Research Smarter, Not Harder
Earlier this year, the National Research Council and the Institute of Medicine published a review on health in the United States. As the country that spends more than any other on medical research, we ought to have a great deal to show for it. But that is not what the report found. Quite the contrary. America lags behind others in life expectancy and in prevention of chronic diseases, disability, and infant mortality. Of all developed countries, the United States has some of the worst statistics for obesity, heart disease, and diabetes. Somehow the research investment is not paying off.
It is clear that we need a different kind of research.
In centuries past, when infectious diseases were the major scourges of the day, researchers were preoccupied with minutiae, and rightly so. The more we learned about the bacteria responsible for TB or the viruses causing smallpox, rabies, or yellow fever, the more power we had to counter their attack.
That approach only goes so far. In research on lung cancer, teasing out a single chemical in tobacco smoke that caused cancer proved an impossible task. There were at least 20 potential culprits. Instead, it was the science of epidemiology that tracked cancer trends in large populations and conclusively linked lung cancer to smoking. And that was tobacco’s undoing.
Today, our most deadly epidemics are caused, not by bacteria, but by behavior. Heart disease, diabetes, obesity, and hypertension are not caused by microbes, but by McDonald’s—and Wendy’s and KFC and Burger King, and by the meaty, cheese-laden culture that has insinuated its way into our lives with the stealth of a virus but that easily eludes detectives using microscopes and petri dishes.
In this issue, we discuss PCRM’s research program. In many cases, our work follows on large population studies that have identified nutritional risk factors for diabetes, obesity, or lipid disorders. Our job is to change those risk factors. In other cases, such as chronic pain, large population studies have not been done, and our research efforts are exploratory, based on prior human studies or on our understanding of human biology.
The primary thrust of our work is to test nutrition interventions in human patients. We are finding ways to tackle diabetes, hypertension, obesity, cholesterol problems, arthritis, migraines, and other conditions. We do not ignore human behavior; we embrace it. By designing methods that help people to understand how foods affect them, we can give them the tools they need to change and to track their results. We also scale these interventions for large businesses or the Internet, creating a model for a new, results-oriented kind of research. Our hope is that this is the sort of inquiry that will allow us to reach our health goals.
Neal D. Barnard, M.D.
President of PCRM