Book Reviews

The Warmth of Other Suns

 

Simply put, this book by Isabel Wilkerson is the best-crafted non-fiction book that I have ever read. It came recommended to me by a literature professor that I ran into on a bus here, and I bought it both because of her praise and because my background in African-American studies is weak at best. The main subject is the ‘Great Migration’ of blacks from the South of the US to the North between 1910 and 1970. Wilkerson does a masterful job of weaving the intimate histories of three main characters together with the stories of the other 1,200 or so people she interviewed for the book. Then she brings in well-researched and relevant demographic, economic, political, and sociological research and provides the broad context that perfectly frames and informs the individual pictures that she presents. The result is a perfect balance of breadth and depth, personal and universal in the African-American experience of the 20th century. She takes us into the terrors of lynchings, the injustice of sharecropping, the indignities of ‘separate but equal’ and white flight, the joys of success in the North and the pains of leaving lives behind in the South. The carefully constructed narrative defies simple summary or breakdown into main points. We can think of her book as a perfectly created and assembled puzzle. So precisely do her pieces fit together and blend into one another that it would be impossible to take it apart to look at individual parts. The effect is a holistic experience of one of the most important and least understood sociological and demographic shifts in our country’s history. I highly recommend this book to anyone interested in modern urban life, African-American issues, American history, sociology, the civil rights movement, or just good writing. 🙂

The China Study

 

“There is enough evidence now that the U.S. government should be discussion the idea that the toxicity of our diet is the single biggest cause of cancer.”

-T. Colin Campbell, Ph.D. and Thomas M. Campbell II in The China Study

Reading this book feels a bit like listening to one of my interesting and brilliant science-y friends ‘nerd out’ about their favorite topic. They tend to jump around a bit, talk excitedly and refer to things that are kind of obscure, but they still manage to come back and explain it well. They sometimes mix personal and professional facts because the lines between their work and home spheres aren’t very well defined, as is common for those who love their job. I found the tone earnest, energetic, optimistic and endearing. It was easy to read and understand despite its feeling a bit messy structurally. I can see how trying to fit all the disparate pieces of scientific evidence, institutional analysis, and practical diet advice together in a cohesive and flowing structure would be challenging. I found myself much more appreciative for the information than the format, but the solidity and clarity of the science more than make it worth the read.

The author first explains the research he has done regarding the effect of animal protein on cancer initiation and growth in a study with rats, as well as parallel evidence (from a massive study that provides the title of the book) that diet affects cancer as well as many other diseases. He then goes into great depth with numerous diseases to explain the literature on the diet-disease connection and specifically how animal-based foods are consistently linked with increased risk and exacerbated symptoms of heart disease, cancer, autoimmune diseases, kidney stones, bone diseases and dementia. After this lengthy and convincing discussion, he spells out specific principles that the reader can use to guide his or her diet choices. Finally, he addresses why he believes the average American is hearing such conflicting and poor information about nutrition. It boils down to system-wide failures on the parts of government, scientific institutions, the scientific process itself, and corporate interests. Instead of sounding like a conspiracy-theorist, however, he manages to calmly and logically explain the shortcomings without vilifying or speculating. He simply talks about his vast personal experience and points out the many ways in which the system is skewed to favor misinformation and support the status quo. It’s a lot of ground to cover in one book, but succeeds in being uniformly convincing, important, and earnest. I especially appreciate his scientific and conservative approach to drawing conclusions and this tendency lends more credibility to his still far-reaching recommendations.

As I see it, the big themes in the book are:

-Environment is more important that genes for determining health! The existence of genetic predispositions toward diseases is not as important as the environmental conditions that trigger its expression. How do we know? Disease rates vary drastically by country (and therefore by diet). Still think this could be genetics? Turns out that if people from these countries move into areas with higher or different diseases, they adopt the risks inherent in that area within a short period of time. “Furthermore, we have seen disease rates change over time so drastically that it is biologically impossible to put the blame on genes. In twenty-five years, the percentage of our population that is obese has doubled, from 15% to 30%.”

-Technology is too narrowly focused to solve problems. It is great at dealing with symptoms, but because the causes are complex, the scientific process of single-variable manipulation fails to provide cures or preventative technology. We don’t understand in a comprehensive way the complex systems involved in our nutrition, but we are beginning to see enough tiny points of light to conclude that plant-based whole foods are far superior to animal-based foods.

-Medical doctors are rarely trained in nutrition. The entire medical establishment is entrenched in the paradigm of treating symptoms, from their training in med school to the current pay structures. It makes sense that they are reluctant to open their minds to evidence that their entire life’s work has been pursuing less effective methods. Additionally, it shifts the power dynamic between doctor and patient. All of a sudden, it is largely up to the patient, not the doctor, to change their condition.

-It’s easy to destroy ‘scientific consensus’ by placing academics on food and drug company payrolls, hiring lobbyists with access to legislators, taking scientific results out of context, and taking advantage of the naturally speculative nature of the scientific process. Arguing about what to do with the science is left to those who want to take the results and apply them in support of their cause. Who has the most interest in doing this and money to do it with? Those who are benefiting from the current system.

-“Nutrition represents the combined activities of countless food substances. The whole is greater than the sum of its parts.” This is Dr. Campbell’s first principle of nutrition in his recommendations section. It applies to many of his sections and his critique of modern nutritionism, which is that our focus on individual chemicals is crippling our ability to understand that food works in infinitely complex ways and cannot be reduced to its individual parts. I just want to point out to my readers the title of this blog: “Greater than the Sum.” Boo yah.

Here I’m going quote a big section from the conclusion of the book. I hope this isn’t copyright infringement, but as I was reading I tried to summarize his main scientific arguments and then ran into his own summary that is just way better than my own, and shorter (italics are the author’s):

“Never before has there been such a mountain of empirical research supporting a whole foods, plant-based diet. Now, for example, we can obtain images of arteries in the heart, and then show conclusively, as Drs. Dean Dornish and Caldwell Esselstyn, Jr., have done, that a whole foods, plant-based diet reverses heart disease. We now have the knowledge to understand how this actually works. Animal protein, even more than saturated fat and dietary cholesterol, raises blood cholesterol levels in experimental animals, individual humans and entire populations. International comparisons between countries show that populations subsisting on traditional plant-based diets have far less heart disease, and studies of individuals within single populations show that those who eat more whole, plant-based foods not only have lower cholesterol levels, but have less heart disease. We now have a deep and broad range of evidence showing that whole foods, plant-based diet is best for the heart.

Never before have we had such a depth of understanding of how diet affects cancer both on a cellular level as well as a population level. Published data show that animal protein promotes the growth of tumors. Animal protein increases the levels of a hormone, IGF-1, which is a risk factor for cancer, and high-casein (the main protein of cow’s milk) diets allow more carcinogens into cells, which allow more dangerous carcinogen products to bind to DNA, which allows more mutagenic reactions that give rise to cancer cells, which allow more rapid growth of tumors once they are initially formed. Data show that a diet based on animal-based foods increased a female’s production of reproductive hormones over her lifetime, which may lead to breast cancer. We now have a deep and broad range of evidence showing that a whole foods, plant-based diet is best for cancer.

Never before have we had technology to measure the biomarkers associated with diabetes, and the evidence to show that blood sugar, blood cholesterol and insulin levels improve more with a whole foods, plant-based diet than with any other treatment. Intervention studies show that Type 2 diabetics treated with a whole foods, plant-based diet may reverse their disease and go off their medications. A broad range of international studies shows that Type 1 diabetes, a serious autoimmune disease, is related to cow’s milk consumption and premature weaning. We now know how our autoimmune system can attack our own bodies through a process of molecular mimicry induced by animal proteins that find their way into our bloodstream. We also have tantalizing evidence linking multiple sclerosis with animal food consumption, and especially dairy consumption. Dietary intervention studies have shown that diet can help slow, and perhaps even halt, multiple sclerosis. We now have a deep and broad range of evidence showing that a whole foods, plant-based diet is best for diabetes and autoimmune diseases.

Never before have we had such a broad range of evidence showing that diets containing excess animal protein can destroy our kidneys. Kidney stones arise because the consumption of animal protein creates excessive calcium and oxalate in the kidney. We know now that cataracts and age-related macular degeneration can be prevented by foods containing large amounts of antioxidants. In addition, research has shown that cognitive dysfunction, vascular dementia caused by small strokes and Alzheimer’s are all related to the food we eat. Investigations of human populations show that our risk of hip fracture and osteoporosis is made worse by diets high in animal-based foods. Animal protein leeches calcium from the bones by creating an acidic environment in the blood. We now have a deep and broad range of evidence showing that a whole foods, plant-based diet is best for our kidneys, bones, eyes and brains.

-T. Colin Campbell, Ph.D. and Thomas M. Campbell II in The China Study

In the end, what has the book meant for me personally? I now have serious concerns about the healthiness of animal products. My previous year in the states was spent mostly vegetarian, but for reasons stemming from the wasteful and harmful US food industry. I hadn’t worried too much about my own health. I was active, didn’t eat much meat, and tried to balance my diet well. I figured that, compared to the average American, I was doing great. The problem is that the average American diet is such an extreme example of a dangerous diet that I need to stop focusing on relative measures and think about objective measures of the health of my diet. After reading this book, I am convinced that consuming almost no dairy, eggs, and meat is the only way to eat truly healthily. I will not take this one book’s conclusions as the final word, because that is exactly the kind of mentality that the author attacks in the form of fad diets and reductionist science, but I do want to structure my eating habits around what the world’s best science can tell us and also what makes sense to me.

My personal litmus test for ‘what makes sense’ is how human evolution has led us to our current state. Considering that we are omnivores, I don’t see myself ever completely cutting animal-based foods from my diet for purely health reasons. I will, however, really work to minimize my animal-protein, fat, and refined carbohydrate intake to very low levels and increase my plant-based, whole food consumption. Milk and cheese are going to be my biggest challenges, but their connection with cancer formation and promotion, autoimmune diseases and kidney stones is too strong to ignore. My current options in Nicaragua for changing my diet are limited, but I am looking for ways to decrease the amount of eggs and cheese even here. The real challenge now that I accept the author’s arguments is figuring out how to implement the changes necessary to avoid disease. The most important factor for me in regulating and determining my diet is based on understanding why and to what extent something will affect me. I know that Coca-Cola is not good for me. But, it’s ‘not good’ in such a vague, marginal way that my cravings frequently outweigh my convictions. It’s only through knowledge of the specific effects and the implications for my health that regular consumption of unhealthy foods has on me that I can give the logical part of my decision-making the upper hand and the final say. I also feel more aware of how the food industry manipulates the information available to the public and how this affects my perceptions and preferences. This book goes a long way in informing and empowering me to make good food decisions and take control of my future.

Afterthoughts on The China Study:

In the week after finishing the book, a few doubts have surface in my mind that I didn’t bring up in the review. I probably wrote it too quickly after reading the book and didn’t allow time for possible problems to sink in. I still think the book is incredibly compelling and have begun to shift my diet away from animal-based foods, but I want to mention some shortcomings in the author’s arguments:

  1. It’s rare to find a book that argues from a specific position and with a clear agenda and yet presents the other side of the story. Unfortunately, this book doesn’t really talk about what its opponents would say about it. This lack of balance makes me naturally suspicious. I doubt that there are no reasons to eat animal-based foods, even if, on balance, it’s better not to. I would have appreciated some more information, even if it didn’t support his thesis.

  2. In any review or statistical analysis, there is the possibility to ‘cherry-pick’ data or examples that prove a particular point. As an example, if we pick particular years in the last few decades, we can statistically show a cooling trend, even though on average there has been a warming pattern emerging. By taking extreme and non-representative examples, nearly anyone can show a trend. Without more information about the two primary examples that the author uses, China and the US, we can’t know how representative these countries are in terms of what he argues. He does use a lot of data showing comparisons across many different countries, but the reliance on two potentially extreme sources is also suspicious. On the other hand, it makes sense to compare extremes because it shows the relationship between variables most clearly. Still, the lack of comprehensiveness in terms of showing diet and disease correlations in other populations is worrisome.

  3. While the author uses several extremely impressive studies to support his position, the majority of the studies and examples he cites were relatively small and potentially anecdotal. The dramatic results shown by doctors who work with small groups of patients to change diet and turn around disease is powerful, but the risk inherent in small-n studies is that statistical variation or unseen variables are having a significant effect. He also doesn’t say anything about potential selection bias in these studies, which is the possibility that the people who sign up for the studies have other attributes in common besides the manipulated variable, diet.

These three aspects of the book have made me less overwhelmingly convinced about the conclusions that he draws, though I still firmly believe that he has assembled the most comprehensive case for a diet change that I have ever come across. I am still going to follow his recommendations, but I want to hear dissenting opinions and understand more of a balanced view. The author does a very impressive job of being scientific, balanced and conservative in his conclusions, but he’s still human and pursuing an agenda and the lack of a devil’s advocate is a nagging detail that raises doubts.

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2 responses to this post.

  1. Posted by Cindy Salo on February 12, 2011 at 4:40 pm

    Andrew,

    This is great! Thanks for getting after a couple of the books on my reading list and telling me about them.

    You have a gift for explaining complex ideas clearly.

    Cindy

    Reply

  2. Posted by Janet Boddy on February 18, 2011 at 1:10 pm

    Dearest Andrew,
    Again, you impress me. I’m so grateful you share your ongoing thoughts, questions, conclusions. You have a gift for seeing broadly across issues and questions and remaining as fair as possible. I love your inherent good-natured and curious skepticism.
    Love, Mom

    Reply

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