Why There Is so Much Commercial Corruption in Nutrition

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.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

What to Feed Your Gut Bacteria

For many years, it was believed that the main function of the large intestine was just to absorb water and dispose of waste, but “[n]owadays it is clear that the complex microbial ecosystem in our intestines should be considered as a separate organ within the body,” and that organ runs on a MAC, microbiota-accessible carbohydrates. In other words, primarily fiber.

One reason we can get an increase of nearly two grams of stool for every one gram of fiber is that the fiber fermentation process in our colon promotes bacterial growth. The bulk of our stool by weight is pure bacteria, trillions and trillions of bacteria, and that was on a wimpy, fiber-deficient British diet. People who take fiber supplements know that a few spoonfuls of fiber can lead to a massive bowel movement, because fiber is what our good gut bacteria thrive on. When we eat a whole plant food like fruit, we’re telling our gut flora to be fruitful and multiply.

From fiber, our gut flora produce short-chain fatty acids, which are an important energy-source for the cells lining our colon. So, we feed our flora with fiber and then they turn around and feed us right back. These short-chain fatty acids also function to suppress inflammation and cancer, which is why we think eating fiber may be so good for us. When we don’t eat enough whole plant foods, though, we are in effect starving our microbial selves, as I discuss in my video Gut Dysbiosis: Starving Our Microbial Self. On traditional plant-based diets, we get lots of fiber and lots of short-chain fatty acids, and enjoy lots of protection from Western diseases like colon cancer. In contrast, on a standard American diet filled with highly processed food, there’s nothing left over for our gut flora. It’s all absorbed in our small intestine before it even makes it down to the colon. Not only may this mean loss of beneficial microbial metabolites, but also a loss in the beneficial microbes themselves.

Research shows the biggest issue presented by a Western diet is that not leaving anything for our bacteria to eat results in dysbiosis, an imbalance wherein bad bacteria can take over and increase our susceptibility to inflammatory diseases or colon cancer, or maybe even lead to metabolic syndrome, type 2 diabetes, or cardiovascular disease.

It’s like when astronauts return from space flights having lost most of their good bacteria because they’ve had no access to real food. Too many of us are leading an “astronaut-type lifestyle,” not eating fresh fruits and vegetables. For example, the astronauts lost nearly 100 percent of their lactobacillus plantarum, which is one of the good guys, but studies reveal most Americans don’t have any to begin with, though those who eat more plant-based are doing better.

So it’s use it or lose it. If people are fed resistant starch, a type of MAC found in beans, within days the bacteria that eat resistant starch shoot up and then die back off when you stop. Eating just a half can of chickpeas every day may “modulate the intestinal microbial composition to promote intestinal health” by increasing potentially good bacteria and decreasing pathogenic and putrefactive bacteria. Unfortunately, most Americans don’t eat beans every day or enough whole grains, enough fruits, or enough vegetables. So, the gut flora—the gut microbiota—of a seemingly healthy person may not be equivalent to a healthy gut flora. It’s possible that the Western microbiota is actually dysbiotic in the first place just because we’re eating such fiber-deficient diets compared to populations that may eat five times more fiber and end up with about 50 times less colon cancer.


This is one of the reasons I recommend three daily servings of legumes (beans, split peas, chickpeas, and lentils) in my Daily Dozen checklist.

The microbiome connection may explain the extraordinary results in the study I featured in my video Is It Worth Switching from White Rice to Brown?.

More on the musical fruit:

More on the microbiome revolution in medicine:

For more on bowel health, check out:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Were We Wrong About Fiber?

In my video Is the Fiber Theory Wrong?, I present that fiber-containing foods may not only help prevent heart disease, but also help treat it as well. Heart patients who increase their intake of fiber after their first heart attack reduce their risk of a second and live longer than those who don’t. But what if we don’t want to have a heart attack in the first place? If 7 grams of fiber gets us a 9 percent reduced risk, would 77 grams a day drop our risk by 99 percent? That’s about how much fiber they used to eat in Uganda, a country in which coronary heart disease, our number-one killer, was almost nonexistent.

Heart disease was so rare among those eating traditional plant-based diets in Uganda that papers were published with such titles as “A Case of Coronary Heart Disease in an African.” After 26 years of medical practice in East Africa, doctors finally recorded their first case of coronary heart disease (in a judge who consumed a “partially Westernized diet,” in which fiber-free foods, such as meat, dairy, and eggs, displaced some of the plant foods in the traditional diet).

Were there so few cases because Africans just didn’t live very long? No, the overall life expectancy was low because of diseases of childhood, such as infections, but, when Africans reached middle age, they had the best survival rates, thanks in part to our number-one killer being virtually absent. Of course, since diets have been Westernized across the continent, coronary heart disease is now their number-one killer as well, going from virtually nonexistent to an epidemic.

Some blame this change on too much animal fat, while others blame it on too little fiber, but they both point to the same solution: a diet centered on unrefined plant foods. In fact, sometimes, it’s easier to convince patients to improve their diets by eating more of the good foods to crowd out some of the less healthful options.

The “dietary fiber hypothesis,” first proposed in the 1970s, zeroed in on fiber as the dietary component that was so protective against chronic disease. Since then, evidence has certainly accumulated that those who eat lots of fiber appear to be protected from several chronic conditions. But maybe fiber is just a marker for the consumption of foods as grown, whole, unprocessed plant foods, the only major source of fiber. Maybe all these studies showing fiber is good are just showing that eating lots of unrefined plant foods is good. “Fiber is but one component of plant food, and to neglect the other components [such as all the phytonutrients] is to seriously limit our understanding.”

Why did Drs. Burkitt, Trowell, Painter, and Walker—the fathers of the fiber theory—place all their bets on fiber? One possible explanation is that they were doctors, and we doctors like to think in terms of magic bullets. That’s how we’re trained: there’s one pill, one operation. They were clinicians, not nutritionists, and so they developed a reductionist approach. The problem with that approach is that if we reach the wrong conclusion, we may come up with the wrong solution. Burkitt saw disease rates skyrocket after populations went from eating whole plant foods to refined plant and animal foods. But instead of telling people we should go back to eating whole plant foods, he was so convinced fiber was the magic component that his top recommendation was to eat whole grain bread—though they never used to eat any kind of bread in Uganda—and sprinkle some spoonfuls of wheat bran on your food.

However, studies to this day associating high fiber intake with lower risk of disease and death relate only to fiber from food intake rather than from fiber isolates or extracts. It is not at all clear whether fiber consumed as a supplement is beneficial. In retrospect, it might have been a mistake “to isolate fiber from the overall field of plant food nutrition.” The evidence supporting the value of fruits, vegetables, and whole grains, as opposed to only fiber, has proved to be much more consistent. Whole plant foods are of fundamental importance in our diet. Fiber is just one of the beneficial components of fruits, vegetables, nuts, grains, and beans. “Much of the effort on defining fiber and studying the fiber isolate would have been better applied to a whole-plant-food approach.”

What would have happened if Burkitt and others had emphasized instead the value of plant foods? The value of eating unrefined plant food, which incorporates fiber and phytonutrients, might have been the focus of attention rather than just isolated fiber, which led to people shopping for their fiber in the supplement aisle instead of the produce aisle.


My Solving a Colon Cancer Mystery video is a perfect example of the concept I presented here. If fiber were really the key, then sub-Saharan Africa would be rife with colorectal cancer these days.

For an extreme example, how about disease reversal with a diet centered on white rice? See Kempner Rice Diet: Whipping Us into Shape and Drugs and the Demise of the Rice Diet.

My video The 5-to-1 Fiber Rule discusses a way to identify less processed foods using fiber as a marker of whole foods.

For more intrigue in the world of fiber, check out Does Fiber Really Prevent Diverticulosis?.

And, if you’re thinking, “Dr. Who?,” then, for a historical perspective, see Dr. Burkitt’s F-Word Diet.

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations: