Are ‘vegetarians’ or ‘carnivores’ healthier?

Nutrition studies has been plagued with problems. Most of the research in the past was extremely low quality. Few other fields would allow such weak research to be published in peer-reviewed journals. Yet for generations, epidemiological (observational and correlational) studies were the norm for nutrition studies. This kind of research is fine for preliminary exploration in formulating new hypotheses to test, but it is entirely useless for proving or disproving any given hypothesis. Shockingly, almost all of medical advice and government recommendations on diet and nutrition are based on this superficial and misleading level of results.

The main problem is there has been little, if any, control of confounding factors. Also, the comparisons used were pathetically weak. It turns out that, in studies, almost any dietary protocol or change improves health compared to a standard American diet (SAD) or other varieties of standard industrialized diets based on processed foods of refined carbs (particularly wheat), added sugar (particularly high fructose corn syrup), omega-6 seed oils (inflammatory, oxidative, and mutagenic), food additives (from glutamate to propionate), and nutrient-deficient, chemical-drenched agricultural crops (glyphosate among the worst). Assuming the dog got decent food, even eating dog shit would be better for your health than SAD.

Stating that veganism or the Mediterranean diet is healthier than what most people eat really tells us nothing at all. That is even more true when the healthy user effect is not controlled for, as typically is the case with most studies. When comparing people on these diets to typical meat eaters, the ‘carnivores’ also are eating tons of carbs, sugar, and seed oils with their meat (buns, french fries, pop, etc; and, for cooking and in sauces, seed oils; not to mention snacking all day on chips, crackers, cookies, and candy). The average meat-eater consumes far more non-animal foods than animal foods, and most processed junk food is made mostly or entirely with vegan ingredients. So why do the animal foods get all the blame? And why does saturated fat get blamed when, starting back in the 1930s, seed oils replaced lard as the main source of cooking fat/oil?

If scientists in this field were genuinely curious, intellectually humble, not ideologically blinded, and unbiased by big food and big farm funding, they would make honest and fair comparisons to a wide variety of optimally-designed diets. Nutritionists have known about low-carb, keto, and carnivore diets for about a century. The desire to research these diets, however, has been slim to none. The first ever study of the carnivore diet, including fully meat-based, is happening right now. To give some credit, research has slowly been improving. I came across a 2013 study that compared four diets: “vegetarian, carnivorous diet rich in fruits and vegetables, carnivorous diet less rich in meat, and carnivorous diet rich in meat” (Nathalie T. Burkert et al, Nutrition and Health – The Association between Eating Behavior and Various Health Parameters: A Matched Sample Study).

It’s still kind of amusing that the researchers called carnivorous a “diet rich in fruits and vegetables” and a “diet less rich in meat.” If people are mostly eating plant foods or otherwise not eating much meat, how exactly is that carnivorous in any meaningful and practical sense? Only one in four of the diets were carnivorous in the sense the average person would understand it, as a diet largely based on animal foods. Even then, it doesn’t include a carnivorous diet entirely based on animal foods. Those carnivores eating a “diet rich in meat” might still be eating plenty of processed junk food, their meat might still be cooked or slathered in harmful seed oils and come with a bun, and they might still be washing it down with sugary drinks. A McDonald’s Big Mac meal could be considered as part of a diet rich in meat, just because meat represents the greatest portion of weight and calories. Even if their diet was only 5-10% unhealthy plant foods, it could still be doing severe damage to their health. One can fit in a fairly large amount of carbs, seed oils, etc in a relatively small portion of the diet.

I’m reminded of research that defines a “low-carb diet” as any carb intake that is 40% or below, but other studies show that 40% is the absolute highest point of carb intake for most hunter-gatherers. As high and low are relative concepts in defining carb intake, what is considered a meat-rich diet would be relative as well. I doubt these studied carnivorous “diets rich in meat” are including as high amount of animal foods as found in the diets of Inuit, Masai, early Americans, and Paleolithic humans. So what is actually being compared and tested? It’s not clear. This was further confounded in how vegans, vegetarians, and pescetarians (fish-eaters) were combined into a single group mislabeled as ‘vegetarian’, considering that vegetarians and pescetarians technically could eat a diet primarily animal-based if they so chose (dairy, eggs, and/or fish) and I know plenty of vegetarians who eat more cheese than they do fruits and vegetables. Nonetheless, at least these researchers were making a better comparison than most studies. They did try to control for other confounders such as pairing each person on a plant-based diet with “a subject of the same sex, age, and SES [socioeconomic status]” from each of the other three diets.

What were the results? Vegetarians, compared to the most meat-based of the diets, had worse outcomes for numerous health conditions: asthma, allergies, diabetes, cataracts, tinnitus, cardiac infarction, bronchitis, sacrospinal complaints, osteoporosis, gastric or intestinal ulcer, cancer, migraine, mental illness (anxiety disorder or depression), and “other chronic conditions.” There were only a few health conditions where the plant-based dieters fared better. For example, the so-called ‘vegetarians’ had lower rates of hypertension compared to carnivores rich in meat and less rich in meat, although higher rates than those carnivores rich in fruits and vegetables (i.e., more typical omnivores).

This is interesting evidence about the diets, though. If the carnivorous diets were low enough in starchy and sugary plant foods and low enough in dairy, they would be ketogenic which in studies is known to lower blood pressure and so would show a lesser rate of hypertension. This indicates that none of these diets are low-carb, much less very low-carb (ketogenic). The plant-based dieters in this study also had lower rates of stroke and arthritis, these being other health benefits seen on a ketogenic diet, and so this further demonstrates that this study wasn’t comparing high-carb vs low-carb as one might expect from how the diets were described in the paper. That is to say the researchers didn’t include a category for a ketogenic carnivore diet or even a ketogenic omnivore diet, much less a ketogenic ‘vegetarian’ diet as a control. Keep in mind that keto-carnivore is one of the most common forms of those intentionally following a carnivore diet. And keep in mind that plant-based keto is probably more popular right now than keto-carnivore. So, the point is that these unexpected results are examples of the complications with confounding factors.

The only other result that showed an advantage to the ‘vegetarians’ was less urinary incontinence, which simply means they didn’t have to pee as often. I haven’t a clue what that might mean. If we were talking about low-carb and keto, I’d suspect that the increased urination for the ‘carnivorous’ diets was related to decreased water retention (i.e., bloating) and hence the water loss that happens as metabolism shifts toward fat-burning. But since we are confident that such a diet wasn’t included in the study, these results remain anomalous. Of all the things that meat gets blamed for, I’ve never heard of anyone suggesting that it causes most people to urinate incessantly. That is odd. Anyway, it’s not exactly a life-threatening condition, even if it were caused by carnivory. It might have something to do with higher-fat combined with higher-carb, in the way that this combination also contributes to obesity, whereas high-fat/low-carb and low-fat/high-carb does not predispose one to fat gain. The ‘vegetarianism’ in this study was being conflated with a low-fat diet, but all of the four categories apparently were varying degrees of higher carb.

The basic conclusion is that ‘vegetarians’, including vegans and pescetarians, have on average poorer health across the board, with a few possible exceptions. In particular, they suffer more from chronic diseases and report higher impairment from health disorders. Also, not only these ‘vegetarians’ but also meat-eaters who ate a largely plant-based diet (“rich in fruits and vegetables”) consult doctors more often, even as ‘vegetarians’ are inconsistent about preventative healthcare such as check-ups and vaccinations. Furthermore, “subjects with a lower animal fat intake demonstrate worse health care practices,” whatever that exactly means. Generally, ‘vegetarians’ “have a lower quality of life.”

These are interesting results since the researchers were controlling for such things as wealth and poverty, and so it wasn’t an issue of access to healthcare or the quality of one’s environment or level of education. The weakness is that no data was gathered on macronutrient ratios of the subjects’ diets, and no testing was done on micronutrient content in the food and potential deficiencies in the individuals. Based on these results, no conclusions can be made about causal direction and mechanisms, but it does agree with some other research that finds similar results, including with other health conditions such as vegans and vegetarians having greater infertility. Any single one of these results, especially something like infertility, points toward serious health concerns involving deeper systemic disease and disorder within the body.

But what really stands out is the high rate of mental illness among ‘vegetarians’ (about 10%), twice as high as the average meat-eater (about 5%) which is to say the average Westerner, and that is with the background of the Western world having experienced a drastic rise in mental illness over the past couple of centuries. And the only mental illnesses considered in this study were depression and anxiety. The percentage would be so much higher if including all other psychiatric conditions and neurocognitive disorders (personality disorders, psychosis, psychopathy, Alzheimer’s, ADHD, autism, learning disabilities, etc). Think about that, the large number of people on a plant-based diet who are struggling on the most basic level of functioning, something I personally understand from decades of chronic depression on the SAD diet. Would you willingly choose to go on a diet that guaranteed a high probability of causing mental health struggles and suffering, neurocognitive issues and decline?

To put this study in context, listen to what Dr. Paul Saladino, trained in psychiatry and internal medicine, has to say in the following video. Jump to around the 19 minute mark where he goes into the nutritional angle of a carnivore diet. And by carnivore he is talking about fully carnivore and so, if dairy is restricted as he does in his own eating, it would also mean ketogenic as well. A keto-carnivore diet has never been studied. Hopefully, that will change soon. Until then, we have brilliant minds like that of Dr. Saladino to dig into the best evidence that is presently available.

 

Here are a couple of articles that come from the BBC. As a mainstream news source, this demonstrates how this knowledge is finally getting acknowledged in conventional healthcare and public debate. That is heartening.

[Text below is from linked articles.]

Why vegan junk food may be even worse for your health
by William Clark, BBC

There’s also the concern that the health risks associated with these kinds of nutrient deficiencies might not show up immediately. It could take years to associate foggy thoughts and tiredness with low B12 levels, infertility with low iron, and osteoporosis brought on by calcium deficiency does not show up until late 40s and 50s in most people, says Rossi.

“People will think about their health now and not their future health,” she says.

How a vegan diet could affect your intelligence
by Zaria Gorvett, BBC

In fact, there are several important brain nutrients that simply do not exist in plants or fungi. Creatine, carnosine, taurine, EPA and DHA omega-3 (the third kind can be found in plants), haem iron and vitamins B12 and D3 generally only occur naturally in foods derived from animal products, though they can be synthesised in the lab or extracted from non-animal sources such as algae, bacteria or lichen, and added to supplements.

Others are found in vegan foods, but only in meagre amounts; to get the minimum amount of vitamin B6 required each day (1.3 mg) from one of the richest plant sources, potatoes, you’d have to eat about five cups’ worth (equivalent to roughly 750g or 1.6lb). Delicious, but not particularly practical. […]

There are small amounts of choline in lots of vegan staples, but among the richest sources are eggs, beef and seafood. In fact, even with a normal diet, 90% of Americans don’t consume enough. According to unpublished research by Wallace, vegetarians have the lowest intakes of any demographic. “They have extremely low levels of choline, to the point where it might be concerning,” he says.

For vegans, the picture is likely to be bleaker still, since people who eat eggs tend to have almost double the choline levels of those who don’t. And though the US authorities have set suggested intakes, they might be way off.

Meat and mental health: a systematic review of meat abstention and depression, anxiety, and related phenomena
by Urska Dobersek et al

Conclusion: Studies examining the relation between the consumption or avoidance of meat and psychological health varied substantially in methodologic rigor, validity of interpretation, and confidence in results. The majority of studies, and especially the higher quality studies, showed that those who avoided meat consumption had significantly higher rates or risk of depression, anxiety, and/or self-harm behaviors. There was mixed evidence for temporal relations, but study designs and a lack of rigor precluded inferences of causal relations. Our study does not support meat avoidance as a strategy to benefit psychological health.

The Secret of Health

I’m going to let you in on a secret. But before I get to that… There is much conflict over diet. Many will claim that their own is the one true way. And some do have more research backing them up than others. But even that research has been extremely limited and generally of low quality. Hence, all the disagreement and debate.

There have been few worthwhile studies where multiple diets are compared on equal footing. And the results are mixed. In some studies, vegetarians live longer. But in others, they live less long. Well, it depends on what kind of vegetarian diet in what kind of population and compared against which other diet or diets. The Mediterranean diet also has showed positive results and the Paleo diet has as well, although most often the comparison is against a control group that isn’t on any particular diet.

It turns out that almost any diet is better than the Standard American Diet (SAD). Eating dog shit would be improvement over what the average American shoves into their mouth-hole. I should know. I shudder at the diet of my younger days, consisting of junk food and fast food. Like most Americans, I surely used to be malnourished, along also with likely having leaky gut, inflammation, insulin sensitivity, toxic overload, and who knows what else. Any of the changes I’ve made in my diet over the years has been beneficial.

So, here is the great secret. It matters less which specific diet you have, in the general sense. That is particular true in decreasing some of the worst risk factors. Many diets can help you lose weight and such, from low fat to high fat, from omnivorian to vegetarian. That isn’t to say all diets are equal in the long term, but there are commonalities to be found in any healthy diet. Let me lay it out. All health diets do some combination of the following.

Eliminate or lessen:

  • processed foods
  • vegetable oils
  • carbs, especially simple carbs
  • grains, especially wheat
  • sugar, especially fructose
  • dairy, especially cow milk
  • foods from factory-farmed animals
  • artificial additives

Emphasize and increase:

  • whole foods
  • omega-3s, including but not limited to seafood
  • fiber, especially prebiotics
  • probiotics, such as fermented/cultured
  • foods that are organic, local, and in season
  • foods from pasture-raised or grass-fed animals
  • nutrient-density
  • fat-soluble vitamins

There are some foods that are harder to categorize. Even though many people have problems with cow milk, especially of the variety with A1 casein, more people are better able to deal with ghee which has the problematic proteins removed. And pasture-raised cows produce nutrient-dense milk, as they produce nutrient-dense organ meats and meat filled with omega-3s. So, it’s not that a diet has to include everything I listed. But the more it follows these the greater will be the health benefits.

It does matter to some degree, for example, where you get your nutrient-density. Fat-soluble vitamins are hard to find in non-animal sources, a problem for vegans. But even a vegan can vastly increase their nutrient intake by eating avocados, leafy greens, seaweed, etc. The main point is any increase in nutrients can have a drastic benefit to health. And the greater amount and variety of nutrients the greater the improvement.

That is why any diet you can imagine comes in healthy and unhealthy versions. No matter the diet, anyone who decreases unhealthy fats/oils and increases healthy fats/oils will unsurprisingly increase their health. But as an omnivore could fill their plate with factory-farmed meat and dairy, a vegan could fill their plate with toxic soy-based processed foods and potato chips. The quality of a diet is in the details.

Still, it is easier to include more of what I listed in some diets than others. Certain nutrients are only found in animal sources and so a vegan has to be careful about supplementing what is otherwise lacking. A diet of whole foods that doesn’t require supplementation, however, is preferable.

That is why there are a surprisingly large number of self-identified vegans and vegetarians who will, at least on occasion, eat fish and other seafood. That also might be why the Mediterranean diet and Paleo diet can be so healthy as well, in their inclusion of these foods. Weston A. Price observed some of the healthiest populations in the world were those who lived near the ocean. And this is why cod liver oil was traditionally one of the most important parts of the Western diet, high in both omega-3s and fat soluble vitamins and much else as well.

Whatever the details one focuses upon, the simple rule is increase the positives and decrease the negatives. It’s not that difficult, as long as one knows which details matter most. The basic trick to any health diet is to not eat like the average American. That is the secret.

* * *

Getting that out of the way, here is my bias.

My own dietary preferences are based on functional medicine, traditional foods, paleo diet, nutritional science, anthropology, and archaeology — basically, any and all relevant evidence and theory. This is what informs the list I provided above, with primary focus on the Paleo diet which brings all the rest together. That is what differentiates the Paleo diet from all others, in that it is a systematic approach that scientifically explains why the diet works. It focuses not just on one aspect but all known aspects, including lifestyle and such.

Something like the Mediterranean diet is far different. It has been widely researched and it is healthy, at least relative to what it has been tested against. There are multiple limitations to health claims about it.

First, the early research was done after World War II and , because of the ravages to the food supply, the diet they were eating then was different than what they were eating before. The healthy adults observed were healthy because of the diet they grew up on, not because of the deprivation diet they experienced after the war. That earlier diet was filled with meat and saturated fat, but it also had lots of vegetables and olive oil as. As in the US, the health of the Mediterranean people had decreased as well from one generation to the next. So, arguing that the post-war Mediterranean diet was healthier than the post-war American diet wasn’t necessarily making as strong of a claim as it first appeared, as health was declining in both countries but with the decline in the latter being far worst.

Working with that problematic research alone, there was no way to get beyond mere associations in order to determine causation. As such, it couldn’t be stated with any certainty which parts of the diet were healthy, which parts unhealthy, and which parts neutral. It was a diet based on associations, not on scientific understanding of mechanisms and the evidence in support. It’s the same kind of associative research that originally linked saturated fat to heart disease, only to later discover that it was actually sugar that was the stronger correlation. The confusion came because, in the American population because of the industrialized diet, habits of saturated fat consumption had become associated with that of sugar, but there was no study that ever linked saturated fat to heart disease. It was a false or meaningless association, a correlation that it turns out didn’t imply causation.

That is the kind of mistake that the Paleo diet seeks to avoid. The purpose is not merely to look for random associations and hope that they are causal without ever proving it. Based on other areas of science, paleoists make hypotheses that can be tested, both in clinical studies and in personal experience. The experimental attitude is central.

That is why there is no single Paleo diet, in the way there is a single Mediterranean diet. As with hunter-gatherers in the real world, there is a diversity of Paleo diets that are tailored to different purposes, health conditions, and understandings. Dr. Terry Wahl’s Paleo diet is a plant-based protocol for multiple sclerosis, Dr. Dale Bredesen’s Paleo diet is part of an even more complex protocol including ketosis for Alzheimer’s. Other ketogenic Paleo diets target the treatment of obesity, autism, etc. Still other Paleo diets allow more carbs and so don’t prioritize ketosis at all. There are even Paleo diets that are so plant-based as to be vegetarian, with or without the inclusion of fish and seafood, more similar to that of Dr. Wahls.

Which is the Paleo diet? All of them. But what do they all have in common? What I listed above. They all take a multi-pronged approach. Other diets work to the degree they overlap with the Paleo diet, especially nutrient-density. Sarah Ballantyne, a professor and medical biophycisist, argues that nutrient-density might be the singlemost important factor and she might be right. Certainly, you could do worse than focusing on that alone. That has largely been the focus of traditional foods, as inspired by the work of Weston A. Price. Most diets seem to improve nutrient-density, one way or another, even if they don’t do it as fully as the best diets. The advantage of the Paleo diet(s), as with traditional foods and functional medicine, is that there is scientific understanding about why specific nutrients matter, even as our overall knowledge of nutrients has many gaps. Still, knowledge with gaps is better than anything else at the moment.

The list of dos and don’ts is based on the best science available. The science likely will change and so dietary recommendations will be modified accordingly. But if a diet is based on ideology instead, new information can have no impact. Fortunately, most people advocating diets are increasingly turning to a scientific approach. This might explain why all diets are converging on the same set of principles. Few people would have been talking about nutrient-density back when the FDA made its initial dietary recommendations as seen in the Food Pyramid. Yet now the idea of nutrient-density has become so scientifically established that it is almost common knowledge.

More than the Paleo diet as specific foods to eat and avoid, what the most important takeaway is the scientific and experimental approach that its advocates have expressed more strongly than most. That is the way to treat the list I give, for each person is dealing with individual strengths and weaknesses, a unique history of contributing factors and health concerns. So, even if you dismiss the Paleo diet for whatever reason, don’t dismiss the principles upon which the Paleo diet is based (for vegetarians, see: Ketotarian by Dr. Will Cole and The Paleo Vegetarian Diet by Dena Harris). Anyone following any diet will find something of use, as tailored to their own needs.

That is the purpose of my presenting generalized guidelines that apply to all diets. It’s a way of getting past the ideological rhetoric in order to get at the substance of health itself, to get at the causal level. The secret is that there is no single healthy diet, not in any simplistic sense, even as every healthy diet has much in common.