By Barbara Berkeley
It’s a tough crowd out there in the optimal eating community.
I just finished reading The China Study. I don’t know if you’ve read it, but a friend gave it to me after being impressed by its conclusions. Basically, it’s a treatise based on the work of T. Colin Campbell, a Cornell researcher who spent many years on an exhaustive study of eating habits in China. At the end of the day, Campbell concluded that animal proteins were associated with the diseases of modern society and that the optimal human diet was clearly vegan.
Campbell’s study and the other evidence he presents pose intriguing questions but point out the difficulties in making connections between diet and disease. There are so many variables involved in large population studies of this kind, that it is impossible to draw definitive conclusions. For me, the more fascinating aspects of The China Study are the sections of the book that chronicle the fate of doctors who dared to suggest that these dietary therapies might prevent or effectively treat modern disease. For example, Campbell tells the story of Caldwell Esselstyn a well-known surgeon and researcher at the Cleveland Clinic (now retired) who was able to document effective treatment – even regression – of coronary artery disease on a plant-based diet. Despite being married to the daughter of the revered founder of the Clinic, Esselstyn was unable to get the Clinic’s cardiology department to consider serious use of dietary therapy for coronary disease. He was essentially marginalized.
Just today, I spoke with a patient whose brother died of a heart attack at age 42 and whose family had a strong history of premature coronary disease. She had been treated by a preventive cardiology service for some years but reported that she had gotten no useful guidance from their dieticians. She was simply told to “lose weight.” The idea that specific dietary guidelines might prevent or halt heart disease had still not reached the level of clinical acceptance. I noted the same phenomenon when I recently consulted my own cardiologist for routine follow up. I had not been to the office for five years and his nurse wanted to update my medical history. I was asked detailed questions about my medications, exercise habits, frequency of physical activity, smoking, alcohol and other health habits. At the end of this thorough history, though, not a single question had been asked about what I routinely ate.
Doctors like me who believe that dietary interventions are powerful medicine – perhaps the most powerful medicine of all – are looked at as less than whole physicians. Meals, after all, are not pills. To put it bluntly, we are looked down upon.
But the criticism and looking down doesn’t end there. On the site “Beyond Vegetarianism,” for example, reformed vegetarians are highly critical of Dr. Campbell and his vegan hypotheses. Readers of online diet sites can be incredibly disparaging . Of some pretty mild maintenance advice attributed to me in Women’s Health OnLine, one reader wrote, “This is horrible... and she's an ‘MD’... no wonder America is fat. This woman should be fired.” The discourse surrounding diet can be vicious.
The Vegetarian community thinks that the Paleolithic community is full of it. The Weston Price people think that all whole foods are terrific, fat and cholesterol be damned and are highly critical of vegetarians. And of course, those eating the Cheesecake Factory diet believe that those of us who try to eat healthily are judgmental food-Scrooges who want to prevent everyone else from enjoying life.
Of all the choices we make it life, why do our dietary choices provoke so much antagonism? There are probably as many reasons as there are diets. For the scientist, the idea that dietary manipulation might cure disease is too simplistic. For the pleasure eater, the idea of dietary restriction is too threatening. For the vegetarian, the idea of meat eating is too political. Whatever our agenda, one thing can surely be concluded from the ferocity of the debate – food is powerful! Diet is meaningful! And the foods we choose to incorporate into our body make a statement about who we are that declares itself to the world.
