Kara's Reviews > The China Study: The Most Comprehensive Study of Nutrition Ever Conducted And the Startling Implications for Diet, Weight Loss, And Long-term Health

The China Study by T. Colin Campbell
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's review
Nov 01, 2012

did not like it
Read in January, 2012

Whew, where to start with this one! I do feel compelled to explain why I see this book as a one star. it is frankly bad science. I think most people would read this book and seriously feel scared, he certainly wrote it with that purpose in mind. Many of my thoughts stem from years of math and statistics classes, years of working with statistics in environmental engineering, some come from the dozens of research studies that I’ve read over the years, some come simply from being a die-hard critical thinker. I truly question everything I read (and as a result can drive my ownself nuts). I don't want you to think for one minute that I think I have all the answers to what we “should” be eating. I eat based on what I personally feel is the best odds for health. This changes and evolves, and I definitely struggle with a sweet tooth (I think refined sugar may be the worst evil of all the foods, yet I love it, go figure),. If I speak my truth, based on everything I’ve read, researchers and health professionals that I respect and trust, I do strongly belief that quality meat rich in omega 3’s is the healthiest source of protein for our bodies. I would eat more fish if I didn’t feel so much concern over toxins in our oceans and thus our fish. Grass-fed beef has a better omega 3 fat profile than grain fed beef,but without the toxins of the wild fish. This is what I eat predominantly for meat.
Who knows, maybe further research will come out to show that a no-meat diet is best, but I really do not believe that any science so-far proves that to be the truth (from a health standpoint).

So if you really want to know why I think this book is bad science, here is a start (tip of the ice berge to be honest). Epidemiology is a good tool for predicting future outcomes for large communities, but is terrible for predicting individual causations. He even admits himself (very quietly and sort of as a side note) that there are incredible amounts of variables that confound the results.
Correlations does not equal causation (this is basic statistics, yet almost all of his data is based on correlations. (Rich people eat more meat than poor and rich people have more cancer than poor therefore eating meat causes cancer……don’t even get me started on how this poves nothing)

The author definitely says many things that I agree with and are scientifically backed up by lots of other studies. That’s a big thing for me, I don’t trust anything until it has been shown repeatedly in unrelated studies. The Standard America Diet (SAD as they call it) is certainly dismal. Processed and refined foods are terrible for us and he talks a lot about that in the beginning of the book. This is all very, very true. I’m not vegan (obviously) but I would consider a vegan diet and a whole-foods diet more closely related than most. Both attempt to eat whole fruits and veggies, lots of omega 3’s, fibre, and adequate protein. But there are also many technically incorrect statements this books makes, as well as leaps of logic that are truly unscientific. I could actually be more forgiving of minor technical errors, but the data has been presented in a way that I believe is irresponsible.

I would imagine anyone who would take the time to read this book as it stands would certainly be afraid of dairy. I am not. When you start looking into the real data and how it was interpreted that the problems start to surface and I lost faith in the rest of his possibly accurate data.

Anyway, most people don't take enough interest in their diet to even read one book or they are not open minded enough to consider whether meat, or wheat or big macs are good for their health. I'm not emotionally tied to my “diet” and I read a lot, so I am happy to read and consider what is best for my personal health. I want to believe I am open to change. Sorry for the rambling review.
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Comments (showing 1-24 of 24) (24 new)

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Heather Can you point me to or explain what you mean about the "real data" that means that this book did not make you afraid of dairy? Please and thanks.

message 2: by Kara (new) - rated it 1 star

Kara By "Real Data" and "Dairy" Two things come to mind.
1) Data from Dr. Campbells actual China Study
2) Studies on rats and Casein

First, the data he refers to in the book but never actually shows you (he kind of shows us bits and pieces where he deems fit, and irritated me to no end). Much of the data he references is based on a book called "Diet, Life-style and Mortality in China". Anyone can order this book for a mere $240 but I can't imagine many want to. It is 900 pages of data. It is a scientific observational study that shows hundreds and hundreds of correlations and nothing else. Correlation does not equal causation. There is a strong correlation between ice cream sales and drowning deaths in north america. Eating ice cream must cause drowning deaths. Imagine writing a book on not letting children have ice cream to prevent drowning.

Second bit of "data" I refer to is his rat studies, and other studies outside his own that he never acknowledges. I'm sure you can recall in his book he says....

" rats fed a diet of 5% protein in the form of casein exhibited dramatically fewer lesions than rats fed a diet of 20% casein. Additional experiments showed that wheat and soy protein did not promote cancer growth, even when fed at the 20% level."
Campbell concludes that casein could be "the most relevant carcinogen ever identified."

***This next bit I am copying word for word from a critique of "the china study" because it is late, and it sums it all up nicely without sending you 50 pages . (Link to follow if you want to see the whole thing).

"Yet in a 1989 study, Campbell discovered that wheat protein exhibited similar carcinogenic properties as casein when lysine, its limiting amino acid, was restored.57 This suggests that any complementary combination of amino acids will spur cancer growth under certain experimental conditions, and that carcinogenic qualities are not unique to casein nor to animal protein at large. The sole reason plant protein appeared protective in rat studies was due to a deficiency in one or more amino acids, a scenario that rarely occurs in real-world situations when a variety of foods—whether plant or animal in origin— are consumed. Campbell himself notes that eating a variety of plant foods provides a full spectrum of amino acids58—indicating that even a plant-only diet can yield the complete protein Campbell claims to be carcinogenic.
However, the notion that complete protein is inherently carcinogenic is contradicted by more recent literature. Although Campbell’s focus on casein is understandable, given the research is chiefly his own, he does not acknowledge the abundance of similar studies showing that whey—another milk protein— consistently boasts anti-cancer properties,59,60,61 including when studied under the same experimental conditions that demonstrate the carcinogenic qualities of casein.62,63 This is significant, as even a single example of animal protein inhibiting rather than spurring cancer invalidates Campbell’s hypothesis that the effects of casein can be extrapolated to all animal protein."

Here is a link to that critique...

phew, sorry. I couldn't have just made that simple could I?

Heather Thanks a TON! I will read that formal analysis. Who is this Denise Minger, I wonder?

Anyway, bah. This is all a bit frustrating. I don't know that I totally agree that his book is "bad science", at least not in entirety, but you don't either, I guess. I'm trying to figure out which parts to take on board and which not to. It is pretty compelling to me that a plant-based diet is healthier than a meat-based diet, even if it's based on correlations. The ice cream/drowning correlation is missing the obvious link and is clearly absurd, but I don't think of many of the correlations that Campbell finds as being quite so absurd (or at least not all of them). I am 100% on the same page as you in terms of being uber-critical and I take everything with a grain of salt, including this book. I am basically navigating the nutritional world at the moment trying to get some ideas of "truth" or at least utter fiction. Pretty frustrating. I just read a bit of Nourishing Traditions which advocates heavy-meat, heavy-milk, etc and it actually used the Framingham Heart Study as evidence, which Campbell uses as well. That one blew my mind... just to see how easily something can be used to prove two completely opposing ideas.
Anyway, do you find it compelling when patients with heart disease/cancer/diabetes are treated nutritionally (generally with a vegan diet) and their illnesses reverse? I know it could be that their increased veggie intake and decreased crap (sweets, refined foods, etc) intake is really to credit and not strictly that they aren't eating meat or dairy.
Hmm. I don't know.
Are there any other nutrition books/studies that you would point me to as being more reputable? At this point it seems like a person can find a study to prove just about anything... but obviously some hold up better than others. If there is something that has seemed rationally compelling to you that you can recommend, I'd appreciate that.

Thanks again. Really glad to have this information.

message 4: by Kara (new) - rated it 1 star

Kara Hi Heather,
I totally relate to everything you just wrote. It is frustrating, and a lot of work to wade through the piles of information out there. I’m still working on that myself. There is always more to read and consider. Those reading this book are all genuinely wanting to make their lives as healthy as possible, it is a common bond, and the one that we should focus and commend each other on . As for the flaws in this book, the things I’ve mentioned is just the tiniest tip of the ice berg.

Anyway, to address some of your questions/thoughts....

I get why you might question who this Denise Minger person is, I did as well at first. I don't want to fall into the trap known as "confirmation bias". I really want to be critical of all that I read, Denise included of course. The thing that seals the "bad science" deal on this book for me is that Denise really stirred up the pot, so much so that Dr. Campbell himself responded to her comprehensive critique. Instead of showing detailed examples why her use of his data is incorrect, he just gets defensive, calls her names and finally this....
“But she suffers one major flaw that seeps into her entire analysis by focusing on the selection of univariate correlations to make her arguments (univariate correlations in a study like this means, for example, comparing 2 variables–like dietary fat and breast cancer–within a very large database where there will undoubtedly be many factors that could incorrectly negate or enhance a possible correlation). She acknowledges this problem in several places but still turns around and displays data sets of univariate correlations.”
Umm…he just described his own ENTIRE China Study in a nutshell. He just shot down his entire works in one paragraph, and that was exactly the point that Denise was trying to make through her examples.

As for my “bad science” comment, I still stand by that whole heartedly. I do think there are snippets of truth, but nothing significant that we don’t already hear at any Dr. office or Nutritionist….”eat whole foods, eat veggies and fruit, don’t eat processed food”.

You commented that “I don't think of many of the correlations that Campbell finds as being quite so absurd (or at least not all of them)”….I think if you delve into Denise’s assessments you will see exactly why my ice cream/drowning analogy isn’t so far off (though I purposely made it obvious just to make the point). She very clearly demonstrates that he twisted and cherry picked data to prove what he wanted to prove. The man is actually quite brilliant at the art of confusion and misrepresentation. The raw data does not support his conclusions in any scientific way. Another Dr. wrote about this very well…here is a link to that article:


Let’s touch on the heart disease example as well....
I’m guessing you are referencing the study conducted by Dr. Esselstyn that proves a vegan diet can reverse heart disease? Desnise did a bang up job of reviewing his study when she did a mile long review of the movie “Forks over knives”. I’ll paste an excerpt and link you to the entire article because it is really impressive….there are a few pages just on Dr. Esselstyn’s research, but this paragraph is almost enough on it's own , she is discussing the diets of the 24 patients…

“A whole bunch of variables changed. This wasn’t a study that examined the effects of one component of diet; it did a complete menu overhaul, changing total fat intake, animal food intake, processed food intake, sugar intake, vegetable oil intake, and about ninety gazillion other things. Combined with that lack of a control group, it’s impossible to determine exactly which diet components had an effect on heart disease, and which were neutral (or even negative).”

At the end of the day I do not have the answers, but I consider my diet to be a “best odds” diet. I eat nutritionally dense fruits and vegetables, quality grass feed/finished meat (I buy once per year and stock my freezer form a local ranch), I try to avoid wheat, sugar, corn, and potatos in favor of higher nutrient dense foods….sweet potato, broccoli, spinach etc.. I take omega 3 oil on a teaspoon, 5000 IU’s vitamin D every day (I live in a northern climate) , I exercise regularly (swim and bike a few times per week, and lots of walking) and stay active with my kids. I am far from perfect though. I love a latte now and then. My Mom is an amazing baker and it is hard to resist sweet baked goods. I’m trying to avoid dairy (I know, confusing right?) but I happen to have an auto immune disorder that could potentially rob me of my mobility and I am willing to let go of dairy (or most of it) on the remote chance that it might help reduce inflammation. I am not scared of dairy causing cancer however. Whey protein has actually been shown to be cancer protective, so it’s all just too confusing to say much.

I haven't read Nourishing Traditions, but I might have to add that to the pile just for kicks ;-) If you found that contradiction mind blowing, you will find Denise's work just as mind blowing.

Well, that should keep the ball rolling for you for a little while ☺ I’m having a nice lazy Sunday morning with my kids, and as you can probably tell I find the topic fascinating (thus the long winded response. Enjoy your weekend ☺

Oh, one more interesting link about vegetarianism and heart disease…..


Heather Kara,

Thanks so much again for your thorough response. I have only been absent in responding to you because I have been buried deep in reading. It was FANTASTIC and really enlightening to go through all of Denise's criticisms and then to read everything else related. I still have quite the list to go through, but I got a lot of it done. Thanks so much for the link to her, because I feel like I've found someone who is speaking my language.
Anyway, I'm pretty much with you now, in terms of my disbelief in the validity of The China Study on the whole, but of course I'm trying not to be too quick to judge.
I do find it disconcerting and entirely a bad sign that Campbell hasn't seemed to actually respond to any of Denise's valid scientific arguments against his published work. His 12-page response was very general and philosophy-based and at times petty. This is too bad. I think he's probably a decent guy and there might be more to the story that I'm missing out on. I just wish he would say, for example, "This is why my data is still valuable even though I didn't correct for schistosomiasis in my claims about liver cancer and animal protein." It is very suspect that he can't match her in his "defense" with some hard facts.
Having said all of that, I don't know what I might be missing considering I'm not an epidemiologist or all that proficient in statistics or data analysis. I am wondering if I can be equally as fooled by Denise's way of presenting things as I was by Campbell's because I am not aware enough to see the holes. If you know what I mean.

After all of the reading I feel pretty firmly grounded in the basic fact that the key to success lies in eating whole foods and exercising a whole lot. I need to read more about grains which I find it hard to give up as I'm a pretty voracious eater. I'll keep on eating meat (which for me is generally only free range, etc) but I need to find out more about raw foods vs cooked and all that. I'm also not totally sure about milk. If I could have a goat out back that'd help...
Have you read any of the Paleo/ancestral stuff that you would recommend? Oh navigating the world of nutritional claims...
Oh, and as for "Nourishing Traditions," I don't recommend it. I skimmed it and it seemed pretty dogmatic to me. I'm sure my Campbell bias, at the time, was skewing things a bit, but I'm sure there is much better researched and grounded writing on the same type of thing than that book. It's mostly a cookbook, anyway.
It was funny when you mentioned living in a northern climate because I did notice that you are from Calgary. I think it said it beside your name or something. I live in Edmonton, so we are neighbours!
It has been such a pleasure writing with you.


message 6: by Kara (new) - rated it 1 star

Kara Loved your note, I think we are in the same boat at this moment in time. It really is Campbells lack of scientific response to Denise that makes it all so dodgy. I am also sure that he means well and believes in what he is saying, but I probably would too if I had sunk my entire life into that one notion. The reality is that his science doesn't back it.

As an engineer and one who has spent a fair amount of time and energy on statistics, I feel pretty comfortable in saying that Denise's assessments are accurate, unless she fabricated the data, but that is pretty easy enough to check since she references absolutely everything. I doubt anyone with a career in the sciences would read her material and say differently.

I am very interested in Paleo, I don't know much on the science of it myself, but it certainly seems somewhat logical to an extent. The missing piece for me is that nothing is one size fits all. Another big factor I very much believe in is our genetic ancestry, so in many cases I think what is healthy for one is not for another. I know for a fact that I feel very healthy eating red meat, but my husband doesn't do that well with it. I don't know anything (haven't' looked yet) on the science on raw vs. cooked either, but if there was something worth reading, I would consider reading it. Not sure I have it in me to go raw though. It's a journey! Good luck, and I agree, it's been a pleasure "chatting".


Rami Saber Thanks for your review, I am currently reading the book but
one thing always confuses me in nutrition, how come people in the Sahara or the Eskimo for example have a healthy life although most of what they eat is meat related food.

message 8: by Kara (new) - rated it 1 star

Kara Rami wrote: "Thanks for your review, I am currently reading the book but
one thing always confuses me in nutrition, how come people in the Sahara or the Eskimo for example have a healthy life although most of ..."

Absolutely. This is one of many things that this book does not address at all. I believe that ancestral genetics plays a big role in what is healthy for any individual. What is best for one is not best for another. This is another issue that is not addressed in this book.

Stephanie I read your review and wanted to point out one thing. While grass fed beef does have more omega-3s than regular non grass fed beef, it does not have a similar profile to fish. I too eat grass fed beef when I eat beef, and before I looked into it more I believed this to be true as well. I just pulled up some data to prove my point, and grass fed beef has about 5 times the amount of saturated fat as salmon. Grass fed beef has far more omega-6 (inflammation promoting) fats than omega-3 fats, and an ounce of salmon has has about 24 times the amount of omega-3s as one ounce of grass fed beef. (P.S. - I'm an ex-engineer studying to be a dietitian... so we have similar interests) Here's the data I used: Grass fed beef - http://nutritiondata.self.com/facts/b... Coho alaskan salmon: http://nutritiondata.self.com/facts/e...

message 10: by Kara (new) - rated it 1 star

Kara Okay, I will stand corrected, but it was a semantics error on my part. They are not the same profile, no. I used the word similar, and later stated that eating grass fed beef was like eating wild fish. What I meant and SHOULD have said is that eating grass fed beef is a healthy alternative to wild fish. The risk for metals contaminated meat is much lower with the grass fed beef while still getting a very healthy Omega3 to Omega6 ratio. I guess for me it is best odds with the grass fed beef. Fish still has a role, but I'd prefer it not to be a daily role myself so the grass fed beef is a healthy option. Certainly a large improvement to the Standard american diet (SAD)

A healthy diet should consist of about 1 to 4 times more omega 6 than omega 3. The SAD takes in about 14 to 30 times omega 6 to omega 3. Omega 6 is not bad, it's the ratio that is important.

Here is a table that summarizes many studies and the 3:6 ratios they concluded between grass fed and grain fed.


Full study:

Rachel What a wonderful, well-written review! You summed up a lot of what I said, in a much more concise way. Bravo! Also I appreciate all the research you've done and the links you've provided in your comments. You did far better than I did, I just read the book and then went spouting off on my opinions about it! Kudos to you for caring and learning and for taking pains to follow a healthy diet. Not everyone does this! Here's a link to my review. http://www.goodreads.com/review/show/...

message 12: by Alessandra (new) - added it

Alessandra Hello Kara, I like your review very much. Do you have other nutrition books to suggest?

message 13: by Kara (new) - rated it 1 star

Kara Alessandra wrote: "Hello Kara, I like your review very much. Do you have other nutrition books to suggest?"

Thanks Alessandra. I unfortunately don't have any one really good go-to nutritional reading. In my particular case I suffer from an auto-immune disorder (MS) and started wanting to know more and understand my body better. My background is in environmental engineering so I understand risk assessment and am happy to read through data. For me the science is so important. If there is not solid science backing I'm not going to take it too seriously. For me much of my nutritional learning and reading has come from the context of MS and trying to calm inflammation in my body. I wish I had a better answer for you. Keep reading and never take one persons opinion at face value. Bounce ideas and discuss them with people you respect and trust. Dig deeper, value facts ignore opinions, words like "I feel" or emotional statements. :-) All the best.

message 14: by Gerald (new)

Gerald Shaffer To me, knowing whether or not to eat a cow is answered when I scratch her behind the ears and she is happy.

message 15: by Rachel (new) - added it

Rachel Agreed Gerald!

Rachel Gerald and Rachel, the comment from Gerald totally missed the point. The book THE CHINA STUDY is not about cruelty to animals. It's about nutrition information.

David Of course he had a 'purpose in mind' FFS!

message 18: by Fish (new)

Fish Punch thanks for this review

message 19: by Patrice (new)

Patrice I appreciate your expert opinion and it sounds right to me. I havent read this book but "Eat to Live" which cites this study as the ultimate in scientific evidence.

message 20: by Patrice (new)

Patrice What stands out to me is that the body needs b12 and b12 ONLY comes from animal sources. So how could we be meant to eat NOTHING from animals? We can't live without B12!

David Patrice wrote: "What stands out to me is that the body needs b12 and b12 ONLY comes from animal sources. So how could we be meant to eat NOTHING from animals? We can't live without B12!"

Rubbish. Never heard of Marmite? Yeast extract rich in vitamin B12

message 22: by Patrice (new)

Patrice Ah! I have heard of Marmite but I have never had it. I hear it tastes terrible...to an American. I hadn't thought of yeast.

message 23: by David (last edited May 09, 2015 10:25AM) (new) - rated it 5 stars

David Patrice wrote: "Ah! I have heard of Marmite but I have never had it. I hear it tastes terrible...to an American. I hadn't thought of yeast."

Yes, you either love Marmite or hate it :)

message 24: by Patricia (new) - added it

Patricia Jackisch I have a quick question? Where do you get all the information that disagrees with what this book sais? Genuinely just curious so I can go and have a look myself :)

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