T. Colin Campbell’s book, “The China Study” has caught my attention recently.  Campbell has popped up in a few places recently and last evening, a client of mine brought his book in for me to analyze.  I decided to give it a look and to do so with an open mind.  “The China Study” is a book written by a vegan whose hypothesis is simply that the consumption of animal meats is the root of degenerative diseases, including obesity, cancer and heart disease.  Campbell promotes a whole food plant based diet with an accordance to avoid refined sugars/carbohydrates (I agree with him on the whole foods and refined carbs).  I flipped through the book to check a few things out here and there…here is my first criticism of Campbell’s work:

Campbell decided to use the Framingham Study as his guideline in later chapters.  He concedes that blood pressure and obesity play a major role in coronary heart disease.  He then goes on to attack cholesterol, which he clearly has no concept of cholesterol and its functions.  Perhaps he should be enlightened with this cholesterol article.  Campbell also fails to mention anything about CReactive Protein as a solid indicator of heart disease and he does not have any discussion based on LDL and HDL particle sizes.  Basically, his argument is lacking a general background of crucial information surrounding his case.

I decided to check out some stuff from Dr. Michael Eades to help us further break down Framingham to help us analyze whether or not it is justifiable for Campbell to use the Framingham study to back up his argument against meat based food consumption.

Background on Framingham: This is a heart observational study that began in 1948 and is now on its third generation of research.  Researchers focus on diet, exercise and medication to consider issues in heart disease and negative or positive correlations in life habits.  The study began with 5,200 healthy men and women and is still continuing today.

It is fairly ironic that he uses Framingham as his study of choice. This is a direct quote from Dr. William Castelli in 1991, head of the Framingham Study…“…In Framingham, for example, we found that the people who ate the most cholesterol, ate the most saturated fat, ate the most calories, weighed the least and were the most physically active.”

More on Framingham…Here is Dr. Michael Eades’ analysis of a direct copy of Framingham. Eades obtained a copy of Framingham results (from early 1970’s) and thankfully, he decided to share the copy and results found. These are all quotes and implications with dietary consumption and its impact on cholesterol (my emphasis added):

Fat intake and Cholesterol?

Paralleling the findings for total calories there is a slight negative association between daily intake of total fat (and also of animal fat) with serum cholesterol level, in men but not in women. This parallel is not surprising given the high correlation between fat intake and total caloric intake. No association between percent of calories from fat and serum cholesterol level was shown; nor between ratio of plant fat to animal fat intake and serum cholesterol level.

How about protein?

There was a trivial negative correlation between daily protein intake (in grams) and serum cholesterol level.

Dietary cholesterol and its impact on serum cholesterol?

There is no indication of a relationship between dietary cholesterol and serum cholesterol level. If the intake on animal fat is held constant there is still no relation of cholesterol intake to serum cholesterol level. If (further) a multiple regression is calculated [using animal fat and dietary cholesterol] there is also little suggestion of an association between this pair of variables and serum cholesterol level.

When it comes to diet and coronary heart disease, nothing changes.

In undertaking the diet study at Framingham the primary interest was, of course, in the relation of diet to the development of coronary heart disease (CHD). It was felt, however, that any such relationship would be an indirect one, diet influencing serum cholesterol level and serum cholesterol level influencing the risk of CHD. However, no relationship could be discerned within the study cohort between food intake and serum cholesterol level.

In the period between the taking of the diet interviews and the end of the 16-year follow-up, 47 cases of de novo CHD developed in the Diet Study group. The means for all the diet variables measured were practically the same for these cases as for the original cohort at risk. There is, in short, no suggestion of any relation between diet and the subsequent development of CHD in the study group…

Framingham conclusions…

With one exception there was no discernible association between reported diet intake and serum cholesterol level in the Framingham Diet Study Group. The one exception was a weak negative association between caloric intake and serum cholesterol level in men. [As to] coronary heart disease–was it related prospectively to diet. No relationship was found.

What does this mean? Campbell uses the Framingham study to prove his point, yet neglects to recognize what the actual documents read. The basis of Campbell’s entire argument is that consuming anything with cholesterol is bad and that has a negative impact on serum cholesterol levels along with CHD. He uses Framingham to justify his argument yet neglects to actually peer into the findings of Framingham. He goes on to attack saturated fat consumption and the role that dietary fats play in elevating cholesterol levels.  Clearly, he did not do his research and actually investigate the numbers.

I have decided to include a few other studies/researchers that use the same criteria to predict CHD (tryglycerides, blood pressure, obesity, cholesterol) as Campbell and show everyone what they concluded.

I recommend reading studies from Dr. Eric Westman who has done tremendous amount of research on Low Carb diets at Duke University and has also found low carb diets to have a positive impact on blood pressure, blood cholesterol (higher hdl, lower ldl) and weight loss…all aspects that Campbell deems signs of heart disease.

Ditto that with Dr. Ronald Krauss, Director of Atherosclerosis Research at the Children’s Hospital Oakland Research Institute, Senior Scientist in the Department of Genome Sciences at the Lawrence Berkeley National Laboratory, and an Adjunct Professor in the Department of Nutritional Sciences, University of California at Berkeley.

Here are the findings of one particular Atkins based study, one administered by Gary Foster at the University of Pennsylvania School of Medicine and the other done by the Philadelphia Veterans Affairs Medical Center:

• After six months, the Atkins dieters lost an average 15 pounds; conventional dieters, 7 pounds. (the weight loss is more significant)

• After a year, the Atkins followers kept off 9½ pounds; the conventional dieters kept off 5½. This difference is not considered statistically significant. (The dieters remained leaner for a longer period of time which is very important)

• At the end of the year, the Atkins dieters had an 18% increase in HDL (good) cholesterol, compared with 3% increase for the other group; Atkins dieters had a 28% drop in triglycerides (blood fats), while others had a 1% increase. Neither group had changes in LDL (bad) cholesterol. (Their cholesterol profiles actually improved with the Atkins diet)

• The low-carb followers lost 13 pounds in that time compared with 4 pounds for the low-fat dieters. (Again, weight loss is more significant)

• Triglycerides dropped 20% for low-carb dieters compared with 4% for those in the low-fat group. (Another measurement Campbell uses for heart disease risk which was improved by the Atkins-like diet)

In my next blog, I will analyze Campbell’s break down on obesity and diabetes.