Author Archives: Paul Jaminet - Page 134

The China Study: Evidence for the Perfect Health Diet

Posted by on July 9, 2010 54 comments

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.

Multiple Sclerosis: A Curable Infectious Disease?

Posted by on July 7, 2010 46 comments

For more than a century many strands of evidence have pointed toward an infectious cause for MS.

Pierre Marie, lecturing in 1892, said that “the causative agent in multiple sclerosis is manifestly of an infective nature.  What is its precise nature?  No one so far has been able to isolate it but one day this goal will be achieved.” [1]

For a long time, little progress was made. In the 1950s, however, Paul Le Gac noticed similarities between multiple sclerosis and symptoms developed in the aftermath of diseases like Rocky Mountain spotted fever and typhus caused by Rickettsia bacteria. [2]  Rickettsia are obligate intracellular parasites that cannot survive outside a host. By 1966, Le Gac recognized that the Chlamydiae, another order of intracellular parasitic bacteria, might be responsible for MS. [3]

Le Gac tried treating multiple sclerosis with tetracyclines and other broad spectrum antibiotics, and reported a number of cures. Here is one of his case studies:

Mr. Maurice Q., a Belgian citizen, 46 years of age. Multiple sclerosis was manifested in 1955 by transient retrobulbar neuritis. In 1956 he became bedridden. As of November 1961, [he had been] totally quadriplegic for three years….

Antibiotic treatment and alginated baths were followed, within a few months, by a spectacular improvement.

In May 1962, Mr. Q. was walking normally. He was able to discard all assistive devices, and soon afterward went back to work as a freight–truck driver. [3]

However, Le Gac’s work was criticized on the ground that MS patients generally lacked antibodies to Rickettsia, not all MS patients responded to Le Gac’s treatment, and no controlled clinical trials had been conducted. [4]

Meanwhile, epidemiological evidence was accruing in support of the idea of an infectious origin.  For instance, MS was virtually unknown in the Faeroe Islands until British troops were stationed there in 1940, after which an epidemic of MS occurred.  Nearly all the MS cases diagnosed between 1943 and 1960 were in people who had resided as children in the towns where the British were stationed. [5] In general, MS risk is increased in populations with low vitamin D and poor hygiene; both associations are suggestive of an infectious origin, since vitamin D is so crucial for intracellular immunity. [6]

Technological advances in molecular biology in the 1980s and 1990s finally made possible a robust investigation into microbial causes. A key invention was real-time PCR, which was honored by the Nobel Prize for Chemistry in 1993. This technique permitted sensitive detection of bacterial DNA from tissue or fluid samples, and enabled for the first time reliable detection (and species identification) of intracellular bacteria. PCR entered research use in the 1990s.

Some scientists at Vanderbilt, who had previously been studying the role of Chlamydia pneumoniae in chronic fatigue, discovered its presence in the cerebrospinal fluid of MS patients. [7] PCR showed that DNA from C. pneumoniae was present in the cerebrospinal fluid of up to 97% of MS patients. [8] In 2002, the Vanderbilt scientists patented a combination-antibiotic therapy for C. pneumoniae [9]. They established a clinic at Vanderbilt specializing in antibiotic treatment of chronic fatigue syndrome and MS.

In medicine, some of the most important progress has been made by doctors and scientists trying to cure their own conditions. The combination of high motivation, intimate familiarity with the disease, and technical expertise is hard to beat. For this reason, I think the story of Dr. David Wheldon, a clinical microbiologist from Britain, and his wife Sarah is significant in the history of MS.  I will abridge their story from various accounts they have published. [10, 11, 12, 13]

In 1999, the Wheldons contracted a respiratory infection which produced a mild pneumonia. In its aftermath, Sarah developed asthma and David developed a myalgia which prevented him from turning his head. By 2003, Sarah had developed full-blown multiple sclerosis: she could not walk unaided, her speech was slurred, she was numb from the waist down, and an MRI revealed numerous white-matter brain lesions. 

Dr. Wheldon searched the literature and found the Vanderbilt work.  He gave his wife doxycycline and roxithromycin, both effective anti-chlamydial agents.  He writes:

What followed was dramatic. For a few days, Sarah had a Herxheimer-like reaction, with a fever and night-sweats. After this, her mental fog and cognitive deficits speedily began to vanish. Slowly, the disease was rolled back … [12]

Sarah improved from a grade of 7 on the Kurtzke Expanded Disability Status Scale (EDSS) to a grade of 2, and remains at that grade seven years later. The same antibiotics cured David’s myalgia.

Dr. Wheldon and Dr. Stratton of the Vanderbilt group have since collaborated on papers summarizing the evidence for C. pneumoniae as the causal agent of MS.  [14] Dr. Wheldon now treats MS patients, and he and his wife also helped popularize a site, cpnhelp.org, set up by a chronic fatigue and fibromyalgia patient, Jim Kepner, to help chronic disease suffers defeat C. pneumoniae infections. This site has a rich lode of MS patients recounting their experiences with antibiotics.

On the clinical research side, pilot trials of antibiotic therapies for MS have been undertaken by several groups, with promising results. [15, 16, 17] It seems only a matter of time, patient pressure, and perhaps a few funerals before large-scale trials are funded.

The experience of MS patients shows that combination antibiotic treatments targeted at C. pneumoniae often halt MS progression and sometimes, as in the case of Sarah Wheldon, bring about substantial recovery.

In an upcoming post, I’ll talk about dietary reasons why antibiotics may fail, or succeed only after a protracted struggle with exceptionally difficult side effects.

[1] Marie, P., Leçons sur les Meladies de la Moelle, Paris, Masson, 1892. Cited in: “Cures” for multiple sclerosis. Br Med J. 1970 Jan 10;1(5688):59-60. http://pmid.us/5411441.

[2] “Cures” for multiple sclerosis. Br Med J. 1970 Jan 10;1(5688):59-60. http://pmid.us/5411441.

[3] Le Gac P et al. The psittacosis virus in the etiology of multiple sclerosis. C R Acad Sci Hebd Seances Acad Sci D. 1966 Nov 28;263(22):1793-5. http://pmid.us/4963916. A translation of the full text is available here:  http://www.davidwheldon.co.uk/Le%20Gac%204.pdf. More case studies may be found here: http://www.davidwheldon.co.uk/Le%20Gac%206.pdf.

[4] Field EJ, Chambers M. Rickettsial antibodies in multiple sclerosis. Br Med J. 1970 Jan 3;1(5687):30-2. http://pmid.us/4983591.

[5] Kurtzke JF, Hyllested K. Multiple sclerosis in the Faroe Islands: I. Clinical and epidemiological features. Ann Neurol. 1979 Jan;5(1):6-21. http://pmid.us/371519. Kurtzke JF, Heltberg A. Multiple sclerosis in the Faroe Islands: an epitome. J Clin Epidemiol. 2001 Jan;54(1):1-22. http://pmid.us/11165464.

[6] Cantorna MT. Vitamin D and multiple sclerosis: an update. Nutr Rev. 2008 Oct;66(10 Suppl 2):S135-8. http://pmid.us/18844840.

[7] Sriram S et al. Multiple sclerosis associated with Chlamydia pneumoniae infection of the CNS. Neurology. 1998 Feb;50(2):571-2. http://pmid.us/9484408. Stratton CW et al. Does Chlamydia pneumoniae play a role in the pathogenesis of multiple sclerosis? J Med Microbiol. 2000 Jan;49(1):1-3. http://pmid.us/10628821.

[8] Sriram S et al. Chlamydia pneumoniae infection of the central nervous system in multiple sclerosis. Ann Neurol. 1999 Jul;46(1):6-14. http://pmid.us/10401775.

[9] Mitchell, William M. & Stratton, Charles W. “Diagnosis and management of infection caused by Chlamydia,” U.S. Patent Number 6,884,784, http://patft.uspto.gov/netacgi/nph-Parser?Sect1=PTO2&Sect2=HITOFF&p=1&u=%2Fnetahtml%2FPTO%2Fsearch-bool.html&r=1&f=G&l=50&co1=AND&d=PTXT&s1=6884784.PN.&OS=PN/6884784&RS=PN/6884784.

[10] David’s story told by himself: http://www.cpnhelp.org/?q=david_wheldons_story_cpn_treatment_of_cardiac_myalgic_symptoms

[11] Sarah’s story told by herself:  http://www.cpnhelp.org/?q=node/4

[12] Sarah’s story told by David: http://avenues-of-sight.com/Ignoring-the-Evidence.html

[13] http://www.davidwheldon.co.uk/ms-treatment.html

[14] Stratton CW, Wheldon DB. Multiple sclerosis: an infectious syndrome involving Chlamydophila pneumoniae. Trends Microbiol. 2006 Nov;14(11):474-9. http://pmid.us/16996738.  Stratton CW, Wheldon DB. Antimicrobial treatment of multiple sclerosis. Infection. 2007 Oct;35(5):383-5; author reply 386. http://pmid.us/17882356.

[15] Sriram S et al. Pilot study to examine the effect of antibiotic therapy on MRI outcomes in RRMS. J Neurol Sci. 2005 Jul 15;234(1-2):87-91. http://pmid.us/15935383.

[16] Minagar A et al. Combination therapy with interferon beta-1a and doxycycline in multiple sclerosis: an open-label trial. Arch Neurol. 2008 Feb;65(2):199-204. http://pmid.us/18071030.

[17] Metz LM et al. Glatiramer acetate in combination with minocycline in patients with relapsing–remitting multiple sclerosis: results of a Canadian, multicenter, double-blind, placebo-controlled trial. Mult Scler. 2009 Oct;15(10):1183-94. http://pmid.us/19776092.

Is Multiple Sclerosis an Autoimmune Disease?

Posted by on July 5, 2010 8 comments

Multiple sclerosis is almost universally labeled an “autoimmune disease.” Yet after decades of research, there is still no proof that MS is the result of autoimmunity.

Several papers by Drs. Abhijit Chaudhuri and Peter Behan [1,2] discuss problems with the conventional explanation:

  1. Unlike other diseases which are known to have an autoimmune component (rheumatoid arthritis, systemic lupus erythematosus, and myasthenia gravis), MS has no specific immunological marker. This after 60 years of search for such a marker.
  2. The standard animal model for MS, experimental allergic encephalomyelitis (EAE), is generated by inducing autoimmunity against myelin basic protein in mice.  However, EAE symptoms do not closely resemble those of MS; rather, EAE mice look like humans with a different disease — acute disseminated encephalomyelitis (ADEM). Some differences: EAE and ADEM lack the characteristic large plaques radiating from a central focus seen in the brains of MS patients. EAE and ADEM both feature destruction of endothelial cells lining blood vessels, a pattern not seen in MS. 
  3. The autoimmune model does not explain the neurodegeneration and loss of brain matter in the brains of MS patients; the observation that widespread neuronal loss is present even at the earliest clinical stage of the disease; the absence or slight infiltration of lymphocytes in MS plaques; the role of vitamin D in MS prevention; and the general failure of immunotherapies.

Whether MS is an autoimmune disease has implications for treatment.  Autoimmune diseases are commonly treated by immunosuppression.  But if MS is an infectious disease, immunosuppression would be a terrible mistake.

After 60 years of research, the autoimmune model has failed to produce a single effective treatment for MS. Drugs have been found that improve mice with EAE, but none does much to help MS patients. Chaudhuri and Behan note:

The two most widely prescribed therapies for MS (interferon and glatiramer acetate) have no effect on the progressive forms of the disease (primary or secondary MS), although relapse rates may be reduced by about one third in some patients. A response rate of one third is considered to be a powerful placebo effect in treatment trials. [2]

The continued dominance of the autoimmune paradigm in MS research calls to mind Einstein’s definition of insanity. 

Meanwhile, other work has established that at least some cases of MS are infectious in origin, and can be cured with antibiotic and dietary therapies. That will be the subject of tomorrow’s post.

[1] Chaudhuri A, Behan PO. Multiple sclerosis: looking beyond autoimmunity. J R Soc Med. 2005 Jul;98(7):303-6. http://pmid.us/15994589.

[2] Chaudhuri A, Behan PO. Multiple sclerosis is not an autoimmune disease. Arch Neurol. 2004 Oct;61(10):1610-2. http://pmid.us/15477520.

It’s easy to be malnourished

Posted by on July 2, 2010 18 comments

I recently came across a paper analyzing the micronutrient deficiencies in four popular diets – the South Beach Diet, the Atkins for Life Diet, the DASH diet, and the Best Life Diet.

According to this paper [1], none of these diets provides the RDA for more than 15 of the 27 micronutrients studied.  Some nutrients were lacking in all four diets. The diets averaged:

  • 58% of the RDA for pantothenic acid (vitamin B5).
  • 29% of the RDA for biotin.
  • 34% of the RDA for vitamin E.
  • 56% of the RDA for choline.
  • 9% of the RDA for chromium.
  • 34% of the RDA for iodine.
  • 73% of the RDA for potassium.

Of these I would take the chromium and iodine deficiencies very seriously.  These would certainly merit supplementation – indeed, in our book they are among the 8 micronutrients we strongly recommend supplementing.

Cases can also be made for supplementation of others on this list:

  • Biotin and pantothenic acid are harmless in very high doses, and extremely cheap – less than 4 cents for 500 mg pantothenic acid or 5 mg biotin.
  • Choline deficiency is widespread and there is evidence that choline supplements are very helpful for pregnant women.

More important than any specific deficiency, however, is the implication for ordinary diets.  If these comparatively healthy diets are deficient, then nearly any modern diet is likely to produce micronutrient deficiencies.

Agriculture – planting the same crops, year after year, in the same fields – tends to deplete the soil of nutrients, and hence both plant crops and crop-fed animals tend to be low in nutrition. Water treatment also removes minerals like calcium and magnesium from drinking water. 

A British study, for instance, found that copper levels in UK foods have declined by 76% in vegetables, 90% in dairy foods, and 55% in meat. [2] Some other nutrients have declined nearly as much.

It’s important to take some care, therefore, to eat a nourishing diet.  Especially nourishing foods include seaweed, green leafy vegetables, organ meats including liver, and seafoods.

Cooking style is also important:  Cooking should be done in a way that doesn’t throw away drippings from foods, but rather preserves them as a sauce or soup.  Also, very high cooking temperatures which can destroy or denature nutrients should be avoided. 

Even with these steps, supplementation is probably necessary for optimal health.  We recommend taking a daily multivitamin plus a few other supplements, notably including iodine, magnesium, vitamin D, and vitamin K2.

[1] Calton JB. Prevalence of micronutrient deficiency in popular diet plans. J Int Soc Sports Nutr. 2010 Jun 10;7(1):24. http://pmid.us/20537171. Full text:  http://www.jissn.com/content/pdf/1550-2783-7-24.pdf.

[2] Thomas D. The mineral depletion of foods available to us as a nation (1940-2002)–a review of the 6th Edition of McCance and Widdowson. Nutr Health. 2007;19(1-2):21-55. http://pmid.us/18309763. Hat tip Robert Andrew Brown, http://wholehealthsource.blogspot.com/2010/04/copper-and-cardiovascular-disease.html.