Why the Vegan Twin Study Got it Wrong

Dr. Mark Hyman:
Coming up on this week’s episode of the Doctor’s Farmacy, if you put people on a vegan diet, take ’em off a standard American ultra processed diet and put ’em on a Whole Foods vegan diet, they’re going to do better for sure. In the short run, the devil is in the details. Will going plant-based solve our health and climate problems? Or is the real problem how we’re forming, how we’re raising animals, how we’re doing agriculture, and is it industrialized agriculture including factory farming animals and mono crops is the problem? Yes.
Welcome to the Doctor’s Farmacy. I’m Dr. Mark Hyman, and this is a place where conversations that matter, and today we’re going to talk about the vegan twin study that got so much attention, so much news, and was so messy in so many ways that we’re going to break down and help you understand what the science says, what it doesn’t, and what the take homes are and what they aren’t. And it’s not what you read in the headlines. This is one of our Help bite series where we dive deep into topics of science and help you understand what’s really going on underneath the headlines in reading between the lines. Today we’re zooming in on this groundbreaking study that comes from Stanford University and was recently published in JAMA Open, which is a major medical journal. So Stanford JAMA sounds great. Okay? It’s got to be real and right, not so fast, right?
The researchers basically put a vegan diet head to head with an omnivore diet for 22 pairs of identical twins to see which one comes out on top as the best diet vegan or omnivore. But as we’ll soon see the whole study and the conclusions were not as straightforward as they seemed. Now the buzz around the study was huge, right? It sparked immense conversations anywhere from social media to professional circles and adding to all this excitement, the research forms the basis of this new documentary called You Are What You Eat, A Twin Experiment. Wow. Okay. So I’ve never seen before a study that was done and at the same time a documentary was filmed about the study as it was being done, which I think was really interesting and makes you wonder about the whole thing and we’ll get into what the messy details of that all are.
So stay tuned for this. Who knows? Maybe you’ve watched the documentary already. Maybe you are convinced that the vegan diet is better, and let’s talk about what that science shows and what it doesn’t. I mean, it’s kind of absurd to do a documentary while doing a study unless you know the conclusions in advance, right? Study design is everything, and you can manipulate science by stacking the deck in favor of the outcome you want. Now today, our journey takes us through the intricate details of the study. We’ll dissect exactly what the twins ate on their diet plans, the effects on their cholesterol levels and other blood biomarkers and other important body composition markers, which were not actually reported in the study, which I think are some of the most important findings of the study that somehow the authors didn’t seem inclined to want to publish because they contradicted the views that the vegan diet was better.
And we’re going to get into that and I think that’s one of the most important findings of the study. And what is the implication for cardiovascular health? How do they cherry pick the data? We’re going to get into all of this. This is just the tip of the iceberg here. We’re going to dive deep into overlooked aspects of the study. We’re going to contrast those findings with previous data because one study doesn’t tell you everything. You need to understand any study in the context of all the previous research of observational data. Basic science studies can randomize controlled trials and really look at what the data show as a whole and not just grab on any new study as the headline. And we’re going to also look at research gaps, an alternative, more sustainable solutions for eating that you might not be aware of that are better for your health and the climate than a vegan diet.
Make sure you stay on the podcast the whole way through because we’re also investigating lots of conflicts of interest, funding sources, hidden agendas that were not fully disclosed, but have had a major hit in clouding the study’s conclusions and the implications for applying this globally to the world’s population, which they seem to want to do and make everybody a vegan. We also get into the Netflix docuseries, what it got right, what it got wrong, and they got a few things right as well as the confusing and very convoluted information they presented. We’re going to clear it all up for you. You top it off. We’re going to explore a functional medicine approach to diet and how we can feed our bodies to create health and also take care of the planet in a healthy and sustainable and ethical way. It’s not a binary choice. Be a vegan for your health and the planet or eat meat and you’re destroying your health and the planet.
It’s not so simple. My goal for this episode is to equip you with the knowledge, the skills, and the confidence to cut through what is clearly a vegan sales pitch and find the right diet that works for you to achieve peak nutrition, longevity and optimal being. So let’s jump into this touchy topic and unravel the latest in nutrition science this dive into the study. The study was called Cardiometabolic Effects of Omnivorous versus Vegan Diets in Identical Twins or randomized controlled trials. So that’s a good thing, right? A randomized controlled trial is the gold standard of proving causation. That’s good. It’s not just a population study where you look at correlation. Now, why does this study matter so much? The study and the resulting Netflix documentary are a byproduct of an ongoing quest to figure out what’s the best diet for us humans and what’s the best diet for the planet.
Now, nutrition research as a whole, starting at a high level is pretty confusing. There’s all kinds of studies, and we’ve covered this in other podcasts, but essentially there’s two major kinds of nutritional studies. One are population studies where they follow people for many years, they track their habits, their behaviors, their diet, and then they see if there’s any correlations with bad outcomes, heart attacks, drugs, cancer, diabetes, whatever. It doesn’t prove anything. It just shows an association not causation. So if I did a study of menopausal women who are over 55 years old and I followed ’em for many years who had sex, I would conclude that having sex never leads to pregnancy. It’s not true, but the study proves it even though it’s not actually factually correct. I mean, yes, 55-year-old woman have six are not likely to get pregnant, but it doesn’t mean that having sex never leads to pregnancy.
See what I mean here? So that’s part of the problem. So what we want to do is more deeper randomized controlled trials, which this was. Now when you see these observational data, you get confused because there’s a lot of, we’ll call confounding variables. There’s factors in people’s lifestyle that can’t be accounted for. So let’s say you’re eating meat and that shows that you have a high risk of heart disease, cancer, stroke, and death. Well, what are your other habits? Are you a smoker? Do you drink a lot? Do you not eat fruits and vegetables? Are you overweight, eat more starch and sugar? Do you not take your vitamins? Well, that’ll impact the results. That’s what we call confounding variables, and it’s very hard to control for these, so they can’t really prove anything. Now we really need to look at more long-term, randomized controlled trials.
Short-term trials can be helpful. And this one was an eight week trial, but that’s a very short time. For example, if you put people on a vegan diet, take ’em off a standard American ultra processed diet and put ’em on a whole foods vegan diet, they’re going to do better for sure in the short run. But what happens when you put people on a nutrition efficient vegan diet, which by definition is nutrition efficient, it doesn’t have a lot of the key nutrients we need for human health, which will get into those, and you put those people on vegan diets for years or decades, what happens then? I’ve seen these people, I’ve seen them in my practice as a doctor every day I see patients who are nutrition deficient, who are vegans, and it’s concerning to me, even people who are healthy vegans who you think would be healthy, there are deficient iron and vitamin D and omega fats and many, many other nutrients.
So we really have to look at how hard it’s to do a feeding study of nutrition because nobody wants to be locked up for years in a metabolic lab and fed a certain diet and give it a certain lifestyle and be monitored like a lab rat. That’s just not going to happen. So we have to kind of rely on short trials like this one or maybe a bit longer that can be done, and there have been some that are done that are quite good. So the other thing we have to look at is bias. There’s a lot of bias in nutrition studies. One study that was done by David Ludwig reviewed all the science around various nutrition topics and they found that if industry funded this study, in other words, the Dairy council funded a study on milk or dairy and its health effects, it was five to eight times more likely 500 to 800% more likely to show a positive benefit for the food that was studied.
So if you’re Coca-Cola studying whether soda causes obesity, guess what? It’s not likely to show that it does, right? So when another study was published in plus one, we have all, by the way, all the references, everything I’m talking about is in the show notes. You can go ahead and click on the research, find out for yourself. Don’t take my word for it, but the food industry funding is a big issue. The nutrition industry funds 12 times as much research as the NIH. They spend about $12 billion a year of funding nutrition research. NIH maybe spends a billion, but as a whole, that’s probably even a lot because a lot of it’s not real true nutrition research. Now, 13% of research articles published in the top most cited nutritional journals in 2018 were backed by the food industry. So about 13% were funded by the food industry.
Of those studies, 56 of those studies reported findings that were favorable to industry interests. And the Journal of Nutrition has the highest number of incidents of industry involved. 28% of studies were funded by the food industry. Now that leads to all kinds of problems, conflicting studies, headlines, confusion from the public. It’s hard to separate fact and fiction. And so based on this, let’s talk about this particular study which was industry backed, and we’re going to talk about what that is later. But I think there’s a lot of conflicts of interest really you should know about as part of this study, the Stanford study, and it’s resulting. Netflix documentary was a randomized control trial, which is a good thing, and it was in twins, which it seemed to be good, but it sounds too good to be true. It showed clearly the vegan diet was better.
Is it true? Is it not? Let’s see. Let’s go into the study design. So the authors tried to compare the effects of a healthy vegan diet with a healthy omnivorous diet on various markers of heart health or cardiometabolic markers during eight weeks. And by the way, just so you know, at a high level, everybody knows we found this forever and ever that vegan diets lower LDL cholesterol. Now, whether it’s a good thing or bad thing, it’s really important to understand because LDL is not the most predictive biomarker for heart disease. In fact, it’s a crappy one. There’s much more effective markers such as a OB lipoprotein fractionation. I’ve talked a lot about this in a health bite on cardiovascular disease. We’ll talk about that more in a minute. That shows the quality of cholesterol. It also didn’t look at insulin resistance in a meaningful way that I would like to see him done.
And so we really don’t have the gold standard for cardiovascular disease. We just talked about LDL and in people’s mind, LDL is bad. You lower LDL, that must be good. End of story. Well, it’s not so simple, and I talked about this a lot in my books. Most people enter the hospital with a heart attack, have normal LDL cholesterol, but they have high triglycerides. They have low HDL, which is a sign of poor metabolic health. So I don’t think that lowering LDL in and of itself is an important biomarker to assess cardiovascular risk. And yet that’s the thing they looked at. Because they know from all the other data, we know that vegan diets lower LDL cholesterol, it doesn’t mean that that’s a good thing. You can produce more damaging heart disease causing cholesterol particles that are more particles, smaller particles. Whereas if you ate saturated fat, you’d have the opposite.
So really it’s important to look at a much more nuanced view of cardiovascular risk. And I encourage you to listen to my health bite on cardiovascular risk because it, I go into all this in great detail. So this study was done as a single center RCT. It was at one facility, one location, which minimizes the generalizability of this if it was done in 10 centers with 10 different populations, and it could be a more reliable study. So they use 22 pairs of identical twins that were 18 and older. And basically in good health, the average BMI was 25.9. So right there, I don’t think they’re in good health, but your BMI should be like 21, 22, 25 to consider overweight. So basically the average BMI was overweight to start with and they used twins to control for genetic variation, which can be confounding variables and that can be useful.
But again, it’s not a perfect study design. Now, one twin went on one diet and one twin went on another diet. One twin got a vegan diet and one twin got an omnivore diet and it was eight weeks. And the primary outcome measure was LDL cholesterol. And that’s really what they used to see whether the study was going to prove the hypothesis that a vegan diet improve your cardiovascular risk. Now, the study was in two phases. The first phase was four weeks, and the second phase was four weeks. The first phase, which was week one to four, they were three meals a day that were provided at no cost by food delivery service and health coaching. It helps them understand what their diet should be and they focused on fruits and vegetables, whole grains, limited sugar, limited added refined grains, which is all a good thing.
And they were then encouraged to purchase and consume snacks to meet their calorie requirements. So they gave them some food and then they got some snacks, but they were guiding ’em what to get the second phase five to eight weeks, five to eight. They were told to buy, cook, and prepare food on their own, but adhere to the diet guidelines. And they were expected to understand the type and the amount of food to eat after phase one. So it kind of gave them an input they should eat. And they were basically told to choose mentally processed foods to build balanced plates with vegetable, starch protein, healthy fats to choose a variety of foods within each group and to personalize the diet to meet their preferences and their needs. And they were not told to restrict calories. So they said, eat as much as you want.
And they were not restricting calories. So what was the healthy vegan diet? Well, it was lots of vegetables, which is awesome. Should be, we probably should have five to nine servings of fruits and vegetables that probably should be more like nine to 18. Actually three servings of fruit a day, five servings of beans, nuts, seeds or vegan meat per day. So fake meat, highly processed meat, six servings of grains or starchy veggies a day, which is a lot. And then the vegan group, they were instructed to avoid all animal products. Now on the healthy Omniware diet, they were told to eat six to eight ounces of meat, fish or poultry day, one egg per day, one and a half serving dairy per day, three servings of veggies, which is really low. Why would they be telling them to eat less fruits and veggies than is the minimum guideline recommended in our dietary guidelines, which sits five to nine servings of fruits and vegetables.
Now a serving is half a cup, so it’s not a cup and a half of fruits and vegetables today, which is extremely low. And you add in this fruit, it was two servings of fruit, so let’s say five, but it’s really at the low end as opposed to the vegan group was told to eat nine plus servings a day as opposed to just five. And they also were told to eat six servings of grains or starchy vegetables each day. Now this is a problem when you eat a diet that’s high in starch and sugar, which we’ll talk about. The omnivore diet had more sugar. It is a driver of poor metabolic health and it’s something that may offset some of the benefits if you followed a low starch and sugar diet as well as being an omnivore. So they didn’t actually design the study to really test a healthy low starch sugar diet in an omnivore population versus a typically higher starch and carbohydrate diet for a vegan diet.
So it wasn’t even the right study design in my view. It was just not looking at the right parameters to understand what’s really going on because we know that if you eat, for example, starch and sugar with saturated fat, it’s a bad thing for your health and it makes everything worse. So what they did to figure out what’s going on, well, they basically gave them 24 hour recalls over the phone to collect data baseline week four and eight. So they basically just called them up, say, Hey, what do you eat in the last 24 hours? Okay, maybe they remember the blood samples were drawn basically at baseline four in eight weeks, and stool samples were collected to see what happened in the microbiome, but they haven’t really reported on that yet or did anything with it. So let’s talk about what happened when they did this study.
Well, how did the dietary interventions affect their overall calorie intake? So both vegan and omni twins had changes in their macronutrient intake, meaning protein, fat in carbs, the dietary fat. They have both had an increase in good fats like mono saturated fats from olive oil, which are heart healthy and antiinflammatory. They both had a decrease in saturated fat. Now, saturated fat gets a bad rap and I’ve written a whole book called Fat yet than you can go at that. And there’s more even data since that book was published. But it’s not as bad as I to believe. It depends on the individual, their diet, their lifestyle, genetics. And actually in many, many studies diet’s, hindsight tract can be beneficial, whether keto low carb diets, if you’re eating low starch and sugar saturated fat general isn’t an issue. If you’re a metabolic disease, which 93% of Americans do saturated actually may be helpful with your lipids increasing H-D-L-L-D-L particle size, which is a good thing, reducing triglycerides if you don’t eat it with starch and sugar.
So the worst thing is bread and butter, right? SA fat and carbs, good thing would be butter on your vegetables, right? That’s fine. So it’s really what you eat it with and I think if we understand our standard American diet, if we eat a lot of saturated fat with carbohydrates, starch and sugar, that’s bad news. So I agree with that, but not the saturated fat in and of itself is bad. And again, there’s many men analyses, randomized controlled trials, lots of data on this, but I think the saturated fat is a boogeyman is really be an overstated and it really genetically variable depending on the population, but for most of us it’s okay. Both increased carbohydrate intake. That’s interesting. They were both told to eat a lot more grains. They reduced refined grains. Although in phase two when people were eating what they wanted, the refined grains went up.
They both had a little bit less added sugar, but the vegans ate 17% less added sugar than the omnivores now added sugar. We know it causes all kinds of issues with your health. So we don’t know if the results are because of less added, more added sugar or what’s going on. Vegetable intake increased for both. That’s a good thing. Fiber intake increased for both groups, although the vegans had a little bit more about 30% more than the omnivores in phase two. And that’s a good thing. I think omnivores should eat a lot of fiber. So it’s important what you eat with, it’s not what you’re eating, it’s what you’re eating it with. If you’re eating beans and grains and a vegan diet, but you’re also drinking soda, that’s a bad thing. If you’re having an omnivore diet, but you’re eating tons of fruits and vegetables and lots of fibrous foods and overall healthy diet, it’s not necessarily a problem.
Just the vegan twins, they ate a lot more meat alternatives, right? Tofu, temp based soy nuts, veggie burgers, not necessarily bad. It was about sevenfold increase from baseline. Their total carb intake increased more of the omnivores. Their protein increased 20% from baseline, their vitamin B12, which is a critical nutrient, we’re going to talk about that more in a minute, went down by 65% from the baseline. And in the short term it may not cause effects. But imagine if you’re doing this over years, what’s going to happen? Their iron intake increased from baseline, but this was a non-heme iron from fortified grains that doesn’t necessarily benefit you. They also had higher levels of poly on saturated fats. That’s a whole nother conversation, but not necessarily that their cholesterol intake went down obviously because they’re not any animal foods. And it was replaced with something called plant sterols which compete with cholesterol that’s made by the heme body and lowers serum cholesterol.
So soybeans for example, has this, but the research is really mixed on whether or not replacing animal cholesterol with plant cholesterol is beneficial and we don’t know if it reduces heart disease risk or just lowers cholesterol, right? So just so you understand, LBL cholesterol is not an indicator of heart disease. It’s a risk factor that may actually drive an increased risk, but it may not, depending on the quality of the cholesterol, the type of cholesterol, your other biomarkers, whether it’s inflammation. For example, I had a patient yesterday who had extremely high cholesterol LDL of 180, really high total particle number. He has no inflammation, he has totally normal metabolic health. His A1C is 4.8, his blood sugar is perfect, his insulin’s perfect. So he has no inflammation, no metabolic disease. And he was a 64-year-old guy and you’d think this guy would be full of plaque.
But we did a heart scan, very sophisticated heart scan called the clearly scan, which looks at AI, interpreted CT angiograms, and we found he had zero plaque. He also had zero calcium score. So here’s a guy with extremely high cholesterol that has no heart disease. So again, it just, it’s an indicator that she should look at other factors, but LDL in itself is not the beyond end all of your cardiovascular risk. So to say that lowering LDL cholesterol by a small percent in the study with a vegan diet is the holy grail that tells us that vegan diets protect us against cardiometabolic disease is just nonsense. Now, the omnivore twins, they did increase protein from baseline and their cholesterol and their dietary cholesterol did increase a little bit as well. So that’s fine, but minimally, right? So just so you understand, cholesterol is not according to the dietary guidelines, not a nutrient concern anymore, and it’s nearly debunked as a cause of heart disease.
And just to explain the math to you, you have 200 milligrams per deciliter cholesterol, which is your number. Let’s say your cholesterol is 200, you have about five liters of blood, that’s five liters. So every liter you’ve got about 2000 milligrams five times. So you’ve got about 10,000 milligrams of cholesterol in your blood. Adding two or 300 milligrams is not going to move the needle very much. Most of it’s produce in your liver or reabsorb from your gut. So what happened? What was the effect of these dietary interventions on cardiometabolic risk factors? Well, eight weeks, the twins on the vegan diet had a lower amount of cholesterol, so their cholesterol dropped by 13.9 milligrams per deciliter, which is not really that significant, but it is something, right? Although it’s statistically significant, their insulin dropped a little bit, which is a good thing. They also added less sugar and less calories, which does affect your insulin production.
So that may explain it and it seems like a good thing, but they lost 1.9 kilograms more than the omni board group. Now that’s fascinating to me. So you say, okay, weight loss, cholesterol comes down, that’s all good, insulin comes down, but what was the weight loss? And we’re going to talk about why the decrease in body weight was not a good thing, but a bad thing in this group, and we’ll talk about that in a minute, but what I’m talking about is actually, just to give you a heads up, is body composition. And they didn’t report on body composition in the study, but they did report it in the movie, which was so interesting to me and in the study it kind of would debunk the whole study if you looked at it, but I don’t even know why they focused on in the movie because it kind of undermines their argument.
The other things that happened were these are non-significant reductions that weren’t scientifically, statistically significant, but HDL went down a little bit, which is the good cholesterol is protected. Their blood sugar went down, the TMA went down because they didn’t eat meat, and that can be produced from gut milk probes that are processing meat and that may be linked to heart disease or may not. We don’t know yet. Their triose spreads went down a little bit, okay, they probably eat less sugar, but here’s an interesting fact. The satisfaction with the diet was quite different. The omnivores actually were satisfied and had an increased satisfaction or stayed the same for the vegans. They all had a reduction in their diet satisfaction, so they didn’t like it. They liked the healthy lifestyle part, but not the vegan diet. Now let’s talk about the issues with this study. First focus exclusively on LDL as the primary endpoint.
I just explained why that doesn’t matter as much as we think. You can’t determine your cardiovascular risk by just looking at one biomarker. Now, I’ve co-founded a company called Function Health, and for 4 99 you can get 110 biomarkers. Normally the cost would be about $50,000. It’s a membership model for twice a year testing and you get a full cardiometabolic panel, not just one marker, you get lipoprotein fractionation, which is what we should be looking at, not just LDL cholesterol, which is mostly meaningless in my view, given the data we have now, we’re looking at particle number, particle size, we’re looking at for that for both HDL, triglycerides, LDL. We’re looking at inflammatory markers, we’re looking at insulin levels, glucose, and a much more detailed look at what’s going on. It’ll give you a better sense for looking at a OB lipoprotein A. And if you really want to know what’s going with your cardiovascular health and cardiometabolic health, it’s important to get the full panel, and you probably won’t get this with your doctor.
Less than 1% of cholesterol tests are the right one. Less than 1% are the newer version, which is called lipoprotein fractionation essentially means looking at the particle number and size, not just the total number of cholesterol you get, like your regular test, but actually the quality of your cholesterol, not just the quantity. And that’s really much more important. Looking at your risk, I encourage you to listen to my podcast on assessing cardiovascular risk. It’s another one of my health bites. We’re going to put the link in the show notes. You can read the transcripts, you can listen to the podcast, but it goes into this in great detail and you’ll understand why. I think just looking at LDL itself is pretty meaningless. Second, they didn’t control for things that could also account for the lower LDL like weight loss or lower calorie intake. So the vegan group had weight loss, more weight loss and ate less food.
They didn’t like it, so their LDL went down could have gone down because of that. What’s interesting is weight and fasting insulin were not included as endpoints in the study design and they were added after the study was completed. So normally you do a study, you have to declare you’re declaring your major in college, you have to declare what you’re looking to see an impact on, which was LDL. But then they saw benefits from other things, and so they added those after, which is I guess okay, but just because it made the study look better for them, they didn’t actually include the fact that HDL was reducing the abstract and it kind of reflects this cherry picking where they emphasize the things that went well, but deemphasized the things that didn’t go well. So they deemphasized the lower HDL, they deemphasized the change in body composition, which were much worse in the vegans.
This is important. We’re going to talk about why that’s important. Also, the study was short term. Like I said, it only lasted eight weeks and you really can’t assess long-term risks. You can’t assess the risk of nutritional deficiencies on your muscle mass or sarcopenia energy levels. The risk to iron levels and anemia, gut issues, immune function, you just can’t look at all that in eight weeks. So you need much longer studies and they’re harder to do, right? They only gave the people four weeks of prepared food and four weeks they had to figure it out and they kind of deviated after the four weeks and there was no follow-up period really. So they didn’t really look at what happens over the long term of these patients. What was their sustainability of the diets? Did they like it? What are the nutrient deficiencies? Did they adhere to it?
Were they satisfied with it? None of that was looked at. Also, they only did 3 24 hour diet recalls to look at their macronutrients. Now, do we really know what you ate by just looking at one day? I mean maybe, but again, food frequency questionnaires are highly unreliable, and I talked about that in other podcast also. This didn’t really represent the normal population of the country. You can’t just generalize a study. That’s the thing about randomized controlled trials. They’re good, but they only are good for looking at the patients. They’re looking at. If you’re only studying 70 kilogram white males from Kansas, it doesn’t apply to someone or Asian or from India or from Africa somewhere. So it doesn’t really look at that 70%. Sorry, 77% of the group were females, 72% were white. Only 11% were Asian, 5% were black, 2% were Pacific Islander. So we really can’t generalize this study.
Also, there was a lack of diversity of socioeconomic and education status. So what about people who are less privileged, who live in food deserts who can’t really access a healthy vegan diet, which is really much harder to do, and there’s also genetic variability they need to look at. So we tend to look at things as if everybody’s the same, but there’s a lot of variability from person to person. For example, some people have genetics that make them extremely susceptible to B12 deficiency effects. So for example, N-T-H-F-R, which is a methylation SNP, requires methylfolate, b12, folate supplements, and if you don’t have this, you increase your risk of heart disease. Mental illness and B12 deficiency is almost universal unless you supplement with B12. The diet did not supplement or address the potential for these nutrient deficiencies. There are many nutrients beyond B12 that are low or absent on a vegan diet.
B12 wasn’t supplemented in this study. The dietary intake for the vegans was much, much lower. B12 stored the liver, so it was stayed more or less the same in the range, not the same, but it stayed in the range, but it probably was coming down over time. Also, iron and vitamin A and calcium all had reductions in their intake in the vegan and really didn’t seem to be a concern in the study because it takes a while for the effects of these dietary deficiencies to show up, and maybe that’s why we only did eight weeks instead of six months. So maybe it was the cost, but they didn’t really have to address this fact, which is a really big issue. Now, one of the kinds of things that we see, and because deficiencies really don’t show up for months to years on a vegan diet, the things we see typically are omega threes being low because these come from fatty fish, low vitamin A, certain B vitamins, low low vitamin K two, low calcium, vitamin D, iron, zinc, iodine, which is often from fish, selenium, and choline.
Now you can get some of these from plants, but they’re less bioavailable, right? For example, iron intake is increased for vegans, but it was heme iron, which isn’t well absorbed. Also, certain things in your diet like oxalates and phytates, which are in spinach, collard greens really affect absorption. So I eggs months or years for nutritional deficiencies to show up in vegans, and there’s a lot of nutrients we should be concerned about. Omega threes, vitamin A, particularly retinol certain B vitamins like B12, vitamin K two, calcium, vitamin D, iron, zinc, iodine, which suffer from fish, selenium, which is also fish choline, which comes from fatty fish and other animal foods like eggs. So we’re often seeing these deficiencies in patients who are vegans, even healthy vegans if they’re not taking supplements. Now you can get some of these nutrients from plants, but often they’re less bioavailable.
For example, the iron intake was increased for the vegans in the study, but it was non-heme iron, which doesn’t really get absorbed as well or is as good to raise your blood count. Also, calcium can be inhibited in its absorption because oxalates and phytates found in beans and certain plants, spinach, collard greens can hinder the absorption. I want to talk about that in more in a bit. Also, a proper vegan diet where you stay healthy requires lifelong planning and it requires supplementation and even requires supplementation with highly processed plant proteins. And I’ll explain why this is important later, but it’s almost impossible to get the required amount of protein for what we call muscle protein synthesis. Now you can get a protein for your basic kind of life functions, but what really matters as we age is the amount of muscle and the quality of muscle and building muscle.
And vegan diets are clearly inferior to doing this. And often we’ll see a lot of issues with sarcopenia as people get older and vegans, and this is a big concern of mine, particularly in terms of longevity. Now even with supplements, it’s hard to make up for the differences. You can’t actually compare getting supplements just from a vitamin pill compared to eating a complex food, which has a deep nutrient matrix and a synergy of health ingredients. And by the way, not everybody can afford supplementation, particularly the amount you need if you’re vegan. Also, it doesn’t address the best and worst candidates for a vegan diet because not everybody should be doing, are we recommending this for everyone? Well, Gardner, who was the study author from Stanford, said in the press release, our study used a generalizable diet meaning for everyone that is accessible to anyone because 21 out of the 22 vegans followed through the diet.
Well, I don’t know about this. I’m guessing most study participants are enthusiastic about participating in study, want to do it right, and it doesn’t mean that because they did it for eight weeks that they’re going to continue to do it. And remember, this was done in generally healthy twins and it doesn’t account for genetics. They’re underlying health conditions, immunity, thyroid issues, lots of other things. What about pregnant women and kids? Well, there’s a lot of data that this is a concern, and when you have vegan mothers, they’re deficient omega fats, which is critical for developing the brain. B12 for iodine, for thyroid function, selenium important for thyroid function as well. And vitamin D, I mean the list goes on and vegan diets in mothers have been linked to neurodevelopmental issues to lower iq, weaker bone mineral density, and even failure to thrive. So some countries actually outlaw vegan diets in shelter, which I think is a little extreme, but I think really it speaks to the challenges of actually growing a healthy kid on a vegan diet.
Now, it can be beneficial. Vegan diets can be beneficial for weight loss or cardiometabolic health if you have comorbidities, chronic disease like type two diabetes, obesity, heart disease, but only when coming from a standard American diet. So my sister always, always a stupid joke when the Vermont farmer was asked, how’s your wife? He’s like, compared to what? Right? Compared to what matters. If you’re comparing an extremely healthy omnivore diet with lots of nutrient dense foods, whole foods or generally raised meat sustainably or generally raised fish, lots of nuts and seeds, lots of fruits and vegetables, low starch and sugar compared to a healthy vegan diet. Now this is not what they did in the study. They actually had a fairly high carb diet and more sugar in the omnivore diet in the study. So it wasn’t really studying the right diets. It should have been studying what I said first with a healthy vegan diet.
I don’t think what the omnivore diet was that necessarily healthy, but when you’re coming from a standard American diet, if you just switch to a healthier diet, whatever it is, if it’s vegan or omnivore or keto, whatever, you are going to get better. But the question is how long does that last and what other problems accrue over time including nutritional deficiencies, muscle loss, which I think is my biggest concern. Alright, so now let’s talk about the conflicts of interest because that is a big problem with this study. Now, this whole thing is just kind of unbelievable if you actually asked me about it. The head of the study, Christopher Gardner, he is a great man, good guy. He’s the director of nutrition studies at the Stanford Prevention Research Center, and he’s also by the director of the Stanford Plant-based Diet Initiative. Now, this seems to me to be a very biased title because if the assumption is that plant-based diets are better as a priority hypothesis, how do you do independent research?
It’s just like, okay, we know plant-based diets are better, so let’s just study that and prove that they work. That’s kind of what’s going on. He’s been vegan for over 40 years and that does induce introduce bias. He admitted that his research is primarily driven by his personal values, animal rights and welfare and the environment climate change versus strict focus on nutrition health. So there I would say between the meat story is complicated. There’s really three big issues that people debate about and they’re all conflated. One is health, one is animal welfare, and one is the environment and climate. So they’re not all the same, and it depends on what you’re eating and we’ll talking about that in a minute and how it affects overall these factors. And I wrote a book about a lot of these things called Food Fix in which I talk a lot about these issues.
I also wrote a book called The Vegan Diet, where I do talk about a lot of these issues and help you understand them, but his personal bias towards a vegan diet could favor vegan diets In his reporting. Now in the conflicts of interest disclosures, he admits to receiving funding from a company called Beyond Meat, which is a vegan plant-based, highly processed meat. So that’s where a lot of the funding came from. He also serves on the dietary guidelines advisory committee, which makes me concerned a little bit about the committee’s report if he’s already biased toward a vegan diet, scientists should be impartial, should look at the evidence and should not be focused on one outcome or another based on their own personal views. Now, the funding, this is interesting, the funding of the Stanford Plant-based diet initiative of which he’s the director, is funded by Beyond Meat, which is a processed meat fake meat company, and it probably does influence the direction and the conclusions from all the work they do.
It’s sort of advocacy disguised as science, right? It’s like Coca-Cola funding a department at a medical school and studying soda like, well, how does that make sense? Right? Just because plant-based or vegan doesn’t mean it’s impartial. Now, the Stanford Plant-based diet initiative has a stance that plant-based diets are superior. So how can they do neutral scientific research? And that raised a lot of questions about the integrity of the research itself. There’s also selective disclosures, so all conflicts should be disclosed, but they weren’t. And the twin study did disclose some of it. They disclosed that some of the funding of the study was from the Voight Foundation, but it doesn’t disclose the advocacy nature of this particular foundation. This foundation is a vegan philanthropy group run by Kyle Voight. They donated $850,000 to vegan promoting films like Game Changers, and he markets himself a vegan athlete.
He also de donated $600,000 to the Oceanic Preservation Society, which is a production company with the mission to create media for environmental advocacy. They filmed the vegan twin study. So the Voight Foundation helped fund the twin study and the documentary that resulted from it that suggests a bigger agenda to influence public opinion through the media. Now, there’s a lot of ethical considerations too that I think were not considered. And also I want to dive into the documentary a little bit, just like if you want to convince people and produce a documentary, and I think they can be impartial documentaries, they can be very scientific, they can be well done, or they can be just pure propaganda. And a lot of the vegan documentaries, I think like what the health or game changers are primarily propaganda and not real science. When you dissect them and they’re really powerful, they work to captivate people’s minds and persuade an audience.
The twins added really little scientific value to this study in the normal randomized controlled trials they can control for genetics, and the world is sort of fascinated by twins. And Gardner even said that in his press release. He said, not only did the study provide a groundbreaking way to assert that a vegan diet is healthier than the conventional omniware diet, but the twins are a right to work with. Well, who cares? Why does that matter? Well, it maybe creates a sexy documentary. Maybe it creates more tension media headlines, but it’s kind of weird. In addition to the sort of chronic disease focus, this paper was heavily focused and influenced by this whole idea about climate change and how we need to go plant-based in order to lower the environmental impact and to reduce climate change and so forth. But that requires a lot of unpacking, and this is what they said in the introduction of the paper.
The most significant global health crises affecting our generation are non-communicable diseases like diabetes, heart disease, cancer and so forth. And climate change, which are both inextricably linked to diet and dietary patterns, high in plants and low in animals can maximize health benefits and environmental benefits. Wow, okay. Well, again, I wrote a whole book on this called The Food Fix, how to Save our Health, our Economy, our communities, and our Planet, one by a time, and this is not true, it’s not true. Now the devil is in the details. Will going plant-based solve our health and climate problems? Or is the real problem how we’re farming, how we’re raising animals, how we’re doing agriculture, and is it industrialized agriculture including factory farming animals and mono crops is the problem? Yes, I a hundred percent agree that we should not be factory farming animals, that we should not be doing mono crops, that we should not be doing industrial agriculture.
A hundred percent agree, and I a hundred percent agree that those are damaging the environment. It’s bad for our health with the products they produce and it’s bad for the animals. So no argument there and a hundred percent we should get rid of all that stuff. No question. And again, I wrote a lot about this, but we’re going to dive deeper into this, but I first want to talk about, before we get into the whole environment climate thing, I want to talk about what other studies have found and whether vegan diets work. Now in the short term, like I said, if you switch from a standard American ultra processed diet to a Whole Foods vegan diet, you’re going to do better. And this was what they found in obesity reviews. It was a systematic review and meta-analysis looking at the effective vegan diets for 12 to 26 weeks on cardiometabolic risk factors in people who are overweight or had type two diabetes.
And what they found was that vegan diets help reduce body weight. The BMI, blood sugar cholesterol, LDL, no effects were seen on blood pressure, hdl, triglycerides in these studies. They were really highly supported with tons of coaching and nutrition support, and it was a benefit. But again, compared to what, right? Compared to what diet, like I said before, they studied vegan diets versus omni board diets. And people who shop at health food stores, they reduce the death risk in half or both groups. So it’s not necessarily the meat, it’s what you’re eating with the meat. And again, most of the studies on this are showing that meats a problem in observational studies when people are doing a lot of other bad things. And I talked about this in my red meat type two diabetes health bite, but essentially if you look at the data on this, the people who ate red meat in these studies were typically unhealthy.
And the people who didn’t eat meat were more healthy because we were told that meat is bad for you. But you look at this, for example, the data, the red meat has dramatically dropped over the last three, four years and diabetes has dramatically increased. So how is red meat linked to that? I don’t know. Again, correlation, not causation. So why does a vegan diet seem to have this effect? Well, you eat less saturated fat, so you reduce LDL, which may or may not be a good thing, may also lead to weight loss. You decrease calories because you’re potentially eating less caloric foods, you’re increasing fiber, which is a good thing. And fiber lowers cholesterol. It makes you feel full. It balances blood sugar. It may help your gut microbiome with increasing prebiotics in your diet. That’s all great. Plant-based diet cells have more phytochemicals or anti-inflammatory cardioprotective, all great if you’re eating a healthy vegan diet, which is not processed food, not processed fake meats, not chips and soda vegans, but really nutrient dense vegan food, it also can reduce your intake of ultra processed food, but not always.
And here’s the key, the quality of the vegan diet matters. Chips and soda and french fries are vegan in the diet. It doesn’t mean that they’re healthy. Now, if you’re eating an ultra processed vegan diet, it actually increases your risk of disease. So if you avoid animal foods with higher consumption of ultra processed foods, which many vegans do, and by the way, in this study, energy intake from ultra processed food was higher in the vegetarians, about 37% of their total energy intake and especially, so 40% of vegan’s diet is ultra processed food. So industrial plant-based meat and dairy substitutes, which are kind of fake processed foods, accounted for 42% of total energy intake for the vegans, but only 3.4% for meat eaters. And then by the way, the plant-based meat intake in the twin study increased by sevenfold. So it is an ultra processed food and we don’t really want to be eating that stuff.
A higher intake of processed food in vegan than vegetarians was also with higher weight in BMI. Another study in the Journal of the American College of Cardiology Exam and the effects of healthy plant-based diets, namely whole foods to an unhealthy plant-based diet like juice, refined grains, sugar sweetened beverages, sweets, desserts, over 5 million years of follow-up, they looked at the nurse health study health professional study, and they found that the healthy plant-based diet was associated with a 25% reduced risk of heart attacks and heart disease and an unhealthy plant-based diet was associated with a 30% increased risk of heart disease. So the quality of the diet matters. Now, here’s an interesting thing they call the vegan paradox, which is both LDL goes down PO soda is the good cholesterol, HDL. Now good and bad are not really the way we should be talking about ’em. It’s really the quality of them and what they do, and it’s more complicated.
I encourage you list in my health bite on cardiovascular disease and assessing and reducing your risk of heart disease. But I go into way more detail there. But there was a review of over 30 observational in 19 clinical trials, randomized controlled trials looking at the relation between plant-based diets and the effects on cholesterol. Now compared to omnivores, the vegetarian diets do reduce CODAL and LDL cholesterol, but they also reduce HDL, no seemingly effect on triglycerides and vegetarians. In the twin study, we saw the same thing, lower HDL, but also lower LDL and lower triglycerides, but it wasn’t significant. Now, another study in the American College of Cardiology was a meta analysis of 30 randomized control trials. Looked at the impact of vegetarian and vegan diets versus omni ward diets on blood lips, and again, lower LDL in total cholesterol. But that doesn’t necessarily mean your risk is reduced because if the quality of the cholesterol is worse, if you have lower levels of HDL, if you have more small particles, more LDL particles, you can still have a lower total cholesterol or LDL cholesterol, but actually the quality gets worse and that increases your risk.
So it’s complicated, I know, but LDL in of itself is not enough. And as I mentioned, you took to all the biomarkers, this particularly around cardio metabolic health, which is insulin resistance and inflammation. Those are the things that drive heart disease. Now, long-term, what else should we see with vegan diets? We see B12 deficiency. Now that’s some really important nutrients found only in animal foods involved in red cell formation, neurotransmitter production, synthesis of DNA cell division, energy metabolism, your heart health, your mood, bone health, pregnancy, pretty much everything. And strict vegetarians or vegans who don’t supplement or have high risk of problems. There’s another study in the European Journal of Clinical Nutrition. By the way, all these are in the show notes. There was analysis of 700 men. 52% of the vegans were B12 deficient versus 7% of vegetarians and 0% of omnivores, only 19% of vegans actually took a B12 supplement.
Now, certain subgroups are at risk like pregnant, vegan or vegetarian women. There’s high risk of birth defects like neural tube defects like spina bifida, poor cognitive function, still birth pre and delivery, low birth weight. It’s not a joke. So if you’re pregnant, you have to supplement with methylfolate and methyl volin, which is an active form of B12, not the typical kinds or multivitamin like folic acid or cyanocobalamin. And by the way, this won’t be in your typical prenatal vitamin and it won’t be what your doctor tells you. But if you’re vegan and you assist on this during pregnancy, which I don’t think is a good idea, you have to make sure you’re taking all the right nutrients, including iodine, choline, omega threes, the right, B12 folate, et cetera. If you’re older in your’re vegan, it’s a problem because a lot of people have, we call atrophic gastritis, they may not absorb B12 as well.
They get B12 deficiency. They are often taking acid blockers, which reduce stomach acid, and you can’t even absorb B12. You’re taking drugs for insulin resistance like metformin. All those things affect your nutrients, and you can get a lot of problems with that. You can get fatigue, memory loss, brain fog, depression. You can be irritable, anemic and neurologic symptoms if you’re B12 deficient. So it’s no joke and it’s really common. Another thing we often see is high levels of homocysteine, which is a sign of B12 or folate or B six deficiency. And it’s really important that we get the right amount of methylating B vitamins, B12 F and B six because if you don’t, you get increased risk of stroke and heart attack, and then you get more oxidative stress, more blood clots, heart attacks, and maybe that over time will have a negative effect on the vegan vegetarian diet, even if your LDL is lower.
Now, what about Omega-3 deficiency? Well plant-based omega threes like a LA from flax seeds, walnuts, things like that, they don’t convert very well to the active omega threes, EPA and DHA. There’s only about a 15% conversion of that, and some even less depends on the enzymes and genetics and omega deficiencies are so important. 90% of Americans are omega deficient, not because they’re vegan, because they just don’t eat wild food anymore. And it leads to more depression, anxiety, mood changes, inflammation, dry skin, dry hair, I mean the whole list of omega deficiency problems. And it’s important to supplement. Now, there are plant-based omega threes, but often I don’t think they work as well. And I’ve seen some studies where this doesn’t work. And in my patients, if they’re often taking plant-based omega threes, they’re just not getting enough. Vitamin A. Another big one, vitamin A is the actual final product that you get from the carotinoids, which is like orange vegetables, leafy greens.
They actually have betacarotene or the carotinoids. Those get converted to A, but it has to get converted. Now, if you don’t have a good conversion rate, if you’re not doing that well, you can end up with vitamin A deficiency, but you need the proper form. You need dietary fat. All this stuff your digestive health met is important. The conversion to beta carotene to vitamin A is low. It’s about a 12 to one ratio. In other words, you need 12 times as much of the betacarotene to get one microgram of retinol. It’s really important, right? Why do you need vitamin A? It’s important for your gut and the barrier for all mucosal surfaces, your immunity, the gut associated lymphoid tissue. And if you have low levels, it’s associated with all kinds of stuff like inflammatory bowel disease and decreased immune function, and poor skin health and blindness.
I mean, when it gets really bad, what about calcium? We only need calcium and we should get it from our food. But when you take calcium, a lot of certain plants like beans or certain oxalate vegetables like spinach and beets, it can actually bind to the minerals and it can cause problems. Then you get worse gut issues and autoimmune stuff. So you have to cook these things to reduce the antinutrients. We call them anti. So you need to pressure cook greens, pressure cook beans, well cooked leafy greens and plant-based diets seem to be lower associated with lower bone mineral density. So that’s concerning. So you get more osteoporosis. And this was from National Health Examination Survey, which is an NANE study, and they found that it was like people who had a plant-based diet had an increased risk of bone loss, increased bone mental density, and increased risk of fracture potentially.
So it’s a bit of a concern. I encourage people to get bone density tests, a DEXA bone density and a body comp as well to see what’s really going on. The body comp is key because you could be thin and you could look thin on a vegan diet, but if you do your body comp, you’ll see you’re mostly fat. So you can be, I would call a skinny fat person. You can get basically muscle loss and fat deposition, so you look thin, but actually you’re fat on the inside. We call that skinny fat protein. Let’s talk about protein. That’s a big one. Now, vegans and vegetarians usually consume less protein than meat eaters, although they seem to still meet the RDI if you classify that as the right amount, which is 0.8 grams per kilo. But that’s the minimum amount to prevent deficiency disease, not the optimum amount for health.
So plants contain different amino acids than animals. It doesn’t contain all the amino acids that we need, the essential amino acids. So it’s an incomplete protein. If you combine beans and grains, you can get more complete protein, but it’s not just having all the amino acids, it’s the amount of different amino acids that are important for regulating different body functions. For example, lysine is lower in grains. Sulfur containing AM acids are lower in legumes and sulfur is really important for making glutathione and is a really critical component of our biology. So you have to eat different plant proteins to meet the requirements and you require a lot of planning. But you also need to be honest with you, if you want to build muscle, you need actually processed plant proteins, which I’m not a big fan of for a lot of reasons. So it’s more difficult and the science is really clear on this.
I’ve written about this in my book forever. I’ve done podcasts about this. I’ve had Gabrielle Lyon on the podcast on layman protein experts talking about this, and it’s really more difficult to build muscle with plant protein. Plant protein is far less bioavailable. There’s tannins phyto acid that bind proteins. Meat increases the essential amino acids much more than plants after eating and leucine, and this is really important. Leucine is much, much higher in animal protein and low in plant protein. Now, why should we care about leucine? It’s the rate limiting step for building muscle. There’s something called muscle protein synthesis. That means building muscle. If you don’t have two and a half grams of this amino acid in a protein meal, you won’t turn on the switch to build muscle. Now, this is really important to understand because if you don’t actually supplement with leucine as a vegan or have jacked up plant proteins that are full of extra amino acids that are added to it, you’re not going to be able to get enough.
Now, a lot of researchers needed, but if you look at older adults, given Isoc Clark meals, the same amount of calories, the same amount of protein, same amount of grams of protein, one from plants, one from animals, the animal protein resulted in a 47% higher rate of muscle protein synthesis than the plant protein. This was published in the general of nutrition. So the study, this is one study, but there’s study after study that confirms this. It’s also hard to consume enough calories to hit the protein goals on a plant-based diet, right? If you have, for example, a four ounce piece of chicken or meat that’s the same as protein as 30 grams of six cups of brown rice or two cups of beans, who can eat that, right? So it’s just a lot of stuff you have to, and then on top of that, you’re not only getting only a couple of hundred calories with the protein from meat or chicken.
You’re getting hundreds or a thousand plus calories from the amount of rice you would need to get or beans you would need to get, and that’s a problem. So you really need to look at what’s going on. If you actually get the plant proteins, you need a lot more of them, and you need to probably eat these processed plant proteins like isolated soy protein, which may cause cancer or pea proteins or lots of other things. So when you start to eat more protein and more calories as a plant-based person, you’re going to be eating a lot more calories from carbs. You’re going to eat lots of glucose and insulin produced, and if you don’t have enriched proteins, you’re going to be in trouble. So if you have ultra processed plant meats too, what are those impossible foods or beyond meat? Those are made with GMO soy with wheat pesticides, environmental impact, mono crops.
I mean, nobody talks about that. And to me, protein requirements, people often have to eat these ultra processed foods, these plant-based meats or plant-based proteins that are often highly processed. And in one study of 774 adults on a vegan diet for over six months, the minimally processed foods basically constituted about 66% of their diet, whereas ultra processed foods is made up 13%. But to meet the protein requirements, the vegans had these ultra processed foods like soy protein isolate, which leads to higher calorie intake and also may cause cancer. So I am really concerned about the need to use these jacked up ultra processed vegan foods for protein, which may affect long-term health and may have other processed ingredients. And there was a study we’re going to link to here, which shows that they have a lot of other things, flavors, colors and emulsifies gums, lots of starch.
So it’s not just so straightforward. Okay, let’s talk about the Netflix documentary a little more because I think this is a big concern of mine and how this manipulates people’s public opinion and actually doesn’t give people a clear view of what the science is. So here’s what they got. They addressed how problematic our food culture is ultra processed food and it’s linked to chronic disease. No argument there. They talked about how we should not be doing factory farming of animals, and we should be focused on farming that improves climate and soil health and all that a hundred percent agree. They highlighted the importance of body composition, which is really important, and their documentary actually showed how bad the vegan diet was for body composition. But they did mention it was important, and I think it’s really important that you need to build or maintain muscle mass while losing body fat.
And they also talked about the role of food on epigenetics, which I think is important. And we have to understand the food is medicine. It can regulate our gene expression. I’m down with that. I’m talking about that for years. But what are the problems with the study? Well, we highlighted some of them, but it was presented as a Stanford LED study, a twin study. That was what the show was about, but they didn’t even talk about the study until much later in the episodes, right? I think the first three episodes were basically a vegan sales pitch promoting plant-based meats, cheese and egg alternatives. Many of the claims are not based on scientific evidence. The Stanford Alternative Plant Protein Project, which are students working in lab, developed plant-based meat alternatives. In fact, one of the students said in an interview that plant-based meats are truly a better cut of meat.
And Mico plant-based cheese was an amazing vegan cheese. But what is it? It’s like tapioca starch, cashew milk. It’s got a lot of carbs, very little protein. It’s not really meat. It may look like it tastes like it in some way. I don’t think it does, but a lot of these plant-based alternatives, these weren’t even consumed by the vegan in the study, but they were promoted in the film. Vegans consume no egg substitutes, but they focus on that in the movie, even though in the study they didn’t eat that other claims were crazy that have no scientific evidence, which is meat was not a part of our diets before 150 years ago. Well, right there, you should just stop and go, wait a minute, what about our hunter gatherer past all our societies we’re not agrarian. We weren’t growing grains and beans and vegetables. We were hunting and gathering, and I just visited a tribe in Africa.
There are a hundred gatherers have been around for 50,000 years and they were killing animals. Of course, they ate meat. I don’t know where they would come up with that. And then the other thing I say is every time you eat a steak, a little puff of smoke goes up in the Amazon. Well, that’s true if you’re eating industrial factory based meat, not if you’re eating regenerative erased meat. It’s actually restoring the soil, reducing climate change, storing carbon, preserving our freshwater resources, limiting the use of chemicals, just not using fertilizer. I mean, there’s just so many benefits from regenerative agriculture that are actually a positive net benefit for climate in the environment versus traditional farming and factory farming is what they’re talking about. So you can’t just talk about the things that you want to talk about. You have to talk about the whole story.
Now they also focus on animal welfare, factory farming, climate change, and that was main focus and saturated fat as their main focus rather than nutrition quality or anything else. They didn’t mention really nutrition at all. They don’t mention sugar at all, which is crazy as a root cause of chronic disease and obesity. They focus on saturated fat instead. And again, there’s so many studies that show that saturated fat is not the boogieman we once sought and they focus on the dangers of foodborne illness. Oh my god, you’re going to get salmonella from eating chicken. Well, no, not of you cook it, eat raw chicken for sure. But foodborne analysis kills 2,400 people a year. It’s an issue, but it’s not that big of an issue if you’re smart about what you’re doing. You don’t eat stuff that’s rotting or raw this and raw that. It also doesn’t really mention the dangers of industrialized agriculture, which is something that is a big deal.
And the way we grow beans and grains and a lot of vegetables in this country is not regenerative. It’s industrial and uses heavy amounts of tilling, herbicides, pesticides, for example. There’s 1.2 billion pounds of pesticides used annually in the us, glyphosate used on wheat and corn and many others crops. 70% of all crops is herbicide. It also kills the microbiome of the soil and your microbiome. By the way, there’s 280 million pounds of this glyphosate, Monsanto Roundup stuff. It’s spray on crops every year, mostly wheat, corn, and soy, which is the backbone of ultra processed food. And also a lot of what vegans will eat, they’ll eat a lot of soy foods, a lot of wheat, corn-based products, and it sticks on the plants and it’s in our diet. I know this because I’ve tested my patients. I even tested myself because I don’t eat at home all the time, so I’m not eating out and I’m getting glyphosate too.
In fact, scent was awarded a patent for glyphosate as an antibiotic in 2010, and it destroys our microbiome, which is really concerning to me in very low amounts. Now in the movie, they do acknowledge that regenerative agriculture is important, but they say it’s not scalable. And again, this is not true. And I wrote about this in my book, food Fix. In fact, we can produce more cows by far using all the unused land that the Bureau of Land Management has or the land we’re using to grow crops like soy and corn for factory farming animals. And we converted that to Regener farms. We could produce more cows than we do now given our industrial factory farming system. This is Alan Williams data, and again, I write about this in my book Food Fix. Now, they didn’t really break down the data and the results of the study until the third episode.
So this whole thing was supposed to be up to the study, but it really wasn’t. Out of the four episodes, only a really small portion of the series was dedicated to the study, to the design and the results, and the rest was really promoting plant-based meats like Beyond Meat. Now, the data was really underwhelming in this study. I mean focused on LDL, which has just slightly decreased in the vegan group, TMA, another marker potentially for cardiac risk based on your microbiome. There was really no difference in the primary analysis, but they did claim a difference in the study. The only difference was after they outliers were excluded from the dataset, which means, oh, we’re going to get rid of all the people who have high, extremely high, extremely low levels and what they’re eating, and we’re going to only pick the people we want to pick, not looking at all the data.
This is, we’ll call it cherry picking. The weight changes were interesting. They looked at weight in a study, but not body composition, which is way more important than weight or body mass index. But what was interesting to me, and I dunno why they did this, was they did focus on body composition in the study. Now, the results did not favor the vegans, and I think this is one of the most important findings of the study. For example, the twins, Michael and Charlie. Charlie was a vegan. He lost three and a half pounds, but he lost 2.6 pounds of fat and about a half a pound of lean muscle mass. Michael only lost 0.1 pound, but he lost 3.8 pounds of fat more than the vegan, and he gained 3.6 pounds of muscle, meaning when you ate meat, you lost more fat and gained more muscle, which is the name of the game, protecting your health long-term and for having good metabolic health.
So they lost more weight in the vegan study and they lost less body fat and also lost muscle. So that’s really concerning to me. The omni war twin lost less weight, but they lost more body fat and gained more muscle. This is really, really important, and I think we should not ignore this, and I think it sort of almost negates the entire study because over time, the phenomenon will lead to poor metabolic health because your muscles turn to fat, that leads to insulin resistance and inflammation, lots of other things. Now, the vegans who lost weight and body mass, lean mass were blamed because they didn’t eat enough. Well, maybe they didn’t like the food. So the whole thing is ridiculous. I mean, to do a documentary that’s propaganda while conducting a study is just kind of nuts. So to conclude, I just want to talk about a more comprehensive approach to addressing your health and the environment health, rather than just saying vegan is good for your health and the planet.
How about we nuance that a little bit and talk about the real data? We discuss a healthy balance that looks like how to eat for our health in the environment and what the power of agriculture is for healing the planet and addressing climate change and how to appropriately follow a plant-based diet, if that’s what you choose. First is eat real food, right? If it has a label, don’t eat it. It’s probably bad for you. So I mean, some things are fine. If it’s a can of sardines or canned tomatoes or something that you recognize ingredients, it’s fine. But focus on whole foods, no matter what diet, you’re fine. You have to personalize the diet. Some people do well better on vegan diet. Some it’ll be worse. I’m going to do better on omnivore or high fat or low carb diets or higher carb diets. You just have to understand what your dietary individual needs are, and this is personalization.
Now, I wrote a book called The Vegan Diet where I talk about basic principles to deal with nutrition in a very confusing world. And the Pegan diet, just generally talking about it was a joke between pegan was sort of a pun on paleo and vegan. They’re basically more or less the same in every aspect except where you get protein. So they both eat whole foods, get rid of dairy, no processed foods, lots of whole foods and so forth. You should have a plant rich diet. I’m a hundred percent in favor of a plant rich diet, but not a solely plant-based diet. 70% of your diet should be non-starchy veggies. It should be plant-based by volume, but not by calories. Broccoli’s a lot of calories. I think you need 35 cups of broccoli to equal one big golf drink because it’s sugar. It has a lot of benefits to eating plant rich foods, polyphenols or phytochemicals, fiber, prebiotic foods, it’s gut healthy.
It promotes microbial diversity. You should eat nuts and seeds. Some whole grains and beans can be okay depending on what you’re eating, but should be in the whole food form. People eat wheat, but they eat wheat as wheat flour. They don’t eat wheat berry. So I would say flour is a problem in general. Gluten-free, ideally for most people would be helpful, not for everybody, but if you’re eating gluten, it should be actually from more heirloom grains. Avoid American wheat if sometimes European wheat can be better. They don’t spray with GMO there. But most wheat is full of GMO. Healthy fats, really important staple the diet. Omega threes from small cold fish, mono and saturated fats from olive oil, avocados, nuts and seeds. Saturated fat and cholesterol, not all the same. There isn’t one such thing as saturated fat. There are many saturated fats from dairy.
There’s one’s from me. There’s one’s from butter, there’s one’s from coconut, and they’re all different and have different effects. And I wrote a lot about S in my eight fat get thin and they have different properties. For example, steric acid is in meat, but it doesn’t really raise cholesterol. Palmitic acid is a different fat that may have a different effect. So you have to look at what’s going on. Some people have dramatic improvements of the cholesterol on saturated fat diets. Others get a lot worse. For example, the lean mass hyper responds, which I’ve talked about before. I’m one of those being if you’re an athlete and thin and fit, you often have a problem. So you have to look at your own numbers. So tests, don’t guess. Look at lipoprotein fractionation. Look at the quality of your cholesterol. Do a dietary fi, then recheck your numbers.
Don’t rely on some large study that may not have anything to do with your biology. And I’ve written a lot about this in my book if I get thin. But I also encourage you to check out function health. I’m a co-founder and chief medical officer. We created an access for testing for people at a very low cost 4 99. And you get all the relevant biomarkers, including all lipid fractionation, all metabolic markers, inflammatory markers, hormonal markers, and we can see what’s going on. And that’s the best thing you should do to know what’s really going on with your health. Now what about protein and animal versus plant protein? Well, meat actually is one of the most nutrient dense foods in the planet, but you have to look at other factors, right? Ethical and moral considerations. And I think it’s an issue. How are animals raised or they humanely raised or not?
And I can talk about different aspects of this, but what’s the environment impact? What’s the impact on our health? So these are the three things that we need to think about and we can’t conflate them. So factory farm meat, a hundred percent, no, right? It has bad consequences in the environment for the climate. The diets are of the animals are super unnatural. Candy, soy, acorn, it has negative effects on farmers climate, the environment, our health, animals, farm workers, the list goes on and on. I’ve written a lot about this in my book, food Fix. And also the destruction that’s caused by industrial farming, including increased fertilizers, pesticide herbicides. It’s destroying our waterways, overuse of irrigation, the dead zones from all the fertilizer that’s put on our farms that drains into the rivers and causes massive dead zones around the world, killing all the fish and animal life in the water.
Even plant agriculture can be destructive, right? If you’re not having regenerative raised animals, regenerative raised vegetables and fruit, it’s a problem, right? So industrial farming techniques are used for organic food, even for most crops that are grown and fed to people at least to soil erosion from excess tillage. There’s lots of pesticides and herbicides. I mean, we use 400 billion pounds of nitrogen based fertilizers annually. It causes greenhouse gases. Nitrogen oxide destroys the carbon in the soil, rivers, lakes and streams leads to all this dead zones. It’s just disaster now. So animals are killed in plant agriculture. You’re basically destroying their habitat. There’s 7.3 billion wild animals killed in crop production. So our way of growing often vegetable crops has had this massive destruction in our bird population over the last 50 years. We’ve lost 50% of our bird species. So if you’re vegan for ethical reasons, then you need to be advocating for regenerative farming.
And you should not be eating any vegetables or plant foods that aren’t generally farmed or farmed away, that doesn’t destroy the environment because I think people aren’t realizing this. But even if you do, you’re still killing a lot of animals, whether you like it or not. It’s just the way it is. Now, regenerative agriculture is a science-based approach to producing really high quality food while restoring ecosystems. You have to integrate animals into farming. You don’t have to eat them, but you have to integrate them into farming because they are the ones that build the soil. For example, we had 168 ruminants that were roaming around America, building huge amounts of top soil, 80 to 50 feet of top soil in some areas. Now we’ve destroyed a lot of that, but that was because of the ruminants. They were pooping, peeing, digging. The hosts were aerating the soil.
And that led to the massive amounts of top soil growth. And we see this on farms, and I’ve been to these farms, one in Rome ranch in Texas where they use bison and reintroduce them, and they increased the water absorption of the soil. They increased wild animals coming. They increased the soil carbon by sixfold. It was just amazing to see what happened in just a few years by doing the right type of animal husbandry, you have to build the soil and animals are doing that also helps with carbon sequestration, water retention. I mean, there were rivers and streams coming back in this ranch in Texas that hadn’t been gone for a hundred years. It was amazing. And regenerative agriculture, according to some estimates, may be able to sequester a hundred percent of our annual carbon emissions. So talking about carbon capture, one of the best ways it can reduce net greenhouse gas emissions by 86%.
Regenerative livestock production is 74% lower in greenhouse gas emissions than commodity crops that use feedlots or beyond meats, soy burgers or impossible burgers. There was a large study done by Qantas looking at the climate impact of regeneratively raised meat versus an impossible burger. And they found that while the impossible burger was better than factory farm meat, it still added about three and a half kilos of carbon in the environment, whereas the regeneratively raised meat actually removed three and a half kilos of carbon. So you basically have to eat two generally raised burgers to offset the carbon emissions of an impossible burger. So swallow that one. Then again, I’ve written about this in my book. The data’s there, the references are here, the show notes as well. And when you actually do regenerative agriculture, you restore the environment. You restore biodiversity, pollinators, insects, wildlife, you reduce the amount of fertilizers, pesticides, herbicides, water use, and it really important for food security, for climate change, for biodiversity, for health.
So the debate really shouldn’t be about plants versus animals. It should be about regenerative agriculture versus industrial agriculture. As one regenerative farmer said, it’s not the cow, it’s the how. It’s not the the how are we raising that matters. And of course, generally raised meat is way better for our health and the planet. And in these plant-based meats, ruminants, again, as I mentioned, forge on diverse plants and phytochemicals reduced methane production. There are lots more phytochemicals in plant-based. I mean, sorry, there are a lot more phytochemicals in regenerative raised meats. They’re anti-inflammatory. There’s conjugated linoleic acid, which is great for your metabolic health and cancer. There’s less fat or less calories in them, there’s less toxins in them, and you can buy them. You can buy regener areas [email protected], at thrive market.com. And you can find these also, butcherbox.com has grassfed meats as well. So if you’re going vegan, you want to do it the right way.
Eat real food, not Franken food. Replace all the star you’re eating bread, pasta, rice, and sugar with vegan proteins like Tempe, tofu, lentils, low starch beans, nutrient dense, whole grains like quinoa, black rice, buckwheat prioritized protein. Two cups of beans equals six ounce of chicken, four six ounce of chicken. So you might have to supplement with amino acids. I would say if you’re really committed being vegan, and there are branch cino acids you can get. Certain protein powders aren’t so bad with two and a half grams of leucine with other branched amino acids. You can supplement with them as a supplement branched amino acids or something I use called the amino acid complex, which is really great for building muscle. And you can supplement also with the multivitamin and mineral with the right B12 with omega threes from algae-based supplements. You might need retinol in your vitamin, which is a preformed vitamin A.
You reduce starch your sugar and up the protein and quality fat, and you can do okay, but it’s not that easy. So I hope you’ve enjoyed this very complicated discussion of the vegan twin study. And now understand that it’s not so simple that you need to read between the lines, not just at the headlines. There are lots of conflicts of interest and that it’s a much more newest conversation than plant versus animal, and we’re really having the wrong conversation, unfortunately. Now, the Stanford study really throws a spotlight on just how tricky nutritional science can be. It’s a field where the one size fits all guidelines. It’s just tough. You got to consider a whole bunch of variables like biases, our genetic makeup, our personal goals, and our health, our lifestyle, how we want to live. All that really is important to consider. Any nutrition study that claims they got, the answers should always be taken with a grain of salt.
And look, this study in particular points out how hard it is to apply findings broadly or really understand what’s happening, and they just fuel the debate about what diets are best for us in the planet. But you have to think about funding sources and ethical challenges and study design, and it’s like a lot of complicated stuff. But you can’t ignore that and you can’t just read the headlines. We need to question our beliefs about our diet. We need to go on a personal journey to figure out what’s good for us that’s tailored to our own individual health needs and the environmental impact. It’s all about the balance, but you’ve got to figure out what’s good for you and look at the science critically. And that’s what we’ve done, and that’s what we’re going to continue to do on our health bytes. So again, thank you for joining this Health Byte, this episode on the Doctor’s Farmacy podcast.
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Dr. Mark Hyman:
This podcast is separate from my clinical practice at the Ultra Wellness Center, my work at Cleveland Clinic and Function Health, where I’m the Chief Medical Officer. This podcast represents my opinions and my guest opinions. Neither myself nor the podcast endorses the views or statements of my guests. This podcast is for educational purposes only. It’s not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. If you’re looking for help in your journey, seek out a qualified medical practitioner. Now, if you’re looking for a functional medicine practitioner, you can visit ifm.org and search their find a practitioner database. It’s important that you have someone in your corner who is trained, who’s a licensed healthcare practitioner, and can help you make changes, especially when it comes to your health. Keeping this podcast free is part of my mission to bring practical ways of improving health to the general public. And in keeping with that theme, I’d like to express gratitude to those sponsors that made today’s podcast possible.