I spent 3 days at the 6th International Congress on Vegetarian Nutrition this past week in Loma Linda, CA. Held every five years or so, the event is hosted by the School of Public Health of Loma Linda University and is considered the premiere conference on plant-based nutrition. It brings experts and researchers together from all over the world and its proceedings are published in the American Journal of Clinical Nutrition, the most prestigious of all nutrition journals. I was honored this year (and a bit terrified, since I felt very much out of my league) to be a speaker.
Material presented at the conference included reviews of earlier research as well as new findings from the most current studies. Even where the information was familiar to me, though, it was informative and interesting to hear perspective from the researchers themselves.
Some findings that were presented at this year’s conference:
- Vitamin B12 continues to be a problem for vegans (and often vegetarians) who don’t supplement.
- Higher protein diets do not appear to raise risk for osteoporosis. To the contrary, protein appears to be protective, and vegans who eat more beans and veggie meats may have a lower fracture risk. Vegans who fail to get adequate calcium put themselves at risk for poor bone health. (Jack recently wrote about protein and bone health, too)
- Replacing certain animal foods in the diet–especially processed and red meats–with plant foods reduces risk for chronic disease. No surprise here. In contrast, we face an uphill battle if we want to demonize dairy foods from a health perspective. The science does not support any particular danger of consuming these foods. (There is evidence, however, that skipping dairy is a good way to shrink your carbon footprint.)
- Higher fat plant foods are good for you. The research on nuts suggests myriad health benefits. New, hot-off-the-press research presented at the conference also suggested that there are benefits to including olive oil in plant-based heart-healthy diets. At the very least, there is no reason to think that it is harmful.
The conference gave me confidence that the themes that come up often on this blog are well supported by the evidence. That is, vegans do need to pay attention to certain nutrients. And, there are no plant foods that need to be avoided completely on a healthy vegan diet. And finally, while there is abundant evidence supporting health benefits of a plant-based diet—ie, a diet that contains mostly plant foods—it’s difficult to build the case for veganism without bringing ethics into the picture.
Actually, it’s easy to build a case for veganism without even mentioning animal welfare or nutrition. Veganism is clearly better for public health.
Eating plants instead of animals means fewer antibiotics being used, and fewer antibiotic-resistant bacteria. (Even if the U.S. someday tightens restrictions on antibiotic use, a few of the ones also used for humans will probably still be used to treat sick animals.) It also means fewer animal-origin and animal-spread illnesses (avian flu, swine flu, etc.) and fewer Salmonella and E.coli-related food contamination issues. Basically, plants are less likely to make us sick (though they can still become contaminated).
Growing plants is also much less burdensome on the environment, and a more efficient use of resources like land, fuel and water. These things also translate to better public health.
Despite possible nutrient deficiencies, the only responsible public health message is to advocate a massive decrease in (if not total elimination of) animal foods (except maybe a few fish, insects, synthetic meat, etc). Maybe we should tax them more, like we do cigarettes. It’s not fair that animal food producers and consumers don’t pay for the environmental and public health toll they take on everyone else. They externalize the financial costs. A vice tax would help pay back those costs, and also discourage consumption. It works for alcohol.
Most developed nations already fortify food staples with iodine, folate, iron, and so on. Just make it mandatory that B12, algae oil, or whatever be added to certain things. A fair number of people besides vegans struggle with low B12 so maybe start with that. Seriously, it’s time to petition the government.
I’m a LLU School of Public Health alumni and wish I could’ve made the conference this year! Thanks for writing about it for those of us that couldn’t be there.
You say, “In contrast, we face an uphill battle if we want to demonize dairy foods from a health perspective. The science does not support any particular danger of consuming these foods”. I’m wondering what you think of the research presented in The China Study, showing that casein protein can turn on and off the proliferation of cancer cells and the evidence Dr. Campbell presents on cow’s milk and Type 1 diabetes (among other chronic diseases) I’m curious to hear your thoughts on the study/book because, in my opinion, it does present compelling scientific evidence that consuming dairy products can be dangerous.
Thank you!
Janine, feeding pure casein to rats doesn’t tell us anything about what happens when humans drink milk. There are data suggesting that feeding cow’s milk to infants raises later risk for type-1 diabetes, but it’s not clear whether this is an effect of cow’s milk or of a lack of breastfeeding. But, even if cow’s milk is bad for infant in the first year of life–when breast milk is the ideal food for infants–it just doesn’t tell us anything about later consumption.
Ginny, what about this study:
Colorectal cancer
People who consume 2 or more servings of dairy products daily have a three times greater risk of developing Colorectal cancer, compared to people who have consumed little or no dairy products. American Journal of Clinical Nutrition ( 86: 1722-1729)
George, you and I both know that single studies are meaningless! We have to look at all the data and note the trends. I wrote a peer-reviewed article last year on vegetarian diets and cancer and one of the most frustrating aspects was trying to make sense of the data on dairy and cancer. The bulk of the evidence suggests that dairy protects against colon cancer, while excessive intake *may* raise risk for prostate cancer–although those findings are conflicting.
Data presented at this conference also suggested a protective effect against metabolic syndrome. I wish it were otherwise. Fortunately, we don’t need to prove that dairy foods are bad. It’s enough to know that vegans don’t need dairy in order to be healthy. There is no excuse ever to consume it.
Dairy is high in saturated fat and cholesterol, isn’t that a case in and of itself?
Not if people are consuming nonfat dairy.
Are there negative health consequences from the hormones given to the animals?
Campbell’s research, as Ginny points out, tells us nothing about what happens when humans drink whole milk. The anti-cancer effects of whey protein are well-documented, so whole milk may well have no cancer-inducing effects. Also, the process by which casein is fractionated from milk, may well cause significant changes to the molecular structure of casein molecules, and this damage in itself may cause cancer in lab animals eating large quantities of the isolate.
“it’s difficult to build the case for veganism without bringing ethics into the picture.”
That’s because veganism is a moral philosophy, not a diet.[1] It is only recently that the “vegan diet” fad has bent the popular definition of veganism in that direction.
This might sound pedantic, but it is terribly important. We can’t let veganism go the way of vegetarianism, which now includes chicken or fish, depending on who wants to call themselves “vegetarian” that day. There is no veganism without ethics in the picture, because veganism is itself an ethic, roughly formulated as the doctrine that humans should not exploit nonhuman animals.
A similar thing is happening with “nutritionist” versus “registered dietician”. Those two words are considered synonyms by many, but I’m sure your blood boils every time you think about how much damage “nutritionists” are doing to the reputation of nutrition science. It’s not exactly the same phenomenon, but similar enough to warrant a comparison, I think.
1. http://human-nonhuman.blogspot.ca/2012/09/the-search-for-veganism.html
I agree, Rob. I really should have said “vegan diet” rather than veganism.
These are some great points and thank you for the brief summary of the findings.
The statement about B12 had me checking the back of my multi vitamins to make sure it was included, and I am glad to hear that all of the healthy fats that I include in my diet are still good.
Hello,
Speaking of dairy, what about Parkinson’s disease and prostate cancer?
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2232901/
http://jn.nutrition.org/content/143/2/189.sho
Carlo, the evidence for prostate cancer is conflicting, but I think it does suggest that very high intakes of dairy foods is potentially harmful. I was talking about whether we have scientific evidence to suggest that people can never safely consume any dairy.
That statement seems a bit extreme! Remember: “Everything is poisonous and nothing is poisonous, it all depends on the quantity”
So, there is technically no food that would do us harm if the dose were small enough. But that’s just missing the forest for the trees. We’re talking about having milk with cereal, a yogurt for lunch, and a glass at night with dinner followed by a bowl of ice cream. You know…what ppl actually consume!
Yes, what most Americans actually consume is definitely bad for their health. The evidence is pretty clear about the fact that eating large amounts of animal foods is bad for you.
Be sure to see / promote Jack’s latest post, documenting the harm done by overly-restrictive, low-fat, low-protein vegan diets!
PS: “I felt very much out of my league”
I would put the Ginny/Jack team up against anyone!
Ginny,
I’m surprised at your positive reference to the Spanish study on the Med Diet — that study has been dissected effectively in the last week by leading plant-based, no oil researchers. Yes, the Med Diet is better than the SAD — but that’s not saying much.
I thought Colin Campbell in the China Study identified casein (in dairy) as the most harmful animal protein in terms of turning cancer on/off in his trials.
Doesn’t sound like the Veg Conf showcased anything very new or helpful (?)
William, please see my response above about feeding casein to rats. And also this post http://www.theveganrd.com/2013/02/vegans-and-vivisection.html
I certainly have no interest in defending milk. I don’t think anyone should drink it. It’s unnecessary and unethical. It should be enough to know that!
The Spanish study referenced above is one of many studies suggesting that higher-fat diets are safe and/or beneficial when the fat comes from healthy plant foods. It’s not an isolated example of this. There is very little support in the scientific community for diets that avoid all high-fat plant foods.
Ginny, I have dreamed of being able to attend that conference for years. 🙂
I have a question about your comment that there’s very little support in the scientific community for diets that avoid all high-fat plant foods. What about the work of Drs. Ornish, McDougall, and Esselstyn in disease reversal with their patients?
I’m not an anti-fat person by any means(and I’m an ethical vegan) , but I find these discussions both intriguing and at times tiring because of the virtual ‘mud’ that gets slung between the various diet camps within the plant based arena.
Val, the only controlled clinical trial to show disease reversal with a low-fat vegetarian diet was the one by Ornish. It’s more than 20 years old and has never been replicated which means that the findings can’t be considered definitive. That’s not to say they aren’t important, though. However, the main thing is that the program used in that study included multiple interventions which means it’s not possible to identify which factors were responsible for the disease reversal. Most likely the factors that mattered were the very low saturated fat and high fiber content of the diet, the stress management, and weight loss, because those are all things that have been shown in other research to be protective. Research does not show that plant fats are harmful, so it’s hard to imagine that the lack of plant fats in the Ornish diet was a contributing factor.
I don’t mean to sling mud! I just want to make vegan diets as accessible as possible, so don’t want to see us making them unnecessarily restrictive.
Thanks so much for the info Ginny. I didn’t mean to imply that you’re a mudslinger specifically. 🙂 I was just referring to the general tone of the plant based/vegan movement. Although I think I’ve seen more mud “slung” from anti-fat folks. 🙂
But I tend to lean more towards yours and Jack Norris’s perspective in that we ultimately do this for the animals and want to make vegan eating more accessible.
Then on the other hand, I love to read the perspectives of ALL plant based professionals, chefs, and authors and put into practice what I can. Blame it on my training at IIN. lol
Heart disease reversal is fairly common with statin therapy, statin combined with Nicotinic Acid and in one study injecting a group with a Human “Super HDL” (ApoA1-Milano).
Epidemiological studies of groups that do not get heart disease also show a consistent pattern with the intervention studies, and are consistent with molecular biological models.
That is, when LDL < 70mg/dL, atherosclerosis progression is arrested and reverses when a person has "normal" HDL and triglyceride levels.
The emerging picture is that "normal" levels (<100mg/dL) of LDL are still too high. When LDL drops below ~70mg/dL, normal HDL levels can recycle stray lipids more effectively, but might just be overwhelmed when LDL is above ~70mg/dL.
Here's an interesting paper that combines several studies as well as compared populations known to have very low levels of heart disease.
http://content.onlinejacc.org/article.aspx?articleid=1135650&issueno=11
Here's another paper that shows a reversal of heart disease using statins+Nicotinic Acid.
http://content.onlinejacc.org/article.aspx?articleid=1140163
Notice the reversal group (NA) had levels LDL <70, while the placebo group had LDL ~84, still normal. T
This paper shows how a "super HDL" decreased atheroma volume by 4.2% in just 5 weeks!
http://jama.jamanetwork.com/article.aspx?articleid=197579
So what does that mean for a vegan?
All the data suggest if your LDL levels are low, your dietary intake of fats is inconsequential. It might even be inconsequential if you LDL is above that, b/c it's oxidation of LDL cholesterol that creates the inflammatory response that initiates atherosclerosis.
It's unclear whether having higher circulating levels of Vits C, Vit E, dietary carotenoids,polyphenols are cardio-protective, but it appears they might be.
It is clear that taking data from "Fat, Sick & Nearly Dead" patients (as the Guru Doctors do) and extrapolating it to normal, healthy individuals is not good science. It's even poorer science to apply it to vegans, who generally have much lower cholesterol levels (unless they're on birth control medication).
Exactly how many studies exist that even examine the health effects of diets that avoid all high-fat plant foods? How many studies exist which compare a no-oil, low fat Esselstyn/Ornish type die with a higher fat type of plant-based diet?
Thanks for the description! I am a vegan, and love your website because it is non-biased -you aren’t afraid to present facts that might not be 100% anti-dairy, anti-meat. It is hard to find objective information, so thanks again!
“In contrast, we face an uphill battle if we want to demonize dairy foods from a health perspective. The science does not support any particular danger of consuming these foods”.
What about these studies from PCRM
?http://www.pcrm.org/health/diets/vegdiets/health-concerns-about-dairy-products
Also if they are promoting a plant based diet, it would be great if they changed their name to the International Congress on Vegan nutrition. People learn through repetition and the less we demonize the word “vegan” the less threatening it will be.
Nancy, that’s a pretty selective overview of the relationship of milk to disease. When you look at all of the research, the relationship becomes much murkier.
And the congress doesn’t promote any particular diet. It’s a gathering of experts for presentation and discussion of research related to vegetarian nutrition–both lacto-ovo and vegan.
Again, these examples are fairly selective and obviously a bias to the source but for what it’s worth: http://nutritionfacts.org/topics/dairy/
So the articles that the dairy industry funds are not “fairly selective” and “obviously a bias to the source?”
Of course many studies funded by the dairy industry are biased, and all of the educational materials that the dairy industry produces are biased. It’s why I look at the actual body of research rather than what either the dairy industry or animal rights groups say. It’s certainly hard for me, as an animal rights proponent, to avoid bias, but we need to do it if we want to be the best possible advocates for animals as well as advocates for the health of vegans. We look at what the science shows, not what we want to believe it shows. If you disagree with that, that’s fine. But you probably won’t be happy with this blog!
May I see some instances of research not funded by the dairy industry or vegan organization, some from “the actual body of research” How do you determine which are funded by the cows milk industry which have limitless resources,do you trace them back to their sources?
You determine it by looking at the study. All published studies list the funding sources and the researchers’ conflicts of interest.
Nancy, that’s a pretty selective overview of the relationship of milk to disease. When you look at all of the research, the relationship becomes much murkier.
really? this article has over 30 references, can you please explain how it is ” fairly selective.”
Also how can you look at ALL the research and how does the relationship become “murkier?”
I was so nice meeting you and Mark at the conference. This is my first time on your blog. Thanks everyone for this discussion on Dairy! I left the conference confused because I have always believed that dairy was doing more harm than good (healthwise) but the scientific evidence presented that weekend spoke otherwise. I have now realized my bias in wanting to hear only the negative health effects of Dairy. I still will try to promote a dairy free lifestyle to my friends and family but instead of backing it up with science I will use ethical reasoning.
Thank-you Ginny for your energy and efforts into this blog!
Thanks, Greg. It was great to meet you and also to have a chance to chat at the airport!
Hi Ginny. Really enjoyed this article. I’ve started taking B12 per your recommendation, and haven’t had any trouble with it. After reading a few of your posts about calcium, I purchased an algae based supplement from Whole Foods, and oh. my. Horrible stomach pains., along with other issues. On the very same trip, I’d purchased chia seeds, eager to try “Chia Fresca” (chia seeds in water, I’m sure you know.) I started to wonder, if these chia seeds are such a superfood, do they contain calcium? And lo and behold, they contain quite a bit. Ounce for ounce, the same amount as milk, if I understand correctly. I’m wondering, what is your stance on chia seeds as a daily source of calcium? I’ve read many of your posts, but not all, so I apologize if you’ve already addressed this. I eat some leafy greens, but not as much as I should. I hope to hear back from you, and thank you so much for all you do for the vegan community.
Chia seeds have about 175 milligrams of calcium per ounce, so theoretically they could make a contribution to your calcium intake. But I don’t know who well absorbed that calcium is; absorption from whole sesame seeds, for example, tends to be low. So, I don’t think I’d depend on chia seeds for calcium. Thanks for asking about this–it’s not something I had addressed.
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Interesting to know about the absorption of sesame seeds. Thank you for responding so quickly.
Ginny,
in regards to Ornish, the results has been replicated in multiple sites in multiple hospitals throughout the US and reported accordingly in peer-reviewed journals. The degree of plaque regression among his patients mediated through reduction of LDL cholesterol in linear fashion. The Ornish program is documented to to lead in ~40% reduction in LDL cholesterol in 12-weeks in average patient. This is equivalent to high-dose statin therapy and these results are soon to be replicated by C. Esselstyn in a setting which includes 200 patients (a pending study). Now, obviously we don’t see dramatic results such as these if oils are being consumed. Olive oil is 14% saturated fat and that ofcourse something to be scared about.
Now, let’s not pretend Brown & Goldstein never existed:
“If the LDL receptor hypothesis is correct, the human receptor system is designed to function in the presence of an exceedingly low LDL levels. The kind of diet necessary to maintain such levels would be markedly different from the customary diet in Western industrial countries (and much more stringent than moderate low-cholesterol diets of the kind recommended by the American Heart Association). It would call for total elimination of dairy products as well as eggs, and severely limited intake of meat and saturated fats”.
http://www.ncbi.nlm.nih.gov/pubmed/6390676
What are the citations for the studies that replicated Ornish? And whether or not that diet improves heart health, there is no reason to think that it’s because of the lack of oil.
Here’s the citations,
The effectiveness and efficacy of an intensive cardiac rehabilitation program in 24 sites
I am a big fan of your blog, however, I think you and Jack show often very little effort to understand what McDougall, Ornish, Esselstyn, Campbell etc. are about. There’s difference in in perspective, mechanism/cardiology vs. nutrition science/epidemiology.
Ornish’s program is a drug-free option for high-potency statin therapy. In order to be an option for drug-therapy it need to show similar results, which is what Ornish’s program does. Average patients LDL cholesterol drops ~40% in 12-weeks. LDL cholesterol is the direct, causal factor influencing CHD, in fact it’s the only causal lipid fraction to CHD as recent mendelian randomization studies have shown. Mediterranian diet is not an option or surrogate for LDL-lowering therapy. You probably did not miss the fact that patients in the PREDIMED intervention arm were obese and sick and under statins and diuretics at the baseline and stayed obese and sick and under statins and diuretics throughout the trial, showing only statistical significance in decrease of strokes incidence when measured against the controls (no difference in MI, heart failure or sudden death). Ornish and Esselstyn are about plaque regression, regressing the disease. This is not what mediterranian diet is about. On the other hand, Campbell’s huge ecologic data showed that serum cholesterol is the most single explanatory variable in all chronic disease, this was showed in a population setting that had significantly lower cholesterol levels as do Western populations. Campbell’s finding are easy to accept since not only do we know that cholesterol (especially elevated LDL) the causal factor in CHD, but it appears to causally related to fatal prostate cancer and possibly to Alzheimer’s disease as well. I mention this, because there’s a lot of confusing about the China Project, it wasn’t about a diet per se, the punchline was about serum cholesterol concentrations. The lower they were, the less chronic disease incidence, in China.
Although, I enjoy reading your blog, I must admit I find much closer affinity with atherosclerosis research and cardiology than I do for epidemiology and cohort studies about homogeneous, high-risk Western people.
Richard, that citation does not replicate Ornish’s original study. It’s an observational, non-experimental report, not an RCT, and it looked at different endpoints.
And, I agree–findings about health effects in high-risk Western populations are not of much interest to me, either. My interest is in the health of vegans and in promoting a vegan diet. Is a healthy vegan diet improved by the elimination of all oils? I know of no evidence to support that, and based on what we know about the relationship of unsaturated fats to heart health, I think it’s highly unlikely.
Thank you for reading my blog even though we aren’t in agreement. 🙂
Ginny,
drawing from the totality of evidence, I’d be conservative with the use of oils, especially with MUFA. I use canola oil sparingly. Personally, my LDL runs around ~1,8mmol/l (69.5mg/dl). Scientists would call these levels as physiological; they are low enough even to regress existing plaques, and I ain’t planning to screw up my hard-earned digits with lots of saturated fat containing oils.
It would be unethical and waste of resources to replicate the findings of the original Ornish RCT. RCT’s require huge efforts and loads of money. The observational studies of Ornish program at various sites are in full concordance with the original RCT. We do not need any control groups to verify this anymore at this point. Scientists are bound to the rules of logic.
Best,
R
Hi GInny,
Very interesting article.
I am feeling very confused now. I always thought dairy was something that was meant to be very unhealthy for human consumption. I stopped eating it years ago and since then have resolved my severe asthma, cystic acne, seasonal allergies, and acid reflux. I also keep my 2 year old son away from it, I get a lot of grief for this and have always felt very confident in my decision. Now, I am not so sure. Why am I avoiding it again? I know for the animals but to be honest I do care more about human health and the health of my son. Within the plant based world there is just so many different views and ideas with each passing day. I don’t blame people for just throwing their hands up and eating whatever!
I did agree with what you said about high fat plant foods. I am so tired of hearing about how high fat plant foods are demonized. There is so much “mud slinging” (as mentioned above) within the plant based community that it is really starting to turn me off. Between Dr. Fuhrman, Dr. McDougall, Dr. Esselstyn, Dr. Campbell, they are all turning me into a nuerotic freak who is afraid to eat anything at all. Now Dr. Fuhrman is saying salt directly causes MS. I almost feel like a sort of anorexic. I don’t know what to believe or what to eat anymore. Dr. Esselstynn says green smoothies will cause heart disease, now a Dr. at the conference is saying dairy is not in fact unhealthy. I want to just throw my hands up.
Bonnie, there is very good reason to avoid dairy foods. They are not needed for health, and since consuming them is harmful to animals and the environment, they should be avoided completely. Not to mention the fact that plant foods have lots of other healthful compounds that dairy is lacking. So really, it shouldn’t matter whether it is harmful to your health or not.