Posts Tagged ‘Cholesterol’

Bill Clinton, Vegan Poseur

November 28, 2010

He certainly wasn’t the first person you would expect, so when the news hit it was all over the veggie blogosphere. “Bill Clinton goes vegan!” the headlines read, “so should you” was the unwritten subtext. Nevermind that he really wasn’t claiming veganism, admitting to eating fish and taking no stances on animal rights.

If the former Big Mac munchin’ president of the United States could go “(mostly)vegan” for heart health and receive such great benefits, why not you. By his own account Clinton after adopting “essentially a plant-based diet…[living] on beans, legumes, vegetables, fruits” he lost 24 lbs and is feeling great. But is this really the best argument for veganism?

As I’ve said before we need to be very careful about health claims, as far too often the media reports one-off, poorly controlled and designed studies while vastly overstating the implications.

By all accounts Clinton’s dietary change is a health experiment inspired by the likes of Dean Ornish whose work he references in interviews, “I did all this research, and I saw that 82 percent of the people since 1986 who have gone on a plant-based, no dairy, no meat of any kind, no chicken, no turkey — I eat very little fish, once in a while I’ll have a little fish — if you can do it, 82 percent of people have begun to heal themselves.”

In a post over on Science-Based Medicine Dr. Harriet Hall explains the study that is the source of this statement:
“He started with 48 patients with angiographically documented coronary artery disease and randomized 28 of them to an experimental group (a 10% fat vegetarian diet, stopping smoking, stress management training, and moderate exercise) and 20 to a usual-care group. Only 20 experimental and 15 control patients completed the 5 year study. The diameter of the coronary arterial stenoses improved by 3.1 percent in the experimental group and worsened by 11.8 percent in the usual care group. Overall, 82% of experimental-group patients had an average change towards regression. They had about half as many cardiac events: 25 in the experimental group versus 45 in the usual care group. None of the experimental subjects were on any cholesterol-lowering medication, but the usual care group allowed cholesterol-lowering prescriptions, and after 5 years the LDL levels of both groups were the same. In short, only 20 patients were on the diet, and it was not a trial of diet alone, but of intensive lifestyle management involving several other interventions. The study has not been replicated.”

Studies like this might point the direction for further research but with such a small sample size and poor controls its nothing to hang your hat on. While the nutritional adequacy and some benefits of a vegan diet are well accepted, many of the specific and sometimes extreme health benefits claimed by advocates have yet to be irrefutably established in the medical literature. Long term diet and nutrition can be a complex issue for study with many confounding variables, more rigorous studies and much more data will be required to establish any real positive (or negative) effects of a vegan diet.

Clinton also cites Caldwell Esselstyn and authors of The China Study, T. Colin Campbell and his son, Tom Campbell as inspiration. Ive previously mentioned the China Study as an example of poor evidence for the nutrition argument and it has been thoroughly torn apart so I will not directly address that book for now. In Dr. Esselstyn’s book, Prevent and Reverse Heart Disease, he oversteps the evidence to conclude that following his restricted vegan-type diet can prevent “strokes, hypertension, obesity, osteoporosis, adult-onset diabetes, and possibly senile mental impairment, as well … impotence and cancers of the breast, prostate, colon, rectum, uterus, and ovaries.”

Such grandiose promises may appeal to an unskeptical segment of the population already obsessed with health and fad diets, but the claims just are not rational or well supported. Poor reasoning and fallacious arguments in the long run distract from the central cause of animal rights. Once the weight is off or health benefits don’t materialize folks are likely to abandon the diet and be the next poster child of the ex-vegans. As noted by Ginny Messina, The Vegan RD, in a recent must-read-post on supplements, “There are many reasons why people abandon vegan diets, and bad nutrition advice from within the vegan community is probably one of them. “

When promoting veganism our reasons should be clear, it isnt the newest weight loss fad, nor a panacea. It’s a stance that rejects the anthropocentric and speciesist bias of our culture, an ethical choice aimed at reducing suffering and ultimately achieving animal liberation. As Matt Ball of Vegan Outreach had to say, “Ultimately, the bottom line is: Reduce Suffering. Everything has to answer to this. I can’t emphasize this enough: the only thing that matters is to reduce suffering. If you accept this as the What, the next question is, How? At this time, in this country, we choose to promote veganism. However, veganism is not an end in and of itself. We don’t promote veganism because ‘veganism is good.’ Veganism is merely a tool to reduce suffering.”

UPDATE:For more on this topic I highly recommend this new post titled How the Health Argument Fails Veganism by Ginny Messina, the Vegan RD. She pulls no punches in getting to the point,“here is the problem with using the health argument in this way—it’s that there isn’t any health argument for veganism. There is, of course, a pretty good argument for eating more plants (lots more plants) and less animal food, but no one has shown that you must eat a 100 percent plant diet in order to be healthy. So to make an argument for a 100% vegan diet based on health benefits alone, we have no choice but to stretch the truth. We have to overstate the benefits of vegan diets, and sometimes minimize or dismiss the risks. And as soon as we stray from the actual facts, our advocacy is on shaky ground. “

Ex-Vegans and Cholesterol Skeptics

November 24, 2010

Once again ex-vegans are causing a stir. This time it’s Tasha of the quite popular foodie blog VoraciousEats (formerly VoraciousVegan). In a recent post she describes her health problems of depression, fatigue, dizziness, and other troubles, her subsequent abandonment of veganism, and near instantaneous recovery “My first bite of meat after 3.5 years of veganism was both the hardest and easiest thing I’ve ever done. Tears ran down my face as saliva pooled in my mouth. The world receded to a blank nothingness and I just ate, and ate, and ate. I cried in grief and anger, while moaning with pleasure and joy…I had only eaten a small piece of cow flesh, and yet I felt totally full, but light and refreshed all at once.” Excuse me if I’m a bit skeptical.

I dont wish to disparage someone with genuine health problems but given the context and tone of the post it is clear that more than just a necessary dietary shift for health reasons has taken place but a total change of philosophy. Tasha arrives at the same “epiphany” as numerous new “happy meat” advocates, that a vegan diet is destructive to personal health and the environment.

That numerous ex-vegans mention reading the likes of Derrick Jensen, Lierre Keith(discussed earlier), or even the long de-bunked Secret Life of Plants just prior to their conversion makes me a bit suspicious. Especially when people sometimes appear to self-diagnose by matching their non-specific symptoms to those of a writer with lifelong chronic health problems. The symptoms described by many ex-vegans are reminiscent of “symptoms of life” experienced by imagined sufferers of chronic fatigue, Lyme disease, or gluten intolerance all of which actually do afflict some people but have in recent times become widespread self-diagnosed fads. The non-specific nature of the symptoms mean we must be very careful in ascribing them to any particular pathology. While people can have genuine vitamin deficiencies and medical issues, these things need to be confirmed with a doctor (as Tasha appeared to do) and preferably a dietitian not a nutritionist as the latter is an unregulated title. If you do have a nutrient deficiency you can usually work with a dietitian to find out how to modify your diet or what supplements you need while still remaining vegan.

Importantly we must remember to not put put too much stock into anecdotes about health on the internet. Keep in mind, the plural of anecdote is not data.

Another thing that raises a red flag for me is that many are abandoning veganism not for a traditional western diet but for raw, gluten-free, or paleo diets which are themselves on the fringe with mostly controversial evidence to support them. The attitude of these ex-vegans also does not seem to reflect an anguished anti-speciesist forced into consuming flesh, rather they revel in it as noted by Ginny Messina, The Vegan RD, “I understand that someone who believes they require meat may need to tweak their overall perspective to make it feel ethically okay to eat it. But, there is a big difference between choosing to include small amounts of meat in your diet for health reasons versus absolutely reveling in meat consumption as is reflected in Tasha’s recent twitter post: “Bacon, bacon, bacon…how did I ever live without you for so long?” Or this: “Lunch – bacon egg cheese and jalapeno quesadilla. I’m so happy to be eating food that I love.””

Tasha removed all doubt as to her bias when she dropped this hammer, “I know that the lipid hypothesis is completely fallacious, these animal foods won’t hurt me or cause me ill health in anyway, in fact, the vitamins and minerals they provide, along with the nutritious cholesterol and wholesome saturated fat, will restore my health.” Nutritious cholesterol!? Wholesome saturated fat!? Im sorry but as already stated in this vegan dietitians review of The Vegetarian Myth, “we have no dietary need for either saturated fat or cholesterol—there is no RDA for either. The liver makes all the cholesterol our bodies require. And the two essential fatty acids required by humans—both unsaturated—are found in plant foods.”

The Vegetarian Myth is likely where Tasha got this idea. In her book Keith writes mockingly, “The Lipid Hypothesis—the theory that ingested fat causes heart disease—is the stone tablet that the Prophets of Nutrition have brought down from the mountain. We have been shown the one, true way: cholesterol is the demon of the age, the dietary Black Plague, a judgment from an angry God, condemning those who stray into the Valley of Animal Products with disease.” The resources Keith sites are less than impressive being mostly non-scientific and pseudo-scientific popular sources with little reliance on the medical literature. The lipid hypothesis is the now well supported hypothesis that a major factor in heart disease is the accumulation of lipids on the arterial walls or more generally elevated blood cholesterol levels but Keith is part of a wider movement of “cholesterol skeptics” represented in part by groups such as the Weaston A Price Foundation (“butter is a superfood”) and the The International Network of Cholesterol Skeptics (THINCS). In stating their *clearly* unbiased scientific opinion on their home page THINCS had this to say “For decades, enormous human and financial resources have been wasted on the cholesterol campaign, more promising research areas have been neglected, producers and manufacturers of animal food all over the world have suffered economically, and millions of healthy people have been frightened and badgered into eating a tedious and flavorless diet or into taking potentially dangerous drugs for the rest of their lives. As the scientific evidence in support of the cholesterol campaign is non-existent, we consider it important to stop it as soon as possible.”

Just like Anthropogenic Global Warming skeptics, THINCS are skeptics in name only. They place themselves at the fringe of science ignoring vast amounts of peer reviewed literature in the name of supporting or tearing down a hypothesis often seemingly with political or economic bias. Their web page is filled with emotionally charged language alleging a conspiracy to cover up the “truth”. The overreaction from the global warming alarmists or in this case health-nuts doesn’t help matters when they make unfounded health claims of their own or present flimsy evidence such as the China Study. Contrary to what the cholesterol deniers would have you believe there is plenty of evidence for the lipid hypothesis, though they do raise some reasonable concerns about over-prescription of statins and the need for much more research in nutrition, they come off as ideologues.

The debate over the evidence for the lipid hypothesis is still very complex, so we need to be careful about any health claims we make. The most rational position is to not make positive health claims but to just stick with the ADA, “It is the position of the American Dietetic Association that appropriately planned vegetarian diets, including total vegetarian or vegan diets, are healthful, nutritionally adequate and may provide health benefits in the prevention and treatment of certain diseases. Well-planned vegetarian diets are appropriate for individuals during all stages of the life-cycle including pregnancy, lactation, infancy, childhood and adolescence and for athletes.” What we need is a measured and rational approach to nutrition, be skeptical of health claims for particular foods and to not overstep the literature.

I highly recommend this article by Harriet Hall over on Science-Based Medicine and this follow up for an in-depth look at cholesterol skeptics by a knowledgeable doctor.
The Skeptic’s Dictionary review of Uffe Ravnskov’s The Cholesterol Myths is also well worth the read

Please go read Theo’s post on our companion blog VeganSkeptic about this incident and how it illustrates a greater need for skepticism in the animal rights and vegan community.