If you're a health professional you should know that you can't implicitly trust medical news outlets. They may be manipulating you!
The China Study: Does Avoiding Animal Protein in Pregnancy Help or Harm?
Lessons on Health From The China Study:
Author T. Colin Campbell, PhD, makes the following argument to support a vegan diet:
- Avoiding animal proteins cuts a woman’s estrogen and progesterone levels
- This delays the onset of puberty, stunts her growth, and leads to early menopause
- Which may reduce her risk of breast cancer.
Therefore, he argues, mothers should put their daughters on a strictly vegan diet. Skeptical? Me too.
Maybe you’ll be convinced if you hear it straight from the horse’s mouth. From page 164 of The China Study:
“The ability of dietary factors to control female hormone levels has long been known in the research community, but a recent study was particularly impressive. Several female hormones, which increase with the onset of puberty, were lowered by 20-30% (even 50% lower levels for progesterone!) simply by having girls eight to ten years of age consume a modestly low-fat, low animal-based food diet for seven years….These results are extraordinary because the were obtained with a modest dietary change and were produced during a critical time of a young girl’s life, when the first seeds of breast cancer were being sowed. These girls consumed a diet of no more than 28% fat and less than 150 mg cholesterol/day: a moderate plant-based diet. I believe that had they consumed a diet devoid of animal-based foods and had they started this diet earlier in life, they would have seen even greater benefits, including a delay in puberty and an even lower risk of breast cancer later in life.”
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Dr Campbell’s Diet May Someday Be Found to Lower Risk For Some Types of Breast Cancer, But At What Cost?
Cambpell’s argument is an example of the thinking that has guided nutrition science for the past half century. Clearly Dr Colin Campbell cares deeply about preventing breast cancer. But to make the statements above is, in my medical opinion, not just scientifically premature (given the lack of consideration of the larger picture here) but also potentially harmful.
Are there ANY OTHER Implications of Reducing Estrogen and Progesterone Levels?
Reproduction is a big part of life. In fact, it’s one of the life’s defining characteristics. However, based on his own statements, it appears Dr Campbell believes that the timely onset of the hormones associated with puberty is not in any way essential to health or well-being but as ugly by-products of an animal-protein inclusive diet that serve only to put women at risk of breast cancer. As a woman, I feel torn by the fact that his stated intention is to reduce the chances of breast cancer, which none is a fan of, but at the same time I find myself cringing a little at the idea of my teenage self or somebody’s daughter being included in his population-wide experiment to stall puberty for up to six years.
Though Dr Campbell doesn’t explicitly say this in his book, I suspect he would argue is that what’s unnatural is a young woman entering puberty at the tender age of 9-13 (the currently accepted normal ranges for the initial signs of puberty i.e. breast bud development), I suspect he would go on to argue that what is normal, natural, and healthy is for a girl to enter puberty between the ages of 15-19. It’s one thing to want to reduce breast cancer rates. But to do so at the expense of female development seems to me a bit extreme. Besides, we know hormones don’t have anything to do with some types of breast cancers. We also know that there are other ways to reduce breast cancer risk that don’t endager overall health.
Are there any potential downsides to a woman reducing her hormone levels to the lowest possible range?
The Worst Case of Hormone Deprivation I have EVER Seen
I have personally seen what may be the worst possible outcome of following an all plant-based diet: A stolen womanhood.
A young lady came to see me in clinic after suffering 8 compression fractures in her spine from severe osteoporosis after following an all plant diet for less than a decade. When I got her DEXA report (DEXA is the name of the most common bone-density test) my jaw dropped. The definition of osteoporosis is a T score of -2 or lower, which is not uncommon in 80-year-olds. Her’s was the first T-score I’ve ever seen so low: -8. She was 31.
When we first met, she was in tears. She was scared. She was in pain (those fractures hurt!) She had not had a period in something like five years. She was depressed. She couldn’t work, couldn’t support herself, and had to move back in with her mom. She couldn’t hike or do any of the things she loved. The hunch in her spine was hard not to notice, and she hated that. Yet, even after all this suffering, she was terrified at the prospect of re-introducing milk into her diet because of years of unwavering faith in Dr Campbell’s recommendations. The China Study was, after all, “the most comprehensive study of nutrition ever conducted.”
It says so right on the cover.
As a human being and an animal lover, I deeply empathize with people who have decided to go vegan in order to ensure they in no way support the horrible practices now endemic in the meat industry. I agree that those practices, and the companies that promote them, should be eliminated. As a scientist, however, I cannot countenance linear thinking when a more comprehensive, holistic consideration of the dynamic nature of physiology and growth is called for. As a physician dedicated to disease prevention and health promotion, I am angered and frustrated when a person comes to see me riddled with the debilitating complications from following any ill-conceived medical advice. Vegans have seen images of animal cruelty and said “This should never happen.” When I see a woman who’s quality of life has been taken from her, a woman who is suffering, I say “This should never happen.”
We’ve got to be able to figure out a way to prevent both.
For a great place to start researching what kind of diet is good for pregnancy, here’s a podcast by one of my favorite wellness personalities: Sean Croxton at Underground Wellness
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After my pregnancy I show all the signs of malnutrition (huge loss of weight, being sick all the time etc) so I want to change my diet completely.
Is there any possibility to maintain a healthy diet without eating animals? If yes, how?
Vegetarian would be ok for me, but let’s be realistic, animals are being tortured for more than just meat, so vegan + supplementing B12 seems like the easiest option, especially hence most of the animals receive a B12 supplementation themselves because they don’t really get to live outside in nature.
What is your advice for people who don’t want to eat meat out of moral reasons?
Hi, I’m very interested in your take on women’s nutrition before & during pregnancy. I’d love to know your stance on prenatal vitamins vs receiving adequate nutrition through nourishing foods (including the four pillars, obviously). There seems to be a lot of conflicting advice in books & through out the medical world. I worry if I am already eating grass-fed liver, bone broth, & varieties of nutrient dense vegetables that I could be setting myself up for toxicity problems by adding a vitamin.
Steph
You do risk some degree of problems by adding vitamins because MOST are synthetic. They contain a mix of molecules we need and molecules that will block them. Whether and which vitamins you do take depends on details of your diet and the balance of risk and harm that creates.
I will be talking about real foods versus vitamins in my talk Breaking through the Hype: Five simple questions that will tell you if a product is actually healthy during Sean Croxton’s (undergroundwellness.com) upcoming Real Food Summit!
Dr. Cate, I have translated this article to Portuguese and published in my facebook community about children nutrition. I hope you don’t mind.
https://www.facebook.com/notes/meu-filho-n%C3%A3o-quer-comer/the-china-study-a-dieta-vegana-e-a-redu%C3%A7%C3%A3o-do-c%C3%A2ncer-de-mama/270515479700542
I have been having problems with fertility for a long time. I drank soy milk for ages trying to be “healthy” and now I’m hypothyroid and have low progesterone. I don’t know if I will ever have a baby. I got the China Study out of the library in good faith – thinking maybe I was just doing something wrong and it would have my answer. I had read it before but hadn’t been thinking as much of fertility then, so thought it might have some answers. I read that page you mentioned. I was shocked. I shut the book, and took it back to the library. Now I’m looking at Weston Price. While I’m trying to be a mum, I want my hormones thank you!
http://www.vegsource.com/ar…
http://www.vegsource.com/articles2/campbell_china_response.htm
Dr Campbell’s arguments for cutting protein to reduce breast cancer rates is flawed by multiple factors, too many to go into here but I will list two: not all breast cancers are hormone receptive, and we know cutting protein to the levels he suggests leads to malnutrition.
Mmk–no special insight here, but I just want to point out that there is always a wrong way to approach a diet, like the unfortunate case of the woman in the above article. I’ve been a vegetarian for several years and a vegan for two and I can say that I have never been in better health. I think that nowadays veganism is looked at as more of a “fad” diet, that some try but don’t know much about. You wouldn’t say you’re on the Atkins diet without knowing much about it…I mean, clearly that can potentially be a bad-news situation.
I read the China Study, and I don’t think Dr. Campbell’s argument was to drastically reduce the total amount of protein in general as much as it was to reduce the amounts of animal protein. Reading some of these comments, I really begin to doubt if the book was thoroughly read as much as skimmed for controversial paragraphs. Until someone can scientifically prove (with the same amount of thorough research) that Dr. Campbell’s studies aren’t valid, then I don’t see the opposition’s argument holding any real weight. One’s decision to eat meat is a personal choice that I can and do respect. The only thing I hate to see is people basing their opinions of veganism (or any diet/lifestyle) based on one case. I could just as easily say that I saw a morbidly obese person eating a steak and jump to the premature conclusion that all people who choose to consume animal protein are bound to be morbidly obese. It’s just false….
Just two last things–this has nothing to do with altering women’s bodies to suit men. I mean, if anything wouldn’t men want puberty earlier? I’m not a man so I wouldn’t know, but I really don’t think sexism plays any role in this argument. Also–did someone SERIOUSLY say that PETA should be sued? For WHAT?!? They do good work. Yes, they can be extreme and a little much at times, but other than that they’re wonderful (in my opinion. Everyone else is entitled to their own of course).
All the best to all of you!
Slash
You are wise in asking a basic question: What’s wrong with delaying puberty. And there’s another implied in your comment: Who says puberty at 16-19 is a delay?
For the first point: Delayed puberty is associated with osteoporosis and a wide variety of other indicators of poor health, including premature menopause.
As far as the second point, the data available at this time suggests that puberty at 16-19 is later than at any point in human history.
The linked article says only that there is a concern that we may see more breast cancer down the road among children who are going through puberty abnormally early.
I find it interesting that so far, without exception, all the people suggesting women ought to alter their bodies natural cycles happen to be men.
If I were to advise reducing young boys’ protein intake for the sake of theoretically reducing prostate cancer, and so what if it stunts their growth, I don’t think that suggestion would be tolerated.
Why is it always men trying to manipulate women’s bodies?
Dr. Cate,
Thank you for posting my reply. Armchair Nutritionism, lol.
I might not be offering you any special insight into b12 deficiency but I’m sure I am to others reading this blog. Of course b12 is not the only cause of osteoporosis but b12 deficiency is a cause of osteoporosis in vegans. Your blog talks about avoiding animal protein and how it caused osteoporosis but there’s no mention of b12 deficiency nor the link of b12 deficiency to osteoporosis.
I never said to purposefully deprive women or the hormones associated with puberty as a form of birth control. I said “What is the problem with delaying puberty?”. You still haven’t answered the question. What is the problem with women starting puberty at 15 or 16?
If the age of 9-13 (the currently accepted normal ranges for the initial signs of puberty i.e. breast bud development) is now average age for puberty would you have a problem if dairy and meat industry put more hormones in the milk and meat so that age dropped to 7-11 or 5-9 years of age?
Comparing a women that starts puberty at 15 to foot binding is ridiculous. Starting puberty later does not disfigure a woman body. The research shows that girls that start puberty earlier has an increase risk of breast cancer.
http://www.cnn.com/2010/HEALTH/08/09/girls.starting.puberty.early/
Many women that get breast cancer end up getting a mastectomy which does disfigure a womens body. Sort of like your foot binding comparison,
Eating plant based is very healthy but remember to take a b12 supplement once a week.
Here’s a link on feeding kids plant bases meals.
http://vegans-in.blogspot.com/2011/07/feeding-vegan-kids.html
Slash
Thank you for providing me with an excellent example of armchair nutritionism. First, you are not offering any special insight; the vegan-b12 deficiency association is well-known. Second, b12 is not the only cause of osteoporosis or depression. And third, most vitamin deficiencies tend to cluster so that if you are deficient in one you are very likely multiply deficient.
As for purposefully depriving women of the hormones associated with puberty as a form of birth control, I think you might want to reconsider that position. It reminds me of the kinds of reasoning behind the now outlawed process of Japanese foot binding for the purpose of producing women with ‘dainty’ feet.
Sounds like this woman was not taking a B12 supplement.
Dr. Greger talks about the importance of taking B12 for people on a plant based diet.
In his clinical nutrition videos, he states that these cases come up because of a lack of B12.
http://nutritionfacts.org/blog/2011/08/25/vegan-b12-deficiency-putting-it-into-perspective/
Here is a link that discusses osteoporosis and depression because of the lack of B12.
http://www.osteopenia3.com/Osteoporosis-B12.html
What is the problem with delaying puberty? If we could delay puberty in many of the US cities maybe we’d have a higher graduation rate and a lower teenage pregnancy rate.
Not to mention a decrease in breast cancer.
Exercise daily, eat whole plant based food and take a 2500mg b12 once a week.
You know what they rarely take into account in food studies is GMO’s, synthetic hormones, pharmaceuticals, estrogen mimicing hormones…etc. Plenty of reasons a girl may have a lower risk of cancer by eliminating tainted meat (from cows fed GMO’s and posions). Do they specify if the meats and dairy they were fed were the type that Weston Price and others talk about…animals that get their proper diet, exercise, and are fed from healthy soil? Some can argue that butter can be a super food…but it depends on what the cows are raised like and how it is processed.
If I ate meat from GMO-fed animals, I might be worse than some vegans that did not. Many animals that are fed GMO’s become infertile…what happens when those animals are fed to us? I haven’t read the China study, and perhaps they did specify what type of animal products were fed to “meat eaters” vs. the girls on the vegan diet, but if it doesn’t specify, maybe the quality of the animal products was crap filled with synthetic hormones and foreign proteins and poisons?? A lot of meat products are also laced with MSG and other chemicals that can cause health problems. I would like a study done on clean, pure meat. The people I know who eat clean and nutritious food are way healthier than the rest.
I agree that this opens the door for an extreme nutritional fad…where people look at one thing and go to the extreme without concidering the greater whole and long-term consequences. just a thought.
Hi Mary!
She did get better with vitamin D, lots of yoghurt, bone broths, eggs, nuts, and plenty of fresh veggies.
Nice to hear back from you, stay well!
Hi Dr. Cate,
Your story about your patient was so sad. Dis she ever change her eating habits? And if so, how is she doing now?
Yes, I understand that most people do not want to be cruel to animals. I love animals…especially dogs but I love farm animals too. But I do eat meat. I feel so much better following your dietary principles. So I make a point of searching out humanely raised beef, pork, etc. It can be more expensive but it gives me peace of mind and I make sure that we eat everything…right down to making bone broths. I let nothing go to waste. I teach my family that the animal made the ultimate sacrifice for us (so that we could live a healthy life), so we honor it by eating everything. When I see people trimming off every last bit of fat from a steak, I just cringe.
I think so many medical studies are very biased. I look around me and the people following various diet advice from the government, scientists, etc. all seem to have health problems. I was one of them! Then I discovered Sally Fallon and now you and I feel so much better! Eating as our ancestors makes so much sense. And I don’t have to look back too far in my own family history. Both my parents are in their 80s, in good health, and they have always eaten meat and love butter! 🙂
All the best to you and continued success! Thank you so much for all you do to spread good dietary advice.
Love,
Mary
Carina
I really like your idea of working w/ PETA against animal cruelty in the farm, not by shutting down all animal farming, but by shutting down the bad ones and supporting the good, wholesome, healthy farmers who love the animals they care for.
An example of a farmer who could use PETAs support: http://www.youtube.com/watch?v=XSM7iiMil6Y
(He’s Canadian, I don’t know if PETA goes up there…)
I was vegetarian and on-and-off vegan for three years. My body is a mess. I have to fight depression on and off (I finally found some relief with supporting amino acids and a herbal hormone balancer), my bone frame is really small – my perfect vision diminished, my hair and skin looked just dead, and I developed chronic fatigue syndrome and a chronic pain disorder, both of which conventional medicine cannot cure. I’m on a really good cal-mag right now, it’s a soft gel (excellent absorption) with a support formula including boron. It’s by Inno-vite. I’m also on a great multivitamin in powder form that has all kinds of support nutrients in there including digestive enzymes and a super green foods formula, among other things.
I wish we could sue PETA for pushing this lifestyle instead of pushing us to actually taking action against the cruelty. We can save those animals by obtaining our meat from local farmers who have free-range, grass-fed animals (or otherwise fed their natural diet). THAT is what they should be pushing. Because they keep feeding us these myths that have been completely debunked again and again by various professionals and as it turns out, when our furry, lovable ancestors started eating meat, their BRAINS GREW and their INTESTINES SHRANK. What happened when ancient Egyptians started eating grains? They got shorter and their brains got smaller (I’d like to point out that grains are loaded with phytic acid, and unfermented soy beans are just LOADED with it). Yet we are told to eat as little meat as possible and what are we told to eat a lot of? Grains. Even more than we are supposed to eat vegetables. We’re told to eat grains. Seriously? SERIOUSLY??
In one of the most recent Vitamin D council newsletters they claimed that excessive estrogen, caused by poor estrogen clearance, was mostly a vitamin d and vitamin d cofactor problem. Perhaps this is the vital piece of the puzzle? Like you said, rarely are these things so simple, and there are so many pieces that go into the breast cancer puzzle that it is hard to support wild interventions with known risks as the go-to solution.
Hello Dr Cate,
I expect that the Danish authorities will discover over time there will be no lessening in the increase in obesity or a general improvement as a result of this tax. They will not attribute this to a faulty analysis but probably decide that the tax must be even more punitive in order to stop people eating saturated fats. Unfortunately the advocates of low fat high carb rule the universe at the moment. I’m familiar with the works of various authors who challenge this consensus…yourself, Weston Price, Schwarzbein, Wofgang Lutz, Jan Kwasniewski’s optimal diet, Sissons, Uffe Ravnskov’s cholesterol myths, Taubes etc etc. It seems that with the power of the internet the various authors need to corral themselves to present some sort of united front and seriously challenge this consensus otherwise I fear that the global increase in obesity,diabetes etc will be met with more government intervention like the Danes.
I agree. The reality is it costs much to lobby the politicans and pays little, so what we need is a celebrity willing to either support the cause of someone who is already financially independent to become the figurehead.
Slighlty off topic but I would just like to bring attention to the news that Denmark has just introduced a tax on saturated fat. I’ve heard similar ideas being put forward here in the UK where I live. If, as Dr Cate and other advocates of traditional non processed food believe , that the problems lie with pufa’s rather than saturated fats, then this is a pretty appalling decision by the Danish authorities.
Tim is that bit of terrifying news. Also sounds like an administrative nightmare so hopefully it will fail on that account alone.
Veganism is a scary thing. Although the factory farming/animal cruelty thing is a big issue too, I wish more people would at least stick to milk, eggs and fish – or pasture-raised meat if they can afford it.
+1 to Sean and underground wellness too. That’s how I first heard about your book 🙂
While I am not a vegan, I can sympathize, as you say in the article, with wanting to reduce cruelty to animals. But if the choice of being a vegan leads to severe osteoporosis, as this article suggests,then this would not be following the path of minimizing harm. However, I wonder if there are missing pieces to the information we have? Was your patient undereating or maybe consuming lots of caffeine or alcohol or something else that we know depletes the bones of calcium? Was she taking any glucocorticoids in her medications, shown to also cause loss of bone density. Is there some other factor, or combination of factors, that lead to this young lady’s tragic loss of bone? Or maybe it was as you say, diet. The questions around osteoporosis and hormone health are complex no doubt but so important that we educate ourselves about the choices we can make to improve our health and others. Thank you for reminding me about this issue.
Adrienne: I didn’t include the young ladies full history but I and several specialists did a full investigation to identify other causes.
The results we’ve seen speak for themselves: In the 9 months since we’ve gotten her on a better diet, one including dairy, eggs, and bone broths (and all Four Pillars), she’s improved dramatically, has no more pain, no further fractures, and is no longer depressed. She’s even regained 1/4 inch of height. We will be retesting her DEXA in 18 months and I am optimistic we will see improvements.