The government's mandarins of the medical sciences went to Capitol Hill last week to proclaim that they are terribly keen for nutrition research and that they are even drumbeating on the nation's campuses to find qualified takers for their money.
True, and welcome, but it leaves unanswered why the world's greatest biomedical research enterprise, the$3-billion-a-year National Institutes of Health, is a late arrival in seriously looking into the obviously important relationship between diet and health. NIH, after all, has long claimed exemption from political intrusions on the grounds that science is best navigated by the collective wisdom of the scientific community. Provide the money, leave us alone, and we'll produce for the good of society -- so goes the traditional appeal of basic science, which is the main business of NIH.
Given the Nobel-certified scientific success associated with this credo, dissenters risk being labeled quacks and cranks or disgruntled grant rejectees. And let's face it: the critics of the system for dispensing research money do, indeed, include ample numbers of modern-day alchemists, perpetual-motion engineers and psychokinetic metal-benders.
However, in looking for NIH's suddenly developed affection for nutrition research -- the National Cancer Institute alone says its spending on nutrition research has gone from $18 million to $32 million in two years -- we can ignore the crank fringe; instead, let's take note of some disturbing testimony that was offered by orthodox scientists at hearings Oct. 2 before the Agriculture subcommittee on nutrition chaired by Sen. George McGovern (D-S.D.).
More than anything else, it has been McGovern's insistent prodding that has stirred NIH first to examine and then to acknowledge its neglect of nutrition research, and to progress from inflating its claims of nutrition spending to actually putting substantial money into the subject. Two years ago, for example, NIH claimed it was spending $85 million a year on nutrition research, but when the Congressional Office of Technology Assessment went over the NIH list, it reported that less than $5 million met NIH's own definition of nutrition research.
The testimony given to McGovern strongly charged that the NIH decision-making system -- which depends on the evaluation of research applications by panels of outside experts -- is so dominated by traditionally defined scientific specialties that it cannot cope with a cross-disciplinary field like nutrition research. That was the core of the testimony given by Dr. Stanley J. Dudrick, professor of surgery and chairman of the department of surgery at the Hermann Hospital and the University of Texas Medical School in Houston. While praising the changes that have begun to occur under Donald Frederickson, director of NIH, and Arthur Upton, director of the Cancer Institute, Dudrick said that the prevailing system of peer review for dispensing research money "has failed dismally in my experience in the evaluation and support of nutrition research."
Referring to his own experience on the advisory board that the Cancer Institute established to guide nutrition research, Dudrich said, "I know from bitter firsthand experience that from the first day we convened, the majority of the members of the board appeared to be more concerned with diverting even the small amount of funds at our disposal back toward their own interests or those of their colleagues rather than supporting novel nutrition research projects of clinical relevance and importance. After engaging in a series of meetings in which a 'you scratch my back and I'll scratch yours' attitude prevailed," the surgeon continued, "a set of guidelines and priorities emerged which doomed to failure any meaningful thrust in the area of diet, nutrition and cancer."
The presence of a senatorial champion on the relatively obscure issue of how a government agency decides to award research money has made a difference on nutrition research, as is evident from the funds that are now going into this field, as well as the Cancer Institute's issuance -- reluctant though it was -- of what it considers to be the best available advice concerning cancer and nutrition.
But still to be accounted for is science's continuing devotion to the traditional peer-review system, a money-dispensing ritual that the managers of American basic science portray as indispensable for high-quality research. However, left to itself, the peer-review system failed on nutrition research.
Which, of course, leaves a question: how well is it performing in areas that have not had the good fortune to attract the skeptical interest of an influential legislator?