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Straits Times (Used by permission)
by Johan Jaafar
A FRIEND introduced me to a book, The China Study: The Most Comprehensive
Study of Nutrition Ever Conducted, and the Startling Implications for
Diet, Weight Loss, and Long Term Health. Worry not about the title,
the book is in fact meant for lesser mortals like you and me, not just
physicians and nutritionists. It is trully mind-boggling in its findings, and as
the title suggests, it is indeed the most comprehensive study ever conducted
anywhere in the world.
Dr T. Colin Campbell, who wrote the book, was the project
manager of the study. Prior to that, he co-authored the report Diet, Nutrition,
and Cancer financed by the United States' National Academy of Sciences. For the
China Study he worked hand-in-hand with such luminaries as Dr Junshi Chen,
attached to the Chinese diet and research laboratory, Dr Junyao Li from China's
Academy of Medical Sciences and Sir Richard Peto of Oxford University, one of
the world's renowned epidemiologists. The study was a collaborative effort
involving Cornell University in the US, Oxford University in England and the
Chinese Academy of Medical Sciences.
What a study it was. It is said to be the most ambitious bio-medical research
ever undertaken. All in all, at least 600,000 people were involved cataloguing
death rates for 12 types of cancer in more than 2,400 counties in China. It
covers 24 out of 27 provinces in China, or more than 96 per cent of the entire
population of the country at the time -- 880 million people to be exact.
Legend has it that when Chinese premier Chou En-Lai was dying of cancer in the
early 1970s, he instructed the study to be done. It was only seven years after
his death of liver cancer that the study began. China was ideal for the study.
Unlike the Western world in the 1980s, there was little movement of people
across counties and cities. More than 90 per cent of adults studied still lived
in the localities they were born in. China after all is a land of many faces.
One county hardly 80km away is different in eating habits and ways of living
from the next. But one strong point is that China is largely a one-people
country, 87 per cent of its inhabitants are of the same ethnic group -- the
Hans.
Researchers went to these counties, bringing along diet and lifestyle
questionnaires, collecting urine and blood samples. Everything eaten for a
period of three days was recorded, food samples from marketplaces were analysed.
Nomads were not spared so too the many minority groups in the remote corners of
China.
The whole idea of the study was "to discover whether the varying diets in
different parts of China would correlate to the widely varying death rates from
cancer and other diseases". The difference in cancer rates was, to say the
least, shocking. Not unlike the Western world, the Chinese were facing two
classes of diseases, "the diseases of poverty" and "diseases of affluence".
The former takes the form of infectious diseases like pneumonia, tuberculosis,
diarrhoea, respiratory-related ones and measles. Diarrhoea and measles seldom
kill children in advanced countries. But in situations where nutrition is not
balanced and sanitation is taken for granted, millions of children die of such
sickness every year. One cannot say for sure if at all there are diseases of
affluence at the point of time in China. Perhaps "affluence" was a relative
concept in its application to China. Dr Campbell would be more comfortable to
label it "diseases of nutritional extravagance".
Problems relating to such diseases are evident in many Chinese cities at the
time of the study. The improved standard of living in cities came with a price.
Cancer, heart disease and diabetes were making a mark in some areas. The culprit
as the researchers found was high cholesterol in the blood. But compared with
the West, the cholesterol level among Chinese was still lower than the
Westerners. The study pointed to the fact that death from heart disease was 17
times lower in China than in the Western countries at the time.
Another interesting finding was that in some parts of China, heart-related
diseases were almost non-existent. The provinces of Sichuan and Guizhou in
southwestern China did not register anyone dying from such diseases even after
three years of continuous observation. In this book Dr Campbell wrote, "One of
the most dramatic findings of the China Project was the strong association
between foods of animal origin and cancer". The moral of the story is, eat more
plant-based foods, reduce foods derived from animals.
There are many reasons why the study should be taken seriously by all of us. It
shows how localities determine the incidents of cancer. In some parts of China,
breast cancer was 2,000 per cent higher than the rest. In one particular area,
men died of oesophagus cancer 435 times more than in other areas.
But China is changing. The study conducted in the 1980s would not be accurate
today. China is a giant awakening from a prolonged stupor. It is probably the
most robust economy in the world. The dynamics are changing in China, so too
values and people. When the study was conducted, China was moving from years of
communism to a more open market system. Issues of poverty and malnutrition were
addressed as never before. Chinese are on the move. There are many more cities
with populations of more than 10 million than anywhere in the world.
When the study was conducted in 1983, Chinese people were largely poor. Today,
affluence is the name of the game. Eating habits too are changing. Back in the
1980s, one hardly found an obese Chinese. Today, almost a third of Chinese
people are overweight. And as the figures stand, there are more overweight
Chinese than the entire population of all Southeast Asian countries combined. In
1995, childhood obesity was almost unheard of in China. Today, 10 per cent of
Chinese children between the ages of three and six are obese.
The China Study can never be replicated in its magnitude and effort. It gives us
an understanding of a changing society and how lifestyles and eating habits
determine how healthy and how sick we can be.
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Circular No 304/2008 : Invitation - HR Debate 2008
