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A Chinese lesson.

A Chinese lesson If Americans and others in the developed world ate like the Chinese, would they be better off? The answer, provided this year by the largest study ever undertaken of a nation's eating habits, life-style, and disease rates, appears to be yes. More than 6,500 Chinese in 130 villages (two in each of 65 counties located in 24 provinces, chiefly in rural areas in the populous eastern half of this vast country) took part in this survey, recently published here by Cornell University Press and conducted by scientists at Oxford University, the Chinese Academy of Preventive Medicine in Beijing, and Cornell University. For two years researchers interviewed subjects (aged 34 to 64) about their eating and other health habits, such as drinking and smoking. Blood samples were taken to measure cholesterol and other constituents, dietary records were obtained, and in some households foods were weighed and measured so that nutrients could be accurately accounted for. Among the important findings:

* The Chinese consume much more fruit, vegetables, and grains than Americans or Britons.

* The daily fiber intake of the average Chinese (33 grams) is three times that of the average American (11 grams).

* The average Chinese derives anywhere from 6% to 24% of his calories from fat, compared to 39% for the average American and 45% for the average Briton.

* In most of the counties studied, people eat meat only about once a weak. In counties where meat is regularly on the menu, rates of cardiovascular disease are also higher.

* The Chinese eat more calories daily for each pound of body weight than Americans, but suffer little obesity. The reason for this, perhaps, is that the Chinese do more physical labor, and few depend on cars for transportation.

* The average Chinese blood cholesterol level is only 127 milligrams per deciliter, compared with 212 here.

Why were the Chinese selected for this enormous and important study? Because 90% of them live in the provice they were born in and eat the same food all their lives. In addition, the Chinese still have a "local" diet: they generally eat what is raised nearby and retain traditional dietary patterns. However, there are large variations in eating habits as well as disease and mortality patterns from one provice to another, which allows for instructive comparison. Moreover, what the Chinese eat and what they die of provides notable contrasts with patterns in the U.S. and Europe.

The rate of colon cancer among the Chinese, for example, is half that among Americans, and the rate of heart disease among Chinese men just one-seventeenth that among American males. The leading cause of mortality in China is respiratory disease--pneumonia, bronchitis, tuberculosis, and other infections ailments that are well controlled in the industrialized world. The rate of breast cancer is five times higher in the U.S. than in China. Yet the Chinese do die of cancer: the leading cancer killer for both men and women is stomach cancer (now rare in the U.S.), followed by cancer of the esophagus for men and cervical cancer for women. Cancer is the second leading cause of death among men, the fourth among women, ranking after respiratory disease, stroke, and heart disease. Cigarette smoking has been on the increase for 20 years or more: 80% of Chinese men smoke, as compared with less than 29% of all Americans. Thus lung cancer rates are rising. (Two decades ago, the smoking rate among American men was as high as 70%.) Chinese life expectancy, based on figures from 1973-75, is estimated to be currently about 70 years, compared to 75 in the U.S. and Britain.

Epidemiological studies--that is, studies of this sort that look at disease patterns in large groups of people--provide evidence of association rather than ironclad "proof" of cause and effect. The health of the Chinese people is certainly influenced by other factors besides diet: heredity, social attitudes, environment, and the quality of their medical care. The Chinese clearly have something to learn from the West when it comes to the prevention of infectious respiratory diseases and cervical cancer and of the deadly effects of smoking. But westerners can also learn something from these findings, which support the thesis that a diet high in fat and animal products but low in fiber contributes to heart disease and perhaps to cancers of the breast and colon as well. The Chinese government is now taking active steps to keep the traditional diet from evolving into the high-fat diet of the West.
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Title Annotation:results from a study of eating habits, life-style, and disease rates in China
Publication:The University of California, Berkeley Wellness Letter
Date:May 1, 1991
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