Dear Mr. President,
I hear that the health care cost problem tormenting us is presently just beneath the political radar screen, for obvious reasons. But I also hear that it will re-emerge after the elections. I hope so.
We have a very big problem, only to worsen if we don't start seriously thinking about fundamental change. Mr. President, I am not yet absolutely sure of your identity but never mind, because I am proposing a solution to this problem that is entirely bipartisan. But, Mr. Obama, I have observed that you, apart from your fellow candidates who ran in the primaries, come closest to my proposed solution. You are promoting health care reforms that encourage the use of newer technologies, improve prevention and chronic disease management services and push for more comprehensive and affordable health insurance coverage. I also very much like your view that health care is a fundamental right. While I wonder a bit about your program specifics, I rather like where I think you are going.
I have little or no hope that any of the other health care plans will cut costs by doing the most important thing of all--actually improving health for as many people as possible. These plans only talk about who pays the bill or who is entitled to health care coverage.
We Americans pay far more per capita for health care than any country in the world, yet we rank embarrassingly low in quality of health care (thirtieth or lower, depending on criteria used). Further, we push aside 45-50 million of our people with no coverage at all. How can we pay so much and get so little in return, and then, to make matters worse, we mostly agree that it's only going to get worse?
Something is dreadfully wrong. It is this. These plans omit any serious consideration of the one factor that has the most to offer to make people well. It is nutrition. When truly understood and done right, the same kind of nutrition can restore health and prevent ailments like nothing else in medical science. It is more profound and broad based than almost anyone knows.
My scientific research and teaching career in nutritional science began over 50 years ago and mostly continued thereafter at Cornell University. Using our experimental findings along with those of others, I now have an understanding of nutrition that is strikingly different from what I was initially taught and what I myself first taught to my own students. I am referring to the extensive and profound nutritional benefits of consuming reasonably intact and minimally processed plant-based foods. My views these days are far removed from my days on the farm milking cows and later doing doctoral dissertation research that emphasized the health value of consuming more protein, especially animal based protein that we euphemistically called 'high quality'. Our research findings, which have been published in the very best peer-reviewed scientific journals and which were almost entirely funded by taxpayer money, is the primary basis for my views, now published in book form.
Coupled with my membership on expert panels on food and health policy development, I also have gained considerable insight into the question of why the public is not hearing this information. This exceptionally vital information has been withheld from the public, sometimes intentionally, sometimes not, and it is especially tragic. People die in the thousands. My estimate is that at least 2000 Americans die each day--with many more suffering unnecessary pain and compromised health before their time comes. What makes this especially irksome is my being acutely aware of the existence and implications of this ignored information--demonstrated both in the laboratory and in the clinics of my physician colleagues. Using this same information, my physician friends can cure--yes, cure--advanced diseases like heart disease and diabetes (mostly type II but even can remediate type I) and many other less serious ailments. The list of health benefits continues to grow and many are of the most profound nature.
I am constantly gnawed by the thought that we now know enough about food and health to make this information part of our health care system but we don't. Doctors essentially receive no training in nutrition--that is, none. Instead, they are trained in the use of drugs and procedures as the principal means to health, the antithesis of using food as the principal means to health. The underlying biology for the nutrition-based and drug-based strategies for health maintenance and promotion could hardly be further apart. Drug activity is biologically targeted and opposes the natural order of things. Nutrition is biologically comprehensive and supports the natural order of things. The drug strategy depends on a yearning for acquisition of capital by the few. A nutrition strategy depends on a yearning for acquisition of health by the many.
The guilt that I feel in my gut becomes so intense when I constantly see people needlessly suffering because they do not know what some of us have come to know. My guilt also arises from my knowing that a highly capitalized and drug-based system too often trivializes the scientific evidence on nutrition and, in doing so, it will support and encourage a self-serving and very expensive health care system.
We can do better--far better. I envision a nationally based health care system that is far more affordable, convenient, efficacious and cost effective than our present system. It is neither coercive nor unreachable. Its format is grassroots because it encourages and rewards people who take responsibility for their own health. I am confident of this plan because it encompasses--in sequence--awareness, experience, convenience, motivation and affordability. Each of these components is critical for a solution to our current health care crisis--a solution that is possible if government agrees to stop hosting the self-serving interests of the corporate sector and, by doing so, to provide objective personally useful information for its citizens. It is time for change, real change that matters. tcc1@cornell.edu
http://freire.mcgill.ca/files/kahn-epistemologiesofignorance.pdf
For example, randomized clinical trials have done more harm to our understanding of nutrition than any other research methodology. This research strategy is not the 'gold standard' that is often told. Testing the benefits of a truly nutritional intervention is not double blinded, nor even blinded. But more importantly, its testing of single nutrient effects is grossly out of context, causing more noise than good information. Assuming that we can identify THE mechanism explaining a cause-effect relationship is also a gross oversimplification. Relying on human epidemiology methodology also is an oversimplification that usually gives more confusion than clarification. Too often, the study cohorts have insufficient range of exposure that further compromises the interpretation of results.
These are only a few of the experimental methodology concerns that I have. Others have to do with the long time myths that we automatically assume without question, thus making it difficult to challenge them without a whole lot of ill informed commentators who only believe the myths without question.
Nutrition is a hot political potato all of it's own, with science of varying quality on all sides (and I mean both that there is science on all side and that it's quality varies on all sides). But there is little consensus other than that what we're eating now is making us sick.
It's true, as I know you have often pointed out, that there are powerful and influential forces who don't have health at the top of their real agenda behind much of the nutritional advice that is commonly perceived as 'fact'. But disagreement with the status quo is not a determinant of the accuracy of your argument.
There is a long way to go before anyone can make true and accurate pronouncements on nutrition. The fact that organizations who have incredible influence went ahead and made them anyway in the past got us into the mess we're in. Repeating that mistake with different advice will compound the problem not solve it.
There isn't necessarily one road to healthy eating for everyone and persisting in the belief that there is may be the biggest mistake we make.
What is your criteria for deciding whether an approach has been proven? Has the vegan approach been disproven, or has it not been studied comprehensively (a large long-lasting trial for each disease for which benefits of a vegan diet have been reported)? Do you require a randomized, double-blind trial to show that any medical therapy is proven?
The drug companies have us brainwashed into thinking that if a study is not randomized and double-blind, then it is not scientific. This reasoning is false. How many double blind trials were performed by Sir Isaac Newton and by Albert Einstein? Is there a double-blind trial that shows that parachutes are effective? Double-blind trials are appropriate for studying drugs and little else. They are not appropriate for studying dietary changes, since the patient will know what he is eating and therefore will not be blinded. My opinion is that if anyone with a financial interest in the outcome of a medical trial has anything to do with it, whether in writing it up, performing statistical analysis, reviewing it, or deciding whether to publish it, then the results are not scientific and cannot be trusted, because it is easy to manipulate the results of medical trials for financial gain.
I don't actually believe than any nutritional approach can be 'proven' in this way. My point really is that while there is general agreement that lots of things are unhealthy (processed foods being the main one, and the one that has most corporate money behind it), there is less agreement about what is. And that the reason may be, exactly as you say, that the double blind approach is quite inappropriate here.
But that does not negate the fact that just as there is good evidence that a vegan diet is healthy, there is good evidence that meat based diets are healthy.
It would be really nice if it were possible to make a 10 point list or something equally digestible (sorry!) that gave simple, easily applied, dietary advice that people were likely to follow and stick to. It just isn't and probably never will be.
In the absence of that it's up to those who care to educate themselves and figure out what works for them - and that may not be what works for the guy next door, but doesn't make it inferior.
I have read the China Study. I've also read, very widely, other views and opinions. I have as a result my own way of eating that works for me - but that's irrelevant when it comes to dispensing advice on a population level, just because it works for me doesn't mean it works for everyone.
In my family, I'm the only healthy one by a long shot. A partial list:
Breast cancer: mom, sis, aunt
Heart disease: both sisters, both parents & grandparents
Diabetes: sister, both parents, grandparents
Am I the only one who got good genes? Nope. A plant-based diet has saved my life the past 20+ years. Doctors who have the guts to tell us to eat this way have saved countless lives. I now teach plant-based cooking classes to many, including an insurance company that has figured out it's much cheaper to have healthy employees, and children who know what a zucchini is when they see it. I routinely see people lose significant weight (one as much as 120 pounds, came off all heart meds in 8 months), without counting a single calorie or carb, feel great and are never hungry. Without drugs or surgery. They don't have to buy a gimmicky supplement or gadget. Imagine that?! My students love the variety and flavor of food, once they taste things they never would have purchased. How many doctors see the kinds of changes I've seen? Unfortunately, not many, unless they give their patients the kind of education a pharmaceutical company cannot.