First reason why I do not follow or recommend a vegetarian diet
To talk about nutrition and food these days is to enter a violent, entrenched war, with irreducible positions on all sides. They say that "in the middle is virtue" but to be in the middle is to be in a minefield, in no man's land, becoming everyone's target. In writing this text on vegetarian or plant-based diet I know I am entering that field. I do it consciously with a single goal, to help you make the best choices for your health and performance.
The urge or even the need to dwell on this topic was actually born from my patients. Fortunately I am able to have extensive "discussions" during our consultations (which often last more than 45 minutes) about health, performance and biohacking. I am able to learn nuances and details that would not otherwise be possible, which has allowed me to raise questions about the vegetarian diet.
As a result of these conversations I have noticed that there are commonalities with many who follow her:
They feel better after starting this plan but the improvements disappear after a while
They adopted this plan based on the premise that it is the best for health and performance
They did it for environmental reasons, even though physically they did not feel well
They feel the need to eat more and more often
I therefore dived into the science and the arguments that are used to defend it with a single aim: to find out if it is indeed an option for those who want the best level of health or performance.
Before I share my findings, I must make a few points:
It is more than obvious that some people feel magnificently well following this eating plan over the years. In that case, why change? If you follow a vegetarian diet and you don't have any problems, don't change.
Improving health, preventing disease and optimising performance is not the same as treating disease and, of course, there can be significant differences between nutritional strategies for both situations (for example in relation to the amount of protein and the activation of mTOR in an oncological context). In this series of texts I focus on the first part.
My intention with this text is not to defend a specific food strategy, but to focus on the merits and myths of vegetarian, vegan or plant-baseddiets.
Today I focus on the origins of the vegetarian diet being considered the healthiest option and how we have probably all been misled.
I believe that, like me, you grew up with this image around:
I remember having a poster on my primary school wall that looked like this and studying it over the years as the basis of what healthy eating would be. You must have gone through the same thing.
The Food Pyramid has served as a guide to food choices around the world since the 1980s. It was created by the United States Department of Agriculture (USDA) in order to guide the nutritional choices of Americans in an attempt to stem the rise of heart disease, something that became public concern number one after President Eisenhower suffered multiple heart attacks.
The indications given in the image are clear: the staple diet should be cereals, followed by vegetables and fruit. The consumption of fats and sweets should be as limited as possible, with animal products also being restricted.
Looking at these indications, the diet plan that meets all these requirements is the vegetarian diet: it is low in fats (particularly those of animal origin) and rich in everything that is vegetable: cereals, fruit and vegetables. Thus the connotation of this option as being the healthiest has emerged.
Given the importance that this image had and continues to have among the world population, it would be expected that it would be the fruit of discussions within the scientific community, of doctors and nutritionists, after gathering all the arguments for and against, having been the target of conclusive studies that it is the best option for our health and, only after these points were clarified, becoming "public policy".
For many years I assumed that would have been the case. But I was wrong, very wrong.
The Food Pyramid is the graphical representation of the document Dietary Goals for the United States, o final report of the McGovern Committee. Written in 1977 by Nick Mottern, this document is the summary of the series of Diet Related to Killer Diseases hearings that took place in the US Senate led by Senator McGovern during that year.
Because he had no background in science, medicine or nutrition, Mottern chose as his scientific advisor Dr Mark Hegsted, who led the American Heart Association, the largest association of medical cardiologists. He was an outspoken objectionist to meat on ethical and environmental grounds and a staunch advocate of a low-fat, animal product-free diet as the best diet to prevent cardiovascular disease.
This low-fat diet strategy, called years earlier the "prudent diet for Americans", was born out of the campaign led by Ancel Keys and Jeremiah Stamler against saturated fat because, according to them, it was the cause of cardiovascular disease and eliminating it would put an end to cardiac deaths. The Diet-Heart Hypothesis.
Underpinning this argument are observational studies carried out by both of them in different populations around the world, the best known being the 'Seven Country Study', in which they assessed the dietary pattern of populations in countries suffering from low levels of these conditions, in an attempt to find out which was best for health. The key territories in that study were Crete in Greece and Southern Italy.
With great oratory skills and funding, they got their conclusions across to the 4 corners of the world: "These people who do not suffer from heart disease do not eat saturated fat or animal products! We have found the solution to our problems", thus triggering 60 years of dietary recommendations.
At the time, these were widely criticised by doctors, lipidologists and nutritionists, pointing in one way or another to the lack of sufficiently clear and robust scientific evidence to support the hypothesis that saturated fat was associated with greater cardiovascular risk, and the recommendations that arose from this.
I leave you with 3 "particularities" of the Seven Countries Study so that you can draw your own conclusions:
The data was collected in the 1950s, at a time when Europe was recovering from the Second World War, with very high levels of poverty among the study populations. The socio-economic environment made it impossible to buy meat, meaning that their reduced consumption was not due to free choice but economic 'obligation' (interestingly, when their economic power increased, they returned to eating meat in accordance with their traditions and there was no increase in chronic disease levels);
The third and final observational data collection took place during a religious fast that forbade the consumption of animal products, and this fact was not reported in the study report. It was therefore implied that the meatless diet was normal, when it was clearly the result of an extraordinary context;
The containers in which the food was collected and sent for analysis of its biochemical composition in terms of macro-nutrients (carbohydrates, sugars and fats) absorbed fat, which reduced its quantity in the final analysis.
Any one of these points should have destroyed Keys' theory. Still, despite the criticisms and the limitations that were pointed out (and continue to be pointed out), the message got through and gained importance.
After the final document was drafted and approved by the members of the McGovern Committee, the USDA was created and made responsible for enforcing the laws relating to agriculture and food, in particular the indications contained in the report drafted by Mottern.
To try and generate the greatest consensus and scientific support around them, the American Society of Nutrition was then asked to review these recommendations and the science supporting them.
The conclusion was not as expected: there was only indirect evidence to support the recommendations, and therefore it was not in favour of implementing them.
Despite this, the process has moved forward,literally becoming law.
This means that the creation of the Food Pyramid, the most influential piece of nutritional information in human history, was the result of a report written by a politician, advised by a prominent doctor with a view biased by his personal opinions, without having undergone serious scientific review or achieved a high degree of consensus among the scientific community, based on observational studies designed to prove a predetermined point and with serious technical flaws which today would probably prevent its publication.
And so began what may be considered the greatest nutritional intervention in all of history: that animal products had become toxic and the greatest danger to human health when that consumption, particularly of their fat, seems to have been the factor that led to the last phase of man's evolution: that of the growth of the prefrontal cortex. Curious, isn't it? See what Harvard and Scientific American say on this topic.
The vegetarian diet, with low levels of fat and animal products, was born from a "crooked" context. Now, does the saying "if you are born crooked, you will never be straightened out" still apply or has it been straightened out, with new evidence? In the next text of this series, I will answer this question.