I woke up one morning last week to a bunch of emails from random people, all suggesting that I check out the same article. A really smart and thorough girl wrote a critique of The China Study which resonated with me. I've been sent a few critiques of the China Study before, but none of them were compelling, unlike Denise's.
I may have an ego about some things, but diet isn't one of them; it's too important. I'm happy to be wrong about what I eat if it means that I can improve my diet, and thus improve my health and my longevity. So I read the critique carefully and left it thinking that I'd likely start eating meat again.
I don't have the time or inclination to become an expert on diet. It takes a lot of time and focus, and the research just isn't interesting enough to me. So instead, like many other fields, my approach is to find the person who seems to be the most knowledgeable and follow their lead. Until I read the critique, that person was T Colin Campbell, author of The China Study.
T Colin Campbell is an easy choice because the China Study is the biggest study on human health ever conducted, and he was one of the scientists who conducted it. I'm not sure what sort of credentials could exceed that.
Still, experts can be wrong. I emailed Dr. Campbell to ask his opinion on her piece. He read it and replied with this, which I have been given permission to publish here:
I don't have time to review every comment but did quickly scan the text. This analysis seems very impressive, especially given the writer's young age with no training in nutritional science (see her web page).
She claims to have no biases--either for or against--but nonetheless liberally uses adjectives and cutesy expressions that leaves me wondering.
As far as her substantive comments are concerned, almost all are based on her citing univariate correlations in the China project that can easily mislead, especially if one of the two variables does not have a sufficient range, is too low to be useful and/or is known to be a very different level of exposure at the time of the survey than it would have been years before when disease was developing. There is a number of these univariate correlations in the China project (associations of 2 variables only) that do not fit the model (out of 8000, there would be) and most can be explained by one of these limitations.
A more appropriate method is to search for aggregate groups of data, as in the 'affluent' vs. 'poverty' disease groups, then examine whether there is any consistency within groups of biomarkers, as in considering various cholesterol fractions. This is rather like using metanalysis to obtain a better overview of possible associations. I actually had written material for our book, elaborating some of these issues but was told that I had already exceeded what is a resonable number of pages. There simply were not enough pages to go into the lengthy discussions that would have been required--and I had to drop what I had already written. This book was not meant to be an exhaustive scientific treatise. It was meant for the public, while including about as much scientific data and discussion that the average reader would tolerate.
She also makes big issues out of some matters that we had no intent to include because we knew well certain limitations with the data. For example, only 3 counties (of the 65) consumed dairy and the kind of dairy consumed (much of it very hard sun-dried cheese) was much different from dairy in the West. It makes no sense to do that kind of analysis and we did none, both because of the limited number of sample points and because we discovered after the project was completed that meat consumption for one of the counties, Tuoli, was clearly not accurate on the 3 days that the data were being collected. On those days, they were essentially eating as if it were a feast to impress the survey team but on the question of frequency of consumption over the course of a year, it was very different. Still, the reviewer makes a big issue of our not including the data for this county as if I were being devious.
In short, she has done what she claims that should not be done--focusing on narrowly defined data rather than searching for overarching messages, focusing on the trees instead of the forest.
I very carefully stated in the book that there are some correlations that are not consistent with the message and, knowing this, I suggested to the reader that he/she need not accept what is said in the book. In this very complex business it is possible to focus on the details and make widely divergent interpretations but, in so doing, miss the much more important general message. In the final analysis, I simply asked the reader to try it and see for themselves. And the results that people have achieved have been truly overwhelming.
One final note: she repeatedly uses the 'V' words (vegan, vegetarian) in a way that disingenuously suggests that this was my main motive. I am not aware that I used either of these words in the book, not once. I wanted to focus on the science, not on these ideologies.
I find it very puzzling that someone with virtually no training in this science can do such a lengthy and detailed analysis in their supposedly spare time. I know how agricultural lobbying organizations do it--like the Weston A Price Foundation with many chapters around the country and untold amounts of financial resources. Someone takes the lead in doing a draft of an article, then has access to a large number of commentators to check out the details, technical and literal, of the drafts as they are produced.
I have no proof, of course, whether this young girl is anything other than who she says she is, but I find it very difficult to accept her statement that this was her innocent and objective reasoning, and hers alone. If she did this alone, based on her personal experiences from age 7 (as she describes it), I am more than impressed. But she suffers one major flaw that seeps into her entire analysis by focusing on the selection of univariate correlations to make her arguments (univariate correlations in a study like this means, for example, comparing 2 variables--like dietary fat and breast cancer--within a very large database where there will undoubtedly be many factors that could incorrectly negate or enhance a possible correlation). She acknowledges this problem in several places but still turns around and displays data sets of univariate correlations. One further flaw, just like the Weston Price enthusiasts, is her assumption that it was the China project itself, almost standing alone, that determined my conclusions for the book (it was only one chapter!). She, and others like her, ignore much of the rest of the book. Can any other diet match the findings of Drs. Esslestyn, Ornish and McDougall, who were interviewed for our book (and now an increasing of other physicians have done with their patients)? No diet or any other medical strategy comes close to the benefits that can be achieved with a whole foods, plant based diet.
I also know that critics like her would like nothing better than to get me to spend all my time answering detailed questions, but I simply will not do this. As we said in our book, no one needs to accept at face value what I say. Rather, as we said in the book, "Try it" and the results will be what they are. So far, the reports of positive benefits have been nothing less than overwhelming.
I hope this helps, although it was written in haste.
I also heard back from Denise. She very reasonably cautioned me against changing my diet based only on her critique, unless I was having problems as a vegan, and added this:
He's absolutely right that I only posted univariate correlations -- in fact, an epidemiologist pointed this out as well as a flaw in my analysis -- but what I posted was nowhere near the full extent of my data-crunching. [...] I ran multiple variable regressions on the data and it not only confirmed what I demonstrated through simpler graphs, but actually revealed more pronounced inverse relationships between animal foods and diseases (especially heart disease). I'll be compiling the results of the MRAs I ran, since it seems to be a sore point and perceived weakness in my critique, and posting them in a future blog entry.
So here's what I think about everything:
I think I have to trust that Dr. Campbell is the authority on the subject. As he said, with so many correlations, there well always be outliers. That's the truth of any large survey or study, and to expect otherwise is unreasonable. Denise doesn't purport to have studied the entire data, so no matter how much I respect her work, as both she and Dr. Campbell agree, it's not necessarily wise to base a diet change on it.
That said, I don't believe that Denise has any connection with the dairy industry, and I wish Dr. Campbell didn't accuse her of it. She appears to be nothing but genuine to me (and doesn't eat dairy herself). Even if she was associated, I think it's irrelevant. Reasoning stands independent of affiliation. Denise also wrote a response to this point, but in the interest of keeping things as succinct as possible and focusing on the science, I've left it out.
Dr. Campbell is sometimes accused of making rather obvious mistakes or having an agenda. I don't believe that this is true either. I've had the fortune of knowing a lot of people in positions of high accomplishment and have universally found such conspiracy theories to be false. Fakes and people prone to gross oversight just don't make it that far.
Maybe the most important factor is this: there isn't a perceptible downside to eating a healthy vegan diet. I've tracked my diet meticulously over multi-day periods and found that I exceed, often drastically, all required nutrients. Beyond that, I feel as good as I ever had eating my diet, although I will admit that I have felt equally excellent when eating meat. Sugar and flour, on the other hand, are certainly dangerous and negatively affect how I feel.
So I remain a healthy vegan. Other than my twice monthly meat-meals (which fall under the 5% admitted by Dr. Campbell as not affecting health), I only eat whole plant based foods. No flour, no sugar. If you're new to how I eat and my reasoning, read this post about the Max Diet.
I think Campbell's response was appropriate and not unprofessional at all. We are all human and have our breaking points when being attacked. Minger essentially attacked this man's credibility. It is so easy to sit and judge a person's reaction, how would you have handled it? As far as this senseless debate, all I have to say is one thing: Make up your own minds. Do what works for you.
campbell's response, half of it anyway, questions the creditials and identity of denise. odd, no? after all, what do her creditials or identity have to do with her arguments, none of which were, conveniently, addressed by campbell. oh well.... i guess if you can attack someones "real" identity because you find it hard to believe that a common joe can think on such a high level, you don't have the obligation of addressing their criticisms... and so it goes...
It may seem like a pointless ad hominem argument, but in the realm of scientific research credentials and identity are very important. They are a way of establishing that you are who you say you are. You put yourself out there, into the public domain so that people can verify your results or challenge them. You then create a reputation for yourself. Is your research good, bad, flawed? I think Dr. Campbell has been attacked a lot by people in a position to lose from the results of his research and findings. That would be enough to make any person question someone's motives.
It's very rare for a researcher to ever respond directly like this to public criticism. Usually they only deal with criticism from their peers, because these are the people that have the necessary background to make valid points.
Researchers do make mistakes in their statistical application, sometimes faulty work even gets published. However, so far no one has published a paper to discredit the China Study findings.
"the Weston A Price Foundation with many chapters around the country and untold amounts of financial resources"
The Weston A Price Foundation is a 501(c)3, and as such, its financial statements are available to the public.
You can see their budget here:
2009 expenses were $1,406,000.
Very, very small, as such things go.
Please compare this to the real "agricultural lobbying organizations" out there.
i just finished reading the china study, and thought that it was great to hear from someone who was actually willing to get 'inside' the system and who is brave enough to take risks that not one blogger or responder i have read yet would dare come close to - in the name of our national health.
He is not proposing to take away your outdoor grills, he is just providing some healthy choices. for the pot bellied beer drinkers who are addicted to their gas grills and pretending to be 'all american'...if you are pro america, you care about the obesity problem - read the book again, he's telling us why we grew up with these food biases and myths... deal with the politics people, and shooting the messenger is just plain ignorant. shame on the adults who didn't read the book, and for only thinking of themselves and their next steak dinners.
what a bunch of whiners, no wonder the kids are a mess these days.
1. You want a long, healthy, happy life? It takes more than diet. Exercise, good sleep, fresh air, and good relationships are needed also. Get out of the city, and get outside doing something, anything.
2.Rigorous exercise can nearly eliminate the bad parts of one's diet. Look at Michael Phelps. The dude eats 12,000 calories a day, including pizzas, milkshakes, and other junk food. But his body is such a fine tuned machine that it takes the necessary nutrients and energy from that food and discards the rest as waste. Really it's the couch potatoes that need to watch their diets the most because their bodies are so inefficient. Of course, it's their laziness that made them fat and inactive in the first place, so it's no wonder couch potatoes have the worst diets.
3. There is no perfect diet. The best you can do is avoid foods you know are bad (unhealthy) and eat foods you think are good (healthy). Things with chemicals on the labels, pretty much any junk food, etc., cannot possibly be of great benefit to the body.
4. One of the worst diets possible is any strict diet. That includes all the self-righteous vegans and vegetarians out there who think they are being so "ethical" and "green." Lame hippies. What they don't understand besides all of those labels being false, is that trying to adopt a very strict diet, no matter what the reasons, will inevitably lead to occasions of malnutrition. Most vegetarians I know are skinny, like unhealthy skinny, with no muscle mass, little energy, and sunken eyes. They look five years older. Eating meat is OK! Wild game is best.
Please don't label every v as self righteous lame hippies. If everyone was v the world would be a much nicer place. You should be thanking them for the insight and courage to do what's right.
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"No diet or any other medical strategy comes close to the benefits that can be achieved with a whole foods, plant based diet."
This in rebuttal:
Enjoy your fat steak.
I have to second Dave, RN's comment. A vegan diet is unsustainable- period. No group of people in the history of the human race has successfully followed a strict vegan diet. No, I don't count all the privileged white kids in western society that have been vegan for five years and then have babies with bad teeth and poor development. Even a quick study of sustainable systems in agriculture will show that raising livestock is essential to growing your vegetables. The most efficient, productive and healthy farms will incorporate animals which provide rich manure, insect control and weed maintenance. By the way, if you believe that eating a vegan diet assures you are not supporting the raising of meat animals, think again. Your mung beans and kale need fertilizer too and it likely came from factory farmed animals. Many types of eco-systems around the world aren't even suitable for veg and fruit production, instead grasses are the natural flora. Humans, not being able to eat grass, must raise or hunt ruminants to survive this type of habitat. If we are to change our dismal food system in this country we need to focus on supporting small sustainable farms. We also need more people to get out there and start small farms or at least raise some food for personal use. Veganism and vegetarianism supports monoculture in farming b/c soy, corn and wheat tend to be staples of these diets. Don't focus on labeling yourself or restricting yourself through your diet- just support small farms and learn how they raise your food!
I know you commented 4 years ago but you know you can raise animals without eating them right? And I'm not sure why you think vegans baby's are unhealthy. Sure some vegans are unhealthy because they still eat unhealthy so there baby's will be unhealthy, and the same thing goes for meat eaters. As for all successful civilizations not ever being strictly vegan is kinda stupid. What people did in the past doesn't matter if you don't need to do what they did to be successful today. As for being healthy, plants have every nutrient that you get from meat without the various unhealthy things meat has. I also don't get why you seem to think privileged white kids are the only people who can be successfully vegan. I'm assuming you are saying they are rich enough to afford to be vegan. I don't know if you've ever gone grocery shopping, but plants are a whole hell of allot cheaper than meat.
Of all the people in Asia I find Chinese the most interesting people. By the way, if you're thinking of studying abroad why not consider studying in China. You'll be amazed at what you'll learn and get from this experience. Good luck!
I occasionally mention my diet, which has spawned some questions in a recent thread as well as in my survey results.
So this week I'm going to explain my diet in detail, focusing on what I eat, why I eat it, and the facts behind the food.
The ideas aren't mine originally, and I'm certainly not the only person to eat this way, but I call it the MaxDiet because there is no formal name for it, and from the research I've done it appears to be the best possible diet.
I’ve gone gluten free over the past 7 months and have to say that the changes have been incredible. I always had it in the back of my head that wheat was not good for me, and that I shouldn’t eat it, but would completely forget about this when I was ordering a large BBQ chicken pizza at 11:30pm. I would always feel god awful the morning after, but it took me a really long time to put two and two together. Going Gluten Free (GF) and then basically grain free has been life changing for me. I remember at its worst, I literally cried myself to sleep because my skin problems related to eating gluten were so painful. It is an intense process that I think is pretty similar to detox, and considering how gluten is in nearly all processed foods and restaurants, it is doubly hard.
My symptoms were the reason I explored dietary changes. My main problem was my scalp, it was extremely irritated, flaky, and at times even had open sores. I vividly remember going to the hairdresser's to get my hair cut. He was freaking out about my scalp. It was basically a series of open sores that were slowly bleeding, like a pimple that had just been popped. It got to the point where I thought that he might call me an ambulance due to his level of concern. It was super awkward and I was really embarrassed. From then on, I have cut my own hair.
It was a chronic condition, so I figured it must be a lifestyle issue. I changed my shampoo, conditioner, used different oils on my scalp, and even put my own urine on my scalp, in hopes of fixing it. Nothing worked.
I then started changing up my diet. I read The China Study by Dr. Campbell, and figured that it might be meat that is causing my problems. So I went vegetarian. Was still having problems, so I decided to take it further. I had joined a raw food ‘cooking’ class, at a local organic food store. The women hosting it explained how she was on the 80/10/10 diet, which is basically where all you eat is fruit. It all sounded really good, so I hopped on. I ate nothing but fruit for 3 weeks. It was a super cool experiment in and of itself, but was too difficult to maintain. I needed to be eating at least 15 to 20 pieces of ripe fruit every day to simply get enough calories, which wasn't only expensive, but impossible with the selection that my grocery store had.