SOME SNIPPETS OF INFORMATION FROM THE CHINA PROJECT
T Colin Campbell
[ Further details of the study I Author's resume I Exclusive Interview ]
This is the most comprehensive project on diet and disease ever undertaken.
Two major surveys were undertaken, 1983 and 1989-90. These surveys were
undertaken in China because cancers and various other diseases exhibit exceptional
geographic localization. Thus, it made sense to examine these local regions
to determine the responsible dietary and lifestyle factors.
In a 1983 survey, 367 items of information were collected on how people
live and how they die in 138 rural Chinese villages; 6500 adults and their
families were surveyed. In a 1989-90 survey, more than 1000 items of information
were collected in 170 villages in rural China and Taiwan, involving 10,200
adults and their families. These new data, including a large number of socioeconomic
characteristics, will be combined with a new survey on causes of death for
a population of 100 million (1.4 million death certificates for the years,
There are sufficient data available in these combined surveys to interpret
for the next 20+ years -- at least. The opportunities for exploration of
the causes of disease, both specifically and generally, are incalculable.
We believe that these data have the potential to establish a new paradigm
for thinking about nutrition and health -- for all countries, rich and poor,
East and West, North and South.
Public recognition given to project
The project has been featured as a cover or lead story in numerous news
print media, including the New York Times, the China Daily, USATodgy, and
the Boston Globe, among many others, and at least in part or whole, in several
TV documentaries shown in Tokyo, Seoul, Rio de Janeiro, Beijing, London,
Frankfurt and US cities.
In an analysis of food trends prepared by Smith Barney Shearson, the banking
investment firm, the China Project was said to be the "seminal', work
driving the current marketplace trends; furthermore, it was said to have
been undertaken with "rigorous methodology".
Some findings from the 1983 survey
The dietary patterns in China are strikingly different from Western countries,
the major difference being the consumption of foods of animal origin. Animal
protein intake, for example, is 10-fold greater, on average, in the US.
than in China.
Although the biology of the diet and disease relationship is infinitely
complex and is easily misunderstood when interpreted in a reductionism manner,
the main nutritional conclusion from this study is the finding that the
greater the consumption of a variety of good quality plant-based foods,
the lower the risk of those diseases which are commonly found in western
countries (eg., cancers, cardiovascular diseases, diabetes). Based on these
and other data, we hypothesize that 80-90% of all such diseases could be
prevented before about age 90 years.
The optimum lifetime blood cholesterol concentration may be as low as 100-125
mg/dL (compared to an average concentration of about 210 mg/dL in the US.).
The same dietary factors which increase blood cholesterol concentrations
among Americans (at the much higher ranges) also increase cholesterol at
the lower concentrations of the Chinese; these include, for example, increased
intakes of dietary fat and animal protein and decreased intakes of dietary
fiber and legumes. Moreover, the lower the blood cholesterol, the lower
the risk for various cancers; there is no evidence of a cholesterol threshold
below which further decreases in disease would not occur. These two facts
are quite remarkable, in that they suggest that almost any consumption of
animal-based foods (higher in fat, lower in fiber) may increase blood cholesterol
(among many other biochemical changes) from a very low level, this to be
followed by a significant increase in the prevalence of the degenerative
diseases (many other analyses of these same data for individual diet-disease
relationships support this interpretation).
Chinese consume more total calories (per unit of body weight), yet have
far less obesity than AMericans, probably accounted for both by greater
physical activity and greater consumption of a low fat, plant-based diet.
chronic infection with hepatitis B virus is a major cause of primary liver
cancer. Together with the highly significant nutritional findings, this
cancer appears to be a viral/nutritional disease, not a viral/chemical carcinogen
disease as previously thought (our data on this question are more comprehensive
than all others combined, thus our conclusion on the role of nutrition,
even though different, is highly relevant). Control of the prevalence of
this disease may be best achieved through immunization of young children.
Prevention of disease progression among individuals who suffer chronic hepatitis
infection may be best achieved through strict adherence to a low fat, plant
Consumption of salt-preserved ("pickled') vegetables increases stomach
cancer while consumption of fresh vegetables decreases this cancer.
Provided there is adequate dietary variety and quantity of plant-based foods
and an otherwise good public health environment, achievement of adult height
can be maximized without consuming animal-based foods.
Breast cancer, low in China, nonetheless is greater with the consumption
of the typical Western diet (high in animal- based foods and fat, and low
in plant-based foods) which encourages body growth rates to be too rapid,
and sexual maturation to occur too early.
More speculative ideas
Chronic infection with Herpes virus may increase coronary heart disease.
Chronic infection with schistosomiasis, an intestinal parasite, may increase
the risk for colon cancer.
Increased consumption of cadmium, a toxic heavy metal, may increase liver
cancer. Infection with Helicobacter pylori (a bacterium) is a risk factor
for stomach cancer. implications of this study
Conclusions drawn from this and other studies suggest that it should be
possible to simultaneously reduce diseases typically found either in Western
industrialized countries or in developing countries (of this, we have considerable
If all countries were to use the dietary and lifestyle recommendations emerging
from this study, it is estimated that the reduction of disease burden would
result in an enormous savings in health care costs. (At least $120 billion
per year in the US alone might be saved).
The savings in utilization of the earth's resources resulting from the use
of fewer livestock for human food also should be enormous.
Developing countries should continue to use their traditional plant-based
diets, but give more emphasis to food quality and variety (of plant-based
foods). This will constitute an enormous savings in future capital otherwise
needed to sustain a western-type food production system in these countries.
Land use in these countries would be more environmentally friendly and equitable,
thus providing a more politically stable condition.
The optimum diet for peoples residing in all countries of the world appears
to be virtually the same.
The present dietary guidelines, mostly focused on the effects of dietary
fat when reduced to 30% of calories, is not likely to yield the disease
prevention benefits originally inferred.
At least 97-98% of the available data are yet to be analyzed, interpreted
T. Colin Campbell
Project Director China-oxford-Cornell Diet and Health Project
Division of Nutritional Sciences Cornell University Ithaca, NY
Colin Campbell, who was trained at Cornell (M.S., Ph.D.) and MIT (Research
Associate) in nutrition, biochemistry and toxicology, spent 10 years on
the faculty of virginia Tech's Department of Biochemistry and Nutrition
before returning to the DiviSion of Nutritional Sciences Cornell in 1975
where he presently holds the endowed chair of Jacob Gould Schurman Professor
of Nutritional Biochemistry. His principal scientific interests, which began
with his graduate training in the late 1950's, has been on the effects of
nutritional status on long term health, particularly on the causation of
cancer. He has conducted original research both in laboratory experiments
and in large-scale human studies; in addition, he has participated in multiple
deliberations on state, national and international policy matters, has lectured
extensively, and has authored over 300 research papers. In addition, he:
In summary, he has been interested both in original research investigation
(particularly on the effects of dietary protein on health outcomes) and
in the application' of this information for national policy and public information.
- has coordinated a USAID- supported technical assistance program for
a national nutrition program for malnourished pre-school age children in
the Philippines (1966-74),
- currently iS Director of a multinational project responsible for nationwide
surveys of diet, lifestyle and mortality in the People's Republic of China
- was a co-author and member of National Academy of Science's expert panels
on Diet, Nutrition and Cancer (1981-83); Saccharin and Food Safety Policy
(1978-79); and Food Labeling and Nutrition Components of Food Labeling (1989-1990),
- was the principal witness for the National Academy of Sciences in two
Federal Trade commission hearings on issues concerning product- specific
health claims (1984-1986),
- was Visiting Scholar at the Radcliffe Infirmary, university of Oxford/England
- has been the Senior Science Advisor for the American Institute for Cancer
Research/World Cancer Research Fund (1983-1987, 1992-present),
- presently holds an Honorary Professorship at the Chinese Academy of
Preventive Medicine. He also presently co-chairs an international panel
of scientific experts who are researching dietary and nutritional policies
concerning the dietary prevention of cancer worldwide.