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Thankfully, the diagnosis of female hysteria is a thing of the past. But why did it disappear? Obviously, the symptoms that characterized a diagnosis haven’t gone away. Nobody got a Nobel Prize for curing hysteria. It’s simply that Western doctors have stopped attributing these symptoms to a misbehaving uterus. The symptoms are real, but the “disease” is subject to cultural and gender bias. A disease is nothing more than a theoretical model applied to a cluster of symptoms.

Conversely, the medical establishment sometimes denies the existence of a disease—the relationship between a cluster of symptoms—that many people claim to have. Modern examples of this denial include chronic fatigue syndrome, chronic musculoskeletal pain, and fibromyalgia. When many doctors hear these disease names, they roll their eyes and translate them into a single diagnosis: hypochondria. The reason they don’t consider them diseases is that their sets of symptoms cannot be correlated to particular, reductionist “underlying pathologies,” like an infection or an immunological response. In other words, if a doctor can’t reliably diagnose it through an objective test, it isn’t actually a disease. See the circular logic at work here? The definition of a disease is whatever the medical establishment rather arbitrarily calls a disease.

The initial purpose for naming and monitoring disease occurrence was to detect patterns of changes in people’s health that might forecast emerging epidemics. The naming system was also used to standardize medical records, so that health practitioners could more easily communicate with each other when patients changed doctors or when discussing hereditary conditions. Proper disease classification is crucial throughout the medical practice and research communities for the conduct of research as well, especially for epidemiological studies.

But the tendency to think of each disease as a separate, distinct entity has a dark side. It encourages tunnel vision, and promotes the idea that each disease has its own specific cause(s), its own unique explanatory mechanism, and its own targeted treatment (usually a specific drug).

The classification and treatment of disease isn’t always so strictly reliant on this single-factor model. Medical professionals sometimes recognize
that there may be more than one cause for a specific disease, or more than one drug to treat it. For example, many cancers are attributed to multiple possible factors: genes, environmental toxins, and viruses, working either separately or in combination. And most doctors can think of a few different antibiotics that are equally useful for bacterial infections, a few different analgesics for pain, or a few different antihypertensives for controlling blood pressure. This type of thinking definitely goes beyond the one cause/one disease worldview upon which much of medicine rests. But most practitioners view such instances as exceptions rather than the rule, and this line of thought still diverts attention away from the possibility that there are more effective natural ways of treating ailments. This is a shame, since really paying attention to the amount of overlap among causes, mechanisms, and outcomes could help more medical professionals break out of the narrow disease paradigm.

Most people in the medical community of practitioners and researchers do not regard looking for global mechanisms of health and disease as proper science. Before admitting nutritional medicine to the “legitimate disciplines” club, they would want to know the precise details of how such a complex system works for each disease event. Short of that, they would insist on identifying the “active agents” of food, rather than simply accepting that the food itself is what’s good for us. Of course, they are asking for something that is impossible, at least when it comes to nutrition—we don’t know exactly how it works, because we cannot identify all the parts, what they do, and how they do it. We just know that it
does
work.

The medical community often cites the mantra that there is no such thing as “one size fits all,” revealing their inability and abject refusal to fully embrace the idea of complexity and its implications. Nature does a far better job of arranging for proper biological functioning than we like to admit, and once we accept the ability of the body’s infinitely complex system to attain and maintain health, then the one-size-fits-all philosophy begins to make sense. We can imagine “one size” being whole, plant-based foods, with an almost infinite number and variety of parts acting
harmonically as one, as in symphony, and “fits all” as their ability to act on a broad variety of illnesses. While the one-size-fits-all approach cannot be applied within the paradigm of targeted drug therapy, it is immensely useful and powerful within the wholistic nutrition paradigm.

Another way to say this is that poor nutrition causes vastly more diseases than the disease-care system currently acknowledges; and that good nutrition, in contrast, is a cure for all those diseases and more. Poor nutrition is the root cause that all those blind elephant doctors can’t see.

Nutritional solutions to disease should seem like just so much common sense at this point, but it’s still worth taking a moment to look at how a medical system based on nutrition contrasts with the reductionist system we have today (see
Figure 10-1
).

FIGURE 10-1.
Disease management versus nutrition

While the disease management system is reactive, nutritional medicine is proactive in preventing diseases before they develop. Disease management focuses on symptoms, while nutrition addresses the underlying causes of those symptoms. Disease management chooses isolated, reductionist treatments that attempt to target specific sites in our bodies, while nutrition simply gives the body the resources to select what it needs to maintain and regain health wholistically. And while disease management favors synthetic drugs that our bodies recognize as toxins, nutrition deploys the foods we have evolved to eat over hundreds of thousands of years, thereby avoiding side effects.

Medicine has become synonymous with ingesting foreign chemicals when our health deteriorates to the point that we have recognizable diseases. Medical practice means chemical practice—on our bodies. There is and always will be a place for the use of isolated chemical substances— even foreign chemicals—but only when all else fails. Reductionist disease management should, however, be a last-ditch accessory to health practice. It can’t be the main game in town.

Science advances one funeral at a time.

—
ANONYMOUS

M
ost of us know “alternative health”-minded people who are suspicious of the medical/pharmaceutical industries, and instead bet their lives on nutritional supplements: not only specific, identifiable vitamins and minerals, but also other “natural” ingredients like nutraceuticals, prebiotics, probiotics, omega-3 fats, and various whole food concentrates. The supplement industry has grown dramatically over the past thirty years or so; as of 2008, worldwide sales of dietary supplements were estimated at $187 billion.
¹
Sixty-eight percent of American adults take dietary supplements, while 52 percent consider themselves “regular” users.
²
Forget apple pie—now nothing is as American as a multivitamin.

By now, I hope you recognize this as one more example of the reductionist paradigm at work, even when it’s couched in natural and alternative terms. As we saw in
chapter ten
, one of the major problems with modern medicine is its reliance on isolated, unnatural chemical pharmaceuticals as the primary tool in the war against disease. But the medical profession
isn’t the only player in the health-care system that has embraced this element of reductionism. The natural health community has also fallen prey to the ideology that chemicals ripped from their natural context are as good as or better than whole foods. Instead of synthesizing the presumed “active ingredients” from medicinal herbs, as done for prescription drugs, supplement manufacturers seek to extract and bottle the active ingredients from foods known or believed to promote good health and healing. And just like prescription drugs, the active agents function imperfectly, incompletely, and unpredictably when divorced from the whole plant food from which they’re derived or synthesized.

The reductionist sleight of hand goes something like this: Oranges are good for us. Oranges are full of vitamin C. Therefore, vitamin C is good for us—even when extracted from the orange, or synthesized in a lab and stuck in a pill, or “fortified” into a breakfast cookie. But there’s no evidence that this is the case. As we’ll see, not only do most supplements not improve our health, some that have been studied most intensely actually appear to harm us.

Consider the humble apple. We all know the folk wisdom that “an apple a day keeps the doctor away.” This insight is supported by all the evidence science has amassed that shows the apple is a food that contributes to health. But what is it about the apple that promotes health? Food composition tables tell us that the average apple contains a significant amount of the following nutrients: vitamin C, vitamin K, vitamin B
₆
, potassium, dietary fiber, and riboflavin. Also, it’s got smaller amounts of vitamin A, vitamin E, niacin, magnesium, phosphorus, copper, manganese, and a whole host of other nutrients.
³
From this long list, can we figure out what really matters about an apple?

A friend and colleague of mine, Dr. Rui Hai Liu, got curious about this question, and he and his research team set about looking for the answer.

Professor Liu was among that early wave of Chinese students who came to the United States when our two countries began to open their doors (and their hearts and minds) in the early 1980s for scholarly exchange.
Because of my early work in China and the rapidly growing reputation of our joint project—the first research project jointly funded by the United States and China (and England)—Liu had sought me out to help him come to Cornell. He tells me that mine was the first American family and home that he visited. He did his PhD research program in Cornell’s food science department, and I was a member of his graduate research advisory committee. Upon completion of his studies, an opportunity then arose for him to apply for an assistant professorship in the same department (he clearly demonstrated great potential). Again, he asked me to write a reference letter to support his application. Not long thereafter, he applied for and succeeded in getting some very competitive research funding from the NIH to enable him to develop a substantial research program. Since then, Liu’s successes have been impressive. Now a tenured professor, he has amassed a very productive research career, establishing himself as an internationally prominent researcher and lecturer in his field.

The course of that career included his early findings about the health effects of the apple, an area of study that flowed naturally from his personal background. Professor Liu’s father was a well-known herbalist in China, and, as a young boy, Liu helped his father make herbal preparations. He grew up in a family concerned with human health, within a culture that viewed health care wholistically. When Chinese doctors counsel patients, they traditionally consider the whole person: physically, mentally, socially, and environmentally. Their practice of “medicine” also considers the wholistic effects of whole plants, usually multiple plants, in their preparation of herbal remedies (plants comprise about 95 percent of remedies in traditional Chinese medicine). So Professor Liu was accustomed to looking at things not only in a reductionist way, as he was trained to in his Western biomedical schooling, but also in a more wholistic way, based on his familiarity with Chinese medical philosophy.

In studying the apple, Professor Liu and his research team began by choosing to focus on vitamin C and its antioxidant effect. They found that 100 grams of fresh apples (about four ounces, or half a cup) had an antioxidant, vitamin C-like activity equivalent to 1,500 milligrams of vitamin C (about three times the amount of a typical vitamin C supplement). When they chemically analyzed that 100 grams of whole apple, however, they found only 5.7 milligrams of vitamin C, far below the 1,500 milligrams that the level of antioxidant activity associated with vitamin
C indicated. The vitamin C-like activity from 100 grams of whole apple was an astounding 263 times as potent as the same amount of the isolated chemical! Said another way, the specific chemical we refer to as vitamin C accounts for much less than 1 percent of the vitamin C-like activity in the apple—a minuscule amount. The other 99-plus percent of this activity is due to other vitamin C-like chemicals in the apple, the possible ability of vitamin C to be much more effective in context of the whole apple than it is when consumed in an isolated form, or both.