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The China Study Summary

The China Study: Revised and Expanded Edition: The Most Comprehensive Study of Nutrition Ever Conducted and the Startling Implications for Diet, Weight Loss, and Long-Term Health 



If you ever have a chat with a vegetarian or vegan friend, The China Study is bound to come up. It’s often called the bible for vegans because the research that made up the groundwork of this book is what first backed a vegan diet scientifically on a big scale.

It’s been a big step forward for advocates of plant-based diets, because like in most divisive issues, such as politics or religion, it’s really hard to argue when all you have to argue with is morals and ethics. Now, with some scientific truth to back up a plant-based diet, supporters of vegetarian or vegan diets can make themselves heard.

The book is loosely based on a 20-year study conducted with over 6,000 people from 65 rural counties in China.

Here are 3 lessons from the book to get your thinking gears spinning about food:

  1. Your health is not a matter of medicine, it’s a matter of nutrition.
  2. You don’t need as much protein as you think.
  3. Animal-based protein is more likely to cause cancer than plant-based protein.

Ready to learn something new about nutrition? Let’s go!


What’s The China Study?

In 1983, T. Colin Campbell was one of the lead scientists of the China–Cornell–Oxford Project, a collaboration between Cornell University, the University of Oxford, and the Chinese Academy of Preventive Medicine. This was the most comprehensive study ever undertaken to explore the relationship between nutrition and disease, widely known as “The China Study”. This study, combined with lab research findings, showed the risks of a diet high in animal protein, and the benefits of a whole-foods, plant-based (WFPB) diet. The findings were shared in the 1st edition of this book in 2005. This 2nd edition was published in 2016 with updates and new evidence on the benefits of a WFPB diet.

An Escalating Health Crisis

The USA spends more money per capita on healthcare than any other country, yet Americans have some of the worst disease rates in the world. 2/3 of Americans are overweight, 1/3 of Americans are killed by heart diseases, 1 out of 11 Americans has diabetes, and the American Cancer Society estimates that a typical American male or female has a 47% or 35% chance of getting cancer in his/her lifetime.

Healthcare costs are exploding, both in absolute amounts and as a proportion of disposable income. Errors and adverse effects from medication and surgery also contribute to some 225,400 deaths a year.

In the book, Campbell shares numerous statistics to show the worrying rate of growth in both diseases and healthcare costs. It’s time to acknowledge that drugs and surgery are not a sustainable solution to our health crisis.

The good news is, there’s a relatively simple solution to this crisis: by changing what we eat, we can prevent and even reverse a wide range of chronic diseases. The bad news is, we’re surrounded by lots of misinformation about health and nutrition. That’s why we may hear one day that olive oil is good for us and the next day that it is bad. Or, we may be told one day that eggs are a great source of protein and the next day that an egg a day can kill us.

Nutrition and Disease


3 stages of cancer growth

Basically, cancer progresses in 3 stages:

• Initiation. This is the process where chemicals called carcinogens are absorbed by the body and permanently change certain cells to create a potential for cancer. Carcinogens come mainly from industrial processes and partly from nature (e.g. aflatoxin in food). This process is like planting a seed.
• Promotion. This is when the cancer cells grow, like how a seedling sprouts overtime under the right conditions.
• Progression. This is when the cancer cells spread, like how weeds spread in your garden. Cancer cells grow and spread when there are more promoters (to feed cancer growth) than anti-promoters (to slow cancer growth).

Lab research findings

Essentially, cancer initiation is less critical than cancer promotion. Most of us will have some carcinogens in our bodies. Whether they develop into cancer cells and spread depends on the conditions in our body, which is influenced by diet and nutrition. Lab research findings involving animals found that:

• Nutrition played a bigger role than carcinogens in controlling cancer promotion, and there’s a strong link between protein and cancer. Animals that were fed high levels of animal protein had high rates of tumor development and growth, while animals that were fed low consumption of animal protein had low rates of tumor development and growth even if they were given much higher doses of carcinogens.

• Plant-protein didn’t promote cancer growth in the same way as animal protein, even when consumed at higher levels.


Findings from The China Study and other studies

How far do the animal lab experiments reflect real-life human experiences? The China Study helps to answer this question. In 1983, 6,500 adults were randomly selected from 65 rural counties in China. Over 20 years, researchers tracked how these people ate, lived and died, to examine 367 variables in health and disease. Two distinct groups of disease were found across different areas:
• Diseases of affluence (e.g. cancer, diabetes, coronary heart disease) come from nutritional excess. These are similar to the “Western diseases” found in America.
• Diseases of poverty (e.g. pneumonia, parasitic disease, rheumatic heart disease) come from nutritional lack and poor sanitation.

Basically, the China Study found that people who ate the most plant-based foods had the least or no chronic diseases. Those who ate the most animal protein had the most heart disease, cancer, and diabetes.

There’s also a distinct pattern from the various research studies to show that lifestyle affects disease more than genes:
• Diseases of affluence tend to be much more prevalent in countries with rich meaty Western diets;
• In developing countries, such diseases are higher amongst those who adopt Western diets or migrate to Western countries; and
• A WFPB diet universally counters such diseases.

Diet guidelines almost anyone can follow

I apologize for dragging you in with a teasing introduction that some readers will think is grossly unfair, because I haven’t yet said what or what not to eat. My doctor friend who hooked me into this subject has not apologized for his trickery and has no guilty feelings (in fact, I think he is quietly chuckling to himself about his devious methods). However, I choose to take the high moral ground and at least summarize to readers what the authors conclude to eat and not to eat, to back my apology with some substance. This summary is data based on the book:

    • Eat lots of different types of fruit that are unprocessed (no, strawberry Pop-Tarts do not fit in this category).


    • Eat many types of vegetables (Popeye was right, spinach is a great food).


    • Eat less (but maybe eat some) fish, vegetable oils, and few refined carbohydrates (Yes, it means to cut back or cut out eating candy and cakes).


  • Avoid meats and dairy (this last category is the one that is the most controversial).

Yes, I know that many readers may still feel I cheated them about what to eat and what not to eat. For example, I have not commented on many details about how much to eat, how to prepare healthy meals, what should people eat if they have a specific disease, should pregnant females and children follow the China Study diet and numerous other questions.

Many specific questions are put forth and then answered by the authors, but this article is about long enough, so I choose to refer the readers to the book for a number of specific answers. Finally, many readers may wonder if, in my view,

I agree with all of what the authors conclude. I cannot say that I do; I am still processing their conclusions and data and I have many unanswered questions. However, I would recommend any book that makes one think over how they approach a basic aspect of one’s life, food, and drink.

For those of you who made it this far in the article and vow never to read another article about nutrition or to read this book, I have good news. The China Study book has been made into a documentary film titled Forks Over Knives released in 2011. If nothing else, the movie likely will be an interesting subject to discuss over a meal.


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