Since “The China Study” book came out and “Forks Over Knives”, the documentary, the idea that animal protein, and animal meat in general, is bad for you is as widespread as ever. Many people are claiming that animal protein is a leading cause of cancer, increases mortality, increases the chances of heart disease, and does not have any nutrients that you cannot obtain from plant protein, such as soy, legumes, and seeds, and other plant products. A leading figure in this argument is Dr. T. Colin Campbell, the Jacob Gould Schurman Professor Emeritus of Nutritional Biochemistry at Cornell University and Project Director of the China-Oxford-Cornell Diet and Health Project.
While Dr. Campbell outlines some great benefits of plant protein and some good reasons to avoid animal products, some say that the research he bases his findings on has a few major limitations, and others add that the conclusions he arrives at are questionable. Since “The China Study” gives one side of the argument, I will post here a review posted by Anthony Colpo, an independent researcher, physical conditioning specialist, and author of the groundbreaking books The Fat Loss Bible and The Great Cholesterol Con. The main point I want to get across is not to believe everything that an “authority figure” says just because they say that research backs their beliefs up. A great deal of the time, deeper research is necessary. The original review can be read here.
By Anthony Colpo:
Campbell is sadly misinformed when it comes to the topic of protein, something especially regrettable for someone whose “entire professional career in biomedical research has centered on protein”. Within minutes of beginning his book, even the dullest reader will quickly realize that Campbell is on a zealous mission against animal protein, which he believes to be public healthy enemy number one.
Campbell’s anti-animal protein bent began while working in the Philippines, where he observed that children from the wealthiest families reportedly ate the most protein and had the highest rates of liver cancer. In itself, this observation is next to useless. Wealthy inhabitants of third world countries are often the first to adapt Western-style diets, which include not just more animal foods but a vast array of nutrient-depleted processed food items loaded with refined flours and sugars. Why blame animal protein–a perfectly natural food for the human species, one that we have been eating with great benefit for our entire 2.4 million year history–yet ignore the role of the nutrient-depleted garbage that we only began consuming during the last 150 years? It is the proliferation of the latter–not animal protein–that corresponds with the rise of degenerative diseases in the Western world.
According to Campbell, his protein suspicions were confirmed when Indian researchers found that feeding casein (a type of milk protein) to rats increased their susceptibility to aflatoxin-induced liver cancer. Campbell and his colleagues began replicating these experiments and repeatedly found that casein did indeed trigger cancer in susceptible rodents. According to Campbell, “The safe proteins were from plants, including wheat and soy.”
Extrapolating from the deleterious effects demonstrated by casein in rodents, Campbell goes on to warn that all animal proteins are a deadly threat to humans.
Campbell’s position constitutes little more than a totally unscientific leap of faith. Casein is one of the major protein-containing fractions of milk; the other is whey. Campbell does not mention that while casein is often observed to promote cancer in rats, whey protein does the exact opposite. Numerous experiments have shown that rats lucky enough to be fed whey experience greatly reduced tumor incidence when compared to rats fed casein, beef, soy or standard rat chow[Badger TM][Hakkak R][Hakkak R][McIntosh GH][Papenburg R][Bounous G].
Preliminary research suggests a similar effect may even occur in humans. A pilot study by researchers at Dalhousie University, Nova Scotia, Canada followed 7 cancer patients who were fed 30 grams of whey protein concentrate daily for six months. Five patients had metastatic carcinoma of the breast, one of the pancreas and one of the liver. Two patients exhibited signs of tumour regression, 2 showed stabilisation of the tumour, while the disease progressed in the remainder but with a trend toward higher lymphocyte glutathione levels. Glutathione is a potent antioxidant and whey consumption has been shown to raise glutathione levels in the body. The researchers concluded that “These results indicate that whey protein concentrate might deplete tumour cells of GSH and render them more vulnerable to chemotherapy.”[Kennedy RS]
Whey protein concentrates and isolates are now widely available in health food stores and supermarkets. But nowhere in The China Study does Campbell discuss the potent anti-cancer effects of whey in rats, and nowhere does he call for further research into the promising cancer-fighting benefits of whey in humans. I guess that would conflict with his rabid venting against animal protein…
Changing the facts
The whey-cancer issue is not the only one in which Campbell deletes inconvenient facts that would dramatically weaken his anti-animal protein hypothesis. After turning the discussion to heart disease, Campbell cites the work of Dr. Lester Morrison, the Los Angeles physician who conducted the earliest clinical trials into the effect of diet on heart disease recurrence.
Morrison took 100 heart attack patients and placed half of on what he himself described as a“high-protein, low-fat” diet and a regimen of nutritional supplements that included calcium, phosphorous, wheat germ, and brewer’s yeast. After eight years, thirty-eight of the fifty control patients had died, compared to only twenty-two of the treatment patients[Morrison LM].
To listen to Campbell though, you would think that Morrison’s dietary intervention group subsisted on anemic protein intakes. Campbell is quick to point out that Morrison allowed only two ounces of meat for lunch and two ounces at dinner. He further points out that whole eggs and whole dairy were prohibited on the diet. What he doesn’t mention–but would full well know seeing that he has obviously read Morrison’s papers–is that Morrison also prescribed the consumption of 13 ounces of skim milk daily. Morrison’s published “Foods Permitted” list also allowed for “egg whites as desired”[Morrison LM]. Clearly, Morrison’s diet was not the very low-protein diet regimen that Campbell would have us believe; in fact, the patients consumed protein levels in excess of the RDA and far greater than the miniscule amounts recommended by Campbell. So why doesn’t he just level with us? Is it because he has already spent a good portion of his book dumping on protein and dairy products, and can’t bring himself to acknowledge that a diet that prescribed daily milk consumption and relatively high protein levels was successful in reducing heart disease?
Campbell also neglects to mention Morrison’s intervention was multi-faceted; it also incorporated overall calorie restriction that resulted in weight loss and the use of nutritional supplements. Excess weight has long been linked to higher rates of CHD, while weight loss has been clinically demonstrated to improve various measures of cardiovascular health. Along with a number of vitamins and minerals, Morrison prescribed supplemental wheat germ and brewer’s yeast because of their high B-vitamin content, the latter also containing the important antioxidant mineral selenium. It is now well-recognized that certain B-vitamins lower blood levels of a potentially atherogenic substance known as homocysteine, while a small pilot trial found a marked reduction in mortality among CHD patients taking selenium-rich yeast on a daily basis[Schnyder G][Korpela H].
Maybe Campbell didn’t feel the supplements were worthy of mention. After all, despite their clinically-proven effectiveness, Campbell doesn’t like nutritional supplements.
Campbell repeatedly pooh-poohs nutritional supplements, insisting they are of little to no value when it comes to improving health and fighting disease. I agree that healthy eating habits should form the foundation of one’s dietary arsenal against disease, but to denigrate nutritional supplements as largely useless is downright wrong.
Nowhere does Campbell mention the numerous large placebo-controlled clinical trials–involving real live humans, not lab rats–that showed substantial reductions in cancer incidence and mortality in the subjects randomized to take selenium supplements (ironically, two of these trials were conducted in China…)[Clark LC][Yu SY][Blot WJ].
Nowhere does Campbell mention SUVIMAX, the large randomized, double-blind, placebo-controlled trial involving over 13,000 healthy French adults aged 35-60. The participants took a single daily capsule containing 120 milligrams of ascorbic acid, 30 milligrams of vitamin E, 6 milligrams of beta carotene, 100 µg of selenium, and 20 milligrams of zinc, or a placebo. After 7.5 years of supplementation, cancer and overall mortality rates in men were significantly reduced, by thirty-one and thirty-seven percent, respectively![Hercberg S]
Of course, denigrating nutritional supplements and recommending a vegan diet, as Campbell does, presents a huge problem–namely, how to get enough B12? After all, animal foods are the only meaningful source of vitamin B12.
Campbell infers that only plants grown on “lifeless” soil lack B12 (actually plants grown in any soil will lack B12, unless they are grown in manure and eaten without washing prior to consumption). Campbell also laments that modern-day vegetables are scoured of all soil before consumption, and thus grudgingly acknowledges that B12 supplements for vegans are a good idea. He also suggests that “..if you never get any sunshine exposure, especially during the winter months, you might want to take a vitamin D supplement”.
So this is Campbell’s solution to the lack of B12 presented by veganism, a pattern of eating that humans were never meant to follow on a long-term basis: Take B12 supplements…or eat dirt!
Thanks, but no thanks! I’ll obtain my B12 the way nature intended–from fresh, nutrient-dense meats.
More anti-animal food fanaticism
On page 230, Campbell states in bold type:
“There are virtually no nutrients in animal-based foods that are not better provided by plants.”
Clearly, Campbell knows little about the nutritional content of animal foods. Animal flesh contains many nutrients that are either found in scarce amounts or entirely absent from plant foods. Here are some examples:
Creatine is used to form adenosine tri-phosphate (ATP), our ultimate source of cellular energy. Creatine availability is critical during situations when neither fat nor glucose can be processed quickly enough to form ATP, such as during the first few seconds of high-intensity physical activities like sprinting and picking up heavy objects. Creatine supplements have been shown in numerous studies to aid performance in power-oriented sports, and to improve muscular strength in patients with congestive heart failure[Kreider RB].
Creatine only occurs naturally in animal foods, with meat by far the richest source. Not surprisingly, habitual vegetarians exhibit poorer creatine status than omnivores[Maughan RJ].
Meat, along with certain species of fish and seafood, is a rich source of taurine, an important amino acid whose concentration in eggs, milk, and plant foods ranges from negligible to none[Laidlow SA][Pasantes-Morales H]. Taurine is found in high concentrations in the heart, brain, and central nervous system, where it helps stabilize the cellular response to nervous stimulation. Taurine possesses antioxidant capabilities and has been shown in double-blind clinical trials to improve cardiac function in patients with congestive heart failure[Schaffer SW][Azuma J][Azuma J].
Taurine cannot be found in plant foods. Humans are able to manufacture their own taurine but with far less efficiency than herbivorous animals, as evidenced by significantly lower blood taurine levels in vegans and rural Mexican women reporting low meat intakes[Laidlaw][Pasantes-Morales H].
Carnitine is a remarkable amino acid that plays a pivotal role in energy production, and is absolutely essential for the fat-burning process to proceed. Because of its pivotal role in energy production, high levels of carnitine are found in the heart and skeletal muscle. Clinical trials have observed markedly improved survival outcomes resulting from carnitine supplementation in patients with heart failure and coronary heart disease[Davini P][Rizos I][Singh RB][Iliceto S]. A review of the scientific literature shows that this versatile amino acid has been shown to benefit anorexia, chronic fatigue syndrome, heart disease, male infertility, sexual dysfunction and depression in aging men, and pregnancy outcomes. Exercise, even at moderate levels, can cause a significant drop in muscle carnitine levels; in patients with angina and respiratory disorders, carnitine enhances exercise tolerance[Kelly GS][Cavallini G][Gentile V].
The richest food source of carnitine, by far and away, is meat. Compared to omnivores, vegetarians repeatedly exhibit lower blood levels of carnitine[Krajcovicova-Kudlackova M][Lombard KA]. Carnitine status appears to also be worsened by the high-carbohydrate diets recommended by folks like Campbell. In healthy men receiving the same amount of dietary carnitine, blood levels of this all-important amino acid rose significantly in individuals following a high-fat, low-carbohydrate diet, while no change in carnitine levels were observed in individuals on a high-carbohydrate, low-fat diet[Cederblad G].
Meat is the only food containing significant amounts of carnosine, an amino acid with some rather interesting and highly beneficial properties[Chan KM]. Carnosine is a potent antioxidant, being particularly effective in protecting cellular fats against free radical damage. Research shows carnosine may accelerate wound healing, boost the immune system, protect against cataracts, reduce gastric ulcer formation, rid the body of toxic metals, and even help fight against cancer[Hipkiss AR]. The most potent effect of carnosine however, appears to be its ability to prevent glycation, which, along with free-radical production, is a major contributor to degenerative illness and the aging process[Price DL, et al].
The potent anti-glycation effects of carnosine may explain why a comparison of vegetarians, vegans and meat-eating omnivores revealed the latter to have significantly lower levels of nasty glycation end-products known as advanced glycosylation end-products (AGEs) circulating in their bloodstreams. The difference could not be explained by total carbohydrate intake, blood sugar, age or kidney function, as all these variables were similar between the vegetarian and omnivorous groups[Sebekova K].
Meat, especially red meat, is the richest source of B-complex vitamins. The B vitamins perform a myriad of crucial functions in the body and requirements for these vital nutrients are dramatically increased during periods of stress, illness and physical activity. Unfortunately, the body cannot store a surplus of B-vitamins for times of increased need, so optimal amounts must be consumed on a daily basis.
Meat, especially red meat, is also a rich source of iron. Iron forms an essential component of hemoglobin, the red pigment in blood that transports oxygen from the lungs to the various body tissues. Insufficient iron intake can result in impaired immune function, decreased athletic performance and lack of energy. A double-blind Swiss study of women aged between 18-55 who had sought medical advice for fatigue, found that most of the women had low blood concentrations of iron. After four weeks, a significantly greater number of women receiving iron supplements reported a decrease in fatigue symptoms than those receiving placebo[Verdon F]. Australian women complaining of fatigue showed similar improvements when treated with either iron supplements or a high-iron diet[Patterson AJ].
Those who need to boost their iron stores should look to read meat rather than supplements or plant foods. When previously sedentary women were challenged with 12 weeks of aerobic exercise, a high meat diet protected iron stores more effectively than iron supplements[RM Lyle]. Heme iron (the form of iron found in meat) is far more easily absorbed by the body than non-heme iron from plant sources. Men and women on lacto-ovo vegetarian diets consistently exhibit lower blood levels of iron, even when consuming similar total amounts of dietary iron as omnivores[Alexander D][Hunt JR].
Animal foods are also by far and away the richest source of zinc. Apart from oysters, meat is the richest source of this mineral, with red meats again containing greater amounts of this mineral than white meats. Zinc is essential for optimal growth and repair, being involved in the actions of several vital hormones and hundreds of enzymatic reactions in the body. Zinc is essential for the formation of superoxide dismutase, one of the body’s most potent antioxidants. Zinc deficiencies can result in growth retardation in children, significantly weakened immune function, poor wound healing and muscle loss, lowered testosterone levels and sperm counts, and have also been linked to depression and gastric cancer[Prasad AS][Brown KH][Siklar Z][Dardenne M][Ibs KH][Maes M][Nakaji S][Prasad AS][Hunt CD].
Overt zinc deficiencies are common to Third World countries where animal protein consumption is low. Milder, ‘sub-clinical’ zinc deficiencies also appear to be a common phenomenon in modernized nations. Those who follow low fat diets are at even greater risk of zinc deficiency[Retzlaff BM][Baghurst KI, et al].
Animal foods, most notably brains and fatty fish, are the only dietary source of long chain omega-3 fats such as DHA and EPA (special algae supplements containing LCPUFA have only recently become available). Some plant foods do contain omega-3 fatty acids, but in a form known as alpha-linolenic acid (ALA). To obtain the LCPUFA the body needs, ALA must be converted endogenously to longer-chain omega-3s such as DHA and EPA. The conversion rate, however, is very low, with clinical studies repeatedly showing that omega-3 fats from plant sources to be vastly inferior to those from animal foods when it comes to boosting long-chain omega-3 status[Fokkema MR][Francois CA][Tang AB, et al].
Numerous studies have shown that vegetarians consume far lower levels of long-chain omega-3 fats–not surprising considering their avoidance of meat and fish[Rosell MR, et al]. Studies of pregnant women show that, compared to omnivores, vegetarians have significantly lower levels of DHA in their breast milk, with vegans displaying the lowest levels of all. These negative fatty acid profiles are reflected in infants, with vegan newborns displaying significantly lower red blood cell levels of DHA. This is an ominous finding, given the critical role that omega-3 fats play in healthy immune function and cognitive development[Williams C][O’Connor DL][Helland IB][Moriguchi T][Dunstan JA].
Along with lowering one’s omega-3 levels, low meat intakes also increase the concentration of omega-6 fats inside the body. A high dietary and bodily ratio of omega-6:omega-3 fats increases the risk of numerous diseases, including cardiovascular disease. A sizable portion of heart attacks are triggered when blood clots lodge themselves in narrowed coronary arteries and prevent the flow of blood to the heart, a process also known as arterial thrombosis. One of the early and key events in the development of thrombosis is platelet aggregation, the ‘clumping together’ of blood platelets. Researchers from Melbourne, Australia, compared heavy-meat-eaters, moderate-meat-eaters, lactoovegetarians and vegans and found that as meat consumption increased, platelet aggregation decreased. Heavy-meat-eaters displayed the lowest levels of platelet aggregation, while vegans displayed the highest levels.
While meat eaters ate more of the omega-6 fat arachidonic acid, vegetarians consumed significantly higher concentrations of the omega-6 fat linoleic acid and significantly lower amounts of long chain omega-3?s. The resultant unfavorable omega-6:omega-3 is believed to be responsible for the higher levels of thromboxane A2 (TXA2) seen in the vegetarian group[Li D]. TXA2 is an eicosanoid that stimulates platelet aggregation. Chilean researchers have similarly observed significantly lower blood levels of EPA and DHA, and concomitant increases in blood platelet aggregation, among vegetarians[Mezzano D]
Plant foods contain all the nutrition that animal foods do? You’ve got to be joking!
So what about the China Study itself?
Despite it’s title, only a small portion of The China Study is actually devoted to discussing the giant epidemiological study of the same name; the rest of the book simply reads like an extended sales brochure for veganism.
Beginning in the early eighties, Campbell was part of a group of Chinese, British and US researchers that presided over the massive epidemiological study known as the China Project, or China Study. The New York Times dubbed it “the Grand Prix of epidemiology”, and it gathered data on 367 variables across sixty-five counties and 6,500 adults. After the study data was compiled, the researchers had calculated “more than 8,000 statistically significant associations between lifestyle, diet and disease variables.”
According to Campbell, the China Study data showed that: “People who ate the most animal-based foods got the most chronic disease. . . . People who ate the most plant-based foods were the healthiest and tended to avoid chronic disease.”[p. 7]
In reality, the China Study showed nothing of the sort.
What Campbell won’t tell you about the China Study
The China Study does not contain the actual data gathered from its namesake study. So when Campbell claims that the China Study found a consistent relationship between animal foods and various diseases, readers have no way of verifying this information for themselves.
Unless of course, they get up off their butts and go retrieve the actual China Study data for themselves. To do this, they will need to check their local libraries (university libraries are the best bet) for a book titled Diet, life-style, and mortality in China: A study of the characteristics of 65 Chinese counties[Chen J]. Once readers have this book in their possession, they will quickly discover that there is a galaxy-sized gap between the actual findings of the China Study and the claims made by Campbell in his popular book version.
Let’s start with overall mortality, unarguably the most important mortality statistic of all. Animal protein, fish protein, meat intake, saturated fat, and fat calories were all negatively associated with all-cause mortality in infants, children, teenagers and adults, although none of the associations reached statistical significance (for those unfamiliar with research-speak, a negative correlation means that as intake of these foods increased, mortality risk decreased; failure to reach statistical significance means that researchers can’t be sure these findings were not due to chance).
Among those aged 0-64, total protein returned a 29% negative association with overall mortality. This finding was statistically significant (p=0.05).
In all age groups, egg consumption was negatively associated with all-cause mortality, with a statistically significant 43% decrease (p=0.01) in overall mortality among those aged 0-64.
No statistically significant relationships, protective or otherwise, were found for milk intake, fiber, cereal grains, legumes, and vegetables among those aged 0-64.
The only other dietary factor that was significantly associated with overall mortality among those aged 0-64 was soy sauce (not soy products), which showed a 43% decrease in mortality risk (p=0.001)
Neither total protein (+12%), animal protein (+3%), fish protein (+7%), plant protein (+12%), meat intake (-20%), saturated fat (+2%), fat calories (-17%), eggs (+19%), nor milk (+6%) demonstrated any statistically significant association with mortality from all cancers. Rice (-26%, p=0.05) and green vegetables (-28%, p=0.05) were statistically associated with reduced cancer mortality, as were the use of alcohol (-27%, p=0.05), home-made cigarettes (-32%, p=0.01), and total tobacco use (-25%, p=0.05).
(Readers can now see why I have such a generally low opinion of epidemiological research–if we were to treat the findings of the China Study seriously, then we would all go out and start drinking and smoking cigarettes in order to improve our odds against cancer! Despite his obvious enthrallment with the results of the China Study, Campbell for some reason doesn’t recommend this…)
With regards to specific types of cancer, no statistically significant associations were observed for total protein, animal protein, fish protein, meat intake, milk intake, saturated fat, total fat, fiber, cereal grains, legumes, vegetables and mortality from colorectal or breast cancers.
No statistically significant associations were observed for total protein, animal protein, fish protein, meat intake, milk intake, saturated fat, total fat, fiber, legumes, and mortality from coronary heart disease.
Rice was associated with a statistically significant decrease (-58%, p=0.001) in CHD risk, while wheat flour was associated with a statistically significant increase in CHD risk (+67%, p=0.001). A similar phenomenon was noted for stroke mortality, with a statistically significant risk decrease noted for rice (-44%, p=0.01), and a statistically significant increase in risk observed for wheat flour (+55%, p=0.001) (again, despite his apparent rapture with the China Study results, nowhere does Campbell recommend the avoidance of wheat or wheat flour; in fact, he encourages the consumption of whole grain cereals).
So there you have it…the “Grand Prix” study that supposedly showed “People who ate the most animal-based foods got the most chronic disease. . . . People who ate the most plant-based foods were the healthiest and tended to avoid chronic disease” actually showed that animal-based foods imparted no increased risk of all-cause mortality, cancer deaths, or cardiovascular mortality.
Is Campbell deliberately lying to us? Or is he merely suffering from an inability to cast aside his own personal prejudices and present a full and objective presentation of the facts, because the facts conflict with what he wants to believe? I can’t get inside Campbell’s head to give you the answer, but it is not at all uncommon for even highly decorated researchers to “ignore” or flippantly dismiss evidence that fails to support their deeply-held beliefs, and instead focus intently on that which does. The China Study is a classic example of this phenomenon in action.
Campbell’s lopsided presentation of the facts is most regrettable. If you visit the The China Studypage at Amazon.com you will see that the book is selling well and has received glowing reviews from unwitting readers who clearly have not taken the time to validate Campbell’s claims for themselves. Like so many people in today’s society, these folks are too lazy to think and research for themselves, and are therefore ready prey for misguided “gurus” peddling scientifically unsound nonsense.
Anthony Colpo is an independent researcher, physical conditioning specialist, and author of the groundbreaking books The Fat Loss Bible and The Great Cholesterol Con. For more information, visit TheFatLossBible.net or TheGreatCholesterolCon.com
Badger TM, et al. Developmental effects and health aspects of soy protein isolate, casein, and whey in male and female rats. Int J Toxicol. 2001 May-Jun;20(3):165-74.
Hakkak R, et al. Dietary whey protein protects against azoxymethane-induced colon tumors in male rats. Cancer Epidemiol Biomarkers Prev. 2001 May;10(5):555-8.
Hakkak R, et al. Diets containing whey proteins or soy protein isolate protect against 7,12-dimethylbenz(a)anthracene-induced mammary tumors in female rats. Cancer Epidemiol Biomarkers Prev. 2000 Jan;9(1):113-7.
McIntosh GH, et al. Dairy proteins protect against dimethylhydrazine-induced intestinal cancers in rats. J Nutr. 1995 Apr;125(4):809-16.
Papenburg R, et al. Dietary milk proteins inhibit the development of dimethylhydrazine-induced malignancy. Tumour Biol. 1990;11(3):129-36.
Bounous G, et al. Dietary whey protein inhibits the development of dimethylhydrazine induced malignancy. Clin Invest Med. 1988 Jun;11(3):213-7.
Kennedy RS, et al. The use of a whey protein concentrate in the treatment of patients with metastatic carcinoma: a phase I-II clinical study. Anticancer Research, Nov-Dec, 1995; 15 (6B): 2643-2649.
Morrison LM. A nutritional program for prolongation of life in coronary atherosclerosis. Journal of the American Medical Association, Dec 10, 1955; 159 (15): 1425-1428.
Morrison LM. Diet in coronary atherosclerosis. Journal of the American Medical Association, Jun 25, 1960; 173: 884-888.
Schnyder G, et al. Effect of homocysteine-lowering therapy with folic acid, vitamin B12, and vitamin B6 on clinical outcome after percutaneous coronary intervention: the Swiss Heart study: a randomized controlled trial. Journal of the American Medical Association, Aug 28, 2002; 288 (8): 973-979.
Korpela H, et al. Effect of selenium supplementation after acute myocardial infarction. Research Communications in Chemical Pathology and Pharmacology, Aug, 1989; 65 (2): 249-252.
Clark LC, et al. Effects of selenium supplementation for cancer prevention in patients with carcinoma of the skin. A randomized controlled trial. Nutritional Prevention of Cancer Study Group. Journal of the American Medical Association, Dec 25, 1996; 276 (24): 1957-1963.
Yu SY, et al. Protective role of selenium against hepatitis B virus and primary liver cancer in Qidong. Biological Trace Element Research, 1997; 56 (1): 117-124.
Blot WJ, et al. Nutrition intervention trials in Linxian, China: supplementation with specific vitamin/mineral combinations, cancer incidence, and disease-specific mortality in the general population. Journal of the National Cancer Institute, Sep 15, 1993; 85 (18): 1483-1492.
Hercberg S, et al. The SU.VI.MAX Study: A Randomized, Placebo-Controlled Trial of the Health Effects of Antioxidant Vitamins and Minerals. Archives of Internal Medicine, Nov 2004; 164: 2335-2342.
Kreider RB. Effects of creatine supplementation on performance and training adaptations. Molecular And Cellular Biochemistry, Feb, 2003; 244 (1-2): 89-94.
Maughan RJ. Creatine supplementation and exercise performance. International Journal of Sport Nutrition, Jun, 1995; 5 (2): 94-101.
Laidlow SA, et al. The taurine content of common foodstuffs. Journal of Parenteral Enteral Nutrition, Mar-Apr, 1990; 14 (2): 183-188.
Pasantes-Morales H, et al. Taurine content in foods. Nutr Rep Int, 1989; 40: 793-801.
Schaffer SW, et al. Interaction between the actions of taurine and angiotensin II.
Amino Acids, 2000; 18 (4): 305-318.
Azuma J, et al. Therapeutic effect of taurine in congestive heart failure: a double-blind crossover trial. Clin Cardiol. 1985 May; 8 (5): 276-282.
Azuma J, et al. Double-blind randomized crossover trial of taurine in congestive heart failure. Curr Ther Res 1983; 34 (4): 543-57.
Laidlaw SA, et al. Plasma and urine taurine levels in vegans. American Journal of Clinical Nutrition, 1988; 47: 660-663.
Pasantes-Morales H, et al. Taurine content in breast milk of Mexican women from urban and rural areas. Arch Med Res. 1995 Spring; 26 (1): 47-52.
Davini P, et al. Controlled study on L-carnitine therapeutic efficacy in post-infarction. Drugs Under Experimental And Clinical Research, 1992; 18: 355-365.
Rizos I. Three-year survival of patients with heart failure caused by dilated cardiomyopathy and L-carnitine administration. American Heart Journal, Feb, 2000; 139 (2, Pt 3): S120-123.
Singh RB, et al. A randomised, double-blind, placebo-controlled trial of L-carnitine in suspected acute myocardial infarction. Postgraduate Medical Journal, Jan. 199; 72 (843): 45-50.
Iliceto S, et al. Effects of L-carnitine administration on left ventricular remodeling after acute anterior myocardial infarction: the L-Carnitine Ecocardiografia Digitalizzata Infarto Miocardico (CEDIM) Trial. Journal Of The American College Of Cardiology, Aug. 1995; 26 (2): 380-387.
Kelly GS. L-Carnitine: Therapeutic Applications of a Conditionally-Essential Amino Acid. Alternative Medicine Review, 1998; 3 (5): 345-360.
Davini P, et al. Controlled study on L-carnitine therapeutic efficacy in post-infarction. Drugs Under Experimental And Clinical Research, 1992; 18: 355-365.
Cavallini G, et al. Carnitine versus androgen administration in the treatment of sexual dysfunction, depressed mood, and fatigue associated with male aging. Urology, Apr 2004; 63 (4): 641-646.
Gentile V, et al. Preliminary Observations on the Use of Propionyl-L-Carnitine in Combination With Sildenafil in Patients With Erectile Dysfunction and Diabetes. Current Medical Research and Opinion, September 2004; 20 (9): 1377-1384.
Krajcovicova-Kudlackova M, et al. Correlation of carnitine levels to methionine and lysine intake. Physiological Research, 2000; 49 (3): 399-402.
Lombard KA, et al. Carnitine status of lactoovovegetarians and strict vegetarian adults and children. American Journal of Clinical Nutrition, Aug, 1989; 50 (2): 301-306.
Cederblad G. Effect of diet on plasma carnitine levels and urinary carnitine excretion in humans. American Journal of Clinical Nutrition, 1987; 45: 725-729.
Chan KM, Decker EA. Endogenous skeletal muscle antioxidants. Critical reviews in food science and nutrition, 1994; 34 (4): 403-26.
Hipkiss AR. Carnosine. a protective, anti-ageing peptide? International Journal of Biochemistry & Cell Biology, 1998; 30: S63-868.
Price DL, et al. Chelating Activity of Advanced Glycation End-product Inhibitors. Journal of Biological Chemistry, Dec. 28, 2001; 276 (52): 48967-48972.
Sebekova K, et al. Plasma levels of advanced glycation end products in healthy, long-term vegetarians and subjects on a western mixed diet. European Journal of Nutrition, Dec, 2001; 40 (6): 275-281.
Verdon F, et al. Iron supplementation for unexplained fatigue in non-anaemic women: double-blind randomised placebo controlled trial. British Medical Journal, May 24, 2003; 326: 1124-1128.
Patterson AJ, et al. Dietary and Supplement Treatment of Iron Deficiency Results in Improvements in General Health and Fatigue in Australian Women of Childbearing Age. Journal of the American College of Nutrition, 2001; 20 (4): 337-342.
RM Lyle, et al. Iron status in exercising women: the effect of oral iron therapy vs increased consumption of muscle foods. American Journal of Clinical Nutrition, Dec 1992; 56: 1049 – 1055.
Alexander D, et al. Nutrient intake and haematological status of vegetarians and age-sex matched omnivores. European Journal of Clinical Nutrition, 1994 Aug; 48 (8): 538-46.
Hunt JR, Roughead ZK. Adaptation of iron absorption in men consuming diets with high or low iron bioavailability. American Journal of Clinical Nutrition, Jan 2000; 71: 94 – 102.
Prasad AS. Zinc deficiency. British Medical Journal, Feb. 22, 2003; 326 (7386): 409-410.
Brown KH, et al. Effect of supplemental zinc on the growth and serum zinc concentrations of prepubertal children: a meta-analysis of randomized controlled trials. American Journal of Clinical Nutrition, June 2002; 75 (6): 1062-1071.
Siklar Z, et al. Zinc Deficiency: a Contributing Factor of Short Stature in Growth Hormone Deficient Children. Journal of Tropical Pediatrics, June 2003; 49 (3): 187-188.
Dardenne M. Zinc and immune function. European Journal of Clinical Nutrition, Aug, 2002; 56 (Suppl. 3): S20-23.
Ibs KH, Rink L. Zinc-altered immune function. Journal of Nutrition, May, 2003; 133 (5, Suppl. 1): 1452S-1456S.
Maes M, et al. Hypozincemia in depression. Journal of Affective Disorders, June, 1994; 31 (2): 135-140.
Nakaji S, et al. Relationship between mineral and trace element concentrations in drinking water and gastric cancer mortality in Japan. Nutrition and Cancer, 2001; 40 (2): 99-102.
Prasad AS, et al. Zinc status and serum testosterone levels of healthy adults. Nutrition, May 1996; 12 (5): 344-348.
Hunt CD, et al. Effects of dietary zinc depletion on seminal volume and zinc loss, serum testosterone concentrations, and sperm morphology in young men. American Journal of Clinical Nutrition, July, 1992; 56 (1): 148-57.
Hambidge M. Human zinc deficiency. Journal of Nutrition, May, 2000; 130 (Suppl. 5): 1344S-1349S.
Retzlaff BM, et al. Changes in vitamin and mineral intakes and serum concentrations among free-living men on cholesterol-lowering diets: the Dietary Alternatives Study. American Journal of Clinical Nutrition, 1991; 53 (4): 890-898.
Baghurst KI, et al. Demographic and dietary profiles of high and low fat consumers in Australia. Journal of Epidemiology and Community Health, 1994; 48 (1): 26-32.
Fokkema MR, et al. Short-term supplementation of low-dose gamma-linolenic acid (GLA), alpha-linolenic acid (ALA), or GLA plus ALA does not augment LCP omega 3 status of Dutch vegans to an appreciable extent. Prostaglandins Leukot Essent Fatty Acids, 2000; 63 (5): 287-92.
Francois CA, et al. Supplementing lactating women with flaxseed oil does not increase docosahexaenoic acid in their milk. American Journal Clinical Nutrition, 2003 Jan;77(1):226-33.
Tang AB, et al. Preferential reduction in adipose alpha-linolenic acid (19:3n-3) during very low caloric dieting despite supplementation with 18:3n-3. Lipids, 1993; 28: 987-93.
Rosell MR, et al. Long-chain n-3 polyunsaturated fatty acids in plasma in British meat-eating, vegetarian, and vegan men. American Journal of Clinical Nutrition, 2005; 82: 327-334.
Williams C, et al. Stereoacuity at age 3.5 y in children born full-term is associated with prenatal and postnatal dietary factors: a report from a population-based cohort study. American Journal of Clinical Nutrition, Vol. 73, No. 2, 316-322, February 2001.
O’Connor DL, et al. Growth and Development in Preterm Infants Fed Long-Chain Polyunsaturated Fatty Acids: A Prospective, Randomized Controlled Trial. Pediatrics, August 1, 2001; 108(2): 359 – 371.
Helland IB, et al. Maternal Supplementation With Very-Long-Chain n-3 Fatty Acids During Pregnancy and Lactation Augments Children’s IQ at 4 Years of Age. Pediatrics, January 2003; 111 (1): e39-e44.
Moriguchi T, et al. Behavioral deficits associated with dietary induction of decreased brain docosahexaenoic acid concentration. Journal of Neurochemistry, 2000; 75: 2563-2573.
Dunstan JA, et al. Fish oil supplementation in pregnancy modifies neonatal allergen-specific immune responses and clinical outcomes in infants at high risk of atopy: a randomized, controlled trial. Journal of Allergy and Clinical Immunology, Dec, 2003; 112 (6): 1178-1184.
Li D, et al. The association of diet and thrombotic risk factors in healthy male vegetarians and meat-eaters. European Journal of Clinical Nutrition, 1999; 53: 612-619.
Mezzano D, et al. Vegetarians and cardiovascular risk factors: hemostasis, inflammatory markers and plasma homocysteine. Thrombosis and Haemostasis, 1999; 81 (6): 913-917.
Chen J, et al. Diet, life-style, and mortality in China: A study of the characteristics of 65 Chinese counties. Oxford, UK; Ithaca, N.Y. Oxford University Press; Cornell University Press, 1990.”