The China Study

This study suggests that the more animal protein you eat, the more heart disease you have. In addition, dozens of experimental studies show that feeding rats, rabbits, and pigs animal protein (e.g., casein) dramatically raises cholesterol levels, whereas plant protein (e.g., soy protein) dramatically lowers cholesterol levels.25

Reviews of this early literature30 report that animal protein was substantially more effective than cholesterol in inducing the formation of early heart disease.

These eighteen patients achieved remarkable success. At the start of the study, the patients’ average cholesterol level was 246 mg/dL. During the course of the study, the average cholesterol was 132 mg/dL, well below the 150 mg/dL target!52 Their levels of “bad” LDL cholesterol dropped just as dramatically.51 In the end, though, the most impressive result was not the blood cholesterol levels, but how many coronary events occurred since the start of the study. In the following eleven years, there was exactly ONE coronary event among the eighteen patients who followed the diet. That one event was from a patient who strayed from the diet for two years. After straying, the patient consequently experienced clinical chest pain (angina) and then resumed a healthy whole food, plant-based diet. The patient eliminated his angina, and has not experienced any further events.52 Not only has the disease in these patients been stopped, it has even been reversed. Seventy percent of his patients have seen an opening of their clogged arteries.52 Eleven of his patients had agreed to angiography, a procedure in which specific arteries in the heart can be “x-rayed.” Of these eleven, the blockages in the arteries were, on average, reduced in size by 7% over the first five years of his study. This may sound like a small change but it should be noted that the volume of blood delivered is at least 30% greater when the diameter is increased by 7%.53 More importantly, this is the difference between the presence of pain (from angina) and absence of pain, indeed between life and death. Authors of the five-year report note, “This is the longest study of minimal fat nutrition used in combination with cholesterol-lowering drugs conducted to date, and our finding of a mean decrease of arterial stenosis [blockage] of 7.0%

Well-meaning institutions are not exempt from such closed-mindedness. The American Heart Association recommends a diet for heart disease that favors moderation. The National Cholesterol Education Program does the same thing. These organizations pitch moderate diets with trivial changes as being healthy lifestyle “goals.” If you are at high risk for heart disease, or if you already have the disease, they recommend that you adopt a diet containing 30% of total calories as fat (7% of total calories as saturated fat) and less than 200 mg/day of dietary cholesterol.69,70 According to them, we should also keep our total blood cholesterol level under the “desirable” level of 200 mg/dL.70 These venerable organizations are not giving the American public the most up-to-date scientific information. While we are told that a total blood cholesterol level of 200 mg/dL is “desirable,” we know that 35% of heart attacks strike Americans who have cholesterol levels between 150 and 200 mg/dL71 (a truly safe cholesterol level is under 150 mg/dL). We also know that the most aggressive reversal of heart disease ever demonstrated occurred when fat was about 10% of total calorie intake. Studies have clearly demonstrated that many patients who follow the more moderate government-recommended diets see a progression of heart disease.72 The innocent victims are health-conscious Americans who follow these recommendations, keeping their total cholesterol around 180 or 190 mg/dL, only to be rewarded with a heart attack leading to a premature death.

Two studies, each involving a team of experienced researchers at prestigious institutions, provide compelling evidence that food can protect against macular degeneration. Both studies were published two decades ago. One evaluated diet44 and the other assessed nutrients in blood.45 The findings of these two studies suggested that as much as 70–88% of blindness caused by macular degeneration could be prevented if the right foods are eaten.

antioxidant-containing foods should be helpful. Starting in 1988, researchers in Wisconsin began to study eye health and dietary intakes in over 1,300 people. Ten years later, they published a report48 on their findings. The people who consumed the most lutein, a specific type of antioxidant, had one-half the rate of cataracts as the people who consumed the least lutein. Lutein is an interesting chemical because, in addition to being readily available in spinach, along with other dark leafy green vegetables, it also is an integral part of the lens tissue itself.49,50 Similarly, those who consumed the most spinach had 40% fewer cataracts. In 2014, Chinese scientists reported that consumption of lutein and another antioxidant found in high quantities in green leafy vegetables, zeaxanthin, significantly improved macular degeneration. This can only be considered preliminary but it suggests an ability of antioxidants to help prevent progression of this difficult disease. These two eye conditions, macular degeneration and cataracts, both occur when we fail to consume enough of the highly colored green and leafy vegetables. In both cases, excess free radicals, increased by animal-based foods and decreased by plant-based foods, are likely to be responsible for these conditions.

There is a widely held perception that cancer is caused by toxic chemicals that make their way into our bodies in a sinister way. For example, people often cite health concerns to justify their opposition to pumping antibiotics and hormones into farm animals. The assumption is that the meat would be safe to eat if it didn’t have those unnatural chemicals in it. The real danger of the meat, however, is the nutrient imbalances, regardless of the presence or absence of those nasty chemicals. Long before modern chemicals were introduced into our food, people still began to experience more cancer and more heart disease when they started to eat more animal-based foods.

So what do these examples tell us? In practical terms, you aren’t doing yourself much good by eating organic beef instead of conventional beef that’s been pumped full of chemicals. The organic beef might be marginally healthier, but we would never say that it was a safe choice. Both types of beef have a similar nutrient profile. It is useful to think of this principle in another way: a chronic disease like cancer takes years to develop. Those chemicals that initiate cancer are often the ones that make headlines. What does not make headlines, however, is the fact that the disease process continues long after initiation, and can be accelerated or repressed during its promotion stage by nutrition. In other words, nutrition primarily determines whether the disease will ever do its damage.

simple is essential if we are to enjoy our food. One of the most fortunate findings from the mountain of nutritional research we’ve encountered is that good food and good health is simple. The biology of the relationship of food and health is exceptionally complex, but the message is still simple. The recommendations coming from the published literature are so simple that we can state them in one sentence: eat a whole foods, plant-based diet, while minimizing the consumption of refined foods, added salt, and added fats.

For most Americans, the idea of giving up virtually all meat products—including beef, chicken, fish, cheese, milk, and eggs—seems impossible. You might as well ask Americans to stop breathing. The whole idea seems strange, fanatical, or fantastic. This is the biggest obstacle to the adoption of a plant-based diet: most people who hear about it don’t seriously consider it, despite the truly impressive health benefits. If you are one of these people—if you are curious about these findings but know in your heart that you will never be able to give up meat—then no amount of talk will ever convince you to change your mind. You have to try it and see it for yourself. Give it one month. You’ve been eating cheeseburgers your whole life; a month without them won’t kill you.

A month isn’t enough time to give you any long-term benefits, but it is long enough for you to discover four things: 1.   There are some great foods you can eat in a plant-based diet that you otherwise may never have discovered. You may not be eating everything you want (desire for meat may last longer than a month), but you will be eating lots of great, delicious foods. 2.   It’s not all that bad. Some people take to this diet quite quickly and love it. Many take months to fully adjust to it, at which point they often discover some new tastes. But almost everyone will find that it’s a lot easier than they thought. 3.   You’ll feel better. Even after only a month, most people will feel better and likely lose some weight, too. Try having your blood work done both before and after. Odds are, you’ll see significant improvement in even that period of time if you’ve been eating the standard American diet. (Since we made the one-month recommendation in the first edition of this book, several groups have organized relatively formal opportunities to use the diet for periods of 7–10 days only, with blood work done before and after. My eldest son, Nelson, and his consulting physician have done it six times, for groups as large as 130 people. Depending on what diet and numbers people begin with, it is possible to see total cholesterol drop by 100 points or more, LDL cholesterol by 50–75 points, and body weight by 5–10 pounds in as few as seven days. Also, blood pressure generally decreases more than with antihypertensive drugs.) 4.   Most important, you’ll discover that it’s possible. You may love the diet, or you may not, but at the very least you’ll come away from your one-week or one-month trial knowing that it’s possible. You can do it, if you choose to. All the health benefits discussed in this book are not just for Tibetan monks and fanatical Spartans. You can have them, too. It’s your choice.

and more health information, specifically nutrition information, was being generated at a furious pace. In 1976, Senator George McGovern had convened a committee that drafted dietary goals recommending decreased consumption of fatty animal foods and increased consumption of fruits and vegetables because of their effects on heart disease. The first draft of this report, linking heart disease and food, caused such an uproar that a major revision was required before it was released for publication. In a personal conversation, McGovern told me that he and five other powerful senators from agricultural states lost their respective elections in 1980 in part because

Luckily, reason prevailed in this whole farcical encounter. A board meeting was held to vote on whether I should be expelled from my society, and I handily survived the vote (6–0, with two abstentions). It was hard not to take all of this personally, but there’s a larger point here, and it’s not personal. In the world of nutrition and health, scientists are not free to pursue their research wherever it leads. Coming to the “wrong” conclusions, even through first-rate science, can damage your career. Trying to disseminate these “wrong” conclusions to the public, for the sake of public health, can destroy your career. Mine was not destroyed—I was lucky, and some good people stood up for me. But it could have gone much worse.

The fruit industry plays this game just like everyone else. For example, when you think of vitamin C, what food product comes to mind? If you don’t think of oranges and orange juice, you are unusual. Most of us have heard ad nauseam that oranges are a good source of vitamin C. This belief, however, is just another result of good marketing. How much do you know, for example, about vitamin C’s relationship to diet and disease? Let’s start with the basics. Although you probably know that oranges are a good source of vitamin C, you may be surprised to know that many other plant foods have considerably more. One cup of peppers, strawberries, broccoli, or peas all have more. One papaya has as much as four times more vitamin C than one orange.35

Americans who suffer from nutrition-related illnesses. The covenant

The only person that likes change is a newborn, and it’s natural, it’s human nature. Anywhere you go, 99% of the people are eating incorrectly. The numbers are against you, and it’s very hard for those 99% to look at you in the 1% and say, “Yes, he’s right, we are all wrong.”