The prevalence of chronic diseases such as diabetes has skyrocketed, as has the number of articles published about diabetes in medical journals. “Why does our wealth of academic knowledge not translate more directly to improving the human condition?” Perhaps our over-attachment to the reductionistic mindset that proved so successful with acute deficiency diseases may actually represent an obstacle to success battling chronic disease.

These days, health seems to have been reduced to a highly commercialized commodity, in which we’re marketed all sorts of high-cost, high-tech tests and treatments of dubious value with substantial risks attached. “This is worrisome because most of the things that make us healthy and keep us healthy are cheap and largely available without professional help or commercial prodding.” This isn’t to say modern medicine can’t work miracles, but what about the big picture? That is, what about the 80 percent of death and disability caused by preventable diet-related diseases?

What about the field of nutrition? In my video Why Is Nutrition So Commercialized?, I discuss how it’s become about profits and products, and extracting nutrients from whole foods so they can be repackaged and marketed. But food is best eaten whole. Eat the broccoli and the blueberries, not some broccoberry supplement. But the reason there aren’t more studies on whole foods is fairly obvious: You can’t patent them. Why should a company spend a lot of money, time, and effort to convince you to buy broccoli when any other company can sell it to you? That’s why the field of nutrition can be more about marketing profitable products than educating people about the fundamentals of health and wellness. For example, the benefits of whole grains over refined grains is commonly attributed to the fiber, which enables the food industry to whip out fiber-fortified Froot Loops and make you feel all better.

Let’s consider this ingenious study: Burkitt and colleagues thought the extraordinarily low rates of killer chronic diseases in sub-Saharan Africa were due to all the whole, plant foods they were eating. This turned into the fiber hypothesis, the reductionistic thought that fiber must be the magic bullet active ingredient. What happens if we put it to the test? What if we compared two groups of older women, both getting around six grams of grain fiber a day, but one group mostly from whole grains and the other mostly from refined grains? Who do you think lived longer? If it was just the fiber, there shouldn’t be much difference because both groups ate about the same amount. In fact, the whole grain group lived longer and with a significantly lower mortality rate, which implies that it may be all the other wonderful things in whole plant foods “linked to fiber [that] may confer important health benefits above and beyond effects of the fiber itself.” That’s why fiber supplements wouldn’t be expected to offer the same benefit.

Indeed, food, not nutrients, is the fundamental unit in nutrition.

As Dr. David Katz has pointed out, “Our culture doesn’t want to hear that the active ingredient in broccoli is broccoli—it wants to know what supplement it can take.”

This is part of my extended series on the reductionist trap, which includes:

The Five to One Fiber Rule still holds, though, since it’s an indication of how heavily processed a product is.

There are two sides to the intellectual property argument when it comes to food. I explore both in Plants as Intellectual Property: Patently Wrong?.

And, of course, this is why I always recommend Taking Personal Responsibility for Your Health.

In health,

Michael Greger, M.D.