The China Study (52 page)

BIG MED I ( I NE: WHO SE HEALTH ARE THEY PRO TE CT I NG?       341
The Clinic is now injecting stem cells to try to make new heart
vessels grow. Wouldn't it be easier to stop the disease? It's appall-
ing, isn't it? It's just so grippingly unbelievable to think that we're
being led around by people who refuse to believe the obvious!
Both Esselstyn and McDougall have now been denied reentry into
the establishment, after headline-making success at healing people with
a nutritional approach. You can focus on the money-according to John
and Ess, 80% of St. Helena's and 65% of the Cleveland Clinic's respective
incomes were generated by traditional heart disease treatments, surgi-
cal interventions-but it's something more than just money. It may also
be the intellectual threat that the patient should be in control, and not
the doctor; that something as simple as food could be more powerful
than all the knowledge of pills and high-tech procedures; it may be the
lack of credible nutrition education in medical school; it may be the
influence of the drug industry. Whatever it is, it has become clear that
the medical industry in this country is not protecting our health as it
should. As McDougall reaches his arms out, palms up, and scrunches
his shoulders up, he simply says, "It's beyond comprehension."

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Repeating Histories
IN 1985, when I was on sabbatical in Oxford, England, I had the op-
p o r t u n i t y to study the history of diet and disease at some of the great
medical history libraries in the Western world. I made use of the famous
Bodlean Library in Oxford and the London libraries of the Royal Col-
lege of Surgeons and the Imperial Cancer Research Fund. In the quiet
recesses of these marble-lined sanctuaries, I was thrilled to find authors
who wrote eloquently on the topic of diet and cancer, among other dis-
eases, over 150 years ago.
One such author was George Macilwain, who wrote fourteen books
on medicine and health. Macilwain was born and raised in Northern
Ireland. He later moved to London where he became a prominent sur-
geon in the early 1800s. He was to become a member, and later, an hon-
orary fellow, of the Royal College of Surgeons. He became vegetarian at
the age of forty, after identifying "grease, fat and alcohol" as being the
chief causes of cancer.l Macilwain also popularized the theory of the
"constitutional nature of disease," mostly in reference to the origins and
treatment of cancer.
The constitutional nature of disease concept meant that disease is not
the result of one organ, one cell or one reaction gone awry or the result
of one external cause acting independently. It is the result of multiple
systems throughout the body breaking down. Opposing this view was the
local theory of disease, which said that disease is caused by a single
external agent acting at a specific site in the body. At that time, a fierce
fight was under way between those who believed in diet and those who
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344                          THE CHINA STUDY
supported surgery and the emerging use of drugs. The "local disease"
proponents argued that disease was locally caused and could be cut
out or locally treated with isolated chemicals. In contrast, those who
favored diet and lifestyle believed that disease was a symptom resulting
from the "constitutional" characteristics of the whole body.
I was impressed that these old books contained the same ideas about
diet and disease that had resurfaced in the health battles of the I980s. As
I learned more about Macilwain, I came to realize that he was a relative
of mine. My paternal grandmother's maiden name was Macilwain, and
that "branch" of the family had lived in the same part of Northern Ireland
that George Macilwain had come from. Furthermore, there were family
stories about a famous Macilwain who had left the family farm in Ireland
to become a very well-known doctor in London in the early 1800s. My fa-
ther, who had emigrated from Northern Ireland, had referred to an Uncle
George when I was young, but I never was aware of who this man was.
Through further genealogical research, I have come to the near certain
conclusion that George Macilwain was my great-great uncle.
This discovery has been one of the more remarkable stories of my
life. My wife Karen says, "If there's such a thing as reincarnation .... "
I agree: if I ever lived a past life, it was as George Macilwain. He and I
had similar careers; both of us became acutely aware of the importance
of diet in disease, and both of us became vegetarian. Some of his ideas,
written over 150 years ago, were so close to what I believed that I felt
they could have come from my own mouth.
I discovered more than my family history while reading in these au-
gust, history-laden libraries. I found out that scholars have been arguing
over the nature of health for centuries, even millennia. Almost 2,500
years ago, Plato wrote a dialogue between two characters, Socrates and
Glaucon, in which they discuss the future of their cities. Socrates says
the cities should be simple, and the citizens should subsist on barley
and wheat, with "relishes" of salt, olives, cheese and "country fare of
boiled onions and cabbage," with desserts of "figs, pease, beans," roasted
myrtle-berries and beechnuts, and wine in moderation. 2 Socrates says,
"And thus, passing their days in tranqUility and sound health, they will,
in all probability, live to an advanced age .... "
But Glaucon replies that such a diet would only be appropriate for "a
community of swine," and that the citizens should live "in a civilized
manner." He continues, "They ought to recline on couches ... and have
the usual dishes and dessert of a modem dinner." In other words, the

345
REPEATING HISTORIES
citizens should have the "luxury" of eating meat. Socrates replies, "if
you wish us also to contemplate a city that is suffering from inflam-
m a t i o n .... We shall also need great quantities of all kinds of cattle for
those who may wish to eat them, shall we not? "
Glaucon says, "Of course we shall." Socrates then says, "Then shall
we not experience the need of medical men also to a much greater ex-
t e n t under this than under the former regime? " Glaucon can't deny it.
"Yes, indeed," he says. Socrates goes on to say that this luxurious city
will be short of land because of the extra acreage required to raise ani-
mals for food. This shortage will lead the citizens to take land from oth-
ers , which could precipitate violence and war, thus a need for justice.
Furthermore, Socrates writes, "when dissoluteness and diseases abound
in a city, are not law courts and surgeries opened in abundance, and do
not Law and Physic begin to hold their heads high, when numbers even
of well-born persons devote themselves with eagerness to these profes-
sions?" In other words, in this luxurious city of sickness and disease,
lawyers and doctors will become the norm.2
Plato, in this passage, made it perfectly clear: we shall eat animals
only at our own peril. Though it is indeed remarkable that one of the
greatest intellectuals in the history of the Western world condemned
meat eating almost 2,500 years ago, I find it even more remarkable that
few know about this history. Hardly anybody knows, for example, that
the father of Western medicine, Hippocrates, advocated diet as the chief
way to prevent and treat disease or that George Macilwain knew that
diet was the way to prevent and treat disease or that the man instru-
m e n t a l in founding the American Cancer Society, Frederick L. Hoffman,
knew that diet was the way to prevent and treat disease.
How did Plato predict the future so accurately? He knew that con-
s u m i n g animal foods would not lead to true health and prosperity. In-
stead, the false sense of rich luxury granted by being able to eat animals
would only lead to a culture of sickness, disease, land disputes, lawyers
and doctors. This is a pretty good description of some of the challenges
faced by modern America!
How did Seneca, one of the great scholars 2,000 years ago, a tutor
and advisor to Roman Emperor Nero, know with such certainty the
trouble with consuming animals when he wrote 2 :
An Ox is satisfied with the pasture of an acre or two : one wood
suffices for several Elephants. Man alone supports himself by the

THE CHINA STUDY
346
pillage of the whole earth and sea. What! Has Nature indeed given
us so insatiable a stomach, while she has given us so insignificant
bodies? ... The slaves of the belly (as says Sallust) are to be count-
e d in the number of the lower animals, not of men. Nay, not of
them, but rather of the dead .... You might inscribe on their doors,
"These have anticipated death."
How did George Macilwain predict the future when he said that the
local theory of disease would not lead to health? Even today, we don't
have any pills or procedures that effectively prevent, eliminate or even
treat the causes of any chronic diseases. The most promising preven-
tions and treatments have now been shown to be diet and lifestyle
changes, a constitutional approach to health.
How did we forget these lessons from the past? How did we go from
knowing that the best athletes in the ancient Greek OlympicS must
consume a plant-based diet to fearing that vegetarians don't get enough
protein? How did we get to a place where the healers of our society, our
doctors, know little, if anything, about nutrition; where our medical
institutions denigrate the subject; where using prescription drugs and
going to hospitals is the third leading cause of death? How did we get
to a place where advocating a plant-based diet can jeopardize a profes-
sional career, where scientists spend more time mastering nature than
respecting it? How did we get to a place where the companies that profit
from our sickness are the ones telling us how to be healthy; where the
companies that profit from our food choices are the ones telling us
what to eat; where the public's hard-earned money is being spent by
the government to boost the drug industry'S profits; and where there is
more distrust than trust of our government's policies on foods, drugs
and health? How did we get to a place where Americans are so confused
about what is healthy that they no longer care?
Our country's population, which numbers almost 300 million peo-
ple,3 is sick.
• 82% of American adults have at least one risk factor for heart dis-
ease 4
• 81% of Americans take at least one medication during any given
week 5
• 50% of Americans take at least one prescription drug during any
given week 5
• 65% of American adults are overweight6

347
REPEATING HISTORIES
• 31% of American adults are obese6
• Roughly one in three youths in America (ages six to nineteen) is
already overweight or at risk of becoming overweight
• About 105 million American adults have dangerously high choles-
t e r o l l e v e l s 7 (defined as 200 mgldL or higher-heart-safe choles-
t e r o l l e v e l is under 150 mgldL)
• About 50 million Americans have high blood pressures
• Over 63 million American adults have pain in the lower back
(considerably related to circulation and excess body weight, both
influenced by diet and aggravated by physical inactivity) during
any given three-month period9
• Over 33 million American adults have a migraine or severe head-
ache during any given three-month period9
• 23 million Americans had heart disease in 2001 9
• At least 16 million Americans have diabetes
• Over 700,000 Americans died from heart disease in 2000
• Over 550,000 Americans died from cancer in 2000
• Over 280,000 Americans died from cerebro-vascular diseases
(stroke), diabetes or Alzheimer's in 2000
At the great peril of ignoring the warnings of Plato and others, Amer-
ica has, in the words of Seneca, "anticipated death." Starvation, poor
sanitation and communicable diseases, symbols of impoverishment,
have been largely minimized in the Western world. Now we have an
urgency of excess, and some of the previously less developed countries
are racing to get where we are. Never before have such large percentages
of the population died from diseases of "affluence." Is this the affluence
that Socrates predicted 2,500 years ago-a society full of doctors and
lawyers wrestling with the problems caused by people living luxuri-
ously and eating cattle? Never before have so many people suffered such
high levels of obesity and diabetes. Never before has the financial strain
of health care distressed every sector of our society, from business to
education to government to everyday families with inadequate insur-
ance . If we have to decide between health insurance for our teachers
and textbooks for our kids, which will we choose?
Never before have we affected the natural environment to such an ex-
t e n t that we are losing our topsoil, our massive North American aqUifers,
and our world's rainforests.lO We are changing our climate so rapidly that
many of the world's best-informed scientists fear the future. Never before

348                           THE CHINA STUDY
have we been eliminating plant and animal species from the face of the
earth as we are doing now. Never before have we introduced, on such a
large scale, genetically altered varieties of plants into the environment
without knowing what the repercussions will be. All of these changes in
our environment are strongly affected by what we choose to eat. II
As the billions of people in the developing world are accumulating
more wealth and adopting the Western diet and lifestyle, problems cre-
ated by nutritional excess are becoming exponentially more urgent with
each passing year. In 1997, the director-general of the World Health Orga-
nization, Dr. Hiroshi Nakajima, referred to the future chronic disease bur-
d e n in developing countries as "a crisis of suffering on a global scale."12
We've fumbled around for the past 2,500 years, building up the un-
sustainable behemoth that we now call modern society. We certainly
won't have another 2,500 years to remember the teachings of Plato,
Pythagoras, Seneca and Macilwain; we won't even have 250 years. From
this urgency arises great opportunity, and because of that I am filled
with hope. People are beginning to sense the need for change and are
beginning to question some of the most basic assumptions that we have
about food and health. People are beginning to understand the conclu-
s i o n s of scientific literature and are changing their lives for the better.
Never before has there been such a mountain of empirical research
supporting a whole foods, plant-based diet. Now, for example, we can
obtain images of the arteries in the heart, and then show conclusively,
as Drs. Dean Ornish and Caldwell Esselstyn,jr., have done, that a whole
foods, plant-based diet reverses heart disease. 13 We now have the knowl-
edge to understand how this actually works. Animal protein, even more
than saturated fat and dietary cholesterol, raises blood cholesterol levels
in experimental animals, individual humans and entire populations.
International comparisons between countries show that populations
subsisting on traditional plant-based diets have far less heart disease, and
studies of individuals within single populations show that those who eat
more whole, plant-based foods not only have lower cholesterol levels, but
have less heart disease. We now have a deep and broad range of evidence
shOWing that a whole foods, plant-based diet is best for the heart.
Never before have we had such a depth of understanding of how diet
affects cancer both on a cellular level as well as a population level. Pub-
lished data show that animal protein promotes the growth of tumors.
Animal protein increases the levels of a hormone, IGF-l, which is a risk
factor for cancer, and high-casein (the main protein of cow's milk) diets
allow more carcinogens into cells, which allow more dangerous carcino-