LESSONS FROM CHINA 79
adult leukemia,1 childhood brain, adult brain,1 stomach and esophagus
(throat) decreased. As you can see, this is a sizable list. Most Americans
know that if you have high cholesterol, you should worry about your
heart, but they don't know that you might want to worry about cancer
as well.
There are several types of blood cholesterol, including LDL and HDL
cholesterol. LDL is the "bad" kind and HDL is the "good" kind. In the
China Study higher levels of the bad LDL cholesterol also were associ-
ated with Western diseases.
Keep in mind that these diseases, by Western standards, were rela-
tively rare in China and that blood cholesterol levels were quite low
by Western standards. Our findings made a convincing case that many
Chinese had an advantage at the lower cholesterol levels, even below
170 mgldL. Now imagine a country where the inhabitants had blood
cholesterol levels far higher than the Chinese average. You might expect
that these relatively rare diseases, such as heart disease and some can-
cers, would be prevelant, perhaps even the leading killers!
Of course, this is exactly the case in the West. To give a couple of
examples at the time of our study, the death rate from coronary heart
disease was seventeen times higher among American men than rural Chi-
nese men.^13 The American death rate from breast cancer was five times
higher than the rural Chinese rate.
Even more remarkable were the extraordinarily low rates of coronary
heart disease (CHD) in the southwestern Chinese provinces of Sichuan
and Guizhou. During a three-year observation period (1973-1975),
there was not one single person who died of CHD before the age of six-
ty-four, among 246,000 men in a Guizhou county and 181 ,000 women
in a Sichuan county! 14
After these low cholesterol data were made public, I learned from
three very prominent heart disease researchers and physicians, Drs.
Bill Castelli, Bill Roberts and Caldwell Esselstyn, Jr., that in their long
careers they had never seen a heart disease fatality among their patients
who had blood cholesterol levels below 150 mgldL. Dr. Castelli was the
long-time director of the famous Framingham Heart Study of NIH; Dr.
Esselstyn was a renowned surgeon at the Cleveland Clinic who did a
remarkable study reversing heart disease (chapter five); Dr. Roberts has
long been editor of the prestigious medical journal Cardiology.