Quote from macho grande:
For instance, the japanese smoke more than Americans, they also die less of lung cancer. That doesn't mean that smoking is protective for lung cancer; and you can prove this with proper prospective epidemiology because within either one of those populations individuals who smoke at time "X" are more likely to die of lung cancer several years out.
It's quite possibly the amount of fat in the diet:
"An unhealthy diet will increase a person's susceptibility to known causes of lung disease, such as allergens, tobacco smoke, infectious agents, and air pollution. One of the best examples of the importance of diet and lung health is demonstrated by the low incidence of lung cancer among Japanese cigarette smokers. The risk of lung cancer in the United States is at least 10 times higher than in Japanese living in Japan despite the higher percentage of smokers among the Japanese.(1) Smokers of Japanese descent living in the US have the same incidence of lung cancer as do the rest of Americans. These findings point to the importance of the differences in the diets followed in Japan and the US. The starch-based (rice and vegetable) diet followed by most Japanese smokers allows the body to defend and repair the damages from smoked tobacco far more effectively than does a diet of fat and protein (meat and dairy products), the American diet.
Many large population studies have shown that people who eat healthier diets, meaning more vegetables and fewer animal foods, have less lung disease.(2-6) One study of 52,325 participants found that individuals whose diets are rich in meat reported new onset of persistent coughs with phlegm 43 percent more often than those who consume a diet high in fruit." - John McDougall, M.D.
References:
1) Stellman SD, Takezaki T, Wang L, Chen Y, Citron ML, Djordjevic MV, Harlap S, Muscat JE, Neugut AI, Wynder EL, Ogawa H, Tajima K, Aoki K. Smoking and lung cancer risk in American and Japanese men: an international case-control study. Cancer Epidemiol Biomarkers Prev. 2001 Nov;10(11):1193-9.
2) Butler LM, Koh WP, Lee HP, Tseng M, Yu MC, London SJ; Singapore Chinese Health Study. Prospective study of dietary patterns and persistent cough with phlegm among Chinese Singaporeans. Am J Respir Crit Care Med. 2006 Feb 1;173(3):264-70.
3) Walda IC, Tabak C, Smit HA, Râ°sâ°nen L, Fidanza F, Menotti A, Nissinen A, Feskens EJ, Kromhout D. Diet and 20-year chronic obstructive pulmonary disease mortality in middle-aged men from three European countries. Eur J Clin Nutr. 2002 Jul;56(7):638-43.
4) Jiang R, Paik DC, Hankinson JL, Barr RG. Cured meat consumption, lung function, and chronic obstructive pulmonary disease among United States adults. Am J Respir Crit Care Med. 2007 Apr 15;175(8):798-804.
5) Varraso R, Jiang R, Barr RG, Willett WC, Camargo CA Jr. Prospective study of cured meats consumption and risk of chronic obstructive pulmonary disease in men. Am J Epidemiol. 2007 Dec 15;166(12):1438-45.
6) Varraso R, Willett WC, Camargo CA Jr. Prospective study of dietary fiber and risk of chronic obstructive pulmonary disease among US women and men. Am J Epidemiol. 2010 Apr 1;171(7):776-84.
Check out the huge disparity in fat intake between the Japanese and American diets:
http://www.ncbi.nlm.nih.gov/pubmed/1618693
Quote from macho grande:
Here's a proper prospective epidemiological study:
Mortality in vegetarians and nonvegetarians: detailed findings from a collaborative analysis of 5 prospective studies.
Am J Clin Nutr. 1999 Sep;70(3 Suppl):516S-524S.
PMID: 10479225
Just as the title implies, this was a meta-analysis (a study of selected studies), not a "proper epidemiological study". It looked at data from five analytical studies to compare death rates from common diseases between vegetarians and non-vegetarians. The five studies took place between 1959 through 1984, two from California, two from the U.K. and one from Germany, all countries with similar rich Western diets, which this analysis makes quite clear in the Discussion:
"We believe that the 5 studies analyzed here are the only large,
prospective studies that included a large proportion of subjects
following a Western-style vegetarian diet. Therefore, the results
presented represent most of the information available on comparisons of mortality between Western vegetarians and nonvegetarians with broadly similar lifestyles."
These were shallow studies, based strictly on questionnaires. No blood or urine was tested, no food samples collected. The vegetarians ranged from those who'd followed the vegetarian diet for less than 5 years to those greater than 5 years.
Compare that to the Cornell China Project in which the 89-94% of the participants had lived in their province their entire lives and had eaten the same way throughout their lives as a result.
Also, this analysis made assumptions (not good science):
"The number of vegans was small, so the analyses in Table 7 were repeated with the inclusion of data from the Health Food Shoppers Study, making the assumptions that all nonvegetarians were regular meat eaters and that vegetarians who reported that they did not consume dairy products were vegans."
How do you consider this meta-analysis of five limited analyses, with assumptions made, a proper epidemiological study?
Despite the flaws of this meta-analysis, the results were still compelling arguments for a plant-based diet:
"Mortality from ischemic heart disease was 24% lower in vegetarians than in nonvegetarians (death rate ratio: 0.76; 95% CI: 0.62, 0.94; P < 0.01)."
Also, "the numbers of deaths from individual cancers among vegans remained small."