ISSN: 2940-3243


Opinion

Mind-Body Medicine: A Funder´s Perspective

by Rainer Lüdtke1


1EDEN Stiftung, Essen, Germany

Cite as: Lüdtke, R. (2024). Mind-Body Medicine: A Funder´s Perspective. THE MIND Bulletin on Mind-Body Medicine Research, 4, 9-11. https://doi.org/10.61936/themind/202406044

THERE'S PLENTY OF MONEY FOR RESEARCH!

The development of a single new cancer drug costs at least 800 million euros, usually much more (Schlander et al., 2021). The world's 10 largest pharmaceutical companies alone have an annual research budget of over 140 billion euros (Statista, 2024). In 2022, the German Research Organization (DFG) has awarded new grants totalling almost 500 million euros in the field of medicine (DFG, 2024). The largest German foundation, the Robert Bosch Foundation, spends around 15 million euros a year on "medical research funding" (Robert Bosch Stiftung, 2023); money that was generated from total assets of over 5 billion euros. A typical, medium-sized foundation in Germany does not have 5 billion, but "only" 5 million euros in foundation capital, and can therefore only realise funding projects of a maximum of 100 thousand euros per year. So why investing in science and research for medical purposes at all? Isn't every amount a drop in the ocean that evaporates invisibly and ineffectively?

 

RESEARCH FUNDING BY FOUNDATIONS: IRRELEVANT, USELESS, SUPERFLUOUS?

The answer is: "No". It would be "yes" if the foundation acted like a major research organisation, i.e. if it addressed topics focusing on university and private research. It would be "no" if the foundation did not focus on the (preclinical or clinical) development of a new drug for one of the major widespread diseases, but instead focussed on the many areas of medicine that lie outside the mainstream and lead a niche existence. Such niches can be, for example, rare diseases in children, or therapeutic procedures with an unexplained - possibly even dubious - mechanism of action (think of acupuncture, for example), or therapist-centred and non-patentable procedures that offer hardly any opportunity for commercial use of a product.

 

THE EDEN FOUNDATION FOR THE PROMOTION OF NATURAL LIVING AND HEALTH CARE

The EDEN Foundation is a foundation of the type described above. With assets totalling 7.7 million euros, it is one of the medium-sized foundations in Germany. It provides its funding - less than 100 thousand euros per year - solely from interest and dividend income generated from the investment of the foundation's assets. Since its establishment in 1962, it has been tasked with promoting science and research in three areas: Organic farming, wholefood nutrition and holistic medicine. These are all three subject areas that 60 years ago described genuine research niches that were rarely addressed by research sponsors – and certainly not by commercial companies.

 

WHY FUND MIND-BODY MEDICINE?

Even if the protagonists of Mind-Body Medicine don't like to hear it and perceive it differently from their perspective: Mind-Body Medicine is still a niche medicine. Even though the number of yoga courses on offer has exploded in the last 20 years and the density of integrative medicine clinics in Germany, Europe and the US is steadily increasing: In 2024, Mind-Body procedures are still perceived by most medical professionals and patients as part of lifestyle rather than preventive or even therapeutic medicine. 

 

And this is precisely the reason why foundations such as the EDEN Foundation are taking on this medicine and funding research projects: The niche ensures that the research funds do not go to waste, but are used sensibly, visibly and hopefully effectively and efficiently. For the benefit of patients. 

Of course, it is not only the visibility of the funds that plays a role in a foundation's decision as to which projects and areas it invests its funding in, but also the potential, originality and innovative strength of these areas. The EDEN Foundation is committed to a holistic approach by virtue of its statutes. However, it is also convinced that something groundbreaking has emerged or can emerge from the linking of body, mind and behaviour. The concept of self-efficacy, both in the prevention and treatment of illnesses, is not new, but it is innovative and full of potential. The aim is to leverage this potential through research and optimise the effects.

 

WHERE EXACTLY SHOULD WE FUND?

How exactly the potential is best realised certainly depends in many respects on the personal attitude of the promoter, his or her own experiences and preferences. I myself have been involved for many years in patient-centred research into the clinical effectiveness of Mind-Body interventions (i.e. does fasting lead to improved sleep and better health (Michalsen et al., 2003)? Is Iyengar Yoga effective for neck pain (Michalsen et al., 2012)?...). Nowadays I would be less interested in whether certain interventions work, but rather why they do: What exactly is actually happening (immunologically, neurologically, morphologically...) to our bodies when we do relaxation exercises? Which are specific stimuli for certain diseases, which stimulate in a rather non-specific way? Why are there placebo effects and how can they be used specifically? How and why do mind-body techniques fit into multimodal therapy approaches? I know, much work has already been done in these fields. However, I believe we can and should go into much further detail here.

We know that yoga exercises can relieve back pain (Anheyer et al., 2022), as can Mindfulness-Based Stress Reduction (MBSR) (Anheyer et al., 2017). However, a landmark study by Cherkin et al. (2016) has shown that MBSR and cognitive behavioural therapies are roughly equally effective in relieving chronic back pain . That must make a researcher wonder. Does it really matter which method we use to tackle health problems on the Mind-Body axis, as long as we do it? Are the individual specifics of the procedures indeed irrelevant? I am convinced that a clarification of the details, a decomposition of the procedures could provide insights.

 

As a Board member of the EDEN Foundation, I must and want to adopt a different funding perspective. As already mentioned, the foundation not only has a funding focus on Integrative Medicine, but also on nutrition. In the context of Mind-Body Medicine, it would therefore be expedient for the EDEN Foundation to promote research at this interface in order to understand the interactions of nutrition, nutritional behaviour, and attitudes with psychological, mental and physical phenomena more precisely; aiming at implementing them in self-efficacious interventions. 

 

 


References

 

Anheyer, D., Haller, H., Barth, J., Lauche, R., Dobos, G. & Cramer, H. (2017). Mindfulness-Based Stress Reduction for Treating Low Back Pain: A Systematic Review and Meta-analysis. Ann Intern Med, 166(11), 799-807. https://doi.org/10.7326/M16-1997.

Anheyer, D., Haller, H., Lauche, R., Dobos, G. & Cramer, H.  (2022). Yoga for treating low back pain: a systematic review and meta-analysis. Pain, 163(4), 504-517. https://doi.org/10.1097/j.pain.0000000000002416.

Cherkin, D. C., Sherman, K. J., Balderson, B. H., Cook, A. J., Anderson, M. L., Hawkes, R. J., Hansen, K. E. & Turner, J. A (2016). Effect of Mindfulness-Based Stress Reduction vs Cognitive Behavioral Therapy or Usual Care on Back Pain and Functional Limitations in Adults With Chronic Low Back Pain: A Randomized Clinical Trial. JAMA, 315(12), 1240-1249. https://doi.org/10.1001/jama.2016.2323.

DFG (2024). Fachbezogene Statistiken. https://www.dfg.de/de/aktuelles/zahlen-fakten/statistik/fachbezogene-statistiken#251146.

Michalsen, A., Schlegel, F., Rodenbeck, A., Lüdtke, R., Huether, G., Teschler, H. & Dobos, G. J. (2003). Effects of short-term modified fasting on sleep patterns and daytime vigilance in non-obese subjects: results of a pilot study. Ann Nutr Metab, 47(5), 194-200. https://doi.org/10.1159/000070485.

Michalsen, A., Traitteur, H., Lüdtke, R., Brunnhuber, S., Meier, L., Jeitler, M., Büssing, A. & Kessler, C (2012). Yoga for chronic neck pain: a pilot randomized controlled clinical trial. J Pain, 13(11), 1122-1130. https://doi.org/10.1016/j.jpain.2012.08.004.

Robert Bosch Stiftung (2023). Bericht 2022: Die Stiftung in Zahlen. https://www.bosch-stiftung.de/sites/default/files/documents/2023-07/final_dt_20230713_Taetigkeitsbericht-2022_DE_RZ_ANSICHT.pdf.

Schlander, M., Hernandez-Villafuerte, K., Cheng, C. Y., Mestre-Ferrandiz, J. & Baumann, M. (2021). How Much Does It Cost to Research and Develop a New Drug? A Systematic Review and Assessment. PharmacoEconomics, 39, 1243–1269. https://doi.org/10.1007/s40273-021-01065-y.

Statista (2024). Top 10 Pharmaunternehmen nach den höchsten Ausgaben für Forschung und Entwicklung im Jahr 2022 (in Milliarden US-Dollar). https://de.statista.com/statistik/daten/studie/311837/umfrage/top-pharmaunternehmen-nach-den-hoechsten-forschungsausgaben/.