.
8 Health Insurance Association of America. Source Book of Health Insurance Data: 1999–2000. Washington, DC, 1999.
9
World Health Organization. The world health report. “The World Health Report 2000—Health systems: improving performance’ Geneva, Switzerland: World Health Organization, 2000.
10 Some of the criteria used to rank healthcare systems include: life expectancy adjusted for disability, a high level of
responsiveness, or a fair distribution of the financing burden. Responsiveness was measured by asking participants to rate their experiences of: dignity, autonomy and confidentiality (jointly termed respect of persons); and prompt attention, quality of basic amenities, access to social support networks during care and choice of care provider. 11 Website http://www.drugs.com/drug_information.html.
TCC501: State of Health regularly using drugs or pharmaceuticals.13 The cost for these folks is now approaching $3,000 a year.14 You can imagine the number of seniors who simply can’t afford that kind of cost. This is out-‐of-‐pocket cost, by the way, and this is up from $550 per capita in 1992. In this short period of time, it’s gone from $550 up to almost $3,000 a year.15
Also, on average, it is now said that these seniors are getting close to 40 prescriptions filled per year.16 That’s huge. And amongst the seniors who are using pharmaceuticals, and that’s most of them, the average number of drugs they take per day is 8 drugs per day.17 Again, it’s really an alarming figure, and of course we all know some of the older people who have the little pillboxes and follow very carefully scripted prescription procedures during the course of the day. While all this huge use of drugs is occurring on the one hand, on the other hand we know from some studies that were done now approximately 15 years ago, showing that we also are getting over 100,000 prescription drug deaths per year.18 So here we are using an enormous volume of these drugs as people get older and yet, at the same time, over 100,000 people are incurring the costs of using these drugs in the form of losing their lives.
Chapter 6: Where Does Nutrition Fit In?
So, in the next slide, [slide number 9] since I am talking here in this particular course about nutrition and how does this fit in, I’ve just posed the question. So where does nutrition fit into the scheme of things—with the kind of conditions we have, the huge number of diseases that tend to kill us before time, and a huge number of them that are influenced by diet, and instead we’re turning to drugs? So, I think it’s fair to ask the question: where does nutrition fit in? Well, it really doesn’t. It really doesn’t in a number of different ways; first off, it tends not to fit in because the public is really confused about what nutrition really means, and so I think we would all agree that this subject is very, very poorly understood and most people hardly know what to do in order to really to take advantage of what nutrition can do.
Nutrition also as a scientific topic receives really only miniscule amounts of funding compared to the funding to do research in other areas of medicine at the National Institutes of Health, which is the premier biomedical research agency—not just in the United States, but in the world. At the present time, there are somewhere in the neighborhood of about 27 institutes and centers and programs that are included in the National Institutes of Health. 27 institutes and centers and programs—there is not one that’s called the Institute of Nutrition, just to give you some indication of how little respect nutrition gets within the biomedical research organizations. There is some nutrition programming and a small amount of funds, maybe 2% or 3% or 4% or so, in a couple of the big institutes like Heart and Cancer. But that funding, with which I am quite
13 http://www.cdc.gov/nchs/data/databriefs/db42.htm 14 Cost Overdose: Growth In Prescription Spending for the Elderly: Accessed online 2/12 at
TCC501: State of Health familiar, has been used primarily for testing nutrients as nutrient supplements, which I quite frankly call pharmaceutical research, not nutrition research. So, the funding for nutrition within the medical research establishment is almost non-‐existent.
Secondly, the doctors the public turns to for getting professional information on health, for obvious reasons, unfortunately are not trained in nutrition. There’re a couple of programs that have nutrition for sure, but for the most part doctors are really not learning about nutrition.
In addition, nutrition doesn’t fit into our narrative and our thinking because at the policy level— and I spent about 20 years in national policy development—policy, insofar as nutrition is concerned, doesn’t really apply in an effective way. In large measure because the standards that are set, whether I am talking about recommended dietary allowances, for example, or food labeling and other national education policies, these standards that are established unfortunately have reflected a very strong influence from the food and drug industry, which is most unfortunate because they are interested in selling products, not necessarily interested in selling health.
Chapter 7: US Medicine: Annual Deaths
This is a publication that I referred to before, that was published in the Journal of the American Medical Association in the year 2000.19 [See slide number 10.] And it lists here the number of deaths per year in the United States as a result of errors and other medical misfortunes concerning the present medical system. And you can see that between the medication errors and unnecessary surgery that occurs, and hospital errors and hospital-‐borne infections and, of course, the figures that I’ve referred to before—drug adverse effects being more than 100,000— the total deaths we are seeing in the year 2000, and there is some indication it is more now, that it hasn’t really necessarily slowed down. 225,000 deaths per year from basically going through the medical system to get care actually turns out to be the number three cause of death.
And you recall in that first list I talked about the first 10 causes of death. I haven’t seen a list that anyone has yet put out to show that the number three cause of death is actually going to the hospital or the medical system to get care.
In the next slide, [slide number 11] I’ve taken advantage of some of these numbers, and these numbers by the way are rough approximations, and they’re also very conservative. What I’ve done is to make an estimate, for example, of the proportions of the three major diseases—the proportions of these diseases that do not need to occur were we to use nutrition properly. And I am suggesting, for example, that if we assume that a third of all cancers could be prevented by an appropriate use of diet—and as I have mentioned before, this number really comes from a report in 1981 by Sir Richard Doll and Sir Richard Peto at the University of Oxford20 when they estimated that 35%...and their estimate was conservative, by the way, because they suggested upwards of 70% of cancers could be prevented by appropriate use of diet. So, I am using this
19 Anderson RN. “Deaths: leading causes for 2000.” National Vital Statistics Reports 50(16) (2002) 20 Doll R, Peto R., The causes of cancer: quantitative estimates of avoidable risks of cancer in the United States today. J Natl Cancer
TCC501: State of Health figure of one third—as I say, it’s a conservative figure—that of the 550,000 deaths that existed, a third of those cancers could be prevented. That gives 182,000. If we also assume that about a third of all heart diseases (that would be a more common, of course, cause of death) that gives us 237,000. And let’s say we assume that a third of all strokes and other cardiovascular diseases like coronary heart disease above—but in any case we’ll take about a third of all strokes and a third of all diabetics, and I think most people would agree these are very conservative estimates in terms of the percentage of these diseases that could be spared—or, I would suggest, perhaps you can cure, certainly in the case of heart disease and stroke.
And then, we add to that, let’s say we were able to cut down the prescription drug use by half. Put all those numbers together, add them up, and the revised cause of death in my terms is that the number one cause of death is nutritionally controllable diseases. It’s very clear. I would emphasize again this is a very conservative estimate. This essentially highlights the huge problem in the practice of medicine caused by a lack of knowledge of nutrition.
Now I am going to now use numbers that are more realistic in my estimation, and I’ve got some new numbers here. [See slide number 12.] Let’s say that two-‐thirds of all cancers could be prevented. I think that’s reasonable to assume. In fact, as I said before, the original publication that gave rise to this sort of latitude in sort of shifting numbers around a little bit is the report by Sir Richard Doll and Sir Richard Peto at the University of Oxford, when they were submitting a report to the General Accounting Office in Washington. Doll and Peto are perhaps the best-‐ known biostatistical epidemiologists in the world today, and were very important in this activity.
So, let’s say, two-‐thirds of all cancers could be prevented, we got a number there. 90% of heart diseases. Again, I am going to say that’s a conservative estimate, but it’s certainly a more realistic one because we now know from the work of Dr. Esselstyn and Dr. Ornish and others that virtually 100% of the people who have heart disease in advanced stages, they can reverse their conditions back to a state where the risk of suffering another attack is close to zero. So, let’s say 90% of all heart diseases could be prevented, 80% of all strokes and diabetes—again these are reasonable numbers, really, and let’s say we could cut down the use of these unnecessary prescription drugs by 80%, so we’ve got some numbers there.
You can see the new number, that the number one cause of death for the nutritionally controllable diseases is over a million, and put that number beside cardiovascular diseases and cancer. So, I think this kind of perspective, using the numbers in this way, is basically saying to us that we have this huge opportunity to really do something about our healthcare system if we simply understood what nutrition can do and then find appropriate ways to implement this information into the marketplace.
Chapter 8: Toward a New Nutrition Paradigm
I want to now shift your attention a little bit in this overview to what I am really driving towards, not only with respect to this lecture, but for the remainder of the course, and that is I am going to suggest that we at the present time do have a nutrition definition that we tend to work with, but I
TCC501: State of Health am going to also suggest a new nutrition definition for the future. So, let’s consider first the way we think about nutrition at the present time.
When we conduct research or set standards such as the Dietary Guidelines, we are really referencing the independent effects of individual nutrients on health. This can be misleading, because the effect of many nutrients acting in concert may not be the same as what we might predict if we were to take all the individual effects of those same nutrients and essentially add them together.
And so, the measurements that we use to create food labels in the marketplace appear to be rather specific if you look at the label. Food manufacturers do attempt to control and standardize the quantities of nutrients present in foods as much as possible in the food processing, but as I’ll discuss a little later, the amount of nutrients that are actually present in food varies enormously. But nonetheless, we think about nutrition in terms of the absolute amounts of nutrients presumably present in the package of foods.
The Recommended Dietary Allowances or RDA, again, is focused on individual nutrients—that’s the way we think about it, and this whole concept of talking about nutrition in the context of individual nutrients comes out in the marketplace in our use of nutrient supplements, now a $30 billion a year industry, and we’re now learning that these nutrient supplements are really not working.
Similarly, when we actually study nutrition in research protocols, we tend to work with individual nutrients as we study them, controlling everything else out of the picture, so to speak, and as I’ll discuss in another lecture on experimental testing, you can see that even the kinds of studies that we tend to favor are those that really focus in on what the effects of individual nutrients are. So, that’s our present nutritional paradigm. It’s this definition of looking at nutrients as singular agents minus their context.
In contrast, I think it’s time to think differently about nutrition—a definition that I would say is far more realistic, it’s much more natural, and I call it the “wholistic” effects of nutrients on health, which represent a synergistic effect. That is, nutrients tend to work together, obviously. We’ve known this for a long time, and now there are just an almost unlimited number of nutrient-‐nutrient interactions that have been published as we study them. We know they exist; they are very important.
And so, as we talk about the wholistic effects of nutrients on health, I’m going to suggest that what we really need to focus on are the whole food effects as they relate to health, where nutrients can naturally work together to create a response. So now that was a nutritional paradigm.
Now, let’s shift our thinking a little bit here and talk about the medical paradigm on the next slide.
TCC501: State of Health The present medical paradigm is what I refer to as a classic case of reductionist thinking, or reductionism. Once again, as I said with respect to nutrients, we tend to focus on one thing at a time.
In the case of medicine, we really depend on the use of drugs, and just drug use alone by older people is just over the top. And a lot of people actually do believe in fact that if we are going to improve our health care system, we need to have better access to drugs and more drug development. I would argue strenuously against that particular approach, but that’s a very reductionist approach—considering the effect of one chemical, namely a drug, on one effect in the body, that leads to one kind of disease. In fact, the development of drugs is in many cases now being targeted to very specific sites and so we refer to this as targeted therapy. Again, it’s this very singular reductionist approach—one chemical affecting one particular topic, for the most part, ignoring the larger context.
Nutrient supplements, to the extent they’re used in the present medical paradigm, it’s the same philosophy. Trying to see what level of nutrients we need to consume is based on research that has been focused on the individual nutrients.
Also, the present medical paradigm that we all know is true is: we tend to let diseases happen. When the doctors discover the diseases—or we discover them ourselves, and then get some evidence from the doctors. So what we end up doing in the present medical paradigm is to treat symptoms—to treat symptoms. We give a little bit of attention to trying to prevent disease in future, but in the total context of things, there is very little attention. Not many people pay attention anyhow. So, the present medical paradigm is focused on the treatment of symptoms, which incidentally, once we get to know what these chemicals are, what these drugs are, it’s only natural to assume there are going to be toxic side effects to every single one of these drugs. This is just a matter of time before we actually discover the side effects that occur. So, we are using these single things again, out of context, and having to experience toxic side effects along the way.
Again, I want to turn our attention to the possibility of a different medical paradigm for the future—one that is based on wholism, not reductionism; where we depend on food, not nutrients or chemicals. Depending on food, not nutrients or chemicals. I am going to suggest that based on the evidence we now have, nutrition and food can be used to actually treat diseases, essentially with no toxic side effects. So, I would ask you just to compare the present medical paradigm and future medical paradigm, and see my point is that the future medical paradigm really is a much more effective strategy for creating and maintaining health than is the first system. And, if we do have problems, we now know we can actually treat those problems with the same approach as we would when we are preventing these diseases.
TCC501: State of Health Chapter 10: Research Assumptions
I am going to try to finish up here with giving some consideration to the research assumptions that we also tend to have when we are looking at the questions like this, and I think everybody needs to know that research for the most part—at least, respectable researchers start out with a hypothesis about something: that A causes B, or whatever the case may be. And so, we will consider that hypothesis, do some work on it, and then get some results that quite frankly do reflect a personal bias as we went into this study.
The first question that I would ask is: Who is choosing the hypothesis and why did they choose that hypothesis? Science is not perfect. I would like to suggest that researchers or medical professionals, especially when they are starting their careers, may begin with some questions. They may want to investigate some important questions, so they form a hypothesis. But if I’m evaluating the strength of their research later I would like to know who chose the hypothesis and why did they choose that particular hypothesis? Often, the hypothesis does reflect what turns out to be a considerable amount of personal bias, whether they know it or not. And the research hypothesis that is actually examined over years, quite frankly can still be focused very specifically on individual entities in the food.
Once we start doing that, looking at one thing at a time, that’s the old drug model, single nutrient supplement model, we’re back into the game of reductionism again, and we end up with a huge amount of confusion with the American public. And so biases occur at all levels of research, and what really turns out to be an interesting kind of phenomenon is that the biases that we tend to have doing this kind of research are biases that we’re dragging up from personal past, maybe bias associated with a funding agency, biases supported by a lot of colleagues as well. And so, bias comes from here, there, and everywhere, and pretty soon the biases sort of aggregate into almost a crescendo of bias; we finally get to a point in having a bias that we don’t even see it. We are living within the inner realm of this bias and don’t tend to question it—it becomes so pronounced in a sense, without [our] necessarily knowing it, that it becomes a theory, becomes a way of living, a way of thinking.
I just want to point out that science is not so perfect as people tend to believe it is. It’s a great concept. If we can do it right, we can learn a lot, but it’s also subject to bias.
I want to point out that as we focus our attention on one thing at a time, as we do in the present system, this gives rise to confusion because we’re just choosing the little trees in this big forest and trying to draw conclusions about the whole forest by looking at one thing at a time. One of the best examples of this is—I’ll mention later and I should introduce it now—is this idea that randomized controlled trials are supposedly the gold standard. I don’t consider this the gold standard at all; it’s a gold standard for testing drugs, but it’s not the gold. It’s probably one of the most misleading kinds of experimental trials that I can possibly think of in research, because a randomized controlled trial is one [in which] we’re looking at one thing at a time.
TCC501: State of Health attention to that kind of thing, and they don’t do that kind of thing because they are always looking for the specific agent in that food or that dietary pattern.
In any case, there is another assumption that is prominent in our system. In the next slide, I just want to point out a couple of other ideas too. [See slide number 21.] Namely, that as we do research, and as science publishes this research, and especially as the media then tell this to the American public and so forth, and all these biases tend to creep in, we have a tendency in research to publish the results that favor our hypothesis or whatever it may have been in the first place; that’s why I raised the question [of] who is choosing these hypotheses and why did they choose them. And once they get sort of invested in doing that kind of research and getting a certain kind of result, then everything from thereon, if it favors the hypothesis, they will tend to publish it. If it doesn’t, it doesn’t get published, and that’s a serious problem. There is evidence of that. There have been surveys done of that, showing that there is a tendency to publish favorable results when we should be looking at the reverse.21 22
So, on the last comment, I talk about trying to gain an understanding of “proof” and “truth.” I’d like to use these words with much less certainty. In my realm of thinking, as far as research is concerned, I’d like to talk about science being an art of observation, basically pursuing a truth. Not necessarily ever finding a truth, but pursuing the truth, and in the process actually gathering evidence to a point where we have so much evidence, let’s say, for a certain point of view that then enables us to make decisions about ourselves, or about the society. So, for me, it’s a weight of evidence concept—not looking at one thing at a time, especially doing it with precision. The more precise we get in these kinds of studies, I would suggest, the more likelihood it’s going to be an irrelevant result in our everyday life.23
So, I like the idea in science of looking at the network of evidence, the breadth of the evidence, and the consistency of the evidence from all different kinds of perspectives to try to get a feeling for that, as opposed to trying to search for the magic bullets.
Chapter 11: Nutrition and the Medical Practice
Nutrition doesn’t fit into medicine, as I said before; it just doesn’t, and this cartoon explains, I think, really quite well. [See slide number 22.] And so, what we need in this business is to get away from the usual model of thinking about doing things really precisely and saying that’s the best of science; that’s really not true. We need to stand back and look at the broader perspective of the results we get, and using critical thinking, just really think about what we’re getting and see if it makes sense from all these different perspectives.
21 Chan AW, Altman DG. Identifying outcome reporting bias in randomised trials on PubMed: review of publications and survey of
authors. BMJ. 2005 Apr 2;330(7494):753. Epub 2005 Jan 28.
22 Lesser LI, Ebbeling CB, Goozner M, Wypij D, Ludwig DS. Relationship between funding source and conclusion among nutrition-‐
related scientific articles. PLoS Med. 2007 Jan;4(1):e5.
23 By “precise” Dr. Campbell is referring to research conducted on single nutrients and single effects, as opposed to examining the
TCC501: State of Health And so, the only way that we’re going to get nutrition into the practice of medicine, into our lives and then we understand it, is to first recognize that it is a very complex subject and we’ve got to treat it with respect—at least the science with respect, and then gather the evidence.
Chapter 12: Consequences of Deciding What’s for Dinner
In the next slide, [slide number 24] I’m just simply showing this idea that nutrition operates within the body in a very complex way, and we’ve got to look for the balance of evidence, and look at it carefully and try to control our biases, at least be aware of the biases we have. That extends all the way to what we decide to do with everything in our lives. In other words, deciding what’s for dinner has consequences, and I’m going to suggest based on the first slides I showed that the diseases occur because we don’t understand nutrition. I mean, a huge proportion of the diseases are really related to what we’re choosing to eat and the nutritional effect they have, and it’s not just on our bodies. It’s related to strongly to environmental degradation; whether it’s the global warming issues, contamination of water, soil loss.
We already know, as I mentioned before, that it’s associated to the way we do things now—it has excessive medical costs. Inappropriate research design and interpretation, I’ll briefly just touch upon that; we’ll learn more about that in the course, political policy corruption too comes into play, and all of these sorts of outcomes or consequences are really important and they all start with what we decide to eat.
And the last slide is just, I’ll leave you with a thought; namely, it kind of helped me to think about it this way, I think. [See slide number 25.] We need to investigate the details. I’m not against reductionist research—I’m very much for that kind of very detailed kind of research. But we should investigate what those details mean in a larger context, and use the details to support the construction of the bigger picture we are coming to understand. So, we investigate the details but apply the generalities. This is just a sort of thought that I would leave with you as you go through the series of courses.