Dr. Howard Jacobson is a health educator and contributing author to T. Colin Campbell’s new book Whole: Rethinking the Science of Nutrition. He holds a Masters of Public Health and Doctor of Health Studies from Temple University, and a Bachelor of Arts degree in history from Princeton. Howard also founded FitFam.com as a resource for busy parents trying to raise fit and healthy children. He speaks, coaches, and consults on marketing for small and green businesses, health and fitness for individuals and families, and permaculture and planetary sustainability.
Here are my 5 questions with Dr. Jacobson and his answers:
1) A number of articles have been written over the past 10 years that raise concerns about clinical studies that address public health, food, and nutrition- related issues. As examples, an essay written by Nobelist, James Watson, plays down the importance of anti-oxidants in diets (New Scientist, March 16, 2013); a New Yorker article from December, 2010, entitled “THE TRUTH WEARS OFF – Is there something wrong with the scientific method?” describes the difficulty in repeating and validating complex drug, public health and related clinical studies. Do you believe there is a single source of truth that applies to the global population regarding nutritional information?
I believe there is a really thick veil between us and the “Truth”, so the best we can do is be really respectful regarding what we do know. I look at Truth as a dinner guest. You invite Truth to dinner with the utmost humility. In my opinion, that is how you glean Truth from scientific study. You ask Truth to come for a visit, with the hope of getting yourself a little closer to true objective reality. Given there are so many ways of asking questions it seems to me the most respectful thing to do is to encourage people to ask lots and lots of questions in various different ways – from micro-concerns to global issues and everything in between – then look at all the information you’ve amassed and try to create nested priorities. When claims are made off isolated studies (as discussed in the article you mentioned THE TRUTH WEARS OFF), they’re often reputed as fact and acted upon, only to find out as time passes that the benefits are only applicable in a scientific setting, or worse, they cannot be replicated. Given that goes on, I think a strong case can be made for judgment through diversity. You can approach scientific inquiry like an ecosystem. An overabundance of one type of organism is going to create havoc. You need diversity in any system so when weird things occur, and they will, you will have enough information you can rely on the preponderance. In this sense, when you come up with a counter-intuitive study – instead of sensationalizing it and broadcasting it as Truth – nest it as part of a holistic approach to inquiry and weigh its significance. So in the case of nutrition, we can look around the world and see that the people who tend to be slim, healthy, and live long lives are those that tend to eat a lot of complex carbohydrates, very little processed food, and not that many animal products. There is a large body of evidence to support this. So using this as a starting point, in my opinion, it is ridiculous to promote a 70% fat and protein diet when it flies in the face of a really robust empirical observation. I believe it is fair to be suspicious of purported evidence and mechanisms discovered in isolation that contradict more holistic observations that have proven evident through more vigorous means.
2) What advice do you have for consumers of this type of information in making nutritional judgments given the criticism that nutritional advice seems to come from a very diverse group of researchers and evaluators?
I’ll approach the question like this, given we live in a very unnatural society and we have the power of choice, how shall we eat? So someone might suggest let’s eat like a caveman… well, but wait, we do not live in that paradigm. We are not roaming the earth essentially working out eight hours a day, at least not most of us, that lifestyle involved a lot of physical labor. We now have unique demands that are specific to the environment we’ve created. It is a bigger issue than just being anthropological in nature however. We have power over our environment and ecosystem, so shouldn’t we make choices that are sustainable? That is one issue. Another is that as individuals we’re all different. If you are eating in a manner that is sustaining you in a healthy way, you are at a healthy weight and all your biomarkers are optimal, then maybe you do not need advice? I’m not a doctrinarian saying there is a single approach and everyone should eat a certain way. I will close by saying in spite of what I have just said, I think as individuals there is an obligation to be considerate of the fact we operate in a system larger than ourselves. For instance, there are a lot of ways to make a living. Some of these occupations might be harmful to other people but be financially advantageous. The spectator might look at an individual in one of these occupations and think that person is happy because of wealth and/or other measures, but pull back the lens and it proves to be a much bleaker picture. You can use this analogy regarding our food choices as well. Nutritional advice might be suitable for an individual but in the context of societal concerns be terrible (i.e. unsustainable farming practices, workforce exploitation, etc.). For these reasons I do suggest that the context of the information you consume is important to consider. Think beyond food choices that sustain only you, but choices that sustain your community, as well as the Earth.
3) An interesting section of your book deals with reductionism and the development of the many sub-specialties that now define aspects of biology. However, those with whom I have previously discussed the question of reductionism seem to argue that because science has advanced so much and has become so complex that some kind of subdivision is a necessity (this is true in both biology and life science). There is simply too much to know. They are also quick to point out that in addressing broad questions, the first and essential step is to put together teams with diverse viewpoints. The team approach also seems to be at the heart of what is often referred to as bench to bed or translational research. Isn’t reductionism needed so that others can “stand on the shoulders of giants”?
Let me clarify I’m not against reductionist research. On the contrary, reductionist research is an important part of a holistic view. The opposite position would be like a left-armed man saying, “well, I am left-handed so let me cut off the right one.” To be a literate scientific society we need all types of research. What we decry in the book is people who spend their lives looking down microscopes and then try to convince the rest of us that they’re the only ones that can see the Truth. Again, as I posit in your first question there is no “single source of Truth”.
4) You also have some interesting perspectives on reductionistic approaches with regard to addressing broad questions. If the goal is to make a recommendation, isn’t it necessary to have some sense of the mechanism of the putative interaction? The point being that recommendations most likely come from a reductive process or require methods or concepts that are products of reductionism (e.g., good compositional data or knowledge of what a single component in food might do). Could you give some insights in approaching food related research questions, particularly when making an association to a given health aspect it may be a necessity to only be correlative without a lot of fundamental information?
Having a passion and conviction for something you’re involved in is very human, especially among intelligent, successful individuals. Scientists who make an important finding tend to get identified with it, and that’s okay. It is very rare for scientists, or anyone for that matter, to be truly egoless. You need drive to do meaningful work. Part of the beauty of the scientific method is the desire to prove that you are right. The challenge is separating the real Truth from rhetoric. The issue in our modern society is that through media and other means, interpretation of Truth can sometimes actually be disseminated as Truth and that’s a big issue. It’s a big issue for two reasons. One, it gives the people with money a real advantage, because with money you can basically disseminate a distorted (aka your) version of Truth. Two, and even more concerning, is that reductionism is used to create marketable products with purported benefits that rarely can be achieved (at least as advertised) in a real-world environment.
Consumers have a hard time telling the difference between marketing and science. For instance, a lot of discourse has been spinning around the Cheerios’ ad featuring a biracial couple because of the alleged proactive portrayal of a mixed race couple, when we would be better served discussing the merits of the claim that Cheerios are good for your heart. These claims about Cheerios being good for your heart are so far from any scientific truth… they are loosely based on tangential data, and turned into marketing messages based on ingredients studied in isolation. I believe this controversy is more worthy of debate. It is like the old fable of a guy searching for his keys under a streetlamp. He lost his keys in the dark but the lamp was the easiest place to look so he started there.
The spirit of Whole is to suggest that in most cases nutrition is too complex to associate an expected outcome with a single nutrient. It’s like asking, “What is the best note in a particular symphony?” You certainly can take out a single note and examine it, but the examination is going to be of little use in creating your next symphony.
5) Given the complexity of the arguments made in your book, if the reader is to walk away understanding one concept what would you hope that is?
There is almost always a larger “whole” to examine. When you’re examining anything always try to see if you can broaden the context of your inquiry. Ask these questions: In what cases is the concept true? In what cases is the concept only a half-truth? In what cases is the concept false? The laws of phenomena are so unbelievably complex that whenever we attempt to break things into smaller pieces – as useful as it is to do so – we need to appreciate that some things are lost in the process. Reductionism very often comes with a cost or trade-off, and when that trade-off is not fully explored – or worse omitted for the economic benefit of special interests – the things that society loses in the process are not mitigated by societal gain… and worse yet, the gains are usually not shared equally but rather benefit only a select group of individuals (through monetary gain). Regarding nutrition specifically, as a society we have evolved in such a way that a plant-based diet simply makes sense. Eating is a way we turn the world into ourselves. It is one of the most intimate things we do and it is a shared commonality amongst all of us, so I believe it really does behoove us to slow things down and focus on building habits that will contribute to the greater good… as individuals… as an ecosystem… and for the betterment of the planet.