Whole (36 page)

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.

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.

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.

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 halftrillion 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.