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China Study – How Not to do Science

by Alex boersma

The scientific method demands that researchers ask salient questions, develop applicable hypothesis, perform thorough experimentation and draw valid conclusions.  Unfortunately, human nature does not lend itself well to the scientific method.  More often than not, our environment and experience provide us with preconceived conclusions which our egos vigorously and single mindedly defend. 

We like to think that scientific institutions rise above human nature, follow the scientific method, and avoid the dissemination of misinformation.  We like to think that scientists and researchers  are more open minded and less biased than the rest of us.  We like to think that the upper echelon of academia would be particularly rigorous in their search for the truth. 

Dr. Colin Cambell, the primary author and researcher behind the “bible” of vegetarianism entitled The China Study most definitely belongs to the upper echelon of academia.  A Professor Emeritus of Nutritional Biochemistry at Cornell University, Dr. Cambell has been studying various aspects of nutrition for longer than I’ve been alive.  He received his master’s degree and Ph.D. from Cornell, served as a Research Associate at MIT and  spent 10 years on the faculty of Virginia Tech’s Department of Biochemistry and Nutrition.  That was before he started doing serious research.  He has since “conducted original research both in laboratory experiments and in large-scale human studies; has received more than 70 grant-years of peer-reviewed research funding, mostly from the National Institute of Health, and has served on several grant review panels of multiple funding agencies, lectured extensively, and has authored more than 300 research papers.” (from

Surely he would know about the scientific method.

Maybe so.  But you wouldn’t know it if you examine his book through even the dimmest of critical  lenses.  In the spirit of full disclosure, I have to admit that I approached this read with my own preconceived notions.  This being the case, the lens through which I examined Dr. Cambell’s assertions was by no means dim.  I had read previous critical reviews of The China Study and was fully aware that the science was less than exemplary.  Still, I found myself entirely bewildered by the depth of distortion to which Cambell exposes the truth. 

I am not going to tackle the nitty gritty details of Dr Cambell’s subterfuge here.  Greater minds than mine have already dealt withering blows to his arguments; his responses, which are readily available online, do not serve to raise him in my esteem.  Chris Masterjohn does a great job picking Dr. Cambell apart here, here, and here.  Denise Minger does an even more convincing job here, here and here.   Cambell responds here to Masterjohn;  here and here to Minger.  I highly recommend reading these mini-debates in their entirety; they are both entertaining and educational.

I will, however, provide a quick summary of the issues:

Back in the day, when Dr. Cambell worked as a research associate at MIT, he was involved in a research project which found a link between aflatoxin (a mold found in peanuts),  liver cancer and affluence in the Philippines.  Somehow, he decided that since animal protein consumption was higher in affluent families, it was also the reason affluent families were more likely to be affected by aflatoxin induced liver cancer.  I suppose, following the scientific method, this was him establishing an applicable hypothesis to the question: “Why do affluent Filipinos seem predisposed to aflatoxin induced liver cancer?”

Fair enough, although a number of other hypotheses were also available.

Including the possibility that affluent Filipinos consumed higher levels of refined carbohydrates!

Still adhering to the scientific method, Dr. Cambell set out to prove his hypothesis with a series of experiments on rats.  Low and behold, he found that if you use aflatoxin to induce liver cancer in rats, you can control the growth of that cancer by how much isolated casein you feed the rats.  Feed them a 20% casein diet and they get cancer.  Feed them a 5% casein diet and they don’t get cancer.  Even more fascinating was the fact that you could literally use casein as a switch to turn cancer on and off.  Reduce the casein content from 20% to 5% and you put the cancer into remission.  Bring it back up to 20% and voila…the rat has cancer again!

This was very compelling evidence indeed.  Being a conscientious scientist, though, Dr. Cambell understood that if he wished to make any associations between this research and general protein consumption, he would have to test his hypothesis with some other types of proteins as well.  He proceeded to perform the same experiments with soy protein and wheat protein.  With neither one was he able to reproduce the results found with casein.

This is the part where the conscientious scientist goes for a long walk in the woods.   

The conclusion Dr. Cambell drew from these experiments, as expressed in his book, was that “nutrients from animal-based foods increased tumor development while nutrients from plant-based foods decreased tumor development”  So isolated casein protein equals all animal-based nutrients and soy/wheat protein equals all plant-base nutrients.  Wow…that’s quite a leap of nutritional faith!  Never bothered to check whether any other animal proteins (perhaps something people actually eat, like beef or chicken or even real dairy products) caused the same problem as casein.  After all, it is not news that isolated casein is implicated in abnormal cell growth as well the development of several autoimmune diseases.  Nor, by the way, is it news that isolated whey (the other protein found in milk) is implicated in cancer reduction, thereby nullifying the effects of isolated casein in real dairy products…something Dr. Cambell never bothers to mention.

Although it is obvious that, by this time, Dr. Cambell had convinced himself that animal protein was detrimental to health, he must have realized that he would have to come up with something a little more convincing than rat studies.  At this point, a conscientious scientist would begin to perform experiments on humans to see if the results found in rats could also be found in humans.  Of course, exposing humans to aflatoxin and feeding them varying portions of isolated casein to see whether they get cancer or not is niether practical nor ethical.

That’s the problem with doing nutritional research on humans.  Pesky ethics and practicality always seem to get in the way!

So Dr. Cambell set himself on a different course.  He undertook what turned out to be the most comprehensive epidemiological study ever done;  The China Study.  This study was so expansive that Cambell claims he made 8,000 statistically significant associations between nutritional variables and disease.  Even his detractors admit that this is one of the most thorough and useful pieces of epidemiology they have ever seen.  They just disagree with his interpretation of the data.

Regardless, the China Study is still just epidemiology…it proves nothing!

In the book, Dr. Cambell clearly delineates the shortcomings of epidemiology.  He then goes on to explain, rather unconvincingly, that if you have enough other research to back up your position, epidemiology can stand strong in support of your hypothesis.  Although he never admits to it, he probably understands that the “other research” he is referring to doesn’t amount to more than a handful of flawed rat studies and a long list of equally useless epidemiological studies.  So he goes in search of some clinical evidence.  In other words, he tries to find some people who are successfully practicing what he is preaching.

Of course, if you look hard enough, you can find clinical evidence which looks like it supports just about anything.  Dr. Cambell parades a few particularly well known clinicians who appear to have had success in reversing western diseases by using low fat, vegetarian diets.  He exhalts the work of Dr Esselstyn, but when you actually look at Dr Esselstyn’s accomplishments, it turns out that his fame is based on the fact that he induced a 7% decrease in arterial stenosis (narrowing of the arteries) in 11 out of 22 people over 5 years by decreasing fat to less than 10% AND FEEDING THEM CHOLESTEROL LOWERING DRUGS! 

You too can have a 50/50 chance of minimally reducing your hardened arteries if you eat really low fat/mostly vegetarian and take a powerful drug for 5 years. 

Bets are off on whether you will live any longer or feel any better though.

Another clinician who’s accomplishments Dr. Cambell trumpets is Dr. Ornish of “Dean Ornish Diet” fame.  Although it is true that Dr. Ornish’s vegetarian/very low fat diet has had some success in slowing/reversing the progression of heart disease, there are, as usual, a number of confounding factors involved.  Along with his low fat/vegetarian advice, Dr. Ornish puts a lot of emphasis on exercise, stress management, and reduced consumption of trans fats, refined carbohydrates and processed foods.  Would a high saturated fat, meat and vegetable diet including exercise, stress management and minimal consumption of processed, refined, man-made foods have similar if not superior results?  Neither Dr. Ornish nor Dr. Cambell seem the least bit interested in finding out.


(On No Man’s Word…motto of the Royal Society of London)

Both in his book and his responses to detractors, Dr. Cambell places great weight on his scientific pedigree and the extensiveness of his references.  Indeed, the book is heavily salted with references.  In fact, there are so many references that a normal person would never bother to start checking them.  I suppose Dr. Cambell imagined his pedigree would make a normal person assume that reference checking was unnecessary.

Not being a normal person, I decided to check every single one.  Though daunting, the task provided me with an invaluable lesson on believing anything just because a distinguished person or entity has written it.  The shear volume of misdirection in this book is astounding.  The margins of my copy are literally peppered with notations like “That’s not at all what the reference says!” or “The reference actually says the opposite!”   This is the kind of chicanery we might expect from amateur salesmen, not pedigreed researchers.  Many of his critics have given Dr. Cambell the benefit of the doubt, conceding that he may simply not have known better.  I disagree.  I believe Dr. Cambell’s obfuscation is shameful and does a disservice to all researchers…he should and does know better!  A lay person should be able to take a distinguished scientist on his or her word.  When scientists such as Dr. Cambell resort to the methodology of amateur salesmen, it leaves the rest of us with diminished faith in an already precarious nutritional establishment.



At the end of the day, Dr. Cambell is just another “expert” selling his agenda and hoping that people will buy his book.  He may even be altruistic.  He may even truly believe that his agenda is the only path to health and longevity.  Who am I to question his motivation?

No, my issue is more with Dr. Cambell’s supporters than with the man himself.  As might be expected, the bulk of Dr. Cambell’s support comes from vegans and vegetarians.  Many in this meat-phobic community have adopted The China Study as the “bible” of vegetarianism.  I believe their unwavering support for this book seriously discredits them.

Here’s the thing.  Despite what I have said about vegetarianism in the past, there is no doubt in my mind that a well informed, responsible vegetarian diet and lifestyle is much healthier than the Standard American Diet and lifestyle.  Responsible, informed vegetarians are people who actually eat lots of fruits and vegetables; who actually focus on nutrient density; who actually remain active and maintain a normal body weight; who actually avoid sugary and processed foods.

These people can and do live longer and healthier lives than the typical North American.  Although their diet is, by my standards, far less than optimal, it is also far better than average.  That being said, their support of pseudo-scientific salesmanship like the The China Study infuriates me.   Dean ornish says about The China Study:  “This is one of the most important books about nutrition ever written”.  John Mackey, the decidedly vegetarian CEO of Whole Foods, calls it:  “The most important book on health, diet and nutrition ever written”

This is all pure hogwash.  This book is poorly written, poorly researched and poorly supported.  It is about as important to nutrition as the long discredited fascination with dietary cholesterol as a cause of heart disease.  The only place where it might have some value is in an introductory science classroom as an example of how not to do science.  Dr. Cambell’s claims are not supported by research.  They are not supported by clinical studies.  And, most importantly, they are not even remotely supported by the China Study research.  If I were a vegetarian, I would quietly throw this book into the recycling bin and hope that nobody noticed it was ever written.  I would certainly not go public in claiming that this book was any kind of justification for becoming vegetarian or vegan.

Somebody might notice that isn’t:

Oh oh…I guess it’s too late!



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