The China Study | Part IV – Heart Disease

chinaSo, what is heart disease and how can diet and nutrition not only prevent it, but reverse it as well?

Whether your family has a history of heart attacks or not, buckle up! What we’re getting ready to discuss, while it’s focused on heart disease, inevitably applies to a myriad of conditions and diseases that can be treated by simply changing your diet. While that might sound a little over the top, the data says otherwise.

You ready?


While the word, “fat” tends to resonate as a negative, it’s absolutely necessary for good health. But when a specific type of fat starts to accumulate in your arteries – oftentimes because of a bad diet –  that’s when things start to go south.

Before we get into that, let’s go over a couple of terms:

Epidemiology (eh-pih-DEEM-ee-ah-low-gee) – the study of diseases as far as the way they surface and are treated in specific people groups

Cholesterol – a white, waxy substance that is not found in plants – only animals. It is an essential component of the membrane that coats all our cells, and it is the basic ingredient of sex hormones. Our body need cholesterol, and it manufactures it on its own. We do not need to eat it. But we do, when we consume meat, poultry, fish and other animal-based foods, such as diary products and eggs. In doing so, we take on excess amounts of the substance. What’s more, eating fat causes the body itself to manufacture excessive amounts of cholesterol which explains why vegetarians who eat oil, butter, cheese, milk, ice cream, glazed doughnuts, and French pastry develop coronary disease despite their avoidance of meat.

Lipids represent a category of substances that have one thing in common in that they don’t mix with water. Cholesterol is one type of lipid. Another kind of lipid is Triglycerides. Triglycerides are a type of fat that is found in your blood. It’s the combination of Triglycerides and Cholesterol that forms what is referred to as “plaque” in your arteries and can lead to
Atherosclerosis (eh-thir-ah-skler-OH-siss), or, the hardening of the arteries.

Medicine subdivides cholesterol into two types. High-density Lipoprotein (LIP-oh-pro-teen), or HDL, is sometimes known as “good” cholesterol. Medical experts do not know precisely how, but it seems to offer some protection against heart attacks – by collecting excess cholesterol and carrying it away from the arteries to the liver, which can break it down and dispose of it. As total blood cholesterol rises, you need more and more of the HDL cholesterol to protect you against heart disease.1

Low-density lipoprotein, or LDL, is “bad” cholesterol. When too much of it is present in the  bloodstream, it tends to build up along artery walls and helps to form the “plaque” that narrow blood vessels and can ultimately may clog them all together.

The thing is, it’s not just LDL that’s present in an artery that is forcing it to narrow. It’s a combination of LDL, Triglycerides (see box to the right) and other “sticky” substances combined with white blood cells.

Here’s Where it Gets a Little Gross…

As the plaque is formed, a fibrous cap begins to develop at the very top. That cap begins to erode because of the initial white blood cells (macrophages referenced in the diagram to the right) that are now spewing chemical substances that erode the surface of the cap. As blood continues to flow through the artery and race past the eroded plaque, it can rupture which initiates a catastrophic sequence of events.

Screen Shot 2019-04-10 at 1.23.00 PMThe ruptured plaque registers as an emergency and platelets are activated in order to form a clot around the damaged area. The healing process the body is attempting to apply, however, often proves to be lethal in and of itself in the way the clotting forms a blockage in the artery itself…

…and this is what’s known as a heart attack.

Pause for a moment and ponder the essential ingredients that constitute the recipe the for disaster described above. You’ve got fat and…


Fat is a good thing, like we talked about before. Cholesterol is a good thing. Our bodies need it, but we get all that we need from our liver. The problem starts when we eat animal products that not only contain high amounts of cholesterol themselves, but are also high in fat. The fat triggers the liver to make more cholesterol than it would normally and that’s where you start having problems. It’s not the cholesterol that’s coming from plants, it’s what we ingest from animal based foods.

Doesn’t that sound like something that points to a pretty obvious solution?

But rather than adjust our diets, most will default to surgery and pharmaceuticals. There’s a problem with that approach, however, and the following comes from Dr. Campbell, author the book, “The China Study.”

The mechanical interventions that we use in this country are much less effective than most people realize. Bypass surgery has become particularly popular. As many as 380,000 bypass operations were performed in 1990, meaning that about 1 out of 750 Americans underwent this extreme surgery. During the operation, the patient’s chest is split open, blood flow is rerouted by a series of clamps, pumps and machines, and a leg vein or chest artery is cut out and sewn over a diseased part of the heart, thereby allowing blood to bypass the most clogged arteries.

The costs are enormous. More than one of every fifty elective patients will die because of complications during the $46,000 procedure. Other side effects include heart attack, respiratory complications, bleeding complications, infection, high blood pressure and stroke. When the vessels around the heart are clamped shut during the operation, plaque breaks off the inner walls. Blood then carries this debris to the brain, where it causes numerous “mini” strokes. Researches have compared the intellectual capabilities of patients before and after the operation, and found that at stunning 79% of patients “showed impairment in some aspect of cognitive function” seven days after the operation.

Why do we put ourselves through this? The most pronounced benefit of this procedure is relief on angina or chest pain. About 70-80% of patients who undergo bypass surgery remain free of this crippling chest pain for one year. But this benefit doesn’t last. Within three years o the operation, up to one-third of patients will suffer from chest pain again. Within ten years half of the bypass patients will have died, had a heart attack or had their chest pain return. Long-term studies indicate that only certain subset of heart disease patients live longer because of their bypass operation. Furthermore, theses studies demonstrate that those patients who undergo bypass operation do not have fewer heart attacks that those who do not have surgery.2

Here’s the thing, though. Consuming additional fat and cholesterol is an obvious problem, specifically in the context of eating animal based products.

But it’s not just the fat and cholesterol.

Fact is, animal based protein is even more of a problem:

Although dietary fat was found to induce formation of early atherosclerosis in experimental rabbits, animal-based protein (such as casein) proved even more effective. As early as 1909, Dr. Alexander Ingatowski attributed the formation of atherosclerosis to animal protein. Review of this early literature report that animal protein was substantially more effective than cholesterol in inducing the formation of early heart disease.

Yet somehow animal protein has remained in the shadows while saturated fat and cholesterol have taken the brunt of the criticism. /these three nutrients (fat, animal protein, and cholesterol) characterize animal-based food in general. So isn’t it perfectly reasonable to wonder whether animal-based food, and not just these isolated nutrients, causes heart disease? (If only this research on the importance of animal-based protein in heart disease been taken seriously over the past century, progress in understanding the dietary cause of heart disease would have been far greater, with much less confusion and dispute!)3

The solution is not represented by the scalpel or the pharmacist. Both of those have their place, but if heart disease is going to be effectively treated, you have to address the cause and not just relieve the symptoms. And oftentimes, merely relieving the symptoms does nothing to stop the damage that’s being done. And how is it going to be done?

Wait for it…

Heart disease is primarily caused by the fat, cholesterol and protein coming from the animal products that we eat.

There have been several studies that compared the rate of heart disease in the United States with other countries. The difference, in many cases, is significant. Why?

“Quite simply, it was a case of death by food. The cultures that have lower heart disease rates eat less saturated fat and animal protein and more whole grains, fruits, and vegetables. In other words, they subsist mostly on plant foods while we subsist mostly on animal foods.”4

That’s it! Eliminate the animal products in your diet and you’re now eating in a manner that’s consistent with those areas in the world where heart disease is virtually non-existent. And it’s not enough to just eat animal based products “in moderation.” Especially if you’re trying to keep your pipes clean.

In Moderation?

Your typical fast food meal contains an enormous amount of animal fat. While that sounds unhealthy, there’s more to it than just having to loosen your belt a few notches.

The Endothelium (end-oh_THEE-lee-um) is the lining of our blood vessels and our heart. Your typical American meal injures the Endothelium which is what produces the nitric oxide that keeps the inside of your blood vessels slippery. By keeping it smooth and slick, the chances of anything  getting stuck (i.e. cholesterol, fact, calcium, cellular debris [plaque]) becomes far less. But a meal that is high in fat compromises normal nitric acid production by the Endothelium cells for up to six hours.

That’s a problem and that’s one meal!

Imagine that affect spread out over multiple meals every day for 365 days a year for several years?

Every mouthful of oils and animal products, including dairy foods, initiates an assault on the Endothelium and the membranes that together work to promote healthy heart function.  Having an ice cream sundae as a treat isn’t a deal breaker. Nor is having a steak on a rare occasion going to send you into cardiac arrest. But making animal products a staple in your diet is not healthy.

It’s not healthy.

It’s. Not. Healthy.

Good News

Whether you’re just interested in being healthy or you’re in a spot where you’ve been identified as someone who is at risk of having a heart attack, this is all good news. And it’s not just about heart disease, although that is the number one cause of death in the United States. A whole foods plant based diet has been objectively linked to preventing and even, in some cases, reversing diabetes, cancer and even some neurological disorders.

But if you’re curious about the disease that tips the scales when it comes to causing the greatest amount of deaths in our country, including my Dad when he was only 60 (see sidebar), then this is really good news and I’ll let Dr T. Colin Campbell have the last word..

The future is filled with hope. We no know enough to nearly eliminate heart disease. We know not only how to prevent the disease, but how to successfully treat it. We do not need to crack open our breast plates to reroute our arteries, and we no not need a lifetime of powerful drugs in our blood. By eating the right food, we can keep our hearts healthy.5


China Study | Part III


1. “Prevent and Reverse Heart Disease”, Caldwell B. Esselstyn, Jr., M.D., Penguin Group, New York, NY, 2007, p30-31
2. “The China Study,” T. Colin Campbell, PhD, with Thomas M. Campbell II, BenBella Books, Dallas TX, 2004, p123
3. Ibid, p109
4. Ibid, p105-106
5. Ibid, p130

The China Study | Part III

chinaDoctors vs Dietitians

Doctors don’t get a great deal of academic training when it comes to the way in which one’s diet can prevent and reverse some of the more common diseases that plague our nation’s populace. This, despite the way it has become increasingly clear that diet plays a major role in the way a person can be cured and treated in a manner that is far superior to pharmaceuticals and surgical procedures. And it doesn’t matter if your inspiration is to eliminate sickness or just body fat, you want to align your approach to fitness with the way in which your body functions as opposed to the way it will react to a scalpel or a drug. From that perspective, it can be wise to enlist the help and counsel of a Dietitian.

Still, it can be daunting, and even a little exasperating, when you attempt to sort through all of the information that is out there in an effort to ascertain the ideal diet and exercise regimen that translates to results and not just routines. How do you discern the difference between facts and truth, especially when an authority can be ethical without being completely honest or a resource can be knowledgeable without being totally informed?

You Can’t Argue With Success

I remember once asking my Dad why our family subscribed to the religious practices that we did. Given my father’s propensity for a lengthy response, I was surprised and forever impacted by his response…

“It works.”

That coupled with, “You can’t argue with success” – another “David Gust-ism” – has become a highly effective filter through which I can feel confident in separating facts from fiction, regardless of how compelling either of which may sound.

If you want to lose weight, you have to burn more calories than what you consume. Regardless of how you facilitate that dietary deficit, you must have a deficit of some kind. If your current dietary regimen is not yielding the results you’re striving for, change it. And remember: Starving yourself and / or denying your body the nutrients that it needs may translate to some short term gains in terms of a reduced waistline, but ultimately you need a healthy lifestyle and not a detrimental habit. Not only is that healthy lifestyle going to give you enduring results, it will also provide a number of ancillary benefits that go beyond general aesthetics.

If you want to build muscle, you have to tax the muscles you’re wanting to develop. What you need to accomplish is something called “hypertrophy” (pronounced “high-PURR-truh-fee”). Hypertrophy is defined as “inducing an ‘over-load’ on the working muscles with various training techniques during a bodybuilding workout.” While there is a difference between discomfort and damage, just like to create a dietary deficit, you’re going to be hungry, if you’re working out correctly, you’re going to be uncomfortable. It doesn’t happen by itself nor does it happen in the absence of profuse perspiration.

Those are your bottom lines. Follow those absolutes and you’re well on your way to becoming fit and trim. And as far as the inevitable minutiae that can sometimes surface as seemingly dramatic distractions – what to eat and what not to eat, how to train and how not to train – remember, “It works!” and “You can’t argue with success.” By using those two phrases and ensuring that your  approach can be labeled with both of those statements, you can filter out the news from the noise.

To get to that point, however, from time to time you’re going to have to do a little digging. And by “digging,” I mean some research and not just “google-ing.”

Eggs cause cancer in terms of the dietary cholesterol they represent.

But it’s not just the cholesterol.

Animal protein is accurately touted as a necessary element in a person’s diet that is wanting to build muscle mass because it’s composition is very similar to human protein. In that way,  it represents a very efficient way to build and repair our muscle tissue. However, efficiency is not the same as quality. With animal protein, you’re also getting Cholesterol, Carcinogens and, in some cases, an exorbitant amount of fat.

The natural variety of plant proteins that you encounter every day, however, provides all of the essential amino acids we require, while simultaneously avoiding all of the detrimental effects of animal based protein.

Let me give you an example…

Grab a Shovel – The China Study Debunked?

I’m coming out of the gym and I see a table set up where the staff dietitian had some questions displayed in an effort to get people engaged. One of the questions was: Are eggs a good source of protein? Because I was reading “The China Study” at the time, I confidently responded by saying, “No.” At that point, I was told that I was wrong and I shouldn’t trust the advice of my cardiologist – the “advice” in this instance being that I should read “The China Study” by T. Colin Campbell, PhD and learn how nutrition can prevent and treat heart disease.

Her disposition is not unique, though.

“Get Inspired” is a website featuring the advice and commentary coming from Angela Pifer who is a Functional Medicine Nutritionist with multiple academic credentials and an impressive array of professional accomplishments. She vehemently disagrees with the notion that animal-based protein products are a contributing factor to cancer, and that includes any kind of dairy products. And her web page is but one of a slew of medical journals and professional publications that insist animal protein is not a factor at all when it comes to treating and preventing disease.

Here’s what she says about Dr Campbell’s research:

Let’s dive into the idea that dairy causes cancer – casein and whey are the two proteins in milk. The China Study book, clearly states that dairy causes cancer. What he is basing this off is rat studies. Here is what he presents: in this study rats were either fed a 20% casein diet or a 5% casein diet (so one group of rats is on a 20% protein diet and the other group is on a 5% protein diet). What he and the film Forks Over Knives state is that the rats eating a 20% casein protein diet acquired cancer and saw increased tumor growth on this diet. The rats eating the 5% casein protein diet, did not get cancer. Furthermore, when the rat’s that were eating a 20% casein diet were reduced to 5% casein, the tumor growth slowed. This sounds convincing, doesn’t it?

What he failed to mention is this, in these studies the rats were injected with the highest level of Aflatoxin allowed by the FDA in animal studies. Aflatoxin is the toxin associated with peanuts that cause peanut allergies in some humans. The dose of Aflatoxin administered to these rats was equivalent to a human eating over 100,000 peanut butter sandwiches. The Aflatoxin is what caused the tumor. In fact, if a study is being designed to test a medication, chemical or nutrient on a tumor, Aflatoxin is one of the ways to induce a tumor that you would then test your hypothesis on.

The Rats Eating Less Protein (less casein) Died Faster

What was also not presented was that the rats eating 5% casein actually died at a faster rate than the rats eating 20% casein. Why did this happen? Because detoxification is protein driven and the rats eating the 20% casein protein were kept alive longer by being fed a higher protein diet – long enough for the tumors to grow. Dairy does not cause cancer. Casein does not cause cancer.

Grab a Shovel – The China Study Debunked? Not So Much…

Here’s what I learned by reading “The China Study” myself:

The research project she was referring to was a program that began as a way to combat malnutrition in the Philippians by teaching mothers how to best nourish their children with the most ideal, locally grown foods with an emphasis on protein. Peanuts were the most accessible sources of protein, especially for those who did not live along the coast where fish could be conveniently caught and consumed. There was a problem, however, in that it wasn’t uncommon for peanuts to be contaminated with a carcinogen called “Aflatoxin” (AF).

Before focusing on nutrition, they chose to first investigate AF since that was prevalent in peanuts, their preferred source of dietary protein. They found it to be very common in peanut butter and the affects of the contaminated legumes were seen primarily in children in the form of liver cancer. As they continued their research, however, a pattern began to emerge that went beyond the consumption of peanuts. Liver Cancer was not limited to those who were malnourished or had unwittingly ingested the AF carcinogen in the form of contaminated peanut butter. It was a common disease among children, yes, but many of the children that were dying before they reached the age of ten were coming from the best-fed families that were consuming more protein than the majority of their peers.

At this point, the focus changed. Those parts of the world that had the most cases of cancer were also among those that were the most malnourished. It was therefore assumed that the better the diet, with an emphasis on protein intake, the better the chances of a person not getting cancer. But now, what began as a strategy to combat malnutrition by promoting a diet rich in protein intake, was being retooled to find out if animal based protein was actually a catalyst for the growth of a cancerous cell as opposed to the long held belief that protein prevented the growth of cancer cells.

For a scientist, this was not a popular, let alone a career enhancing, path to take. In addition to cultural convention and scientific tradition, there was also a huge industry behind things like beef, poultry, fish and eggs. To uncover anything truly credible that revealed animal protein as a detriment to good health would be a significant blow to those profit margins associated with meat, chicken and dairy products.

Still, you go where the evidence takes you and this is what lead to Dr Campbell’s three decades worth of well documented and thoroughly researched conclusions that compellingly decries the consumption of animal products.

Angela’s first criticism of Dr. Campbell’s book, “The China Study” implies that it was AF that caused the cancer and the varying degrees of protein consumption had nothing to do with the growth or the deterioration of the cancer cells. She’s correct in saying that AF was the dietary villain that caused the cancer. What she fails to acknowledge is that the amount of AF was fixed in both scenarios…

One group was given AF and then fed diets containing 20% protein. The second group was given the same level of AF and then fed diets containing only 5% protein. It was not a trivial difference; it was 100% versus 0%. This was very much consistent with my observations for the Philippine children. Those who were most vulnerable to liver cancer were those who consumed diets higher in protein. 1

Later, Dr. Campbell facilitated a study that allowed for the adjustment of the AF dosage. They found they could turn  the growth of cancer cells “on” and “off” by adjusting the amount of animal based protein being fed to the laboratory rats.

Angela again takes aim at Dr. Campbell’s research again by saying the rats eating less protein died faster. Frankly, I’m not sure where she gets this information as “Appendix A” of Dr. Campbell’s book provides additional information about the experiments on the laboratory rats including the overall health of the rodents on a low-protein diet.

Many researchers have long assumed that animals fed diets this low in protein would not be healthy. However, the low-protein animals were healthier by every indication. They lived longer, were more physically active, were slimmer, and had healthy hair coats at 100 weeks, while the high-protein counterpart rats were all dead.2

But here’s the kicker: Not all proteins are created equal.

Here’s another snippet from Dr. Campbell’s book:

If you have followed the story so far, you have seen how provocative these findings are. Controlling cancer through nutrition was, and still is, a radical idea. But as if this weren’t enough, one more issue would yield explosive information: Did it make any difference what type of protein was used in these experiments? For all of these experiments, we were using casein, which makes up 80-85% of cow’s milk protein. So the next logical question was whether plant protein, tested in the same way, has the same effect on cancer promotion as casein. The answer is an astonishing “NO.” In these experiments, plant protein did not promote cancer growth, even at the higher levels of intake.3

Plant-Protein-DanielHenryFitness-1While animal protein would be considered “high quality” because of the way it is so readily synthesized by our body, it brings with it cholesterol, carcinogens, added hormones and bacteria. On the other hand, plant based protein, while it provides all of the 9 essential amino acids, doesn’t include the aforementioned problems and instead includes healthy fiber, antioxidants and a variety of vitamins and minerals.

You Can’t Argue with Success…But Does it Work?

So, back to my original “filter” – You can’t argue with success! That statement seems to apply…

…but does it work?

Consider this:

Dr Caldwell B. Esselystn, Jr is an incredibly accomplished surgeon who works at the renowned Cleveland Clinic, one of the premier cardiac treatment facilities in the world. At one point, he wrote:

Eleven years into my career as a surgeon, I became disillusioned with the treatment paradigm of U.S. medicine in cancer and heart disease. Little had changed in 100 years in the management of cancer; and in neither heart disease nor cancer was there a serious effort at prevention. I found the epidemiology of these diseases provocative, however: Three quarters of the humans on this planet had no heart disease, a fact strongly associated with diet.4

He was inspired to launch a revolutionary approach to heart disease treatment by having his patients engage a plant-based diet with minimal medication. Within the 8 years leading up to the study, these 18 people had suffered through 49 coronary events, include angina, bypass surgery, heart attacks, strokes and angioplasty. In the following 11 years, there was exactly 1 coronary event of the 18 he started with. In addition, 70% of his patients saw a reversal of their heart disease.

However dogmatic someone might want to be in their criticism of a plant based-diet when it comes to fitness and the prevention / reversal of terminal diseases, it becomes suspect when you look at the people who have changed their dietary habits and been able to benefit dramatically by avoiding animal products.

It works…

Bottom Line

Again, there is a great deal of information out there and it can be a daunting task to sort through the data and locate a credible bottom line. But that bottom line does exist. Does it work? Beyond the “facts” and the “statistics,” does the information translate to real results? You can’t argue with success. If the information is credible and lines up with the truth, it will yield results that go beyond debates and even academic credentials.

To lose weight you have to burn more calories than what you consume. If you want to build muscle, you have to tax that muscle to the point where it’s uncomfortable and not just mildly challenged. And if you want to avoid the liabilities that go along with animal-based proteins, switch to a plant-based diet and you get all the benefits without the consequences.

It works and you can’t argue with success!

 China Study | Part II <- -> China Study | Part IV


1. “The China Study”, T. Colin Campbell, Thomas M. Campbell, BenBella Books, Dallas TX, 2016, p28
2.  Ibid, p371
3.  Ibid, p51
4. Ibid, p115-116

Postscript: There have been some very outspoken critics of Dr Campbell. In some instances, he’s refuted some of their criticisms and you can read some of his responses by heading out to Chris Masterjohn and Denise Minger

Also, when God first put man on the planet, he gave them fruits and vegetables to eat (Gen 1:29). Meat wasn’t on the menu. That came later after the flood (Gen 9:3). While meat is obviously permissible, with some exceptions (Leviticus says “No” to Pork and Shellfish along with some other meats), I’m willing to subscribe to the idea that eating fruits and vegetables is consistent with the way we were originally designed and that’s enough for me to embrace it as a credible way to thrive and stay healthy – especially when dairy and meat products have been linked to diseases that can prove to be toxic. I don’t think eating a steak is going to put you in the grave, but I think if make it’s a staple rather than a treat, you’re placing a burden on your health that doesn’t need to be there.