Every Friday, I answer a question or two from readers. Starting today, a special guest will be joining me. His name is Stabby, and he’s a raccoon. Stabby is the pen name of an unnamed nutrition science expert (who’s apparently also a raccoon). Stabby’s written a lot about the science of binge drinking and the science of preventing hangovers. Confused? Me too. But trust me, this will all make sense in time.
Today’s question is so important that the other questions I received will have to wait until next week. You see, today’s question is…
“I am vegan. I feel fine. Numbers seem fine. Will I die? Will my future baby die of malnutrition from my malnourished breast? Please answer.”
S.C., Cambridge MA
Kamal’s answer: You will die, like all other mortals, but in the meantime it might be fruitful to analyze your diet
To some, this question may seem like a joke, but it’s actually a critical issue for millions of people who avoid or limit animal products. On the continuum from an all-meat diet to a no-meat diet are a variety of healthy combinations. The oldest humans on record have had diverse diets and habits that included varying amounts of meat, chocolate, smoking, and activity. So it’s definitely possible to live to an old age and eat varying amounts of animal products. While none of the world’s oldest people have been vegan, that doesn’t mean much, since there have been relatively few life-long vegans compared to life-long omnivores living on Earth. But to my knowledge, no vegans or life-long vegetarians have cracked the list of the 20 oldest humans. So that might hint that avoiding animal products is not a certain pathway to a superhuman lifespan.
So on to the question. S.C. states that her numbers are fine. That is both good and bad. It’s good because a “fine” blood panel means that she isn’t in kidney or liver failure, isn’t an uncontrolled diabetic, and probably won’t die this week. Except…doctors aren’t usually so good at interpreting blood panels for health, but rather for acute sickness. What do I mean by that? Well, a doctor will tell you if your vitamin D is within range, but not always if it’s sub-optimal. They might know that you have depression issues, but typically won’t order tests that can link it to nutrient deficiencies or other biomarkers. They definitely won’t order omega-3 / omega-6 measurements because it’s not covered by insurance. And so on, and so on.
Okay, so we’ve suggested that lab tests might not be enough to prove that everything’s fine and dandy. What about S.C.’s second question…”Will I die?” Well, nobody wants to die early if they can help it. And while there have been case reports of malnutrition-related deaths caused by inappropriately used vegan diets, such as in infants, this is moreso a game of probabilities. Are there nutrients a vegan is missing in their diet that could impact the probability of having a long lifespan? Or more importantly, sickness and quality of life? Julia Taylor, a New Zealand based nutritionist, showed that even a fruitarian (meaning someone who eats pretty much only fruit) can attain high levels of major nutrients, but that some important deficiencies and imbalances can occur .
Stabby will get more into these nutrients in just a second, and you can track your own nutrients using a tool like Cronometer. For now, let’s set a baseline scenario. Vegans are not evil and they are not harming you. If they choose to not eat animals due to ethical reasons or health reasons, don’t be a douche and act all superior to them. But if they are willing to discuss nutrition science, then it’s going to get interesting. Avoid the protein issue, because any vegan worth their salt tries hard to get enough protein. Other issues are probably more important. And P.S.– we won’t talk about the effect of the mother’s vegan diet on her baby during this post. It’s already hella long. Let me turn the mic over to MC Stabby, who will fill in all the nutrient details.
Hi there, I’m Stabby and I’ll be giving my best short-notice answer to the above question.
The determinants of health are anything but a simple topic. I can’t pretend to have a definitive answer and there will invariably be something that I have overlooked, but I’ll give it my best shot! Hang on tight (to your head maybe?)…this will be a bumpy ride.
If you fully accept the health beliefs of many vegan diet advocates, then here’s your outlook: you’re doing the most important thing you could possibly do to be healthy and live a long life and there aren’t any downsides worth mentioning. If you listen to many advocates of meat-containing diets you’ll get the exact opposite story : they will say that you are indeed going to die. Imminently. And your baby has no hope for tomorrow!
I don’t really agree with either of these positions. I can’t look inside your body and tell what’s going on and I can’t tell what you’re going to do in your life, so how can I know what your life-long prognosis will be? So let’s ask some questions.
Are vegans dropping like flies?
Vegans don’t eat any animal products at all: no meat, no dairy, no eggs and no fish. In general, vegetarians (those who simply don’t eat meat but aren’t vegans in that they might consume dairy and eggs) are somewhat healthier than those who do eat meat. They live a little bit longer on paper and have lower rates of cardiovascular diseases and some cancers from the studies that have actually evaluated this. Occasional meat eaters and people who eat fish live just as long. However vegans do not live longer than the average every-day omnivore and are more likely than lacto-ovo vegetarians and fish-eaters to die of all causes over the same period of time. They are even a little more likely to die of a heart attack.
That’s certainly a concern, but we have to interpret these facts correctly and not start claiming things such as that you need to eat eggs or you’ll die. These are just facts about who lives longer, not about which foods cause or prevent diseases. For example I don’t think that the fact that meat-eaters have higher rates of certain diseases means that meat necessarily increases the risk of developing them. There could be other factors at play that bias the association. Plus you can sometimes attain the advantages of a food through supplementation, or reduce the disadvantages of a food through proper preparation. All I can do is give you the pros and cons of a vegan diet, give you possible solutions to the cons, and let you decide for yourself what to do.
Possible pro of vegan diets: Eliminating harshly cooked meat.
Not eating meat means that you’re not eating overly cooked meat. High heat cooking techniques like grilling, broiling and cooking meat until it’s well-done form carcinogens and reactive molecules which harm the body when consumed, and potentially contribute to disease. However, moderate cooking techniques don’t appear to be much to fret about. If vegans don’t eat any meat that is cooked harshly, and they don’t live longer than people who do, does that mean that a vegan could live longer by eating moderately cooked meat which poses a minimal risk? Just a thought, not necessarily an assertion that they would. Just as a side note, meat isn’t the only food that becomes detrimental when cooked excessively, but it appears to be a major source of food carcinogens. I’m no raw foodist, but it appears to be an important issue.
Possible pro of vegan diets: No processed meat.
Vegans also don’t eat processed meat. Bacon and sausage, that sort of thing. Cured, smoked, filled with additives…delicious. PROCESSED meats seem to be consistently associated with disease risk, whereas scientists are very hesitant to say that UNPROCESSED meat contributes to diseases like cardiovascular disease and diabetes without strong data. Correlation isn’t the same as causation, but processed meats tend to be overcooked and are especially likely to form large amounts of harmful reactive compounds. So does that mean if meat-eaters cut way down on the processed meat, that they’d live longer than vegans? Is non-processed-meat-atarianism the way to go? Just another thought.
Possible pro of vegan diets: Healthier lifestyle (not actually a pro, but then again the previous two weren’t necessarily pros either)
Vegans are far less likely to eat at fast food restaurants with their trans fats, thermally oxidized frier oils, and literally hundreds of unpronounceable ingredients. Vegans are overwhelmingly more health-conscious than omnivores on average, and often have an aversion to such restaurants. Many become vegans because they’re so interested in being healthy. Some don’t care about their health at all and smoke, drink, use illicit drugs, eat junk food, and do a myriad of other unhealthy things, but on average vegans love their vegetables and fruits, like to do things like meditate or go to yoga classes (practitioners often explicitly promote veganism) which have been demonstrated to have great health benefits, and simply try a lot harder to be healthy than the average omnivore. While being an “advantage” associated with vegan lifestyles, this isn’t actually related to avoiding animal products, and could be a benefit obtained by a health-conscious omnivore.
Simply telling people to go on a vegetarian and vegan diet causes them to spontaneously increase many plant nutrients that most people are lacking. So if nutrients from animal foods weren’t at all important, vegans should be blowing the average junk-food-and-grilled-burger-with-crispy-bacon-eating-omnivore out of the water with their amazing longevity. Yet they‘re not less likely to die of disease in any given period of their lives.
And quite frankly lacto-ovo vegetarians should be living longer in the majority of the studies done on their longevity. Their only advantage comes from studies on the religious group the Seventh Day Adventists. These people are in love with vegetarianism and believe that it’s the healthiest thing in the world, so the most devout and most health-conscious of them are vegetarians and have higher intakes of many nutrients from generally better diets. Plus they experience the mental health benefits of being devoutly religious as opposed to being dispassionate. I’m not so sure that it’s necessarily the lack of meat in their diets as much as the dramatic differences in other aspects of their diets and lifestyle that are the true cause of their superior health. They definitely smoke less, drink less and exercise more than their omnivore counterparts , so don’t be so quick to attribute their better health to the lack of meat in their diets. What was I on about again? Oh yeah, I hope all of this justifies the hypothesis that maybe…just maybe…there might be some nutrients in meat that improve health. The data on vegan health already justifies the hypothesis that eggs and dairy might have important nutrients that aren’t found in significant amounts in plants.
Interlude: Stabby’s personal vegan experience
Now let me share a personal story. I once believed that a vegan diet would be the best diet for my health, and tried it due to hearing so many health claims from vegan diet advocates. I was doing well, not in the throes of death or withering away. But I didn’t notice any of the amazing health benefits that I was supposed to see from my vegan diet. Then again I was already eating a nutritious diet based on whole food at the time. Maybe because of that, I didn’t experience any of the benefits that some vegans do when they drastically change every part of their diet and lifestyle …and then say that it was the elimination of animal foods that primarily produces their health benefits.
Then months later I discovered a grass-fed bison company and figured that I might as well give their meat a try. I cooked and ate at least a pound and a half of it, and enjoyed it immensely. Feeling full, I retired to my room and began to read a book quietly. Hours later I noticed that something strange was going on, I was feeling great, abnormally good; it was like a wave of euphoria was washing over me and my thoughts quickened in a good way; I was filled with new strength and vitality. I was the Highlander! Have you seen that movie? Anyone who has knows what I mean. Anyway, it could only have been the bison. Since that day I have yet to return to a vegan diet and don’t plan on doing so any time soon.
I began searching for the reason why I might have experienced the health benefits that I did from eating meat. Was it protein? No I was getting quite a bit of plant protein; there are no doubt differences in the composition of amino acids between meat and plants, but it wasn’t the amount of protein that made the difference. Was it vitamin B12? No I was supplementing with methylcobalamine, the better form, and my levels were high. Iron levels were good and I was eating a moderate fat diet at the time so it couldn’t have been that either. I was taking zinc too, since that can be low on vegan diets, and you have to eat a literal crapload of chickpeas and pumpkin seeds to get enough without animal foods. None of those nutrients can explain what I felt . I have since identified some possible unique benefits of eating meat that might explain this phenomenon. Some of them might even explain the discrepancies between the health of lacto-ovo vegetarians and vegans. Let’s run through them…
Possible pro of meat: Creatine
Creatine is a molecule with great utility in our bodies. It helps us generate ATP very quickly and plays an important role in brain energetics. It has been shown to improve some aspects of athletic performance, but also short-term memory and mood . The only dietary source is from meat and vegetarians have lower levels of creatine. Although we produce some of it ourselves, we obviously don’t produce optimal amounts ourselves or else supplementation wouldn’t be beneficial and vegetarians wouldn’t benefit from taking creatine.
Possible pro of meat: Carnosine
Carnosine is a functional peptide that has numerous potential protective properties and is seen to be anti-aging. While its importance in the diet is still speculative, it’s another nutrient that we synthesize ourselves, but not in optimal amounts, because vegetarians have lower levels of it and supplementation is beneficial. Maybe some plant nutrients could help compensate for the lack of it in vegan and vegetarian diets, but it’s definitely beneficial and desirable in its own right.
Possible pro of meat: Carnitine
Carnitine is another compound based on amino acids and has numerous metabolic health benefits. The main dietary source is meat and vegetarians do have lower levels; supplementation is definitely beneficial in many cases. Synthesis can be improved by consuming various nutrients in high quantities, particularly vitamin c, however it still might be the case that dietary carnitine is beneficial for the muscles and brain.
Possible pro of meat: Taurine (yay, one that doesn’t start with ‘C’)
Yet another non-essential nutrient that we benefit from getting in the diet. It’s very susceptible to heat and cooking so we don’t get very much of it from eating meat, but we do get some and vegetarians have lower levels than omnivores. Taurine protects lipids from damage and thus protects tissues from damaged lipids, relaxes the nerves, improves hormone and bile synthesis, and is another potential candidate to explain my improved health from eating meat.
What about lacto-ovo vegetarianism versus veganism?
Lacto-ovo vegetarians may have a nutritional advantage over vegans because of a number of nutrients in eggs and dairy which compensate for the lack of meat in the diet. These are…
Everyone should know this one, it’s important for the body because of its role in methylation. It’s needed for maintaining the myelin sheaths of neurons, energy production, and metabolizing homocysteine, a toxic byproduct of methionine metabolism which vegetarians and to a greater extent vegans have elevated levels of. This could possibly explain the higher risk for heart attack among vegans when contrasted with lacto-ovo vegetarians who have moderate sources of B12 from eggs and dairy. I recommend the methylcobalamin form for supplementation, it works and is likely to be superior to cyanocobalamin, the most commonly used form.
Choline’s metabolites are important for a variety of signalling processes in the body and it is essential for a healthy pregnancy. Most women don’t obtain anywhere near as much as they need which could be remedied by consuming egg yolks. Soybeans are good vegan source and so is cauliflower, but it‘s not anywhere near as easy to obtain enough from plant sources as it is to eat eggs or take supplements.
Vitamin A is only found in animal foods, and can be formed from previtamin A carotenoids found in plants, but it appears that a large number of people simply can’t synthesize enough vitamin A from carotenoids. Dr. Chris Masterjohn has a good article on this phenomenon and why many people’s vitamin A needs will not be served by an unsupplemented vegan diet. Eggs and dairy are the next best sources to eating liver and this might also help to explain higher all-cause mortality among vegans in contrast to lacto-ovo vegetarians.
There’s more that has gone unmentioned and probably more that science hasn’t discovered yet, but I think that I have covered the basics. How important is all of this? I don’t know. I truly don’t. There are healthy unsupplemented vegans, and then there are many who swear that it’s the kiss of death. Different people have different nutritional needs and can subsist on different diets healthily, but I think that the wisest policy for anyone is to maximize their intake of beneficial nutrients from food and supplements if they need to use them . Will you die from your vegan diet? That depends on you!
Am I overlooking the negative effects of meat and other animal products on health? I haven’t covered every possible issue, this post is already long enough! [note from Kamal: we’ll cover issues like hormones and dioxins from animal products in later weeks] But even if animal foods have disadvantages, there is a strong possibility that their nutrients are still important.
Maybe there will be a sequel where I talk more about this, maybe I’ll be shown to be off my rocker by critics and maybe a raccoon shouldn’t be using a computer in the first place! We’ll have to wait and see.
Stabby T. Raccoon