Throwback: Speaking with Thomas Campbell, MD about his book, The Campbell Plan; Plant Based Diet
Below is a CYInterview that took place in 2015 its entirety with Thomas Campbell:
Jay Bildstein: I’m Jay Bildstein. With us today on CYInterview, a man destined to go down in history as a true American hero. He, along with his father T. Collin Campbell, authored the China Study of which the NY Times stated, “The study can be considered the grand prix of epidemiology.’ He’s authored a new book entitled The Campbell Plan. He is none other than Thomas Campbell, MD. Dr. Campbell, welcome to CYInterview.
Thomas Campbell: “Well, thank you for that introduction, for having me on your show. I appreciate it.”
Jay Bildstein: Well, we’re honored to have you. And joining us is my colleague, a man who needs no introduction, the editor in chief of CYInterview, Mr. Chris Yandek. Chris, good to have you here with us as always.
Chris Yandek: It is an honor to be with you as always and the great doctor who has written many great, remarkable books.
Jay Bildstein: Well, let’s begin. We are beset by health challenges. Obesity has gripped the nation, diabetes trends ever upward, heart disease and cancer present significant challenges, millions upon millions of Americans have high cholesterol, auto immune diseases seem to be everywhere and the U.S.’s healthcare infrastructure does not appear to be able to handle the health crisis we face. Doctor Campbell, first, do I overstate the case? And second, how can your excellent book The Campbell Plan help save us from the health care maelstrom approaching us?
Thomas Campbell: “Well, actually I think you put it very, very well. I talk to people and sometimes they don’t appreciate that there are so many problems because I think in some ways in this country we’ve adapted to a new normal that is actually quite bad. It’s a normal where many of us are on prescription medications, the majority of us, especially over 50 are on prescription medications or struggling with weight, pain related to being overweight or obese and many other problems as you stated. And the financial aspect of this is really quite profound for us financially, our governments and personally.
So, I don’t think you overstate the case at all and what’s so exciting about where we stand and this challenge and this opportunity in front of us is really that food is actually the key to all of these issues. There is no single topic out there, it’s not new drugs, it’s not genetic discoveries, it’s not new procedures. There’s no single approach to these issues that has the power of making the right food choices both for personal health or societal health, environmental health, financial health and on and on. It’s where all those things meet is our food choices.
And The Campbell Plan that I wrote is, you know, it’s one of many, many diet books of course. I mean, a lot of this has been said before but we, my dad and I wrote The China Study and my dad was the original researcher who conducted The China Study and earned that quote from the NY Times for his research project. And what we did is we wanted to comprehensively summarize that just give people a hint, a hint in 400 pages or 350 pages of the depths and breadth of evidence how the mountain of evidence that’s out there that’s largely unknown, that food is so profound for so many of our problems. And the diet that we came to recommend was what we call a whole food plant-based diet.
Now this is a diet that minimizes or eliminates animal foods and processed plant foods. Foods like added oils and sugars and white flours and that type of thing. Now that’s a very different diet for the average American and it’s not very popular and I’m not very popular for a lot of people for spousing such a diet, but the evidence is absolutely overwhelming that this is very powerful for personal health and all the other things. So, what I wanted to do was create a how to book to help people go from a very different diet, a very bad American diet and begin to incorporate some of these healthy dietary things into their life. And so they have a tool, a resource book that not only shows them step by step how to go from adapter diet, however long they want to take.
If they want to do it over 10 years or if they want to do it over 2 days, you know, you can use the principles in the book. And then I also wanted to have a section that was devoted to the details of the diet. I mean, we talk about a whole food plant-based diet, but there’s so many questions that people come up with over and over and over. You know, what about soy? What is this about gluten? Is it true that we’re, we need to be so concerned about gluten? And why in the world do you say added oils are bad? You know, questions that we get over and over and over that I really wanted to give a little bit of additional science, sort of the science behind our recommendations about some of these details. So it has over 50 recipes, a menu plan and all the practical bits, but it also stays true. My intention was for it to stay true in a very scientific basis, you know, for the details of this diet.”
Jay Bildstein: Is it fair to say doctor that the reason the public is confused about what will put us on the road to good health both individually and collectively is that we’re not accurately communicated critical information and please allow me an example. I don’t know, let’s consider a study in a certain area in a neighborhood of a major city which has a particularly high rate of STDS, sexually transmitted diseases. And let’s say in the study two groups are looked at. One group has random, unprotected sex daily. The other group is very cautious and receives safer sex counseling and consequently they only have random, unprotected sex every Saturday night in this same high-risk area and both groups are followed for five years.
Now at the end of five years, the researchers note that both groups have high rates of STDS and thus conclude that safer sex practices are no better than unprotected sex. Isn’t this what’s happened when it comes to reporting about nutritional practices and health? Like when a 30 percent [fat] diet is considered low fat and then when remarkable differences in health and disease are not seen?
Thomas Campbell: “Yeah. You’ve really hit the nail on the head here actually. So many of our studies in western culture and you’re mostly in America and Europe where so much of our biomedical research takes place are dealing with populations that are eating a Western diet. Now a Western diet is a very high fat, people eat a lot of added fats and they have high fat foods. You know, meats, milks, cheeses and so forth that if we’re eating about 35 percent of all of our calories from fat, I consider that to be a fairly high fat diet.
Now when you go down to 30 percent, so if you go from 35 percent to 30 percent in many of these studies, that’s actually considered a low fat diet ok? Going from 35 percent of calories to 30 percent of calories. In reality, that’s not a big difference. I mean, when we’re talking about a whole food plant-based diet, you’re getting down closer to 10 percent of your total calories from fat. Now that’s a big difference and that’s where the studies show in reversal of established heart disease. You know, the diets that have reversed heart disease proven by angiograms, that those diets have gotten down to 10 percent fat. Now when you have diets that are 30 percent fat that are somehow construed to be the same sort of low fat approach, it’s really not, it’s not an accurate interpretation of the research.
And unfortunately we see this mistake happen not just from in the public or in the media, it’s actually in much of the language of the research because people don’t appreciate necessarily that these small distinctions that people are making are not, you know, you can have a very meat heavy diet that has more red meat and you’re comparing it with another meat heavy diet that has more skinless chicken and there’s a little difference in fat, but really, you know, you’re not talking about dramatically different diets. It’s really not that meaningful. And so you end up with all these confusing results about, you know, this thing in this study is linked to this outcome in that study, but not in this other study. We hear fat, it makes a difference, fat doesn’t make a difference, cholesterol matters, cholesterol doesn’t matter, it’s saturated fat, no, no it’s not saturated fat and so you end up with very, very confusing research. And that’s, you know, nutrition is hard to study to begin with and when we make these mistakes of research interpretation and communication, it compounds all the difficulties 10 times.”
Jay Bildstein: Well, The Campbell Plan certainly I believe brings these ideas across in a very direct, easy to understand way. Chris?
Chris Yandek: Dr. Campbell, thank you again so much for being on and shedding light on this very important topic that affects us all. I’d like to ask you something and I thought about this as I was reading the beginning of your book. As we grow up, we get many pieces of information in school and around us that fruits and vegetables are good for us and things like candy, chips and soda are not good for us in large portions. Why do you think even though we get these messages, the education has not worked to possibly keep people on a healthy trajectory and thus why has the education failed you think?
Thomas Campbell: “Well, there’s so many answers to that question and it’s a very comprehensive, you have to look at it very comprehensively and I think from a public health point of view, from a personal health point of view, from an education point of view, from a social point of view, all these things matter. So, just to start with our education system, our school lunches and our school education system, yes we hear fruits and vegetables are good, but look at we’re modeling for our kids. Our school lunch program is not healthy and it could be much, much better. So we’re failing in our schools to educate kids about basic health, the fundamentals of basic health.
In our families, we, like as I started out was saying that I think in some ways, I’m a practicing family doc and I see quote unquote normal patients, I don’t have just an exclusively sort of nutrition practice and I see people who are just adapted to, now they’re a couple generations in to breakfast of pop tarts, a lunch of a McDonalds sandwich and a dinner of some other fast food or TV dinner, you know, mac and cheese and so they’re a couple generations in. And so they don’t communicate to their kids, in fact they’re modeling exactly all the wrong behaviors. And then we have a medical system that does not adequately address food. We don’t have reimbursement for medical practitioners to actually talk about food the way that we reimburse them, we reimburse physicians for doing procedures and prescribing medications and so forth.
We don’t have a system that allows the time to interact with patients and help them change in a meaningful way and we don’t have an education in our medical system that educates doctors on how important this message is and how important food is. So we’ve got a medical system that’s a failing us, we’ve got a school system that failed us, we’ve got often times for many people, we’ve got a personal history of bad health that goes totally unnoticed, but people just don’t know anymore that that’s in fact not a normal state of health. You know, it’s not normal to be that overweight and have kind of aches and pains and be on pills. And so it’s the social aspects of that whole system, the education, the medical system and then I think, you know, I think our media and a lot of this goes back, I’m not a conspiracy theorist, but a lot of this goes to industries that are very entrenched and a media that largely tells us good things about our bad habits.
So, we hear, because we love to hear good things about our bad habits and more people are gonna click on the story of the 104 year old woman drinking three cans of soda a day than the story about eating broccoli three times a day. So they’re looking for clicks and eye balls, you know, and you can’t blame them, but that’s the media and industry of course is practicing the status quo and the entrenched profits that come with all these endeavors. So we’ve really got, you know, I would agree that we often hear that fruits and vegetables are healthy, but it’s never really told to us in a meaningful way with a meaningful structure that really helps people change and get it and get it in their core. So I don’t think our education from all these different sources is doing enough. It’s not strong enough; it’s not saying it strong enough. So there’s a lot of work to do. And I think we’re more often bombarded with confusing statements that make us want to throw our hands up.”
Jay Bildstein: And consequently, we’ll see people who are, who consider themselves to be in the know and they will trumpet their virtuousness when you go out to lunch with them and [they] say, I’m not having a hamburger, I’m not having a pastrami sandwich, I’m not having corn beef, I’m gonna have something healthy, the chicken Caesar salad. Right? Because it’s salad. But as pointed out, chicken Caesar salad is an animal based, animal dense, high fat, high saturated fat offering, which is very interesting. Now, there are a couple of different interesting things that pop up between your latest offering The Campbell Plan, which again I believe is a wonderful starting place for folks because it’s so accessible and it’s also got a lot of delicious recipes in it.
For people who really want to create greater depth to their knowledge then I probably go The Campbell Plan, then the China Study and then into Whole. Of course the China Study, you co-authored with your dad who, as you said, put this together out of Cornell and Whole I believe was with Howard Jacobson, which is also a very, very compelling book. I think I remember at some point, I think it was in the China Study saying like the upward amount of cholesterol that should be taken in by a person is zero. Maybe your dad actually said it in a talk. And so, I have a question about that and I think this comes back to the China Study itself when there was actually a remarkable decrease in disease in rural China between people who were maybe at a cholesterol level of 140, 130, all the way down to 90.
Now in the United States, if somebody had a 140 cholesterol, some doctors might say they were doing remarkably well. Other doctors may panic and say their cholesterol is too low. And yet when you look at these good folks in China, people who were even well below that were even more healthy. Let’s, by the way, do I have that right in my sum up because I want to get to some specific points?
Thomas Campbell: “Yeah, yeah. You got it. You got it. The range of cholesterol in rural China in the ‘70s and ‘80s was way lower then, their highs were at our lows, you know, in the mid to upper 100s.”
Jay Bildstein: So let’s talk about that on a working end for the average person listening to this, how about a person right now, they’ve got high cholesterol, they’ve got good blood pressure. Let’s say their blood pressure is, I don’t know, 110/70, they exercise every day, but they’ve just got persistently high cholesterol. What risks are they running if they don’t adopt something like The Campbell Plan? Are they destined for statins, can they ignore this or is there going to be the piper to pay for somebody with no other risk factors, but they’ve just got a darn high cholesterol and low density cholesterol?
Thomas Campbell: “Right, well, it’s hard to say. You know, with the devil, with making predictions for an individual is that you just can’t say things for sure. Some people have a genetic pre-disposition to have a high baseline cholesterol even though they probably have a fairy low risk of heart disease. And some people have a baseline predisposition to have a low cholesterol and when they get to that upper range it still seems kinda low to most doctors, but boy they’re at high risk for heart disease. So it’s hard to know what your cholesterol level exactly means for you. We know from a population level that once you start getting above 150, your cholesterol, your total cholesterol, it’s linked in a population with higher rates of heart disease and particularly with LDL or the so called bad cholesterol.
Now, with cholesterol, even if you’re within the so called normal range, if your total cholesterol is between 150 and 200, we know that a sizable chunk of all heart attacks and heart disease, deaths will occur in people within that range, so from 150 to 200. So cholesterol, having a normal cholesterol is not necessarily protective unless you have a very low cholesterol below 150, which is sort of the total goal.”
Jay Bildstein: And if I understand doctor, I believe Cadwell Esselstyn and his studies, he never had anybody who had a heart attack who had cholesterol under 150. I believe that was Dean Ornish’s experience and I believe that was also the experience that was drawn from the Framingham Study correct?
Thomas Campbell: “Right. So if your cholesterol, there is an important caveat here, if your cholesterol is naturally that low, heart disease, although not impossible, becomes much, much more rare and the risk really drops. Now if you have a cholesterol that’s artificially dropped because of high dose statins or because of statins in general, you know, those lower numbers are not necessarily as protective as a low number naturally, ok.”
Jay Bildstein: And when you say naturally, you mean because of the diet someone’s eating?
Thomas Campbell: “Right, without medication, without medication.”
Jay Bildstein: Ok. So now let me swing because I’d like to get as much good information out there to folks as possible so that they get the book and they really look into what you are saying and see really the revealed truth and the wisdom. Breast cancer, certainly a very, very big concern, certainly in the United States there’s certain areas, Long Island for example, breast cancer clusters and so forth I believe. Some women who have fibrocystic breasts are told avoid coffee. Does research bare this out or is it far more important to avoid milk and animal products? I mean, what do we really know when it comes to that for example?
Thomas Campbell: “Yeah. I’m not sure that coffee, for example, has a huge, I just don’t know the research on coffee and breast cancer. Although I certainly haven’t heard any sort of overwhelming, overwhelming convincing argument that coffee is related to breast cancer. We know that breast cancer is related to obesity and estrogen levels, you know, throughout a woman’s lifetime. We know it’s also related to alcohol and lack of physical activity. So those things are far more important I think than coffee. We know coffee is related to some fibrocystic incidence, but in terms of cancer, I think I would focus much more on other diet and lifestyle factors. So having a plant-based diet, giving up dairy and meat and plenty of exercise and maintaining a healthy weight I think would do much more than just worrying about coffee.”
Jay Bildstein: And the information born out in the China Study from which The Campbell Plan stems, really bares out the danger of milk protein correct?
Thomas Campbell: “Yeah. There’s interesting, I would call it indirect evidence. Indirect evidence that it’s very compelling, very compelling and people don’t realize this that in animal models, for example, when we study something to see what’s carcinogenic. So what in our environment causes cancer? What we often do and many people are familiar with this, what we often do is we have a rodent model and we give them very high doses of a chemical and see if the cancer grows or not, if there’s a higher incidence of cancer. There’s different factors to see whether that’s a compelling link or not, compelling result or not.
People don’t realize this, but you can actually give a rodent model, you can give a rat that has initiated liver cancer, you give them a carcinogen that starts liver cancer. You can turn on and turn off the cancer growth in that rat using casein, the main protein in cow’s milk. Now this sounds like some sort of ludicrous conspiracy theory, alternative thing, but this is actually NIH research that my dad conducted at Cornell University and was published in the very best journals, was supported by the best competitive funding and over many decades of research landed him on the national expert panels for diet and cancer and this type of thing. So this was recognized, you know, real research and people just don’t want to touch it quite frankly because it’s not very popular. It’s not very popular, but this kind of indirect evidence to just a diet makes a big difference in cancer.
We’re still, I would say with cancer, cancer doesn’t have in terms of human intervention research, cancer does not have the depth of evidence that heart disease does or diabetes or obesity, the risk factors for heart disease. So we’re still waiting, I think we still need a little bit more research to know in human cancer for example, how much affect does diet have in treating or preventing recurrence in cancer and particularly a whole food plant-based diet. But there’s a lot of direct evidence. There’s a lot of direct evidence that this stuff matters a great deal.”
Jay Bildstein: Understood. What I’m going to do is I got one more of these specific questions Chris, then I’ll throw it to you. Then doctor, I’m gonna tell you a little experiment I did following some of the recommendations in The Campbell Plan, The China Study and so forth and get your feedback on it and then will go to wrap up. Autoimmune diseases, it seems, it’s amazing how things pop up either in the media or they pop up in commercials. It seems over the last couple of years, more and more medications are being advertised on television news channels at least that I’ve seen, for all kinds of autoimmune challenges and diseases, things like rheumatoid arthritis. I mean, people have rheumatoid arthritis, psoriatic arthritis and so forth. In terms of The Campbell Plan helping people who have auto immune disease, what does a whole food, plant-based diet have to offer folks who are struggling with auto immune diseases?
Thomas Campbell: “I think there’s a lot that we need to learn in this area, but I will say that there is some interesting small research that’s been done, small studies that have been done on rheumatoid arthritis, multiple sclerosis and these are, you know, very crippling obviously, very crippling, very important autoimmune diseases that, you know, by some of this research suggests that there’s a very important benefit to be had by adopting a whole food plant-based diet. So I think that we, I think that a whole food plant-based diet can only help. I would never make the claim of course that all autoimmune diseases are due to diet and you can treat it and reverse it. Just to give you one example on the flip side, I’m not sure that once you have your thyroid knocked out, Hashimoto’s Thyroiditis, and a low thyroid, I’m not sure that you can change that dramatically with a whole food plant based diet.
But I think that one of the things you have to keep in mind is that often times autoimmune disease is linked to other diseases that are not necessarily autoimmune. So Psoriatic arthritis or psoriasis for example is linked to heart disease and some of these things cluster together. So whether you’re gonna reverse the auto immune disease fully or not, you’re gonna do good things for your body, you’re gonna improve your risk in innumerable other ways. So I always suggest, even though we need a lot more research, to understand exactly how diet, you know, can treat autoimmune disease, we need to understand that we have enough evidence basically that everyone should be eating a healthy diet and adopting a healthy lifestyle to have optimal health, you know, across the board because it has a broad affect.”
Jay Bildstein: Chris.
Chris Yandek: Doctor Campbell, I do have one other question for you before we go back to Jay. In my lifetime, I have heard and read many times about how a low carb diet is something that would be beneficial to lose weight, but you talk about how such a diet could actually have long term negative health impacts. Can you please speak about that?
Thomas Campbell: “Yeah. It’s interesting. That is the most common dietary goal when I see people in clinic. I say, ‘What have you been doing? What are you trying to do?’ And almost universally, the goal is to cut carbs. It’s so prevalent to cut carbs to achieve health and you know, there’s some truth to this right. It’s not hogwash because in this country, we consume absolute vast quantities of what I call naked energy or naked calories through refined carbs. We consume lots of pizza, we consume lots of white flour in bread, in pasta, we consume vast quantities of sugar and so we’re gorging ourselves on white flour and sugar. These things don’t have nutritional value. So people actually end up consuming too many calories when they’re gorging on these things and it causes a lot of problems.
And guess what? When you get rid of the cookies, cakes and pastries and pizza and the white bread, what’s gonna happen? You’re gonna do better. And I see that and there’s truth to that. But here’s the problem with that, is that when people cut those things out, one of the reasons it’s so popular is because people don’t necessarily need to change their tastes. They don’t need to start eating fruits and vegetables. They can just cut that out and have more bacon and chicken and steak. And if you do that and increase your amount of animal foods, you are putting yourself I believe at grave risk for worsening heart disease in the long run. There is an interesting, really a very interesting sort of animal experiment, several years ago looking at mice.
And they put them on what’s considered sort of the standard mice chow, which is a relatively high carbohydrate, high fiber diet and they put them on a low carbohydrate diet and then sort of an American diet, which is a high fat, low carbohydrate, sort of a high fat, high saturated fat diet. And what they found was the mice eating the normal mice chow did fine, the mice eating the high saturated fat American diet did much worse as you would expect. They had, after they sacrificed these animals, they killed the animals and then they looked at their blood vessels and they found that the mice having the American diet had pretty bad atherosclerosis, but guess who did the worst? That mice who had the low carbohydrate diet. And what’s fascinating about this is that these mice actually gained weight slower.
So they were a little slimmer and when you looked at their cholesterol panels, their cholesterol if anything was no worse than any of the other mice right. They didn’t see much worsening cholesterol. But when they opened them up, they were riddled with blockages in their arteries. They had plaque ,far more plaque than the mice eating the standard chow. And so what we see, then you look at human population ok and you look at the observational studies that have followed large, tens of thousands of people over time and in many studies now, the people eating the fewest carbohydrates and therefore usually the most meatiest, the fattiest diets, they have the most mortality and particular the one thing that keeps coming up is the cardiovascular mortality.
So, I’m all for people cutting out sugar, white flour, refined carbs, you know, this sort of naked energy that, you know, sodas, get rid of it. You know, the pizzas, get rid of it. White bread, get rid of it. But when you’re replacing it, when you’re not looking at the entire diet and you’re not also getting rid of some of the added fats and some of the meats or maybe you’re even eating more once you’re getting rid of the sugar, you may see some short term benefits, but I’m very concerned about your long term health and if you look at the science, it’s well supported that it’s really in the long term, in the long run, it’s not a healthy way to go.”
Jay Bildstein: I’d also add that from my experience, because years ago I did, you know, hearing about all kinds of supposed health benefits going to a low carb diet and all and now I eat in a way that is constant with The Campbell Plan. I can say at least for myself and of course I’m only a study of one, that your plan, doctor, allows people to eat, I don’t want to say limitless, but certainly eat in abundance a variety of tasty whole foods where people I don’t believe, at least for myself, are gonna feel washed out and weak and things like that. So I think there’s a lot to be said not simply for the science, but how the individual feels about doing it on a day-to-day basis.
I went and tried a little test on myself. Now, admittedly I’m a true believer and I believe what you have laid out in The Campbell Plan, what your dad and you laid out in The China Study and what was written in Whole and have followed people like John McDougal and have read the works of Caldwell Esselstyn and Dean Ornish and Walter Kempner and Nathan Pritkin who I’ll bring up in a moment for one point when I get to where I’m going here. So, you know, I’m probably somewhat atypical. But I’ll tell you what I did, I had been eating essentially a whole food plant-based diet, but I was eating about, oh I don’t know, about six ounces of wild Alaskan salmon twice a week divided two different meals and once in a vast while out on the weekend, maybe I’d have another piece of salmon. And daily I’d have a small fistful of walnuts and a quarter of avocado.
Now I had my check up in May and in the middle of May [of 2015] my cholesterol was 133 and my triglycerides was 68 and the LDL was 65 and my doctor who was a cardiologist, who was a new doctor I went to see because I do a lot of sports training, so it was a prophylactic visit. First said, ‘Well, nobody has cholesterol under 70, LDL cholesterol under 70 unless they’re on a statin, what are you taking?’ I said, ‘I’m not taking anything. This is just a result of how I eat.’ And he was flabbergasted. And the way he said nobody has LDL under 70 unless they’re on a statin, he was somewhat shocked.
But I’ll tell you what I did, I eliminated my intake of salmon and at the same time, I eliminated walnuts and avocado and thinking of works of like Cadwell Esselstyn and not adding extra, kind of very fat dense foods. And just had my cholesterol retested. It was very interesting. This time, I had a blood glucose of 72, my cholesterol went down to 117 and that was without depriving myself, without feeling hungry at any point. As a matter of fact, stuffed myself. Triglycerides 64, LDL down even lower, 62, but this time, my HDL cholesterol had dropped from 54 to 42.
Now I’m not asking for a diagnosis. I did this as a test. And by the way, I want to tell all our listeners, one of the wonderful things that you’ve done doctor is you’ve talked about fish and you make the point that within the context of a whole food, plant based diet, you’re not endorsing eating fish, you say that somebody could go out and be perfectly healthy without doing it, but you say if somebody does it, they probably want to keep it to three to six ounces a week from what I read in the book, but you believe they can do perfectly fine without it.
My question to you is, did I make a positive change in my blood profiles? In other words, based on The China Study, the lower the cholesterol; the better by natural means. So I did it by natural means. Is a drop from 133 to 117 good if it also means a 12 point drop in HDL in someone with no risk factors for heart disease?
Thomas Campbell: “I think you can get a little bit, a little bit lost in the numbers and tyranny of those numbers and wonder what’s more important, the drop in the total, the drop in the LDL or the ratio, you know, of the total to HDL, we know that all of these things matter to some degree. Which ones matter more? Do they cancel each other out? I think you can kind of drive yourself a little crazy. It’s a little hard to know, you know, for sure how these things will impact your individual risk. I do know that, you know, when you get to a very total low cholesterol, the predictive value of your HDL is I think less important from my understanding. So if you have a low HDL, but you have a very, very low total, I sort of talk about it in a very simplistic way. Like the HDL is good cholesterol. It’s sort of like garbage trucks going around helping to eliminate cholesterol from your body, it takes it back to your liver and you get rid of your total cholesterol.
So you have these garbage trucks and when you have a high cholesterol, you want more garbage trucks to get rid of the stuff. But when you have a very low total cholesterol, you know, how much garbage trucks do you have going around and is less predictive, that number becomes less predictive of risk. So I’m gonna claim that I can’t say, I can’t say whether your cholesterol panel is dramatically different in terms of risk or not. I do think that you mentioned a very important topic in that fish consumption, eliminating animal foods 100 percent versus 98 percent. And I think from a science and nutritional point of view, I think it becomes difficult to say in my reading of the science, I think in terms of just if you were just sitting back and sort of constructing the optimal human diet, what should we be eating?
I think you can have a good argument about whether those last few percentage points of your diet, should it be 100 percent, should it be 98 percent, I think you can have a good argument for both ways. I do. I think that nutrition is not, nutritional science is not precise enough to say 100 percent, 98 percent. But I will say this and the reason for many of my patients I do recommend to avoid fish is because there’s a behavioral aspect to this. And even though nutritional science and its effect on human health, there’s grey zones, from a behavioral point of view, it can be very difficult for people to go most of the way, but not all the way.
You know, that, your, this may work for you, what you’ve done, you know, a couple of ounces of fish a week, but for some other people, when they’re trying to change their diet, if they allow themselves to start having some fatty fish, it’s gonna open the door then the next day to have something else. You know, a little bit of mayonnaise or just they’re just gonna cheat a little bit here on this other day. And for some people, food is a very emotional thing, it’s a very addictive thing and it’s like smoking. You can’t cut down to one cigarette a week. That’s not gonna work even though I can’t say that one cigarette a week is gonna kill you.
From a behavioral point of view, it’s just too difficult. So you know, there’s a good argument I think from a behavioral point of view to go 100 percent of the way and that’s why I recommend that to my patients. But I think from a nutritional science point of view, there’s, at the edges of your diet, there’s a good argument to be had. I prefer to live in the world where everyone’s eating almost entirely whole plant foods.”
Jay Bildstein: And you’ve made the point in the book and you laid it out very, very nicely. Again, The Campbell Plan is an important, compelling read and quite frankly, I don’t know if I’ve ever said this about any book, I think this is literally a book that every single person must buy and must read. It’s a bedside book. It’s a book to really have there, reinforcing what is known and how to put it into place. Based on what you said doctor, it’s very interesting and I’ll take a step back in what I did, for all I know, my HDL dropped down because I cut out the walnuts and avocado.
Thomas Campbell: “Right.”
Jay Bildstein: And I happen to believe for myself what you’re saying about the temptation of eating, of having an escalation of eating animal foods would be true. So quite frankly, I plan on adding back in some nuts and avocado, but I don’t plan on eating salmon, but I think your dad one time gave a talk and he said, “You know, if you’re out and had a tasty soup somewhere, you know, don’t suddenly panic and get so micro-focused, like, oh my God, maybe it had chicken stock in it.”
Thomas Campbell: “Right”
Jay Bildstein: It’s what’s being done every day, day in and day out and what the attention is that makes a difference. I will finish with this. There are, I’m sure you’re familiar with blue zones, like Okinawa and Sardinia and Loma Linda, California and Costa Rica where very high amount of people living into ripe old age, into their 90s, lot of centenarians, people at 100 and over. And I took a look before we spoke, for example, a typical diet in Okinawa, a lot of people think there’s a lot of fish in it, the reality is the Okinawa diet is very much a whole food plant-based diet. However, there are very, very small amounts of fish and there’s actually a very small amount of pork.
And I wonder if somehow those societies in those blue zones have used miniscule amounts of animal food in a way to create B 12 and Vitamin D supplementation and it became engrained in the society, whereas nobody in American society thinks about eating a medicinal quantity of fish or pork. I don’t think many people are gonna sit down and say, “I’m going to have half an ounce of fish today on Tuesday and I’m not gonna revisit this for three months because this is going to help me with some kind of blood profile.” But you think there’s some fairness in that? You think for example in some of these blue zones that the miniscule amounts of animal food really do carry some medicinal value based on what we’ve seen in the longevity of these folks?
Thomas Campbell: “It may. I can’t speak to their intentions. My intuition states that probably the traditional diets of Okinawa for example, you know, there, many of these traditional diets are sort of slowing going away and I can only imagine that in many traditional cultures of course that were agrarian, you know, they were eating basically what they could get. It wasn’t necessarily an abundance of rich choices. It was sort of what can you get today kind of thing and that may have developed. So there’s also this balance between overall calorie intake. So you mention the Okinawans, they, the traditional Okinawan diet is actually super abundant in sweet potatoes.”
Jay Bildstein: Correct. And about 1750 calories I think, which is under what the typical Japanese diet is, the typical Japanese diet has I believe a lot more white rice and is pretty much devoid of the sweet potatoes right?
Thomas Campbell: “Yea. So sweet potatoes, not as much rice, but abundant sweet potatoes. Like you said, actually very little fish. They do have fish, but it’s not nearly as much. People think they’re eating fish, you know, every meal. That’s not the case. It’s just a small percentage of their traditional Okinawan diet according to earlier research. And, you know the B-12 argument is an important one and for the vegan community, it presents a bit of a conundrum. You know, what is the natural, sort of human evolutionary diet? I think you can make an, I’m not popular maybe for this, but I think you can make a good argument that it’s probably not 100 percent vegan diet. You know, certainly what we’ve evolved on, we ate what we could find.
And meat does have B-12, B-12 is not made by animal foods, but it does accumulate in animal foods. It’s made by bacteria. And it does provide that B-12 so perhaps, perhaps there is an element of that little bit of animal food providing the vitamin B-12 that is not in our modern plant food. That being said, I can’t speak necessarily how those particular traditions, you know, evolve themselves.”
Jay Bildstein: Well, you know, we romanticize so much. I mean, we don’t talk about in society flesh foods and foods based on secretions. I don’t think anybody wants to have a nice cold glass of secretion. I don’t think many people are interested in eating a slice of charred flesh. We tend to forget where things come from. Similarly, when a lot of folks talk about the hunter gather diet and paleo and so forth. If they actually study some paleoanthropology, which I have, they may realize that we weren’t so much hunter gathers as perhaps scavenger gatherers.
And maybe we weren’t mighty hunting. Maybe we were meekly running behind a lion that killed something and picking a miniscule piece of meat off a bone when we were starving and then went back to eating what in effect is a whole food plant based diet and perhaps that’s how we got the B-12. Just my hypothesis.
Thomas Campbell: “Right.”
Jay Bildstein: Last question doctor, Nathan Pritikin, there’ve been a line of people over time who have strived to bring a healthy diet to the American public. I can think of, the first one that comes to my mind is Walter Kempner and the rice diet. Nathan Pritikin went forward and did a lot good work. Of course he was an engineer and he studied the Tarahumara Indians in Northern Mexico and so forth and their level of cardio of aerobic activity and the kind of diet they had, largely devoid of animal foods.
He died, he died relatively young and I believe at his autopsy, he had remarkably low cholesterol. I think it was something like 100 and I don’t know if he had leukemia or what have you. I remember it years ago, this being one of these bugaboo fears, oh my God if you have really, really low cholesterol, you’re inviting disease. Can you once and for all dispel that myth?
Thomas Campbell: “Yeah. I’m just not aware of that being true at all. I think we’ve moved beyond that fear of low cholesterol. We know from The China Study some counties had average cholesterol as low as 80, 90 total cholesterol.”
Jay Bildstein: And they were healthy.
Thomas Campbell: “And that was actually linked to lower rates of Western diseases. So I think that we can kinda put aside the idea that you’re gonna have too low of a cholesterol. I’m sure that there’s some people out there with sort of rare, very rare, uncommon cholesterol synthesis genetic, sort of very rare genetic cholesterol synthesis issues where there cholesterol is maybe like 20 or 30.”
Jay Bildstein: Right. And it’s not because of their diet. It’s not that they eat more of certain things and it goes back up.
Thomas: “Right.”
Jay Bildstein: But what’s interesting is that in the age of the Internet, it is remarkable how many things and we have no idea who these folks are that publish it, they could be very smart folks, but, you know, a lot of information goes up on boards, people talk, people have diseases and all kinds of different things facing them and they kind of reach out and try to find information online to help them and the jam they’re in healthwise. I would suggest doctor that they pick up, I would suggest they run, if they can run, if they’re cleared by their doctor to run, they run to their local bookstore or go to Amazon as soon as they hear this or Barnes and Nobles online or their favorite book seller online and they get a copy of The Campbell Plan. And after they do that, I really suggest they dive into The China Study and last but not least Whole to come to an understanding of how we found ourselves in this reductionist mess when it’s come to nutrition particularly in the United States of America. Chris, any comments or question in closing?
Chris Yandek: The only question I would have for Mr. Campbell and this would be a very long discussion question, but maybe he can shed some short insight into this as he’s got great knowledge obviously. What will have to happen for all of us to get on a healthy eating pattern that will help us fight all the cancers and diseases that impact us because of what we put in our bodies?
Thomas Campbell: “I think it will be a revolution from the grassroots level. People getting healthy on their own, learning the information and what we’re seeing now is that more physicians are getting on board. I see cardiologists at these conferences, I see professional conferences on plant-based diets, nutrition and health. I see professional societies growing up around this and this is sort of a grassroots approach. And what’s gonna happen is that there’s gonna be enough decision makers, enough people will reach a tipping point where public policy will follow. And that’s when the major changes will happen just as with tobacco smoking. We have to make healthy eating mindless. We have to eat, because many people eat rather mindlessly and they’re gonna continue eating mindlessly because their life has other things.
And so we have to eat, make healthy eating mindless with structural changes to our health system, our health and food production and farming, agricultural system, our retail environment. And once that happens, then will see, as with smoking, will see, you know, big improvements in our health. So I think that’s the road map we have to use and just in the past year the CDC has found the lowest prevalence of smoking in adults in America ever recorded. And we’ve reached that point because it’s very, you have to make sacrifices to make the bad choice to smoke. You have to leave your work station. You can’t. You have to leave the restaurant. You have to leave the bar. You have to pay out the nose to do it. So it’s hard to make the wrong choice with smoking and it’s socially, it’s now abnormal in many circles to smoke. And once we do that with food, you know once we head down that road, we reach the tipping point in the grassroots community, we can get down that public health kind of policy, population level, we start down that road, I think that’s how it’s gonna happen.”
Jay Bildstein: Well, doctor, from your mouth to God’s ears literally because not only on an individual basis, but on a national health care basis, something has to be done now and I think that something that has to be done is going out, getting a copy of The Campbell Plan and I mean this, doctor, you can tell everyone, I don’t know you and I’m not getting any money from your book, this is an absolute must read and not just a must read I believe, a must apply. So, Dr. Thomas Campbell, thank you so much for being with us here on CYInterview.
Thomas Campbell: “Well, thank you so much. I really appreciate it.”
Jay Bildstein: “I hope you can come back with us sometime. So for Dr. Thomas Campbell and his remarkably excellent book The Campbell Plan and of course The China Study and for Chris Yandek and CYInterview, I’m Jay Bildstein.
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