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What to Eat?

Dr. Mercola vs. Dr. Campbell

9/8/10

Clash of the Titans

Dr. Mercola takes on Dr. Campbell and the China Study

When Joe Mercola contradicts the basics of nutrition taught on GreenSmoothieGirl.com and in my books, we get hundreds of emails.meat question

Mercola’s newsletter yesterday supposedly exposes the “DARK SIDE” of The China Study. I’m not going to link to it and therefore give it a higher page rank. It doesn’t deserve it.

Before undertaking to explain what’s radically wrong with this article, let me say this, outside the topic at hand: I agree with Mercola on some macro issues:

  1. The whole concept of prevention and natural remedies should be first-line treatments, rather than drug/surgery medical interventions.
  2. Far too much of our data comes from research that drug companies and agribusiness paid for.
  3. Sugar and processed foods are killing us. (Mercola implies, with the “false dilemma” logical fallacy, in yesterday’s newsletter that either animal proteins are killing us, or processed foods are, as if both can’t be contributors.)

But we must use critical thinking skills to expose fatal flaws in his comments about Dr. T. Colin Campbell and the China Study.

(When you put yourself in the public domain, you invite dissent. Juxtaposition of ideas creates a climate for the truth to emerge.)

As I strongly disagree with Mercola here, I will invariably get some angry email. Most readers will appreciate that my only motive is to learn and then explain the truth (or as close as I can get to it) in this world of nutrition that has so many competing voices.

My own 12 Steps to Whole Foods is a compendium of the best nutrition practices. It advocates for eating much more plant food (especially raw food) than the average American gets and is a practical HOW-TO guide, more than a philosophical debate or meta-review of research. It purposefully doesn’t advocate for vegetarianism or veganism, although I am supportive of others who choose to wear those labels. My own family, except for two vegetarian daughters, eats a bit of homemade kefir, and occasional animal products when we are away from home.

Mercola attempts to discredit the joint effort of Oxford and Cornell Universities by calling theirs an “observational” study, which he infers is somehow inferior to having once had a medical practice.

The Oxford/Cornell China study is a very sound, huge, comprehensive study spanning over 25 years. My own advanced degree, background in research, and understanding of research principles, lead me to say this:

I am thankful, finally, for a vast piece of research in epidemiology that was not funded or influenced by the drug companies or agribusiness (which primarily hawks refined corn/wheat/soy products and processed and refined and GMO foods). I see no conflicts of interest in the Oxford/Cornell research. I see one of the purest voices in nutrition in Campbell and his team.

I interviewed him by phone as I wrote this, and he said, “I feel personally responsible to Americans to tell them what we did with their money,” because taxpayers funded the China study, not profit-motivated industries.

The research was the next natural step from methodical and rigorous animal studies. It’s  a remarkable piece of research examining 6,500 adults in 130 villages of rural China where some populations eat lots of animal protein, and others eat very little. The book The China Study represents the totality of Campbell’s experiences. Those include his many years of work in the Philippines studying malnourished children, to his experimental lab research funded by the National Institutes of Health, to the human studies project in China.

“Forcing” Vegetarianism?

chopsticksMercola refers to Campbell “forcing” everyone into vegetarianism. This makes no sense on two levels beyond the unilateral emotionalism of the word.

First, the two diets Campbell studied were 20% animal protein (which correlates to the Standard American Diet) and 5% animal protein. Neither groups studied were vegetarian. The 5% group correlates to a low-animal-protein diet, similar to Daniel’s Biblical diet, as well as the scriptural “Word of Wisdom” counsel to eat meat “sparingly, only in times of winter/famine/cold.”

Second, Campbell takes the tone of scientist. He reports and interprets the data. He doesn’t “force” or even recommend any specific diet. He allows the reader to infer from the data whatever diet they choose to follow. He isn’t an internet maven selling a philosophy; he’s a researcher who found the opposite of what he expected to. He grew up on a dairy cattle farm and thought, well into adulthood, that a high-protein diet was ideal. Like John Robbins, son of the Baskin Robbins founder, only data convinced him otherwise. I personally am thankful for honest and pure truth seekers, willing to turn another way, when data challenges popular culture and custom.

“Observational” Study?

Mercola attempts to downgrade the massive China project as “an observational study,” which he says does not “prove causation.” This is puzzling to me based on three logic flaws.

First, Campbell is a scientist and would never say his study “proves causation.” No scientist would. I’m not a scientist but know enough about it to be aware you never achieve or claim “proof of causation.” Mercola gives a two-sentence primer on how the scientific process works: initial study, hypothesis, controlled trial. Which is precisely what Campbell and the research team did:

meat loaded riceCampbell’s early research on cancer clusters in the Philippines caused him to form a hypothesis. And then he did a controlled trial, which is what the animal studies were, repeated by other researchers around the world with consistent results. The methods were highly controlled, and the results showed that a 20% animal protein diet (in combination with a carcinogen, aflatoxin), led to faster body growth rates and high rates of cancer and early death. And a 5% animal protein diet led to ideal weights, no cancer (even though the animals were exposed to the same carcinogen), and much greater longevity.

Then Campbell undertook what the New York Times called the “Grand Prix of Epidemiology.” It was a study of 6,500 adults living in 130 villages in rural China where the unique range of dietary experience permitted Campbell and colleagues to investigate whether the lab findings were or weren’t consistent with the China data.

Second, Mercola complains that the biggest nutrition study in history is “observational,” but then complains that his own unscientific, non-peer reviewed, and unpublished—undocumented, in fact—“observations” are more worthwhile? And to add weight to that slim claim without any “meat” to it (forgive the pun), he’s found another “nutritional physician” who he’s never talked to, who agrees with him. (What’s a “nutritional physician,” by the way? Mercola is an osteopath.)

So two men, one of whom has been running a huge product-based company for many years, rather than practicing medicine, disagree with thousands of statistically significant findings generated from the published study by two of the most prestigious universities in the world?

I might cite internationally renowned surgeon, chief of surgery, and researcher Caldwell Esselstyn, M.D., whose own clinical findings support the Oxford/Cornell research. I might cite former Physicians Committee for Responsible Medicine President and peer-reviewed researcher and book author Neal Barnard, M.D., who also came from a cattle ranching family like Campbell. I might cite board-certified author Joel Fuhrman, M.D. for the same cause. Or how about John McDougall, M.D., a board-certified internist and prolific author. These highly credentialed four doctor-researcher-authors extensively document the profound preventative effects of a plant-based diet on heart disease, cancer, auto-immune diseases, and many other modern maladies.

My point: if it’s a credibility war with accomplishments at the core, those advocating the plant-based diet will win every time.

A Plant-Based Diet Was “Killing” Mercola?!

Third, while Mercola touts how many patients he saw when he was practicing, he doesn’t give any data about those patients’ diets. He just mentions that he saw 25,000 patients as a D.O. (Wow, that would take 40 years, if you saw 10 patients a day, only an average of 4 times each, five days a week.) And he cites only his own bad experience with eating fruit in 1985 after reading Fit for Life by Marilynn and Harvey Diamond.

peach juiceMercola says he undertook a short experiment with a plant-based diet 25 years ago, and his triglyceride level skyrocketed. He mentions eating vegetables and fruits. Nothing is said about legumes, whole grains, nuts, seeds, or other whole, plant foods.

I would like to hear of anyone else who this happened to. Then we’d have two people to compare to 6,500 folks in the China study.

He says, “Clearly, this diet was killing me.”

The problem with one person’s 25-year old “case study” (consisting of himself, taking one triglyceride test after a few weeks of eating fruit for breakfast) is that a variety of factors could have been at work here. His anecdote tells me nothing about what caused his problem.

Once someone I know said to me,

“I tried vegetables once. They don’t work for me. I got diarrhea.”

I don’t want to spend paragraphs explaining how cleansing reactions in various body systems can cause problems in the short-term. That is another topic and will insult the intelligence of many who read this. (Is it possible that you could eat something good for you, but you don’t feel good immediately, because your body must adjust to changes? Is it possible that there are other reasons for not feeling well after eating a vegetable, besides, “It must not be good for me”?)

I was amazed to read Mercola using a similar line. Basically he says this:

“I ate fruit and my triglycerides went up 25 years ago. So lots of fruits and veggies don’t work for me personally, and people should beware eating “too many vegetables.” And Colin Campbell said I have a ‘conflict of interest,’ so I’m going to trash his life’s work with 1.3 million people on my mailing list.”

(How would eating more fruits and vegetables cause your triglycerides to increase? This makes no sense.)

Mercola’s Conflict of Interest

Mercola complains that the huge China project was “observational.” Then he cites his own negative experience with eating fruit for breakfast for a few weeks. And he cites one other M.D. he says he has never met, to complete the sum total of the data he offers to contradict the Oxford/Cornell project.

Inexplicably, he says this about his own data and the guy whose comments against the China Project he references, while admitting he’s never met the guy. (When I say “data” I use the term loosely, since except for the 25-year old triglycerides test, he never offers any):

“We were both busy clinicians and never had the luxury to take months out of our lives to publish our observations in the medical literature. Nevertheless the lack of publications does not make the observations any less valid.” [italics mine]

What observations? He never says.

None of this is compelling.

My friends, you and I must make distinctions between one former physician-cum-business tycoon’s claims, and a huge study with outstanding if not impeccable scientific methods.

Another chasing-your-tail logical fallacy arises in Mercola’s article. He’s made an impressive living tackling the Western medical profession and telling people to take responsibility for their own health. He attacks the theories, methods, and financial underpinnings of the motives of the medical establishment / monopoly in North America.

(Excellent! Me, too!)

But then he suggests in his article that he is more trustworthy than Colin Campbell, because Campbell is a PhD, whereas Mercola is a D.O.

First of all, Campbell is a PhD in Nutritional Biochemistry with an endowed professorship. Mercola used to practice as an osteopath. Campbell stayed in nutrition education and research his entire career, while Mercola has been building a sales-oriented internet company for many years. Nothing wrong with either one, but I’m stumped by why Mercola would use credentials in the credibility gauntlet he’s thrown down in his newsletter.

Second, you can’t have it both ways. Either medical education is deeply flawed, or it’s not. Should we think for ourselves, using critical judgment, or blindly do whatever a doctor says, just because M.D. is after his name (or in Mercola’s case, D.O.)? You can’t teach people to question medical doctors, and then say, listen to me instead of the Oxford/Cornell research, simply because I got a medical degree decades ago.

Third, the half-life of a medical degree these days is a few years, since practices are now codified to a discrete list of acceptable technologies, drugs, and surgeries insurance companies will pay for. Your ongoing training as a physician comes primarily from drug reps and medical equipment-company reps, and reading the journals. What one learned in medical school 25 years ago, beyond basic human anatomy classes, is outdated and all but irrelevant in modern practice.

So let’s go sideways for a minute to that “conflict of interest” Mercola says Dr. Campbell called him out on in private communication. Dr. Campbell has a valid point.

Mercola’s Idea of A Healthy Diet…

Mercola's idea of healthyMercola heavily promotes meat and dairy on his site and in his books, and sells whey protein made from milk. He also sells plenty of synthetic, isolated supplements, debunked as useless (or worse, harmful) in huge meta studies since 2002 discussed in Campbell’s book. If the data from the Oxford/Cornell project is valid, Mercola is selling harmful products.

He also has a metabolic typing system lacking any grounding in science. Originally I saw it released as an e-book, and then it quickly and mysteriously disappeared, and now only the recipe books for each nutritional type are sold, along with really expensive phone calls with employees at the Mercola company.

In his Nutritional Typing plan, some people are supposed to eat lots of meat, some people are supposed to eat lots of carbs, and some people are mixed. Very complicated. It’s as lacking in scientific underpinnings as Peter D’Adamo’s nutritional typing based on blood type. Every person in the world has to heavily favor one or two macronutrients, to the exclusion of the third? And we make these massive nutritional changes based on two minutes of filling out an online form?

When will we stop trying to manipulate metabolism, make rocket science of simple nutrition principles, and make money confusing people?

A complicated, exclusionary program is fantastic way to make gobs of money, as people scramble to make very specific inclusions and eliminations from their diet based on dubious doctrine. It makes no sense that God put all these simple, pure foods on the planet and then let people needlessly flounder, nutritionally, for thousands of years until a guy improved on God’s plan and made a complicated, proprietary “program.”

Don’t we all eat differently anyway, based on a number of practical factors? What’s grown locally. What’s in season. What we like and don’t like. What’s in the fridge. What we can afford. What a lifetime of personal experience tells us about how we respond to individual foods. And for a growing number of people–probably thanks to three generations who have now eaten genetically modified foods and processed foods–food sensitivities and allergies?

The Nutritional Typing system, when the emperor’s new clothes are exposed, just tells you to eat mostly what you want to eat anyway.

The program reminds me of the work of Dr. Robert Atkins, who rubber-stamped America’s love of fatty, meat-based diets. You’ll be popular and wealthy, if you simply tell the people they’ll be healthy if they eat what they want to eat anyway.

That popularity made the Atkins family wealthy but didn’t save Atkins himself, or millions of people following his program, from heart disease, obesity, and preventable death.

I took Mercola’s test, which took only a couple of minutes and didn’t ask me anything about my heredity or my ancestral eating patterns, even though I was promised that my “type” is based on that. Some questions didn’t have any answer I could say “yes” to, truthfully, about what I eat.

One question asked me which of four types of foods make me gain weight. (Wouldn’t any of them, if overeaten, cause weight gain? Also, doesn’t that depend on how the food is prepared—fried chicken compared to grilled skinless chicken breast, for instance?)

One question required me to choose which meat I want to eat, with no way to choose “none.” At the end of the test, I was called a Veggie Type, and I got an email selling the recipe book for that type.

It makes sense that I’m a “Veggie Type,” since I answered one question after another that I usually don’t eat animal food.

But wait—shouldn’t my “type” be based on what I SHOULD eat, according to a number of very complicated variables? Not what I’ve been eating? I’m confused.

A couple of even bigger head scratchers: first, as a Veggie Type, I am told to eat chicken and turkey. Second, it tells me to eliminate “fruit, grains, potatoes, and rice!”

I feel wonderful eating fruit and whole grains and have done so my entire life. What a tragedy, and what a time-drain and joy-kill it would be, if I were to implement this advice to permanently eliminate two entire classes of high-nutrition, high-fiber foods!

good fruit juiceMaybe that result was because of the question that asked me how I would feel if I drank a glass of juice. I didn’t know whether he meant the glass of zucchini-and-apple juice I made in my Champion Juicer today. Or a glass of Minute Maid orange juice from the grocery store. (Which I never do, so I’m not sure how I’d feel.)

To clear the fog settling over me, I can call and get a 30-minute phone call with somebody who works at Mercola for only $80. They won’t make specific recommendations, but will only “review the Nutritional Typing plan.” (I wonder, if I pay $80, will they explain the science behind the two-minute questionnaire that diagnosed my “type?” Because it’s nowhere to be found on the site or in the materials.)

It’s brilliant product development that makes meal planning highly individualistic and complicated—read: frustrating, expensive, and pointless.

The Mountain of Evidence

mountain of evidenceSince The China Study came out in 2005, I have met and questioned Dr. Campbell myself, after his lecture I attended, and found him to be dedicated to science, open minded, and very truthful about his findings. I have also corresponded with him via email.

I spoke to him on the phone at length yesterday (9/7/10) with my questions, and he promised that he would give me the reply he is writing to the Mercola newsletter. Stay tuned on my blog for that. I will also soon do an interview for my blog with Dr. Campbell about the new movie coming out about him and his research, along with Dr. Esselstyn’s, called Forks Over Knives.

I still don’t know what the “Dark Side” is of The China Study, that Mercola’s article title touts. It’s emotionally charged hyperbole.

I am sorry that Dr. Mercola had a bad experience in 1985 eating fruits and vegetables for a few weeks. But I am deeply concerned about the undeserved effect of Mercola’s unsubstantiated words on the reputation and validity of decades of Campbell’s renowned research.

Until something compelling comes along to convince me otherwise, I stand behind that massive mountain of evidence, that plant foods heal and protect us against disease.