[jimbo2012]

Breast cancer (Marshall JR, Qu Y, Chen J, Parpia B, Campbell TC. Additional ecologic evidence: lipids and breast cancer mortality among women age 55 and over in China. Europ. J. Cancer 1991;28A:1720-1727; Key TJA, Chen J, Wang DY, Pike MC, Boreham J. Sex hormones in women in rural China and in Britain. Brit. J. Cancer 1990;62:631-636.)

Liver cancer (Campbell TC, Chen J, Liu C, Li J, Parpia B. Non-association of aflatoxin with primary liver cancer in a cross-sectional ecologic survey in the People's Republic of China. Cancer Res. 1990;50:6882-6893; .Youngman LD, Campbell TC. Inhibition of aflatoxin B1-induced gamma-glutamyl transpeptidase positive (GGT+) hepatic preneoplastic foci and tumors by low protein diets: evidence that altered GGT+ foci indicate neoplastic potential. Carcinogenesis 1992;13:1607-1613).

Energy utilization (Horio F, Youngman LD, Bell RC, Campbell TC. Thermogenesis, low-protein diets, and decreased development of AFB1-induced preneoplastic foci in rat liver. Nutr. Cancer 1991;16:31-41:Campbell TC. Energy balance: interpretation of data from rural China. Toxicological Sciences 1999;52:87-94).

Colon cancer (Campbell, T.C., Wang G., Chen J., Robertson, J., Chao, Z. and Parpia, B. Dietary fiber intake and colon cancer mortality in The People's Republic of China. In: Dietary Fiber, Chemistry Physiology and Health Effects, (Ed. Kritchevsky, D., Bonfield, C., Anderson, W.), Plenum Press, New York, 473-480, 1990).

Affluent-Poverty Diseases (Campbell TC, Chen J, Brun T, et al. China: from diseases of poverty to diseases of affluence. Policy implications of the epidemiological transition. Ecol. Food Nutr. 1992;27:133-144).

Protein-growth rate (Campbell TC, Chen J. Diet and chronic degenerative diseases: a summary of results from an ecologic study in rural China. In: Temple NJ, Burkitt DP, eds. Western diseases: their dietary prevention and reversibility. Totowa, NJ: Humana Press, 1994:67-118; Campbell TC, Junshi C. Diet and chronic degenerative diseases"perspectives from China. Am. J. Clin. Nutr. 1994;59:1153S-1161S).

As I previously said, one of my interests in the China database was simply to see if there was evidence supporting the health benefits of a plant-based diet for these various models (and many more). The fact that we observed a slew of statistically significant results supporting this proposition, especially for a dietary experience having such low total fat and animal based foods, was quite remarkable. Did every correlation among our 100,000 show the expected? This was my comment, verbatim, already published in our book (that Denise did not acknowledge in her critique):

"Do I think the China Study findings constitute absolute scientific proof? Of course not. Does it provide enough information to inform some practical decision-making? Absolutely. An impressive and informative web of information was emerging from this study. But does every potential strand (or association) in this mammoth study fit perfectly into this web of information? No. Although most statistically significant strands readily fit into the web, there were a few surprises. Most, but not all, have since been explained."

In summary, Denise's critique lacks a sense of proportionality. She gives (with considerable hyperbole, at times) the analyses of the China data more weight than they deserve by ignoring the remaining evidence discussed in the other 17 chapters in the book. The China research project was a cornerstone study, yes, but it was NOT the sole determinant of my views (as I have repeated, almost ad nauseum in my lectures). In doing so, and except for a few denigrating remarks on our experimental animal research, she also ignores the remaining findings that I presented in our book. She seems not to understand what our laboratory research was showing. Using univariate correlations mostly without adjustment for confounding factors, qualification of variable authenticity, and/or biological plausibility can lead to haphazard evidence, subject to the whims of personal bias. Also, univariate correlations of this type can lead to too much emphasis on individual nutrients and foods as potential causes of events.

Also, as I already mentioned, she questions our omission of the Tuoli County data as if this was some sort of sleight of hand on my part (in addition to my comments above, I already explained this omission in one of my papers and on my preliminary blog). She over-interprets our very limited 'dairy' data which only includes 3 counties (of 65) that use a very different product from what we consider to be dairy. And she continues to characterize my views in reference to veganism and vegetarianism (I don't even use these words) as if I were motivated by an ideology instead of by my consideration of empirical data and biological plausibility.

Not only does Denise misrepresent and misunderstand the rationale for the science in The China Study, her choice of words do not facilitate what she hopes to achieve. Her overall message, often embellished with adjectives and subjective remarks, appeals to some questionable characters sympathetic to or subservient to the Weston A Price Foundation, a farm lobbying group whose advocates and apologists have accused me of being a "fraud", a "liar", a "buffoon" and (earlier) an associate of a "terrorist" organization. I doubt that this is what she wanted to achieve. These individuals, for much too long, have been carelessly using or even ignoring science to further their own interests, such as advocating for the use of a very high fat, high protein diet mostly consistent with the diet that has caused us so much difficulty.

This name calling means nothing to me personally but it does indicate their desperation with our message. They would be well advised not to use such tactics because it reflects on them, not me. Whether Denise intended this is not clear, but the results of her critique is clearly apparent.

I must repeat for emphasis that no single study (or even a group of similar studies) is perfect in its design, in its data collection or in its interpretation of results. From the perspective of developing a research career, I see two possible paths that a researcher may follow. One option proceeds from experiment to experiment by probing ever deeper into the details of one of those experiments that they may happen upon where precision of measurement matters deeply and where the findings can become useful at some future time-indeed, they may "happen upon" an observation that becomes their life's work very early in this process, maybe even at the outset.