The China Study (48 page)

GOVERNMENT: IS IT FOR THE PEOPLE?                       315
literature. To address various health topics, the NIH is comprised of
twenty-seven separate institutes and centers, including its two largest,
the National Cancer Institute (NCO and the National Heart, Lung and
Blood Institute. l4 With a proposed 2005 budget of almost $29 billion,15
the NIH is the center of the government's gigantic medical research ef-
forts.
In terms of nutrition research, however, something is amiss. None
of these twenty-seven institutes and centers at the NIH is devoted to
nutrition, despite the pivotal nature of nutrition in health, and despite
the public interest in the subject. One of the arguments against having a
separate institute for nutrition is that the existing institutes already con-
c e r n themselves with nutrition. But this does not happen. Chart 16.3
shows the funding priorities for various health topics at the NIH.l6
Of the $28 billion NIH budget proposed for 2004, only about 3.6%
is designated for projects that are related in some way to nutrition l7 and
24% for projects that are related to prevention. That may not sound too
bad. But these figures are seriously misleading.
Most of the prevention and nutrition budgets have absolutely noth-
i n g to do with prevention and nutrition, as I have written in this book.
CHART 16.3: NIH 2004 ESTIMATED FUNDING
FOR DIFFERENT HEALTH TOPICS17
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THE CHINA STUDY
316
We won't be hearing about exciting research on dietary patterns, nor
will there be serious efforts to tell the public how diet affects health.
Instead, the prevention and nutrition budgets will be designated for
developing drugs and nutrient supplements. A few years ago, the direc-
tor of the NC!, the oldest of the NIH institutes, described prevention
as "efforts to directly prevent and/or inhibit malignant transformation,
to identify, characterize and manipulate factors that might be effective
in achieving that inhibition and attempts to promote preventative mea-
sures ." 1 This so-called prevention is all about manipulation ofisolated
8
chemicals. "Identifying, characterizing and manipulating factors" is a
not-so-secret code for drug discovery.
Considered from another perspective, the NCI (of the NIH), in 1999,
had a budget of $2.93 billion. 1 In a "major" 5-A-Day dietary program, it
9
was spending $500,000 to $1 million to educate the public to consume
five or more servings of fruits and vegetables per day. 18 This is only three
hundredths of one percent (0.0256%) of its budget. That's $2.56 for every
$1O,000! If it calls this a major campaign, I pity its minor campaigns.
The NCI also has been funding a couple of multi-year large studies,
including the Nurses' Health Study at Harvard (discussed in chapter
twelve) and the Women's Health Initiative, mostly devoted to the testing
of hormone replacement therapy, vitamin D and calcium supplementa-
tion, and the effect of a moderately low-fat diet on prevention of breast
and colon cancer. These rare nutrition-related studies unfortunately
suffer from the same experimental flaws described in chapter fourteen.
Almost always, these studies are designed to tinker with one nutrient at
a time, among an experimental population that uniformly consumes a
high-risk, animal-based diet. These studies have a very high probability
of creating some very expensive confusion that we hardly need.
If very few of our tax dollars are used to fund nutrition research, what
do they fund? Almost all of the billions of dollars of taxpayer money
expended by the NIH each year funds projects to develop drugs, supple-
m e n t s and mechanical devices. In essence, the vast bulk of biomedical
research funded by you and me is basic research to discover products
that the pharmaceutical industry can develop and market. In 2000, Dr.
Marcia Angell, a former editor of the New England Journal of Medicine,
summarized it well when she wrote2°:
. . . the pharmaceutical industry enjoys extraordinary government
protections and subsidies. Much of the early basic research that

GOVERNMENT: IS IT FOR THE PEOPLE?                    317
may lead to drug development is funded by the National Institutes
of Health (ref. cited). It is usually only later, when the research
shows practical promise, that the drug companies become in-
volved. The industry also enjoys great tax advantages. Not only are
its research and development costs deductible, but so are its mas-
sive marketing expenses. The average tax rate of major u.s. indus-
tries from 1993 to 1996 was 27.3% of revenues. During the same
period the pharmaceutical industry was reportedly taxed at a rate
of only 16.2% (ref. cited). Most important, the drug companies en-
j o y seventeen-year government-granted monopolies on their new
drugs-that is, patent protection. Once a drug is patented, no one
else may sell it, and the drug company is free to charge whatever
the traffic will bear.20
Our tax dollars are used to make the pharmaceutical industry more
profitable. One could argue that this is justified by gains in public
health, but the alarming fact is that this litany of research into drugs,
genes, devices and technology research will never cure our chronic dis-
eases . Our chronic diseases are largely the result of infinitely complex
assaults on our bodies resulting from eating bad food. No single chemi-
cal intervention will ever equal the power of consuming the healthiest
food. In addition, isolated chemicals in drug form can be very danger-
ous. The National Cancer Institute itself states, "What is clear is that
most of our current treatments will produce some measure of adver-
sity. "21 There is no danger to eating a healthy diet, and there are far
more benefits, including massive cost savings both on the front end of
preventing disease and on the back end of treating disease. So why is
our government ignoring the abundant scientific research supporting
a dietary approach in favor of largely ineffective, potentially dangerous
drug and device interventions?
PERSONAL ACCOUNTS
In terms of public nutrition policy, I want to leave you with one short sto-
ry that says so much about the government's priorities. One of my former
graduate students at Cornell, Antonia Demas (now Dr. Antonia Demas) ,
did her doctoral research in education by teaching a healthy food-and-nu-
trition-based curriculum22 to elementary school kids and then integrating
those healthy foods into the school lunch program. She had been doing
this work as a volunteer mother in her children's schools for seventeen

THE CHINA STUDY
318
years prior to her graduate studies. I was her advisor for the nutrition
part of her dissertation research.
The U.s. Department of Agriculture administers the school lunch
program to 28 million children, largely relying on an inventory of gov-
e r n m e n t - s u b s i d i z e d foods. The government program, as it now stands,
uses mostly animal-based products and even requires that participating
schools make available cow's milk. At the local level, this usually means
that consumption of milk is mandatory.
Dr. Demas's innovative research on the school lunch program was a
great success; children loved the learning style and were excited to eat
the healthy foods when they went through the lunch line. The children
then convinced their parents to eat the healthy food at home. Dr. Demas's
program won national awards for the "most creative implementation of
the dietary gUidelines" and "excellence in nutrition education." The
program has proven to be of interest to more than 300 school lunch and
behavioral rehabilitation programs around the U.S., including schools
in areas as widely dispersed as Hawaii, Florida, Indiana, New England,
California and New Mexico. In this effort, Dr. Demas has organized a
nonprofit foundation (Food Studies Institute, Trumansburg, New York)
and written a curriculum ("Food is Elementary"). And here's the kicker:
Dr. Demas's program is entirely plant-based.
I had the opportunity to go to Washington and talk with Dr. Eileen
Kennedy, who, at the time, was the director of the Center for Nutrition
Policy and Promotion at the USDA. Dr. Kennedy was deeply involved
both in the school lunch program and the dietary guidelines commit-
tee, on which it was revealed that she had ties to the dairy industry. She
is now the Deputy Undersecretary for the USDA's Research, Education
and Economics division. The topic of our discussion was Dr. Demas's
innovative school lunch program and how it was garnering national
attention. At the end of this discussion, I said to her, "You know, that
program is entirely plant-based." She looked at me, wagged her finger as
if I were being a bad boy, and said, "We can't have that."
I have come to the conclusion that when it comes to health, govern-
m e n t is not for the people; it IS for the food industry and the pharmaceu-
tical industry at the expense of the people. It is a systemic problem where
industry, academia and government combine to determine the health
of this country. Industry provides funding for public health reports,
and academic leaders with industry ties play key roles in developing
them. A revolving door exists between government jobs and industry

319
GOVERNMENT: IS IT FOR THE PEOPLE?
jobs, and government research funding goes to the development of
drugs and devices instead of healthy nutrition. It is a system built by
people who play their isolated parts, oftentimes unaware of the top de-
cision makers and their ulterior motivations. The system is a waste of
taxpayer money and is profoundly damaging to our health.

.. 11 ... .
.
Big Medicine: Whose Health
Are They Protecting?
WHEN IS THE LAST TIME that you went to the doctor and he or she told
you what to eat or what not to eat? You've probably never had that ex-
perience. But the vast majority of Americans will fall prey to one of the
chronic diseases of affluence discussed in Part II, and, as you have seen,
there is a wealth of published research that suggests these diseases are a
result of poor nutrition, not poor genes or bad luck. So why doesn't the
medical system take nutrition seriously?
Four words: money, ego, power and control. While it is unfair to
generalize about individual doctors, it is safe to say that the system they
work in, the system that currently takes responsibility for promoting
the health of Americans, is failing us. No one knows this better than
the tiny minority of doctors who treat their patients from a nutritional
perspective. Two of the most prominent doctors in this minority have
spent many years emphasizing diet and health, both in public within
their profession and in private with their patients. They have had ex-
ceptionally impressive results protecting their patients' health. These
r
two doctors are Caldwell B. Esselstyn, Jr., whose work I discussed in
chapter five, and John McDougall, an internist. My son Tom and I sat
down with these men recently to discuss their experience advocating a
whole foods, plant-based diet in the medical setting.
321

322                          THE CHINA STUDY
DR. SPROUTS
Long before our country was founded, Dutch pioneers had settled in
the Hudson Valley north of New York City. One of these settler families
were the Esselstyns. They started farming a plot of land in 1675. Nine
generations later, that farm still belongs to the Esselstyn family. Dr. Es-
selstyn and his wife Ann own the several-hundred-acre Hudson Valley
farm, just over two hours north of New York City. They spent the sum-
m e r of 2003 living in the country, working the farm, growing a garden,
hosting their kids and grandkids and enjoying a more relaxed life than
what they're used to in Cleveland, Ohio.
Ess and Ann have a modest house: a large, rectangular, converted
storage building. The simplicity of it belies the fact that this is one of
the oldest family farms in America. Only upon closer inspection does
it become apparent that there is something unusual about this place.
Hanging on the wall is a framed certificate from New York State given to
the Esselstyn family in recognition of their family farm, a farm that has
now seen parts of five different centuries. Nearby an oar hangs on the
wall. It is the oar Ess used in 1955 as an oarsman at Yale, when Yale beat
Harvard by five seconds. Ess explains he has three other oars: two from
beating Harvard in other years, and one for winning the gold medal in
the Olympics with the Yale crew in 1956.
Downstairs, there is an exceptionally old photograph of Ess's great
great grandfather on the farm. Around the corner there's an impressive-
l o o k i n g museum-style schematic of the Esselstyn family tree, and on
the other end of the hall, there's a large black and white picture of Ess's
father standing in front of a microphone, exchanging comments with
John F. Kennedy during a White House address. Despite its humble
appearance, it is very clear that this is a place with a distinguished his-
tory.
After touring the farm on a tractor, we sat down with Ess and asked
him about his past. After graduating from Yale, he was trained as a sur-
geon at the Cleveland Clinic and at St. George's Hospital in London.
He remembers fondly some of his most influential mentors: Dr. George
Crile, Jr., Dr. Turnbull and Dr. Brook. Dr. Crile, a giant at the Cleve-
l a n d Clinic, eventually became Ess's father-in-law upon Ess's marriage
to Ann. Dr. Crile was a man of exceptional accomplishment, playing
a courageous, leading role in questioning the macabre surgery called
"radical mastectomy."l Dr. Turnbull and Dr. Brook were also renowned