The China Study: Evidence for the Perfect Health Diet

T. Colin Campbell became famous for his book The China Study, which claims that a Chinese epidemiology study supports a vegetarian diet.  Chris Masterjohn pointed out some time ago that Campbell’s conclusions had little basis in the study data. [1] Now, Denise Minger has delved into the raw data and shows clearly that Campbell has presented “a strongly misleading interpretation of the original China Study data.” [2] She concludes:

Campbell’s “China Study” book is a spectacular example of how you can cherry-pick data to create a trend that isn’t there. [3]

Campbell’s recommended diet is very different from the Perfect Health Diet. Although hardly carnivores, we at PerfectHealthDiet.com are not idolators of plant foods. Plants have much higher toxin levels than animal foods, and are more difficult to digest. Fiber is often adduced as a reason to eat plant foods, but fiber’s influence on gut bacteria is complex; not all plant fiber improves the composition of gut flora.

We recommend eating daily some safe starches (sweet potato and taro are our favorites; white rice is quick and easy), fruits and berries, seaweed, and assorted vegetables.  We eat vegetables mostly to improve the flavor of our meals. What would a beef stir fry, chicken soup, omelette, or bibimbap be without vegetables?

But, though plant foods constitute 50-70% of the mass of food eaten on our diet, we recommend that carbs provide only 20% of calories.

So, now that Ms. Minger has summarized a lot of the data from the China Study, I thought it would be interesting to see whether the China Study data is supportive of the Perfect Health Diet. The China Study data, as summarized by Ms. Minger, is relevant to four of our claims.

1. Animal Proteins Are Preferable To Plant Proteins

The Perfect Health Diet deprecates plant proteins (which are often toxic) and recommends that protein be obtained from meat, fish, and eggs.  However, we also recommend lower levels of protein consumption than other Paleo diets. We personally obtain about 10% of calories from protein.

So, did the China Study prefer plant or animal sources of protein?  And what is its result for total protein intake?

Ms. Minger reports how protein intake is associated with cancer deaths:

[W]hen we look solely at the variable “death from all cancers,” the association with plant protein is +12. With animal protein, it’s only +3. [2]

The positive numbers mean that more protein is associated with more cancer deaths, suggesting that Chinese should eat less protein.  Since the plant protein association is higher than the animal protein, it’s better to eat animal protein than plant protein.  Just as we would expect!

What about heart disease?

Correlation between animal protein and myocardial infarction and coronary heart disease: +1

Correlation between fish protein and myocardial infarction and coronary heart disease: -11

Correlation between plant protein and myocardial infarction and coronary heart disease (from the China Study’s “diet survey”): +25

Correlation between plant protein and myocardial infarction and coronary heart disease (from the China Study’s “food composite analysis”): +21

Looking at myocardial infarction and coronary heart disease, fish protein was apparently protective (perhaps because it comes with omega-3 fats), animal protein was neutral (as we would expect from healthy protein, which is fairly innocuous health-wise), and plant protein was harmful (as we would expect from toxins).

2. Dairy Fats Good, Dairy Proteins Problematic

The Perfect Health Diet strongly approves of dairy fats (such as butter and heavy cream – clarified butter or ghee for those with dairy sensitivity) and approves of fermented dairy products (yogurt, cheese), but recommends avoiding most dairy protein – especially products containing pasteurized cow casein that has not been pre-digested by bacteria.

In the China Study, dairy proteins seem to have a strong relation to high blood pressure. Ms. Minger notes the following correlations with hypertension:

Milk and dairy products intake: +30

Egg intake: -28

Meat intake: -4

Fish intake: -14

Meat, fish, and eggs are all healthy.  Milk and dairy products – higher blood pressure.  Presumably this is because of the casein.

Cow casein, especially the pasteurized form which is difficult to digest, has various well-documented problems. Ms. Minger cites several studies showing that cow casein increases cancer growth, while milk whey and other protein sources are benign. [2]

3. Grains Are Bad; But Rice Is OK

The Perfect Health Diet strongly recommends eliminating all grains except rice.  Wheat, which has an exceptionally high toxin load, is strongly deprecated.  Rice, on the other hand, is accounted along with taro, sweet potatoes, and other underground starch storage organs among our “safe starches.”

Ms. Minger notes the extraordinary correlations of wheat consumption with disease rates:

Why does Campbell indict animal foods in cardiovascular disease (correlation of +1 for animal protein and -11 for fish protein), yet fail to mention that wheat flour has a correlation of +67 with heart attacks and coronary heart disease, and plant protein correlates at +25 with these conditions?

Speaking of wheat, why doesn’t Campbell also note the astronomical correlations wheat flour has with various diseases: +46 with cervix cancer, +54 with hypertensive heart disease, +47 with stroke, +41 with diseases of the blood and blood-forming organs, and the aforementioned +67 with myocardial infarction and coronary heart disease? (None of these correlations appear to be tangled with any risk-heightening variables, either.) [2]

Wheat was, indeed, by far the most toxic food found in The China Study.  It consistently produced the highest correlations with disease. Ms. Minger concludes:

[W]heat may be one of the most toxic things you could ever put in your mouth. [3]

Note that almost everyone in China eats substantial amounts of either rise or wheat; the people who eat little wheat eat a lot of rice.  Wheat has a high correlation with disease only because rice is anti-correlated with disease. If rice were not safe, wheat would not appear so dangerous.

In fact, the correlation coefficient of rice with heart disease deaths is -58%, almost the opposite of the +67% for wheat. Other grains had a correlation coefficient of +39%. [4] So: rice good, other grains bad, wheat worst of all.

4. Calories Should Come Predominantly From Fat

The Perfect Health Diet recommends obtaining most calories from fat:  the ideal macronutrient ratio is around 20% carbs, 10% protein, and 70% fat by calories.  These fat calories should consist of saturated and monounsaturated fats; polyunsaturated fats should be less than 5% of calories.

No region in China eats at these macronutrient ratios, but one comes substantially closer than others:  the county of Tuoli. [5] Located in the far northwest of China, Tuoli is occupied by a herding people who traditionally eat a great deal of dairy and meat but very few vegetables.

While the average macronutrient intake of all counties in the China Study was 74% carbs, 10% protein, 16% fat, the macronutrient intake in Tuoli was 35% carbs, 19% protein, and 46% fat.

Helping the comparison with the Perfect Health Diet, the Tuoli obtain their fats predominantly from dairy and meat; these contain few polyunsaturated fats. Plant oils, legumes, nuts, eggs, and fish are all non-existent in their diet; so we can be sure they aren’t eating soybean oil, canola oil, or corn oil.

So how do the people of Tuoli stack up in health compared to the rest of China?  Pretty well.

Death from all causes for people under the age of 65 was lower in Tuoli county than in 11 of the 13 counties that ate the least animal protein.

This excellent result was achieved even though the people of Tuoli are among the highest consumers of wheat in China:  they average 0.82 pounds per day of wheat flour.  Without their high consumption of this most toxic of foods, Tuoli county might have the best health in China. Add another point in favor of fat-rich diets.

But What About Seaweed?

In reading Ms. Minger’s discussion, I was able to find only a few correlations that went the wrong way. The only significant one was the correlation of sea vegetables with colorectal cancer (+76%). We highly recommend seaweed consumption, in part for its high content of iodine and other micronutrients.

However, as Ms. Minger notes, the association of seaweed with colorectal cancer is the result of a confounding factor. The areas of China that eat a lot of seaweed have very high rates of schistosomiasis infection, which is an extremely strong promoter of colorectal cancer.  

Conclusion

At least in the data provided by Ms. Minger, there appears to be no data from the China Study that contradicts a recommendation of the Perfect Health Diet, and plenty of data that support our recommendations.

It seems that the China Study is much more supportive of the Perfect Health Diet than of T. Colin Campbell’s diet! 

This doesn’t surprise us:  the Perfect Health Diet is the result of a rigorous five year search through the literature, and every recommendation has, we believe, the weight of scholarly evidence behind it.  But it’s nice to examine new data and find that it agrees with our findings. I’m tempted to look into the raw data of the study, now available from Oxford University’s web site [6], to see if the rest of the study is also supportive of our recommendations.

Thanks much, Denise, for your work. Bravo!  A fine analysis of a large data set.

References

[1] Chris Masterjohn, http://www.cholesterol-and-health.com/China-Study.html.

[2] Denise Minger, http://rawfoodsos.com/2010/07/07/the-china-study-fact-or-fallac/. Hat tip Stephan Guyenet, for the link.

[3] Denise Minger, http://rawfoodsos.com/2010/05/25/exciting-update/.

[4] Brad Marshall, http://bradmarshall.blogspot.com/2005/12/is-wheat-killing-us-introduction-maybe.html

[5] Denise Minger, http://rawfoodsos.com/2010/06/23/tuoli-chinas-mysterious-milk-drinkers/.

[6] “Diet, Lifestyle and Mortality in China,” http://www.ctsu.ox.ac.uk/~china/monograph/chdata.htm.

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45 Comments.

  1. The China Study Smackdown Roundup | Free The Animal - pingback on July 10, 2010 at 12:39 pm
  2. lol great references.

    Don’t be fooled people, Denise has misinterpreted raw data, just as many inexperienced “researchers” do. Denise is not qualified to read such data correctly.
    Please refer to the use and misuse on pp. 54-82 of the China Project monograph.

    The following is Dr Campbell’s rebuttal. The rest can be found http://www.vegsource.com/articles2/campbell_china_response.htm

    ” China Project results are no exception to these limitations of single experiments. It was very large, unique and comprehensive but it was observational (i.e., not interventional), simply observing things as they were at a single point in time. It provided an exceptionally large number of hypothetical associations (shown as statistically assessed correlations) that may indicate but does not prove cause and effect relationships. These unanalyzed correlations are considered raw or crude. It is highly unusual to find such ‘raw’ data in a scientific report because, in part, untrained observers may misunderstand such raw data.

    For the monograph, we were somewhat uncertain whether to publish such raw data but decided to do so for two principle reasons. First, we wanted to make these data available to other researchers, while hoping that data misuse would not be a significant problem. Second, because these data were collected in rural China at a time when data reliability might have been questioned, we chose to be as transparent as possible. We discussed data use and misuse on pp. 54-82 of the China Project monograph that curiously was overlooked by Masterjohn and Jay’Y’.

    • Dear John,

      Thanks for commenting. Your quote from the China Project monograph is quite true — correlations do need interpretation. My own post alludes to this, in discussing why the correlation of seaweed consumption with colorectal cancer is likely spurious.

      The trouble for Dr. Campbell, however, is that most correlations in the China Study seem to run against his diet and in favor of very different diets such as the Perfect Health Diet. So he needs a lot of interpretation to reconcile his diet with the China Study’s evidence! And unfortunately he hasn’t provided any such interpretation.

      Indeed, the link you provide calls to mind the old lawyer’s axiom: “When the facts are on your side, pound the facts. When the law is on your side, pound the law. When neither is on your side, pound the table.” Dr. Campbell provides no evidence there in support of his diet, but he does pound the table aggressively, attack his opponents’ credentials and move the ball. E.g., his response to criticisms based on China Study evidence is to suggest that the real evidence for his diet is NOT from the China Study: “my views are not about one study … I see three types of evidence that has most influenced my present views. First, there is the research data from our own studies that are summarized in our book. Second, there is the evidence obtained by many other laboratories, a sample of which is summarized in our book. Third, there is, perhaps, the most important evidence of all, the clinical experiences of the practicing physicians who I had come to know …” How foolish were his critics to think that a diet touted in a book titled “The China Study” was supposed to be based on that study!

      If Dr. Campbell ever decides to engage his scientific critics in an actual discussion of the evidence, please let me know, I’ll be happy to join the debate.

      Best, Paul

  3. Correlation is not causality. Who cares about all of these correlations? It seems you are willing to use one correlation when it agrees with your biases like wheat, but you ignore other correlations. There are healthy groups that eat wheat like the Sikhs studied by Dr. Robert McCarrison. See Matt Stone’s blog “180 Degree Health” for more information about McCarrison whose research he regards as being as significant as Dr. Weston A. Price’s. The correlation of wheat with disease is weak. Any factor that does not double the risk of a disease is usually dismissed by a credible scientist. Why don’t you dismiss it?

    http://180degreehealth.blogspot.com/

  4. Hi Ian,

    Correlations are not causality, but they are evidence. Therefore scientists care about them.

    And no, I don’t ignore contrary correlations. That’s why I specifically included the section on correlations contrary to the Perfect Health Diet, and mentioned seaweed.

    Dr. McCarrison was one of the great pioneers of dietary science. He noted that wheat consumption was associated with kidney stones, and asserted that it was dangerous to eat too much wheat, especially if vitamin D was low. He argued that wheat needed to be combined with various other foods, including dairy, and a high-vitamin diet if toxic syndromes were to be avoided. All in all, this was a fairly balanced view of wheat for the 1920s. Recall also that traditional methods of bread preparation, involving soaking and fermenting as in our sourdough bread, help detoxify wheat; so the experience of 1920s Sikhs is not necessarily relevant to modern supermarket foods.

    Dr. McCarrison himself attributed the relative good health of the Sikhs to the high vitamin content of their diet. They did not get those vitamins from their wheat consumption.

    I can assure you that “credible scientists” do not dismiss factors merely because they do not double the risk of a disease. If that were so, we would never find the causes of ill health, because ill health is usually the compounded effect of many mistakes. Each mistake contributes its mite to disease and ill health.

    Matt Stone: I do read his blog. He mixes pearls and dross more vigorously than almost any other blogger. I would rather read someone like him, often wrong but often interesting, than many a correct but boring blogger.

    If there’s something specific about Matt Stone’s recommendations that you would like me to discuss, please let me know. I am generally happy to debate science.

    Thanks for your comment Ian, I hope to see you back again.

    PS – Oh yes – “why don’t I dismiss the correlation of wheat with disease?” The evidence for wheat toxicity is discussed extensively in our e-book. Wheat proteins have been proven in cellular and molecular biology studies to be serious toxins. When you know independently that wheat is toxic, the epidemiological evidence against it should be taken seriously.

    Best, Paul

  5. Denise’s analysis of The China Study is heavily flawed and therefore invalid, not my opinion those words from a cancer epidemiologist.

    Here it is…
    http://www.30bananasaday.com/group/debunkingthechinastudycritics/forum/topics/a-cancer-epidemiologist

    The proper testing procedure as stated by an expert on analysing stats…
    http://www.30bananasaday.com/group/debunkingthechinastudycritics/forum/topics/my-response-to-denises

    Campbells response to Denise..
    http://www.30bananasaday.com/group/debunkingthechinastudycritics/forum/topics/campbells-response-to-denises

    • Hi freelee,

      All of these responses point to valid methodological limitations in Denise’s analysis, and point out that deeper analysis could reverse the results. That’s true.

      However, none of them present results of such a deeper analysis and therefore none of them actually refute the inferences suggested by the raw correlations. Furthermore, Dr. Campbell tells us clearly that his analysis was subject to equally severe methodological limitations: he threw out or ignored contrary data, and drew inferences through complex multiple regressions that are likely to be the result of data mining.

      It would be very desirable to repeat a correlation analysis using individual, not ecological, data. That would be a good first step toward identifying relationships that deserve further study, in the form of a look at possible confounding factors and evaluation of the robustness of the associations.

      If I get time, I’ll look into the published papers on the China Study to see what they report. I don’t believe they’re all that consistent with Dr. Campbell’s diet.

      Best, Paul

  6. day crew,nice blog.
    How come NONE of these pro meat bloggers have any real muscle with all that protein talk? :)

    Come and see if ANY of you guys can out bench press/dead lift us at
    http://www.veganbodybuilding.com
    http://www.veganstrength.org
    http://www.organicathlete.org

    Here are more websites for the doubters.
    http://www.pcrm.org
    http://www.drmcdougall.com
    http://www.notmilk.com
    http://www.preventcancer.com
    http://www.heartattackproof.com

    Mike Arnstein ran a 2:28 marathon this year at Boston. He is the FASTEST runner in the raw food movement today. Long time vegan and now powered by sweet fruit. How come there is no competitive athletes eating this ‘paleo fat diet?’ Please shut me up and show me cos Im sick of seeing cardio and muscle deficient paleo crew trying to debunk the china study that us elite athletes are thriving on.

    Can you debunk me with a high fat eating paleo athlete that is a national level runner, cyclist, power lifter, UFC fighter like us vegans clearly have provided.

    Didnt think so.. :)

    Love, peace and banana grease.

    Durianrider

    • This is some awesome trolling, let the real nutrition and health experts talk and you keep that banana in your mouth where it belongs.

    • “A living example that a ketogenic diet can indeed be combined with outstanding achievements in physical exercise is the Olympic biathlon gold medalist Björn Ferry, who won his gold medal after about 6 months on a low-carbohydrate high-fat diet.[118] A ketogenic diet has not been found to impair physical performance of athletes. [119]” Wikipedia

      • Hi Jamie,

        Interesting. The Wikipedia page is http://en.wikipedia.org/wiki/Low-carbohydrate_diet, and citation 118 is to a Swedish news story. Here is the Google translation: http://translate.google.com/translate?sl=sv&tl=en&js=n&prev=_t&hl=en&ie=UTF-8&layout=2&eotf=1&u=http%3A%2F%2Fwww.dn.se%2Fmat-dryck%2Freportage%2Fferrys-guldrecept

        However, it’s far from obvious that his diet is ketogenic. He says nothing about ketosis or MCT oil, and he says, “I have found a balance, because I do not believe that completely exclude carbs, he says on the phone from Germany the day before a race.” So it looks like he’s lower carb than many athletes, but not very low carb. He might be eating PHD ratios.

        Also, many endurance athletes benefit by training on low-carb diets but then carb loading before competition. The article doesn’t address his preparation for an event, only that he ate low-carb for 6 months before the event.

        • To be honest, I know very little about endurance events, I just thought that met Durianrider’s challenge.

          I am familiar with the sport of whitewater canoe/kayak slalom, a shortish (usually a little under two minute) event that, admittedly, emphasizes skill as much as strength or conditioning. I don’t know of any successful racers who were vegetarians. But they weren’t paleo, either. The joke was that we were on a “seefood” diet; “when we see food, we eat it.”

  7. Perfect Health Diet » Update - pingback on July 18, 2010 at 8:28 am
  8. Durianrider, if he’s the top vegan runner, then what does that say about everyone who can ran a sub-2:28 marathon? What is it that they have in common?

  9. Let’s Talk Rice « The Domestic Man - pingback on January 27, 2011 at 10:57 pm
  10. The China Study is fine, but there are different approaches. I read this blog, you are excellent

  11. Paul, i am recently a converted pescetarian, with ample amount of raw eggs, fruits, veggies, and unpasteurised cheese thrown in for good measure.

    Denise’s comments about cadmium startled me, and i want to find more info about the cadmium content in different seafood.

    I eat a lot (as in every day) of Chilean farmed mussels, shrimp, scallops, squid, and Alaskan pollock, and one of the criteria for me choosing these foods was, apart from them being quite cheap in the UK, the low environmental impact, low level of mercury, PCB’s and dioxins. However, the site I used to get this info ( http://apps.edf.org/page.cfm?tagID=1521) does not mention cadmium content.

    Can you point me in the right direction for getting more info about specific seafood cadmium content levels?

    Thanks

    Rob

  12. Hi Rob,

    In general, you want to avoid predatory fish high on the food chain, since metals concentrate in the eater each time a fish gets eaten, and fish from highly polluted areas like China.

    You might browse the results of this search: http://www.ncbi.nlm.nih.gov/pubmed?term=cadmium%20seafood.

    I looked very quickly and the general result seems to be that cadmium levels are low. Eg http://www.ncbi.nlm.nih.gov/pubmed/22054198 found that farmed fish in the Tenerife Islands have cadmium 1-3 mcg/kg vs an EU safe limit of 50.

    Best, Paul

  13. Hi Paul,

    thanks for that! Some interesting studies there, and it seems that there are a few whitefish species that are pretty safe like bream and hake. Also, as you point out the source of the seafood is a massive factor.

    However, because i eat mainly shrimp, mussels, and squid, i am not sure that studies just looking at fish, as opposed to shellfish, would help me out. I have seen more than a few studies point the finger at mussels as being generally unacceptably high in cadmium, even from supposedly ‘good’ areas like France http://www.ncbi.nlm.nih.gov/pubmed?term=cadmium%20seafood%20mussel http://www.ncbi.nlm.nih.gov/pubmed/21541848.

    Also, many of the studies conclude withthe comment along the lines of “because it is not a major part of the diet, you should be ok” or “as long as you dont eat it (e.g. mussels) every day, you should be ok”. The problem is, it is a major part of my diet and i DO eat it every day!
    Financially, being a pescetarian is more expensive than a meat-eater, and mussels and shrimp are among the most cost effective foods for me (much cheaper in the UK than actual fish), so after reading these kinds of studies it freaks me out even more.

    Do you know if there there any herbs or supplements i could use alongside my diet to prevent absorption of these metals? I was reading of a few here http://www.lef.org/protocols/prtcl-156d.shtml, but i’m not sure of the truth behind those claims.

  14. Rob,
    This food database shows cadmium, here are the search results for cadmium,
    http://bit.ly/zl0p43
    ( from site http://www.foodstandards.gov.au/ )

    With regards to your supplements query; Chris Kresser wrote an article on the safety of eating fish, that may be of interest to you.
    Two bullet points from the overview;
    - “Selenium protects against mercury toxicity, and 16 of the 25 highest dietary sources of selenium are ocean fish”
    - “If a fish contains higher levels of selenium than mercury, it is safe to eat”
    http://chriskresser.com/is-eating-fish-safe-a-lot-safer-than-not-eating-fish

  15. Rob, i should just mention that the Chris Kresser article does not talk specifically about Cadmium. But thought it would be of interest anyway.
    It does mention other contaminants such as mercury, PCBs and dioxins.

  16. Thanks for the great info Darrin!

    That database link confirms my fears – that crustaceans and molluscs (esp. molluscs – huge amount!) are very high in cadmium (along with crab meat). Suprisingly, potatoes are also pretty high in it!

    I was considering liberal use or fresh cilantro with my meals for chelation, along with a tsp chlorella daily. These have some evidence that they could help remove toxic metals from the body.

    I have also read that keeping selenium and zinc intake high can help limit the oxidative stress that toxic metals can induce, although they dont directly chelate and help remove them.

    I also already consume quite a lot of glycine from gelatin (a Peat-inspired innovation), and it seams glycine is a good toxic metal chelator.

    However, after seeing how much cadmium is present in molluscs im not convinced that any of these measures would be effective against prolonged high intake of metals like cadmium, so i am considering dropping molluscs as a regular part of my diet.

    I had a quick look at the Kresser link. Interesting idea about the SeHBV rating as a good way of examining the net health promoting or health adverse effects of different seafood. However, as someone commented there, selenium merely helps to offset oxidative damage from mercury, but it doesnt actually remove it from the body.

    Also, as you say he doesnt really look at cadmium or shellfish in that article. From my research the logn term effects of high levels of cadmium in the body are even worse than mercury.
    I am going to post a comment there to see if Chris Kresser has any comments on this.

    Seeing as alot of people think seafood-based diets are excellnt for health perhaps Paul J might be able to blog something in the future about some of these hidden dangers of pescetarianism, or controlling toxic metal accumulation through appropriate dietary choices and use of chelating agents.

  17. Almond milk - pingback on March 13, 2012 at 2:16 pm
  18. Paul,

    Rob raises some interesting concerns.

    I’d also be interested in your view on this topic of fish/shellfish consumption and metal chelating, considering apoE4 reduced ability to handle metals.

    Grace seems to feel this is critical from an apoE4 perspective and goes as far as recommending fish avoidance:

    cysteine amino acid is lacking in E4, at the 112 site. E2 has 2 cysteine’s per allele; E3, 1 cysteine; E4, N-O-N-E. This protein conformation apparently stupendously reduces the capacity for apoE to shuttle trace metals out of nervous system tissues. Many enzymes regulate and control metals in the brain however having the E4 allele is like a neuronal death sentence in a world that is contaminated by metals

    Thanks,
    Mark

    • Hi Mark,

      Well, it’s an important issue, but I don’t have a well formed view yet.

      When it comes to safe food production in the modern world, you can find flaws in nearly every food. Yet we have to eat something.

      For now my view is: barring concentrations of toxic metals, shellfish should be extremely healthy; I like them; I would hate to lose them from my diet.

  19. i never heard of apoE4 till just now.
    the cost of a test looks to be quite pricey from a quick cursory google (so i could quite easily be wrong).

    so i was wondering if there are any other common blood tests results (that i probably have already) that may be an indication that you could be an apoE4 carrier (if that’s the correct term).

    eg. if a particular cholesterol number (or numbers) is (are) out of kilter.
    or your Vit D level is off the charts,
    or some other marker or markers.

    hope you get my drift

    • Hi Darrin,

      I think most people suspect they might have apoE4 genes when they tend to have high cholesterol compared to others with similar diets, but not familial hypercholesterolemia type levels essentially independent of diet. An example is changing to a high fat diet and cholesterol numbers shoot up, but thyroid/copper/iron seems fine. Of course there are many factors to consider. My LDL tends to be 140’s on low fat (20%, low SFA) diets and so far 300 on higher fat (50%, high SFA) diets.

      Here’s an interesting related study:
      The Effect of Dietary Fat on LDL Size Is Influenced by Apolipoprotein E Genotype in Healthy Subjects

      I found out my APOE allele through 23andme.com. It’s currently $300 for a full genome (not just APOE) and individual genetic reports on disease risks, traits, carrier status, drug response, and ancestry info. The raw data can also be downloaded and imported into other sites. Keep in mind that some folks prefer to not know their APOE because of its strong association to Alzheimer’s.

      • may be the two things are linked (Alzheimer’s & cholesterol).

        this is some of what Chris Kresser had to say,
        “…So ApoE4 carriers have a higher risk of Alzheimer’s and dementia, and they have a higher risk of heart disease. And you know, the conventional view is that they have that higher risk because of higher levels of LDL, but actually the most recent research and our recent understanding of what causes both Alzheimer’s and heart disease suggests that the reason they have a higher risk is that ApoE4 carriers are more susceptible to oxidative damage and inflammation, and it’s the oxidation of the LDL particle that’s the common thread in both increased risk of heart disease and increased risk of Alzheimer’s and dementia. So this ApoE4 mutation that helps dark-skinned people produce vitamin D and also lighter-skinned people in northern latitudes produce enough vitamin D wouldn’t have been a problem in an environment where oxidative risk factors were low, like people weren’t smoking, they were getting plenty of exercise, their stress levels were managed, they weren’t eating a lot of omega-6 polyunsaturated fat that has the potential to oxidize. But in this modern world where the modern lifestyle is full of oxidative risk factors, then this ApoE4 mutation has a dark side…”
        http://chriskresser.com/the-latest-discoveries-in-evolutionary-biology-genetics-and-epigenetics

        • And maybe metals and Alzheimer’s are linked …

          Fish: One of the Most Pesticide-Ridden and Toxic Foods
          Where is the source? Pesticides and industrial pollution are bioaccumulated in algae, daphnia, marine life and large predacious fish and marine mammals. Human variance shows that not everyone is severely affected by heavy metals (mercury) and pesticides but certainly some are more sensitive than others or bioaccumulate at extremely higher rates than other individuals. The carriers of apo E4 allele, the ancestral ‘efficiency’ allele, appear to exhibit higher harboring and decreased detoxification of trace heavy metals (iron, copper, lead, mercury). This may explain the link between increased incidence of central obesity, metabolic syndrome, T2DM, Alzheimer’s and dementia and those of ethnic descent where the apo E4 allele is more dominant (Inuit, Amerindians, aborigine subpopulations, northern Chinese, northern European, Africa).

          http://drbganimalpharm.blogspot.com/2012/03/pesticides-in-shanghai.html

          • Thanks Mark,
            I have no idea if i have the E4 thing or not.
            But i have been trying to reduce my intake of canned Tuna, which is way too much at the moment. But its just so convenient as a quick meal/snack.
            I’m still hunting for another type of canned fish that tastes good to me and is lower down the food chain (less metals).

  20. Yeah, I’ve read Chris’s comments before and it’s interesting. So, the dilemma seems to be high SFA diet, high LDL for best inflammation/oxidation OR low SFA diet, good LDL and worse inflammation/oxidation.

  21. My blood pressure has significantly increased since adapting my diet from percentage 50 carbs/25 protein/25 fat to 20 carbs/15 protein/65 fat.
    By significant I mean systolic/diastolic previously was (130-140)/(85-90)now it is (165-180)/(100-115). I have stopped eating wheat,I use coconut oil, eat grass fed beef…something is wrong. Please advise. Thank-you.

    • Hi Annette,

      Normally blood pressure decreases on our diet, so yes, something is wrong. Possibilities are:
      - You’re not following the micronutrient advice or supplement recommendations. Copper deficiency, magnesium deficiency, potassium deficiency (include tomatoes, potatoes, and bananas) and other problems might account for it.
      - You have significantly increased the number of calories you are eating. If you have the proportions right you should actually be reducing calorie intake — the object is to find the proportions that minimize hunger and minimize food intake. You might try intermittent fasting as a starting point; also make sure you’re not eating even without hunger just because you think your dietary program calls for it.

      If you think it’s not either of those, then give us more details about what you’re eating.

      Best, Paul

  22. My calories have decreased on this diet. I entered the food i ate yesterday onto nutritiondata.com : beef brisket,herring,eggs 100g each raw weight. broccoli, cauliflower 200g each cooked. 100g peas cooked. macadamia nuts raw 35g. potatoes boiled 300g. butter, coconut oil 28g each, olive oil 1 tbsp.
    calories 1877 21% carbs although carb came out as 99.2g of which 25.3 was fibre which doesn’t count as a carb 65% fat 14% protein.mineral wise: copper 1.2mg, magnesium 252mg, potassium 2839mg all slightly low. My sodium is only 446mg, way too low. I haven’t started the supplements yet, I have only altered my diet a few days ago so would mineral deficiencies raise my blood pressure so quickly or could it be due to the higher fat content? I should point out that I also drink 6 units of alcohol daily, but I have done so for years and my blood pressure has gone up only since swapping carbs for fats. Possibly my liver is not functioning efficiently and finds the extra fat difficult to process? Although I believe saturated fats are protective of the liver. Thank-you for your responce yesterday, I look forward to hearing from you.

    • Hi Annette,

      I would look to your electrolytes and minerals first. You can raise sodium by taking salt, try adding a teaspoon of salt per day to your food, and eating a bowl of cherry tomatoes as a snack for potassium. Egg yolks and beef liver once a week would be good for some other important nutrients. Making a bone broth soup will provide calcium and phosphorus. Low calcium causes high blood pressure, and so bone broth might be especially helpful for you.

      It’s possible the alcohol is raising blood pressure — high levels of uric acid raise blood pressure and alcohol will generate uric acid if the liver is undernourished. You might try some extra potatoes and coconut milk for more liver support.

      Another possibility is low antioxidant minerals, zinc, copper, selenium. Shellfish have zinc and selenium, beef liver has copper and selenium. I would supplement vitamins C, D and K2 also — all are important for vascular health.

      In general it’s good that your calories have decreased, that suggests you’ve improved the nutrient mix of your diet. I think a few tweaks to optimize nutrition will probably bring blood pressure back down.

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  24. Hi Paul
    I notice that yoghurt and milk (dairy in general) constipates me. I may be wrong but I notice that when I reintroduce such items into my diet, it blocks me up to some degree
    Is this normal? Can I do anything to offset this effect? I quite like yoghurt and generally feel quite good when eating it except for this one side effect.
    Thanks for any advice you may have
    Ben

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