The China Study: The Most Comprehensive Study of Nutrition Ever Conducted

"This book was a huge hit in the US. Basically, this nutrition expert was working for the agricultural board in the US—selling dairy and meat—and got into doing this epidemiological study in China, working out the relationship between what different local populations were eating and rates of heart disease. In the 1970s, when they did the study, China was a very different place. It was poor. Most people ate very little meat and dairy. And they basically had no heart disease, and hardly any cancers. There were no fat people, no diabetics. They were dying of infectious diseases and other problems—occasionally starvation. It was a very different world. So they studied these different provinces and worked out that the richer ones that were eating more meat and more dairy were getting all the heart disease. That’s where the idea that everyone should be vegetarian for their health came from. The plant-based diet is based on these rules. He was particularly harsh about dairy. Milk and cheese came out very badly in his analyses. He sold millions of copies of this book, and did a lot to jump-start the vegetarian movement in the US, where it had been very, very small, unlike in the UK. So it was very influential, although when I read and critiqued it, I felt a lot of the data didn’t stand up. In a lot of those regions where they were eating meat, they were also doing other things, so it was very hard to draw the conclusions that he did, but I put this book on the list as it’s interesting on the vegetarian vs. meat eating debate that we have now, and how it’s evolved over time. “All of us really should be eating less meat and probably less dairy” Before his study, the vegetarian debate was more about animal welfare; his study made a lot of people realise that it’s also a really good way to avoid heart attacks and cancer. And we now have a third reason to become vegetarian, which is about the planet: 25% of global warming is due to the meat and dairy industry. I think that’s a huge factor for many people who might not have been so worried about the other two factors, and it’s why many young people are turning to vegetarianism and veganism . I think that all the food we eat now has to have some environmental context, which absolutely wasn’t true even when I wrote The Diet Myth five years ago. The question is, of the three reasons to eat less meat, which one are you most worried about? There’s a chapter in my new book on whether meat is really bad for you, and my general conclusion is that small amounts of really good quality meat is fine for most people. It’s about what else you put on your plate. So I’m not against meat eating, per se. I wouldn’t ban it, but I eat it rarely. That just allows you to have more plants on your plate, which helps the planet and your health. So, although I think his studies were flawed, he got the debate going, and a whole movement in the US that wouldn’t otherwise have occurred. It’s just a good sign of evolving science; some of what he said was correct, but for the wrong reasons. All of us really should be eating less meat and probably less dairy. Which is tough for me as I do like my cheese, and I’m still struggling with vegan cheese, which was awful although it’s getting better. Definitely. People have replaced religion with food, and food groups, and food clubs. There’s a general feeling that people want to belong to some group, and eating is very emotive and a public display. You might never discuss your religion with people now, but if you sit down for a meal it’s immediately obvious what your beliefs on food are. When the plant-based movement began, there were less of them, they were a rare sect. Now it’s a growing movement and they are starting to pressurise people into doing the same. Which does have its place. But I’m worried there are increasing extremists in all these groups that cause problems and, of course, vulnerable people who have eating disorders who will use this. There are good examples in gluten-free diets. People who don’t need a gluten-free diet might join a group because they feel special if they’re eating particular foods, or because they think they’ve got some intolerances. In those groups, like the plant-based diet, generally if you eat everything else, it’s very safe and healthy. But some other ones, like people who cut out all grains—there’s another book I could have mentioned, The Grain Brain —as an expansion of the gluten free movement, just restrict your diet. You end up with a very narrow range of foods that you can eat. And the food industry has adapted and made ultra-processed versions of these foods which are very bad for you. Support Five Books Five Books interviews are expensive to produce. If you're enjoying this interview, please support us by donating a small amount . So we need to have more flexibility between these groups and realise that everyone’s different. Even within the gluten free and plant-based diets, there are a whole range of options. I like the word ‘reductionist’: if I eat meat once a month, then I’m not a vegetarian or pescatarian. But I think we need to break down these labels, because they’re restrictive. Or there’s ‘flexitarian’ or ‘progressive eater’, ‘eating for the environment’. These new terms have been forming. But it’s a big danger that adolescents, particularly, can fall into these narrow groups, often driven by celebrities on Instagram, et cetera. We need to be on our guard, to make sure that people still appreciate the full range of foods."