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Has Denise Minger Read 'The China Study'? -- A Collective Rebuttal

Has Denise Minger Read ‘The China Study’? –- A Collective Rebuttal

This will be a series of posts examining Denise Minger’s critiques of “The China Study” (TCS) by various contributors including myself. Since we all live busy lives, this format will allow us to reflect on the different components of her critique as time permits.

Regarding the title, it seems to be a strange question. Denise is undoubtedly a precocious, bright, and hard working young woman. Surely someone who had written a series of apparently thorough and impressive critiques of TCS would know the book like the back of her hand, right? How could anyone doubt whether she has read the entire book?

The question is actually quite understandable, and in the following series of posts myself and others will demonstrate why, in addition to scrutinizing the numerous claims she makes.
 
I will outline here 3 major flaws in Minger’s critiques:

1) The author does not appear to be familiar with many of the objectives, content and key concepts presented in TCS. The intent, message and implications of the book are misrepresented to her readers and strawman arguments abound.

2) In spite of claiming to maintain neutrality, the author shows an unmistakable bias in favor of animal foods in her analysis.

3) As a result of this (and lack of experience in the field of epidemiology) much of the data examined and analyzed by the author is misused and/or misinterpreted.

The following acronyms will be used in this thread:

TCC – T. Colin Campbell (author of The China Study along with his son Tom)
TCS – The China Study (2006 book)
TCP – The China Project (the actual 'China Study' itself, including its collected data)
MFAR - Minger's Formal Analysis and Response (40 pg. PDF)

For those unfamiliar with TCS see this link:
http://webarchive.human.cornell.edu/chinaproject/index.html

--

Table of Contents

1) Minger's Misuses of The China Project Data ** [special thanks to Veganmama18 for her huge contributions to this entry]

2) "Plant Foods Good; Animal Foods Bad"

3) There's Carcinogens and There's Carcinogens

4) Healthy Animal Foods Part 1: What About CLA?

5) Does Animal Protein Promote HBV-Induced Liver Cancer in Rural China?

6) B's Response to Denise #1

7) B's Response to Denise #2

**Note: After writing these posts I was informed that I was incorrect re: ch. 4 of TCS being based on both TCP I and II, it is only based on the former. Apologies to Minger and my readers on that point. This will be reflected in future posts and/or possible revisions to current ones. Nevertheless, the rest of my substantive criticisms still hold.

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Minger’s Misuse of The China Project Data Part 1

One of Minger’s recurring criticisms of TCC is that many of his claims regarding the connection between animal food consumption and disease are not supported by TCP data. There are a number of explanations for this and unfortunately they are not good news for Minger’s credibility:

1) The data she examines in her analyses is incomplete. All the correlation she cites in her analyses are solely from The China Project I data set collected in 1983. The 1989 China Project II data, which shows significant changes in terms of diet, disease and their risk factors from TCP I, is entirely omitted. The claims made in TCS with which she takes issue are based on findings from both.

While she does make it clear in one of her entries that she’s only using the 1983 data, this decision presents a serious problem in her entry “The China Study: Fact or Fallacy?” where she scrutinizes 6 claims outlined in a summary based of a presentation by TCC of the preliminary findings of the China Project II data (collected in 1989). This presentation was given in 2001, 4 years before TCS itself was released. Note the title of the summary is “China Study II: Switch to Western diet may bring Western-type diseases” (emphasis added).
http://www.news.cornell.edu/chronicle/01/6.28.01/china_study_ii.html

Looking at only half the data being discussed makes it somewhat difficult to accurately comment on the veracity of the claims TCC presents. In spite of this she cites this summary’s claims in her formal response 7 times.

This of course does not necessarily invalidate everything Minger has to say about TCS but it doesn’t do much to serve her cause. In addition to looking at the entire data set it may have been more helpful to spend her time addressing claims presented in TCS based on the entire body of research presented in the book (and not just TCP which is only covered in-depth for 1 out of 18 chapters) such as:

- Dietary change can enable diabetic patients to go off their medication.
- Heart disease can be reversed with diet alone.
- Breast cancer is related to levels of female hormones in the blood, which are determined by the food we eat.
- Consuming dairy foods can increase the risk of prostate cancer.
- Antioxidants, found in fruits and vegetables, are linked to better mental performance in old age.
- Kidney stones can be prevented by a healthy diet.
- Type 1 diabetes, one of the most devastating diseases that can befall a child, is convincingly linked to infant feeding practices.

[TCS p. 3]

All these claims are well supported in the book and would be difficult to argue against, though it would be enjoyable seeing critics of TCS try to do so.

2) Minger uses only the data from the 1990 printed monograph rather than the online data which has been updated and corrected by TCC’s colleagues in China and is considered to be more suitable for analysis. In other words the data from the 1990 monograph is outdated.

It is unfortunate that Minger did not attempt to contact TCC before making her critiques available to the public since he might have been happy to explain to her how to properly use and interpret the data.

3) She doesn’t omit Tuoli from her analysis on meat and disease

As pointed out by TCC, since the data collected on Tuoli’s meat consumption for the 3 day food survey for the 1983 data was inaccurate (they were apparently ‘feasting’ on unusually high quantities of meat to impress the researchers) virtually all the correlations she cites between meat and disease in her entries and writings on TCS are skewed (save the few entries in her formal response in which she does omit Tuoli).

Again this does not invalidate everything Minger has to say but it makes much of her discussion around meat and disease rather problematic. Had she used the online data this would likely not be an issue since much of the data on Tuoli appears to be corrected.

4) She ignores a number of TCC’s cautions regarding the improper usage of TCP data outlined in the 1990 monograph.

TCC writes in the original TCP monograph on some issues concerning the use and misuse of univariate correlations:

…both for univariate correlations and, still more so, for multivariate correlations, large numbers of false negative [meaning we may not see a correlation when there is in fact a relationship] and false positive [we observe a correlation when in fact no relationship exists] results must be expected. Particular correlations cannot, therefore, be considered in isolation from other evidence from other sources as to which are likely to be artifacts of chance or of confounding. The major task is to determine which of the very large number of statistically significant associations results from the play of chance and which are biologically plausible...
[TCC, TCP monograph 1990]

In other words even statistically significant correlations in this database are not necessarily meaningful, thus they cannot all be treated equally at face value. Yet this is exactly what Minger does throughout most of her analysis: systematically examining each univariate correlation she cites between animal foods and chronic diseases like cancer and heart disease as if none could be the product of chance. Univariate correlations are not inherently misleading nor is their usage always inappropriate but they must be considered carefully wherever used.

Ignoring this warning she goes on to interpret what these correlations appear to show. In her analysis of meat and disease for instance she makes statements like “meat actually seems protective of heart attacks and coronary disease—at least based on the China Project data set”[*] without considering whether the range and minimum values of relevant variables like total cholesterol, meat intake, and heat disease mortality are adequate to make this sort of statement. Nor in this case does she attempt to establish the biological plausibility of this claim. Certainly Esselstyn’s and Ornish’s ground-breaking studies on the treatment of heart disease with diet for instance suggest quite the opposite.

Her interpretation of the univariate correlations continues in the same entry with the following statements:

…meat sure doesn’t look like the cancer-causing villain we might expect from reading “The China Study”: Its intake correlates negatively with the average for all cancers, which is a fairly important indicator.

And:

The only thing we can say is that meat isn’t playing a convincing role as a cause of all vascular diseases and most cancers.
http://rawfoodsos.com/2010/06/01/a-closer-look-at-the-china-study-m...

This is not to mention of course that these sorts of statements are based on only half the total data which may be largely inaccurate with respect to meat and disease mortality, but hey, everyone makes mistakes.

TCC also makes it quite clear in TCP monograph that the data is not simply something you read cover-to-cover and all the secrets on the connection between diet and disease are revealed:

No attempt is made to provide in this monograph any detailed interpretations of the associations between dietary, metabolic, life-style, and environmental variables and disease mortality rates. Instead, all that is offered are the basic data together (in this and in Chapter 6) with some notes on various general principles and specific pitfalls that may be relevant to the interpretation of the data.
[TCC, TCP monograph 1990]

Yet this following statement from an early entry on TCS makes one question whether she believed completely otherwise from the onset:

…this book [TCP monograph] connects the dots between consumption of specific foods, nutrient status, lifestyle factors, diet habits, and chronic diseases…You can look up fruit consumption, for instance, and see what diseases it correlates with or seems to protect against…
http://rawfoodsos.com/2010/05/25/exciting-update/

5) In spite of all the errors she commits in her use and interpretation of TCP data she insists in later entries that her use of the univariate correlations in her analyses was intended to instruct TCC on his ostensible misuse of the china project data:

Denise writes:
The graphs I posted were not intended to stand as new hypotheses or conclusions about the data. I apologize if I didn’t make this abundantly clear. Their sole purpose was to demonstrate, to the general layperson, how raw correlations (in the instances Campbell used them) can be misleading—as well as show how dramatically a single confounder can affect a correlation and make a positive trend appear where there may not be one at all. The graphs and explanations were meant to be illustrative, not exhaustive.
http://rawfoodsos.com/2010/07/16/the-china-study-my-response-to-cam...

Meat being “protective” of heart disease and cancer seems like new (and unproven) hypotheses to me but I digress.

And from one of her blog comments:

…I’m showing how his use of such correlations is misleading, particularly regarding the lack of adjustment for confounding variables.
http://rawfoodsos.com/2010/07/07/the-china-study-fact-or-fallac/

Given everything described in this post these statements are simply not plausible. According to her entry on meat and disease her original intent was nothing of the sort:

My goal here is solely to look at the original China Study data and see what it says. When Campbell’s conclusions seem valid, I’ll point it out. When Campbell’s conclusions seem awry, I’ll point it out.
http://rawfoodsos.com/2010/06/01/a-closer-look-at-the-china-study-m...

In fact she makes absolutely no mention the term ‘univariate correlation’ in her entries before TCC made his initial response to her. It is doubtful that she was even aware of the issues on the use of univariate correlations TCC originally raised in TCP, and which he reiterates in his initial response to her here:

As far as her substantive comments are concerned, almost all are based on her citing univariate correlations in the China project that can easily mislead, especially if one of the two variables does not have a sufficient range, is too low to be useful and/or is known to be a very different level of exposure at the time of the survey than it would have been years before when disease was developing. There is a number of these univariate correlations in the China project (associations of 2 variables only) that do not fit the model (out of 8000, there would be) and most can be explained by one of these limitations.
http://tynan.net/chinastudyresponse

TCC it seems is not the one who needs to be instructed on the misuse of his data.

There’s much more to say on Minger’s misuse of TCP data in future posts. For now we can summarize that her repeated assertion that TCC’s claims do not match TCP data is completely understandable: she’s using incomplete, outdated, inaccurate data and in the majority of cases it is highly questionable whether she has the experience to even begin knowing how to interpret it. As a result she fails to disprove the majority of the claims TCC presents regarding the TCP findings and whatever possibly valid points of criticism she might make regarding the data are at best inconclusive.
Wow, ths is excellent work, B! I've just read this first section so far and am so impressed by the clarity of your thinking and writing. You substantiate your points with appropriate quotes and make your case convincingly. What you say makes sense to me (Prad would say, that's not easy to do! I am a very layperson)) so even though you've been eloquent and at times technical, you have stated your points simply enough for me to understand. This is great! I look forward to reading the rest!
the ranjana writes:
I am a very layperson

don't believe her, B!! she has degrees in biology, masters in social work and has done ground-breaking national projects for the federal gov. she knows the score really well!

but she is correct - your clarity is really very fine!

in friendship,
prad
“Plant foods good; Animal foods bad”

While Minger presents herself as being an expert on TCS, she does not appear to understand the central message of the book, and as a result leaves her readers with the inaccurate impression that TCC’s bias against animal foods is so extreme that he completely neglects to consider the role any plant foods may play in the development of chronic disease.

So what does Minger think the message of TCS is? The introduction of MFAR states that TCC’s hypothesis is “not altogether wrong but, more accurately, incomplete” [MFAR, p.2]. It is not clearly stated here what his exactly his hypothesis is, other than suggesting:

…his [TCC’s] 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.
[MFAR p.2]

In her previous critique entries, she describes TCC’s hypothesis variously as animal products are “universally harmful” [*]; that they are a “potent, universal cause of disease” [*] and that TCC’s “ultimate message is that animal protein unequivocally causes cancer (as well as other chronic conditions like heart disease and diabetes), and he claims in no uncertain terms that the China Project data supports this conviction” [*]

Unfortunately these simplistic and unqualified statements do not accurately reflect the message of TCS and seem to ignore 1) TCC’s cautions in ch. 2 of TCS that absolute proof is virtually non-existent in the study of human health and nutrition, and that research can only show us the likelihood that certain nutrients or foods may help cause or prevent disease [TCS p. 38]; 2) that multiple factors are involved in the development of chronic disease, for example (as discussed in ch. 11) genes are involved in ALL disease as they are in all biological processes, and greatly influence what health conditions we are susceptible to, even though ultimately environmental factors including diet are far more significant than genetics [TCS p. 233]; 3) in most cases TCC is not arguing that animal products are a necessary and sufficient cause of particular chronic diseases, but that when consumed in excess they are one of the most significant risk factors for virtually all major chronic diseases [TCS p. 308]; 4) even though some research suggests that small quantities of animal foods may be harmful, TCC makes it clear that this has not been conclusively proven [TCS p. 242] and that the concerns associated with the consumption of animal products and the development of chronic disease are largely a function of level of intake, e.g. in the case of TCC’s early experiments on protein and cancer, all the laboratory animals being fed CASEIN at a dose adequate to meet their physiological needs for protein (6% of total calories) showed little or no signs of cancer development and were by every indication extremely healthy in spite of being given extremely high doses of one of the most potent chemical carcinogens known (aflatoxin) or being genetically predisposed to liver cancer (via HBV infection) [TCS p. 352]; 5) that no single study, even the most comprehensive epidemiological study ever conducted, can tell us everything there is to know about the relation between diet and disease, which is why instead of relying strictly on TCP data he examines a very broad range of evidence to support the case against animal products in TCS. This is a point the majority of the books critics still do not seem to get, even though TCC has been saying this repeatedly for years.

To summarize, Minger’s statements listed above are gross over-simplifications of the book’s message, and her last statement in particular (“animal protein unequivocally causes cancer”) is completely inaccurate as far as what TCS claims. I will discuss this point in detail in my next post on TCC’s experimental animal studies.

In addition to oversimplifying and misrepresenting TCS’s message, Minger repeatedly claims that TCC has an inherent bias in favor of plant foods and against animal foods which causes him to misrepresent the data of TCP:

My biggest concern is with the way data appears to be cherry-picked to create a “plant foods are good” and “animal foods are bad” dichotomy when the actual data from the China Study (as well as from Campbell’s own research) does not reflect this.
http://rawfoodsos.com/2010/07/16/the-china-study-my-response-to-cam...

I will begin to address the issue of data misuse as a result of bias in my next entry. For now I will discuss the accusation of bias in TCS in general.

On the one hand this is a strawman; make no mistake, TCS presents a powerful case against consuming animal products. It is completely fair to say that TCC is biased against animal foods, not due solely to personal prejudice or superstitious belief, but because of what TCP findings and the vast body of additional research covered in TCS suggests, not to mention the compelling ethical, environmental and economic factors which further support abstaining from these foods. Minger and others may have preferred he presented animal foods in a more positive light, but whatever health advantages consuming animal foods may have is greatly outweighed by the disadvantages according to the majority of reputable research.

On the other hand, suggesting that TCC is biased to the degree of attempting to uphold a completely black-and-white view such as “plant foods good; animal foods bad” is greatly overstated.

As said previously, whether or not this was intended, one gets the impression from reading Minger’s critiques that TCC neglects to consider the role that plant foods may play in the development of disease at all. Consider the following statement by Minger:

The book [TCS] focuses myopically on the effects of animal foods while not even mentioning the (incredibly strong) associates certain vegan foods [sic] have with disease

http://rawfoodsos.com/2010/06/01/a-closer-look-at-the-china-study-m...

Also, in addition to stating in MFAR introduction that TCC overlooks other non-animal food related diet-disease patterns, section 1.5 of MFAR is dedicated to scrutinizing TCC’s “Biased use of unadjusted univariate correlations to confer protective benefits of plant foods but not with animal foods”. Overlooking possible health problems associated with plant foods is indeed a serious accusation which must be examined here.

To summarize briefly the particular plant foods Minger accuses TCC of neglecting to consider are wheat flour, vegetable oil, refined sugar and starches (she also mentions possible correlations between cereal grains in general and heart disease but we will discuss these in a later entry). What all these foods besides wheat have in common is that they are highly refined plant foods, which TCS clearly recognizes as promoting ill health when consumed in excess. If there are any inherent health problems associated with wheat flour consumption, it is most likely from its highly refined forms (note that TCP does not distinguish between white flour, whole wheat flour, and enriched vs. unenriched). Currently this is the only biologically plausible explanation. In any case wheat and chronic disease in TCP will be discussed further in future entries.

There are other instances in Minger’s critiques which claim TCC neglects to consider the role refined plant foods may play in the development of disease, notably in section 5.3 of MFAR (“Whole-food, plant-based diets versus whole-food diets with animal products”).

This section dedicates nearly an entire page to describing the specific refined plant products proscribed by numerous physicians who use a plant based diet to treat disease, including John McDougall, Neal Barnard, Caldwell Esselstyn etc. [MFAR p. 28] She then quotes Joel Fuhrman stating that someone eating a low fat, junk food vegan diet, with few whole plant foods would be more susceptible to disease than someone eating a predominantly plant-based diet along with small quantities of animal products, as if this was a shocking statement coming from a doctor who recommends his patients consume a vegan diet, or that TCC might somehow disagree with this statement.

It is extremely curious why she would’ve gone to the trouble of writing all this when TCS states 1) that those eating a plant-based diet consisting mostly of “pasta made from refined flour, baked potato chips, soda, sugary cereals and low-fat candy bars…will not derive the health benefits of a [whole-foods] plant-based diet” and that “eating this way is a bad idea” (emphasis included) [TCS p. 99]; 2) that for those new to a plant-based diet, carbohydrates (including specifically non-whole grain pastas, white bread, crackers, sugars, cake and pastries) and added vegetable oils (e.g. corn oil, peanut oil, olive oil) should be ‘minimized’ [TCS p. 243]; 3) the book lambasts the candy industry for their attempts to influence prominent health organizations including the U.S. Food and Nutrition Board (FNB) and the World Health Organization (successfully in the case of the FNB) in favor of their products [TCS pp. 309-310]; 4) and even cites a study demonstrating the cancer-promoting properties of refined sucrose [TCS p. 351]. This is a book espousing the benefits of a diet based on whole plant foods, and it clearly exhibits no categorical bias in favor of all plant foods. Furthermore, even though the health consequences of animal foods are a primary focus of the book, any new findings from the TCP data (or future studies) suggesting increased disease risk from these foods would be entirely consistent with the overall message of TCS. Remember that TCP is only discussed in depth for one chapter of TCS, it is not the sole focus of the book.

Yet in the conclusion of MFAR, Minger continues to insist that TCS’s arguably most egregious sin of omission is its ostensible failure to discuss the possible pathogenic effects of refined and processed foods:

Rather than studying the dissimilarities between healthy populations, perhaps we should examine their areas of convergence—the shared lack of refined carbohydrates, the absence of refined sweeteners and hydrogenated oils, the emphasis on whole, unprocessed foods close to their natural state, and the consumption of nutritionally dense fare rather than empty calories or ingredients concocted in a lab setting.
[MFAR p. 31]

Huh? I think all of us know by now that processed/refined foods from plant or animal sources are bad for us. Certainly TCS doesn’t leave any room for doubt on that issue. But she goes on:

By naming animal products as the source of Western afflictions, Campbell has created a hypothesis valid only under hand-picked circumstances… This is a symptom of a deficient theory, embodying only partial truths about broader diet-disease mechanisms.
[MFAR p. 31]

As we have already established, this is simply not TCC’s hypothesis. Whether intentionally or not, Minger has portrayed TCC’s theory throughout her critiques as (to paraphrase her own words) “plant foods good; animal foods bad”. This does a huge disservice to her readers, particularly those not familiar with the book.

To return to the subject of bias in TCS, the issue many readers seem to have with TCS I believe relates to the book’s title. The book is called The China Study: The Most Comprehensive Study of Nutrition Ever Conducted, yet it is not about TCP ("The Grand Prix of Epidemiology" according to the NY Times) itself exclusively or even primarily. I think a number of readers may feel mislead or disappointed about the book’s content given its title. This is understandable; the title unfortunately was the decision of the book’s publisher, which TCC was not happy with but reluctantly conceded to due to the challenges in finding a suitable publisher.

Perhaps if the entire book were dedicated to solely to discussing the findings of TCP, TCC may have spent more time focusing on the negative effects of certain refined plant foods or even non-dietary factors altogether. However, like it or not, TCC did not decide to write this sort of book. The purpose of TCS is not to discuss the advantages of including large amounts of animal products in one’s diet. The book is intended to demonstrate to its readers 1) that diet is one of the most significant factors in the development, prevention, and even reversal of chronic disease; 2) that animal foods when consumed in excess may be one of the most significant factors in increasing disease risk in terms of diet; 3) and urges its readers to consider adopting a whole foods, plant based diet and enjoy its many proven health benefits.

It’s not news to most people that soft drinks and donuts are bad for you; for almost everyone however, learning that animal protein may be bad for you is absolutely shocking, since this is the opposite of what the media, government and medical establishment leads us to believe.


Even if you think TCC is a total fraud and that every word he writes in TCS is false (you don’t have to buy what TCC says without checking the facts yourself of course, no one need take what anyone says on faith alone, even those with credentials and a long distinguished career), humor me and imagine the following scenario: what if everything TCS claims were indeed true, and this information were NEVER to reach the public. What would the consequences of this be? Done correctly, this little thought experiment may help you better understand why TCC wrote the TCS the way he did.

The fact that Minger misunderstands the message of TCS raises the question of how familiar she is with the book itself. I find it disappointing that someone who took the time to write a lengthy critique of a book did not seem to take the time to understand what it is actually trying to communicate to its readers.
“There’s Carcinogens and There’s Carcinogens”

At times Minger’s lack of familiarity with the book she is critiquing is simply alarming. In this entry I will demonstrate how Minger does not appear to fully understand the true role casein/animal protein plays in the development of cancer as described by TCS. As a result of this misunderstanding, an unmistakable bias in favor of animal foods becomes evident in her critiques.

What proof do I have of this? Consider the following:

As mentioned in our previous entry, if it is indeed true that TCC claims “animal protein unequivocally causes cancer” [*] as Minger states, how can it be that the diagram on p. 64 of TCS clearly shows that the control group of mice uninfected by hepatitis B virus (HBV – one of the greatest risk factors for liver cancer in humans) fed a 22% casein diet (which is a very high amount) did NOT show any signs of liver cancer development?


The answer is simple: TCC never makes such a claim. Casein/animal protein is always used in conjunction with another carcinogenic agent to literally turn cancer growth on/off in the experimental animal studies described in TCS. The book never says animal protein is a necessary and sufficient cause of cancer. This is a crucial point which many of TCS’s readers miss, even those who already consume a plant-based diet.

Other than mentioning in passing that casein was shown to enhance cancer development in rats exposed to aflatoxin [*], based on her above statement and many others (some of which we’ll discuss here later) it does not appear Minger fully grasps this concept. Oddly enough, she never mentions the research on the effect of protein on liver cancer in HBV transgenic mice in any of her critiques, yet she discusses the HBV/liver cancer connection numerous times.

For now I would like to take a bit of time to describe the most fundamental concept regarding cancer etiology in TCS: The 3 stages of cancer development. This concept is essential to understanding how casein and animal protein can act on the body to produce cancer.

As described in ch. 3 of TCS, cancer is recognized by the scientific community as developing through 3 primary stages: 1) Initiation 2) Promotion 3) Progression.

1) The initiation stage, which is virtually always a genetic event, involves the mutation of a cell’s genes by either an external agent (natural occurring or man-made chemical; virus; exposure to radiation, etc.) or the expression of a ‘bad’ gene inherited from one’s parents (e.g. the breast cancer genes BRCA-1 or BRCA-2). The progeny of these cells will all be mutated in the same manner, which sets the potential for cancer development in motion. This stage occurs in a short time frame (often within minutes) and is considered to be irreversible.

2) The promotion stage involves the proliferation of cancer cells over a longer period of time. It may continue for many years if not decades before tumors are even detectable. Certain conditions need to be present in the body for cancer cells to continue to proliferate during this phase (more on this shortly).

3) The progression stage is considered to occur after many years of cancer promotion when the terrible symptoms of advanced cancer begin to manifest (including tumor malignancy, metastasis, etc.), often ultimately resulting in the death of the patient.

The first 2 stages are the most important for us to consider here. Many of the chemical compounds we think of as carcinogens act as cancer initiators, e.g. substances like DDT, aflatoxin, or nitrosamines. TCS convincingly argues however we should be far more concerned about substances that act primarily during the promotion stage if we want to reduce our risk for cancer. In short, what the experimental animal studies examining the effect of dietary protein on cancer development described in TCS ultimately show is that:

1) the promotion stage is far more significant than the initiation stage (even when cancer initiating chemicals are administered at very high doses) in determining whether cancer will develop to the progression stage since the promotion stage is largely reversible.

2) diet is far more significant than genes or chemical cancer initiators in determining whether one will succumb to cancer because different diets can help cause, prevent or even reverse cancer promotion.

3) of all known dietary promoters of cancer, the most significant is protein, specifically casein (the main protein in cow’s milk) and animal derived proteins in general.

To borrow the lawn analogy from TCS, protein is like fertilizer; it promotes growth. Not enough fertilizer, the lawn won’t grow. Just the right amount of fertilizer and it will thrive. Too much of the wrong kind of fertilizer however (i.e. animal protein) and the lawn will proliferate out of control and overrun the garden, driveway, sidewalk, etc.

Casein (and animal protein in general) functions as a cancer promoter when fed in excess of the body’s requirements (other substances can also function as promoters of cancer, e.g. cigarette smoke). As illustrated in the diagram above, casein fed alone was not shown to initiate cancer. So consuming a lot of animal protein does not necessarily mean one will get cancer.

However, most animal-based foods may contain various cancer initiators, either from cooking or preserving techniques (nitrosamines in bacon; heterocyclic amines and/or polyaromatic hydrocarbons in well done meat, etc.) or synthetic chemicals found in the environment/sprayed on the animal’s feed (DDT, dioxin, etc). In the case of environmental toxins and pesticides, these substances accumulate in the fatty tissues of animals over their lifetime since many of these man-made substances are difficult for organisms to metabolize. Due to ubiquitous pollution of our environment, even wild or organically fed animals may be exposed to significant quantities of these chemicals. Consider, for instance, all the poisons found in our oceans at this moment, which fish and so-called ‘seafood’ are swimming in, particularly in the Gulf of Mexico.

Furthermore, humans may be exposed to carcinogenic substances on a daily basis; the cancer initiation process may be ongoing in our body. Our body can defend against the development of these rogue cells quite efficiently, but the evidence strongly suggests that if we eat the wrong things we can cripple our body’s ability to fight off cancer. The good news is we have great control over reducing our risk for cancer (and many other chronic diseases) by shifting our eating habits towards a plant-based diet.

It would seem then that the daily consumption of large quantities of potential dietary cancer promoters (animal-based foods), which are also loaded with various cancer initiators, is like playing Russian roulette with one’s health. But hey I guess some people like to live a bit dangerously.

In spite of what ch. 3 of TCS clearly describes however, Minger does not seem to understand that, for instance, animal protein functioned as a cancer promoter in the laboratory mice infected with HBV, while the mice fed lower protein intakes showed dramatically fewer signs of cancer development.


For those not yet convinced of this, it is easily demonstrated: In MFAR, Minger seems to leave her readers with the impression that even though TCP I data shows a strong correlation between fish consumption and hepatitis B virus (HBV), she suggests the latter is ‘the sole cause’ of liver cancer, ostensibly according to a study of TCC’s [MFAR p.6]. Indeed in her previous blog entry on fish and disease in TCS, she notes that although (in TCP I) fish intake has an overall high and statistically significant correlation with liver cancer (+47), in coastal areas, where the most fish was consumed and where liver cancer mortality was highest above all other regions, the disease had a greater correlation with HBV infection than fish consumption. Thus she concludes:

…this is one disease that, in the China Study populations, has very little to do with diet: It’s linked pretty blatantly to hepatitis B infection across all counties…it looks like fish-eating regions had a lot of HPV[sic]-induced liver cancer, but diet [i.e. fish consumption] wasn’t the cause.
http://rawfoodsos.com/2010/06/09/a-closer-look-at-the-china-study-f...

Since fish protein was shown to promote pancreatic cancer under the same conditions as casein on experimental animals [TCS, p. 66], it is entirely plausible that it could also have the effect of promoting HBV-induced liver cancer in humans. The possibility that consuming high quantities of fish for instance could promote HBV-induced liver cancer in these coastal Chinese populations should not be overlooked or brushed aside, as Minger does here.

From this oversight, a pattern in Minger’s critiques emerges:

- Fish consumption doesn’t cause liver cancer, it’s HBV.
- Animal foods don’t increase risk for breast cancer, canola oil does [MFAR p. 5].
- Meat and eggs don’t cause colorectal cancer, it’s schistosomiasis [MFAR. p. 8]
- Cholesterol is not a useful predictor of disease risk; blood sugar is [MFAR pp. 3; 9-13].
- Green vegetables don’t reduce risk for heart disease, animal foods do [MFAR pp. 6-8][*].
- Whereas wheat (*gasp* a PLANT food) may increase heart disease risk!!! [MFAR p. 25]
- Animal foods don’t cause cancer/heart disease/diabetes, it’s processed/refined/non-organic foods [MFAR p. 31]

In the case of cancer (in the instances mentioned above and numerous others), Minger is consistently operating from the assumption that animal protein is claimed to be a singular cause of cancer by TCC. Thus she dismisses data showing strong correlations between animal foods and cancer because of other factors which she considers to be confounders, but which in reality may also work in conjunction with animal foods in increasing cancer risk (e.g. HBV) or be additional risk factors on their own (e.g. added vegetable oils). In the other instances she repeatedly attempts to dismiss the factors that depict animal foods negatively and plant foods positively (each of which can be discussed in detail in future entries).

The overall effect of this either/or pattern of thinking is that while she projects an extreme pro-plant foods bias onto TCC and TCS, she herself exhibits a pro-animal foods bias in her critique, even though she claims to be neutral. This is not to say that she is entirely wrong in all instances, but that her argument is rather lopsided. Whatever truths she has uncovered may only be partial at best, especially considering she is attempting to use TCP I data to disprove claims based on both TCP I & II findings.

It seems that Minger is more interested in discounting TCC’s claims regarding diet and disease than she is in taking the time to understand what he’s arguing. This is great if you like hearing good things about your bad dietary habits, but not if you’re interested in the truth.
Wow. Way to take the time to do this thoroughly, B. I had caught a few of your points during my initial read through of her critique, but you blew me out of the water.

Have you sent this off to Denise?
Thanks for reading Andrew. We're currently getting our blog bandits organized to post this all over the blogosphere and other forums. We're aiming for top-notch rankings in google.
well it deserves it B!
this is as fine a piece of work as i've seen in some time.

andrew, i hope people who have websites and blogs will link to it. that way, there won't be any need to send it to denise - she'll find out soon enough. :D

in friendship,
prad
This is indeed extremely thorough and very very impressive. I haven't given it the time it deserves yet, but I will in the near future. It's bookmarked for reading!
Thanks B, its very much appreciated.
B amazing work! No rock left unturned....I salute you honestly.
Also Prad, Robert, veganmama and the rest of the team too, awesome!

Cool how are we going to go about spreading this? Link to this discussion? Im going to write a blog about it too and facebook it
lol best salutes i could find

i see you've recruited some new blog bandits, freelee. :D

in friendship,
prad

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