The China Study vs the China study
..man, proud man,
Dress’d in a little brief authority,
Most ignorant of what he’s most assur’d…
From Measure for Measure by Wm Shakespeare
The web has been alive with commentary the past few weeks since Denise Minger lobbed her first cannonball of a critique across the bow of The China Study, the vessel T. Colin Campbell, Ph.D. rode to fame and bestsellerdom. Seems like everyone is now jumping into the fray and gunning for poor Dr. Campbell, who early on in the fracas made a few halfhearted attempts to fight back but has now fled the scene. I’ve been laying low watching it all play out, and so now figured it’s about time I add my two cents worth to the debate. But first a little history.
I met Dr. Campbell about ten years ago (five or so years before the publication of the popular book The China Study) when we both spoke at the same conference. He was a nice enough man who spoke about the work he and his team had done in China gathering the data published in the massive 894 page monograph Diet, Life-style and Mortality in China (pictured above left). As Dr. Campbell presented his data ‘demonstrating’ the superiority of a plant-based diet and demonizing protein of animal origin, I didn’t think much about it because the data was all in the form of observational studies, which, as all readers of this blog should know by now, despite often showing correlation don’t prove causation. My lecture, which followed Dr. Campbell’s, was, as you might imagine, a lecture of a different sort. Then we both sat on a panel after our talks and fielded questions. And were both cordial to one another.
A few years ago, I became vaguely aware that Dr. Campbell had written a popular book on his work in China titled, appropriately enough, The China Study. I assumed it pretty much mirrored his presentation I had watched, so didn’t rush out and grab a copy. Over the past few years a number of people have asked about The China Study through the comments section of this blog, and I’ve typically answered that the data are all observational and so not really meaningful in terms of causation.
(Note: Throughout this post whenever I refer to the popular book Dr. Campbell wrote, I’ll call it by it’s title The China Study, and when I refer to the large study Dr. Campbell was involved with in China and was the basis for the monograph Diet, Life-style and Mortality in China, I’ll call it the China study.)
About a year ago, I wrote a guest post for Tim Ferriss’s The Four Hour Workweek blog. It actually wasn’t a guest post as much as it was an excerpt of a chapter from our book The Six-Week Cure for the Middle-aged Middle extolling the virtues of saturated fat. It was a popular post that has garnered to date 520 plus comments, many of them fairly spirited. I agreed to answer a number of the comments and did so. I noticed as I sifted through them that a handful were absolutely fawning of Dr. Campbell and The China Study. Here is a sampling:
The number one study of diet and disease is the China Study. All other data points are slivers compared to the volume of data and statistical correlations that came from the China Study.
Have you read The China Study? Dr. Campbell points out repeatedly that none of the weight loss studies such as Atkins or South Beach diet follow any type of peer reviewed scientific method.
Tim…and to think I was such a big fan of yours. This is by far the weakest (and least cited) argument I have ever read on diet–especially increasing saturated fats. Half knowledge is a scary thing in the hands of influential people. Maybe it’s another genius marketing ploy (like the myth riddled protein Atkin’s diet)–people love to feel good about their personal yet poor decision making–and diet is very personal. Check out researchers that actually meant to study nutrition–like Dr. T. Colin Campbell’s The China Study comes to mind.
It was pretty apparent that the disease of non-critical thinking was at epidemic proportions.
After reading a number of these, I decided I had better take a look to see what Dr. Campbell had going on that had attracted such devotees. I pulled up his book on Amazon and read through a few comments, most of which were even more nauseatingly gushing than the above. I ordered a copy of The China Study.
I knew that both Anthony Colpo and Chris Masterjohn had done their own critiques of the original data, so I figured, what the hell, I’ll take a look at the ‘real’ China study (as opposed to the popular book of that name) and do one too. And I’ll critique the popular book, which I figured was a rehash of the China project, while I’m at it.
I tracked down a copy of the 894 page book in a bookstore in the UK and forked over $240 to purchase it and have it shipped. As I was awaiting its arrival I told Gary Taubes what I had done, and he replied that he had done the same thing himself a few years earlier. And that I could have borrowed his. And, even worse, that most of the data was available online for free.
When the book arrived, I was amazed at the size of it. Not only was it the 894 pages as advertised, it was in a large format. Much larger than a volume of the Enclyclopaedia Britannica. It wasn’t at all what I thought it would be.
Here are a couple of photographs shamelessly using our own book to show the size of this behemoth
Of the 894 pages, the first 82 are a study overview, description of methodology and author commentary. It is written in the form of a scientific paper with half the page in English and half in Chinese (which, presumably, is a translation of the English half). The remainder of the 894 pages are raw data and correlations. Page after page after page of correlations. I didn’t bother counting them, but Dr. Campbell says there are 367 variables, each of which is compared with every other variable. I don’t doubt him. This study was a massive undertaking, requiring thousands upon thousands of man hours and God only knows how much money. No one can possibly accuse the team members of not giving it their all.
Here is one page of correlations. This one between stearic acid and all the other variables studied.
But in the end it is still only an observational study. And even though – again, according to Dr. Campbell – there are over 8000 statistically significant correlations, correlations are not causation. Any scientist worth his/her salt will tell you that all you can do with data from observational studies is use them to form hypotheses that can be rigorously tested in randomized, controlled trials. Then and only then (assuming the study results show it) can you even begin to talk about causation. The whole enterprise, costly and time consuming though it was, was described perfectly by Shakespeare in the words of MacBeth:
…it is a tale
Told by an idiot, full of sound and fury,
Signifying nothing.
Once I saw that the original China study was nothing but a huge number of correlations, I quickly lost interest. What is the point in going through the brain damage of ferreting around in these to see if Dr. Campbell interpreted them correctly when he tries to make his case that a plant-based diet is optimal. It doesn’t really matter whether he interprets them correctly or not, they are only correlations. Repeat after me one last time: Correlation is not causation, correlation is not causation, correlation is not causation…
I wondered why Dr. Campbell and his group didn’t spend a fraction of the time and money they spent on this behemoth of a spreadsheet full of correlations on a real study that could provide hard evidence. Why not randomize subjects into two groups and provide one a plant-based diet and the other a meat-based diet or something similar. Lock them down as Ancel Keys did if they had to. Surely the money spent on the China study could’ve covered that. Get some real data. I discovered later that I wasn’t the only one who wondered that. Even some of Dr. Campbell’s own colleagues abandoned him to this study and told him it would be worthless. More about this later.
So enough for me. I stuck my copy of the $240 book of correlations in my library and forgot about it. Until Denise Minger’s critique hit the net.
Upon reading her blog post, my first reaction was This is great; someone took the time to do what I was going to do. I figured Dr. Campbell had cherry picked his correlations to make the case he wanted to make, and I had seen Colpo and Masterjohn catch him on it. Ms. Minger went even further and really caught Dr. Campbell with his pants down, correlation-misinterpretation speaking. I continued to read with mounting glee Ms Minger’s successive critiques and a few other bloggers who had critiques of their own. (Believe me, there is no dearth of material here for people to attack without any two attacking the same data twice.)
After this went on for a while, I had my second reaction to the whole affair.
Which was that I had fallen victim to the confirmation bias. My bias was that Dr. Campbell was wrong, so I was more than happy to uncritically accept evidence confirming his error without lifting a finger to double check said evidence myself. I knew that if a blogger somewhere had come out with a long post describing an analysis of the China study demonstrating the validity of all of Dr. Campbell’s notions of the superiority of the plant-based diet, I would’ve been all over it looking for analytical errors. But since Ms. Minger’s work accorded with my own beliefs, my confirmation bias ensured that I accepted it at face value.
Once the fact that I had succumbed to my confirmation bias settled in around me, I became suffused with angst. I had tweeted and retweeted Ms. Minger’s analysis a number of times, giving the impression that I had at least minimally checked it out and had approved it. I had emailed it to a number of people, many of whom, I’m sure, had forwarded it on. I’m sure I played a fairly large role in the rapid dissemination of the anti Campbell/China study info.
(It didn’t really make me feel better to know I wasn’t alone in falling into the confirmation bias quicksand. Take a look at this post from Richard Nikoley’s Free the Animal blog. I doubt that all these people checked Ms. Minger’s calculations before posting.)
My angst wasn’t because I had possibly fed the flames of a misinformation wildfire – I wasn’t particularly worried about that because mountains of other data (including first hand data from my own clinical practice) have persuaded me that Dr. Campbell is dead wrong in his ideas about the superiority of a plant-based diet. No, my angst arose for two other reasons: first, because I was distressed that I so easily fell prey to the confirmation bias, and, second, because I felt I needed to go through all the calculations myself to make sure Ms. Minger and others whose work I had circulated were truly correct in their analyses.
As I was wallowing in self pity over all this, I didn’t realize that salvation was at hand. And that my savior was none other than Dr. T. Colin Campbell himself.
Yep, his first response to Denise Minger’s critique of his work appeared on the Tynan.net website and rescued me from my pit of self-loathing. In it, Dr. Campbell wrote:
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.
In other words, the China study is an observational study comparing one variable to another (univariate correlations) and, as such, meaningless. And this from the man’s own pen.
Since these observational studies are meaningless in terms of causality, it doesn’t really matter how one slices and dices the data because meaningless correlations by any other names are still just as meaningless. All this falderal over whether or not Dr. Campbell had his interpretations right was tantamount to the medieval theological argument over how many angels could stand on the head of a pin. And my participation certainly wasn’t required.
I’d known this all before, of course, but somehow had lost my focus on it.
I was ready to wash my hands of the whole affair when I came across another statement Dr. Campbell made in his response to Ms. Minger’s critique. Writing of her, he said:
One further flaw…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.
Only one chapter? As I mentioned above, I always figured The China Study was simply Dr. Campbell’s tale of the China study and the conclusions he had drawn from it. Now he says that only one chapter is about the China study, leaving me to conclude that the rest must be about something else. I found the book, which I hadn’t yet taken from the pack it came in from Amazon, opened it and started reading.
Wow!
In 1976 author Mary McCarthy famously said live on the Dick Cavett show of her rival Lillian Hellman:
Every word she writes is a lie, including ‘and’ and ‘the’.**
I feel much the same way about The China Study. Except it’s not really a lie, it’s an obfuscation.
In fact, in my studied opinion, The China Study is a masterpiece of obfuscation.
It is obfuscatory in so many ways it could truly qualify as a work of obfuscatory genius. It would be difficult for a mere mortal to pen so much confusion, ambiguity, distortion and misunderstanding in what is basically a book-length argument for a personal opinion masquerading as hard science.
Let me take just one tiny section of the book, one that is in no way atypical, and show you what I mean.
In Chapter 3 titled Turning Off Cancer, Dr. Campbell is starting to hit his stride in his anti animal protein jihad. He has described the three stages of cancer – initiation, promotion and progression – and is setting the stage for his description of his laboratory work implicating animal protein in all three stages.
Here is his setup paragraph starting on page 50:
At the start of our research, the stages of cancer formation were known only in vague outline. But we knew enough about these stages of cancer to be able to structure our research more intelligently. We had no shortage of questions. Could we confirm the findings from India that a low-protein diet represses tumor formation? More importantly, why does protein affect the cancer process? What are the mechanisms; that is, how does protein work? With plenty of questions to be answered, we went about our experimental studies meticulously and in depth in order to obtain results that would withstand the harshest of scrutiny.
The “findings from India that a low-protein diet represses tumor formation” were the results of a rodent study published in the Archives of Pathology in 1968 that Dr. Campbell wrote about 14 pages earlier in the book. He mysteriously refers to the Archives of Pathology as an obscure journal when it is anything but. It was published then by the American Medical Association and still is today under the new name Archives of Pathology & Laboratory Medicine. But the notion of the paper initiating his quest being discovered by Dr. Campbell in an “obscure medical journal” fosters the impression of him as a leave-no-stone-unturned kind of guy. Even the little throw away but incorrect phrase “obscure medical journal” is part of the greater picture of obfuscation that maintains throughout the book.
The study from India showed that rats given aflatoxin along with a high-protein diet got liver cancer while rats given the same amount of aflatoxin while consuming a low-protein diet didn’t. Aflatoxin is a substance released from a fungus often found in peanuts, corn, other grains and even hay. It is converted in the liver to a much more toxic compound and is often used in laboratory experiments with animals to induce cancer and other problems.
Moving on, here is what Dr. Campbell has to say about protein and cancer initiation:
[I] How does protein intake affect cancer initiation? Our first test was to see whether protein intake affected the enzyme principally responsible for aflatoxin metabolism, the mixed function oxidase (MFO). This enzyme is very complex because it also metabolizes pharmaceuticals and other chemicals, friend or foe to the body. Paradoxically this enzyme both detoxifies and activates aflatoxin. It is an extraordinary transformation substance.
[II] At the time we started our research, we hypothesized that the protein we consume alters tumor growth by changing how aflatoxin is detoxified by enzymes present in the liver.
[III] We initially determined whether the amount of protein that we eat could change this enzyme activity. After a series of experiments, the answer was clear (Chart 3.2). Enzyme activity could be easily modified simply be changing the level of protein intake.
[IV] Decreasing protein intake like that done in the original research in India (20% to 5%) not only greatly decreased enzyme activity, but did so very quickly. What does this mean? Decreasing enzyme activity via low-protein diets implied that less aflatoxin was being transformed into the dangerous aflatoxin metabolite that had the potential to bind and to mutate DNA.
These four little paragraphs and accompanying chart take up less than a page in space, and are tiny glittering gems of obfuscation. Let’s deconstruct.
First, take a look at how subtly these four paragraphs are written, especially II. Note how he writes “the protein we consume”? I’m sure many people took these paragraphs to mean that the studies were done on humans. That’s almost the implication. Reread them to see if they indicate anywhere that the author is talking about rat studies.
As Dr. Campbell progresses through this chapter, he does ultimately tell the reader he is talking about rat studies and not human studies, but he doesn’t mention the word rat for another two pages after the above paragraphs. By this time it’s probably implanted in the minds of many readers that he’s talking about human studies.
He describes experiments showing that rats getting diets high in casein (a milk/animal protein) develop more cancer at the same dose of aflatoxin than do rats getting a lower-casein diet. The implication: animal protein causes cancer.
Dr. Campbell then gave his rats diets of varying amounts of plant protein (wheat gluten) and found that they did not get cancer after exposure to aflatoxin irrespective of protein dose. Same thing happened with soy. Implication: plant protein protects against cancer.
If you’re worried about cancer – and who isn’t – you’re now starting to look at animal protein a little differently. Which is what Dr. Campbell wants. But he hasn’t told you the complete story.
As I’ve written often in these pages, rodents aren’t just furry little humans. They are a distinct species separate and apart from humans. The rodents usually used in lab experiments are Sprague-Dawley rats, and inbred strain that has a tendency to develop cancer easily. (See Abelson, PH. (1992) Diet and Cancer in Humans and Rodents, Science 255(5041); Jan 10: 141) In fact, these rats can develop cancer just from a change in diet. I ran quick checks on a bunch of the studies referenced in The China Study, and all checked used Sprague-Dawley rats.
And think about this. If you were to visit a farm and search for rodents, where do you think you would be most likely to find them? In the grain or in the milking area? Like Dr. Campbell, I grew up in a rural area and spent a lot of time on a farm. Rats and mice are in the hay and in the grain. You have a helluva time keeping them out of the animal feed, which they eat, too. Grain and hay are common places for growth of the fungus that produces aflatoxin. Since rodents spend most of their days in this stuff (grains), and since they eat it as well, I would bet that most have adapted over the generations to the combination of plant protein and aflatoxin. If this did them in regularly, there wouldn’t be the rodent problem on farms that there is. So, in my opinion, making a huge issue of the fact that rats didn’t get cancer after dosing with aflatoxin irrespective of how much plant protein they ate is pretty disingenuous.
Most disingenuous of all in the above four paragraphs and chart is the lack of full disclosure in these paragraphs of the very study Chart 3.2 is made from. Let me explain.
Certain enzymes in the liver convert aflatoxin into a more toxic substance that Dr. Campbell claims can initiate the formation of cancer. He demonstrates in rat studies that giving the rats a lower protein diet decreases the activity of this enzyme, meaning that the lower the protein intake, the less conversion of the aflatoxin into the really nasty stuff. Chart 3.2 above and on page 52 of his book shows this graphically.
When I pulled the study from which this chart was adapted (Mgbodile MUK and Campbell TC. (1972) Effect of protein deprivation of male weanling rats on the kinetics of hepatic microsomal enzyme activity, J Nutr, 102: 53-60.) and read it, I found a little disclaimer Dr. Campbell didn’t bother to mention in The China Study. You can read the last paragraph of the study (highlighted in yellow) below:
Nice, eh? He hits the nail on the head. Protein utilization may be influenced by what is eaten along with the protein. Sucrose (table sugar) was eaten along with the protein used in this experiment. In other experiments corn starch was used instead of sugar and the effect of the protein on the enzyme was diminished, meaning that the protein along with starch did not have nearly the same effect as protein with the sugar. Who knows whether or not it’s even the protein that has the effect and not the sugar? It can’t be shown from this study. That caveat certainly didn’t make in into The China Study.
See what I mean about a masterpiece of obfuscation?
I could go on and on, but I’ll quit after I give you just a couple more examples.
On page 107 of The China Study Dr. Campbell writes:
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.
Then one inch below (literally) he writes the following:
The China Study was an important milestone in my thinking. Standing alone, it does not prove that diet causes disease. [Italics in the original]
So, the China study produces valid conclusions as to causality, i.e., “whole plant-based foods are beneficial, and animal-based foods are not.” Yet the China study “does not prove that diet causes disease.” Say what?
Don’t believe me, take a look at a scan of my copy:
On page 73 Dr. Campbell dons the mantle of prestige conferred by one of America’s most august newspapers. Writes he referring to the China study:
We had a study that was unmatched in terms of it’s comprehensiveness, quality and uniqueness. We had what the New York Times termed “the Grand Prix of epidemiology.”
A quick search of that phrase in the online version of the NY Times reveals that it came from an opinion piece by none other than Jane Brody, a kindred spirit to Dr. Campbell. Brody, a lipophobe of the deepest hue, has written a number of low-fat cookbooks and is a believer in the plant-based diet. So she hardly qualifies as an unbiased commenter.
And speaking of the so-called plant-based diet, when Dr. Campbell responded to Ms. Minger’s critique, he took her to task for mentioning the words ‘vegan’ and ‘vegetarian’ as it applied to his work.
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.
Just for grins, I turned to the index of The China Study to see if ‘vegan’ or ‘vegetarian’ were indexed. Here’s what I found on page 417:
vegetarianism or veganism. See plant-based diet
When I flipped over to ‘plant-based diet’ on page 414, I found a long grocery list of references.
Even in his online response to his opponents, Dr. Campbell apparently can’t resist obfuscating.
Okay, just one more, then I’ve got to draw this to a close. Let’s go back to the bottom of page 52, the page the paragraphs above and Chart 3.2 appear on. Dr. Campbell shows in Chart 3.2 how protein is involved in stimulating the liver to convert aflatoxin to the toxic product that he implies is involved in cancer initiation. He then reports how he wanted to see if animal-based protein was involved in the other phases of the cancer progression cascade. So he and his grad students started to look. He writes:
As time passed, we were to learn something quite remarkable. Almost every time we searched for a way, or mechanism, by which protein works to produce its effects [on cancer formation and progression], we found one!
That, my friends, is almost the dictionary definition of the confirmation bias summed up in one sentence.
This tiny bit of the book that I’ve chosen to lay bare is truly the tip of the iceberg. I could go on and on and on, but I’m sure you get the picture.
Before I finish, I want to get back to something I mentioned earlier about how one of Dr. Campbell’s own colleagues bailed out from the China study because he recognized it for what it was: a giant observational study that was meaningless. Here is how Dr. Campbell describes it on page 105-106:
When we first started this project we encountered significant resistance from some people. One of my colleagues at Cornell, who had been involved in the early planning of the China Study, got quite heated in one of our meetings. I had put forth the idea of investigating how lots of dietary factors, some known but many unknown, work together to cause disease. Thus we had to measure lots of factors, regardless of whether or not they were justified by prior research. If that was what we intended to do, he said he wanted nothing to do with such a “shotgun” approach. [i.e., a big, meaningless observational study]
This colleague was expressing a view that was more in line with mainstream scientific thought than with my idea [i.e., a randomized, controlled trial that might demonstrate causality would be a better use of the funds.] He and like-minded colleagues think that science is best done when investigating single – mostly known – factors in isolation. [He and like-minded colleagues are correct.] An array of largely unspecified factors doesn’t show anything, they say. [They are right.] 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…
So I say we need more, not less, of the “shotgun approach.” We need more thought about overall dietary patterns and whole foods. Does this mean that I think the shotgun approach is the only way to do research? Of course not. Do I think that the China Study findings constitute absolute scientific proof? Of course not. Does it provide enough information to inform some practical decision-making? [No.] Absolutely.
Dr. Campbell uses an impassioned written speech to persuade the scientifically untrained that the China study carries vastly more scientific value than it actually does. Once again, it’s a large observational study, but an observational study nonetheless. And as such, it is useful only in developing hypotheses to be tested with randomized, controlled trials. The entire 894 page study proves not a shred of causality.
What saddens me about all this is that hundreds of thousands (probably millions) of people who can’t (or won’t) read critically have fallen for the premise of The China Study without even thinking about it. Believing that the entire book is based on the greatest and most important nutritional study ever completed. What happened to the ability to read critically? Has it vanished from the populace? Based on the comments on The China Study on Amazon it would seem so.
In my opinion, there really isn’t much of substance in the entire 400 plus page book. But I encourage you to buy it and read it to test your own critical reading skills. If you don’t want to test your critical reading skills, you’ll at least enjoy coming across some real howlers such as this one believed only by the vegetarian/vegan zealots out there (oh, sorry, plant-based diet followers):
As you will see in this book, there is a mountain of scientific evidence to show that the healthiest diet you can possibly consume is a high-carbohydrate diet. [italics in the original]
I wonder if Gary Taubes, who wrote a vastly more scientific book, would agree?
Lest you think I’m being too hard on poor Dr. Campbell, let me tell you a few things. First, as I mentioned earlier, the few sections of The China Study I dissected are just a tiny fraction of the whole. I could go on and on. Second, Dr. Campbell mentions Protein Power by name on page 19 and labels it a modern protein fad diet that “continue[s] to inflict a great variety of dangerous health disorders.” Third, he is absolutely and unnecessarily brutal in his treatment of Dr. Robert Atkins. He has an entire section on Dr. Atkins starting on page 95 that runs for almost three pages. After quoting from one of Dr. Atkins’ books, he writes the following about the deceased diet doctor:
There are snake oil salesman, who have no professional research, professional training or professional publications in the field of nutrition, and there are scientists, who have formal training, have conducted research and have reported on their findings in professional forums. Perhaps it is a testament to the poser of modern marketing savvy that an obese man with heart disease and high blood pressure [here he inserts a citation for an article discussing Dr. Atkins’ death] became one of the richest snake oil salesmen ever to live, selling a diet that promises to help you lose weight, to keep your heart healthy and to normalize your blood pressure.
A way below-the-belt commentary when you consider that Dr.Atkins was a trained cardiologist who took care of thousands of real, live patients throughout his career – he wasn’t, like Dr. Campbell, a bench scientist doing rat studies in a lab. Bob Atkins and I have had our differences, but were he still alive, I would vastly prefer to put my own care in his hands than I would those of Dr. Campbell, who has never treated a patient in his life.
You may ask if I took anything of value from my reading of this book? I did. On page 107 Dr. Campbell writes the following:
The results of this study…convinced me to turn my dietary lifestyle around. I stopped eating meat fifteen years ago, and I stopped eating almost all animal-based foods, including dairy, within the past six to eight years, except on very rare occasions, MY cholesterol has dropped, even as I’ve aged; I am more physically fit now than when I was twenty-five; and I am forty-five pounds lighter now than was when I was thirty years old. I am now at an ideal weight for my height.
I have no reason to doubt Dr. Campbell’s own medical and dietary history (except maybe for the part about being more physically fit than he was at age 25 – that’s a tough act for someone who is 73), so I’ll assume it’s all true. As I recall, he had a trim physique when I met him 10 years ago, which, assuming nothing has changed, is probably the same. And I’m going to take Dr. Campbell at his word about what he eats.
Granted, I’m younger than Dr. Campbell, but I follow almost the opposite diet as he does yet I, too, have low cholesterol, very low blood pressure and am ideal weight for my height. What this all tells me is how wonderfully adaptive the human species is where diet is concerned. It’s no wonder we took over the earth.
** Lillian Hellmann was predictably furious over McCarthy’s comment and adopted the typical American response: she sued. In one of those turns in which the law of unintended consequences jumps up and bites one, many of her untruths came to light in the courtroom as McCarthy was forced to defend her statement. Hellmann disengaged by dying during the proceedings.
I think between you and Denise and Dr Colon’s own self-incriminating defense and retreat we can declare this house of cards called ‘The China Study’ officially collapsed.
I am not surprised this one caught your interest. It caught mine.
I watched the Vegans on 30bad (Thirty Bananas a Day) at the beginning of this trying to re-group and wondering how to to handle the now recidivist Denise Minger and how they might create cover from the “new epidemiology” coming from Denise’ analysis. I was amused as it was an argument about correlations.
Later I read Campbell’s defense against the “literary upstart” and noted that he claimed his peer-reviewed rat studies were the basis for a conclusion that animal eating was unhealthy based on a principle of “biological plausibility”. This seemed to me a “big claim” so I wandered over to his website and a rat diet. Hmmm, OK.
In addition, I found a reference to his gluten study, which I tracked down. Here is the abstract.
Effect of dietary protein quality on development of aflatoxin B1-induced hepatic preneoplastic lesions.
Schulsinger DA, Root MM, Campbell TC.
Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853.
Abstract
The effect of the quality of dietary protein on the post-initiation development of aflatoxin B1-initiated putatively preneoplastic foci in Fischer 344 rat liver was compared with the effect of the quantity of dietary protein. Feeding wheat gluten, a low-quality protein, during the postinitiation period (between the end of aflatoxin B1 dosing and the death of the rats) inhibited the development of gamma-glutamyltransferase-positive foci when compared with that in animals fed high-quality protein (casein) diets during the same period. Lysine supplementation of wheat gluten during the postinitiation period enhanced the gamma-glutamyltransferase-positive response to a level comparable with that of the high-quality protein. These results suggest that one can inhibit the development of foci either by decreasing the quantity of protein intake and holding the quality of the protein constant or by decreasing the quality and holding the quantity constant.
OK, if you supplement gluten with lysine then it acts in a similar fashion to casein.
I was now expecting to find reference to studies focused on lysine, but did not find any. HMMMM!
So now I had the basis in Campbells own peer reviewed studies for his claim of “biological plausibility”.
Complete proteins, being animal are cancer feeding, incomplete proteins (like soy and gluten) of vegetable origin do not feed cancers.
Further research showed me that Chris Masterjohn had pointed this out in his review of the book when it first came out.
Frankly, I am astonished that a nutritional scientist is promoting the ingestion of incomplete protein on the grounds that “complete proteins” are carcinogens.
It is bizarre.
I also sensed the glee of many in reading Denise Minger’s analysis, and felt it too. You are correct that we need to be on guard for confirmation bias.
But. Denise was using China study data not to prove that an animal-based diet is superior, but to show that the correlations relied on by Dr. Campbell were so weak and confabulated as to not support even a hypothesis that plant-based diet is superior. She did that well.
This is similar to the famous decimation of Keys, in which his observation that saturated fat consumption in seven countries correlates to heart disease was proven not to be even an observation when 22 countries (the data for which was available to him and likely known by him) were examined and any such correlation disappeared.
Of course we need to read Ms. Minger critically, but the risk that she is bamboozling us or is just confused herself is less given what she was trying to show: Lack of correlation does not even lead to a hypothesis regarding causation.
Moreover, in a debate we can expect the proponents of the opposing view to point out flaws in logic or premises, but the responses I have seen have been almost entirely sound and fury.
An editorial comment: Where you quote Dr. Cambell and indicate that the italicized words were in the original (a couple of places), the italics do not currently show up.
Thanks for the heads up. I fixed the italics.
bravo!
thanks for supporting my own confirmation bias! I’m no scientist, so I live quite comfortably with my bias. Knowing that evolution supports my bias and directly contradicts TCC’s hypothesis (that plants are good, meat is bad) helps!
Phenomenal analysis. This post should be required reading for anyone who… well, for anyone.
When I don’t see a blog post from you in a while and I see, “The Blog of Michael R. Eades, M.D.” subject line in my email inbox, I immediately rush over to see what you’ve been up to and are reporting on.
As usual, I see you’ve been amusing yourself with the data out there in a very productive fashion. Thank you! Great post!
I have a critical reading fun test. Open “The China Study” to any random page. Find as many logical/scientific errors as you can. Forward the page number to a friend and see how many they can find. Fun stuff! Compare what the errors are and which you missed.
Most importantly, make sure none of your error finds are fueled by confirmation bias, but are actually data driven.
This is the key. Low carbohydrate diets need to be driven by the data, not our opinions about the data. If low carb vs plant based becomes a religious war, all hope is lost. We must admit when we are wrong and change our positions as better data become available. The search for ideal human diets must stay a search for truth, not false self deluded certitude.
What a great idea! A critical reading fun test. A win-win for sure. Campbell sells more books, but not to promote his flawed views on diet. Instead he sells books to be used as critical reading primers.
Dr. Eades,
Everyone must have their place within the division of labor, regardless of their original intentions.
As always, great work. Be well.
Ta,
My son has a good friend who’s dad is a long time vegetarian. Two weeks ago he had his first heart attack. He was lucky his wife was right next to him as he fell unconscious. He’s at home now with Lipitor and Nitro. His lipids were sky high. I guess that’s what lots of veggies and “hearthealthywholegrains” will do for you.
And he was a “good” vegetarian, eschewing processed foods in favor of a lot of vegetables.
A wake up call for him (and his daughter, who also is a vegetarian). Probably not. When you eat for ideology, it’s hard to change. The daughter (20) did ask me for some info on what they should do, and brought me his labs to look at, but mostly she was interested in how to supplement so he/they could still be a vegetarian.
Frustrating. It’s like they’re saying “I want to shoot myself, but how can I minimize the damage”.
I think “obfuscation” is the a key word when it comes to this book.
So I understand with this post you gave the starting shot for everybody to stop the hair-splitting, put this China Study back in the bookcase and concentrate on studies that do really matter? Thanks Dr. Eades, I’m sure they will listen to you.
“What happened to the ability to read critically? Has it vanished from the populace?”
Did the populace ever have the ability to read critically?
If you want real insight into Dr. Campbell, take a look at his last word on the topic here:
http://campbellcoalition.com/?p=142&cpage=1#comment-36
Note his reaction to direct questions, e.g. “what is the metabolic pathway by which animal protein increases cholesterol?”. Apparently asking direct scientific questions is “uncivil” in his world. Not sure what constitutes a “civil” scientific discussion with Dr. Campbell, if you’re not allowed to question his conclusions. Also note that he did not publish several comments/questions, including a more pointed from me one about how casein could specifically have any effect on cancer development.
People who have information supporting their hypotheses are generally over-eager to share. People like to be “right”, and love to show detractors “wrong”. No sane person hides key information that shows they are more likely to be right. What possible conclusions can we draw from Dr. Campbell’s unwillingness to address answer questions and share information?
I’m not sure the majority of the population ever really did have the ability to read critically. Most seem to prefer to be given clear cut choices by the so called experts. Do this. Eat that, don’t do this. Our world is full of ‘thou shalt’ and ‘thou shalt not’.
Two of my co-workers have blatantly stated that doing their own research into diet is too much work. Too much trouble. They just want someone to tell them what to do, and are infinately confused because all of the ‘experts’ disagree.
“What this all tells me is how wonderfully adaptive the human species is where diet is concerned.”
Therefore disease is probably the result of a lack of adaptiveness. However, understanding correlation as it relates to observation, disease could be also due to a lack of wonderful. ☺
It appears that Dr. Campbell is consistent in the way he counters those who challenge his ideology. His dismissal of Denise Minger as un-academic and non-institutional [oh, and a girl!], and therefore below him, is quite the same as his argument against Dr. Atkins. When your data isn’t good enough to stand on it’s own, there’s always the ad hominem. And, AS IF the institutional science has improved our health in the last 40 years!!
When your data is not good enough, you don’t dare to publish raw correlations. You must be darn sure about your results.
“I should point out that when we were deciding to publish these data in the original monograph, we decided to do something highly unusual in science—to publish the uninterpreted raw correlations, hoping that future researchers would know how to use or not use them. We felt that this highly unusual decision was necessary because we were
wary of those in the West who might have doubted the validity of data collected in China—we had several experiences to suspect this. But also, we believe that research should be as transparent as possible, simply for the sake of transparency, thus minimizing suspicion of hidden agendas. We knew that taking this approach was a risk
because there could be those who, knowing little or nothing about experimentation of this type, might wish to use the data for their own questionable purposes”
Dr. Campbell
FYI Ned Kock has conducted two multivariate analyses on the China Study data finding totally different associations then the ones Dr Campbell proclaims as gospel at http://healthcorrelator.blogspot.com/
Great post, Doc.
Also, the link you posted http://tynan.net/chinastudyresponse, the author, Tynan, notes that he is a vegan in the intro, and in his conclusion he notes that he will remain so.
Well, not anymore. He eats meat and what seems to be a low carb diet.
http://tynan.net/ieatmeat
Jesus smiled.
We can all blame ourselves for having confirmation bias, but when all those N=1 accounts start piling up by the thousands, you get something more important and that is ‘history’.
I think your little rat comment shows it perfectly:
“And think about this. If you were to visit a farm and search for rodents, where do you think you would be most likely to find them? In the grain or in the milking area? Like Dr. Campbell, I grew up in a rural area and spent a lot of time on a farm. Rats and mice are in the hay and in the grain. You have a helluva time keeping them out of the animal feed, which they eat, too.”
You can call it an observation, which it is, but when bunnies get high cholesterol because they’ve been fed meat, how do these people justify that (and vilify meat) when they’ve just been standing outside protesting for the ethical treatment of lab rats?
Sometimes I think these academician scientists need to get out more. Tag along with Bourdain or take a trip to Spain or France. They can visit the caves and see the paintings of tofu turkeys at Lascaux.
I LOVED, LOVED, LOVED this!
Thanks so much for making my day!
Judi in Fort Collins
I’m glad you enjoyed it.
Thank you, thank you, Dr. Mike. I’ve spent a few frustrating afternoons of late w/ friends raving about their “new” carb diets and their low-fat approach to life (one a diabetic, one w/ high cholesterol) and another selling his version of health by praising “the china diet” study (so he now eats virtually no meat) and tried (gently) to suggest they might be barking up several wrong trees. All to no avail. My husband’s comment that “that cholesterol stuff is all proven nonsense” got their attention, though (because HE said it? dunno). At any rate – finally something to send along to them. Maybe the cool light of reason will dawn here in the hinterlands.
So happy to see you back at your “post” and thanks for your detailed analysis of this particular brand of obfuscated prose.
Marcia
Woah, thanks for the traffic boom!
“He hits the nail on the head. Protein utilization may be influenced by what is eaten along with the protein. Sucrose (table sugar) was eaten along with the protein used in this experiment..”
Great observation! In another of his papers (“Modification of spontaneous mammary tumors in mice fed different sources of protein, fat and carbohydrate”), he notes:
“The only groups with 100% tumor incidence by 120 weeks of age were those fed diets containing sucrose (table sugar) or a high fat level [corn oil or butter].”
Not only that, but the type of fat played a role as well — check out his paper “Effect of dietary intake of fish oil and fish protein on the development of L-azaserine-induced preneoplastic lesions in the rat pancreas.” Fish oil was protective, corn oil spurred preneoplasic lesions.
You truly deserve a traffic boom for getting the ball rolling on all this. Thanks for all your effort and thanks for the heads up on the other papers.
Thanks for another great post…
In this sentence, did you mean to write spend?
“I wondered why Dr. Campbell and his group didn’t spent a fraction of the time “
I did indeed mean to write ’spend.’ Thanks for the heads up – I’ve made the correction. And taken the time to severely discipline MD for missing a typo in her proof reading.
Sounds like the actual data sets from the China Study might be mildly interesting when going over nutrigenomics data coming off of multivariate micro-arrays.
Seems that this sort of data and view of science (no mechanism really, all correlates and anecdotes) is even pre-1960s.
It is not technically difficult to do the large variable genomics studies anymore – its all (or isnt) in the annotation.
With respect to annotation, the China Study data may be of interest tho the data may well be considered rather deprecated.
There are so many confounding factors in all observational studies (known, unknown, non-intuitive) that bias becomes almost the single most important factor.
Who needs that when we can do rigorous studies on mechanism as well as robust deep observation via nutrigenomics.
Why is it that we, and I mean people in general, worship other people just because they can produce a massive book and they have Ph.D. behind their names? This absolutely drives me crazy! What is it in human nature that some, if not most, of us apparently feel the need to be followers, to give up our God-given ability to choose, to decide for ourselves what is true and logical and what is not true and/or logical, and give that choice to somebody else? Are we just lazy? Is it that we just don’t have the time? It wouldn’t be so bad if we just admitted that we didn’t know, that we were indeed too lazy or too time deficient or, maybe more honestly, not interested enough, and we were “reserving” judgment, but then we have to latch onto someone elses’ beliefs as if we formulated them for ourselves through careful study and investigation of all the studies involved. Why can’t we just say, “I don’t know and I don’t care. I know what works for me and I’ve seen what works for some people close to me and I’ve seen what doesn’t work”. My brother-in-law died this year from eating the USDA diet for years. He had gall stones, developed acute diabetes and NAFLD. He went into the hospital for three months and died as all his organs quit on him. His wife has had Crohns disease and Lupus for years. When I was there for his funeral last March I sat in horror as I watched her eat a bowl of cereal with low-fat milk. Ten years ago I tried to tell them that they were killing themselves but they would not listen. He was 63 and she is around 62. They worship their doctor and government agencies.
Sounds like they have paid a pretty hefty price for their worship of false idols.
FYI – thought readers of this blog might be interested to know that HBO’s Taxicab Confessions recently aired an episode where an occupant of the cab claimed to have lived for quite a while in Tanzania with the bush people. He described their way of life, including how they hunted and what they ate. He described how they hunted mostly large animals, and was amazed that the feeding would go on for days, usually 3, until the entire animal was consumed. Afterwards they might go for days without eating anything.
Although the segment was not very long, it was fascinating; definitely a thumbs up.
I have said it before, and I will say it again. The more folk who don’t bother reading critically, the more low-fat/high-carb dieters, just means eventually there will ultimately be less of them due to disease, infertility, et.c.
To quote Dennis Leary: “More meat for the meat eaters!”
But it hurts when you have to watch them die and you know that if they had just listened to you they would live longer and be healthier. I’ve been “blessed” with dozens of friends and family members that are dying slow deaths like this. It is almost too much to bear.
You’re right, Stephen Brand. It’s very tough to watch. In my case, it was a dear friend with Crohn’s, who was treated with prednisone, which resulted in osteoporosis, which was treated with Boniva, which gave her necrosis of the jaw. The pain from all this was treated with Vioxx, which resulted in strokes. The Vioxx was discontinued, but her idiot doctor put her on an ultra low fat diet to “prevent more strokes.” A final stroke felled her in her early 50s. When all this started, I had just started my own research on all this diet stuff, so I didn’t have the information I needed to make suggestions. I just knew that the medical profession wasn’t helping her.
Recently, my youngest son’s girlfriend became symptomatic. They thought it might be Lupus. They finally settled on fibromyalgia, which, as you probably know, is the diagnosis they use when they’ve eliminated everything else. They put her on Lyrica. This made her depressed so now she takes Zoloft. I wrote her a letter and downloaded and printed some web pages that literally took me several days to complete. I printed out a dozen web site pages on leaky gut, gluten, gluten-containing foods, gluten-free diet, the horrible side effects of Lyrica and Zoloft. I warned her about how difficult it would be for her to try to go back to school and get her masters and what would happen when she wanted to get pregnant. I copied the chapter on Leaky Gut Syndrome from PPL. When she read the letter she complained to my son who got mad at me. The next time they visited, a couple of weeks later, she sat me down, very nicely told me to mind my own business, and informed me that she was pretty smart and had done some reading on fibromyalgia and gave me some jumbled BS about “substance P” and how that might be the cause. How can people be so stubborn not to at least consider that what you are telling them is right? Grrrr. Friends, family and aquaintances who are in ill health because of their diet surround me! It’s frustrating.
In other words, human plant eaters like vegans and vegetarians are essentially selecting themselves for extinction. It is ironic since they think they are doing it for better health and instead gradually making the human species less able to withstand and survive the next big extinction event that nature will inevitably toss our way.
Unfortunately, the high carb standard American dieters tend to reproduce before dying.
Thanks for taking the time Dr.Eades to share your thoughts on the recent
“firestorm” Ms.Miniger’s blog post created. Your august credentials certainly pack a whallop.I read her post last week and followed the link to the Campbell response over at Tynan.net. He just blogged that he is now “eating meat!” Here’s a link , http://tynan.net/ . If he’s serious or not, I don’t know, bound to ‘get ‘em going”.
I was a patient at your Foxcroft clinic in Little Rock back in the late 80’s and when Protein Power was published, bought a copy, and have enjoyed basically a low carb lifestyle since. The one glaring fact in all this, I think are the harsh verbal attacks on Ms.Miniger, reminded me of the 3-masked studs that attacked Lierre Keith with a red pepper pie. Like to see them do that to Ted Nugent, a real meat eater. The slogan should in fact be, “hey, lets not let the science and facts get in the way of a good marketing plan.”
rr
I always enjoy reading your blog, Dr. Mike.
BTW, if you had the correct “share” button to repost to Facebook, I would post it there for the benefit of some of my friends who are “watching their cholesterol,” and for one of them who has urged me to follow him on a so-called “China Study” diet. He has lost weight, though, and apparently also put a diabetic relative on the same diet.
I politely told him that I didn’t think I was going to stop eating meat.
Good job, Mike. How much of our public health is jeopardized by nothing more than pervasive petty hatred of Dr. Atkins who isn’t alive. My prediction, though, is that you will think much more highly of Campbell once you dip into the recently released the report of the Dietary Guidelines Advisory Committee. Compared to that report, Campbell is an intellectual giant.
RDF
You are correct on all points. And if Campbell is an intellectual giant, what does that make those on the DGA committee?
[...] how the China Study was recently discredited? Well, Dr. Michael Eades finally weighed in with his response to both Denise Minger’s hefty series of blog posts and T. Colin Campbell’s light-weight [...]
I just wanted to say thanks, Dr. Eades, for taking the time to do the research and write this post. I hope that one day I am able to think as critically and clearly as you do.
Dr. Eades,
From what I can tell the China study is a deductive study of sorts which assumes a meat based diet is cancer causing and therefore a veggie based diet is superior. Without that deductive assumption, it is irrelevant.
Inductive science, as you point out, is far superior in drawing repeatable conclusions. But, i do have the following question.
Without having read the book, do you feel there is any value to the raw data? Perhaps take out the gross conclusions, can something be redeemed from this effort, or is all a loss?
My own confirmation biases aside. Gary Taubes book was enough to confirm my personal experience based on my own athletic performances. Your post has merely strengthened my own convictions.
BTW: I share @Pam Maltzman’s thoughts on you getting a share button for Facebook. I did repost this onto my FB page.
This may help:
http://sexybookmarks.shareaholic.com/documentation/usage-installation
One reason I appreciate your posts is that you have, as well as the intellect to analyze the material, the insight to realize that you might have confirmation bias as well, Not everyone can admit that.
Great article Dr. Eades. Loved it.
Its important to note that the soul carcinogens in the sited study were aflatoxin and its metabolites. The dietary effects were secondary. There is no mention of cancer rates of high plant diet vs. adequate protein diet– in absence of a known carcinogen.
Had the diet had a direct effect on tumor growth or angiogenesis, then he might have been on to something.
That was decidedly not the case: aflatoxin promotes the cancer. It is beyond obfuscation, it is flat out lying, to say that, based on that study, protein promotes cancer.
You’re the only person I follow on twitter and I get tons of great references. I almost feel guilty using your posts. It’s too easy.
Thank you for your work,
Wonderful post, Dr. Eades! Thank you. You and MD are among the Heroes, for sure. (You, too, Denise). Like another commenter said, I’m not a scientist so I can live by my confirmation biases. Actually, I live better than ever because of them and, in fact, so do a number of people whom I’ve been able to convince to come over to the light side of the Force.
A great point about confirmation bias–keeping this in mind helps keep us honest.
Minger’s post inspired me to finally look at the program Body for Life, which I was on for six years. I’m now cringing when I read the book.
I have no problem with the shotgun approact that was the china study correlations. In fact, I think such things are needed in order to get an overall idea of what ‘might’ be going on with multiple variables interacting. THe prob is when people attempt to use this data in ways other than as open minded scientists hypothesizing about the real truth whatever it might be. If the data was used correctly and science was used correctly, then there would be no problem. But no matter what kind of studies you do, if a scientist is so biased as to try to obfuscate the truth, then the truth will likely not be found. In this, Campbell seems to have taken some lessons from Big Pharma!
I think there are even more overt things wrong with his linking casein and cancer in the rat study:
“Paradoxically this enzyme both detoxifies and activates aflatoxin.”
So protein is necessary for the essential process of detoxification (which in this case, in cancer-mice, leads to heightened cancer risk). That rather implies that protein is very important, not a risk.
This is especially so given that he writes:
“the comparisons…can largely be assumed to represent deficiency per se.”
So the comparison isn’t “plant protein” versus “animal protein,” it’s really complete protein versus lack of complete protein (man cannot live on gluten alone). Deprivation of complete protein prevents certain necessary processes, like detoxification or growth. This reminds me of the fact that reduced zinc and iron status can lower the risk of certain cancers. This is unsurprising since these nutrients are essential for growth and cancer is essentially a question of growth. The conclusion to draw is not that zinc, iron, protein (any nutrient at all) is a risk and we should conclude unnutritious or incomplete foods instead.
Don’t you mean “man cannot live on gluten at all”?
As far as I know, aflatoxins are only found in vegetable foods, especially peanuts.
All proteins are not equal. Casien is to animal proteins what gluten is to vegetable proteins. Research using casien as a representative animal protein proves nothing; it is comparable to using mature opium poppies as a representative green leafy vegetable.
This is not the only experiment to find that casien increases liver cancer growth; it also has this effect on liver cancer caused by safrole; biotin decreases the tumours (this experiment was cited, unreferenced, in the book Legal Highs under “safrole”. These effects are probably due to the immunosupressive effects of beta-casomorp hin 7 (BCM7), an exorphin similar to those found in gluten digests. A2 milk (from Jersey cows), hard cheese and butter supply very little BCM7 compared to uncultured milk or pure casien. See the book “The Devil in the Milk” by Woodford.
Sorry to be bossy, but you gotta read these!
‘The Disappearing Spoon, And Other True Tales of Madness, Love, and The History of the World From The Periodic Table of the Elements.’ by Sam Kean.
The Other Brain, R. Douglas Fields
Survival of the Fattest, Stephen C CUnnane
I never mind people being bossy about book recommendations. I’ve read the latter two, but don’t have the first one yet.
David Moss
‘ ..reduced zinc and iron status can lower the risk of certain cancers.’
Yes, and it looks as if this might explain Campbell’s results. Animal proteins seem to make iron and zinc more available than plant proteins do. Here’s some quotes from this paper:
http://jn.nutrition.org/cgi/reprint/115/2/200.pdf
‘Several investigators have noted that dietary iron was more bioavailable to humans when animal rather than soy proteins were fed ..’
‘Zinc was less bioavailable from the diet that contained soy assay protein than from the diet that contained lactalbumin .. These data confirm the observations of other investigators ..’
Another interesting paper says that aflatoxin plus iron overload causes liver cancer in Africa:
http://www.ncbi.nlm.nih.gov/pubmed/17399882
Something else interesting about casein and liver cancer. It seems that casein doesn’t promote uptake of manganese as well as soy protein does:
http://www.ncbi.nlm.nih.gov/pubmed/2915998
‘Liver manganese was higher (P less than 0.0001) in soy protein-fed rats .. than in casein-fed rats .. manganese superoxide dismutase activity also was higher in soy protein-fed rats than casein-fed rats ..’
This is important, because increased expression of manganese superoxide dismutase ’suppresses cancer phenotypes in a large number of human and murine tumours.’
http://jn.nutrition.org/cgi/reprint/134/11/3190S.pdf
@Jane That is interesting. Magnesium supplementation also upregulates manganese uptake and SOD and other antioxidant enzymes (perhaps not surprisingly given its multiple co-enzyme activating roles). Magnesium deficiency is perhaps the most characteristic of all the nutrient deficiencies caused by gluten sensitivity.
My point is that experiments feeding animals on soy protein, casien or lactalbumin tell us nothing about vegetable vs. animal protein, because these proteins have unique effects that are not shared by other vegetable or animal proteins. Also, in foods (as opposed to pure protein isolates) the vegetable proteins tend to come either with more carbohydrates than animal proteins (legumes and grains), or with more PUFA (nuts and seeds) and these factors (as we now know, thanks to you Dr Eades) are far too important to overlook and expect meaningful results.
One could perhaps compare a diet of fresh (not processed) meat, fish, poultry with one of legumes, nuts, seeds, grains; but even so, what sensible meat eater ignores healthy vegetable foods the way a vegetarian ignores healthy meats?
In the real world, the choice is between vegan diet, vegetarian diet with dairy products (probably the worst animal food for most of us), or the vegetarian diet with added meat (omnivore diet).
Vegetarians may avoid much disease because they avoid eating processed meats (often with added gluten) and casien-rich, uncultured dairy products; but a meat-eater who avoids these foods and also avoids gluten may do even better.
Great post. I was so thrilled by Denise’s critique on the China Study but I totally agree with you that we should all not fall victim to the confirmation bias. Critical thinking is important and we should not just accept anything our doctors or experts spew out, especially on health.
Have you seen this study?
http://www.ajcn.org/cgi/content/abstract/ajcn.2009.28713v1
and how it is reported in the news?
http://www.dailymail.co.uk/news/article-1296727/Sorry-Dr-Atkins-eating-LESS-meat-way-lose-weight-results-year-study-show.html#
We have here another study that is epidemiological in nature, which will be used in the future to promote a meat-less and low fat diet. Seems to me like another lack of critical thinking and a confirmation bias by the media.
Yeah, there seems to be some spin going on.
I think basically the study said that if you eat a 450 kcal of steak every day instead of 450 kcal of non-meat, then in 5 years time you would weigh 4lbs heavier.
I can’t tell from the abstract whether they attempted to measure bodyfat in any manner, but right off the top of my head I would wonder if maybe the meat eaters retain muscle better.
I guess meat calories are different than non-meat calories after all…
The China Study is like the Vegan Bible basically. They were all in awe of the immensity and SCIENCE behind it.
Tynan.net saying I EAT MEAT NOW in his new post is like you coming out with a post saying Post-Exercise Lipitor Supplementation Improves Muscle-Mass.
Thanks for the break-down.
I just found this paper about casein and iron:
http://pubs.acs.org/doi/full/10.1021/jf025554v
It says a peptide derived from intestinal breakdown of casein improves iron absorption.
I also found this paper saying that lysine does the same thing:
http://jn.nutrition.org/cgi/reprint/103/1/139
This might explain Campbell’s finding that adding lysine to a plant-protein diet makes it just as ‘bad’ as an animal-protein diet.
‘It has been postulated that low molecular weight chelates are essential to iron absorption and that they function by keeping iron in solution (refs). A number of chelating and complexing agents are effective (refs); however, the amino acids are of special biological interest because they constitute a large ligand pool in the intestinal lumen (refs). Prior work from this laboratory has shown that certain amino acids are effective in increasing (iron) uptake from isolated duodenal segments, and under certain circumstances, they can increase iron retention in intact rats (ref).’
The three amino acids found to increase iron absorption were histidine, cysteine, and lysine.
[...] recent response to the debate again….. The China Study vs the China study | The Blog of Michael R. Eades, M.D. The commentary and excerpts near the end were probably the most entertaining. __________________ [...]
Found this via a commenter on Denise Minger’s blog. Very interesting
http://www.amazon.com/Analyzing-the-China-Study-Dataset/forum/Fx1YJPR95OHW08P/TxY4S5EZD8Y2XE/1/ref=cm_cd_dp_ef_tft_tp?_encoding=UTF8&s=books&asin=1932100660&store=books
[...] The China Study vs the China study [...]
[...] Posted by emeadow A recent response to the debate again….. The China Study vs the China study | The Blog of Michael R. Eades, M.D. The commentary and excerpts near the end were probably the most entertaining. Totally! Now I [...]
What a great analysis. I’ll be sure to share. But, why encourage everyone to BUY this book, which will only make Dr.Campbell a millionare and be given prestige in the publishing world. How about we get it from the library? Or borrow a friend’s copy, or better yet, steal one from a whole foods!
In Campbell’s latest reaction to Denise Minger’s critique he confesses to his “confirmation bias” quite openly:
“I was simply asking the question whether there were biologically plausible data in the China database to support the findings gained in our laboratory,…”
So he obviously didn’t look for Popper’s one black swan, information that might REFUTE his hypothesis about the biological pathway between animal protein and cancer.
It is worth pointing out that Wikipedia in its entry on the China study comes up, under the misleading heading “criticisms”, with this bit:
“Campbell personally responded to Minger’s criticism showing Minger, who has no scientific background, has little understanding of scientific methods and made multiple serious errors in her analysis.[43] An epidemiologist also weighed in on Minger’s analysis, stating Minger was “incredibly naive in her crude analysis of [Campbell's] raw data.” The epidemiologist further stated Minger’s “analysis was crude at best and completely wrong at worst. No card-carrying epidemiologist would EVER be able to publish her results and draw the conclusions that she does.” [44]
”
Campbell does , of course, no such thing. He throws back at Minger the very argument against him and the examples Minger uses to sustain this argument: his misleading use of univariate analyses. The snooty reaction of that “card carrying” epidemiologist seems to be based on the same bad reading.
When Wikipedia looks wrong, think twice and consider your sources. If it still looks wrong — or just worded wrong — click “Edit” and fix it. There’s no need to fuss about the formatting, just the facts.
Think of it as a civic duty.
—————–
BTW, writing [[fat]] links to the article titled “Fat”. Writing [http://www.proteinpower.com/drmike/cancer/the-china-study-vs-the-china-study] inserts a link to this page. Use preview.
[...] If you read the opposing views of his book, you'll see why he is wrong . at least read this one. The China Study vs the China study | The Blog of Michael R. Eades, M.D. It's a fairly short and entertaining [...]
I don’t have a comment about this study but wanted to say it was nice to see you writing again and I’m glad you are home!
Ressy
who has finally made it down from 52 to 30 units of insulin a day!!!!!!
Congrats on the insulin reduction. It’s nice to know someone misses me when I’m gone.
I’m curious, Dr. Eades. Is this blog entry simply not attracting the true-believing Cambellite Brethren & Sistren? Or are you not letting their comments go through?
It must not be attracting the true believers. I haven’t deleted a single comment. Maybe the true Cambellite’s (as you call them) have been so beaten down by the deluge of negative posts about their leader that they’ve taken cover.
[...] The China Study vs the China study (at The Blog of Michael R. Eades, M.D.) [...]
Hi Dr. Eades:
I find all of the mudslinging back and forth between high protein and low protein proponents tiring and unhelpful. This last batch with regards to T. Colin Campbell is along the same lines. I’m a biologist by training (I’m a public school Principal by vocation). I wish I knew who to trust with nutritional advice. A lot of people, yourself included, seem able to peruse the literature and cherry-pick studies that support your hypotheses. It might be that T. Colin Campbell does this, too, to some extent, but it’s just so hard to tell with all of the ad hominems going back and forth. I don’t think that Campbell is the only one who engages in, possibly, “obfuscating” from time to time. I guess what my question boils down to is this:
Who really wants to know the truth and is willing to honestly go where it takes him/her, and at the same time is trained and skilled enough to navigate and evaluate all the research fairly? I think you would claim to be such a person. Who has the courage to change his or her mind, even if it is publicly embarrassing, based on new evidence (or a closer look at the existing evidence)? Would you say that is you, too?
Who can you trust?
Sadly, Dr. Eades, I have to say that I don’t think I can trust you. You are another diet physician slinging the mud around and – it appears to me – engaging in disrespectful attacks on others. I understand. I’m sure you get a lot of it yourself and it’s just human to respond in kind, especially in the blogosphere. I can forgive you somewhat for that, and by that token I guess I would extend the same for T. Colin Campbell. I’m not sure I can trust him either. The work of his that I’ve read (I haven’t read the China Study yet) goes back 10 to 20 years, but it was (as I recall) quite scholarly. I could be wrong.
Why can’t I trust you, though?
1. Years ago, I picked up your book, Protein Power, in the bookstore, and thumbed through it. Two things popped out at me that were immediate deal-breakers. There was the chapter called the “Evidence from the Pharaohs” (or something similar). My God, what a stinker! You suggested that since the Egyptians ate a lot of bread, and the mummies of Pharaohs revealed that they had lots of health problems, therefore high carb diets caused those health problems. This is probably the worst example of evidence, coming from a doctor, I’ve ever heard. As if Pharaohs ate the same things that the common person at that time did. As if this isolates for other variables. You lost your credibility with me, pretty much completely, with that chapter. I still find it unbelievable that you would put that forth as evidence.
2) You suggest that vegetarians should read “a little gem of a book” (your description) whose name now escapes me, by a farmer who describes a world “red in tooth and claw”. This would, you suggest, set them straight about having any feelings for animals that would convince them that it’s not okay to raise, kill, and eat them. Animals kill each other, animals are cruel, nature is cruel. Therefore – I’m giving you my interpretation here – don’t worry about any feelings of compassion you might have for sentient creatures that humans raise for food. Suggesting this so completely misses the mark, and is so insulting to the intelligence of compassionate vegetarians, that I felt immediately repulsed. It gives the impression that you think vegetarians are incapable of abstract thought, and are at best well-meaning buffoons who should give their heads a shake and follow the nature-red-in-tooth-and-claw rulebook, as if that sets some kind of gold standard for compassionate behaviour – that we can’t do better than nature’s playbook.
3) There are other things…you operate a commercial website on which you sell expensive supplements that are clinically unproven (“Immunopro”, “Daily Regimen” etc.). “Enhance your immune system” indeed. That’s the vague and meaningless claim that you can make under the FDA rules – just don’t say that it cures or helps an actual disease or condition (but I think you know that). Do your commercial interests outweigh your ethical obligations as a physician? Can’t say for sure, but this is a large, smelly black mark against you. Your views don’t reflect those of the American Heart Association and a considerable body of peer-reviewed, publicly-funded research. Like most “alternative” medical practitioners, you say that “mainstream” science that disagrees with your assertions (like the AHA) is wrong, while you – a fearless pioneer – make extravagant claims that science doesn’t support. You produce dismal infomercials to sell your books and products and use testimonials as if they were evidence – I’m not even sure that you understand why that is bad science.
Would you have the courage to change your mind publicly, based on new evidence? Or will you ride your Protein Power horse into the sunset, come hell or high water? Nothing I’ve seen from you inspires me that you would choose the former. I would hope that I’m wrong. But I’m afraid you just don’t earn my trust and I can’t in good conscience recommend your work.
Not knowing who to trust (the closest I’ve come to it is Stephen Barrett, M.D. at http://www.quackwatch.org/06ResearchProjects/lcd.html) and the doctors at sciencebasedmedicine.org (http://www.sciencebasedmedicine.org/?s=low+carb), I guess I can only rely on primary sources (and all the work inherent in judging the relative worth of each study). Too bad, it’s a lot of work to do this as an individual.
I am assuming that you will dismiss my criticisms in the usual way (I am sorry, I am really not trying to insult you with that comment – it’s really what I honestly think). You are undoubtedly a good person who is trustworthy in most parts of his life. Thanks for accepting this feedback.
Thanks for the thoughtful comment. I’m not going to address all of your concerns or critiques of my ethics, but I will address a couple.
First, based on your comment, it’s difficult for me to believe you actually read the chapter on diet and early man. The small section on diet and the ancient Egyptians was just a small part of the entire chapter. I thought it was important because it demonstrated that a population of people who existed before sugar, as we know it, existed and who consumed a high-carb,, whole-grain diet, suffered from all the medical conditions – heart disease, diabetes, obesity and probably high-blood pressure – that people do today. And to show how ridiculousness of the mainstream nutritional advice – the advice to follow what is basically an ancient Egyptian diet – when that advice is given to prevent the very diseases the ancient Egyptians suffered.
Second, you obviously didn’t read the little gem of a book – The Covenant with the Wild – or you wouldn’t have so completely mischaracterized it. And you have totally mischaracterized what I had to say about it.
Interesting… here’s what the doctors at sciencebasedmedicine.org have to say about The China Study:
http://www.sciencebasedmedicine.org/?p=385
http://www.sciencebasedmedicine.org/?p=6092
Yes, interesting – though I did think Harriet Hall was being presumptuous in accepting Denise Minger’s work uncritically (Dr. Hall is usually very skeptical).
Closer to home, here’s a few other reviews that might be of interest to readers of this forum:
http://www.sciencebasedmedicine.org/?p=6332
http://www.sciencebasedmedicine.org/?p=5285
http://www.sciencebasedmedicine.org/?p=3298
http://www.sciencebasedmedicine.org/?p=3193
http://www.sciencebasedmedicine.org/?p=3067
http://www.sciencebasedmedicine.org/?p=570
http://www.sciencebasedmedicine.org/?p=491
http://www.sciencebasedmedicine.org/?p=372
http://www.sciencebasedmedicine.org/?p=219
http://www.sciencebasedmedicine.org/?p=207
http://www.sciencebasedmedicine.org/?p=58
@Brett,
“I wish I knew who to trust with nutritional advice.”
Maybe you should trust yourself. The only person with your best interests at heart is you.
“Too bad, it’s a lot of work to do this as an individual.”
Then I guess you’re doomed to ride the coattails of the “guru of the day”.
Thanks for your comments, Dave.
“Maybe you should trust yourself. The only person with your best interests at heart is you.” Certainly a great sentiment, and I support it, though not entirely. Try as I might, I can’t be an expert on everything. I’d love to build an airliner from scratch in my backyard – just can’t seem to get the navigation, hydraulic, engine, or life support systems to work. Are you having any luck with this? I’ve also learned that I can be dead wrong about a great many things. It happens far too often, and it’s going to happen again. I am, for better or for worse, human. Trusting myself is entirely valid when I’m (for example) redecorating my basement (please don’t talk to my wife about this). It’s not so clear that it’s a good thing when it comes to topics where I’m out of my league in knowledge, training, or experience. For example, there exists a “controversy” about vaccinations for children and the increase in reported cases of autism. This is a very important decision! The health, perhaps even the life of my children is at stake. Should I trust my “mommy instincts” (like Jenny McCarthy), listen to people like the fearless pioneering physician (or discredited quack) Andrew Wakefield, follow the mainstream advice of my pediatrician, or go become a pediatrician myself? That last one might not be a timely option anymore. The health of my children requires an immediate decision. What do I do?
I don’t know you, Dave, but I would hazard, as a guess, that I know more about what constitutes effective pedagogy and improving the achievement of at-risk students in public schools than you do. I am a relative expert in this field, and my job involves the practical and theoretical application of educational research. If you were the parent of an at-risk student, I could provide you with practical, proven support strategies for your child that would immediately improve his or her prospects for success. I earned this expertise through training, application, experience, and ongoing study. You can say that you could do just as well (or better) in helping your son or daughter, as a lay person, by “trusting yourself”, rather than listening to advice from people in the field, such as myself. But do you really think that’s the best that you can do for your most important decisions? More generally, is there a place for expert advice in your paradigm?
Having a reliable source of advice on complex matters, such as nutrition, can be very helpful. Too bad it’s so rare. Don’t worry, Dave. I can think for myself and can make decisions in the absence of good advice from relative experts. But I also understand the value of good advice from relative experts. I hope that you can, too.
“Then I guess you’re doomed to ride the coattails of the ‘guru of the day’” I always find being doomed to be so depressing… it’s okay – this is not going to happen for me, and, I hope, not for you, either. Thanks again for your comments, Dave.
Bret, I sympathize with you, brother. If one is not confused about what is the “best” diet for human beings then he simply hasn’t been studying what all the “experts” have been saying. Here’s the solution: try one of the diets…duh. Pick up a representative book on each of the major diets. Read the book. Get a lipid panel. Try each diet for 6 months following the book EXACTLY. Get another lipid panel (one that breaks down LDL like NMR or VAP not the one you usually get from your PCP). Also, make sure to keep a log about how you look, feel and perform. Go with the diet that makes you look, feel and perform at your best. If you cannot adhere to the diet for six months, then that has to be taken into consideration when you’re deciding if that is the diet for you. Good luck!
Thanks, Stephen – I really appreciate your advice and the spirit in which it was offered.
@ Brett, you seemed reasonably plausible, right up to where you touted Quackwatch. I’m sorry, that website is a good example of selective quackery. You won’t find a single expose of harmful medical or psychiatric practice on it, because that’s the built-in bias, and it’s surely a much greater bias than any you’ll find in Dr Eade’s work. In cases where I know significantly more about a subject than the quackwatch bloggers, I have found them to be dishonest. The experiments they cite in the Orthomolecular page, for example, bear no relation to orthomolecular theory or practice. Someone who didn’t know the truth might be inmpressed. The fact is, Quackwatch are shills for an nindustry that kills and mutilates unnecessarily thousands of people every year. What credibility can they have until they address the quackery under their noses? But if they told the truth, they’d be drummed out of their unions and lose the right to put all those letters after their names.
You seem to ignore the “proof of pudding” evidence, that low-carb diets and dietary supplements are effective at controlling or preventing disease, according to us, the people who actually use them. We’re not about to change our minds because of any amount of evidence from rats, or any amount of speculative ad hominem criticism. “Only an idiot lets an expert contradict their own experience”.
It’s a dirty trick to criticise Dr Eades for only making vague claims on his supplements, when you know full well that the law prevents him from refering to the truth, but that if you look in his books (or any biochemistry textbook) you’ll find the whole rationale. Do you educate the kids in your power to that ethical standard?
I don’t know about the AHA but the New Zealand Heart Society is a joke. They put their heart tick on breakfast cereals which are 30% sugar for the reason that they contain less than 2% fat. And, of course, because the manufacturers support the Heart Society.
Ditto re: quackwatch. Who’s watching the watchers?
Bret lost a lot of credibility referencing the site.
Thanks for pointing it out.
I also want to step on the “change your mind publically” to prove you’re a scientist or something.
Most doctors who profess an “alternative” idea have already changed their mind publically about many things. They have actually questioned the prevailing orthodoxy, found it wanting, assessed the evidence and re-aligned themselves.
That’s more than you’re asking of the yes-men already.
The other point is, that if Dr Eades or Dr Atkins or any low-carb proponent said “I was wrong”, they wouldn’t just be dismissing their own idea as false; they’d be rejecting the recieved view of mammalian metabolism that is contained in every biochemistry textbook. This is easy for mainstream nutritionists to do as they either haven’t studied biochemistry or don’t think it’s important. But they’re wrong, and any nutritionist who makes a serious study of what principles govern what happens to nutrients in the body – which has been well-understood for decades – is going to realise that mainstream nutritional practice is completely out of sync with mainsteam biochemical theory, and the latter is the hard science.
Hi George:
Thanks for your comments. I have a little time this afternoon (though not enough for a comprehensive rebuttal), so I thought I would respond to some of your statements. You are asserting a familiar position but are not making a good case, from my perspective, for any of your points. I’ll try to respond in the order you used in your post:
1) “you touted Quackwatch” Please re-read my original post. I’m not touting anything, except perhaps the necessity of the careful study of primary sources. Quackwatch is not where you can do that, but the information there, in my opinion, is certainly more science-based than anything I’ve seen on Dr. Eades site. I am skeptical of any source or site and, as best I can, try to evaluate information in a claim-by-claim basis. Your claim that Quackwatch is a good example of “selective Quackery” is unpersuasive. “You won’t find a single expose of harmful medical or psychiatric practice on it” – I have to assume you have a different definition of medical practice than I do, or else this statement is a non- sequitur. Exposing harmful medical practices is the very reason for the site. Two examples addressed by Quackwatch are homeopathy and acupuncture. What on earth are you talking about? Based on what you wrote, it sounds like you are a proponent of orthomolecular psychiatry – I apologize if I’m wrong on that – and that this is what may be driving some of your own biases. To say the least, the general claims of orthomolecular medicine have not been scientifically proven. To say otherwise would simply not be true, unless you invoke a conspiracy theory (which you seem about to do with your references to you “knowing the truth”, and quackwatch doctors being “shills” for an industry).
“they’d be rejecting the recieved view of mammalian metabolism that is contained in every biochemistry textbook.” What on earth is this “received view”?
2) “I have found them to be dishonest” – another ad hominem. It is possible to be inaccurate without being dishonest. If the information is inaccurate, you can ask them to update it and provide more accurate information and references. The last part of the paragraph that follows this is a bit of an incoherent rant. You can be forgiven for ranting occasionally (this is a blog, after all) but it doesn’t prove any of your points. I suppose you could dismiss whatever I say by calling me a shill for big pharma, but it won’t support your arguments.
3) “We’re not about to change our minds because of any amount of evidence from rats, or any amount of speculative ad hominem criticism.” I certainly believe you on this point. If your beliefs are unfalsifiable, then you have left the realm of science and there is no reason for further conversation. If what you’re saying is “We don’t care about the science (or science that doesn’t confirm our beliefs). It works for us. That’s our truth”, I worry about what happens next. Do you stop vaccinating your children because Jenny McCarthy says it caused her son’s autism? I hope not.
4) “You seem to ignore the “proof of pudding” evidence”. Yes George, I do, because it’s not sufficient evidence. I repeat that testimonials are the weakest form of evidence (but the most seductive) and can’t be relied upon if you wish to make scientific progress. We can all be wrong, partly or wholly, about pretty much anything. We can all be fooled and bamboozled. Our best defense for this is the scientific method. The scientific method is how we painstakingly tease out the truth from half-truths and absurdities. When you abandon it and the critical thinking skills that it engenders, you are defenseless against the next alluring scam that comes along. You are welcome to keep all of your beliefs – just don’t call it science or be offended when someone points this out. If your claims are true, then they can be properly and scientifically tested and validated. At that point, I would be happy to accept those claims.
5) “It’s a dirty trick” [ouch, George, why the ad hominem?] “to criticize Dr Eades for only making vague claims on his supplements” [nonsense – if he is selling a $100 bottle of supplements, he is the one who needs to provide the overwhelming evidence of its safety and efficacy] “when you know full well that the law prevents him from refering to the truth” [the main logical fallacy here is your unstated major premise, which I’m assuming (and forgive me if I’m wrong) is that you think there is a conspiracy to suppress the truth.], “but that if you look in his books (or any biochemistry textbook) you’ll find the whole rationale.” [huh? I’ve studied biochemistry. The “whole rationale” (as you describe it) is not in the textbooks. You need to be more specific with your claims.] “Do you educate the kids in your power to that ethical standard?” [I do the best I can – are you making a point or is this another ad hominem?]
6) “I don’t know about the AHA but the New Zealand Heart Society is a joke.” That may be partly or completely true, but I was only referring to the AHA’s stated position.
7) “I also want to step on the ‘change your mind publically’ to prove you’re a scientist or something.” This isn’t what I said. The question is whether someone has the courage to change their position, even their most cherished position, based on evidence. This is a common practice in real science, and a very rare one in alternative medicine and pseudoscience. Dr. Eades, I would suggest, has built his career and kingdom around his Protein Power diet. He has many adoring fans, and much invested (on many levels) in his position. If science was to show that the claims made by the proponents of this diet were false (for example, if his diet was shown to increase the risk of heart attacks or kidney damage in well-controlled, long-term studies), would he retract his claims and change his practice? In #3 above, your quote points to what usually happens in those sorts of situations. People are so tied to their positions, and so invested in their beliefs, that they can’t change, and so must either move the goalposts or look for other research (often inferior research) that confirms their beliefs. They drift further into pseudoscience. I don’t know if this is the case, or would be the case with Dr. Eades, but it is such a common human behavior that, at the very least, you should agree that we need to be vigilant about it happening to ourselves. It is very difficult to find anyone, actually, who at some point has not been guilty of some form of confirmation bias. I have done it myself many times. The glee with which I see people on this site pouncing on Dr. Campbell is one indicator, I believe, of an underlying confirmation bias. Dr. Campbell may have gone beyond the data in some of his claims (I honestly don’t know – I’m just saying it’s possible). The same could also be said for Dr. Eades, and the same can be said of your claims. If we don’t relentlessly use the error correcting mechanisms built into the scientific method (imperfect though our efforts may be), we will eventually all fall victim to pseudoscientific claims, which can cause real harm and suffering.
9) “This is easy for mainstream nutritionists to do as they either haven’t studied biochemistry or don’t think it’s important.” Another zinger. Ad hominems mixed with cognitive distortions. This is the case for all “mainstream nutritionists” (whatever that is)? Every single one of them? They’re all either ignorant or they don’t think biochemistry is important? There are no other possibilities?
10) “But they’re wrong, and any nutritionist who makes a serious study of what principles govern what happens to nutrients in the body – which has been well-understood for decades – is going to realise that mainstream nutritional practice is completely out of sync with mainsteam biochemical theory, and the latter is the hard science.” Is the acid test for completing a “serious study” of nutrition being in agreement with you? Nutrition, digestion, and the effect of diet on health really are complex topics. Here’s the bottom line: I don’t think the evidence is sufficient to say that low carb, high protein diets are even not harmful, let alone optimal for human health. As best as I can surmise, this is the general consensus of modern science at this point in time. If that changes, it will be because the accumulated evidence changes, not because a bunch of people beat up (metaphorically) T. Colin Campbell on the internet. The thing that bothers me most, George, about your response is the underlying contempt you seem to have for the everyday scientists, physicians, and nutritionists who do not share your position – as if they are out to intentionally mislead people or keep them from the “truth.” It is this casual assumption of moral superiority that I find the most discrediting to your position. I apologize for my frankness and I don’t mean to single you out – I see a lot of this same thing on most of the alternative medicine sites, such as this one. Thanks again for your comments, and I wish you good health.
Thanks for the reply, Dr. Eades. I wish you addressed the tougher points I raised, rather than the “low hanging fruit” about my (admittedly incomplete) recollections of thumbing through your book years ago. The thing that struck me in that Evidence of the Pharaohs chapter is that you are suggesting that the actual Pharaohs (the rare people who got mummified) were the ones who consumed a high-carb, whole grain diet (rather than the common citizen (who weren’t mummified). Really? They were the rulers! They ate the most luxurious foods, including plenty of animal foods and sweets. It wasn’t a high-carb, whole grain diet. Look it up yourself or consult an Egyptologist. It’s a very basic thing, and I’m not sure why you don’t understand my criticism of that specific point.
Your reply contained a few confusing claims (well, they confused me, anyway). Your assertion about “the ridiculousness of the mainstream nutritional advice – the advice to follow what is basically an ancient Egyptian diet” is a rather strange claim to make right after saying that the ancient Egyptians lived “before sugar, as we know it” and “consumed a high-carb, whole-grain diet”. I guess I’m not getting it. Mainstream nutritional advice is to eat no sugar but have a high-carb, whole-grain diet? The ancient Egyptians “suffered from all the medical conditions – heart disease, diabetes, obesity and probably high-blood pressure – that people do today” on this sugar-free, high-carb whole-grain diet? The people today who have those diseases, they are following a sugar-free, high-carb, whole-grain diet? Or are they also eating a diet high in simple sugars and refined carbohydrates? Can you see why this is confusing? Remember, I’m not accepting your claim about the Pharaohs. The fact that the extremely small cohort of well-fed prosperous, later-to-be-mummified rulers of Egypt had heart disease, diabetes, obesity etc. is no surprise given that they could eat and have access to just about any food they wanted, in abundance. We don’t really know, however, exactly what they ate every day, though I’d be more than surprised if it was a purely sugar-free high-carb, whole-grain diet. In such a small sample size, with uncontrolled variables, I just can’t see any merit in this as an example. Perhaps in the rest of the chapter, you had some better points. However, your argument is only as good as the weakest link. I continue to maintain that this is less than a very weak form of evidence for your hypotheses.
You’re right about another part of your reply – of course I didn’t read “The Covenant with the Wild”. I thought it was clear that your recommendation of the book was the part that I found offensive and served as an absolute disincentive to reading it. It really has nothing to do with anything in the book. Really, the suggestion that, by reading some book, you could disabuse people of what is (for many) is the most fundamental reason that they are vegetarian is so dismissive of their deeply held beliefs, it is insulting. I can believe you if you say that the slight was unintentional on your part, but you should at least be able to see why people would find this offensive. Rather than saying that I have totally mischaracterized you (the easiest defense of all), why don’t you address this point with at least some substance? If we are able to put aside any ethical objections to consuming increased amounts of animal foods, it sure makes it easier to promote a high protein diet. But putting these objections aside is not something that is easy to do, or that you have been able to do – and certainly not by casually offering up another book to read. That suggests that you think your vegetarian readers haven’t examined the issue deeply already (at the level of, for example, the work of Peter Singer). You seemed to say, “Read this one book, and the ethical issues around consuming animals, you will see, will no longer be an issue for you.” Please, I’m not interested in mischaracterizing you – and I’m sure a lot of vegetarians would appreciate a more thoughtful response from you – so feel free to set the record straight here. And if you could address some or any of the other points I raised, it would certainly be of interest to skeptics of your work. Thanks again for taking the time to read and respond to my post.
I’m sorry you feel my arguments are less than compelling. But I’m afraid you’ll have to take them as they are.
I argue most of my cases fully throughout this blog, and I typically go into great depth. My full arguments over the issues that are of concern to you are here if you choose to search for them.
I view this blog as my living room, a great room into which I invite anyone who wants to come and listen to me expound on whatever it is feel like expounding on. I try to be a gracious host, and I expect my guests to be gracious as well. And I’ll tolerate polite dissent and polite argument over the points upon which I expound. But, in the end, it is my living room where you and anyone else is invited at any time, and, as such, I’ll decide on which arguments to deal with head on and which to ignore. If I choose to ignore good and rational arguments about the points I’m trying to make, the guests in my living room may find me shallow and leave so that I find myself talking to no one. That is my risk in ignoring specific arguments.
But, I sense that you are an ideological vegetarian, and if so, no amount of reason and argument on my part will persuade you that you might be incorrect. So, since I don’t enjoy tilting at windmills, I’m going to withdraw from this one. If you can give me specific evidence that, if true, would dissuade you from your point of view, then I may try to provide this evidence. But I’ve been around far too long to get myself stuck in the an interminable discussion that ends up leading nowhere.
Dear Dr. Eades:
Thanks for allowing me into your living room for this brief visit. You have been a gracious host. And I understand that you prefer that I now leave.
“But, I sense that you are an ideological vegetarian, and if so, no amount of reason and argument on my part will persuade you that you might be incorrect.” Sorry, though I don’t know precisely what you mean by “ideological vegetarian”, I can assure you that I am not that, and that I will change my mind when presented with good scientific evidence.
Where’s the “reason and argument” piece, by the way, on your part, in our recent dialogue?
“If you can give me specific evidence that, if true, would dissuade you from your point of view, then I may try to provide this evidence.” Sorry, this is awkwardly worded. If what you are asking is “What would convince me that the Protein Power diet is safe and effective?” then great! Here is what I would want to see:
- Properly designed and controlled scientific studies that show there are no long-term negative health effects of this diet
- Properly designed and controlled scientific studies that show this diet significantly improves weight loss over a long period of time (five years seems to be a reasonable number).
- Properly designed scientific studies that predict that this diet, if adopted by a majority of the world’s population, will not have a negative effect on the environment
- Properly designed scientific studies that predict that this diet, if adopted by a majority of the world’s population, will not have a negative effect on the health and welfare of animals.
“I’ve been around far too long to get myself stuck in the an interminable discussion that ends up leading nowhere.” Absolutely. I completely understand where you are coming from here. Thanks, and I wish you all the best.
Brett Raycroft
raycroft@shaw.ca
You wrote:
That is incorrect. I don’t prefer that you leave. You may stay as long as you like. I’ve noticed that many other readers have engaged with you, and that is fine. I just don’t have the time myself to engage in a debate that is likely to go nowhere.
As to your criteria as to what would make you change your mind…you’ve set a pretty high bar. One that any diet you may be in favor of certainly couldn’t meet.
Interestingly, in view of this conversation, here is a study that just came out today in the venerable Annals of Internal Medicine. It’s not a five year study, but it is a two-year study, which is about as long as the longest dietary studies (that aren’t observational studies) go. You may not know all those doctors and researchers in the list of authors, but I do, and virtually all of them are believers in low-fat diets. Must have been a bitter pill for them to have swallowed when the data came in.
Again, please feel free to hang around. My intention is certainly not to drive you away.
Thanks very much, Dr. Eades. I appreciate that the door is still open. To be honest, though, the room doesn’t look as inviting if you’re not going to engage in a substantive dialogue on the points I raised. I respect your right to do so, however, and wish you well in the future.
Sorry, but I have a last comment. By your response, you are saying that you are not a scientist. That’s okay! But please be honest about it.
[...] Power (Dr. Michael Eades): The China Study vs the China study [...]
Brett picked up Dr.Eades’ “Protein Power” in a bookstore and quickly made up his mind that the book was no good. He writes:
“You suggested that since the Egyptians ate a lot of bread, and the mummies of Pharaohs revealed that they had lots of health problems, therefore high carb diets caused those health problems. This is probably the worst example of evidence, coming from a doctor, I’ve ever heard. AS IF PHARAOHS ATE THE SAME THING THAT THE COMMON PERSON AT THAT TIME DID.” (emphasis added A.B.)
I have checked the relevant section. In fact the word pharaoh is not mentioned once there. Dr.Eades talks about mummies in general and states that the
‘number of mummies … has been estimated by some experts to equal the population of Egypt today.’ Does that suggest that we are exclusively dealing with pharaohs here?
One can indeed assume that, generally speaking, mummies are the remains of people who were better off and had therefore perhaps greater access to relatively expensive protein than the common folk. However, we are assured that the bad sieving methods of flour used for bread left flakes of stone and sand in it and that this caused an abrasion of teeth, from which all classes seem to have suffered (the remains of Amenhotep III provide a notable example here). In other words the consumption of bread seems to have been widespread (see http://www.reshafim.org.il/ad/egypt/timelines/topics/bread.htm).
Brett seems to be eager to find his way among the conflicting diet advice. May I suggest that careful reading is the prime requirement here? He also holds it against the low-carb adherents that they act against the advice of ‘mainstream science’. But it was ‘mainstream science’ that saddled us with the ‘food pyramid’ and after (careful) reading of Gary Taubes’ magisterial ‘Good Calories Bad Calories’ concerning the ’scientific’/political background of that piece of misguided advice I lost all trust in ‘mainstream science’ on this point. Did Brett encounter that book or did he pick it up, like Protein Power, in a bookshop and reject it after (mis)reading one paragraph?
(.
Thanks very much for your comments. I appreciate that you engaged less ad hominems than usual for this site
“‘number of mummies … has been estimated by some experts to equal the population of Egypt today.’ Does that suggest that we are exclusively dealing with pharaohs here?”
Okay, fair enough. Could you please tell me what is the size of the cohort group of mummies for which these dietary claims have been made, and what did they eat that that caused their health problems? I will retract my criticisms if this turns out to be a large, homogenous group for which the usual variables have been controlled.
“Brett seems to be eager to find his way among the conflicting diet advice. May I suggest that careful reading is the prime requirement here? He also holds it against the low-carb adherents that they act against the advice of ‘mainstream science’. But it was ‘mainstream science’ that saddled us with the ‘food pyramid’ and after (careful) reading of Gary Taubes’ magisterial ‘Good Calories Bad Calories’ concerning the ’scientific’/political background of that piece of misguided advice I lost all trust in ‘mainstream science’ on this point.”
Thanks for the advice about careful reading. I’ll do my best to follow it.
I’m sorry to hear that you have lost all your trust in mainstream science. Does that mean that you don’t vaccinate your children, drink the water from your tap, drive a car, talk on your cell phone, or use your computer?
Though I don’t know about Gary Taubes work, what I will say is that many errors have been made in the name of science, but that the scientific method contains, within it, error correcting machinery which, if utilized, reduces the error bars with each successive generation. Our generation, thanks to the progress of science, has addressed many of the challenges that our parents and grandparents faced. One of my sons has Type I Diabetes. He would have died an agonizing death years ago without the interventions of modern science.
“Did Brett encounter that book or did he pick it up, like Protein Power, in a bookshop and reject it after (mis)reading one paragraph?”
Thanks for the ad hominem. As a parting request (Dr. Eades would rather I not contribute anything further to his blog), could I suggest that you might be a bit more friendly to those who do not support the specific claims that support your hypotheses?
Being honest is sometimes better than being friendly.
I wish I could figure out how to make hyperlinks on a Mac:
http://www.canlyme.com/quackwatch.html
Stephen Barret of Quackwatch has taken a major fall.
Brett, once again please read carefully. I didn’t write that I had lost all trust in mainstream science in general. I said ‘on this point’ that is as far as diet matters are concerned. You quoted it and then chose to overlook it.
Is there a familiar ring to any of this?
“Barrett is a shill for the medical and pharmaceutical cartels and his bully tactics and unjustified discrediting of leading innovators, scientists and health practitioners should not be tolerated.
Negrete said, “You can be assured that our legal team will be wherever health freedom advocates and practitioners are being persecuted. The tide is now turning and people are no long accepting that synthetic drugs are the only form of treatment are the only way to address health concerns.
Every day, consumers are becoming more educated about the benefits of holistic and alternative methods. This is something that the medical establishment obviously fears and wants to crush with false propaganda.”
Case closed. Thanks for providing the link, Jeanne. Take care, good luck with your Mac, and try to drink the Kool-Aid in moderation.
Huh?!!!
“…and try to drink the Kool-Aid in moderation.”
Would you describe this as an ad hominem attack? Curious.
Hi Arie:
You’re 100% right. You did say “on this point” in your original post. I’m very sorry that I overlooked that – it wasn’t intentional. Thank you for correcting me.
I think one important issue raised here is “I find all of the mudslinging back and forth between high protein and low protein proponents tiring and unhelpful…. I wish I knew who to trust with nutritional advice. A lot of people, yourself included, seem able to peruse the literature and cherry-pick studies that support your hypotheses. …Who has the courage to change his or her mind, even if it is publicly embarrassing, based on new evidence (or a closer look at the existing evidence)? …. Who can you trust?
For a start, style is important. Unrestrained, even ad hominem attacks are ok in your friend’s living room (I envision a SousVide prominently displayed like a sculpture, the Colpo dartboard pretty much reduced to shreds) It is also Ok in a blog (I think that’s what blogs are for). When you put them in a scientific paper or a book that is supposed to be a scientific argument, that’s a really bad sign. I haven’t read Campell’s book. It certainly sounds like it has some devious arguments but I am of the opinion that if a diet works for you, go for it. (Mike and I disagree on this — he thinks carb restriction is almost always best and we have compromised with the principle: there is no reason you have to be on the very best diet). It is the unrestrained attack on Dr. Atkins that makes you think twice. Now few are as tasteless as Mike Lean who wrote a “scientific” article called “Is Atkins Dead (Again).” Even lawyers are considerate of widows. So protesting too much is one sign.
All literature citations are cherry-picked. It is a question of how tart the cherry is. That is why when I referee a review article, I ask the author to include graphs or other data from the original source rather than just citing the conclusion. If the author can’t do that, that is not helpful and may be suspicious. I am sympathetic about how much work it takes to find enough clear information to make a decision but there are some guidelines to reading the original literature. One is whether the data is clearly presented in understandable graphics. If the paper is all tables in a dense, mind-numbing format, the author, at minimum, has not learned his trade: make the data accessible to the reader.
More on this, later. I think I am preparing a guide to reading the scientific literature.
I would say that some people tolerate carbohydrates better than others. Many people smoke and live very long lives (Picasso and Winston Churchill come to mind), but that doesn’t mean that everyone should be encouraged to smoke. We don’t know – but we can reasonably believe – that the long-lived smokers would have lived longer or been in better health had they not smoked. In my opinion, it’s the same with carbs. Just because some people seem to do fine on them doesn’t mean these people are doing optimally or that we should use them as examples to promote carb consumption for everyone. Or even anyone.
An excellent and insightful post, Richard. I’d be interested in reading your guide when you have prepared it. Thanks for your observations.
Here is Denise Minger’s completed analysis:
http://rawfoodsos.com/2010/08/03/the-china-study-a-formal-analysis-and-response/#comments
[...] thoughts on his MovNat experience and we also discuss the Crossfit Games. Here is that blog post I mentioned from Dr. Eades regarding the China study. [...]
First of all you and your wife are my heros along with my brother who got me to read ‘protein power’ in the fall of 1999. That book along allowed me to basically and effortlessly lose the 45 pounds I needed to lose, from195 to 150 in five months. There is absolutely nothing more exhilarating than to do something for your health and find it works meaning you have found or been given the key to health. Atkins is another favorite, bless him too.
But it is shameful for studies that you critiqued to be allowed into the public’s hands, one for promoting the wrong way to eat and two, to enhance the fortunes of the carb industry, which I have come to realize, not just by reading taubes’ ‘good calories – bad calories’ but just experiencing the marketing of those really nasty things people are convinced are healthy foods, especially children. Maybe one day all lobbying will be outlawed and someone like the fda will truly regulate the food industries.
Thank you and your wife for your ‘protein power’ and ‘proteinpower life plan’.
Thank you for the kind words. We really appreciate hearing from you. It makes our day.
Brett,
I have noticed in your posts a certain idealized concept of medical science and the scientific method, which at times in my opinion, was a way more lofty view of science than actually exists in reality. It is understandable that a non-scientist would expect this of science, medical science and the scientific method. Most expect it when exposed intellectually to its tenets of precision and control. But its implementation is usually different, especially as it relates to the difficulty of controlling variables in human studies, and what is often yielded in even the most carefully designed study is more gray area than black and white. When, then, studies do not have careful controls, what you usually get is a complete mess, and unfortunately there is a lot of mainstream medical research that falls into this category.
I received my graduate scientific training at the University of Colorado in exercise physiology under the tutelage of some of the best brains in this field. They were so concerned about this problem of bias in medical research that they drilled us in skepticism constantly. Not to worry about what the homeopaths or the accupuncturists or anybody else was doing, but to first and foremost be skeptics of what was happening in the fields we were gong to be responsible for: metabolic biochemistry, exercise physiology and the diseases of civilization. We were regularly huddled into viewing this film or that presentation on the mischief going on in medical science. We were required to regularly give presentations ourselves on sections of big review articles, analyzing the research cited by those sections to see how well it supported the conclusions made by the review – it often did not. We were required to review studies that did not get published because their findings did not yield statistical significance, an extraordinarily important thing to know but rarely disseminated into the professional literature. And our own work, our thinking and our assumptions were relentlessly critiqued. One entire day of my comprehensive final exams was devoted to analysis of research design and statistics. It was that important to them that the only thing that impressed us was a deep analysis of the actual data. Good training in the medical sciences yields skeptics of medical science.
Therefore, you have clinical professionals like Dr. Eades and Dr. Feinman [and Dr. Atkins and many, many others both from clinical practice and academia] who take everything with the requisite grain of salt in the fields for which they have responsibility. It would be one thing if the messes of medical science mentioned above kept to themselves, but they do not. Many of these messes have found political favor over the years and have found their way into public health policy which many of us feel, with good evidence, have contributed to the escalation of disease, not the remediation of it. When you treat patients who have been “following the guidelines” and are becoming sicker, the responsible thing to do is to question the guidelines. I cannot speak for Dr. Eades on your assertions of ad hominem, but I can relate my own frustration and anger as an advocate for sick patients who keep trying to do what they’re told, which is the same thing over and over again, and keep expecting different results; i.e., success with their health. When another crappy piece of research like The China Study is widely disseminated, it further indoctrinates the bias into public health policy that a particular diet is good for everybody, when there is good research that shows it is not.. And I, for one, get pissed off about this on behalf of my sick friends and family, and the sick patients that I work with, all of whom keep trying to do the right thing and who believe our mainstream nutritional research must have the best credibility for guiding them. Just possibly Dr. Eades and others feel the same..
When you have the “inside baseball” view, you must further address the issue that analyses of the data in The China Study do not even support many of the conclusions and assertions the authors make about the data, and some of their results could be explained by other things than what they conclude. And that is Ms. Minger’s point in her analysis, and the problem I had when reading the book. Like her, I kept asking out loud, “but what about *this* possible confounding variable?! And what about *that* possibly confounding variable?!” These scientific questions are sometimes addressed, but mostly not. Yet this problem doesn’t stop them from concluding that it’s the “most comprehensive study on nutrition ever conducted” and better you to listen up and follow along.
The issue of confounding variables is huge in human research. A perfect example is from today’s news, a new study which analyzed a group of studies on calcium supplements and showed that overall there is an increased incidence of heart attacks among subjects taking calcium supplements. Headlines everywhere today read, “Calcium Supplements Linked To Heart Attacks”. If you look at the actual data, however, what you find is that in the 15 studies reviewed in this meta-analysis, half of them included subjects who already had heart disease and most of the rest of the studies did not have information available whether or not there was pre-existing heart disease in their subjects. As all studies had an inclusion criterion that subjects needed to be over the age of 40 [and therefore at risk for osteoporosis], one can guess that there were also subject with heart disease in the studies that did not indicate heart disease status.. So it needs to be asked, did the calcium supplement increase their risk for heart attack or did their existing heart disease increase their risk for heart attack? Brett, what do you think? Do you think this mainstream scientific paper, published in the prestigious British Medical Journal, is above reproach?
I felt mostly, Brett, that you were sincere in your quest to trust and I understand the upset that people feel when they cannot rely on things that are personally important to all of us. And I do sympathize with your correct assertion that scientific arguments can become all about who’s got the bigger pile of papers to support their point of view. But that’s kinda how the discipline moves forward, and ends up doing good things too, like finding effective treatments for your son’s diabetes. I would have appreciated your comments more though, had you not mischaracterized Dr. Eades points on several occasions, not the least of which was to assert in the end that he didn’t want you posting more, when he said just the opposite. I hope that Dr. Feinman does write a guide on how to read a scientific paper. It would help a lot of people like you who are attempting to find the truth for themselves.
Thank you very much for your lengthy and thoughtful comments.
“a certain idealized concept of medical science and the scientific method”
Prior to this week, I haven’t been called idealistic in a long time – it’s kind of nice! I do understand the difference between how science should be done and how it is done, but I appreciated your perspective.
“Brett, what do you think? Do you think this mainstream scientific paper, published in the prestigious British Medical Journal, is above reproach?”
If you’re asking me this question, you certainly didn’t understand my stance about science and the scientific method.
“I would have appreciated your comments more though, had you not mischaracterized Dr. Eades points on several occasions, not the least of which was to assert in the end that he didn’t want you posting more, when he said just the opposite.”
On the contrary, he said the following, prior to me saying that:
“I view this blog as my living room, a great room into which I invite anyone who wants to come and listen to me expound on whatever it is feel like expounding on. I try to be a gracious host, and I expect my guests to be gracious as well. And I’ll tolerate polite dissent and polite argument over the points upon which I expound. But, in the end, it is my living room where you and anyone else is invited at any time, and, as such, I’ll decide on which arguments to deal with head on and which to ignore. If I choose to ignore good and rational arguments about the points I’m trying to make, the guests in my living room may find me shallow and leave so that I find myself talking to no one. That is my risk in ignoring specific arguments.
But, I sense that you are an ideological vegetarian, and if so, no amount of reason and argument on my part will persuade you that you might be incorrect.”
He didn’t use the words “go away” there, but that was certainly the message I was getting. If you think I’m mischaracterizing him, that’s okay. But he has chosen not to address my points, and told me that he wouldn’t do so in the future. And that I’m an ideological vegetarian (whatever that is). And that no amount of reasoning will change my mind. All real helpful stuff, I’m sure, but not exactly a welcome mat.
His bottom line, “So, since I don’t enjoy tilting at windmills, I’m going to withdraw from this one” is certainly his right, but is for me unenlightening and leaves me with the same questions I came here with.
Thanks again for you comments. You seem to be a thoughtful and decent person and I have no enmity with you around any differences in our viewpoints. I can say the same about Dr. Eades. All the best.
Dr. Eades’ said, “the guests in my living room may find me shallow and leave so that I find myself talking to no one”.
You say you interpreted his words to mean “go away”. I’ve been reading Dr. Eades’ for several years now and my interpretation to his words was more like readers can always chose to go if they don’t find value in what he has to say.
Wow, LC! I found myself cheering and saying, “yep, yep, that’s it, uh-hunh, exactly!” Thanks so much for putting into words so many of my thoughts and feelings. I try to tell my wife and my family not to worship science, scientists and doctors. They are human, just like us. They only know what they’ve been taught and what if the information was wrong? Etc, etc. I copied your comments into a Word file so I can read them again and again and share them with my friends, family and clients. Thanks so much for taking the time to document your experience!
Something interesting to read while the news of the latest LC vs LoCal/LF diet study is fresh news:
http://www.nutritionandmetabolism.com/content/6/1/1
Thanks for the commentary, Dr Feinman. Dr. Eade’s blogged about ITT some time ago, too.
Dr. Eades, it’s good to see you bringing this up, though I would note that you’re rather late with this information. Campbell’s book has been quite influential, and one of the first things people did was analyze the results and find just how distorted his conclusions were. For example, here’s a random Amazon comment that did multivariate analyses that showed that based on the actual data, it’s plant protein, not animal protein, that predicts heart disease:
http://www.amazon.com/Analyzing-the-China-Study-Dataset/forum/Fx1YJPR95OHW08P/TxY4S5EZD8Y2XE/1?_encoding=UTF8&asin=1574535811
In univariate analysis, it is wheat that most strongly predicts heart attacks:
http://bradmarshall.blogspot.com/2005/12/is-wheat-killing-us-introduction-maybe.html
Campbell has been practicing his “it was only one chapter” response to the fact that his results are contrary to the actual China study data since at least 2006:
http://www.vegsource.com/articles2/campbell_china_response.htm (third paragraph from the end)
Finally, yes, the actual Chinese data is all correlations rather than direct proof of causations. However, correlations can be useful in identifying possible theories of causation – as well as ruling them out. Sometimes it’s all we can get. Viewed with skepticism and an open mind by someone familiar with statistical analysis techniques, I think there is value to going through the Chinese data.
I guess I was a little late to the party, but as I mentioned in the post, all the analyzing of his data is for naught. It’s all observational data and worthless for proving causation, so I lost interest. It was only after I read the book The China Study that my blood got up.
On another interesting note, Campbell makes the claim in The China Study that there are over 8,000 statistically significant correlations in his China study data, which is really meaningless because statistics aren’t science and correlations don’t prove causation. But he has 367 variables, each of which he compares and correlates to all the other variables. That gives (367 X 367) 134,689 possible correlations. Most statisticians use a 5 percent confidence interval to determine statistical significance. If you multiply the 134,689 by 0.05 you get 6,734 ’statistically significant’ correlations that would occur just by chance, which is damn close to the 8,000 he’s crowing about.
I have been thinking about starting a movement to ban* correlation studies, much like chemical weapons. Sure, it would reduce the total amount of human knowledge.
But at the same time, if would hugely diminish the amounts of bogus findings in ‘dense-causality’ fields.
*Joke
PS.
I have run some regressions myself, if nothing else it can be useful as a reality check. Especially as a reality check on strong assertions.
This is why Minger´s analysis matters somewhat. Campbell implied that there were correlations present, that… well, weren´t there at all. That´s a pretty big reality check, if nothing else on the credibility of Dr Campbell.
Dr. Eades, allow me to encourage you. In 1999 I was in very bad shape. If I remember correctly, I heard about Protein Power from you on one of those Sunday-morning radio infomercials. I weighed 253 (5′11″), and had high blood pressure which I had just started taking medication for. My doctor wanted to put me on Statins for elevated cholesterol. I told him, give me a few months to try something before we do that. I got your book, Protein Power and then sent away for the kit. Do you remember the kits? LOL. The one with the cassette tapes, the VHS tape, and the carb wall chart, etc? Anyway, long story short, lost 77 pounds, down to 176, cholesterol down a little but HDL at 63 and triglycerides at 29! My doctor was stunned. He asked me how I did it. My next visit I gifted him with a copy of Protein Power Lifeplan. On my next visit he told me that he was recommending it to his patients. You saved my life. I will be eternally grateful to you for that. Also, because of you, I am changing occupations (my old AA’s in Computer Technology and Computer Information Science are just not getting me a good job like they used to and I’m 56). I am currently working on my exam from ISSA to get certified as a Senior Fitness Specialist. In a couple of weeks I start my classes at the community college to earn a two-semester certificate as a Fitness Specialist which will prepare me to take my Certified Personal Trainer exam from ACSM. So, you see, Dr. Eades, you touched my life and now I will touch dozens, maybe hundreds more, and how many lives will they touch? Thanks for taking all the crap that comes your way from all of us you are helping.
Terrific! MD and I love stories like yours. Thanks very much for writing and keep touching others’ lives.
Comments on scientific method: I’ve worked in a number of scientific fields: as far afield from my training in enzyme chemistry as behavioral neuroscience but I have never seen all of this levels of evidence, principles of science, etc. that get discussed in medicine. I probably posted my Mozart story before so won’t again unless somebody wants it.
Science is a human activity and nobody really has a definition. In the end most scientists agree with Justice Stewart’s take on pornography, that they know it when they see it. I do like the definition from a neuroscientist at the NIH who said “what you do in science, is you make a hypothesis and then you try to shoot yourself down.” That, for example is what’s wrong with the Foster paper that just came out. Foster said in public that he set out to trash, an attitude maintained at least by all the other authors on the paper.
So, I don’t think there are general definitions. For example, I don’t think there is a clear difference between observational papers and any other kind. Astronomy is all observational. It is what the observations are and, if there are correlations what the strength of the correlations are and how consistent they are with known mechanisms. For whatever reason, I am dealing with Djousse’s paper (Diabetes Care 2009, 32(2):295-300): Egg consumption and risk of type 2 diabetes in men and women. The conclusion is that the hazard ratio for diabetes and > 7 eggs per week is 1.58. What’s wrong with that (the failures of method I can describe later if anybody cares) is that a hazard ratio is similar to an odds ratio which is pretty much what you think. Should you bet at this blackjack table or that one. Well, 1.58 might be enough to make a decision on if you were going to sit at the table all day but if you place one bet it doesn’t tell you anything. And if you bet on low eggs and lose, you will get diabetes. You don’t get your chips back. For comparison the hazard ratio for lung disease and smoking, I believe is about 22 (number off the top of my head). Also — not an expert on this — I think to introduce scientific evidence in a toxic court case, you need a hazard ratio of at least 2. Associations don’t imply causality if the association is weak.
If the association is strong, then it does imply causality. The cigarette example is a good one. Of course, you can never prove causality, only consistency. You can only disprove causality. So what is the deciding factor. Well, strangely believe it, common sense is part of scientific thinking.
There is also the consistency with effects of cigarette smoke on lung structure and function. So what’s wrong with eggs and diabetes is there is no mechanism and it just doesn’t make any sense.
My thoughts for now.
Would or would it not be a major part of determining the effectiveness of diet and health to measure or detect, what I read in Taubes’ ‘Good Calories…’, this condition of ‘internal starvation’ by the overriding of stored fat as cellular fuel by insulin when carbohydrates are the major provider of fuel to to cells, I think in the form of glucose?
@ Brett, yes I probably have a book in me, but I’m not about to write it in the comment space on the bottom of someone else’s blog. Most of the questions you ask of me you could easily answer yourself. You make a point of misunderstanding me, but I’d be a fool to try to clarify most of those points. I guess that’s the Socratic method, and much good it did him. As for the ad hominem tag – you can dish it out, but you can’t take it.
You are, sad to say characteristically, being obtuse about Quackwatch – I can’t believe I have to spell this out – Quackwatch, despite the name, does not address the egregious abuses of MAINSTREAM quacks. That is a credibility gap I cannot cross. The drugs that kill, the operations that main, the psychotherapies that destroy the chance of happiness. Do you think it’s not quackery if it’s approved by the FDA? Barrett and co. do.
The “proof of pudding” argument; I accept no man’s testimonial as proof. But I do trust my own experience. Most of the things you question here you can more-or-less easily verify for yourself. You don’t have to accept handed-down rules from god-like figures from on high – it’s DIET f’chrisake, eating, something everyone does every day – no-one has a monopoly on the experiment.
The claim about biochemistry texts is not a figure of speech, not even hyperbole. I quote from a passage I found at random last night;
“It has long been known from feeding studies that dietary cholesterol efficiently suppresses the endogenous synthesis of cholesterol. This control occurs at both transcriptional and translational levels, with cholesterol itself or one of its derivatives playing an active role in translational control. In addition, the enzyme [HMG-CoA reductase] is regulated hormonally, by insulin and glucagon”
from Biochemistry 3rd Edition, Mathews, Van Holde, Ahern.
There are two consequences of this; there is no advantage to low-cholesterol eating, and endogenous production of cholesterol can be altered by manipulating the insulin – glucagon balance, insulin being produced in response to carbohydrate. As far as other aspects of the lipid profile go, the role of niacin in elevating HDL cholesterol and lowering LDL and serum triglycerides was discovered by Abram Hoffer in the 1950s, and his ongoing work with niacin, ascorbic acid and hallucinogens led to the discovery of othomolecular psychiatry. One of the many reasons I support orthomolecular medicine when I get the chance is that, when I was much younger, I was called on to use gram doses of niacin and vitamin C to help someone who had overdosed on psilocybin, and the result was a spectacular restoration of normal sanity. I tell you this not because I expect it to convince you, but because anyone might find themselves in a similar situation.
What really matters is helping people to live better lives, not convincing the sceptics.
If you look further into Dr Eades writing (e.g. the “Man the Hunter” excerpt in this blog http://www.ofspirit.com/tw-theproteinpowerlifeplan.htm) you’ll find that he does treat vegetarians too, with a vegetarian diet. It’s just easier to eat low-carb with a fuller dietary range.
Hi
I know its not related to this post…
I just realized that there are some errors in the Fats and Oil section in your PPLP Gram Counter book, for example: Canola 1 Tbsp (which is 14 gram) has 20.3 grams omega 6 and 9.3 omega 3 (page 26) and so are most fats.
Thanks. I’ll double check the numbers. If in error, we can get these changed at the next printing.
I think that disputes like this have more to do with philisophical viewpoints than they do with assessing the evidence. Some people take the POV that we can’t know reality, we can’t trust our senses or judgement and make decisions for ourselves, and they end up, by choice or by default, going along with what insitutional authorities decide for them (or rebelling against it in an equally non-selective fashion).
And others, and I would be one, say that man can know what is real and true for all practical purposes; that if we eat the right food, use the right supplements, and practice the right mental disciplines to learn from our experience we will eventually develop the intelligence we need to decide for ourselves who is right and where even they may be going wrong. We cannot prove we are right to people on the other side of the philosophical gap, but we can say that what we experience FEELS like health; it is the opposite of depression, for one thing. Schopenhauer found it rational to be depressed, and he made a good case, but I think the depression came before the rationalisation.
To someone of the opposite persuasion, Dr Eade’s material success (and I am sure Brett exaggerates it) is cause for celebration, not resentment, because it provides proof that common sense that goes against the grain of lazy thinking can be rewarded in this life.
I’ll define mainstream nutrition for Brett; a food pyramid which has “whole grains and pasta” at the bottom with “eat most” and meat, cheese and fish at the top with “eat least”, advice that you’ll get all the nutrients you need from an “average healthy diet” or some such meaningless formula, and the assumption that when you get sick (and you probably will) there’s nothing you can do but see your doctor and take whatever they give you, because nutrition has nothing significant to offer you. There are alternative viewpoints, but they’re considered “alternative” viewpoints.
There was a comment posted on Denise Minger’s website suggesting that perhaps Gary Taubes should write an article for the mainstream press like the NY Times about how Denise Minger took on Campbell and his China Study. I think this is a good idea and hope that you could suggest this to Taubes. This will bring even more publicity to Minger’s efforts to critically review Campbell’s results and conclusions and once again show how bad science occurs when biased researchers highlight positive results that support their favorite hypothesis and predetermined conclusions while ignoring data and results that do not.
I’ll pass the suggestion along to Gary. It will be up to him.
I’ll pass the suggestion along to Gary. It will be up to him.
Agreed on the statistical significance. With this many variables, one should start with a higher bar than p < 0.05. For example, it's interesting to note that a lot of the correlations with p < 0.001 are also associated with latitude, which is suggestive.
For what it’s worth, I tend to credit the calcium analysis, which is supposed to be from placebo-controlled trials only. If people with age-related disease are only given calcium, and not vitamin D, magnesium, K2 etc, I would expect these results in some. They were deserving of better care. Here are my reasons – 1) the gut has a limited ability to absorb ionic minerals, and large amounts of calcium reduce absorption of magnesium, zinc, manganese and other minerals. 2) low blood levels of calcium are compensated for by activation of vitamin D3 to 25-hydroxy D3. This promotes retention of calcium in the kidneys. The more calcium in the blood, the lower the level of this form of vitamin D, which is the vitamin D metabolite associated with decreased incidence of many age-related diseases. 3) magnesium is required for the conversion of D3 to 25OH D3, and is also a vital electrolyte in maintaining heart rhythm; magnesium levels are often sub-optimal. 4) if vitamin K2 is sub-optimal (as in a low-fat diet) calcium is more likely to be laid down in the blood vessels instead of the bones.
In fact the body has intricate systems for balancing calcium when intake is low. Osteoposoris is not always due to deficient dietary calcium but may be due to hormonal factors, or deficiency of vitamin D, magnesium, or other bone-building factors. If so, supplementing calcium alone may not help, or even make these problems worse.
So I tend to agree with the study not because it was infallibly “scientific” but because there is a clear mechanism to explain the result.
However, I think it only noted heart attacks, not death from heart attacks, and it ignores other common causes of death such as cancer. So, by itself, it does not tell you whether supplementing calcium is a good idea or not.
Dr Eades, I also think you are wrong to fault Campbell for insisting on the observational “shotgun” method. It is his analysis and bias that is wrong. All forms of evidence are valuable and contribute to proof. The current fashion is that the randomised controlled trial is “most scientific”, but the fact is that if you had a RCT that “proved” something and all the anecdotal evidence was opposed to it, the RTC would probably be wrong. It is when anecdotal evidence (including case histories as well as testimonials), observational studies and RTCs agree that you can really claim to have proof of something. Correlation is not causation, but you cannot have causation without correlation.
I agree with your last paragraph, sort of. I do believe that observational studies are important; observational studies demonstrated the huge negative health impact of smoking on humans. The problem I have is when people who should know better use observational study data to persuade those who don’t know better that there is causation.
All forms of evidence are valuable and contribute to proof – even the ancient Egyptians.
First off what a great treasure I’ve found in this blog. So much information in one post I’ll have to dedicate a week to just tracking down all the specific references made here.
Secondly I’m wondering more and more about why we have to keep doing diet studies on rats? I know I know. They’re cheap and easy to breed and we can do this all day.
But what good is it if their metabolisms are almost opposite of ours? So frustrating to read study after study about rats. It would be like reading a study about cancer in horses and then trying to apply that data to fish! *actually on second thought that might be pretty relevant in comparison to rats and humans.
Thanks for the great blog and all your great work, doctor!
“Though I don’t know about Gary Taubes work”
“Good Calories, Bad Calories” is one of the most important works of our era and should be required reading for anyone who wants to discuss nutrition & metabolism in any meaningful way.
1. “- Properly designed and controlled scientific studies that show there are no long-term negative health effects of this diet”
In the 1970’s the McGovern commission and it’s results essentially sent Americans on a 30+ year “experiment”. Look where we ended up.
2. “- Properly designed and controlled scientific studies that show this diet significantly improves weight loss over a long period of time (five years seems to be a reasonable number).”
If you are getting your health news from NBC, you may not know this, but in almost every study ever done where the low carb group actually ate low carb, the low carb group improved in every parameter measured.
3. “- Properly designed scientific studies that predict that this diet, if adopted by a majority of the world’s population, will not have a negative effect on the environment”
Just look at what negative effect on the environment that grain agriculture has.
4. “- Properly designed scientific studies that predict that this diet, if adopted by a majority of the world’s population, will not have a negative effect on the health and welfare of animals.”
This is the same as #3.
I think one of the most important themes that Eades, Taubes and other writers, like Enig and Fallon, show repeatedly is the history of isolated, native populations that are long-lived, healthy, and primarily meat-eaters. There is an isolated Swiss population- one of the longest living populations on the planet- whose diet is composed mostly of butter, cheese, milk, cream, and beef. They don’t require the services of doctors. There is another population in Okinawa that eats enormous amounts of pork, lard, spam, and other tasty animals- and they are neck and neck with the Swiss in terms of health and longevity. Look at the Pima, the Inuit, the Masai of Africa, the Argentinian Gauchos (meat & tea), the American Indians (before govt rations), The French, Austrians, and Greeks… even some isolated Irish. The thing all those native populations have in common is that they don’t eat a high carb Americanized diet. It’s the American Paradox: the Americans eat tons of processed, refined grains yet they’re still alive.
Looking at the totality of the evidence like association studies, or even the gold standard of clinically controlled, double blind metabolic ward studies will only give you a snapshot of a given moment of time which is nothing but a drop in the bucket of history and human evolution.
I can’t begin to tell you how much I appreciate your critique of The China Study. I have been back and forth between veganism and low carb (mostly paleo) for years trying to decide which one is best for my health. In the meantime, I have gained a lot of knowledge plus 50 lbs.! Your critique has finally tipped the balance toward a protein based diet rather than the McDougall starch based diet I was on. I will admit that the McDougall diet assured me I would never be constipated, but I also gained weight on it. I have seen many forums and symposiums online and read books by Dr. Campbell, Dr. McDougall, Joel Fuhrman and Neal Barnard and they certainly do sound convincing, esp. in the light of all the things I had been brought up to believe about fat and meat. But after learning about the latest study that shows that a low carb diet actually lowers bad cholesterol and reading your critique of the China study, I am back to a protein based low carb diet. Thanks for taking the time to critique the China Study which is the Bible for low fat vegans.
Brett brought up the old bogey, that excess protein might damage the kidneys. I know you cite evidence that the opposite is true, that protein tends to protect the kidneys, and I think that you are right, but I think I can see where the opposite claim is conditionally true.
The metabolism of protein depends on many (perhaps all) the other nutrients, and none more so than pyridoxine (B6) in its active form, pyridoxal-5-phosphate. P-5-P converts essential amino acids to inessential ones, removes the amine group (“ammonia”) when surplus amino acids are converted to calories, and processes this to urea which is safely excreted by the kidney (assuming you drink water, another variable).
It follows that the more protein you eat the greater your requirement for B6, and that eating a high-protein diet while B6 deficient might cause problems. We are talking about a requirement of 2mg (from memory) for a standard diet. However, sub-optimal levels of B6 are not uncommon. The conversion of dietary B6 to P-5-P requires minimal gut and liver function, and co-factors including B2, magnesium and zinc. In uncompensated cirrhosis of the liver, the ability to convert vitamins to coenzymes and to metabolise protein fails, so that protein toxicity occurs.
From this it can be seen that it is possible to “prove” that extra protein is harmful just by restricting B6 or a number of other factors. Foods that are high in protein (such as nuts) tend to be high in B6, but the isolation of protein which is then added to foods (such as casien and gluten), and the cooking and processing of protein foods tends to reduce the B6 content.
B6 occurs in whole protein foods because the plant or animal needed it to produce the protein in the first place.
The amount of B6 needed to metabolise protein is small, of P-5-P even smaller. B6 is the rare vitamin that can have long-term toxicity, it can also compete with folate for absorption, and I tend to favour the multivitamin with the lowest ratio of B6 to B1, B3 and B5.