Science, according to an abbreviated definition of the Oxford dictionary, is the activity of observing the natural world, through systematic study and experimentation. I contend that we have strayed from that meaning, much to our disadvantage. Most people still value the word ‘science’ and want to use it to justify their beliefs. But in doing so, many of these efforts are eroding its true meaning. For this discussion, I am mostly referring to the discipline of nutrition and, more particularly, to the little known but very impressive health benefits of a whole food plant-based (WFPB) diet, not vegan and not vegetarian but a WFPB diet.
Much of the supporting evidence for this diet (actually lifestyle) has emerged during the recent 20-30 years. Because it questions some powerful social and economic forces to the contrary, we now have a raging debate, with both sides claiming they have ‘science’ on their side. Thus, it is time to reconsider the meaning of this word, science.
A second word also needs clarification, the ‘Academy’. We generally think of an academy as a physical place of learning. But there is a broader meaning that I refer to here. The Academy (caps intentional)—in reference to our interest in food and health—refers to a virtual intellectual community whose general purpose is to set the rules and manage the basic science that underlies the public’s understanding of food and health.
The Academy includes a range of disciplines and agencies that have a common purpose. These include research funding agencies (e.g., NIH, American Cancer Society, American Heart Association), professional societies (e.g., Academy of Nutrition and Dietetics, American Medical Association), universities and research institutes who do most of the fundamental ‘science’ teaching and research, and food and health policy agencies (e.g., Institute of Medicine, USDA, CDC, Surgeon General’s Office) who make public policy recommendations. I have been active in each of these disciplines and they generally sing from the same songbook. Briefly, their food and nutrition messages differ only in minor details. They can be better summed up by saying they are busy defending the status quo, which is populated by many very large and long-standing industries who have been working very hard to infiltrate the Academy. Unfortunately, they are being unusually successful.
My story about what I knew about science is both personal and professional. It was 1956 when I entered graduate school at Cornell and started my career in the science of food and health. I was completing my first year in veterinary school and unexpectedly received a telegram from a famous Cornell professor unknown to me who offered me a scholarship to join him. I accepted, partly because my father would not have to scramble for money he did not have for my vet school education and partly because getting involved in ‘medical research’ sounded intriguing.
I knew very little about what it meant to be in graduate school working in ‘science’. But in time, I came to believe that it meant something I really liked. I would be asking questions of my choosing then doing experimental research in the laboratory to find answers. More formerly, it meant forming hypotheses then doing research to produce evidence that supported or rejected these hypotheses. It was a world of exploration and discovery, providing I could find funds to support my research (my graduate school funding was provided by the professors I worked with).
Ever since, until relatively recently, I have enjoyed being in ‘science’ doing experimental research to produce ‘evidence’, a charmed career indeed. It was about personal freedom! I also liked the idea of what science is, namely, the ‘art of observation’, as opposed to technology that uses experiments to make things. For me, science is about searching for natural truths, but rarely if ever really finding them. It’s about enjoying the journey and the give and take of intellectual sparring. It also requires continual vigilance about motivations and ideals, and questioning whether interpretations of experimental results are sufficiently free of personal bias. This may sound a bit idealistic—and it is—but this was the ‘science’ environment that I came to understand and experience.
I know that this sounds like a fairy tale from the ivory tower, or Academy, where life is good and research is conducted without personal bias. It’s also quite reasonable, then, to assume that the Academy conducts the most reliable scientific research—they have the best rules. Becoming a member of these institutions generally requires ‘credentials’ and an acceptance of the ‘rules’ by which truths are sought and shared with others. These rules generally refer to the use of public funding, the publication of results that are critiqued by peers and an admission of any personal conflicts of interest, among other criteria that emphasize objective science. Evidence produced by the Academy according to these rules therefore generally infers impartial authenticity. Disobeying these rules meant tough penalties for people caught cheating and frowns for those who went too far to claim fact from fancy.
The Academy has produced massive amounts of ‘scientific’ information and, whether good or bad, people automatically use this information to legitimize their beliefs about human health. It is not necessary that we define the Academy by physical, ivy-covered walls. Walls do exist but they are less visible. In the world of ideas, these walls are probably best defined as the borders of a paradigm.
Being inside the Academy does not guarantee objectivity, authenticity and integrity. And, being outside the Academy does not necessarily mean having beliefs with little or no value. It is my experience that these boundaries, which have been used to assess what’s acceptable and what’s not in the world of science, are becoming more and more blurred. The question therefore is how important are these boundaries? I equivocate because I treasure very deeply the rules or ideals of the Academy but I am becoming more and more troubled by the authority and exclusivity assumed by some members of the Academy, as if membership alone qualifies them to be the arbiters of truth.
According to the Academy’s views on science, if our hypotheses are to be confirmed, we should expect the same results when experiments are repeated. Also, hypotheses must be falsifiable, that is, we cannot make statements of belief for which there is no way to disprove them. The famous philosopher, Karl Popper, went further and proposed that we could develop and refine better hypotheses if we tried to disprove them.
These are the ideals that I came to believe when I started my professional career almost six decades ago and I have tried to live by them. But, now, these ideals seem to be eroding, at least within the discipline of diet, nutrition and health. With such erosion, it becomes more and more difficult to have responsible dialogue, especially on matters of nutrition.
I believe that this compromise of ideals has become more pronounced and common as the exciting health benefits produced by whole, plant-based foods become better known. Lest we forget, this is especially disruptive evidence that questions long standing, deeply held customs and beliefs. Our traditional diet has long been protein-centric, which especially emphasizes the consumption of so-called high quality protein provided by animal based foods. In contrast, this more recent evidence shows that a diet of whole plant-based foods with much less total protein is far more productive of good health. Furthermore, we do not need to consume animal-based foods to get the protein we need. By limiting or avoiding animal-based foods, we also increase our consumption of foods that are far better at promoting health and reducing disease (the same occurs, for somewhat different motivations, when consuming convenience/processed foods made high in fat and refined carbohydrates).
The evidence that favors whole plant-based foods as a source of health is as convincing, profound and relevant as any I have ever seen in my career in nutritional science. But, because this evidence severely challenges some very deep-seated beliefs and corporate practices that constitute the status quo, it invites misguided attempts by the defenders of the status quo to abuse the rules of good science. These defenders may be on either side of the Academy’s borders.
This problem of misrepresentation of information in the name of science has consequences. If not resolved, it will reduce the evidence favoring whole, plant-based foods to public babble not to be taken seriously. This would be tragic because these findings have the capability to make a major contribution to the human condition and to the betterment of our society and our planet. We must therefore strive for excellence of message, one that adheres to the ideals of good science.
I have pondered this problem of scientific discourse becoming more and more corrupted for a number of years, why it exists and even whether I might be overstating my concern. I am certainly open to the idea that I am wrong, that in reality I am only discovering a practice that existed as much before as it does now. I’ll leave that for you to decide. Still, though, I believe in the ideals of good science—as do most of my colleagues—and believe that few will disagree with these ideals and the need to periodically remind ourselves of them.
This problem of abusing the concept of science takes several forms and involves a variety of people and institutions, both inside and outside of the Academy. I am convinced that much of this compromised dialogue is unintentional because of simple ignorance of facts and misunderstanding of the scientific method. Some of this abuse, however, is intentional because of the belief by some that it is more important to defend the status quo (job creation and security, investment return, etc.), regardless of whether this may be beneficial for human health.
Citing examples of what is intentional misuse of science and what is not is difficult and such an exercise might worsen the situation. At least, this was my view when I started to write my book, Whole. Rather than document mischief and miscommunications in this field of food and health, I was more interested in exploring that aspect of the system that fundamentally allows unproductive mischief to occur. I concluded that it is our well meaning, but inadvisable focus on details, which are better able to capture marketplace revenue. Mischievous health claims favoring these details run in parallel, often in the name of ‘science’. This is what I mean when I say that mischievous behavior occurs unintentionally—many people really do believe in details but I submit that they believe it is good science when it is not.
The Academy supports this misadventure by encouraging research that produces details, in the name of good science. The discipline of nutrition is a good example. Details (i.e., individual nutrients) pave the road to the marketplace where revenue is produced. But, because these details on individual nutrients are discovered out of context of the whole (whole food, whole body response), this is not in the name of good science.
This became abundantly clear to me as I participated in so many so-called expert panels that determined what kind of research investigations should be funded and how these findings could be used to make public policy on food and health. To make matters worse, when academic institutions (the core of the Academy) become ever more dependent on external funding to do this research, they become ever more emboldened to protect their source of funding, thus defending the status quo, whether it is producing food that makes people sick, whether it is producing new drugs intended to cure the unfortunate victims of this food and/or whether it is educating health care specialists who are needed to care for the sick. It’s a closed circle that must be broken.
In this maelstrom of sickness and soaring health care costs that we have come to know in the U.S., far too many people working from both sides of the Academy claim to be using science to defend their beliefs, their habits and their practices.
So, on what basis do I believe I can speak from both sides of the borders of the Academy? It’s because I’ve lived on both sides and have experienced their pluses and minuses.
For most of my career, I lived within the boundaries of the Academy and tried to play by the rules and greatly enjoyed the ‘debates’ within the Academy, the collegiality of fellow academics and the exceptional thrill of working with many graduate and undergraduate students. I succeeded in acquiring generous amounts of highly competitive public funding for our research, we published extensive findings in the very best professional journals and I lectured to academic communities throughout the U.S. and abroad (e.g., at universities in about 40 of the 50 states). It has been the good life, academic speaking.
Until the mid 1980s I lamented the legitimacy of so-called outlier groups like the vegetarians and, a little later, the vegans. In the Academy, we ‘knew’ who were legitimate in the name of science and who were not and these ‘V’ groups, whose views were mostly founded on ideological grounds, did not measure up to be legitimate. Needless to say, it was quite an elitist perspective, thus my capitalizing here the word ‘Academy’ in order to emphasize this obvious perspective.
In further exploring what is legitimate science and what is not—that is, according to the Academy—such a determination becomes more challenging when the evidence is substantially different from what we have come to believe. My own research program, for example, was developing a stream of unexpected evidence that clearly was beyond the Academy’s understanding of the science of nutrition (at least at that time). This included the following:
In our experimental animal studies, we were showing that instead of human cancer being primarily caused by the presence of ‘environmental’ chemicals or viruses or family history, it was the nutrients in food, fed at inappropriate levels that were much more prominent. In a long series of experimental rat studies (conducted over 27 years) we could turn liver cancer growth on and off by switching levels of dietary protein and this occurred within ranges of nutrient consumption that many people routinely experience.
We learned that it was animal-based protein (casein, the main protein of cow’s milk) but not plant-based protein that turned on cancer. Indeed, our extensive studies showed that, according to the criteria for testing environmental chemicals for possible carcinogenicity, casein is the most relevant chemical carcinogen ever identified. Dietary fat, although not as well researched by us as casein, did much the same thing, in this case with pancreatic and mammary cancers.
We learned that these results were consistent with human observational studies conducted by other research groups. People moving from high cancer risk societies to a low cancer risk societies (or vice versa) assumed the cancer risks of the countries to which they moved and, further, these risk changes were primarily attributed to nutrition, not to genes.
We learned that although all diseases have a genetic basis, some direct, some indirect, it is the control of gene ‘expression’ by nutrition that matters far more then the mere presence or absence of mutated genes. (Infectious diseases have a microbial basis but our susceptibility to these diseases depends on our immune system whose response has a genetic basis.)
For many years (late 1960s to late 1980s), we searched for the responsible ‘mechanism’ for the cancer producing effect of casein and it eventually became clear that rarely, if ever, is a disease event (or other outcome) due to a single ‘mechanism’ or to a single gene. Instead, countless nutrients found in food operate through countless biological mechanisms arising from a large number of genes. It was as if nutrient effects, good and bad, operate as if they were highly integrated as a part of a symphony.
Eventually, I realized that the far more important story about food and health was the converging of nutrients and mechanisms to show that the ideal diet to promote human health and resist disease is comprised of whole, plant-based foods.
It was about this time (late 1980s and early 1990s) that I was confronted with an experience that tested my willingness to promote serious discussion about our exciting and promising findings not only within the Academy but also for the public.
It started with a lead story in the science section of The New York Times—along with companion lead stories in USA Today, The Saturday Evening Post and others—that prominently announced our nationwide findings in rural China of associations of possible diet and lifestyle characteristics with human disease death rates. As is often the case, the New York Times article, like the others, was rather emphatic, prominent and provocative. I was somewhat uncomfortable with its tone because until that time, I preferred a more conservative approach when discussing our more contentious research findings. Provocative news articles, even if reliable, can spell trouble for academic standing, especially when questioning protein.
Either I downplayed this reporting of our work as being too enthusiastic and stayed within the conservative confines of the Academy or I embraced it and chanced the unknown response from outside of the Academy. In reality, however, there was only one path and this was to tell the truth as I was coming to know it! I had to accept, for example, that this story was a reasonably reliable account of the interview I had given. I also accepted its reliability because these findings in rural China for humans corroborated our laboratory studies, although these latter were generally not discussed in the news story. Therefore the time had come for me to explain and defend these provocative findings instead of playing it safe and only saying, “we need more research”, as we so often do in academic circles. This information was far too important—both to those who paid for the research and those who would benefit from its findings—to remain within the confines of the Academy, while being submerged in lots of ifs, ands and buts.
Something else occurred about this time that encouraged me to be a little more venturesome. I learned of clinical experiences by primary care doctors (Drs. Alan Goldhamer, John McDougall, Caldwell Esselstyn, Jr., and Dean Ornish, in that chronological order) who already were using much the same diet on patients to solve real health problems. Their successes were entirely consistent with our research-based findings.
Four considerations—our laboratory findings, the China project findings, the corresponding clinical results of colleagues and the media-initiated impetus— combined to suggest that this idea had the potential to be a serious game changer for the future of humankind. This new awareness occurred almost 25 years ago, although it was arising from within our research begun 45 years ago.
I looked forward to discussing this supposedly ‘new’ information with my professional colleagues (early to mid 1990s). In fact, I had already drafted a research and teaching program at Cornell for this purpose and was talking with people who three times visited to our research group to discuss their interest in providing substantial funding for this purpose. For many years, I had acquired experience organizing professional symposia, programs and seminar series while presenting a large number of my own lectures to academic institutions. This new project was one of the most promising—so I thought.
But discussing these biologically complex findings for the public posed two challenges. First, I had to explain findings that were not easily accepted by the Academy, lest they be considered quackery and, second, I had to develop a more user-friendly but scientifically qualified narrative accessible to the public. And there was another issue. I was becoming aware of a surprisingly huge gap in food and health knowledge between what the Academy believes is good and sufficient and what the general public deserves to hear. Reporting a story to the public about provocative research findings without violating the scientific basis for the evidence—as demanded by the criteria of the Academy—is a very narrow path to walk.
I want my views to be scientifically reliable, of course, but also I don’t want it to be so constrained by trivial technicalities that it has little or no relevance for the public. I want scientific credibility—as do most of my colleagues—and most of us work hard to achieve this measure of quality.
In choosing pathways of this kind, it is not sufficient to say, very simply, that we want good science. It is important to know well what this privilege really means. Unfortunately, the word ‘science’ in the marketplace has become virtually meaningless. Many people use the word to gain credibility for their beliefs and, most importantly, when advertising their money making products and services. But it is my experience that there are so many questionable claims of scientific support that, at this time, almost none can be believed without going to great efforts to find and examine their sources—if they even exist. Because this is impractical, we must rely on a system that we can trust but, for me, I am finding this to be increasingly difficult, especially when the door is shut to even discuss the information.
In traveling this pathway and often thinking about the idealism but also the realities of what constitutes good science, I have reluctantly come to a cynicism that I never thought possible. Entire food and drug industries now rest on foundations of scientific deception. Even when personally honest, well intentioned individuals state technically accurate facts, these facts may be based on narrowly focused experimentation, thus omitting important but unspoken contexts that may give very different conclusions. More and more frequently, the statement, “…based on scientific evidence”, is wasted breath.
This problem arises not only because of an insatiable desire for money, but also because of the way we think about science, as it applies to human health and more particularly to the science of nutrition and the practice of medicine. From one perspective, we think of science in a very reductionist way, both when doing research investigations and when applying this information in practice. Such research is important, and it can be done well and honestly, thus being considered high quality science. But a perspective without context is not good quality science.
My interest in the meaning of science and how it is used began early in my career with a generous amount of naiveté. Unfortunately, it is still only a work in progress. At this time, however, my thoughts reduce to two fundamental questions, 1) what are the criteria for creating authentic science-based evidence and 2) how should the data collected in the name of science be interpreted and conveyed to others?
For insight, I am inclined to wonder whether we can learn something from the history for our contemporary problems of misusing science. I find that knowing the origin of important ideas is quite informative of the present, especially in the field of food, health and its underlying science of nutrition. From my reading of this history, the problem of scientific abuse has always been present, as if it is part of human nature. In previous times, though, it was individuals who sold snake oil. But, during these more recent times, the causes of abuse are different. We now have to contend with very powerful, impersonal, corporate power that largely controls what many individuals are allowed to say. From this perspective of personal experience, I am quite certain that this problem of science abuse has become worse, much worse.
I started this discussion with the assumption that the best science is conducted by the Academy according to their ideals and their criteria. I then inferred that some individuals qualified to be within the Academy assume that they are the authorities who determine what is acceptable science (i.e., truth) and what is not. Furthermore, there seems to be a virtual boundary around scientific conversation that divides insiders from everyone else. But, in my experience, these walls are rapidly eroding, posing the question whether this is good or bad.
At this point I must conclude that it is not so much the fact of belonging or not belonging to the Academy that matters most but about one’s personal integrity and sincere interest in serving the public. On this matter, I find no difference between the insiders and the outsiders. As a matter of fact, I am inclined to believe that the abuse of science on the inside of the Academy is more worrisome than it is on the outside. It is not where one positions oneself but about where their interests and passions lie.
Setting aside the vast majority of people who are honorable individuals, inside and outside of the Academy, inside abusers misrepresent science largely because they are personally and financially conflicted through their consultancies with the for-profit sector. Outside abusers misrepresent science largely because of ignorance of the facts and the methods by which acceptable science is produced. In both cases, the attraction for abuse is the lure of money.
As to whether erosion of the borders of the Academy is a good or bad thing, this depends on whether we are talking about the Academy’s operations or its ideals. On operations, it is my experience that the Academy has failed to do the public good. Thus there is no reason to assume that simple membership in the Academy automatically qualifies individuals to speak authoritatively about science. If we speak of the ideals of good science—presumably managed by the Academy—then the borders must be strictly maintained. Big name universities (the core of the Academy) are now too much indebted to funding agencies and corporate sponsors of research. Big name funding agencies like NIH are too indebted to the political whims of congressional funding that are mostly controlled by corporations who favor pills and procedures instead of diet and lifestyle as a means to human health.
I suggest that we need a serious discussion of what science is and what it is not and it should involve as much of the society as is possible. Bottom line: science must be objective, transparent, open-minded and self-correcting via professional oversight. The process of science must be a search for the truth and nothing but the truth, and this search MUST NOT be abridged when uncomfortable discoveries are being revealed. This is what First Amendment rights and a free society are all about.