6 Papers Redefining the Sciences of Nutrition, Cancer and Healthcare
I wrote these manuscripts in an attempt to clarify the confusion surrounding nutrition as a science, especially as it relates to the whole food, plant-based (WFPB) dietary lifestyle. I am especially interested in bringing the discussion of the supporting evidence for this dietary lifestyle to a higher level, based on its fundamental science.
This project has been long in coming. It started to take form in 1985-86 when I spent a year at Oxford University and buried myself in the libraries of Oxford and London to seek answers. I wrote a lengthy paper that was never published until now. Recently, I realized that within that history, there were some really important clues as to why we have done so poorly advancing human health during the past two centuries or so—at the cost of hundreds of millions of human lives prematurely lost and billions of dollars (trillions, adjusted for contemporary currency) spent. I decided to dust off that old never-published paper and edit it for professional publication. It gave rise to these papers, which represent a perspective on the past, present and future of the science of nutrition and its relationship to health and disease.
I especially wanted to rely on the integrity and structure of science to make a case for the impressive evidence supporting the health benefits of the WFPB diet, with special emphasis on its effect on cancer.
It’s time that we take a breath and look more deeply into what is human health, especially how that relates to the food we eat. Hippocrates was right when he said “Let food be thy medicine and medicine be thy food.”
Now beginning my 7th decade working professionally in the discipline of nutritional science—both in experimental research and in national food and health policy development—I have seen so much, both that which advances and that which minimizes the importance of nutrition in medical practice and health care. It is disturbing, even immoral, because so many people are denied information that could do so much for their personal health, as well as for the health of our society, our environment, other sentient beings and our planet.
What I find most disturbing is the very poor understanding of the science of nutrition which causes, in turn, enormous confusion, both for public and professional communities (experimental research and medical practice). The consumer becomes the victim and this confusion exists both among those who advocate for and those who oppose the promised health benefits of the whole food, plant-based diet.
Below are the six recently published, peer-reviewed science manuscripts concerning my suggested interpretation of the science of nutrition, especially its effect on cancer (three of the papers). All five of the 2017 papers are open access so that you can read the full text. You can access them through the links below or you can view them on PubMed.
The Past, Present, and Future of Nutrition and Cancer: Part 1 – Was A Nutritional Association Acknowledged a Century Ago?
Professional interest in the association of diet and nutrition with cancer first appeared in the early 1800s, if not before. Yet, progress in understanding this association over the past two centuries has been exceedingly slow and confusing. Without addressing this confusion, progress in using diet and nutrition information to prevent and even to treat cancer, will remain uncertain. To better understand this issue, the present paper is the first of two to explore the history of the diet and cancer relationship prior to a 1982 National Academy of Sciences (NAS) report on Diet, Nutrition and Cancer. This report was a milestone in the nutrition and cancer history because it was the first science-based, institutional report on this topic. But, based on the evidence cited in that report, it could be inferred that this topic was relatively new, perhaps beginning around 1940. While it attracted great public interest, it also generated great controversy, some of which was a natural response from affected industries. Exploring the history prior to 1940, therefore, might provide clues on the present-day confusion concerning the relationship between diet and cancer. This investigation asks three questions. First (the subject of this paper), was the relationship of nutrition to cancer even considered prior to 1940 and, if so, what was said? Second (the subject of the upcoming paper), assuming that nutrition was seriously considered, why then was it ignored or forgotten? Third, has the forgotten information contributed to the contemporary confusion surrounding the relationship to cancer? The answer to the first question, considered here, is that, yes, nutrition as a possible cause of cancer was not only hypothesized, it was a major topic for discussion in some quarters. But it also was a topic struggling to be heard among the authorities who had most of the power and influence in the professional cancer community. This paper documents that history and the corresponding struggle for this message to be heard. One figure, Frederick Hoffman, founder of the American Cancer Society and prodigious researcher, led much of that effort during the period of 1913-1943, but his contributions have remained almost totally unknown.
A 1981 paper submitted to the Office of Technology Assessment of the U.S. Congress by two eminent epidemiologists from Oxford University (Sir Richard Doll and Sir Richard Peto) and a 1982 report by a 13-member committee of the US National Academy of Sciences on Diet, Nutrition and Cancer were the first major institutional documents to claim that cancer was substantially associated with our nutritional practices. Both reports left the impression that the connection of cancer with diet was a relatively new observation in science. But this was misleading. Our present day beliefs and controversies on the food and cancer connection arose from observations begun during the late 1700s and further expanded upon during the mid 1800s and early 1900s. The road mostly traveled since then became rough for modern day beliefs on the cause, prevention and treatment of cancer.
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Nutrition and Cancer: An Historical Perspective. – The Past, Present, and Future of Nutrition and Cancer. Part 2. Misunderstanding and Ignoring Nutrition.
The role that nutrition plays in cancer development and treatment has received considerable attention in recent decades, but it still engenders considerable controversy. Within the cancer research and especially the clinical community, for example, nutritional factors are considered to play, at best, a secondary role. The role of nutrition in cancer development was noted by authorities as far back as the early 1800s, generally under the theory that cancer is “constitutional” in its origin, implying a complex, multifactorial, multistage etiology. Opponents of this idea insisted, rather vigorously, that cancer is a local unifactorial disease, best treated through surgery, with little attention paid to the etiology and possible prevention of cancer. This “local” theory, developed during the late 1700s and early 1800s, gradually included, in the late 1800s and early 1900s, chemotherapy and radiotherapy as treatment modalities, which now remain, along with surgery, as the basis of present-day cancer treatment. This highly reductionist paradigm left in its wake unfortunate consequences for the present day, which is the subject of this perspective.
The idea that cancer is not associated, if at all, with nutrition became firmly established in the early 1900s, as powerful professional cancer institutions formed to create a profound paradigm that makes it very difficult to challenge. So powerful has been this paradigm that it is almost heresy to consider that nutrition has anything other than a minimal effect on cancer. This pushback is promoted by only a very few centers of power that creates highly questionable information that, today, may be considered mythologies.
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Nutritional Renaissance and Public Health Policy.
The science of nutrition has long been entrapped in reductionist interpretation of details, a source of great confusion. However, if nutrition is defined as the integration of countless nutrient factors, metabolic reactions and outcomes, biologically orchestrated as in symphony, its relevance for personal and public health would be less confusing and more productive. This more wholistic interpretation may be observed at the cellular and physiological levels and may be described, in part, by the concept of pleiotropy (multiple cell-based effects from one nutrient source), together with its more expansive cousin, epitropy (multiple cell-based effects from multiple nutrients). There are many consequences. First, wholistic interpretation helps to explain the profound but little-known health benefits of whole plant-based foods (not vegan or vegetarian) when compared with whole animal-based foods and/or with the nutritionally variable convenience foods (generally high in fat, salt, refined carbohydrates and low in complex carbohydrates). Second, wholistic interpretation explains why the U.S. Dietary Guidelines and related public policies, which are primarily conceived from reductionist reasoning, serve political agendas so effectively. If diet and health advisories were to acknowledge the biological complexity of nutrition, then make greater use of deductive (top down) instead of inductive (bottom up) reasoning, there would be less confusion. Third, wholistic nutrition, if acknowledged, could greatly help to resolve the highly-polarized, virtually intractable political debate on health care. And fourth, this definition tells why nutrition is rarely if ever offered in medical school training, is not one of the 130 or so medical specialties, and does not have a dedicated research institute at U.S. National Institutes of Health. Nutrition is a wholistic science whereas medical practice is reductionist, a serious mismatch that causes biased judgement of nutrition. But this dichotomy would not exist if the medical practice profession were to understand and adopt wholistic interpretation. Reductionist research, however, is crucially important because its findings provide the granular structure for wholistic interpretation—these two philosophies are inescapably interdependent. Evidence obtained in this manner lends strong support to the suggestion that nutrition is more efficacious and far more affordable in maintaining and restoring (treating) health than all the pills and procedures combined. Admittedly, this is a challenging paradigm for the domain of medical science itself.
I am proposing a radically different definition for nutrition. It is based on classical science which is the art of observation and which was proposed in ancient times. Our current understanding of nutrition is a great source of confusion and misguided advice by authoritative agencies. It might be better described as ‘disruptive technology.’
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Cancer Prevention and Treatment by Wholistic Nutrition.
Cancer is traditionally considered a genetic disease. It starts with a gene mutation, often caused by environmental carcinogens that are enzymatically activated to metabolites that covalently bind to DNA. If these now-damaged carcinogen-DNA adducts are not repaired before the cell replicates, they result in a mutation, which is inherited by daughter cells and their subsequent progeny. Still more mutations are added that are thought to advance cellular independence, metastasis, and drug resistance, among other characteristics typically observed for advanced cancer. The stages of initiation, promotion and progression of cancer by mutations infer irreversibility because back mutations are exceedingly rare. Thus, treatment protocols typically are designed to remove or kill cancer cells by surgery, chemotherapy, immunotherapy and/or radiotherapy. However, empirical evidence has existed to show a fundamentally different treatment option. For example, the promotion of cancer growth and development in laboratory animals initiated by a powerful mutagen/carcinogen can be repetitively turned on and off by non-mutagenic mechanisms, even completely, by modifying the consumption of protein at relevant levels of intake. Similar but less substantiated evidence also exists for other nutrients and other cancer types. This suggests that ultimate cancer development is primarily a nutrition-responsive disease rather than a genetic disease, with the understanding that nutrition is a comprehensive, wholistic biological effect that reflects the natural contents of nutrients and related substances in whole, intact food. This perspective sharply contrasts with the contemporary inference that nutrition is the summation of individual nutrients acting independently. The spelling of ‘holism’ with the ‘w’ is meant to emphasize the empirical basis for this function. The proposition that wholistic nutrition controls and even reverses disease development suggests that cancer may be treated by nutritional intervention.
This, perhaps, is the most dramatic. It is based on the experimental evidence showing that cancer is not the genetic disease that is so widely claimed in the cancer research and clinical communities. As a consequence, cancer progression can be reversed by nutritional means, even offering the possibility that it can be treated by nutritional means, a starkly different protocol from the use of chemotherapy, radiotherapy and/or surgery and a protocol that may bypass the many serious side effects commonly observed for these therapies. If this proves to be true, it should dramatically affect the public’s understanding and acceptance of the whole food plant-based dietary lifestyle.
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A Plant-Based Diet and Animal Protein: Questioning Dietary Fat and Considering Animal Protein as the Main Cause of Heart Disease.
Dietary ‘fat’ (e.g., oils, triglycerides, cholesterol) has long been considered a major risk factor for cardiovascular and related diseases. As reviewed elsewhere, Vogel in 1847 identified cholesterol as a major component of the atherosclerotic lesion, a precursor of cardiovascular disease. Later, in 1913–1914, experimental animal research showed that dietary fat (including cholesterol) increased atherosclerotic lesions in the aorta. According to Kritchevsky, writing in 1983, so fixated were these early researchers on the hypothesis that dietary fat caused atherosclerosis that decades were to pass without considering the contributions of other dietary components to this disease. Now, after three more decades, most researchers (and the public) still believe that the chief dietary component linked to heart disease is the amount and type of fat, especially cholesterol and saturated fat.
This is an invited paper that was published in a journal dedicated to the group of cardiovascular diseases (coronary heart disease, atrial fibrillation, ischemic and hemorrhagic stroke, and cardiovascular disease, etc.). In reference to nutrition, it is considerably redundant, a lesson in itself, because it is the same cause of these diseases as it is for a wide variety of diseases. The causes of these various disease differ only in the combinations of nutrients involved—but all nutrients of which are provided by whole plant based foods. Imagine what this means when compared with the seriously misguided basis for the use of targeted drug therapy!
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Nutrition is generally investigated, and findings interpreted, in reference to the activities of individual nutrients. Nutrient composition of foods, food labeling, food fortification, and nutrient recommendations are mostly founded on this assumption, a practice commonly known as reductionism. While such information on specifics is important and occasionally useful in practice, it ignores the coordinated, integrated and virtually symphonic nutrient activity (wholism) that occurs in vivo. With reductionism providing the framework, public confusion abounds and huge monetary and social costs are incurred. Two examples are briefly presented to illustrate, the long time misunderstandings (1) about saturated and total fat as causes of cancer and heart disease and (2) the emergence of the nutrient supplement industry. A new definition of the science of nutrition is urgently needed.
This was the first written of these papers, published in 2014. I simply proposed a strikingly different understanding of nutrition, and urgently called for a new definition of nutrition, which was provided in the above-listed 2017 paper, Nutrition Renaissance.
Link to the Article
- Campbell, T. C. The past, present, and future of nutrition and cancer: Part 1-Was a nutritional association acknowledged a century ago? Nutr. Cancer 69, 811-817, doi:10.1080/01635581.2017.1317823 (2017).
- Campbell, T. C. Nutrition and cancer: an historical perspective–the past, present, and future of nutrition and cancer. Part 2. Misunderstanding and ignoring nutrition. Nutr. Cancer 69, 962-968, doi:10.1080/01635581.2017.1339094. Epub 2017 Jul 25. (2017).
- Campbell, T. C. Nutrition renaissance and public health policy. J. Nutr. Biology 3(1), 124-138 (2017). J Nutr Biol. 2017;3(1):124-138. doi:10.1080/01635581.2017.1339094 (2017).
- Campbell, T. C. Cancer prevention and treatment by wholistic nutrition. J. Nat. Sci. Oct 3 (2017).
- Campbell, T. C. A plant based diet and animal protein: questioning dietary fat and considering animal protein as the main cause of heart disease. J. Geriatric Cardiol. 14, 331-337 (2017).
- Campbell, T. C. Untold nutrition. Nutr. Cancer 66, 1077-1082, doi: 10.1080/01635581.2014.927687 (2014).
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