106 THE CHINA STUDYmultiple nutritional conditions in the same study, in the hope of identi-
fying important dietary patterns.
I prefer the broader picture, for we are investigating the incredible
complexities and subtleties of nature itself. I wanted to investigate how
dietary patterns related to disease, now the most important point of this
book. Everything in food works together to create health or disease. The
more we think that a single chemical characterizes a whole food, the
more we stray into idiocy. As we shall see in Part IV of this book, this
way of thinking has generated a lot of poor science.
So I say we need more, not less, of the "shotgun approach." We need
more thought about overall dietary patterns and whole foods. Does this
mean that I think the shotgun approach is the only way to do research?
Of course not. Do I think that the China Study findings constitute abso-
lute scientific proof? Of course not. Does it provide enough information
to inform some practical decision-making? Absolutely.
An impressive and informative web of information was emerging
from this study. But does every potential strand (or association) in this
mammoth study fit perfectly into this web of information? No. Although
most statistically significant strands readily fit into the web, there were a
few surprises. Most, but not all, have since been explained.
Some associations observed in the China Study, at first glance, were
at odds with what might have been expected from Western experience.
I've had to use care in separating unusual findings that could be due
to chance and experimental insufficiency from those that truly offered
new insights into our old ways of thinking. As I mentioned earlier, the
range of blood cholesterol levels in rural China was a surprise. At the
time when the China Study was begun, a blood cholesterol range of
200-300 milligrams per deciliter (mgldL) was considered normal, and
lower levels were suspect. In fact, some in the scientific and medical
communities considered cholesterol levels lower than 150 mgldL to be
dangerous. In fact, my own cholesterol was 260 mgldL in the late 1970s,
not unlike other members of my immediate family. The doctor told me
it was "fine, just average."
But when we measured the blood cholesterol levels in China, we
were shocked. They ranged from 70-170 mgldL! Their high was our
low, and their low was off the chart you might find in your doctor's
office! It became obvious that our idea of "normal" values (or ranges)
only applies to Western subjects consuming the Western diet. It so
happens, for example, that our "normal" cholesterol levels present a