Traditional Chinese food is good for you. It’s rich in rice and vegetables, with little meat and virtually no dairy products. It is a big reason why Western health problems like heart disease are still rare in China, and why the Chinese life expectancy at birth is more than 70 years—four years longer than the global average. But if the World Bank has its way, a wave of burgers and milk shakes might soon wash these benefits away.
In December, the World Bank approved a $93.5 million loan that would build 130 feedlots and five processing centers for China’s young beef industry. “The loan is a bad idea,” says T. Colin Campbell, professor of nutritional biochemistry at Cornell University, “because it will encourage the consumption of foods that will lead to Western-type diseases, which are costly to treat. Raising this kind of food is expensive, too, both in dollars and in cost to the environment.” Almost all of the arable land in China is already used for raising grain. According to various estimates, it takes about 360 gallons of water and five to eight pounds of grain to produce one pound of beef.
Proponents of the loan say it will ease the poverty of small farmers who raise the majority of Chinese cattle. They point out that demand for beef is already rising among the nation’s growing middle class. But the loan’s many opponents, including the Sierra Club, the Physicians Committee for Responsible Medicine, and People for the Ethical Treatment of Animals, question the assumption that affluence must always have a Western face.
In fact, many nutrition and disease experts see China as a test case for the rest of the developing world. Their hope is that China can enjoy the benefits of economic development while avoiding the health mistakes made by other affluent countries. While their chief concern is the control of tobacco, animal fat is not far behind.
The “health transition” is a well-known side effect of economic development. In 1900, about 40 percent of deaths in the United States were caused by 11 major infectious diseases, such as typhoid, smallpox, and pneumonia. Only 16 percent of deaths were caused by cancer, stroke, or heart disease. One life span later, the tables had turned. In 1973, infectious diseases caused just 6 percent of deaths in the United States, and 58 percent were due to the three chronic conditions. Research indicates that most of the improvement was caused by better sanitation in food, water, and waste disposal, not by advances in medical care.
In the mid-1980s and again in the mid-1990s, a team of American and Chinese researchers led by Campbell visited a representative sample of Chinese households to measure that country’s health transition. They confirmed that certain causes of death have a significant correlation with poverty, while other causes are associated with affluence. The “diseases of poverty” include pneumonia and tuberculosis. Cancers and heart disease dominate the “diseases of wealth,” which are far more prevalent where Chinese smoke tobacco and consume diets rich in sugar and fat.
In 1998, another study brought China’s health transition into sharper focus. A team led by Richard Peto of Oxford University found that tobacco now causes about 13 percent of male deaths in China, but will probably account for 33 percent of male deaths if those who recently started smoking continue to smoke at their current rates. (Female smoking rates in China are low, and have actually fallen in recent years.) Two-thirds of Chinese men now become smokers before the age of 25, and tobacco will kill about half of those who persist. The evidence is clear: If the Chinese learn to smoke, drink, and eat like Americans, they will also die like Americans.
The choice of what to eat and whether to smoke should be up to individual people, and few Westerners would favor more restrictions on freedom of choice for the Chinese. Yet, critics of the World Bank loan say, public policies shouldn’t encourage practices that destroy hard-won gains in public health, either. The World Bank stopped making loans to tobacco growers in 1991, but it still makes many loans that promote meat and dairy consumption.
Judith Mackay, a longtime tobacco control activist in China, says that countries going through the health transition must safeguard their gains with preventive measures like health education and extremely restrictive tobacco policies. Those that do not will struggle against problems that are familiar in America—cancer and heart disease epidemics, and entrenched tobacco and livestock industries that manipulate the government, media, and public opinion. In the long run, healthier countries will be far more promising consumer markets, as well as better places to live.