During the early 20th century, several significant developments led to the emergence of what we now call modern medicine:
1. The overhaul of medical education, initiated by the Flexner Report in 1910, commissioned at the request of John Rockefeller and Andrew Carnegie, the two richest men in the world.
2. The discovery of penicillin in 1928 by Alexander Fleming, a bacteriologist at St. Mary’s Hospital in London.
3. The discovery of vitamin C by Hungarian biochemist Albert Szent-Györgyi in 1928, for which he was awarded the Nobel Prize in 1937.
It had long been known that sailors on extendegd voyages suffered from a disease called scurvy. The French and British navies had established recommendations for sailors to consume citrus fruits daily. However, after the discovery of vitamin C, it was believed that the ill health of sailors was due to a deficiency in vitamin C. This understanding contributed to the evolution of the science of nutrition as we know it today. Modern nutrition is largely reductionist, focusing on breaking down food into its nutrient components. Patients are diagnosed based on the composition of nutrients in their blood, with deficiencies supplemented and surpluses managed through dietary restrictions.
Had early observers of scurvy in sailors concluded that the problem was due to a lack of fresh fruits and vegetables, rather than solely a vitamin C deficiency—which we now know to be a more accurate understanding—the trajectory of nutrition science might have been different. However, this approach would have posed a challenge: it wouldn’t have generated profit. Neither doctors, supplement manufacturers, nor pharmaceutical companies would have benefited. Dr. Colin Campbell, regarded as one of the foremost nutritionists today, has consistently emphasized the need to rewrite nutrition science and unlearn much of what has been taught over the past century.
The discovery of epigenetics in recent decades has shown us that it is not just the individual components of nutrition that matter, but the whole food, along with its inherent bacteria. As Dr. Campbell puts it, rather than focusing on individual instruments, we should focus on the symphony.
Nutrition science has unfortunately centered around creating a “normal” range for various nutrients, against which any sample is analyzed. Let’s explore how these so called normal ranges are derived.
What is normal?
When you get lab tests done—whether blood, urine, or stool—the report compares your results to a range called “normal.” But have you ever wondered who decided what “normal” is?
This range is derived from a large sample of the population. For any test, readings vary from person to person, forming a bell curve. The area under two standard deviations (2σ) covers about 95% of the total sample. This is what “normal” means. For example, if your hemoglobin is between 14-17 g/dL, you fall within the 95% of the population. If your reading is above 17 or below 14, it simply means you’re in the top or bottom 2.5%. This is often misunderstood as a sign of a problem, which may or may not be the case.
It’s essential for both you and your doctor to understand why your reading is outside the “normal” range. For some blood chemistry markers, the cutoff is determined by committees made up of healthcare providers, pharmaceutical industry representatives, and government agencies like the FDA. For example, the criteria for total cholesterol, vitamin D, fasting glucose, and blood pressure are established by different bodies.
There are various vested interests in keeping these cutoff points low (or high), as it can increase the number of patients, benefiting doctors and the pharmaceutical industry.
Since modern medicine has largely developed in Western countries like England and America, large samples were taken from their local populations to establish these “normal” criteria. These reflect the diet, lifestyle, and health of those populations. However, in countries like India, medical guidelines are often adopted from the West without considering genetic differences and dietary habits.
For example, Americans predominantly consume meat, while many Indians are vegetarians, leading to discrepancies. Hemoglobin is one area where Indian people often fall short of the established “normal” range. But this doesn’t necessarily mean they are unhealthy or in need of medication or supplements.
Another example is potassium. The normal range is 3.6 to 5.2mmol/L. Americans typically don’t consume much green leafy vegetables, which are rich in potassium. Once you start a diet rich in plant-based whole foods, intermittent fasting, or similar health-conscious programs, your potassium intake rises, and blood tests may show levels above the upper range. This doesn’t mean you have a health problem—it means you’re healthier than 95% of Americans!
Vicious cycle of overdiagnosis
What increasingly happens is that a seemingly healthy person with poor eating habits undergoes a checkup at age 45 or 50. The doctor orders various tests, points out discrepancies, and prescribes medication or supplements. You take the medication, start to worry, and a “nocebo effect” takes hold—you imagine symptoms. Medication also comes with side effects or adverse drug reactions (ADRs). Within six months, you feel unwell and visit the doctor again, who prescribes more medication. This vicious cycle continues, and before long, you’re 60 years old and taking five medications. This is what happened to me.
Doctors today are not trained in nutrition, so they don’t provide dietary guidance. If pressed by patients, they share whatever they’ve gleaned from mass media, which is heavily influenced by the food and drug industry.
Don’t kill the messenger
Lifestyle diseases exist on a continuum. They start as soon as a child is weaned off breast milk and begins eating whatever their parents feed him. If the diet is unhealthy, the body compensates by increasing blood pressure, insulin secretion, or other mechanisms. These compensatory systems keep major markers like blood pressure, blood sugar, and cholesterol in check. However, once the body can no longer compensate, these markers slowly rise. When they reach a certain point, as determined by governing bodies like the ADA, AHA, or ACP, the person is labeled as having a chronic disease.
The right approach would be to correct the diet and lifestyle that led to the rise in markers. However, in practice, doctors focus on lowering the markers through medication. When the markers return to the “normal” range, the person feels “healed,” but no attention is paid to the underlying cause. Over time, the markers rise again, and the doctor either increases the medication dose or adds a new drug. The side effects of these medications often lead to other health issues.
I call this the suppression of symptoms, akin to killing the messenger. Rather than addressing the root cause—an unhealthy diet and lifestyle—we attack the symptoms. Most medications for lifestyle diseases work this way: they don’t address the disease’s cause, just the symptoms. Unfortunately, nutrition science is not part of medical school curricula, and doctors are trained to focus on managing symptoms and bring them in normal range rather than understanding the bigger picture of health.
Please listen to Padma Vibhushan Dr. B.M.Hegde and Dr. Colin Campbell speak on the subject.
What is Normal BP
https://youtu.be/NQoD-LiwSFw?
T. Colin Campbell: The Future of Nutrition
https://youtu.be/0S_IhamT95U?
Disclaimer
Views expressed above are the author’s own.
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