Response to Denise Minger,
Part 4: China Revisited
At this point I’d like to change my focus from the blog post she created about Ancel Keys to her remarks about my videos in her comments section. She says she wasn’t terribly impressed with my China Studies videos. However, she clearly liked my Ancel Keys videos since she decided to represent my ideas as her ideas. Imitation is the sincerest form of flattery, is it not?
Minger began her criticisms of my video by quoting me saying I don’t have the time or expertise to properly fact check her criticisms of Colin Campbell’s China Study and its related papers. Is she suggesting I don’t have the proper training in epidemiology but she does? She says it is hard to engage in an actual discussion of the data with me since I haven’t even tried to look at it. Well, yes, it is generally hard to discuss something that interests you with someone who does not share that interest. No, I didn’t want to get into the weeds with the China Study monograph, so I didn’t. She wants to debate that data but I don’t. Frankly, I have received enough comments about how overly long and technical my project was as is. Making a video debating the China Study monograph might only have made my videos useful to put people to sleep. I didn’t think it was necessary, as I said, because I could demonstrate Minger’s biases and faults as a critic in a much easier way. So no, Ms Minger, if you want to debate that data, you’ll need to find another dance partner.
I’ll try to give you an example what such a debate might look like. Minger says I referenced only one county labeled “PD” in the China study when I said, “over a period of years some provinces in China didn't report a single heart attack in anyone under 64 even though their populations were in the tens of thousands.” Again, she is saying I am referring to someplace called “PD”.
It seems that in the passage in the The China Study referencing this amazingly low rate of cardiac mortality, Campbell is thinking of not one, but two counties, one in Guizhou province and another in Sichuan province.
And he isn’t calling any of the localities in question “PD”. So who is right? Isn’t it more likely Minger is the one who is mistaken? Why is she saying “PD”? What about the villages Campbell is referencing? Are they the same as “PD”? Then why doesn’t he call them “PD”? And were their recorded causes of death accurate or not? This is the sort of tangle I’m not very interested in sorting out.
Her link to the China monograph is 225 pages of tables that look like this. Would you spend much time arguing over the accuracy of all these numbers? Isn’t it more likely that the people who recorded these data, including many who were not named T Colin Campbell, were in a better position to account for their accuracy than Denise Minger?
As I said, the China-Cornell-Oxford Project was an expensive cross-national collaboration of many researchers that was supported by several institutions. It generated a lot of data, which was not sorted through by untrained bloggers but rather by professional researchers. Going to the effort to analyze and debate the data would have been a waste of my effort, especially when I could show more readily how suspect her analytical skills are by discussing another blog post of hers, which I’ll come back to.
Anyway, the upshot of the China Study is that the rural Chinese had very, very low rates of heart disease and cancer while consuming predominantly plant-based diets. The low rates of Western chronic disease observed among these people led in part to T Colin Campbell’s current views about nutrition. This is why Denise Minger has wanted to discredit his work and it is why she is so popular with her low carb and Paleo audience. Disputes like this over the accuracy of mortality statistics are just distractions from the information people need to live healthier lives. She is doing a disservice to the public. If her motivation were to help her audience live better, she would provide some fair context to all this minutiae. Had she done so, she could have debated Campbell’s numbers while not misleading her audience.
As I have said, the low rates of cardiac death and the low consumption of saturated fat in China in past decades is well-studied. This isn’t really in question.
Here’s another reference she could have used for context. I used this slide in video 62. She could have added to her blogs that in a separate study of Chinese women, animal proteins and saturated fats were linked with breast cancer.
I also showed you this study, which tells us that vegetarian Chinese enjoyed superior vascular health, BMI, and blood pressure. Minger could mention this but she doesn’t.
Remember, the reason low carb and saturated fat apologists are so united in opposition to T Colin Campbell is because he published findings like this, revealing that rural Chinese at one time had very low blood cholesterol levels as well as very low rates of heart disease. This makes him an irritant. It’s hard to sustain nonsense low carb beliefs when confronted with this information, so a way must be found to discredit the man and distract from his work.
She said she wasn’t impressed with my China Studies videos because I didn’t address her data, but she didn’t address any of the criticisms I made of her for not presenting fair context or responsible commentary. Since she didn’t answer my concerns in her comments, I’ll repeat them here and try to make them harder to ignore.
Why does she think grains should be investigated for heart disease? Does she think they haven’t been already?
Why does she say grains should be investigated for heart disease? Does she think they haven’t been studied in this way already? Does she really think no one has considered this possibility beside modern low carbers? See my videos called The Futility of Cholesterol Denialism for more on this.
Why does she suggest there is a Green Veggie Paradox that links green vegetables with stomach cancer? Why does she not mention the practice of the pickling of vegetables as a more important consideration here? Was she unaware of this practice?
Was she unaware that T Colin Campbell’s principal Chinese collaborator separately co-authored a comparison of stomach cancer mortality across China? He found an inverse relationship between green vegetable consumption and stomach cancer. Why did this international collaboration fail to find a Green Veggie Paradox if it’s a real thing?
Is she unaware that saturated fat likely impairs glucose metabolism? Why does she fail to mention this?
She thinks Campbell overlooked blood glucose levels as a risk factor in some chronic diseases. Is she unaware that saturated fat likely impairs glucose metabolism? Why does she fail to mention this?
Ms Minger thinks blame should be placed upon wheat for heart disease. She is not making a distinction between whole and refined wheat. I don’t understand why.
Here was a cross-sectional study examining the effects of whole-grain consumption on a variety of risk factors. Those who consumed the most whole grains had lower BMIs, lower weight, less abdominal fat, and better glucose disposal. Only refined grains were associated with higher fasting insulin levels.
In this examination of the effects of whole grains, those who ate three or more portions per day of whole grains had better risk factor scores for heart disease and diabetes. These benefits were not associated with refined grains.
This review of 20 years of research indicated that whole grain and whole wheat bread had a strong inverse association with heart disease.
Here was a controlled study that compared the effects of refined and whole grains on insulin sensitivity. Fasting insulin levels were lowered and glucose disposal was improved by whole-grain foods.
Look at the foods they used and you’ll see there was plenty of wheat involved.
Why would I be at fault for not entertaining the possibility that wheat may cause heart disease?
I think I have good reason not to share her suspicions.
She says Campbell himself surmised that wheat may be a problem, as it might lower concentrations of something called sex hormone-binding globulin. I guess she thinks I would not dare contradict something Campbell has written. Ms Minger, it doesn’t make any difference to me that he wrote this. He was probably incorrect back then. The world has moved on. This is the game the low carb apologists play. It’s not about the science, it’s about the people involved. Wheat most likely does not affect sex hormone-binding globulin levels. To imply that it does today is to misinform your readers. Do you really care about this issue, or are you just playing games now, Ms Minger?
In discussing Campbell’s old remarks on this issue, she said, “wheat-fearers, you’ll enjoy this one.” Could it be any more plain she is pandering to her audience? She tells us low SHBG is bad, and high SHBG is good, and Campbell found an association between low SHBG and wheat.
Ms Minger, do you recall writing this? I gather your point was that correlation does not equal causation, correct?
Then you should forget about this one instance of correlation between wheat and SHBG. This 2008 survey of the literature on the topic could not link any dietary component to SHBG levels. Campbell’s conjecture 12 years earlier doesn’t seem to have panned out. Minger shouldn’t be giving her readers a false impression to the contrary
Instead, if she cared more about SHBG levels than playing games, she might have considered informing her readers of this study, which showed that vegetarians have higher SHBG levels than omnivores. The authors say this may partly explain vegetarians’ lower risk of developing diabetes. Diabetes, of course, is a disease of impaired glucose regulation. That‘s pretty interesting, isn’t it, Ms Minger?
Is she unaware that saturated fat impairs glucose metabolism? Why does she fail to mention this?
Ms Minger, isn’t saturated fat a more appropriate object for your scrutiny if you care about insulin sensitivity? Don’t you remember all my slides?
In case you forgot them, here they are again. Saturated fat potentiates insulin resistance.
Saturated fats are insulin-antagonizing.
Saturated fats were worse for insulin sensitivity.
Saturated fat harms glycemic control.
Saturated fats impede glucose disposal.
Here’s a bonus. Saturated fats inhibit insulin signaling.
Here’s another bonus: In animal models, saturated fat is strongly linked to the development of obesity and insulin resistance.
And high-fiber, high-carb foods enhance insulin sensitivity. Come on, Ms Minger. Impress me. Show me why all these references are wrong.
Ms Minger, why don’t you be more scrupulous and tell your readers that it is high-saturated fat diets that are believed to impair insulin sensitivity and glucose disposal? No, she doesn’t get into any of this because it is more useful for her to keep giving her low carb audience reasons to blame wheat for their problems. This gets us into her responses to my take on her so-called “New China Study,” which I’ll look at next.