In my classes I will usually bring up a point about something called the epidemiological transition. This is the change in overall population characteristics that happens when total productivity and wealth increase in a society to the point where modern innovations like sanitation and increased food production happen.
We can see how this has played out over the last fifty years in China.
Pre-industrial China had a very large population but very low rates of the chronic diseases of affluence that we are familiar with: obesity, coronary artery disease, stroke, heart attack, cancer and diabetes. This was counterbalanced by very high rates of infectious disease, high infant mortality rates and frequent, deadly epidemics that would wipe out large numbers of people in a short time.
As a society becomes more economically successful with higher crop yields and better sanitation, infant mortality begins to plummet, as we see in this graph from China:
At the same time, rates of chronic disease start to increase dramatically, but there is a lag time where the infant mortality is dropping rapidly and chronic disease burden is still at a relatively low rate. This is because the negative consequences of the changes in health outcome take decades to have their full effect. The conditions for developing symptomatic disease depend on arteries clogging slowly, cancer cells gradually dividing and spreading, and blood sugars gradually rising.
We can see the change in China, which had exceedingly low rates of diabetes and obesity but has had marked increases over the last thirty years:
So using the excellent example that we get from China, we can see that increases in fat and protein in the diet reliably bring on obesity. Multiple other studies show that obesity is correlated with the chronic diseases of industrialization. We can be reasonably sure, then, that if a study shows that higher fat, higher protein diets led to better outcomes, that study must have cooked the books in some way.
This brings us to the recently published study on macronutrients (carbohydrate, protein and fat) published in Lancet that I wrote about last time, the PURE study.
This study tried to show that high carbohydrate diets were dangerous, and now that I have looked into it more, the manipulation is obvious. The study was rigged from the start by excluding everyone who had existing cardiovascular disease at the onset. The study only followed participants for ten years. As you can see from the data above, the transition from poor country to developing country demographics takes much longer than that.
Since cardiovascular disease is the number one cause of death, globally, if you remove the people who already have this disease from your study it will skew the numbers dramatically. It will also increase the proportion of deaths from infections, trauma and accidents, and other serious diseases in the people who remain in your study group.
One of the nations in the study is extremely poor, eats a traditional diet high in carbohydrates and has HIV infection rates of about fifteen percent. Another of the poor countries with a similar diet was struck by a tsunami during the period of the study, killing 10,000 people. None of these people were excluded from the study, but everyone with an abnormal EKG was.
The fact that this study got huge headlines should show you what game is being played, because there was another study published last week that got ZERO and I do mean ZERO press.
It was the fifty year findings from the Seven Countries Study that was started in the 1960s. It showed that the members of that study who ate the most saturated fat had an average life expectancy twelve years shorter than those who ate the least saturated fat.
Did the media trumpet this study?
Did it get a lot of TV reports and breathless headlines about how butter and cheese will kill you?
Beware. The news is not the best place to find out about diet.
Do your own research. Study the information from the scientific literature yourself, instead of media headlines and snippets, and you will find out what is really going on.
In the meantime, understand that you already have the benefits of the industrial age. You have good sanitation, clean drinking water, good hospitals and excellent building codes. You don’t have to worry about many of the problems that people in Zimbabwe and Bangladesh do. But you do have to worry about eating like a typical Westerner and getting the typical problems Westerners get, like a heart attack or a stroke.
You can reduce your risk dramatically by eating as if the epidemiological transition hasn’t happened to you. Eat a diet composed of unprocessed plant foods, combined in exciting and interesting ways, take a B12 supplement, and enjoy your health!