The Whole Food, Plant Based Diet
What Dr. T Colin Campbell “has come to know” about all modern ailments – and their solution.
Welcome to Part 1 (of 7) of our special series about holistic nutrition and some of the research behind the Whole Food Plant Based Diet. To learn more about the series, check out last week’s Introduction here, where I explain how this project is something very different than yet another polemic for or against veganism!
These posts are much longer and far more complex than what I usually post at The Healthy Jew. You might find them boring – or the most interesting thing you’ve read in months. (To keep things simpler, I’ve taken out the sources from the online post - you can find them in the PDF version attached at the end.)
If this isn’t your cup of tea, we’ll be back soon with concise, practical guides for Jewish wellness and the Land of Israel.
In the meantime, don’t forget to check out my new book, Land of Health: Israel’s War for Wellness, to learn in detail how Israel is the healthy body of the Jewish people, together with practical strategies for living well during challenging times.
By the way, the ebook is now also available for a crazy cheap introductory sale price of $1.99!
Now let’s get to business…
When our great-great-great-great parents were sick, they imbibed dubious potions cooked up by their local medicine man. More often than not, the primitive knowledge and tools at their disposal weren’t worth much, so their often misdiagnosed diseases played out their full course over pain-racked bedridden months. If they were lucky, that is: many easily curable conditions used to be often mortal.
No such helpless resignation for us. For a minor ailment, we’ll pop a painkiller and get on with life. If the problem persists, we’ll hop over to the doctor. She’ll determine if it’s this infection or that virus, prescribe antibiotics or another drug, and cheerfully send us on our way. If our health-care team is concerned we might have a more serious disease, they’ll order a battery of diagnostic tests that our hapless forefathers couldn’t have dreamed of: x-rays and laparoscopies that can peer at every nook and cranny of our insides, blood and urine tests that profile us down to the last molecule. Whatever disorder will dare rear its ugly head, our doctors are ready to meet it with the latest advanced drug.
Limitations of Modern Medicine
Yet as with all superficial dichotomies, The China Study begins, the truth is more checkered.
With all the undeniable progress of modern medicine, people still suffer from chronic and terminal conditions. It almost seems that for each illness we’ve tossed into the dustbin of history, another has popped up instead.
We’ve beaten tuberculosis, but remain stuck with cancer.
We’ve mostly eliminated malaria, smallpox and polio, but are facing skyrocketing levels of diabetes, stroke, and heart disease.
Our children no longer suffer from nutritional deficiencies, but are being overrun by an epidemic of obesity.
We’ve got an arsenal of medicines for all sorts of psychiatric and neurological conditions, which sometimes even work, but pretty much stand by helplessly when our elderly parents deteriorate with dementia.
Even our medicines can be deadly. The old doctors may have done more harm than good by zealous blood-letting, but today too hundreds of thousands die every year from the health-care system, many of them from the very drugs that are supposed to cure them. In fact, the third leading cause of death in the United States is medical care.
Perhaps our hearts beat for more years than in bygone eras, but to call modern society a picture of health isn’t exactly accurate.
What Dr. Campbell has Come to Know
One of the people who has given a lot of thought to the Western health crisis is Dr. T Colin Campbell, one of the world’s most prominent nutritional scientists. And he believes that all our problems boil down to “three things: breakfast, lunch, and dinner.” By eating right, we would be spared from all our modern maladies – and the dangers in trying to manage them.
In The China Study, he offers a clear “prescription for good health”: eat whole, plant-based foods, and don’t eat animal foods. From the outset, he lets us know that his ideas aren’t based on preconceived philosophical notions. He won’t even use any of the “V” words with their loaded moral and political connotations. Instead, he will use the more neutral “whole food plant-based (WFPB) diet”.
Dr. Campbell asserts that “the scientific basis for my views is largely empirical, obtained through observation and measurement. It is not illusory, hypothetical, or anecdotal; it is from legitimate research findings.” He goes on to invoke Hippocrates’ dictum that science is about knowing whereas ignorance is merely believing to know. Dr. Campbell will tell us “what [he] has come to know.”
Part of what he knows is what aren’t the causes of modern maladies. Right in the beginning of The China Study, he lists the “common notions about food, health, and disease which are wrong.” He continues to explain that synthetic chemicals don’t cause much cancer, that genes aren’t terribly important in predicting or curing disease, and some other less provocative claims. Throughout the book, he repeatedly emphasizes the nutritional causes of health and disease over chemicals and genes.
Dr. Campbell’s Life Story
Dr. Campbell didn’t start his career with an ideological vegan agenda, nor does he have one today. In fact, he grew up as a “meat-loving dairy farmer” and began his academic career as an “establishment scientist.” His PhD was on how to better grow farm animals for meat, and in his early nutritional biochemistry classes, he criticized vegetarian views. So the opinions he developed over decades are based on empirical science only.
His personal history suggests as much. Only after his scientific career convinced him of the health benefits of the WFPB diet did Campbell and his family adopt that way of life.
All that said, he admits that he has since developed an “increasing sensitivity to ethical and environmental reasons for eating a plant-based diet.” I’ve wondered a lot about this slight disclaimer. Is it possible that Dr. Campbell’s later identification with veganism in everything but the name has colored his view on the subject? Can it be that he was somewhat, if only unconsciously, influenced by ideology by the time he wrote The China Study with its total condemnation of all animal products? This would perhaps explain some of the more bizarre leaps of logic that we’ll encounter while reviewing his work.
I don’t know, and let’s avoid armchair psychoanalysis. Although sometimes I can’t help but notice such hidden agendas, our focus is on the many words Dr. Campbell openly wrote.
Readers, Judge for Yourself
Even after putting Dr. Campbell’s motives aside, why should we believe all that “he has come to know” just because he says so? I’m not a qualified PHD in anything; must I trust him just because he’s the expert? We’ll see that he often rails against blind trust in the prevailing winds of nutritional science; why should his opinion be any different?
It’s not like there’s a dearth of opposing views to choose from. In The China Study, Dr. Campbell has a lot of bones to pick with other popular diets, particularly those that promote high fat and protein with low carbohydrates – the opposite of his WFPB diet.
At one point, he goes a diatribe exposing “the Atkins crisis,” concluding:
Perhaps it is a testament to the power of modern marketing savvy that an obese man with heart disease and high blood pressure became one of the richest snake oil salesman ever to live, selling a diet that promises to help you lose weight…
Yet Dr. Campbell himself admits that there has not yet been a study devoted to comparing one of the other popular diets with WFPB. And The China Study itself has been the subject of heated controversy, as we’ll learn in detail. Without conclusive evidence either way, why should we believe him more than his detractors?
Fortunately, Dr. Campbell himself provided the answer in this revealing response to one of his critics:
I very carefully stated in the book that there are some correlations that are not consistent with the message and, knowing this, I suggested to the reader that he/she need not accept what is said in the book. In this very complex business, it is possible to focus on the details and make widely divergent interpretations but, in so doing, miss the much more important message. In the final analysis, I simply asked the reader to try and see it for themselves. And the results that people have achieved have been truly overwhelming.
Dr. Campbell concedes that there are inconsistencies in the data (we’ll learn all about them). He proposes that his readers listen to his tale and see if it adds up for them. The China Study’s arguments are so compelling that even the untrained reader will discern their truth. Readers that reject the book’s conclusions, Dr.Campbell suggests, are too focused the petty details, missing the beauty of the forest for a few ugly trees.
So with The China Study author’s encouragement, we’re going to review its main arguments and see if we’re convinced, beginning with a detailed overview of the landmark diet promoted in the book.
(If you’re interested, now might be a good time to jump over to the Appendix [which you can find at the end of last week’s post] to get to know the players involved in the debate, primarily Chris Masterjohn, Denise Minger, and the reviewers at Red Pen Reviews. I’ll also share some important context on the history and tone of their correspondence.
Or you can just read right on here…)
Whole Food, Plant-Based
What exactly is the WFPB diet? As the name suggests, there are two parts.
Eat whole, unprocessed foods, as close as possible to their natural state.
Those foods must come from the plant kingdom, not the animal one.
Unfortunately, as we’ll learn, The China Study tends to blur the boundary between these two components. The primary focus of the book’s research and findings is the “plant-based” part; the need to eat whole plant foods is often presented almost as an assumed caveat. Don’t think you’ll find health by swapping beef with brownies and chicken with chocolate; you must adopt a lifestyle of eating whole plant foods.
Go For the Low Quality
The key subject of Campbell’s beef with animal foods (pardon the pun) is protein – unsurprisingly, considering that this macronutrient was the focus of his career.
First discovered in 1839, protein quickly became, in Campbell’s words, the “most sacred of all nutrients.” In fact, the word itself comes from the Greek proteios which means “of prime importance.”
Why has protein been considered so important, more than the other two macronutrients (carbohydrates and lipids) that compose the bulk of our diet?
One approach is the deep-rooted association between protein and animals. Although plants too have some protein, meat is only meat when it has lots of protein: all that would remain without it is a puddle of water, a glob of fat, and a melting mound of micronutrients. By identifying protein with animals, people came to view it as a substance that gives more strength and agility than vulnerable, stationary plant foods. Perhaps eating protein even touched on an innate desire to dominate other sentient beings.
Whatever the exact roots, a cultural bias has developed that has civilized, rich, perhaps even spiritual, people eating lots of meat – and therefore protein. Lower classes were considered inferior and incompetent because they ate less meat and less protein.
Protein is indeed a vital component of our bodies, making up much of their structure and fulfilling critical biological functions. Many enzymes and hormones are proteins. Like everything else in life, proteins wear out and need to be rebuilt anew from their building blocks, called amino acids. Human flesh would provide the most efficient arrangement of amino acids to make more human flesh, but since that’s usually unavailable, the next most efficient candidate is other animals. In nutritional jargon, the higher the quality of the protein, the more of the essential amino acids it contains.
But here comes The China Study’s twist. The term “quality,” which sounds like a good thing, is terribly misleading. “A mountain of compelling research,” Dr. Campbell tells us, shows that a slower but steadier building of new protein from so-called “low quality” proteins is in fact healthier. These proteins are found exclusively in plants, and need to complement each other to provide the necessary amino acids needed for life. (The most common way of doing this is combining legumes and whole grains.)
Dr. Campbell will attribute a broad range of benefits from consuming plant proteins which individually contain less essential amino acids, and trace a litany of diseases are to intake of animal proteins with their full amino acid spectrum.
Not Just Anything That Was Once a Plant
Ok, so we’re supposed to get our calories from plants. That means lower-quality but healthier proteins. It also means much less protein overall, because plants have less of that nutrient. Eating plants means eating mostly carbohydrates.
So the WFPB diet is high in carbs. But not just any carbs. Here enters the “whole food” part of the diet: fruits, vegetables, and grains, all of which have biochemically complex carbs that come with lots of vitamins and minerals. In addition, whole foods have lots of fiber which helps the body digest and absorb their starches in a slow and controlled manner.
On the other hand, the simple carbs of processed foods have been cruelly stripped of their fiber and nutrients. Instead of truly nurturing us, they just inject an unregulated rush of energy into the bloodstream, each bite nudging our poor pancreas a step closer to diabetes.
Unfortunately, most Americans eat way too many simple carbs in junk food, which has given carbs in general very bad press. It isn’t healthy to eat a low-protein and fat diet by binging on soda, sugary cereals, and candy bars. The benefits of this diet are from the complex carbs in whole plant foods.
Whole Plants or All Whole Foods?
Even The China Study’s strongest detractors accept this second piece of advice. They claim it’s probably the only reason for good health outcomes in people who follow the WFPB diet. Can it be that the “plant-based” part is nothing but a distraction?
This is what Denise Minger, one of the most talented and vocal critics of The China Study, wrote in the beginning of her academic critique of the book:
While he has skillfully identified the importance of whole, unprocessed foods in achieving and maintaining health, his focus on wedding animal products with disease has come at the expense of exploring – or even acknowledging – the presence of other diet-disease patterns that may be stronger, more relevant, and ultimately more imperative for public health and nutritional research.
There’s also a crucial qualitative difference between WF and PB.
The suggestion to eat whole foods doesn’t isolate any nutrient as hero or villain. Instead, it urges us to view and relate to eating as a broader experience than any single nutrient can possibly offer. Become part of nature’s complexity; honor and enjoy the fullness of its foods. Find health in eating foods as close as possible to their natural state.
I personally have learned much from Dr. Campbell about the wide gap between reductionism and what he calls wholism, another word for holism without the mystical trappings, as we’ll discuss shortly. He will make the case that wholism too can be rooted in scientific inquiry.
But it will prove much more difficult to see wholism when we’re told to abstain from all animal foods, particularly when it’s because of the sort of protein they contain. Protein and amino acids are specific chemicals that were discovered by reductionist science; they don’t exist outside of that context. So although there are lots of animal foods around, and Dr. Campbell lumps them together to form a “whole,” that might be more speculation than transcending reductionism.
We’ll return to the problem often as we work through The China Study’s scientific arguments.
Whole Nutrition Explained
What exactly is wholism?
The China Study explains:
Nutrition represents the combined activities of countless food substances. The whole is greater than the sum of its parts.
Every meal with whole foods contains thousands of individual nutrients and chemicals that are digested in countless ways to support life and health. “It is an infinitely complex process, and it is literally impossible to understand precisely how each chemical interacts with every other chemical. We will never discover exactly how it all fits together.” Focusing on any single chemical or biological process as the key to health is oversimplifying nature’s brilliant complexity.
From this follows a second principle: supplements are a distraction from true nutritional advice. Due to the inherent complexity of human biochemistry, no isolated substance packed into a pill can significantly promote health. Life is way more complicated than that. Nutrients found to be important are indeed important – but as part of their natural context in whole foods.
(Dr. Campbell concedes two possible exceptions in vitamins B12 and D, the first of with can be deficient in a WFPB diet. More on that later).
Reductionism and Wholism
In Whole, a sequel of sorts to The China Study, Dr. Campbell further expands this wholistic outlook on nutrition and life in general, comparing it with its opposite (and some would say nemesis), “reductionism.”
The reductionist believes that understanding the world means breaking it up into its parts. The more components you can isolate, the more you know. The wholist, on the other hand, claims that the whole is larger than the sum of its components, as we saw regarding the wholistic understanding of nutrition.
An ancient parable shows the importance of keeping the whole in sight and not getting lost in details. Six blind men were trying to figure out an elephant by touch alone. Each one was convinced that his part was the true elephant. Of course, this got them all confused: is an elephant a hard tusk or leathery leg or huge underside or flapping ears? The man who can see will know that an elephant is a single being that has all of these parts.
Are the two approaches contradictory?
A hard reductionism probably does exclude wholism; if the truth lies in the component parts, there is no such thing as a bigger picture than that which comes from knowing lots of parts. But wholism, according to Dr. Campbell, doesn’t reject reductionism but rather encompasses it; the many parts together comprise the larger whole. We can appreciate the details while retaining a view of the larger picture.
As Dr. Campbell responded to one of his critics:
Reductionist details are important when used to construct the fabric of the whole. However, they are the source of great confusion when interpreted outside of the whole of which they are the part.
The details play a central role in wholism, Dr. Campbell suggests, because they provide the parts which compose the larger “whole.” Therefore, he’ll use his training in reductionist science to try to reach beyond the details of that science.
In my view, as we’ll learn, here lies the problem with his methodology. The search for wholism is noble, but trying to find it in the details of reductionism will lead to logical fallacies.
History of Reductionism and Wholism
In Whole, Dr. Campbell describes the history of wholism and reductionism. Here’s a slightly expanded version of his account.
In the ancient world, Greece in particular, the physical and metaphysical realms, what today we’d call science and theology, were studied as complementary fields of wisdom, more often than not by the same scholars. In such a world, both reductionism and wholism were allowed to flourish, each in their proper context. While astronomy and biology probed the details of the natural world, philosophy and religion ensured that all those details were understood as part of one seamless whole which is broader than any single natural science and even all of them together.
But as the world regressed into the Middle Ages, theology often took the form of fixed religious dogmas that rejected open-minded examination of the world. Without such “reductionist” examination of the details, theology stagnated into obsolete systems of immutable “wholes.”
And so humankind muddled along until the Renaissance introduced a modern world which rejected theology altogether and championed a purely reductionist perspective. But unlike the ancients, our modern reductionism has lost appreciation of the value of looking at the whole. We’ve forgotten the oneness and interconnectedness of things. We’ve abandoned wisdom in favor of data.
In the current reductionist state of science, we are at a loss to explain the things which reductionism cannot reach. We experience emotions as something much more than neurons and hormones but don’t know exactly what they are. The same has happened with medicine in general, and particularly with nutrition: we’ve lost sight of the impossible complexity of nature because we’re so focused on the petty details.
Some scientists believe that one day biology will advance until we can form a human life in a test tube. But that view, Dr. Campbell explains, only comes from the naivety of reductionism. By looking deeply into all science has uncovered, it’s clear that whole biological systems will never be fully understood. The number of variables produced by the effects of every enzyme and hormone approaches infinity.
Is Nutrition Legit?
Because of modern medicine’s total embrace of reductionism, doctors are barely taught anything about nutrition – the holistic centrepiece of healthy living. And even the little that they are taught is heavily influenced by industries making money from selling unhealthy foods. In their practice, doctors focus on fixing specific diseases and conditions as they arise, not on teaching people how to remain healthy.
There’s even some skepticism about nutrition’s validity as if the whole field is controversial and might border on quackery.
The China Study describes the controversy beautifully:
The scientist is sitting down at the breakfast table and in the one hand he has a paper that says that cholesterol will rot your arteries and kill you, and in the other hand he has a fork shoveling bacon and eggs into his mouth, and he says, “There's something confusing here. I'm confused.” And that's the controversy. That's all it is.
This description demonstrates the unique opportunities and challenges of nutrition science. The researcher’s primal instincts clamber to cloud his judgment, and must be met and acknowledged if he wishes to seek objective truth.
There’s also a kernel of truth in nutrition skepticism: nutrition is indeed very hard to study as an exact science. As we’ll learn later, although biochemistry and research show clearly that what we eat affects our health, it’s much harder to nail down exactly which nutrients are good and bad, and what are the proper amounts and proportions of the good ones.
The widely diverging opinions of the most qualified nutrition experts show the deep complexity of this field.
As Denise Minger cheerfully puts it:
Even the most heavily credentialed experts can’t agree on how to interpret the body of research they all draw from. If we hand over our brains to anyone who seems formally qualified, we might find ourselves eating a Mediterranean diet on Monday, a vegan diet on Tuesday, a paleo diet on Wednesday, a blood type diet on Thursday, and a bowl of our own frustrated tears on Friday.
Writing a Wholistic Book
Because nutrition science defies reductionism, Dr. Campbell believes that focusing on any specific study won’t be able to “define an emerging whole truth or worldview.” It’s a big problem that researchers “almost always focus on very specific hypotheses, investigating how single agents cause specific effects,” because “the combination of a limited design and a narrowly focused hypothesis for individual experiments can only give impressions of a larger truth, even though each experiment may be well done.” How can the full truth be uncovered? Only by many varied experiments.
This was the main theme behind how he structured The China Study:
We tried in our book to avoid this problem by chronologically reporting on the main experiments during my career, along with the research of others, to elaborate a larger view that I thought was taking shape. We felt that this chronology of experiments respects readers, leaving them to decide whether they agree or disagree. It's about connecting the dots, so to speak. This also explains any aberrations that might be found in the data. Single data points aren’t important; what matters is the larger patterns that emerge from many avenues of inquiry.
Although scientific experiments are inherently reductionist, Dr. Campbell suggests they provide a wholistic perspective when they’re viewed all together.
In the coming weeks, we’ll check if the dots indeed connect.
Here’s a PDF version of this post along with all the footnotes:
