The China Study (cont.)

Is there a problem with our so-called normal diet, and if so, what should we as both doctors and patients do about it? By "our diet," I mean the usual diet for most people in the U.S. First, is there a problem with our diet? If the incidence of cardiac problems, obesity, diabetes, and other diseases are related to our U.S. diet, then it is likely there is a problem. In the book, The China Study, data is presented that suggests strong relations exist between what we normally eat in the U.S. and the occurrence of these diseases. Even without stating the same thing about the U.S. diet, some physicians suggest that patients with these problems cut back on the volume of food intake, get more exercise, avoid high cholesterol-containing foods, reduce salt intake, and eat more fiber. The book authors go much further and suggest several approaches to not only improve the U.S. diet, but to establish a routine U.S. diet that will help prevent, and in some cases, reverse damage caused by several of these diseases. In contrast to many nutrition publications, claims are backed up by references in the medical and nutritional literature, not by opinion or belief, but actual data. Although different investigators may interpret or criticize the collected data, they, too need to provide some basis for their interpretation and critique. So as doctors and patients, what should we do if we accept the premise that our normal U.S. diet has problems? The answer seems simple; address or fix the problems.

What are the problems? Upon opening almost any magazine or watch a TV talk show, usually an article or individual has a presentation about what and what not to eat. Many will say to increase protein and reduce carbohydrates, while others will say the opposite; some say coffee is great, others warn about the dangers of caffeine in coffee. The lists of items can go on and on. Most articles present little or no data to back up their conclusions. In contrast, the book's authors present data to define problems with the U.S. diet (for example, too much animal-based protein and fat), then present how to address the problem and finally present evidence (yes, data again) how this stated problem can be effected by changes in the U.S. diet.

Since I hoped to drag in readers for this article with a "teasing title" that some readers will think is grossly unfair, because I haven't yet said what or what not to eat, I apologize. My doctor friend who hooked me into this subject has not apologized for his trickery and has no guilt feelings (in fact, I think he is quietly chuckling to himself about his devious methods). However, I choose to take the high moral ground and at least summarize to readers what the authors conclude to eat and not to eat, to back my apology with some substance. This summary is data based from the book:

  • Eat lots of different types of fruit that are unprocessed (no, strawberry Pop-Tarts do not fit in this category).

  • Eat many types of vegetables (Popeye was right, spinach is a great food).

  • Eat less (but maybe eat some) fish, vegetable oils, and few refined carbohydrates (Yes, it means to cut back or cut out eating candy and cakes).

  • Avoid meats and dairy (this last category is the one that is the most controversial).

Yes, I know that many readers may still feel I cheated them about what to eat and what not to eat. For example, I have not commented on many details about how much to eat, how to prepare healthy meals, what should people eat if they have a specific disease, should pregnant females and children follow the China Study diet, and numerous other questions. Many specific questions are put forth and then answered by the authors, but this article is about long enough, so I choose to refer the readers to the book for a number of specific answers. Finally, many readers may wonder if, in my view, I agree with all of what the authors conclude. I cannot say that I do; I am still processing their conclusions and data and I have many unanswered questions. However, I would recommend any book that makes one think over how they approach a basic aspect of one's life, food, and drink. For those of you who made it this far in the article and vow never to read another article about nutrition or to read this book, I have good news. The China Study book has been made into a documentary film titled Forks Over Knives. It will be released to theaters in Mar. 2011. If nothing else, the movie likely will be an interesting subject to discuss over a meal.


Campbell, T.C., and T.M. Campbell. The China Study. Dallas, TX: Benbella Books, 2006.

Esselstyn, Jr., C. B. "Is the Present Therapy for Coronary Artery Disease the Radical Mastectomy of the Twenty-First Century?" The Amer. J. Cardiol. 106.6 (2010): 902-904.

Forks Over Knives, Dir. Lee Fulkerson. Based on the book The China Study by T.C. Campbell and T.M. Campbell. Monica Beach Media, 2010.

Last Editorial Review: 11/23/2010 4:40:07 PM