Nutrition & Cancer: The China Study

[cbish]

Does anyone know anything about a book called The China Study by T. Colin Campbell? It compares the dietary habits of China with the Western World. Campbell claims that 80-90% of disease is caused by diet; specifically animal protein.

[brettDbass]

It has it's own website (http://www.thechinastudy.com/about.html).

[cbish]

I saw the website and I've read parts of the book and some cliff note versions on the web.

The reason I ask is that I have a neighbor who is a total organo-vegan and he's constantly trying to convince me his diet is superior. He knows I'm a skeptic and has to come well armed, so he brought me this book.

It seems like a well documented survey. I understand that there are links to diet and some diseases such as heart disease. I understand that a balanced diet is essential. There just seems to be some red flags with this.

He amits he has gone "outside the box" and he rejects reductionism as a scientific epistemiology. He admits to having some holistic tendancies. It seems a little conspiratorial to me.

[The Don]

The 80-90% sounds like complete garbage unless you define disease as "that which can be attributed to dietary deficiencies".

All congenital diseases (say haemophilia) are entirely independent of diet.

Diseases which can be attibuted to either viruses or bacteria are also not caused by diet. Perhaps the length and severity of symtoms etc. can be affected by diet but whether or not you are infected in the first place - I think not.

There are plenty of diseases where diet can be a factor, say coronary heart disease but there are always some individuals who seem to dodge the bullet.

[cbish]

As mentioned, this book has red flags all over for me. The relationship with diet and coronary-artery disease is well documented. He claims nutrition also has a major role in cancer and some types of diabetes. He claims that high cholesterol is the cause of cancer (specifically, liver and colorectal cancer). He claims that cancer is caused by by-product of protein metabolism; specifically of animal protein. He exhaustively cites studies and surveys of Asian and western populations and their disease rates and diets.

My gut reaction? Correlation without Causation.

I need to read those sections of the book that address these claims. So far, I see alot of graphs showing linear relationships but no mention of cause or exactly what molecules of amino acid break down are carcinogenic.

[casebro]

I don't think major studies show any great advantage to vegetarianism. Shouldn't they show a 90% drop in cancer deaths? Also 90% drop in diabetes? And a 90% drop in heart disease, leading to a HUGE increase in life expectancy.... Nope, I just don't see it.

[The_Serpent]

I don't think major studies show any great advantage to vegetarianism. Shouldn't they show a 90% drop in cancer deaths? Also 90% drop in diabetes? And a 90% drop in heart disease, leading to a HUGE increase in life expectancy.... Nope, I just don't see it.

I am currently reading this book. I would note that through the book so far, campbell is slowly building his case starting with his early work with mice and liver cancer through to the exhaustive and massive China study. When he ventures off the path into speculation I have found that he notes that is what he is doing and says why he is doing so. He is also very careful to note the level of statistical significance in correlations, which is very very refreshing in a book that people might (mis)label as a 'diet book'.

As mentioned above. You should see 90% drop in diabetes, cancer, and heart disease incidence among people who eat little no no meat, which is exactly the case. I am not really the typical read of this book, because I started with the actually data from the china study itself, looked at the patterns that I could see and then heard there was a book on the subject. It is quite obvious that there are two sets of diseases in our world: Diseases of affluence that effect the western world and diseases of poverty that effect the 'third' world. The diseases of affluence: cancer, diabetes (type one and two) and heart disease are virtually absent in populations where the people eat a predominantly plant based diet.


He claims that high cholesterol is the cause of cancer (specifically, liver and colorectal cancer). He claims that cancer is caused by by-product of protein metabolism; specifically of animal protein..

That's not what I read. Campbell mentions cholesterol as a contributing factor in these diseases, but to say that he says that it's the 'cause of cancer' seems to me to be deliberately misrepresenting his argument. He also does not say that cancer is 'caused' by animal protein at all. He says that (and this is a dumbed down over simplified version) having animal protein in your body makes it easier for cancer causing agents such as radiation or chemicals to cause lasting damage to cells further that protein then feeds those cancer cells, making the promotion stage of cancer growth far more efficient... in essence: Eating animals doesn't cause cancer, it just aids and abets it.

That said, the critiques I have read so far suggest that campbell does not present an iron clad case for veganism per se. The leap from very little meat (which are the populations the china study finds to have the lowest rates of affluence diseases eat less than 5% animal foods, but still eat some) to ZERO animal products is not as trivial as Campbell supposedly makes it seem. I have not made it that far in the book yet, but I am interested to know how he makes that case.

I personally, am a Vegan, becoming one mostly because my wife did about a year and a half ago. I am not an activist or a commie. I am a male American in my 30s and my cholesterol is 70 according to a test about 2 weeks ago. Unfortunately I don't know what it was before I became a vegan, but I can say that both my mother and my father are taking cholesterol lowering medication to (hopefully) lower their risk of heart attack and stroke. I do not include this to convince you my fellow skeptics, as it is anecdotal, merely so you understand why I became acutely interested knowing about the relative health of a vegan diet and any literature on what effect it might have on me... I also wanted to know if a 70 cholesterol was going to hurt me, as my doctor immediately wanted to put me on cholesterol raising drugs. From what I have read so far, I am glad I decided against it.

In end I am beginning to simply see meat eating as a natural selection mechanism. Let the rest of them eat their meat and cheese and icecream and get cancer and diabetes and have heart attacks and strokes. If only the insurance actuaries took my diet into account, I wouldn't even have to pay for everyone else's slow self-induced deaths.

[Hellbound]

Actually, many of these diseases (cancer and heart disease, specifically), increase in a population as the length of life increases. Cacner and heart disease rates are very low in some primitive areas, simply because peopel die of other diseases/wounds/infections/starvation before these diseases take hold. Cancer, in particular, has become much more common in the past decade as lifespans have gotten increasingly longer.

Also, there are issues of correct diagnosis, depending on the level of health care available.

From your description, it sounds as if this was a country-to-country comparison, which leaves literally hundreds of uncontrolled factors in the statistics.

Any mention of how these effects were controlled for? If not, then I'd suggest that the statistical data is worth slightly less than a good roll of Charmin towards proving the hypothesis.

[scotth]

Any mention of how these effects were controlled for? If not, then I'd suggest that the statistical data is worth slightly less than a used roll of Charmin towards proving the hypothesis.

There, that is much better.

[/humor]

If one wants to see the effects of diet, a comparison should be done between groups that are statistically equivilant except for diet.

[The_Serpent]

The comparisons in this book are not built on some country to country slapdash numbers, it is built on (surprise!) The China Study: a 15+ year cross disciplinary cross institutional effort to document what people eat, how they die, how long they live etc. ad nauseum in all parts of China. Yes, life expectancy is taken into account, yes the fact that people in rural areas tend to suffer from intestinal parasites and other diseases that effect people in poor living conditions is taken into account. They would measure their biometric data often in more than 10 different ways! Read the book, or better, read the China study itself. It has a great wealth of information.

[cbish]

Here are some critical critiques.
http://www.cholesterol-and-health.com/China-Study.html
http://www.beyondveg.com/billings-t/comp-anat/comp-anat-8e.shtml#china%20proj

[Silly Green Monkey]

I hate to break this to you, but we actually are filled with animal protein all the time, regardless of how much we eat. We are made of animal protein.

[Jorghnassen]

I hate to break this to you, but we actually are filled with animal protein all the time, regardless of how much we eat. We are made of animal protein.

Not to mention that we are made of those evil things called chemicals too :D...

[The_Serpent]

I hate to break this to you, but we actually are filled with animal protein all the time, regardless of how much we eat. We are made of animal protein.

That is a really funny comment. Is this actually serious or are you just insinuating I do not know what animal protein is to make me look foolish?

Lets assume for a moment this was a serious comment and respond accordingly: Cows are made of animal protein too, but they don't eat it. Chimpanzees are also made of animal protein and their diet consists of almost no animal protein (mostly bugs, with the very rare bit of meat). Obviously being made of animal protein doesn't mean it is what you need to eat or what you should eat.

If I do a study on mice and give these mice an extremely potent cancer causing agent, then I feed half those mice 20% animal protein and the other half 5% animal protein and after a year ALL the 20% mice are dead of cancer, and the 5% mice are tumor free. It is safe to say this is a strong effect and should warrant further study. The China Study is the end result of that further study.

[cbish]

Serpent,
Did you check out my links?

[The_Serpent]

Serpent,
Did you check out my links?

Yes I did. Did you you read the study? Did you read the book about the study?

I would warn against forming an opinion solely from a critique, I would hope that you would not do so. I for instance would not judge whether to buy a Toyota based solely on a writeup from someone at GM.

That said, the most salient point in the critiques you posted that I noticed was the one I already mentioned above... that many suggest that campbell does not do much if anything to prove his assertion (which he notes is not supported by the data) that a 0% animal diet is better than a < 5% animal diet. That sort of data will only come when enough people who eat like I do are studied. The problem is, there are very very few Vegans and our numbers are growing relatively slowly so I bet it will take a long time to get any hard longitudinal data on how healthy it is (if it is ever possible). All I can do is tell you my cholesterol is 70, I dropped all my excess fat, I rarely get sick, and I feel great, but that is all just anecdotal and no one will (or should, really) listen to it.

Just go on eating hotdogs and beef and fish and ice-cream and drinking milk. Like I said before, if I am lucky the insurance industry will catch up and I will not have to pay for all of you... as long as we do not have socialized medicine in the US anyway. Even better, I should start sinking some more money into the pharma and medical industries, the fallout from the recent Atkins diet craze alone should line my pockets nicely in the next twenty years. =):

[cbish]

I would warn against forming an opinion solely from a critique, I would hope that you would not do so. I for instance would not judge whether to buy a Toyota based solely on a writeup from someone at GM.

That said, the most salient point in the critiques you posted that I noticed was the one I already mentioned above... that many suggest that campbell does not do much if anything to prove his assertion (which he notes is not supported by the data) that a 0% animal diet is better than a < 5% animal diet.

Just go on eating hotdogs and beef and fish and ice-cream and drinking milk.

I'm forming an opinion based on the book, Campbells website cited above, and the critiques. Was there anything in the critiques you find objectionable?

See, I'm not anti-vegan. I'm probably 90% vegan myself. The second part of your statement really, really bothers me, though. Perhaps Campbell didn't intend to present his information this way, but this book is being interpreted, by some, as being scientific. It's not. That's what bothers me. I don't care what the topic is, I don't like cherry picked info being interpreted as the Holy Grail. I think this type of thing hinders the very topic they're trying to promote.

I like milk, and I had a hotdog and a beer at the A's game last night! And if you come over for BBQ, I have this great polenta stuffed portebella recipe you have to try!

[casebro]

Just like my 87 year old father, I'm probably 70% Vegan...and the other 30% is the flesh of Vegan animals. He's doing fine, I had a heart attack at 49. My guess is it's all genetics from my mothers side, very little to do with diet.

[ChristineR]

Here are some critical critiques.
http://www.cholesterol-and-health.com/China-Study.html
http://www.beyondveg.com/billings-t/comp-anat/comp-anat-8e.shtml#china%20proj

I'm not completely convinced by the China Study, but are those the best critiques you found? Those are garbage sites!

[cbish]

Well, there isn't alot of info out there apparently. No I haven't found alot of info. Garabage sites? So, what's your objection to the sites?

[ChristineR]

Well, cholesterol-and-health claims that all those studies showing that a low fat diet prevents heart disease are false and urge you to gorge on bacon and eggs.

Beyond Veg I don't know very well, but it appears to be mostly testimony from fruititarians and largely discredited myths about the paleolithic diet.

[cbish]

With the cholesterol site, I saw that. It seemed to me their position was that the cholesterol data was exaggerated. The other one seemed to be OK. The guy is a mathmatician and seems to be more interested in statistic validity.

anyway, was there anything in the actual critiques themselves that was wrong, incomplete, misleading?

[ChristineR]

I honestly don't know enough about the China Study to say how valid its conclusions are. Some of the claims do seem to be weak, but it's easy to mine data one way or the other--which doesn't mean that there isn't a best way to interpret the data. I do know that plenty of people who know what they are talking about have praised the book.

On one site there's this comment:

It isn't uncommon for researchers to claim they found one thing while their own study says they found another. Too often, researchers put the real data in the full text, but then freely contort it to fit their own ideas when they write in the summary. And then doctors, other researchers, and journalists will rely on the summary alone, simply because there are so many studies!

which sounds to me like "we finagled the data and got the conclusions we wanted, and we're complaining about people who don't agree with us."

The Beyond Veg site has some fairly convincing arguments, but I don't feel qualified to judge them. But the more I look around on that site the stronger I feel that it's not a reliable source.

[cbish]

1)On one site there's this comment:



which sounds to me like "we finagled the data and got the conclusions we wanted, and we're complaining about people who don't agree with us."

2) The Beyond Veg site has some fairly convincing arguments, but I don't feel qualified to judge them. But the more I look around on that site the stronger I feel that it's not a reliable source. The numbers are my addition.

#1. I interpret that quote as saying "here's our conclusion and the media has simplified/misinterpreted to the point that that's not what we said."

#2 You don't feel qualified to judge them yet it's not a reliable source? You lost me. Didn't you just make a judgment?

Anyway, the problem I have is that this "study" is being interpreted, right or wrong, as being a valid/definative source of information. Perhaps we should shift topic. Consider Herbal Remedies for example. I'm sure you could find a book that relates eating sea weed to the same health issues (isn't there a infomercial floating out now on this topic). As skeptics, shouldn't we be skeptical or at least investigate all the information? I'm skeptical of the China Study. Not that there isn't correlation in diet. But I'm skeptical as to the degree. I'm skeptical that Serpents diet is superior to mine. Nor, mine to his.

[Dogdoctor]

When I first read this I was thinking it was going to be about this study
http://patient.cancerconsultants.com/esophageal_cancer_news.aspx?id=17550
But it turns out to be published in a non scientific journal or maybe just in a book?

[cbish]

Yep, a book! with many citations to journals. Interesting link. Will investigate further.

[ChristineR]

The numbers are my addition.

#1. I interpret that quote as saying "here's our conclusion and the media has simplified/misinterpreted to the point that that's not what we said."

#2 You don't feel qualified to judge them yet it's not a reliable source? You lost me. Didn't you just make a judgment?

Anyway, the problem I have is that this "study" is being interpreted, right or wrong, as being a valid/definative source of information. Perhaps we should shift topic. Consider Herbal Remedies for example. I'm sure you could find a book that relates eating sea weed to the same health issues (isn't there a infomercial floating out now on this topic). As skeptics, shouldn't we be skeptical or at least investigate all the information? I'm skeptical of the China Study. Not that there isn't correlation in diet. But I'm skeptical as to the degree. I'm skeptical that Serpents diet is superior to mine. Nor, mine to his.

Sorry, I could have been clearer.

The problem with #1 is that just about everybody else on the planet interprets the data (not of the China study, but in general) to mean "cholesterol is bad for you." If you're bound and determined to prove cholesterol is good for you, you can pick around and shift around until you get the result you want. Clearly it can get pretty complicated (there are plenty of circumstances where animal food can be good for you) but that doesn't justify the blanket conclusion that we should eat as much of it as possible.

This is why I don't take Cholesterol-and-Healths claims seriously, even though in general they are correct in warning us to watch for subjectively interpreted data.

#2 I haven't read the China Study book, but I have read some reviews of it, mostly positive stuff on veg sites. The respected veg doctors like it. Now some of the criticisms sound to me like they could be valid. For example, the claim that Campbell used aggregate data from 65 villages rather than the original data points (of which there were many). So I find myself asking questions like "Why they do that?" "How much variation was in the original data?" "Can Campbell draw conclusions from the aggregate data?" and the answer I get is maybe. It would take some serious statistics to decide whether or not Campbell's claims are valid, and I'm not the person to do it.

That's what I mean by not being able to judge.

Now as for the usefulness of Beyond Veg's arguments, they may in fact be statistical experts who have uncovered the flaw in The China Study. But everything else I've seen on their site is romantic, poorly analyzed, ad hominim, full of straw men, and just generally a lot obscurantist rhetoric.

So I mean that for someone like me who isn't qualified to judge the statistics in The China Study, I would absolutely not take Beyond Veg's as an authoritative opinion.

Now when I come to this page (http://www.thechinastudy.com/praise.html) I see a lot of positive comments on The China Study from people with very good reputations, people who really have a chance of knowing whether or not the statistics are flakey. If the only serious critiques of the study out there are those two, then that seems like evidence that the statistical analysis in the study probably is pretty good. Really, I'd expect more conservative nutritionists to be all over this thing.

[Dogdoctor]

Concerning China and diet and cancer, a while back there was a town in China where there was a very high rate of esophageal cancer. Medical personnel there determined that they may have a lot of selenium deficiencies because the locals ate the local produce and the soil was deficient in selenium. They offered supplemental selenium and the esophageal cancer rate dropped markedly. I don't believe there was a scientific study done from that but because of that selenium deficiency was studied and shown to be related to esophageal cancer. It is true that diet has been associated with many diseases. He may be overstating the claims but I am fairly certain that diet is really important in every aspect of health. However using a non-science book as a reference is kind of bozo.

[axon]

That is a really funny comment. Is this actually serious or are you just insinuating I do not know what animal protein is to make me look foolish?

It does seem that way given your next sentence.

Lets assume for a moment this was a serious comment and respond accordingly: Cows are made of animal protein too, but they don't eat it. Chimpanzees are also made of animal protein and their diet consists of almost no animal protein (mostly bugs, with the very rare bit of meat).

Proteins tend to be digested in the stomach into their constituent amino acids. These are the same amino acids that plant proteins are made of.

[Morrigan]

I personally, am a Vegan, becoming one mostly because my wife did about a year and a half ago. I am not an activist or a commie.

Okay. But...

Let the rest of them eat their meat and cheese and icecream and get cancer and diabetes and have heart attacks and strokes. If only the insurance actuaries took my diet into account, I wouldn't even have to pay for everyone else's slow self-induced deaths.
You sure are a condescending, holier-than-thou twat, though. :P

[trvlr2]

Sorry! BZZZZT! PETA???? Those People Eating Tasty Animals??
Well, that stopped ME!

[Ducky]

<snip> Let the rest of them eat their meat and cheese and icecream and get cancer ...


Please explain how eating meat and cheese and icecream causes cancer. Specifically, how digestion of protein effects faulty mitosis, and also, please be very specific which cancers this causes (ie. does it cause Multiple Myeloma, Breast Cancer, Liver cancer, what?).

If you have a peer reviewed published paper for me to review on the subject I welcome the chance to read it.

[Dogdoctor]

Lets assume for a moment this was a serious comment and respond accordingly: Cows are made of animal protein too, but they don't eat it. Chimpanzees are also made of animal protein and their diet consists of almost no animal protein (mostly bugs, with the very rare bit of meat). Obviously being made of animal protein doesn't mean it is what you need to eat or what you should eat.


Cows may not eat much animal protein but they digest a lot of it. They have a rumen where many protozoa grow and they digest those one celled animals. The amount of animal source food that Chimpanzees eat probably depends on the availability of those food sources. I am not sure the frequency of Chimpanzees eating animal source protein but I know it is likely they consume them regularly and are in the more than 0 to 5% or less animal protein category. Yes it is obvious that many animals don't eat much animal source proteins but most of them grow them in their gut. In addition much vegetation has minute animals on them so it is impossible for an animal to be a strict vegetarian.

[Hardenbergh]

I am currently reading this book. I would note that through the book so far, campbell is slowly building his case starting with his early work with mice and liver cancer through to the exhaustive and massive China study. When he ventures off the path into speculation I have found that he notes that is what he is doing and says why he is doing so. He is also very careful to note the level of statistical significance in correlations, which is very very refreshing in a book that people might (mis)label as a 'diet book'.

As mentioned above. You should see 90% drop in diabetes, cancer, and heart disease incidence among people who eat little no no meat, which is exactly the case. I am not really the typical read of this book, because I started with the actually data from the china study itself, looked at the patterns that I could see and then heard there was a book on the subject. It is quite obvious that there are two sets of diseases in our world: Diseases of affluence that effect the western world and diseases of poverty that effect the 'third' world. The diseases of affluence: cancer, diabetes (type one and two) and heart disease are virtually absent in populations where the people eat a predominantly plant based diet.



That's not what I read. Campbell mentions cholesterol as a contributing factor in these diseases, but to say that he says that it's the 'cause of cancer' seems to me to be deliberately misrepresenting his argument. He also does not say that cancer is 'caused' by animal protein at all. He says that (and this is a dumbed down over simplified version) having animal protein in your body makes it easier for cancer causing agents such as radiation or chemicals to cause lasting damage to cells further that protein then feeds those cancer cells, making the promotion stage of cancer growth far more efficient... in essence: Eating animals doesn't cause cancer, it just aids and abets it.

That said, the critiques I have read so far suggest that campbell does not present an iron clad case for veganism per se. The leap from very little meat (which are the populations the china study finds to have the lowest rates of affluence diseases eat less than 5% animal foods, but still eat some) to ZERO animal products is not as trivial as Campbell supposedly makes it seem. I have not made it that far in the book yet, but I am interested to know how he makes that case.

I personally, am a Vegan, becoming one mostly because my wife did about a year and a half ago. I am not an activist or a commie. I am a male American in my 30s and my cholesterol is 70 according to a test about 2 weeks ago. Unfortunately I don't know what it was before I became a vegan, but I can say that both my mother and my father are taking cholesterol lowering medication to (hopefully) lower their risk of heart attack and stroke. I do not include this to convince you my fellow skeptics, as it is anecdotal, merely so you understand why I became acutely interested knowing about the relative health of a vegan diet and any literature on what effect it might have on me... I also wanted to know if a 70 cholesterol was going to hurt me, as my doctor immediately wanted to put me on cholesterol raising drugs. From what I have read so far, I am glad I decided against it.

In end I am beginning to simply see meat eating as a natural selection mechanism. Let the rest of them eat their meat and cheese and icecream and get cancer and diabetes and have heart attacks and strokes. If only the insurance actuaries took my diet into account, I wouldn't even have to pay for everyone else's slow self-induced deaths.

Your total cholesterol is only 70? This is certainly a good advertisement for vegetarianism although you said that you just became a vegan a year and a half ago. I suspect that your cholesterol level must have been low even before you began your vegan diet.

I realize that a hereditary predisposition for elevated cholesterol can increase the risk regardless of your diet. I'm not vegetarian and my cholesterol is about 260 when it was last checked about two years ago. My mother has high cholesterol. I'm not on cholesterol lowering drugs.