When Vegan Is Not Enough!

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When Vegan Is Not Enough!

Postby JeffN » Sun May 05, 2013 8:37 am

When Vegan Is Not Enough!
Jeff Novick, MS, RD

Recently, in a discussion in the lounge on what to call this "way of eating" and whether or not the term "vegan" was adequate to describe this diet,

viewtopic.php?f=1&t=33542

I made the following comments...

JeffN wrote:As an FYI...

.... about a year and a half ago, I was speaking at an event along with Dr Campbell, Dr Diehl, Dr Esselstyn, Rip, Dr John Kelley, Dr Roger Greenlaw, Dr Demas and several other notables and at the end of the event, we had a panel discussion with all the speakers.

The question was asked about the word vegan and its appropriateness in describing this way of life and diet and the person asking the question asked if everyone on the panel could respond to how they felt about it.

As the microphone went down the line from one speaker to the next, everyone, no exception said they did not want to be associated with either the vegan word or the vegan movement as they felt it did more to distract from their main focus and to confuse people then it did to help them as by using the word it associated them with a movement that does not have the same specific focus, goals or details and is often heavily involved in other areas (ie, animal rights) that are not related at all to their specific focus.

In Health
Jeff


and

JeffN wrote:To clarify my comments...

veggylvr wrote: I can certainly understand why the doctors or other plant-based advocates wouldn't use the term. They have a larger responsibility to deliver a health message, and any inconsistencies would be critiqued and ridiculed.


The same holds true for those of us, who in describing what we eat or what we want to eat, do not want to be seen as inconsistent, even if it is just in our daily lives, even if we are just describing our diet. Many have commented in this thread about the inconsistencies it raises for them. I agree with them. As did the panel, which was speaking in regard to much more than just their professional health message.

veggylvr wrote:Most of us, however, aren't delivering any message except what we need to eat.


In many cases, such as when ordering at a restaurant or when explaining to someone who invited you over for dinner, this is true. However, in addition, for many people, there is more to the picture because each time they describe their diet to someone else, they are also sharing (or wanting to share) in their own little way, a little bit of this WOE and this WOL and the message of health and hope that it carries with it.

Therefore, in both cases, describing it accurately is important and while it is true that for many people following this WOE, their diets will be able to be classified vegan, the term vegan falls way short of describing many of the most important aspects.

Because of my unique position, many of the people who come to me are already vegan and/or plant based/strong/perfect, yet they are not well. And, one of their main frustrations they have is that they have been doing the vegan and/or plant based/strong/perfect for some time and it does not seem to be working for them in the same way they hear it does for so many others. There have even been many such discussion in these very forums.

In fact, one of the biggest problems I see in helping people improve their diet is their use of the term vegan to describe their diet or their food choices. So much so, that I ask people not to use the term when discussing what they eat with me.

At the last 10 day program, in one of the classes, we had a long discussion on why the use of the thought process, "well at least it was vegan" can do more harm than good especially for those who are on the path of improving their health, as by using that phrase, they are mixing up two concepts. Too many times, I hear people say that they were out to a restaurant and/or at an event or party and there was not any healthy food to eat so they ate "so and so" food, and then they say to me, "but at least it was vegan!" This tells me absolutely nothing about the food other than it had not animal products in it. And, sadly, most of the time, the food they choose may have been high in fat, sat fat, oil, salt, sugar, refined/processed grains and low in fiber, etc etc (or all of the above) and was nothing more than pure junk food.

The worst part is not that such a food on a rare occasion may hurt them, but that they believe it was OK or "more" OK, because it was "vegan." However, I am not promoting veganism or vegan food but health and healthy food and so an unhealthy choice should not be rationalized in a discussion of health as being a healthy choice just because it is vegan. Label it what is it. Don't say, "at least it was vegan, say "I ate some pure unhealthy junk food that was vegan."

Best of all, make a healthy choice, and/or do the best you can in regard to making a healthy choice and keep that the focus. And, for most of us, it will be vegan too.

I travel about 60% of the time and so am on the road and eating out often. I have found that some of the worst restaurants for me are ones that promote themselves as serving vegan and/or vegetarian options, with those promoting the concept of "raw" being the worse. I rarely if ever can find anything to eat at these restaurants that is healthy. And, if I have to go through the same process of special ordering to get something healthy, then why did I even have to go to a veg/vegan/raw restaurant to begin with as they usually charge more. At our local (and famous) vegan restaurant (at which I can not eat), you are charged extra if you want your food made with whole grains. The most popular item on their menu is their fried cauliflower.

I was at a recent health conference put on by a traditional group. For dinner there was a choice of fish, chicken or vegan. I asked what was the vegan choice and they said a lasagna dish made with vegan cheese, etc. No sides of veggies (as they were supposed to be in the lasagna). So, I asked what was the chicken dish. They said, grilled chicken, with sides of steamed vegetables and sweet potato. I ordered the chicken dish and traded my piece of chicken with the person next to me for their steamed veggies and sweet potato. The non vegan choice was the better choice.

This is why I often say that steak houses are my favorite healthy restaurants. I can get a large plain baked (or sweet) potato, a large salad and some plain steamed veggies without any problems and the fancier the place, the easier it is.

I am currently traveling on vacation and last week I stopped in to a new restaurant featuring local, organic, fresh, healthy, vegetarian food. However, there was nothing I will eat. One item they have is a "Warm Kale Salad" which is finished w/Braggs and it says .. A healthy alternative to soy sauce. So i asked the server, what is Braggs and she said its a healthy alternative to soy as it has much less sodium.

It has the same amount!

And if they are promoting themselves as veg and healthy, they need to know this. Everything is marked veg, or gluten free, organic etc but its all white flour and some of the veg stuff has eggs & milk and the vegan is full of oil.

We spoke to the owner who said, come in for dinner and their chef will make me whatever I want. So, I did. I ordered a large version of an appetizer salad that was ok and got me about 100 calories at most (for about $10). Then we special ordered a plate of quinoa, and steamed vegetables. We reviewed this with the manager several times, emphasizing that I wanted just plain steamed veggies and a starch, either quinoa, brown rice or a sweet potato. Our plate come out and it was a little salad on 1/3 the plate, which I did not need as I already paid $10 for a salad, a small pile of quinoa and a small pile of mixed vegetables DRIPPING in oil and full of salt. It may have been vegan but I would not eat it.

So we got up and left (leaving a few bucks to cover the costs) and ate next door at the Thai place and got nice size salads, steamed edamame without any salt, and a plate full of steamed veggies & steamed brown rice. All for half the price :)

This is what happens to many who go out to eat and describe their diet as vegan. They may think it is easier, but it does not work and they are often left with unhealthy options that they rationalize as healthy because they are vegan.

Your perspective may be different, but mine is as a healthy person and as a health professional who works with unhealthy people (many of them already vegan) to help them get well, and from that perspective, the word vegan simply does not work.

In Health
Jeff



Recently Norman, added this story which highlights the importance of my comments.

viewtopic.php?f=1&t=36547

Norman wrote:In 2004 I had a triple bypass. After this I tried to maintain a lower fat diet with chicken and fish with lots of vegetables and with many meals with no meat at all. In 2009 my wife and I decided to adopt a vegan diet for health reasons. Knowing that my discipline was poor at times I researched how animals are treated in our food system. I was appalled by the great suffering the animals we eat had to endure and became an ethical vegan as well.

Influenced by the writings of John McDougall, Caldwell Esselstyn, Neal Bernard, T Colin Campbell and others, my intention was eat mostly whole unprocessed foods and to eliminate refined oils from my vegan diet. For brief stints I was very successful. Inevitably I would make exceptions and allow more and more exceptions while staying on a vegan diet. Eating out was one place I started to slip with vegan Thai curries, pasta with oily sauce, vegan restaurants that use a lot of oil, ect. I would look at a box of crackers or Microwave popcorn that listed only 1.5 grams of fat a serving. Of course I would eat 8 servings. In cooking without oil, liberal use of Tahini would add a lot of fat. Guacamole seemed so good. Often a diet coke addiction would flair up of fueling my desire for sweets I would get when I went to Gas stations or grocery stores. Paul Neuman's low fat dressing seemed harmless as it had so little fat per serving. You get the picture.

I had fooled myself in believing that because I ate better than many in the US with a vegan diet with many vegetables and some meals cooked without oil that I would be ok. Denial!

I had been dismissing chest pains in hiking and having to stop as being out of shape. On April 20th (2013) in a period of my life with a lot of stress in sorting out some close to hang up I experienced chest pains and light headed and needed to lie down. My wife and I decided we needed to go to the emergency room to check it out.

To be continued next post........


and

Norman wrote:A Vegan diet fails to prevent heart disease! Part 2

The chest pain was gone when I arrived at the hospital and I just wanted to have it checked out. They rushed me in. As I had had a bypass in 2004 they took it very seriously. They hooked me up to a EKG machine. They took my blood pressure which was now up to 160/100. My home readings had been generally 135/85 or less. They stuck needles in two hands and started a nitro drip. Later they came me treadmill stress test along with a EKG. I was able to complete the test with minor chest pain at the end. They also gave me an echo cardiogram (I must have good insurance) They determined I had not had a heart heart attack but had a blockage. They insisted that I be transported by ambulance to a hospital an hour and a half where they did cardiac catheterizations.

I found myself being swept up into the same system that cut open my chest and grafted 3 veins to my heart, offered no alternatives and failed to tell me that they eventually become clogged again with scar tissue.

I tried to talked to nurses and the doctor about diet. They rolled their eyes with deep concern and essentially implied I would be a fool not to get a catheterization. I thought maybe knowing what blockages were there I could make an informed decision on how to proceed. The hospital room was dark and the nurses were very busy to give much attention. Fortunately it was the weekend and they only did catherizations in the weekend on people with resting chest pain which had none. I found out that they did not want to do the procedure without the go ahead to put a stent or stents, if they thought they were needed. This is where I dug in and decided not to do it. Why put pieces of metal in my body they damage the artery walls and often clog up again in time anyway. The physicians assistant talked with me along time urging me to get a stent. I countered with the suggestion diet could work better. She almost had me convinced it was too late for diet for the blockage. When the cardiologist came in to follow up. (kind of like tag team wrestling) When I asked the cardiologist about risk factors and outcomes he admitted a stent would not extend my life. It was about quality of life. He told me that the risk of death was 1% for the procedure and another 1% if a stent was put in. I would have a 1 in 50 chance of dying for something that would not extend my life! That did it. They released me with the agreement that I would take 50mg of Toperal and 40mgs of Zocor. I also agreed to stress test with and echocardiogram in 1 month.
My Ldl is 115. I am confident I can get that down fast and in ashort time get off the Zocar. The also wanted me to go on Metaform for diabetes as I my Ac1 was 6.6 I refused. My home tests after I got back on my new diet have ranged from 101 to 120. I have lost 9 lbs in 20 days.
I will continue to drop weight. so I expect to get better numbers in the future. (Weight entering hospital 215 today 209- Goal weight 160)

I am totally committed to follow Dr Esselstyns and Mcdougalls diet for life. I will never submit to a bypass again.

My blood pressure on medications was at 135/83 but started dropping with a great diet. After 10 days it hit 110/60. I immediately decided to cut the dose in half. Now it is averaging 127/80. I will cut the dose in half again if I have another significant drop. My stress test is coming up on May 22. I have been training for it on the treadmill. I am determined to surprise the cardiologists. Yesterday I was able to walk one hr at 3.4 mph without chest pain. Dr Esselstyn reports increased blood flow in weeks with his diet. My experience seems to bear this out.

Wish me luck on the stress test and dealing with cardiologists.

That's all for now.

Norman


I am sorry to hear of Normans situation and have PM'd him to offer my help in getting him back on track.

However, his story is one I hear all to frequently and truly highlights the importance of the comments I made above, which I will repeat here...

JeffN wrote:
This is what happens to many who go out to eat and describe their diet as vegan. They may think it is easier, but it does not work and they are often left with unhealthy options that they rationalize as healthy because they are vegan.

Your perspective may be different, but mine is as a healthy person and as a health professional who works with unhealthy people (many of them already vegan) to help them get well, and from that perspective, the word vegan simply does not work.


When it comes to health and especially to the prevention and therapeutic intervention of serious health conditions, the term vegan is not enough.

In Health
Jeff

PS: We can also substitute the words plant-based, plant-strong, unprocessed, WFPB, etc etc. (or any label), for the word vegan. While a healthy therapeutic diet will include little to any animal products, it is much more than a diet that has little to any animal products in it. It is also a diet that is low in fat, sat fat, omega 6's, cholesterol, added sugars, added salt/sodium, added oil, and refined grains and processed foods. It is also a diet that is high in unrefined and minimally processed foods that are rich in naturally occurring fiber and nutrients, all in the proper amounts and ratio's.
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Re: When Vegan Is Not Enough!

Postby JeffN » Mon May 06, 2013 9:39 am

PSS A few more thoughts

When people come to see me, either in private or at a program, they come to see me as a health professional because they are not well. Usually they have advanced heart disease, diabetes, hypertension, cancer, auto-immune disease, etc etc and often they may have already had several by-passes, stents and/or even a stroke or two and are on multiple medications. In addition, these days, most are overweight and many are obese.

Many of them, as stated above, have already been following a plant-based/strong/perfect diet and/or vegan diet (some for years) and are coming to me because in spite of this, they are still not well.

In addition, when they come to see me or participate in a program, they have often taken a significant amount of time out of their lives, usually involving travel and spent a good deal of money to do so. They have expended significant time, energy and money.

What this means is they have "highly" self selected themselves to be..

1) in great need

2) highly motivated

&

3) fairly well educated, as this is not a simple thing to understand.

In other words, it is like they have been dropped off by an ambulance at the critical card ward of the hospital. :)

Many ask about moderation. The problem with moderation is that most people can't do it and our national statistics on both health and food consumption, prove that to be true.

http://www.jeffnovick.com/RD/Newsletter ... y_Fit.html

In addition, if someone could do moderation, they would not be coming to see me for help.

So, lets be clear, from my perspective as a health professional, this is about a professional relationship based on the issue of health with very specific guidelines on how to get healthy.

This is why the focus on health is so important and why it is also so important to not confuse this focus with other messages that may have some value (i.e., vegan, plant-based, etc ), but not specifically in regard to addressing the critical issue of health that is at hand.
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Re: When Vegan Is Not Enough!

Postby JeffN » Mon May 06, 2013 10:25 am

What are the criteria for health? Here are my 5 Pillars

The Five Pillars of Healthy Living
"A Common Sense Approach To Health"

1) Plant Centered - Center your plate and your diet around minimally processed plant foods (fruits, vegetables, starchy vegetables, roots/tubers, intact whole grains, and legumes (beans, peas & lentils).

2) Minimally Processed - Enjoy foods as close to "as grown in nature" with minimal processing that does not detract from the nutritional value &/or add in any harmful components.

3) Calorie Dilute - Follow the principles of calorie density choosing foods that are calorie adequate, satiating and nutrient sufficient.

4) Low S-O-S - Avoid/minimize the use of added Salts/sodium, Oils/Fats and Sugars/sweeteners

5) Variety - Consume a variety of foods in each of the recommended food groups.

In addition, include about 30-60 minutes of activity a day (including some aerobic, resistance and flexibility exercise), aim for a BMI of around 18.5-22 and get enough sleep, rest, relaxation, recreation, fresh air, pure water, etc.

http://www.jeffnovick.com/RD/Interview_2012.html

Right now we are all bombarded with every kind of vegan or plant-based diet in the world. How would you capsulize Jeff Novick’s diet?

I have really been thinking about that lately and how best to describe the principles of a healthy diet, and I think, plant-centered, minimally processed, calorie dilute, low SOS really sums it up. It’s not just vegan, vegetarian or plant-based because one could have a pretty bad vegan, vegetarian or plant-based diet. So I like to say “plant- centered” but I also add that it should be minimally processed. I don’t say “whole” or “unprocessed” as not all processing is bad. Processing per se isn’t what’s hurtful, it’s processing that either detracts from the value of the food (i.e., refining) or adds something that is potentially harmful, (i.e., salt, sugar, etc.). So plant-centered, minimally processed, and then calorie dilute, because so much food has become so calorie dense which is a major contributing factor for obesity and many other diseases. The fourth principle is a diet low in SOS, which is salt, oil/fat and sugar. Even if you have a plant-centered, minimally processed, calorie-dilute diet and you cover it with salt, sugar, and oil, it is not healthy. I’m not going to say none, but low, as it isn’t all or nothing.
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Re: When Vegan Is Not Enough!

Postby JeffN » Fri May 10, 2013 10:35 am

Here are 7 recent examples of this point.

All are paraphrased from actual emails/discussions.

Example 1: Weight and T2 DB

After attending a program they were 100% compliant for about 2 weeks, and then decided I'd just be vegan. Their weight at the end of the program was 184 and today it is 253 and they were just diagnosed with T2 Diabetes. They say they do not think they eat all that bad as it is all vegan. They still don't eat meat or dairy and use the vegan substitutes. They tend to eat more tofu, nuts and they eat out a few times a week, but again only vegan.

From their food journal:

At least 9 PBJ sandwiches per week.
Chocolate
Chocolate brownies
Cashew dressing on everything
Lara bars (as snacks most days)
Gardein chicken tenders
Vegan pizza from WFM with dayia cheese
Chipolte vegan burritos
Smoothies with nut butter and vegan protein powder.

Example 2: Weight

After attending a medical program, they lost 100 pounds and was headed toward their ideal weight. They have since gained 50+ pounds back. They say the are still all vegan but they do drink vegan beer, and eat a lot of vegan WFM baked vegan goods and vegan items from the food bar. When they eat out, it is always vegan too.


Example 3: Weight, Cholesterol

Husband and wife watched FOK 9 months ago. Were also concerned over animal rights so went "vegan." Wife's cholesterol was 164 and she weighed 192 pounds. Today her cholesterol is 239 and she weighs 216 pounds. The husband started with a cholesterol of 199 and a weight of 175 now his cholesterol is 220 and he weighs 190 pounds.


Example 4: Weight & T2 DB

They went to a program last year and I was motivated when they left and they lost weight right after. Eventually, they started to include more vegan convenience foods. Since the event they have gained 20 pounds and they are back on metformin for diabetes.



Example 5: Weight, Cholesterol, BP

After watching Forks Over Knives, they went vegan. However, they have gained weight, their cholesterol and LDL is higher than ever, and their blood pressure is also higher.


Example 6: Health

They attended a program last fall and are in worse shape & feel worse than ever. They eat a lot of plant-strong desserts, and things like tofu, and tempeh. They admit to "cheats" here and there and since they have no time to eat at work they will eat cliff bars or lara bars. The also eat a big bowl 2x/day of cold cereal and eat a lot of the crackers with hummus. They also eat green smoothies which include almond milk and chocolate vegan protein powder.


Example 7: T2 DB, Chol, BP, Weight

They went vegan 9 years ago, because of their love of animals, They started being vegan at 21 while in college and ate a lot of vegan junk food. They just found they are pre-diabetic, their cholesterol is 211, their blood pressure is high and they have gained a lot of weight in the 9 years. They don't eat meat or dairy, or eggs at all but they do eat sugar, but only vegan sugar. They also juice every day and drink green smoothie with vegan protein powder.


As you can clearly see, when it comes to health, vegan is not enough.

In health
Jeff
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Re: When Vegan Is Not Enough!

Postby JeffN » Tue May 14, 2013 5:49 am

Special Report
Nutritional Update for Physicians: Plant-Based Diets
Perm J 2013 Spring;17(2):61-66

"It should be noted that the term plant- based is sometimes used interchangeably with vegetarian or vegan. Vegetarian or vegan diets adopted for ethical or religious reasons may or may not be healthy. It is thus important to know the specific definitions of related diets and to ascertain the details of a patient’s diet rather than making assumptions about how healthy it is."

&

"Physicians should advocate that it is time to get away from terms like vegan and vegetarian and start talking about eating healthy, whole, plant-based foods (primarily fruits and vegetables) and minimizing consumption of meat, eggs, and dairy products. Physicians should be informed about these concepts so they can teach them to staff and patients."
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Re: When Vegan Is Not Enough!

Postby JeffN » Wed May 22, 2013 7:48 am

In response to this post, I have received several emails asking if I am 1) distancing myself from vegans and/or 2) if the health movement is ruining the vegan movement by making it to difficult to become vegan by adding in all the strict health guidelines..

Neither one is true.

In regard to point 1, I have been a vegan most all of my life and continue to be one. The point made in this post is just that when it comes to health and a discussion of health, or a professional relationship between a health care professional and patient, as outlined in this thread, "vegan" is not enough.

In regard to point 2, as a health professional, I have never had the goal of trying to make anyone a vegan. That is not my purpose. My goal has always been to help those people who come to me to get and stay healthy. In doing so, many will adopt a diet based entirely on plant foods which only adds to the census of the vegan movement.

Also, many people come to me because they are already vegan, but not doing well in regard to their health. They want to give up being a vegan because they are not healthy. In addition, some who became vegan mainly for the health benefits and are not seeing those benefits, want to quit being vegan. By helping these people get healthy, I am helping them to stay vegan.

If someone wanted to be vegan and does not fall into either of the two scenarios above, then my work has no impact on them and/or their attempts to become and stay vegan. It does not apply to them nor does it in anyway make it more difficult for them, or anyone else, to become vegan.

If they do fall into either of the two scenarios above, then my work only helps them become vegan &/or stay vegan.

In Health
Jeff
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Re: When Vegan Is Not Enough!

Postby JeffN » Wed May 22, 2013 9:39 am

Example 8:

They went vegan about 6 years ago and had been vegetarian for a little time before that. When they went vegan, they thought they were going to get healthier, but the opposite happened. They started out thin and fit, worked out and could run a 1/2 marathon. Six years later years they are 52 pounds heavier, and was diagnosed with "pre-diabetes" two months ago. Their MD told them that being vegan caused their health problems and that they need to eat protein, especially because of the pre-diabetes. They struggled with this, because of the ethical issues of eating meat, but did what the Doctor said because of their health. They stopped being vegan and ate only "local" and "organic" meat, chicken, eggs, low fat cheese and fish. Ironically. Their blood sugar became better and their weight started to go down. The heard that being vegan can reverse diabetes but wanted to know why in their case it caused it.

Here is a list of what they were eating while vegan.

- Any oil at all. They used oil to sautee or in pastries, cakes, cookies. and used shortening sometimes to make cookies

- Fake vegan meat/cheese: Boca chicknless patties were their fast/go to meal. They liked dayia cheese and used that a few times per week.

- Vegan processed foods (baked goods): They liked making cookies, I didn't really buy a lot of vegan baked goods, but I made them.

- Smoothies/juices: They said they were "religious" about juicing and smoothies and had at least 2 per day, usually big green smoothies with at least 4 cups of greens

- Alcohol or coffee: They drank alcohol occasionally & drank coffee every day.

As a result of the above, they went back to eating some animal products and got somewhat better. They lost some weight and their blood sugar and BP came down.

They wanted to know why animal products helped them.
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Re: When Vegan Is Not Enough!

Postby JeffN » Tue May 28, 2013 9:31 am

How well do vegetarians really eat?

In this study, they looked at the diets of vegetarians in the USA from 1999-2004.

A vegetarian dietary pattern as a nutrient-dense approach to weight management: an analysis of the national health and nutrition examination survey 1999-2004.
J Am Diet Assoc. 2011 Jun;111(6):819-27.
doi: 10.1016/j.jada.2011.03.012.

Here are the results from the study.

The vegetarians had a healthier diet then the non-vegetarians in several ways.

The vegetarians had higher intakes of fiber, calcium, magnesium, iron, vitamins A, C, E, thiamin, riboflavin, and folate

Intakes of niacin, vitamin B-12, zinc, protein, total fat, saturated fat, cholesterol and sodium were lower for the vegetarians.

While there was no difference in total vegetable intake, the vegetarians ate more dark-green vegetables, whereas the non-vegetarians ate more potatoes. Vegetarians consumed more total grain, fruit, soy, total dairy products and milk, and less discretionary fat than non vegetarians and they consumed twice as much whole grain and legumes as non-vegetarians.

When measured as an overall score using the Healthy Eaitng Index, the diet for all vegetarians was not different when compared to the non vegetarians

However, both groups were above the 2,300 mg Upper Limit set by the IOM.

Sounds pretty good, but lets take a look at the actual numbers.

Here are the charts right from the study. We will be looking at the column for "all" vegetarians vs non vegetarians as that gives us the best overall picture. (The results for the dieting and non dieting vegetarians is not much different).

The first table is overall nutrient intake and from it, we can see most of what I described above.

Image

However, upon closer look, we see that while the vegetarians did better in several areas, the areas they did better in, still fell way short of what would be considered "healthy."

The fiber was higher, but well below the RDA. The diet was still about 36% fat, 12% saturated fat, had 208 mgs of cholesterol and the sodium was well above the upper limit.

In this table, we get a closer look at their food group intake.

Image

While the vegetarians may have consumed twice the whole grains, their whole grain intake was still only 1.2 oz, which is well below the recommended minimum of 3 oz. The vegetarians also consumed more refined grains then the non vegetarians. While they ate more beans, their intake was only .25 cup per day. The vegetarians ate more nuts but still consumed less than 1 oz per day. They ate a little more soy, but my best guess is, it was not in the form of plain old steamed soybeans :)

The vegetarians ate more fruit and vegetables but their total was still way low, consuming only 1.3 cups of fruit and 1.58 cups of vegetables a day. The vegetarians ate less potatoes, the same amount of orange vegetables and while they ate more dark green leafy vegetables, the differences was only .04 cups/day.

The vegetarians also ate more dairy, milk, cheese and eggs.

Worst of all, the vegetarians consumed more added sugar, more added oil and virtually the same amount of added fat, which I think, tells the real story. So, even though they may have consumed a little more whole grains, vegetables and fruits, it was still covered with salt, fat/oil and sugar.

In this table, we see the results compared to the Healthy Eating Index (HEI), which is a measure of diet quality that assesses conformance to dietary recommendations. The top score is 100.

Image

As we can see, there was virtually no difference between between the vegetarians and non vegetarians in their overall dietary score with both coming in around 50, which is only half, of the top score.

The vegetarian diets in this study were still far too low in fruits, vegetables, whole grains & fiber, and still way to high in fat, saturated fat cholesterol and salt.

While they did not separate out those following a vegan diet, I am sure they would have done better, but still would not have met the standards of a healthy diet.

These results are not much different than an earlier study reported in 2003

What do vegetarians in the United States eat?
Am J Clin Nutr. 2003 Sep;78(3 Suppl):626S-632S.

In this study, the self-defined vegetarians who ate no meat, did consume more grains, legumes, vegetables, fruit, and wine, but they also consumed a diet that still had 25% of their calories from fat, 8.2% from saturated fat, 126 mg of cholesterol, a 9:1 ratio of Omega 6/Omega 3, and only 26 grams of fiber and almost as much added sugars and fats/oils.

Personally, I am not surprised that they vegetarian diet reported in 2003 (data collected from 1994–1996 & 1998) was somewhat healthier than the one reported in the above study of 2011 (data collected from 1999-2004) because as each year passes, so does the proliferation and ubiquitousness of vegetarian and vegan junk food.

A few years ago, another study scored the leading diet books of the time against the Alternative Healthy Eating Index (AHEI), a modified version of the HEI. The top score is a 70.

A dietary quality comparison of popular weight-loss plans.
J Am Diet Assoc. 2007 Oct;107(10):1786-91.

The Ornish diet was included and scored a 64.6, the highest of all the diets tested. At that time, I compared the McDougall program to the AHEI, and by my calculations, it scored a 66 (out of 70).

This is why it is so important to distinguish between a healthy diet and a vegetarian and/or vegan diet.

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Re: When Vegan Is Not Enough!

Postby JeffN » Wed Jun 05, 2013 2:21 pm

I am putting up the charts from the recent Adventist Health Study-2 as I know there is a lot of discussion around them. In the next few days or weeks, I will also put up my comments on the study but I think these charts tell much of the picture, even if one is not versed in statistics.

While many are focusing on the results related to differences in the diets, I would encourage everyone to also look closely at Table 2 and the differences in the demographics and overall lifestyles between the groups, especially the differences between all the types of vegetarians and the non- vegetarians and also between the vegans and everyone else. In Table 4, you will also notice there is a difference in the results between men and women

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Re: When Vegan Is Not Enough!

Postby JeffN » Thu Jun 06, 2013 5:44 pm

This article just came our from VegSource and in it, Jeff Nelson makes some excellent points about this study, studies in general and why generic vegan and vegetarian diets are not enough.

Many of the points he makes, I will be agreeing with, and further expanding on, in my review.

http://www.vegsource.com/news/2013/06/d ... efits.html

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Re: When Vegan Is Not Enough!

Postby JeffN » Fri Mar 07, 2014 7:08 am

Example 9:

The following was sent to me in response to a recent posting of this thread on my FB page..,

"I worked for a very well known animal rights organization for nearly a decade with some of the most unhealthy people I have ever met. Meanwhile we all preached blindly how healthy going vegan was. The truth? My husband and I were grossly overweight and I faced diabetes and high blood pressure in my late 20s and early 30s. I know better now that vegan isn't enough. I learned that the hard way."


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Re: When Vegan Is Not Enough!

Postby JeffN » Mon Apr 14, 2014 1:42 pm

Today, I was in San Francisco and took a picture of a "menu" board of a popular health conscious restaurant.

Image

I posted it in FB with the following comment...

"Don't Be Fooled! This restaurant features food that is seasonal, local, fresh, natural, organic, free-range, grass-fed, sustainable, hormone & antibiotic free with vegetarian & VEGAN options but NOTHING that passed my guidelines for healthy that I would eat other then the bananas, apples & salad."

I though the discussion that followed was relevant to this thread.

https://www.facebook.com/JeffNovickRD/p ... 6071060125

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Re: When Vegan Is Not Enough!

Postby JeffN » Fri Oct 16, 2015 11:53 am

Questioning the Ethics & Science of A Pure Vegan Diet
Dr T Colin Campbell
10/16/2015

http://nutritionstudies.org/questioning ... egan-diet/
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Re: When Vegan Is Not Enough!

Postby JeffN » Fri Dec 11, 2015 7:34 am

Mortality in vegetarians and comparable nonvegetarians in the United Kingdom
Paul N Appleby, Francesca L Crowe, Kathryn E Bradbury, Ruth C Travis, and Timothy J Key*
First published December 9, 2015, doi: 10.3945/​ajcn.115.119461 Am J Clin Nutr

http://ajcn.nutrition.org/content/early ... hort?rss=1

Full Text
http://ajcn.nutrition.org/content/early ... l.pdf+html

Background: Vegetarians and others who do not eat meat have been observed to have lower incidence rates than meat eaters of some chronic diseases, but it is unclear whether this translates into lower mortality.

Objective: The purpose of this study was to describe mortality in vegetarians and comparable nonvegetarians in a large United Kingdom cohort.

Design: The study involved a pooled analysis of data from 2 prospective studies that included 60,310 persons living in the United Kingdom, comprising 18,431 regular meat eaters (who ate meat ≥5 times/wk on average), 13,039 low (less-frequent) meat eaters, 8516 fish eaters (who ate fish but not meat), and 20,324 vegetarians (including 2228 vegans who did not eat any animal foods). Mortality by diet group for each of 18 common causes of death was estimated with the use of Cox proportional hazards models.

Results: There were 5294 deaths before age 90 in >1 million y of follow-up. There was no significant difference in overall (all-cause) mortality between the diet groups: HRs in low meat eaters, fish eaters, and vegetarians compared with regular meat eaters were 0.93 (95% CI: 0.86, 1.00), 0.96 (95% CI: 0.86, 1.06), and 1.02 (95% CI: 0.94, 1.10), respectively; P-heterogeneity of risks = 0.082. There were significant differences in risk compared with regular meat eaters for deaths from circulatory disease [higher in fish eaters (HR: 1.22; 95% CI: 1.02, 1.46)]; malignant cancer [lower in fish eaters (HR: 0.82; 95% CI: 0.70, 0.97)], including pancreatic cancer [lower in low meat eaters and vegetarians (HR: 0.55; 95% CI: 0.36, 0.86 and HR: 0.48; 95% CI: 0.28, 0.82, respectively)] and cancers of the lymphatic/hematopoietic tissue [lower in vegetarians (HR: 0.50; 95% CI: 0.32, 0.79)]; respiratory disease [lower in low meat eaters (HR: 0.70; 95% CI: 0.53, 0.92)]; and all other causes [lower in low meat eaters (HR: 0.74; 95% CI: 0.56, 0.99)]. Further adjustment for body mass index left these associations largely unchanged.

Conclusions: United Kingdom–based vegetarians and comparable nonvegetarians have similar all-cause mortality. Differences found for specific causes of death merit further investigation.
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Re: When Vegan Is Not Enough!

Postby JeffN » Tue Jan 05, 2016 12:58 pm

2 new papers on the long-term health of vegetarians and vegans

1) The long-term health of vegetarians and vegans.
Proc Nutr Soc. 2015 Dec 28:1-7. [Epub ahead of print]
Appleby PN, Key TJ.

http://www.ncbi.nlm.nih.gov/pubmed/26707634

Abstract

Vegetarians, who do not eat any meat, poultry or fish, constitute a significant minority of the world's population. Lacto-ovo- vegetarians consume dairy products and/or eggs, whereas vegans do not eat any foods derived wholly or partly from animals. Concerns over the health, environmental and economic consequences of a diet rich in meat and other animal products have focussed attention on those who exclude some or all of these foods from their diet. There has been extensive research into the nutritional adequacy of vegetarian diets, but less is known about the long-term health of vegetarians and vegans. We summarise the main findings from large cross-sectional and prospective cohort studies in western countries with a high proportion of vegetarian participants. Vegetarians have a lower prevalence of overweight and obesity and a lower risk of IHD compared with non-vegetarians from a similar background, whereas the data are equivocal for stroke. For cancer, there is some evidence that the risk for all cancer sites combined is slightly lower in vegetarians than in non-vegetarians, but findings for individual cancer sites are inconclusive. Vegetarians have also been found to have lower risks for diabetes, diverticular disease and eye cataract. Overall mortality is similar for vegetarians and comparable non-vegetarians, but vegetarian groups compare favourably with the general population. The long-term health of vegetarians appears to be generally good, and for some diseases and medical conditions it may be better than that of comparable omnivores. Much more research is needed, particularly on the long-term health of vegans.


2) Mortality in vegetarians and comparable nonvegetarians in the United Kingdom
American Journal of Clinical Nutrition
December 9, 2015 as doi: 10.3945/ajcn.115.119461.
Paul N Appleby, Francesca L Crowe, Kathryn E Bradbury, Ruth C Travis,
and Timothy J Key

Full Text
http://ajcn.nutrition.org/content/103/1/218.long

Abstract

Background: Vegetarians and others who do not eat meat have been observed to have lower incidence rates than meat eaters of some chronic diseases, but it is unclear whether this translates into lower mortality.

Objective: The purpose of this study was to describe mortality in vegetarians and comparable nonvegetarians in a large United Kingdom cohort.

Design: The study involved a pooled analysis of data from 2 prospective studies that included 60,310 persons living in the United Kingdom, comprising 18,431 regular meat eaters (who ate meat ≥5 times/wk on average), 13,039 low (less-frequent) meat eaters, 8516 fish eaters (who ate fish but not meat), and 20,324 vegetarians (including 2228 vegans who did not eat any animal foods). Mortality by diet group for each of 18 common causes of death was estimated with the use of Cox proportional hazards models.

Results: There were 5294 deaths before age 90 in >1 million y of follow-up. There was no significant difference in overall (all-cause)
mortality between the diet groups: HRs in low meat eaters, fish eaters, and vegetarians compared with regular meat eaters were 0.93 (95% CI:0.86, 1.00), 0.96 (95% CI: 0.86, 1.06), and 1.02 (95% CI: 0.94, 1.10), respectively; P-heterogeneity of risks = 0.082. There were significant differences in risk compared with regular meat eaters for deaths from circulatory disease [higher in fish eaters (HR: 1.22; 95% CI: 1.02, 1.46)]; malignant cancer [lower in fish eaters (HR: 0.82; 95% CI: 0.70, 0.97)], including pancreatic cancer [lower in low meat eaters and vegetarians (HR: 0.55; 95% CI: 0.36, 0.86 and HR: 0.48; 95% CI: 0.28, 0.82, respectively)] and cancers of the lymphatic/hematopoietic tissue [lower in vegetarians (HR: 0.50; 95% CI: 0.32, 0.79)]; respiratory disease [lower in low meat eaters (HR: 0.70; 95% CI: 0.53, 0.92)]; and all other causes [lower in low meat eaters (HR: 0.74; 95% CI: 0.56, 0.99)]. Further adjustment for body mass index left these associations largely unchanged.

Conclusions: United Kingdom–based vegetarians and comparable nonvegetarians have similar all-cause mortality. Differences found for specific causes of death merit further investigation.


Here are my thoughts, which have also been my response to all/any of the WFPB Health Professionals who I have been in discussion with over these recent studies....

This is why differentiating between the vegan & vegetarian dietary patterns and a “healthy” dietary pattern that is based predominately on plants, is so important. They are not the same and will not produce the same health benefits.

Lets see how many of the vegans/vegetarians met the standards of

- don’t smoke
- avoid alcohol (or limit to bare minimum intake)

(BTW, the main factors contributing to why the 7th Day Adventists live longer is because of the above top 2). Same with most all Blue Zones.

- healthiest BMI, preferable in the lower end of the healthy range (18.5 - 22)
- predominately minimally processed and unprocessed foods
- lower in fat
- lower in calorie density
- lower in salt (<1500 mg)
- Lower in added sugar (less than 5% of calories),
- Lower in added oil (less than 4%)
- Lower in Cholesterol (less than 25 mg)
- Lower in refined grains
- lower in saturated fat (< &/or= 6%)
- higher in fiber (> 35-50 grams)
- adequate in omega 3’s
- not excessive in omega 6’s
- met the activity standards of the AHA/ACSM/CDC etc

One could meet all the above, live long and healthy, and not been a vegan (i.e., Pritikin & Ornish Reversal Diets, etc)

Surveys have shown (listed in above posts in this thread) that while vegans & vegetarians do some things better (consume more fruit and veggies), their overall dietary score is not much better as they fair worse in other areas (consume more salt, sugar, oil, etc).

This is why the health movement is really separate from the vegan & vegetarians movements, though there is some minor overlap.

To further elaborate on my point, in my presentation, Lighten Up, and in my articles on Triage, I emphasis the 5 Healthy Lifestyle behaviors that have been show to prevent the most lifestyle related morbidity and early mortality. These are...

1) Not Smoking
2) Healthy BMI
3) Minimum 150 minutes/wk of exercise (or something similar)
4) Minimal to no alcohol
5) Healthy diet (usually defined by a minimum intake of fruits and veggies, and by the consumption of less fat, sat fat, salt and sugar)

Every single study that measures adherence to these 5, showed the greater the adherence, the greater the impact,with an impact far beyond what any study on vegan & vegetarian diets have ever shown. Yet, in every study on these behaviors, no more than 1-4% of the study population ever meets the above 5 criteria.

That is why it is important to distinguish that we are not just promoting a vegan or vegetarian diet but a healthy diet based predominately on plants and a diet that also meets the health criteria of the 5 Healthy Lifestyle Behaviors above and the other ones I listed...

- predominately minimally processed and unprocessed foods
- lower in fat
- lower in calorie density
- lower in salt (<1500 mg)
- Lower in added sugar (less than 5% of calories),
- Lower in added oil (less than 4%)
- Lower in Cholesterol (less than 25 mg)
- Lower in refined grains
- lower in saturated fat (< &/or= 6%)
- higher in fiber (> 35-50 grams)
- adequate in omega 3’s
- not excessive in omega 6’s
- met the activity standards of the AHA/ACSM/CDC etc

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