36 THE CHINA STUDYOur second question concerned who was most susceptible to this AF
contamination and its cancer-producing effects. We learned that it was
children. They were the ones consuming the AF-Iaced peanut butter.
We estimated AF consumption by analyzing the excretion of AF meta-
bolic products in the urine of children living in homes with a partially
consumed peanut butter jar.^12 As we gathered this information an inter-
esting pattern emerged: the two areas of the country with the highest
rates of liver cancer, the cities of Manila and Cebu, also were the same
areas where the most AF was being consumed. Peanut butter was almost
exclusively consumed in the Manila area while corn was consumed in
Cebu, the second most populated city in the Philippines.
But, as it turned out, there was more to this story. It emerged from my
making the acquaintance of a prominent doctor, Dr. Jose Caedo, who
was an advisor to President Marcos. He told me that the liver cancer
problem in the Philippines was quite serious. What was so devastating
was that the disease was claiming the lives of children before the age of
ten. Whereas in the West, this disease mostly strikes people only after
forty years of age, Caedo told me that he had personally operated on
children younger than four years of age for liver cancer!
That alone was incredible, but what he then told me was even more
striking. Namely, the children who got liver cancer were from the best-fed
families. The families with the most money ate what we thought were
the healthiest diets, the diets most like our own meaty American diets.
They consumed more protein than anyone else in the country (high quality
animal protein, at that), and yet they were the ones getting liver cancer!
How could this be? Worldwide, liver cancer rates were highest in
countries with the lowest average protein intake. It was therefore widely
believed that this cancer was the result of a deficiency in protein. Fur-
ther, the deficiency problem was a major reason we were working in the
Philippines: to increase the consumption of protein by as many mal-
nourished children as possible. But now Dr. Caedo and his colleagues
were telling me that the most protein-rich children had the highest rates
of liver cancer. This seemed strange to me, at first, but over time my
own information increasingly confirmed their observations.
At that time, a research paper from India surfaced in an obscure med-
ical journal.^13 It was an experiment involving liver cancer and protein
consumption in two groups of laboratory rats. One group was given AF
and then fed diets containing 20% protein. The second group was given
the same level of AF and then fed diets containing only 5% protein.