Whole (34 page)

In a nutshell, Big Pharma gets Big Subsidies from the taxpayer to fund their research and they pay far less in taxes than they owe. They also vigorously seek—through inflated R&D costs—tax breaks from unsuspecting taxpayers, and they are permitted to advertise directly to the consumer without effective control of what they say. Unsurprisingly, this lax attitude leads to a recent estimate that “of the 192 advertisements for 82 unique products [that were surveyed], only 15 fully adhered to all 20 FDA Prescription Drug Advertising Guidelines. In addition, 57.8%... did not quantify serious risks and 48.2% lacked verifiable references.”
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Not only
that, Big Pharma spends far more on this advertising than on R&D. In a 2008 report, they had, during the previous year, spent twice as much on promotion than on R&D.
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Talk about misplaced priorities! Big Pharma’s “selfless” agenda is simple: sell, sell, sell, sell, and in their spare time, lobby the government for tax breaks and more subsidies.

The annual revenue for Big Pharma, $289 billion in 2010,
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exceeds the total national budgets of at least 80 percent of the countries in the world.
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Arguably, this might be acceptable if the outcome—or even the goal—were increased health. But as we’ve seen, this is emphatically not the case.

As bad as all of this is, Big Pharma has more up its sleeve. A significant problem with the pharmaceutical business model is that healthy people tend not to take drugs. Vitamins and minerals and herbs, yes. Pharmaceutical drugs, no. Big Pharma’s next step is therefore the development of preventive drugs that can be given out like candy to everyone at risk for common killers like heart disease, stroke, cancer, and diabetes—which, in our nutritionally ignorant country, is just about everyone.

One such troubling attempt at “prevention” is the proposal to develop a “polypill” to reduce the risk of cardiovascular disease (CVD).
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This polypill might include a few seemingly effective drugs like “3 blood pressure lowering drugs from different classes each at half doses, aspirin, a statin and folic acid.”
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The stated rationale for this pill is the need “[to reduce] the burden of cardiovascular diseases [by] strategies that are applied to entire or large segments of the population.”
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What a boondoggle for the pharmaceutical companies!

The pill would hypothetically benefit and therefore be recommended for “all individuals with an established CVD and all those over 55 years without CVD”
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—an impressive number of people. This estimate is based on considerable speculation and, it appears, was obtained by adding up the effect of multiple individual interventions for sustained periods of time. However, the combined effects of two or more agents are almost never additive. And the side effects of combined drug therapy are almost impossible to know beforehand. Making the matter even more troubling is the credence given to this idea by prestigious national and international health agencies.
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In their defense of the proposed polypill, the pharmaceutical lobby states that “primary prevention should include multiple strategies: health
policy and environmental changes, individual behavioral changes, and use of proven and safe drugs.”
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They further claim that lifestyle interventions require behavioral modification—true—but then go on to say that such changes are too costly and “have only modest and unsustainable impact, and have failed to reduce CVD events when tested in large, long-term trials.”
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In other words, to echo a metaphor from
chapter two
, if an entire population suffers from headaches caused by hitting themselves over the head with hammers on a regular basis, it’s too expensive and not effective enough to teach them to stop. Instead, we should implement health policy and environmental changes, such as public service announcements reminding everyone to wear their helmets, and recommend that everyone take painkillers with every meal.

The report
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they refer to that supposedly damns lifestyle change as low impact and unsustainable was a meta-analysis of thirty-nine studies that only represented a collection of independently acting interventions. The studies reviewed in this report intervened first with drugs (for hypertension, lower cholesterol, and high blood sugar), and then with meaningless and independently acting (but not necessarily additive) interventions to reduce body weight, decrease fat intake, get more exercise, and stop smoking. In other words, giving people drugs and encouraging them to lose weight, eat less fat, and walk around the block once a day didn’t miraculously make them healthy. That’s what they call “lifestyle change”? Is anyone surprised that this approach doesn’t work?

Big Pharma has used this collection of flawed studies as a straw man, claiming that “lifestyle change” doesn’t improve health outcomes. But the combination of drug interventions (which fail to show adequate long-term benefits) with vague statements to reduce body weight (by any means, healthy or not?) and lower fat intake (another reductionist result that can be accomplished not by meaningful dietary improvement but rather by eating processed “low fat” foods) by no means can be considered a “lifestyle change.” Lifestyle changes are wholistic, systemic, persistent, and comprehensive. A credible study of real lifestyle change to improve health would guide participants to transition to a WFPB diet, at a minimum. Yet most researchers in this field not only fail to acknowledge nutrition as a means to create and restore health, but also refuse even to become curious about its possibilities.

Dietary supplements (which include not only single-nutrient supplements, but also a wide variety of food and herbal extracts) are a huge business—at recent calculation, it totaled $60 billion here in the United States—and one that has everything to lose under a wholistic paradigm. After all, supplements, as with pharmaceuticals, are the products of reductionist science, in which individual nutrients are seen as independent actors, each doing “a thing” in isolation from everything else in the body and the environment. As we saw in Part I, the limited efficacy of supplements reflects the limited science that created them: nutrients outside of their natural food context do little good and sometimes do considerable harm.

This hasn’t stopped the supplement industry, though—and why should it, when there are so many studies to choose from and so much money to be made by choosing the ones, however faulty they may be, that support supplement use?

These days, the supplement industry has the process down to a “science.” New scientific research on single nutrients generalizes in a very superficial way about their ability to promote human health. Companies put these newly discovered “nutrients” into pills, organize public relations campaigns, and write marketing plans to encourage a confused public to buy. But it wasn’t always this way. The supplement industry rose from its modest origins to the multibillion-dollar behemoth it is today by exploiting relatively recent government policy toward deregulating the sale of certain health pills.

The nutrient supplement industry began in the 1930s, and for several decades had only modest growth. In the 1970s and early 1980s, however, it got a big boost, thanks to two events. First, in 1976, U.S. Senator William Proxmire and his colleagues succeeded in amending food and drug regulations to enable food companies to sell vitamins and minerals without a doctor’s prescription.
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Previously, a prescription was required for any preparation containing more than 150 percent of a recommended daily allowance. Second, in 1982, the NAS published that highly publicized report on diet, cancer, and nutrition, which we’ve already discussed,
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that the industry spun to lend scientific justification to their products. That report—coauthored by thirteen scientists (including myself) and two years
in the making—talked about individual nutrients as they existed within whole foods such as cruciferous vegetables. Though we mentioned certain vitamins and minerals, we had no intention of encouraging a nutrient supplement industry, and we made this clear in our executive summary. Ignoring our conclusions, the industry audaciously claimed that we had said the opposite, as if they knew better than we did what we had said!

This fledgling industry was now on a roll. The Proxmire amendment opened up the market, while the NAS report provided, in supplement makers’ opinion, the scientific evidence to justify their products. What a combo! But an obstacle to growth remained: the industry couldn’t yet make specific health claims that rose to FDA standards to help sell their products. Critics were right to be concerned about hyped-up claims, as evidence of such misbehavior had already surfaced with their gross misrepresentation of our NAS report. In fact, the NAS appealed to the Federal Trade Commission (FTC) to investigate the matter and asked me to represent the NAS in the subsequent court proceedings, which continued for about three years. My job was to examine the evidence the industry submitted to support their claims. I testified that most of their evidence was bogus and the FTC court agreed.

Neither the NAS nor the FTC had found any evidence to support these emerging health claims. Yet the industry still found ways to open doors for business, gradually gaining more and more liberty to make claims of improved health. Despite what, in my opinion, were (and are) minor restrictions on the health claims they could make, they essentially found ways—subtly but nevertheless powerfully—to advertise the health benefits of nutrient supplements and to grow their industry. I am not as familiar with the stream of regulatory and legal decisions paving the way for this growth that occurred over the next several years, because I was more involved with my research than with political shenanigans. But I do know that the industry has continued to grow—as did the lawyers’ fees involved in ensuring the supplement industry had a friendly regulatory environment! Revenues climbed as more people succumbed to massive industry advertising and the belief that health could come from bottles of vitamin and mineral tablets.

The industry, now well established, received a further boost in 1994 with the passage of the Dietary Supplement Health and Education Act that amended the Federal Food, Drug, and Cosmetic Act. This amendment
was designed to standardize specific supplement-labeling requirements, among other “housekeeping” chores, which gave supplements the appearance of scientific credibility and class. Most supplements and dietary ingredients could now be classified as food, a change the industry welcomed. By this point, the supplement industry had become as much a part of the American landscape as cars, churches, and apple pie. It had risen to become an elite class of food product, rather like dairy.

According to a 2008 report,
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the variety of dietary supplement products has grown immensely over the last thirty years, all the way from the original alphabet vitamins (A, B complex, C, D, E) and minerals to prebiotics, probiotics, omega-3 fats, and various whole food concentrates. But almost all the health claims for these products rely on the same kind of short-sighted findings we debunked in Part II.

I’ve mentioned these statistics before, but they’re worth laying out, all together, one more time. Sixty-eight percent of American adults take dietary supplements, while 52 percent consider themselves “regular” users.
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As of 2007, the U.S. supplement market was $25 to $30 billion per year, with $7.4 billion spent on vitamins alone. More recent estimates have placed the U.S. market at $60 billion. Worldwide total dietary supplement sales in 2007 totaled $187 billion. Yet, with the immense growth of this “health” product market, the only thing getting any healthier is the supplement industry’s bottom line.

Many other books detail the ways in which corporate money has corrupted government and institutional policies, and not just when it comes to our health. I could write an entire book just on the examples I’ve seen personally, and I shared some of them in
The China Study.
As well, the three industries discussed here—the medical, pharmaceutical, and supplement industries—are not the only ones involved in our health system. The food industries, particularly the animal and junk food industries (which my son, Tom, and I examined in detail in
The China Study),
are also major players in the distortion of our health system, as we’ll see in exploring these effects throughout the rest of Part III. But these three industries
benefit most directly from the reductionist health paradigm, and have done the most to promote and maintain it.

What I want you to take away from the examples I’ve included here is just how much money there is to be made by suppressing wholistic nutrition in favor of reductionist health solutions, and just how far industry will go in pursuit of a larger share of that profit. In our current health care system, these examples aren’t exceptions; they’re business as usual. What looks like industry contributions to our well-being are often pure profit plays, dressed up as health initiatives. And it’s to the many ways and places where industry encourages only those products, services, and beliefs that reliably generate corporate profits that we next turn—beginning with industry’s influence on science itself.