The China Study

Per recommendation from my mother, I've started to read "The China study".  She and I both have an interest in nutrition and disease so I am excited to read the book and gather new insights - and maybe find a new lifestyle ideal to work towards.  I have only started to read the book, but from what I gather, the author is going to build a case that animal products and specifically animal protein in the Western diet is responsible for many of the common diseases that afflict us, including heart disease, cancer, and obesity. 

As I was reading the first chapter, my mind wandered a bit and I remembered the time I spent in east Africa.  The Maasai people are nomads who live in the Great Rift Valley of Kenya and Tanzania and we had many encounters with them on our trip.  Their economy revolves around cattle - they are nomads because they must find new grazing lands for their herds.  Maasai diet is extremely high protein:  they drink milk from their cows and even harvest cow blood from a small cut in the jugular vein to drink raw.  They will consume meat from goats, sheep, and their cattle if they need to.

From the New England Journal of Medicine, on the Masai Diet, from 1971:

"The Masai of East Africa exhibit some unique biologic characteristics. Despite their customary diet composed of 66 per cent calories as fat, they have persistent low serum cholesterol and beta-lipoprotein levels. Post-mortem examinations provided direct proof of a paucity of atherosclerosis. Metabolic studies revealed that the Masai absorbed large amounts of dietary cholesterol, but also possessed a highly efficient negative feedback control of endogenous cholesterol biosynthesis to compensate for the influx of dietary cholesterol.  The high ratios of phospholipid to cholesterol and bile acid to cholesterol in their gallbladder bile explain the extreme rarity of cholesterol gallstones. All these characteristics may reflect a long-term biologic adaptation of the tribe."

I don't think this refutes anything, it is just food for thought.  For example, it seems plausible to me that relative dietary protein excess could be related to "Western" diseases but if such protein is immediately utilized that might be a different story.  The Maasai eat a lot of animal protein but they are also nomads and spend their days in different ways than your average American and probably make more use of the protein in their diets.  Also, I'm not aware of any good studies of cancer among the Maasai but I will keep looking.

Switching gears.  On page 80 off the book I made a self-serving observation:  there was not a statistically significant link between eggs and blood cholesterol found in the China study.  After some arguments with friends about the relative health risks/benefits of eating eggs, I had previously scoured pubmed for links between egg consumption and blood cholesterol.  After viewing multiple studies, I was able to find no such link - only transient increases in blood cholesterol were reported (immediately after consumption). 

From a scientific perspective I wouldn't be totally shocked if eggs were ultimately shown to be fairly benign dietary additions.  I am about to embark on a path of pure unadulterated, unsupported speculation (as I often do).  If there is something unique about animal protein and animal cholesterol as it relates to cancer, causing tumor progression, I wouldn't be surprised if it ultimately proved to be related to the consumption of signalling molecules & growth factors that feed malignancy.  Consuming "animal protein" essentially is an exercise in consuming the cells of various animal tissues.  Those cells all have membranes that are full of cholesterol molecules and transmembrane signalling proteins.  Those cells will also contain a cytoplasm full of hormones,intracellular signalling molecules, enzymes, signal amplifiers, and the like.

Eggs wouldn't necessarily have those things because eggs aren't tissue.  Its a protoplasm of undifferentiated nutrients that will ultimately be built into differentiating (specializing) cells and tissues.  Raw eggs just represent building blocks for later animal protein.  The animal protein in eggs would lack signalling molecules and hormones.

Anyway, I will be curious to see if there is stronger anti-egg evidence later in the book.

Impressions from East Africa: historical development, communities, and finances

Imagine Tanzania in the year 1900. This is a land that is 50% larger than the state of Texas, supporting a population of maybe 3 million. There was no infrastructure, no centralized government, and really, no history of a centralized government. Contrast that to Qing China, the Manchurian dynasty which ruled China up to modern times. Qing China in 1900 was arguably still one of the great powers of the world even if it was quickly falling apart. Back then, the population of China was several hundreds of millions. There was a history of civilization going back four millennia and certainly a tradition of strong centralized government, despite the fact that China is so geographically large.

One of the things required to create a modern nation state and the appropriate institutions is a sufficient population density in the surrounding area. China apparently hit that necessary population density thousands of years ago, but we should remember that Tanzania was nowhere near that threshold even one hundred years ago. A great book that expounds on this topic is "Guns, Germs, and Steel" for anyone interested. Despite these great contrasts, GDP per person in China and Tanzania 30 years ago was not so different. The take-home point is this: strong economic and political development doesn't just happen by default. It can get hindered by any number of things.

Think back to Tanzania in 1900: sparsely populated, inaccessible, every community for themselves. These communities, like other small communities throughout history, would need to be close knit. Vertical ties may involve patronage from a chief or leader who has surplus resources. That leader can distribute those resources to neighbors and subordinates in order to strengthen ties and bonds between them. Horizontal ties would involve relationships between friends, relatives, and neighbors who are on equal footing. In a small self-sufficient society, it is all about hedging risk. Sometimes one family has a good hunt, or a good harvest. Another family may fail to find an animal, or will have crops which get killed by fungus. Obviously, if neighbors are willing to readily share everything they have, the risk gets hedged throughout the community as a whole and everyone is better off.

In a century, the population of Tanzania has increased by 10-fold or more. It has been thrown into the modern world, and expected to develop sound Western institutions of government. Are these aforementioned cultural survival traits just going to disappear in a single human lifetime? Vertical ties of patronage in 1900 are manifested in the modern world as endemic corruption. Horizontal ties between neighbors manifest as a lack of savings. Let me expound on this last point. When we were in Kenya, one Westerner was telling me that if any person makes money or has a big payday, they immediately go out and spend it on all of their friends at the bar or restaurant. An employee of this person didn't want to keep her money at her house. She was afraid a friend or family would ask for it, and she would be obligated to give it away. These two examples help illustrate a source of serious economic problems. Without savings, there can be no investment. Without investment, there is no productivity growth.

I do appreciate that this dynamic is a testament to the strength of the community in Tanzania and Kenya, which is a wonderful thing. I've figured out that it is a big part of the attraction that Colleen feels to east Africa. Really, it is the same for me. The palpable sense of community is something we just don't have in the West anymore for the most part, and its something one can never perceive from photos of Africa. One has to be there to feel that pulse. Not to denigrate my own culture, because I love the West and I think it is the pinnacle of human existence: but this resource-sharing dynamic in east Africa is more instinctively "normal", in the sense that humans are hard-wired to operate that way. Sharing of resources in small, close-knit communities has been the norm throughout human history.

The communal spirit is what enabled clans and small groups of people to survive, because everyone is hedging their successes and failures on their close relatives. Only with the advent of larger towns and cities using national currencies have people in the West in particular moved away from this. There is still an intense attraction to what they have in east Africa, because I believe our brains were designed to function in small communities like they have (and we used to have) instead of the relatively lonely and unfriendly places in which we live in the West. In fact I've read psychological studies which suggest that 150 people is the ideal community size for Homo sapiens; we can keep tabs on and socially interact with that many people.

The move from small self-sufficient community groups to larger cities and towns in the West occurred over an extended period of hundreds of years. This gradual transition allowed for the culture to adjust slowly. We were able to develop a norm of anti-corruption (even though it still happens everywhere). Since everyone was participating in government we began to think in terms of nation or kingdom instead of tribe or clan. Notice in places where political participation was forbidden by some group or another (Jews in Europe, African Americans in the USA) there remained into modern times sort of "tribal" (us versus them) schisms that we see in the news all the time in east Africa and are oh so shocked by. Tribal tendencies, xenophobia, racism - we are talking about the same thing. Barack Obama, show us your birth certificate!

Anyway. If I had one point to this post, I guess it would be this: many people look at the lack of economic development in Africa and think "what has gone wrong?" My reaction is completely different: How could they be anywhere else? There has been so much change in such a short amount of time in east Africa, there is just no way it could have happened smoothly. In east Africa we've been expecting them to make the sort of adjustments in 100 years that in the West we made over the last 700 and in China they made over the last 4,000. This isn't even adding in the complicated history of colonialism, the effect instability of neighbors has on local development, and the effect of poor government economic policies. I don't even need to think about colonialism to not be surprised by the current political and economic position in east Africa. Yet only 30 years ago China was every bit as poor as Tanzania. 70 years ago Italy still had endemic malaria, a high birth rate, and extremely high infant mortality. I don't know how the current situation could make anyone pessimistic about the future of Africa, because to me it makes perfect sense that Africans are where they are now given from where they have come.

Its all about where they are going, and I think the future is promising. Maybe I'm too optimistic, but its never smart to bet against humanity. Topic for another post.

Impressions from Tanzania, Part I

Warning:  I am writing about things that I really know very little about.  Anyone who has seen my political blog knows I do that all the time.  Well, believe it or not, I didn't come all the way over here so I could write about the weather, and about what I did all day.  My main objective is to get at least a superficial feel for the culture and the challenges that east Africans face.

One of the shocking things about being here is that you initially don't feel like you can just casually walk among some of the "poverty" that I've seen here.  Some of the dwellings that are here would not be out of place in the set of the movie "District 9".  Not only do we casually walk through these areas, nobody seems to care.  Its not like the music stops, the DJ screeches the record, and everyone stares at us (and this is Colleen and I without Said escorting us).  The people are usually indifferent, sometimes curious, but never shocked/insulted/hostile at our presence.  I wondered before coming here if I would feel unsafe at all, but I really haven't, except for when traveling in crazy packed buses.  By the way, I don't have any pictures from when walking through places like this because I don't want to offend anyone by blatantly taking pictures of them.

The reason I put the word poverty in quotes above is because these people are extremely poor by Western standards but they don't act like we are led to believe that poor people act.  I'm not sure why there is such a gulf between distant perception and reality in this regard.  I can't have been the only American with that impression, because I would confidently say that I am less easily influenced by others, and more skeptical in general, than most Americans. 

The image we have of the third world from American television sets is a bunch of people sitting around with blank looks on their faces.  In contrast, these people in Tanzania move like they are on a schedule.  Everyone has a livelihood.  Brick-making is a big one.  Younger boys are constantly filling wooden wheel barrels full of rocks and then pulling them to the brick makers.  Lots of people are working the fields.  Machine and mechanic work is common.  Carpentry and construction is too.  Maybe the most common are merchants; it seems like every other person has a shop of some sort, or is selling stuff at market.

So there is an extremely intensive economy here, and it is surprising how intensive it is, given my preconceived notions, which I feel foolish for even having at all.  It isn't a productive economy of course, at least not by our standards.  It takes investment in capital to increase productivity.  China only 30 years ago was a hugely unproductive economy, but now look where it is, thanks to investment and good government policies for business.  The real challenge is to figure out a way to get the technical know-how and the capital in so that the people can take off.  Obviously.

Colleen's friend Mary, who runs the school for special needs children, is a perfect example.  She was an entrepreneur who had a vision and a dream of a school, but no money to buy land or build it.  Colleen provided the initial catalytic boost and Mary has ran with the project, taking it beyond the level that any one person, whether it be the richest Westerner or the most motivated Tanzanian, could have on their own.  When it comes down to it, Colleen didn't buy land or build a school.  Anyone with money can do that.  Colleen invested in a Tanzanian, and Mary turned that investment into something great for her people.  This is an incredibly important distinction that must frequently be lost on people, especially western philanthropists.

Anyway, there is lots more to write about, but I'll stop there.  The concluding theme to this post is that the people of Tanzania are far more wealthy than I ever imagined; as an American it is easy to forget that wealth means more than assets and cash on hand minus liabilities.

By the way, the rest of my travel posts can be found here.