The China Study (30 page)

194                           THE CHINA STUDY
of this review paper.38 Suffice it to say, the author did not acknowledge
the evidence for the cow's milk hypothesis.
Because this issue has mammoth financial implications for American
agriculture, and because so many people have such intense personal
biases against it, it is unlikely that this diabetes research will reach the
American media anytime soon. However, the depth and breadth of evi-
d e n c e now implicating cow's milk as a cause of Type 1 diabetes is over-
whelming, even though the very complex mechanistic details are not
yet fully understood. We not only have evidence of the danger of cow's
milk, we also have considerable evidence showing that the association
between diabetes and cow's milk is biologically plausible. Human breast
milk is the perfect food for an infant, and one of the most damaging
things a mother can do is to substitute the milk of a cow for her own.
MULTIPLE SCLEROSIS
AND OTHER AUTOIMMUNE DISEASES
Multiple sclerosis (MS) is a particularly difficult autoimmune disease,
both for those who have it and for those who care for its victims. It is a
lifelong battle involving a variety of unpredictable and serious disabilities.
MS patients often pass through episodes of acute attacks while gradually
losing their ability to walk or to see. After ten to fifteen years, they often
are confined to a wheelchair, and then to a bed for the rest of their lives.
About 400,000 people in the u.s. alone have the disease, according
to the National Multiple Sclerosis Society.39 It is a disease that is initially
diagnosed between twenty and forty years of age and strikes women
about three times more often than men.
Even though there is widespread medical and scientific interest in
this disease, most authorities claim to know very little about causes
or cures. Major multiple sclerosis Internet Web sites all claim that the
disease is an enigma. They generally list genetics, viruses and environ-
m e n t a l factors as possibly playing roles in the development of this dis-
ease but pay almost no heed to a possible role for diet. This is peculiar
considering the wealth of intriguing information on the effects of food
that is available from reputable research reports. 40--42 Once again cow's
milk appears to play an important role.
The "multiple" symptoms of this disease represent a nervous system
gone awry. The electrical signals carrying messages to and from the
central nervous system (brain and spinal cord) and out through the pe-
ripheral nervous system to the rest of the body are not well coordinated

AUTOIMMUNE DISEASES                            195
and controlled. This is because the insulating cover or sheath of the
nerve fibers, the myelin, is being destroyed by an autoimmune reaction.
Think of what would happen to your household wiring if the electrical
insulation became thin or was stripped away, leaving bare wires. The
electrical Signals would be short-circuited. That is what happens with
MS; the wayward electrical signals may destroy cells and "burn" patches
of neighboring tissue, leaVing little scars or bits of sclerotic tissue. These
"burns" can become serious and ultimately destroy the body.
The initial research showing an effect of diet on MS goes back more
than half a century to the research of Dr. Roy Swank, who began his
work in Norway and at the Montreal Neurological Institute during the
1940s. Later, Dr. Swank headed the Division of Neurology at the Uni-
versity of Oregon Medical Schoo1. 43
Dr. Swank became interested in the dietary connection when he
learned that MS appeared to be more common in the northern cli-
m a t e s Y There is a huge difference in MS prevalence as one moves away
from the equator: MS is over 100 times more prevalent in the far north
than at the equator,l° and seven times more prevalent in south Australia
(closer to the South Pole) than in north Australia. 44 This distribution is
very similar to the distribution of other autoimmune diseases, including
Type 1 diabetes and rheumatoid arthritis. 45,46
Although some scientists speculated that magnetic fields might be
responsible for the disease, Dr. Swank thought it was diet, especially
animal-based foods high in saturated fats. 43 He found that inland dairy-
consuming areas of Norway had higher rates of MS than coastal fish-con-
s u m i n g areas.
Dr. Swank conducted his best-known trial on 144 MS patients re-
c r u i t e d from the Montreal Neurological Institute. He kept records on
these patients for the next thirty-four yearsY He advised his patients
to consume a diet low in saturated fat, most of whom did, but many
of whom did not. He then classified them as good dieters or poor diet-
ers, based on whether they consumed less than 20 glday or more than
20 glday of saturated fat. (For comparison, a bacon cheeseburger with
condiments has about sixteen grams of saturated fat. One small frozen
chicken pot pie has almost ten grams of saturated fat.)
As the study continued, Dr. Swank found that progreSSion of disease
was greatly reduced by the low-saturated fat diet, which worked even
for people with initially advanced conditions. He summarized his work
in 1990,47 concluding that for the sub-group of patients who began the

THE CHINA STUDY
196
CHART 9.4: MS DEATH RATE AFTER 144 PATIENTS DIETED
FOR THIRTY-FOUR YEARS
70%
60%
50%
Percent who 40%
died of MS 30%
20%
10%
0% -t'--...............- - - - . . . , - - -
Poor Dieters                     Good Dieters
low-saturated fat diet during the earlier stages of their disease, "about
95% .. . remained only mildly disabled for approximately thirty years. "
Only 5% of these patients died. In contrast, 80%of the patients with early-
stage MS who consumed the "poor" diet (higher saturated fat) died of MS.
The results from all 144 patients, including those who started the diet
at a later stage of disease, are shown in Chart 9.4.
This work is remarkable. To follow people for thirty-four years is an
exceptional demonstration of perseverance and dedication. Moreover,
if this were a study testing a potential drug, these findings would make
any pharmaceutical manufacturer jingle the coins in his or her pocket.
Swank's first results were published more than a half century ago ,48 then
again49 and again 50 and again47 for the next forty years.
More recently, additional studies 42 , 51, 52 have confirmed and extended
Swank's observations and gradually have begun to place more empha-
sis on cow's milk. These new studies show that consuming cow's milk
is strongly linked to MS both when comparing different countries 52
and when comparing states within the U.S.51 Chart 9.5, published by
French researchers, compares the consumption of cow's milk with MS
for twenty-six populations in twenty-four countries. 52
This relationship, which is virtually identical to that for Type 1
diabetes, is remarkable, and it is not due to variables such as the avail-
ability of medical services or geographic latitude.51 In some studies 52 , 53
researchers suggest this strong correlation with fresh cow's milk might

AUTOIMMUNE DISEASES                            197
CHART 9.5: ASSOCIATION OF COW'S MILK CONSUMPTION
AND MULTIPLE SCLEROSIS
200
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0                       100                           200
Milk Consumption (kg/inhabitants/year)
be due to the presence of a virus in the milk. These more recent studies
also suggest that saturated fat alone probably was not fully responsible
for Swank's results. The consumption of meat high in saturated fat, like
milk, was also associated with MS in these multi-country studies,54
while the consumption of fish, containing more omega-3 fat, was as-
sociated with low rates of disease. S5
The association of cow's milk with MS, shown in Chart 9.5, may be
impressive, but it does not constitute proof. For example, where do
genes and viruses come into play? Each of these, in theory, might ac-
c o u n t for the unusual geographic distribution of this disease.
In the case of viruses, no definite conclusions are yet possible. A
variety of different virus types have been suggested and a variety of ef-
fects on the immune system may be involved. However, nothing very
convincing has been proven. Some of the evidence is based on finding
more viral antibodies in MS patients than in controls, some is based on
sporadic outbreaks of MS among isolated communities, and some is
based on finding virus-like genes among MS cases. 13 , 19.56
With regard to genes, we can begin to puzzle out their association
with MS by asking the usual question: what happens to people who
migrate from one population to another, keeping their genes the same

198                            THE CHINA STUDY
but changing their diets and their environment? The answer is the same
as it was for cancer, heart disease and Type 2 diabetes. People acquire
the risk of the population to which they move, especially if they move
before their adolescent years. 57. 58 This tells us that this disease is more
strongly related to environmental factors than it is to genes. 59
Specific genes have been identified as possible candidates for causing
MS but, according to a recent report,3 there may be as many as twenty-
five genes playing such a role. Therefore, it will undoubtedly be a long
time before we determine with any precision which genes or combina-
tions of genes predispose someone to MS. Genetic predisposition may
make a difference as to who gets MS, but even at best, genes can only
account for about one-fourth of the total disease risk. 60
Although MS and Type 1 diabetes share some of the same unanswered
questions on the exact roles of viruses and genes and the immune sys-
tem, they also share the same alarming evidence regarding diet. For
both diseases, a "Western" diet is strongly associated with disease in-
cidence. Despite the efforts of those who would rather dismiss or mire
these observational studies in controversy, they paint a consistent pic-
ture. Intervention studies conducted on people already suffering from
these diseases only reinforce the findings of the observational studies.
Dr. Swank did brilliant work on MS, and you may recall from chapter
seven that Dr. James Anderson successfully reduced the medication re-
q u i r e m e n t s for Type 1 diabetics using diet alone. It's important to note
that both of these doctors used a diet that was significantly more mod-
erate than a total whole foods, plant-based diet. I wonder what would
happen to these autoimmune patients if the ideal diet were followed. I
would bet on even greater success.
THE COMMONALITY OF AUTOIMMUNE DISEASES
What about other autoimmune diseases? There are dozens of autoim-
m u n e diseases and I have mentioned only two of the more prominent
ones. Can we say anything about autoimmune diseases as a whole?
To answer this question, we need to identify how much these dis-
eases have in common. The more they have in common, the greater the
probability that they also will share a common cause (or causes). This
is like seeing two people you don't know, both of whom have a similar
body type, hair color, eye color, facial features, physical and vocal man-
nerisms and age, and concluding that they come from the same parents.
Just as we hypothesized that diseases of affluence such as cancer and

AUTOIMMUNE DISEASES                            199
heart disease have common causes because they share similar geogra-
p h y and similar biochemical biomarkers (chapter four), we can also
hypothesize that MS, Type 1 diabetes, rheumatoid arthritis, lupus and
other autoimmune diseases may share a similar cause if they exhibit
similar characteristics.
First, by definition, each of these diseases involves an immune sys-
t e m that has gone awry in such a way that it attacks "self' proteins that
look the same as foreign proteins.
Second, all the autoimmune diseases that have been studied have
been found to be more common at the higher geographic latitudes
where there is less constant sunshine. 9 • 10, 61
Third, some of these diseases have a tendency to afflict the same
people. MS and Type 1 diabetes, for example, have been shown to coex-
ist in the same individuals. 62- 65 Parkinson's disease, a non-autoimmune
disease with autoimmune characteristics, is often found with MS, both
within the same geographic regions 66 and within the same individuals. 5
MS also has been associated-either geographically or within the same
individuals-with other autoimmune diseases like lupus, myasthenia
gravis, Graves' disease and eosinophilic vasculitis.63 Juvenile rheuma-
t o i d arthritis, another autoimmune disease, has been shown to have an
unusually strong association with Hashimoto thyroiditis.67
Fourth, of those diseases studied in relation to nutrition, the con-
s u m p t i o n of animal-based foods-especially cow's milk-is associated
with greater disease risk.
Fifth, there is evidence that a virus (or viruses) may trigger the onset
of several of these diseases.
A sixth and most important characteristic binding together these
diseases is the evidence that their "mechanisms of action" have much
in common-jargon used to describe the "how to" of disease forma-
tion. As we consider common mechanisms of action, we might start
with sunlight exposure, because this somehow seems linked to the au-
t o i m m u n e diseases. Sunlight exposure, which decreases with increas-
ing latitude, could be important-but clearly there are other factors .
The consumption of animal-based foods, especially cow's milk, also
increases with distance from the equator. In fact, in one of the more ex-
tensive studies, cow's milk was found to be as good of a predictor of MS
as latitude (Le., sunshine)Y In Dr. Swank's studies in Norway, MS was
less common near the coastal areas of the country where fish intake was
more common. This gave rise to the idea that the omega-3 fats common