Disease Prevention – The Shunned Science

Image of the cover of Modern Nutritional Diseases
This post excerpted and adapted from Chapter 3, Modern Nutritional Diseases

Diseases do not just happen.  Every disease has a cause, and once this cause is known, prevention is often the next most reasonable and cost-effective step.  –Anon.

The United States is in the midst of enormous epidemics of chronic debilitating diseases, the most important of which are cardiovascular diseases, type-2 diabetes, mental disorders, and cancer.  Attack rates of these diseases began increasing in the mid-20th century and have grown steadily since that time.  They are major causes of death in older adults, and, in recent years, their numbers have been rising in younger age groups.  Overall, these diseases are, by far, the major causes of disability and death in the United States. 

The Current System

America faces this enormously costly health care crisis today because national health policy is focused almost exclusively on diagnosing and treating rather than preventing the growing epidemics of chronic diseases.  Under the current diagnose-and-treat scenario, chronic diseases are allowed to occur and progress until they reach the stage where they can be diagnosed medically.  At this point, these diseases are, for the most part, not curable, only treatable.  Very importantly, each new diagnosis represents a new patient and a new recurring medical care cost.

The nation’s current medical care system cannot cure these diseases.  It can treat symptoms and lengthen life to some extent with drugs and surgery, but it cannot maintain wellness by treating these diseases.  And medical treatments are not benign.  This does not suggest in any way that medical diagnosis and treatment are not competent or not important.  To the contrary, diagnosis and treatment and other medical programs are required to care for victims of accidents, illnesses, diseases, and other problems that inevitably occur in all population groups.

Various investigations have charged that incompetence, abuse of mandate, and dishonesty contribute to the high costs of these programs.  Solving these problems alone will not stop the relentlessly growing costs of medical care.  The real cost problem is that early diagnosis and treatment, otherwise known as preventive medicine, no matter how carefully and honestly done, is the most expensive and inefficient way of dealing with epidemics of any kind.

Engineers would describe the use of a diagnose-and-treat medical care system for handling of large and growing epidemics as a positive feedback system that will self-destruct eventually because it creates conditions that encourage steadily escalating costs.  What happens is that each newly diagnosed case represents a new and predictable profit stream.  This growing stream stimulates innovation in better diagnostic and treatment methods, and better diagnostic and treatment methods stimulate more innovation.  The result is a vicious circle that grows stronger with time.

Such conditions predict that the cost of providing medical care for the current chronic disease epidemics will be limited only by the total amount of money available.  A former editor of a major journal has written that the…

American health care has become a vast profit-oriented industry.  The revenue of this industry constitutes the country’s health-care costs.  As in any other industry, providers constantly strive to increase their profitable sales, but unlike other industries, consumers exercise little control over their consumption of products and services.  It should not be surprising that such a system is afflicted not only with relentless inflation, but also with neglect of the needs of the uninsured and with failure to promote the use of valuable but unprofitable health services (1).

What is Disease Prevention?

The phrase “disease prevention” simply means “to preclude or stop a disease from occurring.”  When a disease is prevented, no illness occurs and no medical care is required.  In precise terms, this type of prevention is called primary prevention.  Its methods are clear-cut: It uses sound science and strict logic to identify the true cause of a disease, not pseudoscience or the consensus opinion of a group of experts; it eliminates that disease by eliminating its cause using the best practical means available.

Although simple when diligently followed, these steps have been proven to work; they are a sure-fire recipe for reliable disease prevention.  Few people today realize the importance of disease prevention.  Preventive programs protect whole communities, rich and poor, at low cost, and are effective against both infectious and noninfectious diseases.

The Contribution of Dr. Snow

The science of disease prevention was nonexistent before a London physician, John Snow, discovered the key to ending the cholera epidemics that were common in nineteenth century England and in many other countries.  In 1836, more than 50,000 people died of cholera in England.  It was then that Snow began to suspect that filth was somehow connected with cholera; however, there was no general agreement about the cause, and there was no cure (2, p. 402).

Dr. Snow, unable to help his patients who were dying from cholera, decided to interview the 93 families in his neighborhood that had been hit by cholera and compare the details of their eating and living habits with the eating and living habits of families in the same neighborhood that had no cholera.  He made careful notes about each family.

Studying these notes, he found no association with the type of food eaten or the ages of the cholera victims.  But he did find that workers at a local brewery and inmates housed in a nearby jail, unlike the general population, had no cholera at all.  Both of these establishments used their own wells for drinking water.  Very importantly, Snow noticed that cholera occurred only in families that got their drinking water from one well; this well had a hand pump set up over an open community well on Broad Street.

Dr. Snow took the time to walk around and look carefully at this well.  He saw that human waste was draining from a filthy ditch in the street into the well.  He thought that perhaps the human waste from the sick cholera victims draining into the Broad Street well was somehow connected with the spread of cholera.  To prove or disprove his idea, he asked city officials to remove the handle from the Broad Street Pump so that local people would have to use a different source of water.  In a short time, new cases of cholera stopped occurring among people who had used the Broad Street Pump.  He had rightly concluded that the water from this well was the cause of the disease.

The Lessons From Dr. Snow

Four powerful lessons have come from Snow’s work.  The first lesson is that common sense and good judgment are as important as highly sophisticated methodology in discovering the cause of a disease.  The second lesson is that the suspected cause must be proven by some valid means to be labeled as the true cause.  For Snow, this was removing the pump handle, preventing use of the water from the Broad Street well, and observing that new cases of cholera stopped occurring.

The third lesson is that when the cause or the source is accurately known, the disease can be prevented absolutely by eliminating the cause or by cutting the connection between the source of the infection and the human population.  The forth lesson is that it is equally important that both those affected by the disease and those not affected be studied.  It is worth mentioning that this forth lesson, although critically important, is routinely ignored by today’s medical and nutritional scientists.

The Saga of Public Health

Few people today realize that one of mankind’s great gifts is the science and practice of disease prevention.  Roy Porter, a respected medical historian, pointed out that “facts indicate how little the practice of medicine weighs in the balance of health.  Late stage crisis [medical] management of victims is very costly and of little benefit compared to preventive programs.” (2, p. 714).

The Early Days

It was not until the advent of Dr. Snow and his “remove-the-pump-handle” method of proving cause that the science of disease prevention had its beginning.  The development was furthered by an interest in vital statistics (3, p. 248).  This led to the realization that disease rates were different in different population groups; poor neighborhoods had more sickness and death than rich neighborhoods; and foul smelling, dirty areas were more prone to diseases like dysentery and cholera than clean ones.

Early attempts to control infectious diseases such as cholera introduced some effective preventive programs that remain in place today.  Such programs include purification of domestic water supplies, sewage treatment, mosquito and rodent abatement, pasteurization of milk, food sanitation, and immunization programs.  Today, people and policymakers tend to forget that these prevention programs literally have saved millions of lives over the past several hundred years.

The profession, practice, and organizational structure that ultimately resulted from centuries-long efforts to prevent disease became the discipline known today as public health.  Public health is not an ideology, a religion, or a political belief, but rather a practical method for preventing epidemics of disease along with their associated human and economic costs.  It is silent and inconspicuous.

The High Point

The road to a functioning public health system was not easy, with human behavior being the biggest enemy to its establishment (4).  Disease prevention finally achieved serious public support a little over a hundred years ago.  It was growing and had a clear purpose of disease prevention.  At the turn of the 19th century, the U.S. Public Health Service Commissioned Corps headed by a Surgeon General was created.  Shortly after its creation, the Corps faced a major test with the outbreak of a major epidemic of pellagra across the southern United States (5).

The Pellagra Epidemic:  The pellagra epidemic marked an important milestone in the mission of the Public Health Service; it forced the acceptance by the medical community and general public that serious, even lethal, disease could be caused by a nutritional deficiency.  The demonstration that a vitamin deficiency could cause disease created a new field of medical attention, diseases caused by nutritional ignorance.  Bollet tells the fascinating story of the social and political forces that seriously interfered with medical research and its investigation of the epidemic and its causes (5).

The Demise

It took centuries to build a public health system and less than two decades to bring it down.  America’s public health infrastructure, once the envy of the world, was in a shambles by the end of the 20th century (4, p. 282).  It is now obvious that politicians and other policymakers, beginning in about 1955, methodically destroyed the best public health disease prevention system in the world.  Even today, despite enormous epidemics of preventable diseases, they have no understanding of scientific disease prevention or the enormous value of maintaining a high level of wellness in the American population.

What Went Wrong?  How did this misfortune happen?  From the beginning, politicians, social advocates, and private citizens attempted to influence the activities of public health professionals – and they often succeeded, as happened in the pellagra epidemic (5).  Another difficulty for public health was that from the very start the medical profession held a guarded skepticism toward the aims and approaches of public health.

This wariness is a natural outcome of the difference in goals between the two professions, which often are incompatible with each other.   Physicians treat individuals and have the utmost concern for their privacy and protection.  Public health experts treat societies and consider that if an individual poses a health threat to the community, the needs of the individual are subordinate to those of the community.  This is a difference between curative medicine and primary prevention.

The Coup de Gras:  The death blow for public health and primary disease prevention was delivered by the emasculation of the Surgeon General.  The reason for the action has never been answered publicly, but it smacks of political retaliation for the political storm that devastated Congress in the wake of the public uproar created by the Surgeon General’s Smoking and Health report.  The ultimate result was the abolishment of the independent Office of the Surgeon General.

This eliminated independent leadership of the public health system and ended scientific research on disease prevention in the United States.  It also ended assistance to primary prevention programs in public health agencies and the authority to promote good science in areas of disease prevention and public health (4).  The loss of influence in promoting and supporting good science paved the way for the folly of misuse of nutritional science.

The Rise of Folly

World history tells us that governmental behavior that is hostile to the best interests of its citizens is common to all ages.  Such behavior has been described and labeled as Folly by Barbara Tuchman (6).

The Present Day Folly

The political factors that led to the demise of the public health system in the United States plus the corruption of epidemiology (7) and of sound science itself are antithetical to the public good and have caused it untold damage.  Barbara Tuchman, in her book The March of Folly (6), describes such large scale deceit as folly, namely the pursuit of policies based on false premises and fallacious reasoning.

Tuchman suggests that these activities have their roots in various combinations of greed, self-interest, incompetence, moral failure, corruption, and inability to admit error.  Such governmental activities, in one form or another, persist for long periods, are extremely costly, and with rare exceptions end in national disaster.  Tuchman points out that large scale folly has become dangerously common in our time.

Tuchman is correct.  The March of Folly neatly explains the governmental activities that have led to the current epidemics of modern nutritional diseases.  America is in the clutches of a ruthless folly that we refer to here as nutrition by legislation

The Beginnings:  The beginnings of a folly are often difficult to pinpoint.  They usually begin as foibles of individuals and grow until they ultimately burst on the scene as full blown follies.  Our nutrition folly began in the 1950s with the pseudoscience of Ancel Keys and slowly evolved until it emerged as legislation in 1977 known as Senator George McGovern’s Dietary Goals for the United States.  McGovern’s Dietary Goals marked the official entry of politics into the field of nutrition.

The Dietary Goals signaled a new era and a new direction for dietary guidance with a major shift of focus from choosing food components that contained healthful nutrients to avoiding food components that were linked to chronic disease (3).  The Dietary Goals introduced an era of nutrition by legislation.

The Era of Nutrition by Legislation

Senator George McGovern’s Dietary Goals for the United States brought with them a gradual expansion of a supporting bureaucracy and growth and refinement of regulations.  Nutritional science became the nutritional science of the dietary guidelines committee, which ultimately became the Dietary Guidelines for Americans Committee (DGAC).

DGAC nutrition spread fast.   It was soon adopted and taught by nutrition academia. Because university schools of nutrition have long been the nutrition authority for the medical profession, medical students and physicians became thoroughly indoctrinated.  The DGA flourished; food technology flourished; the pharmaceutical industry flourished;  the medical profession flourished; the burgeoning epidemics of chronic diseases flourished; and Americans continued to sicken and die.

The Awakening

Through the years, a number of physicians and other scientists became increasingly suspicious about an association between the growing epidemics and the DGA.  Nevertheless, interest was lacking in the public arena until it was aroused by the probing and provocative study and writings of Gary Taubes (8).  His story of the origins and health implications of the nutrition folly created enormous anger; how could a government assumedly dedicated to the health of its citizenry foist on it a diet that caused illness or even death?

Taubes created not only anger but also a great public optimism and belief that governmental interference in nutritional science would end.  Sadly with time, anger gradually faded and optimism died, but more importantly the sordid story of government control and exploitation of nutritional science was now in the public mind and domain.

Victory in Sight: All was subdued until a short two years ago when an extraordinary book and author with amazing public appeal expanded upon the folly so providentially introduced by Taubes.  Nina Teicholz’ story (9) charmed and excited a large following both here and abroad and reinvigorated the hope that nutritional science would finally be freed from governmental central planning. Victory again appeared to be within reach.

Public demand and Nina brought the DGAC to account; it was directed by the legislature to assure that its directives were based on sound science rather than the pseudoscience which had been demonstrated to be the case.  Faced with destruction of its fiefdom, the DGAC turned to fight.  It unleashed on Teicholz an incredibly vitriolic campaign of personal denigration – and then withdrew to prepare a report to the legislature.

Victory Denied: A few weeks later, the DGAC submitted its report to the legislature.  It  stated, in essence, that they had done a thorough review of science on which their recommendations were based and deemed them unequivocally to be sound science.  The legislature thanked them and accepted their report. Case closed (10).

Nina’s heartfelt campaign brought great successes and profound heartaches to the competent and resolute Nina (11; 12).  Throughout the years of efforts to right the wrongs of the DGAC, Gary and Nina received overwhelming applause and words of praise, but no one picked up the challenge to strive for a remedy.  Words cannot substitute for action.

The Only Option

It is now 2016.  Why truth was obviously bypassed by a seemingly responsible legislature will probably never be known.  The impact, however, is enormous and growing in terms of life shortening human suffering and economic costs.  Good sense suggests that seeking an answer as to why truth was bypassed is a waste of time.  Petitions are self-satisfying but are seen by blind eyes.  The establishment won the battle.  The DGAC maintains control.  The DGA have been deemed valid and summarily adopted despite widespread and scientifically accurate opposition.

These guidelines, as federal law, are very powerful because they regulate a number of federal activities, such as military menus, school lunch menus, federal health research grants, food manufacturers’ decisions, university nutrition and dietician training programs, and the dietary dogma of essentially the entire American medical profession.

Tuchman found in her research that follies always end in catastrophe.  At the present time, all an individual can do is to prepare to protect his own health and that of his family.  There is no other option. You are on your own!  You must learn to study and make intelligent decisions.

Time to Move On

It is urgent that individuals become responsible for their own health.  They must learn the basics of healthful nutrition from authors that present sound science rather than flawed dogma and take steps to incorporate the simple basics of good nutrition into their daily fare.

The fact is that any disease can be prevented by removing its cause or causes.  The science of biochemistry makes clear that the broad underlying cause of all noninfectious diseases that are now epidemic is chronic inflammation.  All of these diseases have the same underlying cause; long-term, low-level inflammation brought about primarily by unhealthful diet (3).

Sound nutritional science is known; more specifically, it is known that excess consumption of high glycemic carbohydrates (sugar and starch) and omega-6 linoleic acid (LA) are major causes of chronic inflammation (13).  Read and study nutrition books and follow blogs that explain low-carbohydrate and keto diets.  Become familiar with the essential fatty acids and their vital eicosanoid and docosanoid functions.  Secondary components, such as dietary micronutrients and antioxidants, will also be required for effective prevention.

Learn about the true science and benefits of aspirin (14; 15).  A daily aspirin tablet taken as currently recommended by the medical profession will promote the biosynthesis of aspirin-triggered lipid mediators derived from the essential fatty acids.

Pay particular attention to your individual responses to kinds and quantities of different foods.  A written record of your responses could be of great value as you progress in your prevention program.  Finally and most importantly, recognize and appreciate that given the proper nutrients the body is capable of healing and continually repairing itself (3).

In setting up a personal prevention program, please understand that primary prevention is not designed to cure disease. The objective is to stop the cause so that no disease occurs.  Reversal is often possible with some of the inflammatory diseases.  The most appropriate option for individuals who already have disease symptoms is to coordinate dietary changes with medical supervision.

Lessons Learned?

The difficult decades just passed contain some important lessons.  Whether these lessons are learned will not be known till some future soul in some future time looks back to see.

Why Do We Need Dietary Guidelines?

This very important question was raised several years ago by a clever. thoughtful, but as yet unrecognized nutritional scientist when it appeared that independent control of the DGA might be in sight (16).  It is based on the very logical belief that science is not amenable to human legislation.

The truths that dictate the diet for optimal human nutrition evolved in conjunction with the evolution of Man himself.  Therefore these truths should be considered natural laws that are not within the purview of human control.  Most politicians recognize that they cannot regulate the rotation of the earth or the speed of light, but they have no hesitation in assuming control over nutritional science.

The lesson to be learned is that the wisdom of Adele Hite (16) must be followed if nutritional science is ever to be unshackled and set free to become a true science.

Competition by Alternative Nutrition

Despite the decades-long exposé of the failings of governmental nutritional science, it must be proclaimed that sound nutritional science is actually alive and well.  We call it alternative nutrition because it is the alternative to the pseudoscience of the DGA.  Alternative nutrition may ultimately be the weapon that deals the final blow to government interference in nutritional science.

The pioneers who gave us our knowledge of sound nutritional science (13) are the heroes of alternative nutrition.  With common sense and clinical practice founded on study of biochemistry, the prehistoric human, and the evolutionary diet, they produced data that met the criteria for truthful science.  These criteria declare that the data are not in conflict with known scientific fields of knowledge; they are explainable by known sciences such as biochemistry; and they are highly reproducible and survive the passage of time.

The lesson to be learned is that health care providers will come to learn that alternative nutrition delivers the health and well being that people seek.  It has a competitive advantage over medical practice that accepts a dogma that feeds epidemics.  With time, health care based on alternative nutrition will improve, expand, and eventually prevail over that based on the dogma of the DGA.

References

  1. Angell M. The Truth About the Drug Companies. New York, NY: Random House, Inc., 2004.
  2. Porter R. The Greatest Benefit to Mankind. New York, NY: W.W. Norton & Company, Inc., 1997.
  3. Ottoboni A, Ottoboni F. The Modern Nutritional Diseases and How to Prevent Them. Fernley, NV: Vincente Books, 2013.
  4. Garrett L. Betrayal of Trust: The Global Collapse of Public Health. New York, NY: Hyperion, 2000.
  5. Bollet AJ. Politics and Pellagra: The epidemic of pellagra in the U.S. in the early 20th century. The Yale Journal of Biology and Medicine. 1992; 65: 211-221.
  6. Tuchman BW. The March of Folly. New York, NY: Ballantine Books, 1984.
  7. http://ketopia.com/epidemiology-rest-peace/ accessed July 28/ 2016.
  8. Taubes G. Good Calories, Bad Calories. New York, NY: Alfred A. Knopf, 2007.
  9. Teicholz Nina. The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet. New York, NY: Simon and Schuster, 2014.
  10. http://www.natlawreview.com/article/hhsusda-release-2015-2020-dietary-guidelines-americans/ accessed July 28, 2016.
  11. http://thebigfatsurprise.com/contact/ accessed July 28/ 2016.
  12. https://shootingthemessenger.wordpress.com/2016/05/18/voice-in-the- wilderness/ accessed July 28, 2016.
  13. http://ketopia.com/a-tale-of-two-truths/ accessed July 28/ 2016.
  14. http://ketopia.com/aspirin-a-unique-remedy/ accessed August 05, 2016.
  15. http://ketopia.com/?s=aspirin accessed August 05, 2016.
  16. http://v6.examinecdn.com/erd/issue4-sneakpeek.pdf  accessed August 05, 2016.

6 Responses to “Disease Prevention – The Shunned Science”

  1. Donald Ewart

    Wow! That’s terrific. As a healthy engineer and mid-octogenarian who follows a zero-carb ketogenic lifestyle I swallowed the article hook, line and sinker. Thanks for putting together this piece. I had to read Taubes book four times before I GOT IT, and Nina’s book was a fanatistic follow-on. And now with a strong social media venue, and contributions like yours, it gives me hope that change will occur.

    Reply
    • Hi Donald

      Many thanks for sharing your great experience with the ketogenic diet. Hopefully, your example will encourage the undecided to give ketogenesis a second review. They will find that, as you have, the ketogenic diet not only fosters good health but is also the basic diet that is a requirement for prevention of all chronic inflammatory diseases.

      We send you best wishes for every happiness in the many more healthy years you are earning with ketogenesis.

      Reply
  2. Could you list all the supplements, dosages, brands (if possible) you both take? Thank you for your outstanding website. You both are an inspiration.

    Reply
    • Alice and Fred Ottoboni

      Thank you very much for your kind words. We do not discuss publicly what supplements we take because individual needs for kinds and amounts of supplements are not exactly the same for all humans. We do not want to suggest that what is appropriate for us is the same for all. This fact is well described by the late Roger Williams decades ago. (http://amzn.to/2bUqUUl)

      We enjoy talking about supplements that are are important for good health, but we can add no more than what is already in the nutrition literature. One source that we have used extensively is Michae Murray’s books and Encyclopedia. (http://amzn.to/2cnSwTb)

      We wish we could be of more help to you, but we know your interest in your health will serve your needs.

      Reply
  3. Frank Araujo

    Once again the fabulous Ottoboni’s nail the weak link in human health care. As a former public health epidemiologist who had the opportunity to study both human and veterinary preventive medicine, I can only refer any interested reader to the great book by my mentor and inspirator, Calvin W. Schwabe of the EPVM department at the UC Davis, School of Veterinary medicine, Veterinary Medicine and Human Health in which nearly all the points in this fine article are stated. Kudos to Fred and Alice who just keep rocking.

    Reply
  4. Emma Saurus

    Thank you for this beautiful historical piece. What intelligent reading it makes, with many fascinating points to pursue through your references.

    Reply

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