The China Study – by Dr. T Colin Campbell and Dr. Thomas M. Campbell
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This is not the newest book we’ve reviewed (originally published 2005; this revised and expanded edition 2016), but it is a seminal one.
You’ve probably heard it referenced, and maybe you’ve wondered what the fuss is about. Now you can know!
The titular study itself was huge. We tend to think “oh there was one study” and look to discount it, but it literally looked at the population of China. That’s a large study.
And because China is relatively ethnically homogenous, especially per region, it was easier to isolate what dietary factors made what differences to health. Of course, that did also create a limitation: follow-up studies would be needed to see if the results were the same for non-Chinese people. But even for the rest of us (this reviewer is not Chinese), it already pointed science in the right direction. And sure enough, smaller follow-up studies elsewhere found the same.
But enough about the research; what about the book? This is a book review, not a research review, after all.
The book itself is easy for a lay reader to understand. It explains how the study was conducted (no small feat), and how the data was examined. It also discusses the results, and the conclusions drawn from those results.
In light of all this, it also offers simple actionable advices, on how to eat to avoid disease in general, and cancer in particular. In especially that latter case, one take-home conclusion was: get more of your protein from plants for a big reduction in cancer risk, for example.
Bottom line: this book is an incredible blend of “comprehensive” and “readable” that we don’t often find in the same book! It contains not just a lot of science, but also an insight into how the science works, on a research level. And, of course, its results and conclusions have strong implications for all our lives.
Click here to check out The China Study, to know more about it!
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How Primary Care Is Being Disrupted: A Video Primer
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How patients are seeing their doctor is changing, and that could shape access to and quality of care for decades to come.
More than 100 million Americans don’t have regular access to primary care, a number that has nearly doubled since 2014. Yet demand for primary care is up, spurred partly by record enrollment in Affordable Care Act plans. Under pressure from increased demand, consolidation, and changing patient expectations, the model of care no longer means visiting the same doctor for decades.
KFF Health News senior correspondent Julie Appleby breaks down what is happening — and what it means for patients.
More From This Investigation
Primary Care Disrupted
Known as the “front door” to the health system, primary care is changing. Under pressure from increased demand, consolidation, and changing patient expectations, the model of care no longer means visiting the same doctor for decades. KFF Health News looks at what this means for patients.
Credits
Hannah Norman Video producer and animator Oona Tempest Illustrator and creative director KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News’ free Morning Briefing.
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Antidepressants: Personalization Is Key!
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Antidepressants: Personalization Is Key!
Yesterday, we asked you for your opinions on antidepressants, and got the above-depicted, below-described, set of responses:
- Just over half of respondents said “They clearly help people, but should not be undertaken lightly”
- Just over a fifth of respondents said “They may help some people, but the side effects are alarming”
- Just under a sixth of respondents said “They’re a great way to correct an imbalance of neurochemicals”
- Four respondents said “They are no better than placebo, and are more likely to harm”
- Two respondents said “They merely mask the problem, and thus don’t really help”
So what does the science say?
❝They are no better than placebo, and are more likely to harm? True or False?❞
True or False depending on who you are and what you’re taking. Different antidepressants can work on many different systems with different mechanisms of action. This means if and only if you’re not taking the “right” antidepressant for you, then yes, you will get only placebo benefits:
- Placebo Effect in the Treatment of Depression and Anxiety ← randomly assigned antidepressants are, shockingly, luck of the draw in usefulness
- Antidepressants versus placebo in major depression: an overview ← “wow this science is messy”
- Comparative efficacy and acceptability of 21 antidepressant drugs: a systematic review and network meta-analysis ← “oh look, it makes a difference which antidepressant we give to people”
Rather than dismissing antidepressants as worthless, therefore, it is a good idea to find out (by examination or trial and error) what kind of antidepressant you need, if you indeed do need such.
Otherwise it is like getting a flu shot and being surprised when you still catch a cold!
❝They merely mask the problem, and thus don’t really help: True or False?❞
False, categorically.
The problem in depressed people is the depressed mood. This may be influenced by other factors, and antidepressants indeed won’t help directly with those, but they can enable the person to better tackle them (more on this later).
❝They may help some people, but the side-effects are alarming: True or False?❞
True or False depending on more factors than we can cover here.
Side-effects vary from drug to drug and person to person, of course. As does tolerability and acceptability, since to some extent these things are subjective.
One person’s dealbreaker may be another person’s shrugworthy minor inconvenience at most.
❝They’re a great way to correct an imbalance of neurochemicals: True or False?❞
True! Contingently.
That is to say: they’re a great way to correct an imbalance of neurochemicals if and only if your problem is (at least partly) an imbalance of neurochemicals. If it’s not, then your brain can have all the neurotransmitters it needs, and you will still be depressed, because (for example) the other factors* influencing your depression have not changed.
*common examples include low self-esteem, poor physical health, socioeconomic adversity, and ostensibly bleak prospects for the future.
For those for whom the problem is/was partly a neurochemical imbalance and partly other factors, the greatest help the antidepressants give is getting the brain into sufficient working order to be able to tackle those other factors.
Want to know more about the different kinds?
Here’s a helpful side-by-side comparison of common antidepressants, what type they are, and other considerations:
Mind | Comparing Antidepressants
Want a drug-free approach?
You might like our previous main feature:
The Mental Health First-Aid That You’ll Hopefully Never Need
Take care!
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Safe Effective Sleep Aids For Seniors
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Safe Efective Sleep Aids For Seniors
Choosing a safe, effective sleep aid can be difficult, especially as we get older. Take for example this research review, which practically says, when it comes to drugs, “Nope nope nope nope nope, definitely not, we don’t know, wow no, useful in one (1) circumstance only, definitely not, fine if you must”:
Review of Safety and Efficacy of Sleep Medicines in Older Adults
Let’s break it down…
What’s not so great
Tranquilizers aren’t very healthy ways to get to sleep, and are generally only well-used as a last resort. The most common of these are benzodiazepines, which is the general family of drugs with names usually ending in –azepam and –azolam.
Their downsides are many, but perhaps their biggest is their tendency to induce tolerance, dependence, and addiction.
Non-benzo hypnotics aren’t fabulous either. Z-drugs such as zolpidem tartrate (popularly known by the brand name Ambien, amongst others), comes with warnings that it shouldn’t be prescribed if you have sleep apnea (i.e., one of the most common causes of insomnia), and should be used only with caution in patients who have depression or are elderly, as it may cause protracted daytime sedation and/or ataxia.
See also: Benzodiazepine and z-drug withdrawal
(and here’s a user-friendly US-based resource for benzodiazepine addiction specifically)
Antihistamines are commonly sold as over-the-counter sleep aids, because they can cause drowsiness, but a) they often don’t b) they may reduce your immune response that you may actually need for something. They’re still a lot safer than tranquilizers, though.
What about cannabis products?
We wrote about some of the myths and realities of cannabis use yesterday, but it does have some medical uses beyond pain relief, and use as a sleep aid is one of them—but there’s another caveat.
How it works: CBD, and especially THC, reduces REM sleep, causing you to spend longer in deep sleep. Deep sleep is more restorative and restful. And, if part of your sleep problem was nightmares, they can only occur during REM sleep, so you’ll be skipping those, too. However, REM sleep is also necessary for good brain health, and missing too much of it will result in cognitive impairment.
Opting for a CBD product that doesn’t contain THC may improve sleep with less (in fact, no known) risk of long-term impairment.
See: Cannabis, Cannabinoids, and Sleep: a Review of the Literature
Melatonin: a powerful helper with a good safety profile
We did a main feature on this recently, so we won’t take up too much space here, but suffice it to say: melatonin is our body’s own natural sleep hormone, and our body is good at scrubbing it when we see white/blue light (so, look at such if you feel groggy upon awakening, and it should clear up quickly), so that and its very short elimination half-life again make it quite safe.
Unlike tranquilizers, we don’t develop a tolerance to it, let alone dependence or addiction, and unlike cannabis, it doesn’t produce long-term adverse effects (after all, our brains are supposed to have melatonin in them every night). You can read our previous main feature (including a link to get melatonin, if you want) here:
Melatonin: A Safe Natural Sleep Supplement
Herbal options: which really work?
Valerian? Probably not, but it seems safe to try. Data on this is very inconsistent, and many studies supporting it had poor methodology. Shinjyo et al. also hypothesized that the inconsistency may be due to the highly variable quality of the supplements, and lack of regulation, as they are provided “based on traditional use only”.
Chamomile? Given the fame of chamomile tea as a soothing, relaxing bedtime drink, there’s surprisingly little research out there for this specifically (as opposed to other medicinal features of chamomile, of which there are plenty).
But here’s one study that found it helped significantly:
The effects of chamomile extract on sleep quality among elderly people: A clinical trial
Unlike valerian, which is often sold as tablets, chamomile is most often sold as a herbal preparation for making chamomile tea, so the quality is probably quite consistent. You can also easily grow your own in most places!
Technological interventions
We may not have sci-fi style regeneration alcoves just yet, but white noise machines, or better yet, pink noise machines, help:
White Noise Is Good; Pink Noise Is Better
Note: the noise machine can be a literal physical device purchased to do that (most often sold as for babies, but babies aren’t the only ones who need to sleep!), but it can also just be your phone playing an appropriate audio file (there are apps available) or YouTube video.
We reviewed some sleep apps; you might like those too:
The Head-To-Head Of Google and Apple’s Top Apps For Getting Your Head Down
Enjoy, and rest well!
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Ozempic Helps People Walk Further
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There’s often a catch-22 when it comes to exercise: it’s important for good health, and/but people with ill health usually cannot exercise much.
A recent (published today, at time of writing, the 29th of March 2025, never let it be said we don’t bring you the very most up-to-date health science!) study by Dr. Neda Rasouli et al. has shown there is a possible way through that catch-22, depending on the nature of the illness.
This study followed 792 people across 112 outpatient clinical trial sites in 20 countries in North America, Asia, and Europe, with type 2 diabetes and peripheral artery disease.
What they found
Patients taking semaglutide (specifically, 1mg Ozempic) enjoyed a 21% median increase in walking distance, as well as some bonus benefits, namely:
- Weight reduction: the semaglutide group saw a greater reduction in body weight (–4.1 kg; P < 0 .0001)
- HbA1c levels: semaglutide lowered HbA1c by 1 percentage point (P < 0.0001)
- Blood pressure: systolic blood pressure decreased by 3.2 mmHg (P = 0.0042)
You may be wondering what that “P =” means: it’s the probability of this occurring by random chance, on a scale from zero (impossible outcome) to 1 (unavoidable outcome).
For example:
“We hypothesized that singing the happy birthday song before tossing a coin would result in it landing on heads. We sang the happy birthday song and tossed the coin; it landed on heads (P = 0.5)”
In science, generally speaking anything with a probability of under 0.05 (expressed as: “P < 0.05”) is considered a statistically significant result.
All this to say, the cited figures of, for example, P < 0.0001, are very significant indeed.
On which note, that 21% median increase in walking distance? P < 0.0004.
As for side effects? Serious adverse events related to the drug occurred in 1% of the semaglutide group vs 2% in the placebo group. So, that seems quite safe indeed.
You can find the paper itself here:
Want to learn more?
Check out:
- The Doctor Who Wants Us To Exercise Less, & Move More
- Walking… Better.
- 5 Ways To Naturally Boost The “Ozempic Effect”
Take care!
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Top 10 Early Warning Signs Of Dementia
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What’s a harmless momentary mind-blank, and what’s a potential warning sign of dementia? Dementia Careblazers, a dementia care organization, has input:
The signs
With the caveat that this is a list of potential warning signs, not a diagnostic tool, the 10 signs are:
- Memory loss: e.g. forgetting important or well-learned information, such as one’s home address
- Challenges in planning or solving problems: e.g. difficulty with tasks such as paying bills (for organizational rather than financial reasons), following recipes, or managing medications
- Difficulty completing familiar tasks: e.g. trouble remembering rules of a familiar game, or directions to a familiar place
- Confusion with place or time: e.g. forgetting where one is, or making mistakes with the date, season, or other time-related details. Note that anyone can be momentarily unsure of today’s date, but if someone thinks it’s 1995, probably something wrong is not quite right. Similarly, being wrong about who is the current national leader is often used as a test, too—assuming countries with enough political stability to not have five different national leaders in the past four years, including one who did not outlast a lettuce *side-eyeing the UK*
- Trouble understanding visual images and spatial relationships: e.g. increased clumsiness, difficulty parking, or bumping into objects
- New problems with speaking or writing: e.g. losing track in conversations, or struggling to find the right words
- Misplacing things: e.g. losing items and being unable to retrace one’s steps to find them
- Decreased or poor judgment: e.g. falling for scams, giving out too much information or money without investigating appropriately first
- Withdrawal from social activities or hobbies: e.g. losing interest in activities one used to enjoy or avoiding social interactions
- Changes in mood and personality: e.g. increased irritability, anxiety, or other noticeable changes in behavior and personality
For more information on each of these, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Dementia: Spot The Signs (Because None Of Us Are Immune)
Take care!
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Walking can prevent low back pain, a new study shows
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Do you suffer from low back pain that recurs regularly? If you do, you’re not alone. Roughly 70% of people who recover from an episode of low back pain will experience a new episode in the following year.
The recurrent nature of low back pain is a major contributor to the enormous burden low back pain places on individuals and the health-care system.
In our new study, published today in The Lancet, we found that a program combining walking and education can effectively reduce the recurrence of low back pain.
PeopleImages.com – Yuri A/Shutterstock The WalkBack trial
We randomly assigned 701 adults who had recently recovered from an episode of low back pain to receive an individualised walking program and education (intervention), or to a no treatment group (control).
Participants in the intervention group were guided by physiotherapists across six sessions, over a six-month period. In the first, third and fifth sessions, the physiotherapist helped each participant to develop a personalised and progressive walking program that was realistic and tailored to their specific needs and preferences.
The remaining sessions were short check-ins (typically less than 15 minutes) to monitor progress and troubleshoot any potential barriers to engagement with the walking program. Due to the COVID pandemic, most participants received the entire intervention via telehealth, using video consultations and phone calls.
Low back pain can be debilitating. Karolina Kaboompics/Pexels The program was designed to be manageable, with a target of five walks per week of roughly 30 minutes daily by the end of the six-month program. Participants were also encouraged to continue walking independently after the program.
Importantly, the walking program was combined with education provided by the physiotherapists during the six sessions. This education aimed to give people a better understanding of pain, reduce fear associated with exercise and movement, and give people the confidence to self-manage any minor recurrences if they occurred.
People in the control group received no preventative treatment or education. This reflects what typically occurs after people recover from an episode of low back pain and are discharged from care.
What the results showed
We monitored the participants monthly from the time they were enrolled in the study, for up to three years, to collect information about any new recurrences of low back pain they may have experienced. We also asked participants to report on any costs related to their back pain, including time off work and the use of health-care services.
The intervention reduced the risk of a recurrence of low back pain that limited daily activity by 28%, while the recurrence of low back pain leading participants to seek care from a health professional decreased by 43%.
Participants who received the intervention had a longer average period before they had a recurrence, with a median of 208 days pain-free, compared to 112 days in the control group.
In our study, regular walking appeared to help with low back pain. PeopleImages.com – Yuri A/Shutterstock Overall, we also found this intervention to be cost-effective. The biggest savings came from less work absenteeism and less health service use (such as physiotherapy and massage) among the intervention group.
This trial, like all studies, had some limitations to consider. Although we tried to recruit a wide sample, we found that most participants were female, aged between 43 and 66, and were generally well educated. This may limit the extent to which we can generalise our findings.
Also, in this trial, we used physiotherapists who were up-skilled in health coaching. So we don’t know whether the intervention would achieve the same impact if it were to be delivered by other clinicians.
Walking has multiple benefits
We’ve all heard the saying that “prevention is better than a cure” – and it’s true. But this approach has been largely neglected when it comes to low back pain. Almost all previous studies have focused on treating episodes of pain, not preventing future back pain.
A limited number of small studies have shown that exercise and education can help prevent low back pain. However, most of these studies focused on exercises that are not accessible to everyone due to factors such as high cost, complexity, and the need for supervision from health-care or fitness professionals.
On the other hand, walking is a free, accessible way to exercise, including for people in rural and remote areas with limited access to health care.
Walking has a variety of advantages. Cast Of Thousands/Shutterstock Walking also delivers many other health benefits, including better heart health, improved mood and sleep quality, and reduced risk of several chronic diseases.
While walking is not everyone’s favourite form of exercise, the intervention was well-received by most people in our study. Participants reported that the additional general health benefits contributed to their ongoing motivation to continue the walking program independently.
Why is walking helpful for low back pain?
We don’t know exactly why walking is effective for preventing back pain, but possible reasons could include the combination of gentle movements, loading and strengthening of the spinal structures and muscles. It also could be related to relaxation and stress relief, and the release of “feel-good” endorphins, which block pain signals between your body and brain – essentially turning down the dial on pain.
It’s possible that other accessible and low-cost forms of exercise, such as swimming, may also be effective in preventing back pain, but surprisingly, no studies have investigated this.
Preventing low back pain is not easy. But these findings give us hope that we are getting closer to a solution, one step at a time.
Tash Pocovi, Postdoctoral research fellow, Department of Health Sciences, Macquarie University; Christine Lin, Professor, Institute for Musculoskeletal Health, University of Sydney; Mark Hancock, Professor of Physiotherapy, Macquarie University; Petra Graham, Associate Professor, School of Mathematical and Physical Sciences, Macquarie University, and Simon French, Professor of Musculoskeletal Disorders, Macquarie University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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