A Book Review/Summary of T. Colin Campbell’s The China Study: The Most Comprehensive Study of Nutrition Ever Conducted and the Startling Implications for Diet, Weight Loss and Long-term Health (Dallas, Texas: Benbella Books, 2004) 417 pages with references and index.
- Dan Parrott.
Introduction
The China Study is an ambitious book. It’s an autobiography of one of the world’s foremost nutrition researchers, Dr. T. Colin Campbell. It is a science text examining the complex relationship between nutrition and health. It explains the origins, the history and the implications of the groundbreaking China Study. It is also a critique of nutrition science, the food industry, the medical establishment, and government food policy. Written in the first person, Dr. Campbell speaks as a scientist, an advocate, a parent, friend and colleague.
The eponymous China Study referred to in the book has been described as “revolutionary”, “ground breaking”, a “landmark”, and as representing “the Grand Prix of epidemiology.” It was the culmination of a twenty-year partnership of Cornell University, Oxford University and the Chinese Academy of Preventive Medicine.
Dr. Campbell, in turn, is currently a Jacob Gould Schurman Professor Emeritus of Nutritional Biochemistry at Cornell University. He has received more than seventy grant-years of peer-reviewed research funding and authored more than 300 research papers.
The complexity of the book’s subject matter requires careful writing and editing. Unfortunately the autobiographical, first person conversational tone writing is not always up to the challenge. The tone, while meant to reassure a reader unfamiliar with the science, can sometimes create confusion.
For example, the overlap between Dr. Campbell as scientist and Dr. Campbell as advocate can create some confusion. Dr. Campbell, the scientist, states that the results of the China Study suggests that we “Eat a whole foods, plant-based diet, while minimizing the consumption of refined foods, added salt and fats.” Note that the results do not suggest that we eat vegan or even vegetarian. This is due in part because the Chinese subjects in the Study may have eaten small amounts of animal products. Dr. Campbell, the advocate, recommends that people adopt a vegan diet, however. Dr. Campbell sees where the scientific evidence is leading, and considers it irresponsible to wait for incontrovertible evidence before making this kind of recommendation.
Certain critics exploit this apparent discrepancy. For example, some have suggested that by urging people to adopt a vegan diet Dr. Campbell misrepresents the China Study’s results. They suggest that Dr. Campbell is being unscientific, or “ideological.” Such criticism is unwarranted. The critics have either not carefully read the text, or are in turn misrepresenting the nature of these discrepancies.
While the book can be a difficult read in parts, it will handsomely repay the reader’s efforts. The book provides a science-based strategy for avoiding the host of Western diseases that plague our society. It provides a method for evaluating food industry nutrition and health claims. It also reveals some of the sinister interplay between the food industry, government, science and medicine.
For the purpose of the review I have chosen to follow a recurring theme: How “reductionism” affects the science of nutrition. In particular, the review will describe how the science of nutrition is plagued by a scientific methodology that looks at minute parts of a problem, while often ignoring the whole. It will explain how and why this methodology creates confusion, and who benefits from it.
The review will also look at Dr. Campbell’s career. It will trace Campbell’s early years as a student of reductionism, and how he worked towards developing a wider understanding of the complex realities of health and nutrition.
Lastly, the review will look at Campbell’s Magnum Opus, the China Study, and how this Study represents a carefully constructed, scientifically based context for evaluating and understanding information regarding the connection between nutrition and health.
Scientific Reductionism
Campbell defines reductionism as the “…mistake of characterizing whole foods by the health effects of specific nutrients…. For example, the health effect of a hamburger cannot be simply attributed to the effect of a few grams of saturated fat in the meat. Saturated fat is merely one ingredient. Hamburgers also include other types of fat, in addition to cholesterol, protein and very small amounts of vitamins and minerals. Even if you change the level of saturated fat in the meat, all of the other nutrients are still present and may still have harmful effects on health. It is a case of the whole (the hamburger) being greater than the sum of its parts (the saturated fat, the cholesterol, etc.).”
In other words, scientific reductionism is a “…method of investigating details out of context.…”
The beneficiary of this of methodology is the food industry. Almost every sector uses reductionism to market products in the best possible light. For example, the meat and dairy sectors have traditionally focused on the “quality” protein content of their products, and “…the importance of high-quality protein in the diet.” For similar reasons, the Beef Information Centre also highlights iron content , while the US National Dairy Council focuses on calcium.
Variants of the animal based Standard American Diet (“SAD”) and other “fad” diets (SAD fad diets) routinely use this approach. For example, the Atkin’s New Diet Revolution focuses on eliminating carbohydrates and ingesting high-fat and high-protein foods. The South Beach Diet focuses on “good” and “bad” carbs. The Sugar Busters diet focuses on reducing sugar to cut fat. The Zone diet focuses on, “…eating the right combination of foods to reduce insulin coupled with adequate levels of Omega-3 fatty acids (EPA and DHA) that the body cannot make and are seldom found in the average diet….” The Eat Right for Your Type diet attempts to tailor peoples’ diet to their blood types. Weston A. Price Foundation claims that the path to good health is found by ingesting “…the vital fat-soluble activators found exclusively in animal fats.”
Supplement manufacturers go further by ignoring the food component altogether, suggesting that good health requires the overt focus on isolated vitamins and minerals. For example, in 1995 it was reported that people who ate more tomatoes, including whole tomatoes and tomato-containing foods like pasta sauces had a lower risk for prostate cancer. Instead of encouraging tomato consumption, marketers focused on the carotenoid lycopene, the compound that provides tomatoes their red colour. According to Campbell, soon the scientific world escalated its efforts to decipher the “lycopene magic.” By 2004, there were 1,361 scientific publications on lycopene cited by the National Library of Medicine, and a major market developing with trade names like Lycopene 10 Cold Water Dispersion and LycoVit 10% to be used as food supplements. This despite the fact that there is no evidence for a lycopene-specific effect on prostate cancer.
Fruit and vegetable producers also play this game. For example, orange producers have associated their products as being excellent sources of vitamin C. Despite this marketing strategy and while oranges are certainly healthy to eat, there are other foods with considerably more vitamin C. One cup of peppers, strawberries, broccoli or peas all have more. One papaya has as much as four times more vitamin C than one orange.
Even the organic food industry uses this approach, with a twist to be sure, suggesting that their products are more healthful for what they don’t contain, i.e. pesticides, etc.
While Campbell concedes that there is a place for reductionism in nutritional science, the marketing needs of a $700 billion per year US food industry appear to have completely dominated research agendas. As Campbell notes, “Unfortunately, this flawed way of investigating nutrition has become the norm. As a consequence, honest, hardworking, well-intentioned scientists around the world are forced to make judgments about whole dietary effects on the basis of narrowly focused studies on individual nutrients. The greatest danger is that reductionism science, standing naked from its larger environment, has come to be the gold standard. Indeed, I know many researchers who would even say that this is what defines ´good’ science.”
To paraphrase Campbell, many nutrition scientists have become de facto employees of the food industry’s marketing arm.
Campbell also suggests that the food industry’s need for reductionism has resulted in wasted resources, a myriad of confusing and contradictory experimental results, the undermining of the science, and endangerment and damage to public health. Campbell uses the Harvard School of Public Health’s (“HSPH”) famous Nurses’s Health Study (“NHS”) as a prime example.
Starting in 1976, researchers at HSPH enrolled over 120,000 nurses from around the country for a study that was intended to investigate the relationship between various diseases and oral contraceptives, post-menopausal hormones, cigarettes and other factors such as hair dyes. In 1980 the study was expanded to include dietary items. Campbell notes, “Data has now been collected for over two decades. The Nurses’ Health Study is widely known as the longest-running, premier study on women’s health. It has spawned three satellite studies, all together costing $4-5 million per year.”
The NHS suffers from flaws that seriously doom its results, however. According to Campbell, the NHS “…is the premier example of how reductionism in science can create massive amounts of confusion and misinformation, even when the scientists involved are honest, well intentioned and positioned at the top institutions in the world.”
The problem with the study is that virtually all the women in the study consume a diet very rich in animal-based foods, even richer than the average American. In Campbell’s words, “…virtually all of these nurses are more carnivorous than an average American woman. They consume very few whole, plant-based foods.” (Emphasis in original) So when these women report eating low fat, “healthy” diets, or tinker around with their level of carbohydrate, protein and other nutrient intakes, they continue eating an animal-based diet.
This flaw had a huge impact on the experimental results. Campbell summarized the NHS results as they relate to breast cancer risk: “Breast cancer risk does not rise with increased intakes of fat, meat, dairy or saturated fat. Breast cancer is not prevented by increased intakes of fruits and vegetables, or reduced by exercise (either during the teenage years or during adulthood), dietary fiber, monounsaturated fats or polyunsaturated fats. Also, the mineral selenium, long considered to be protective of certain cancers, has no effect on breast cancer. In other words, we might as well conclude that diet is completely unrelated to breast cancer.” (Emphasis in original)
In short, researchers tinkered with individual nutrients with little effect, as they systematically ignored the one unchanging background condition: The animal-based diet.
When that key background condition is taken into account, especially as it was in international studies comparing populations that mostly ate meat to populations that mostly ate plants, considerably different relationships are observed. Campbell noted Ken Carroll’s and other international studies which found that, “…the closer a population gets to consuming a plant-based diet, the lower its risk of breast cancer.”
The NHS continues to produce confusing, and sometimes contradictory results. Alcohol consumption can lower heart attack risk in men, yet increase breast cancer risk in women. Omega-3 fatty acids from fish increases breast cancer risk, while reducing the risk of sudden cardiac death in men. Egg consumption does not lead to increased risk of CHD or stroke, but suggests a possible increased risk of breast cancer.
In summary, $100’s of million have been spent to produce “…a mess of contradictory findings and lack of information on breast cancer…. It’s unfortunate that so much money has been spent to learn so little.” Campbell concluded stating, “The endless stream of confusion generated by misinterpreted reductionism undermines not only the entire science of nutrition, but also the health of America.”
Reducing Reductionism
Ironically, research like that conducted in the NHS proves one thing: “That tinkering with one nutrient at a time, while maintaining the same overall dietary patterns, does not lead to better health or to better health information.”
Unfortunately, larger more complex epidemiological studies are not easily assembled. They are expensive, require certain objective population conditions, political will, and scientists who understand reductionism’s limitations.
Campbell was such a scientist, though it took him decades to arrive at his current level of understanding, however. Part One of the book traces Campbell’s intellectual development in this regard. It starts with Campbell as a child indoctrinated with the reductionism inherent in the SAD. Campbell’s reductionism was further refined through the scientific training he received in graduate school. Fortunately, Campbell’s curiosity overcame the limitations of this approach, and he developed a more comprehensive approach to nutrition that culminated with the China Study.
Campbell’s reductionism focused on protein: “From my early years on the farm to my graduate education, I accepted this virtual reverence for protein.” Campbell remembers that as a child “We were told in school that cow’s milk made strong, healthy bones and teeth. It was Nature’s most perfect food.” A typical breakfast could include eggs, bacon, sausage, fried potatoes and ham with a couple of glasses of whole milk. Campbell also recollected that, “As a youngster, I remember that the most expensive part of farm animal feed was the protein supplements that we fed to our cows and pigs. Then, at graduate school, I spent three years (1958-1961) doing my Ph.D. research trying to improve the supply of high-quality protein by growing cows and sheep more efficiently so we could eat more of them.”
After graduate school, Campbell took a faculty position at Virginia Tech, and in 1965 began working under Professor Charlie Engel, head of the Department of Biochemistry and Nutrition. Engel was implementing a “mothercraft” self-help project in the Philippines focused on educating the mothers of malnourished children. The program aimed at reducing malnutrition by teaching mothers the right kinds of locally grown foods to feed their children. The program emphasized protein as the nutrient centerpiece, and eventually settled on peanuts as a locally grown high-protein food for the program.
Peanuts were often contaminated with a toxic fungus called aflatoxin (“AF”), however. AF was an alarming problem as it was being shown to cause liver cancers in rats. As a result, Campbell had to tackle to closely related projects: Alleviate childhood malnutrition and resolve the AF contamination problem. As a result, Campbell began his investigation and research into the relationship between AF and liver cancer.
During these initial investigations, Campbell discovered research papers suggesting that protein fed to lab rats at normal levels resulted in liver cancers. Intrigued, Campbell decided to follow up and applied to the National Institutes of Health for grants to study the “effect of various factors on aflatoxin metabolism.” Campbell noted that “A study of this protein effect on tumor development had to be done extremely well. Anything less would not have convinced anyone, especially my peers who would review my future request for renewed funding! In hindsight, we must have succeeded. The NIH funding for this study continued for the next nineteen years and led to additional funding from other research agencies (American Cancer Society, the American Institute for Cancer Research and the Cancer Research Foundation of America). On these experimental animal findings alone, this project gave rise to more than 100 scientific papers published in some of the best journals, many public presentations and several invitations to participate on expert panels.”
In the ensuing research, Campbell discovered that protein affected the development at all three cancer stages: Initiation, promotion and progression. At the initiation stage Campbell’s results suggested that the decreased enzyme activity found in a low protein diet slowed the transformation of AF into more dangerous AF metabolites that then go on to bind and mutate a cell’s DNA. Conversely, a diet high in the milk protein casein, would speed enzyme activity, thereby increasing the transformation of AF into more dangerous AF metabolites. At the promotion stage, Campbell’s demonstrated that the rate of cancer tumor foci development could be increased by increasing the amount of casein. Lastly, Campbell found that “The effects of protein feeding on tumor development were nothing less than spectacular. Rats generally live for about two years, thus the study was 100 weeks in length. All animals that were administered aflatoxin and fed the regular 20% levels of casein were dead or near death from liver tumors at 100 weeks.” In contrast, “All animals administered the same level of aflatoxin but fed the low 5% protein diet were alive, active and thrifty, with sleek hair coats at 100 weeks. This was a virtual 100 to 0 score, something almost never seen in research and almost identical to the original research in India.”
Campbell went on to conduct the same kind of research on two strains of lab mice with a transgenic hepatitis B virus (HBV) inserted in their livers. The HBV gene made these mice susceptible to liver cancer. Meanwhile, another research group at the University of Illinois Medical Center in Chicago worked on mammary (breast) cancer in rats. Together, Campbell and the Chicago group found that casein dramatically promoted:
• liver cancer in rats dosed with AF
• liver cancer in mice infected with HBV
• breast cancer in rats dosed with the experimental carcinogens DBMA and NMU
Campbell initiated further studies using several different nutrients, including fish protein, dietary fats, and the antioxidant known as carotenoids. From these studies Campbell concluded that “The results of these, and many other studies, showed nutrition to be far more important in controlling cancer promotion than the dose of the initiating carcinogen…. Furthermore, a pattern was beginning to emerge: nutrients from animal-based foods increased tumor development while nutrients from plant-based foods decreased tumor development. In our large lifetime study of rats with aflatoxin-induced tumors, the pattern was consistent. In mice with hepatitis B virus-altered genes, the pattern was consistent. In studies done by another research group, with breast cancer and different carcinogens, the pattern was consistent. In studies of pancreatic cancer and other nutrients, the pattern was consistent. In studies on carotenoid antioxidants and cancer initiation, the pattern was consistent. From the first stage of cancer initiation to the second stage of cancer promotion, the pattern was consistent. From one mechanism to another, the pattern was consistent.” (Emphasis in original)
The consistency in these results was “stunningly impressive.” There was still the question of if and how these results were relevant to human populations, however. Campbell conceded that he needed direct evidence from human research. “Ideally, this evidence would be gathered with rigorous methodology and would investigate dietary patterns comprehensively, using large numbers of people who had similar lifestyles, similar genetic backgrounds, and yet had widely varying incidences of disease.”
Such an opportunity arose in 1980 when Campbell met Chinese scientist Dr. Junshi Chen. As a result of this meeting, “We were given the chance to do a human study that would take all of these principles we had begun to uncover in the lab to the next level. It was time to study the role of nutrition, lifestyle and disease in the most comprehensive manner undertaken in the history of medicine. We were on to the China Study.”
In short, Campbell was now moving from reductionism to a dramatically expanded and comprehensive scientific methodology.
The China Study: Reductionism Put in its Place
What is so important about the China Study is its dramatic departure from the reductionism plaguing nutrition science. Where reductionism examines nutrients at a micro level, a comprehensive study like the China Study examines the interaction between diet and health at a macro or real world level.
While reductionism examines each isolated nutrient individually, the China Study sees food as a complex system of nutrients interacting dynamically with the complex biochemistry of a human population, and looks for emerging patterns or tendencies.
Ultimately, a comprehensive “landmark” study like the China Study promises to lift the science of nutrition to higher levels of clarity and understanding. A comprehensive study offers a context for scientific reductionism. In other words, research results on isolated nutrients can now be checked against larger real world patterns and tendencies. Such results can be validated if they fit larger patterns. Results that move against tendencies can be re-evaluated, or else abandoned.
Not every scientist saw the value of such a comprehensive study, however.
One of Campbell’s colleagues thought that measuring lots of factors so as to understand larger nutritional systems was nothing more than a “shotgun” approach. In response, Campbell noted, “This colleague was expressing a view that was more in line with mainstream scientific thought than with my idea. He and like-minded colleagues think that science is best done when investigating single-mostly known-factors in isolation. An array of largely unspecified factors doesn’t show anything, they say. It’s okay to measure the specific effect of, say, selenium on breast cancer, but it’s not okay to measure multiple nutritional conditions in the same study, in the hope of identifying important dietary patterns.”
“I prefer the broader picture, for we are investigating the incredible complexities and subtleties of nature itself. I wanted to investigate how dietary patterns related to disease, now the most important point of this book. Everything in food works together to create health or disease. The more we think that a single chemical characterizes a whole food, the more we stray into idiocy.” (Emphasis in the original)
In the end, the China Study produced more than 8,000 statistically significant associations between lifestyle, diet and disease variables. It’s amazing to think that this Study almost didn’t happen, and that its existence hinged on series of historical accidents and unique social conditions existing on the other side of the world.
The China Study: Redux
In the early 1970s, the premier of China, Chou EnLai, was dying of cancer. In the grips of this terminal disease, Premier Chou initiated a nationwide survey to collect information about a disease that was not well understood. It was to be a monumental survey of death rates for twelve different kinds of cancer for more than 2,400 Chinese counties and 880 million (96%) of their citizens. The end result of the survey was a color-coded atlas showing where certain types of cancer were high and where they were almost nonexistent. The Atlas also contained mortality rates for four dozen different kinds of diseases.
Campbell described the differential between localized cancer rates as “truly remarkable.” In some counties the cancer rate was up to 100 times (10,000%) higher than in others. In contrast, the US cancer rates vary at most 2 or 3 times from one part of the country to another. As China is relatively homogenous genetically this meant that the differential had to be explained by environmental causes. In other words, without this remarkable differential and the population’s genetic homogeneity, the China Study would never have happened. Such a study could never been conducted in a place like North America.
One key environmental cause was diet. In China, diets ranged from “rich in plant-based foods” to “very rich in plant-based foods.” In other words, China provided a unique opportunity to view the health effects of a plant-based diet, while at the same time providing a dietary baseline different than, say, that of a meat-based society like the US.
The Study also focused on 6500 people living in 65 counties, one half male, aged 35 to 64 years.
The Study observed that Chinese people living in urban centres were more affluent than their rural counterparts. Urban people ate a more “affluent” animal-based diet, and the resulting disease grouping of cancer, diabetes, and heart disease stood out starkly against the larger rural plant-based backdrop.
The connection between the “diseases of affluence” or “Western diseases” and animal-based diets was further strengthened by the presence of cholesterol in collected blood samples. The Study found that “…one of the strongest predictors of Western diseases was blood cholesterol.” This is not surprising in that animal-based foods correlated with increasing blood cholesterol. Campbell also noted, “With almost no exceptions, nutrients from plant-based foods were associated with decreasing levels of blood cholesterol.”
In addition, the blood cholesterol of Chinese people generally was so low, that the effects of even modest cholesterol increases were noticeable. For example, as blood cholesterol levels decreased from 170 mg/dL (at the low end by Western standards) to 90 mg/dL (an almost impossibly low level by Western standards), cancers of the liver, rectum, colon, male lung, female lung, breast, childhood leukemia, adult leukemia, childhood brain, adult brain, stomach and esophagus decreased.
The sensitivity of the blood cholesterol correlation was important in analyzing the significance of Campbell’s laboratory research on liver cancer. Surprisingly, the Study showed that rural Chinese suffered elevated rates of liver cancer. This went against the larger patterns and trends identified in the Study. Further investigation found that the rural Chinese are chronically infected with hepatitis B virus. Campbell noted that, “On average, about 12-13% of our study subjects were chronically infected with the virus. In some areas, one-half of the people were chronically infected! To put this into perspective, only 0.2-0.3% of Americans are chronically infected with this virus.” This meant that the rural Chinese were highly susceptible to liver cancer in the same way as the HBV mice mentioned earlier.
In addition, as Chinese blood cholesterol increased, albeit modestly, so did liver cancer rates. As a result, the China Study further validated the mice studies. Both confirmed the theory that, “The virus provides the gun, and bad nutrition pulls the trigger.”
So in the end, does the China Study prove that an animal-based diet causes cancer and the other diseases of Western affluence? The short answer is no. As Campbell noted, “Standing alone, it does not prove that diet causes disease.” Campbell qualifies this stating, “Absolute proof in science is nearly unattainable. Instead, a theory is proposed and debated until the weight of the evidence is so overwhelming that everyone commonly accepts that the theory is most likely true. In the case of diet and disease, the China Study adds a lot of weight to the evidence. Its experimental features (multiple diet, disease and lifestyle characteristics, and unusual range of dietary experience, a good means of measuring data quality) provide an unparalleled opportunity to expand our thinking about diet and disease in ways that previously were not available. It was a study that was like a flashlight that illuminated a path that I had never fully seen before.”
With this, Campbell concluded: “At the end of the day, the strength and consistency of the majority of the evidence is enough to draw valid conclusions. Namely, whole, plant-based foods are beneficial, and animal-based foods are not. Few other dietary choices, if any, can offer the incredible benefits of looking good, growing tall and avoiding the vast majority or premature diseases in our culture.”
The Dietary Recommendations
Campbell (the scientist) can sum the Study’s recommendations up in one line: “Eat a whole foods, plant-based diet, while minimizing the consumption of refined foods, added salt and fats.”
Occasionally eating animal products are OK, though Campbell (the advocate) suggests that, “My advice is to try to eliminate all animal-based products from your diet, but not obsess over it. If a tasty vegetable soup has a chicken stock base, or if a hearty loaf of whole bread includes a tiny amount of egg, don’t worry about it. These quantities, very likely, are nutritionally unimportant.” Also, add supplements of vitamin B12, and perhaps vitamin D for people who spend most of their time indoors, and/or live in the northern climates.
Other than that, “That’s it. That’s the diet science has found to be consistent with the greatest health and the lower incidence of heart disease, cancer, obesity and many other Western diseases.”
Dietary Recommendations Used to Treat and Cure Heart Disease
Doctors like Dr. John McDougall, Dr. Caldwell B. Esselstyn Jr., and Dr. Dean Ornish treat and cure heart disease with treatments using these dietary recommendations.
For example, Dr. Ornish’s treatment included having his patients eat a low-fat, plant-based diet for at least a year. Dr. Esselstyn’s treatment included a diet free of all added fat and almost all animal product, and later eliminated animal products altogether. Dr. McDougall is also a practitioner and advocate of a “whole-foods, plant-based approach to health.”
Treatment results are phenomenal. In Dr. Ornish’s Lifestyle Heart Trial, the 28 patients in the plant-based experimental group saw the frequency, duration and severity of chest pain plummet after only a year. “Further, it was clear that the closer the patients adhered to the lifestyle recommendations, the more their hearts healed. The patients who had the best adherence over the course of the year saw the blockages in their arteries diminish by over 4%. Four percent may seem like a small number, but remember that heart disease builds up over a lifetime, so a 4% change in only a year is a fantastic result. In all, 82% of the patients in the experimental group had regression in their heart disease over the course of a year.” (Emphasis in original)
In contrast, “The control group did not fare so well, despite the fact that they received the usual care. Their chest pain became worse in terms of frequency, duration and severity. For example, although the experimental group experienced a 91% reduction in the frequency of chest pain, the control group experienced a 165% rise in the frequency of chest pain. Their cholesterol levels were significantly worse than those of the experimental patients, and the blockages in their arteries also became worse. The patients in the group who were the least attentive to diet and lifestyle changes had blockages that increased in size by 8% over the course of the year.”
In summary, “There are no surgical or chemical heart disease treatments, at the Cleveland Clinic or anywhere else, that can compare to these impressive results.”
The medical profession has coldly received these results. The reasons appear to be partly economic and partly professional. On the economic side, heart disease is big business. “In 2002, physician services and hospital care for heart disease patients cost $78.1 billion (that does not include drug costs, home health care, or nursing home care). The angioplasty procedure alone costs $31,000 and by-pass surgery costs $46,000.” At the hospitals where Dr. McDougall and Dr. Esselstyn practiced, the percentage of each hospital’s income from traditional heart disease treatments (surgery, etc.) was 80% and 65% respectively.
On the professional side, these nutritional treatments seem like a demotion from high ranking heart surgeon to humble nutritionist. Heart surgeons also fear patients learning about these plant-based dietary treatments. According to Dr. McDougall, “They (heart surgeons) were worried about what would happen when their patients would to see me, and it happened all the time when patients would come on their own. They’d come to me with heart disease or high blood pressure or diabetes. I’d put them on the diet and they’d go back off all their pills and soon their numbers would be normal. They’d go back to their doctor and say, ‘Why did you let me suffer, spend all this money, almost die, when all I had to do was eat oatmeal?’ The doctors didn’t want to hear this.”
And while heart surgeons fear their patient learning about these treatments, this hasn’t stopped those surgeons with heart disease from undertaking treatment and lifestyle counseling. “Just as with Dr. McDougall, many of (Esselstyn’s Cleveland) Clinic “bigwigs” with heart disease have themselves gone to Essselstyn for treatment and lifestyle counseling. They know it works, and they seek out the program on their own.”
Lastly, the China Study’s dietary recommendations show similar promise in the treatment and prevention of other Western diseases: Obesity, diabetes, cancers, autoimmune diseases, etc.
Conclusion
The China Study stands as an indictment of the harm caused by the overblown reductionism in the service of SAD. The result of this flawed methodology and those that profit from it, is that Western society is rife with diet-related illness and disease. Cancer, heart disease, obesity, diabetes have all reached epidemic proportions. People in this society are dying prematurely in droves, often after suffering painful, lingering illnesses.
For now, the meat and dairy industry appear satisfied to place Dr. Campbell on a “dangerous” research watch list , and hope that his book is drowned out by the volume of better publicized books and studies.
The medical profession’s response is to push the issue to the margins. Their current approach to nutrition appears to be the same as their approach to smoking cigarettes 50 years ago.
Some of the SAD fads have noisily weighed in with criticisms of Campbell and the Study. Some of it is bitter and ad hominem, suggesting that Campbell deliberately misrepresented the Study’s findings because as a vegan, that he is ideologically motivated and that he has connections to the animal rights movement. Campbell is hardly a zealot, however. Campbell became vegan after the Study’s main results came in , and many of his earlier experiments involved the necessary evil of lab animal testing.
Other criticism relies on reductionism, alleging that Campbell overlooked this or that protein, that he misrepresented some variable or other. This criticism rings particularly hollow when doctors like McDougall, Ornish and Esselstyn essentially use the study’s recommendations to successfully treat patients with heart and other disease.
And so no good deed goes unpunished as the system marginalizes scientists like Campbell, McDougall, Ornish and Esstelstyn. It will be up to the public to make these ideas known and to bring them mainstream. Thankfully this can be easily done, especially by following one relatively simple set of directions: “Eat a whole foods, plant-based diet, while minimizing the consumption of refined foods, added salt and fats.” Or, even better, go vegan.
That’s it.
Notes
The China Study: The Most Comprehensive Study of Nutrition Ever Conducted and the Startling Implications for Diet, Weight Loss and Long-term Health by (Dallas, Texas: Benbella Books, 2004) at 242
For example, see Chris Masterjohn’s review at http://www.westonaprice.org/bookreviews/chinastudy.html#author
Ibid. at 271.
Ibid. at 287
http://www.beefusa.org/NEWSCattleIndustrySummerConferencesetforJuly16-2031113.aspx
As found at http://www.beefinfo.org/bh_iron.cfm
As found at http://www.nationaldairycouncil.org/NationalDairyCouncil/Nutrition/Nutrients/calciumCounselingPage1.htm
http://www.zoneliving.com/ZoneScience/TheSciencebehindtheZone/tabid/72/Default.aspx
http://www.westonaprice.org/splash_2.htm
Supra note 3 at 301
Ibid. at 287
Ibid. at 272
Ibid.
Ibid. at 274
Ibid. at 281
Ibid. at 275
Ibid. at 281
Ibid. at 282
Ibid. at 282
Ibid. at 281
Ibid. at 288
Ibid. at 281
Ibid. at 31
Ibid. at 4
Ibid. at 11
Ibid. at 31
Ibid. at 33
Ibid. at 48
Ibid. at 52
Ibid. at 54
Ibid. at 61
Ibid.
Ibid. at 66
Ibid. at 67
Ibid.
Ibid. at 105
Ibid. at 73
Ibid. at 70
Ibid. at 75
Ibid. at 71
Ibid. at 72
Ibid. at 75
Ibid. at 354
Ibid. at 77
Ibid. at 80
Ibid. at 78
Ibid. at 104
Ibid. at 104
Ibid. at 107
Ibid. at 242
Ibid. at 242
Ibid. at 129
Ibid. at 126.
Ibid. at 329
Ibid. at 130
Ibid. at 130
Ibid. at 130
Ibid. at 131
Ibid. at 336
Ibid. at 340
Ibid. at 291
Chris Masterjohn’s review at http://www.westonaprice.org/bookreviews/chinastudy.html#author; other such reviews can be viewed at www.amazon.com on the page selling this book.
Ibid. at 107
Ibid. at 48