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Speaker 1: Hey, everybody, Welcome to another edition of Wisdom Wednesdays. Today,

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Speaker 1: I want to talk about the pros and cons of

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Speaker 1: having plant based diets. Now I have kind of skirted

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Speaker 1: around the issue a little bit before. I have talked

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Speaker 1: about some studies that have been published around plant based

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Speaker 1: diets and highlighting some of the in inadequacies I should

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Speaker 1: say in these studies just because they were pretty poorly

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Speaker 1: designed and they got a lot of media attention. But

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Speaker 1: I haven't actually given my thoughts comprehensively, and some people

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Speaker 1: have accused me of being anti vegan, anti plant biaist.

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Speaker 1: I'm not at all. I'm just about having good research.

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Speaker 1: So actually, what I thought I would do is look

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Speaker 1: into this in a bit of detail. And I have

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Speaker 1: talked many occasions about the limitations of observational research and

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Speaker 1: how it's really hard to draw conclusions of that. But

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Speaker 1: I have also talked about then when we have systematic reviews,

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Speaker 1: which poos all the data from lots of different studies,

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Speaker 1: that we start to get a bit stronger evidence. So

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Speaker 1: I want to talk about a couple of systematic reviews,

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Speaker 1: one looking at the impact of either meatators, vegetarians or

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Speaker 1: vegans on certain cardiovascular outcomes, particularly the nutrient intakes, because

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Speaker 1: that's really really important, is just looking at those nutrients

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Speaker 1: and any deficiencies. And then there's another systematic review that

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Speaker 1: talked about the mental health outcome. Now there have been

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Speaker 1: other studies and I just want to reference them nigh.

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Speaker 1: So there's lots of bias in nutritional research. I think

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Speaker 1: I've talked about that before. I think there's probably more

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Speaker 1: bias in nutritional research than most other branches of science.

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Speaker 1: And I have highlighted previously a number of studies that

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Speaker 1: have come out and have been particularly critical of these

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Speaker 1: ones from Harvard and a guy called Walter Willard who's

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Speaker 1: a very senior researcher, and Harvard Nutritional department is great,

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Speaker 1: but they've produced a number of what I call shit

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Speaker 1: house studies lately. They did this design, which in concept

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Speaker 1: was a great design, where they took a bunch of

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Speaker 1: twins and had half of them eating a plant piut

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Speaker 1: diet or vegan diet and then the other half on

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Speaker 1: a diet that included meat, and then they compared cardiovascular outcomes.

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Speaker 1: They published a paper on that, and then they compared

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Speaker 1: reductions in biological leads and they published a paper on that.

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Speaker 1: But the massive issue with this gloring issues one. And

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Speaker 1: when they did the study on cardiovascar issues, they measured

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Speaker 1: lipids and things like that, so they measured saturated fat

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Speaker 1: and stuff like that, but they didn't do I think

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Speaker 1: was fasting glue, coaster, tragleistritz one or the other or

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Speaker 1: maybe both, which have a big impact, and they didn't

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Speaker 1: include them. And they we know tend to be a

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Speaker 1: little bit higher in vegetarian and vegan diets. But the

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Speaker 1: main issue with these ones was that the vegans had

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Speaker 1: two hundred calories a day less and they lost more weight,

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Speaker 1: and that could mix. Basically, you can't draw any conclusions

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Speaker 1: because when you have two groups of people, one are

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Speaker 1: having two hundred calories a day less over eight weeks

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Speaker 1: and they're losing more weight, you cannot draw any inferences

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Speaker 1: at all. And the reason I highlighted these things is

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Speaker 1: because it's Harvard University and they push it out there.

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Speaker 1: They were all over the newspapers, and that's why I

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Speaker 1: highlighted these as really poor studies. And the other issue

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Speaker 1: that they didn't really mention is that the vegans lost

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Speaker 1: their shitload of muscle, which as you know, is one

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Speaker 1: of my major concerns, particularly as we euching. But anyway,

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Speaker 1: let's get back to these good studies that were published.

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Speaker 1: So one of them was published in the journal Nutrients,

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Speaker 1: and it was a systematic review and the title was

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Speaker 1: Nutrient Intake and Status in adults consuming plant beat stats

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Speaker 1: compared to meat eaters, A systematic review. Now that just

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Speaker 1: leads me into something that this whole concept of plant

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Speaker 1: beest has confused me a little bit because it is

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Speaker 1: interchangeably used by people who are vegans, people who are vegetarians,

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Speaker 1: but also some people who eat fish and some people

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Speaker 1: who eat a little bit of meat. So like, what

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Speaker 1: is the criteria for plant beast? This is the thing

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Speaker 1: that kind of concerns me when we're looking at the

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Speaker 1: literature is that there's no defined criteria because my diet

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Speaker 1: from some stand points is actually plant best because I

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Speaker 1: probably eat more plants in terms of volume, in fact,

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Speaker 1: I would than meat. If we're talking about calories, would

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Speaker 1: I be plantius I'm not really sure. I'd have to

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Speaker 1: do an analysis. But if you're talking about the from

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Speaker 1: a purest perspective, then I'm not plant beast if plant

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Speaker 1: be means vegetarian or vegan. So that's a little bit

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Speaker 1: that kind of confused me to start with. But anyway,

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Speaker 1: this study compared the three groups vegans, vegetarians, and people

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Speaker 1: who at meat, and they looked at nutrient intake. So

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Speaker 1: I'm just going to drive straight to the conclusions. Actually

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Speaker 1: really good paper in that they measured lots of different

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Speaker 1: nutrients and compared them in the three different groups and

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Speaker 1: what they find. So I'll just go from the table,

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Speaker 1: reading it out right from from top to bottom. And

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Speaker 1: the nutrients were it was fevorable those who had a

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Speaker 1: vegan diet have higher amounts of fiber and puffers, polyon

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Speaker 1: saturated fatty acids alphalinilaic acid, and the vitamins vitamins B one,

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Speaker 1: B six, vitamin C, vitamin E, foliate, and magnesium. Vegetarians

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Speaker 1: tended to have high amounts of poofas alphalinilaic acid, vitamin C,

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Speaker 1: folio and magnesium, and then the meat eaters tended to

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Speaker 1: have higher amounts of protein niasin, vitamin B twelve and zinc.

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Speaker 1: The ones were there was in terms of nutrients at

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Speaker 1: risk of inadequacy or deficiency. The vegans, it was basically

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Speaker 1: EPA and DHA and two of the essential fatty acids,

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Speaker 1: vitamin B, twelve, vitamin D, calcium, iodine, zinc, and just

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Speaker 1: in women, iron as well. The vegetarians had low amounts

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Speaker 1: or suboptimal amounts of fiber, which is a surprising one,

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Speaker 1: but also EPA, DHA, vitamins B, twelve, D, calcium, iodine, zinc,

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Speaker 1: iron in women, but also vitamin E, so very similar

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Speaker 1: to the vegans or other than vegetarians had less fiber,

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Speaker 1: which I find surprising. And also the other difference was

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Speaker 1: vitamin E intakes. And then the metators had suboptimal amounts

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Speaker 1: of fiber, polyon saturated fatty acids alphaalinellaic acid only in men,

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Speaker 1: and then vitamin's D E, foliate, calcium, and magnesium. So

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Speaker 1: across the board there were suboptimal levels of vitamin D

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Speaker 1: and calcium across all three groups, but deficiencies were particular

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Speaker 1: to that. And I will actually post a link to

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Speaker 1: the research paper. So this is a good paper, it's

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Speaker 1: a systematic review, and it's actually looking at nutrient intakes. Now,

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Speaker 1: we do need to be aware that part of the

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Speaker 1: problems with these studies, with these observational studies, is they're

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Speaker 1: asking people what they eat through food frequency questionnaers and

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Speaker 1: they are inherently oh well, there's inherent problems with those

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Speaker 1: sorts of things. But they do look at one hundred

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Speaker 1: and forty one studies from across the world, mostly from Europe,

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Speaker 1: southdc IS, and North America. So that's a pretty good indicator,

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Speaker 1: or it's at least the best that we have currently

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Speaker 1: about nutrient status in those different groups. So it didn't

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Speaker 1: look about outcomes, but it did look about nutrient status.

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Speaker 1: Now what we know in terms of outcomes is that

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Speaker 1: there's another systematic review that looked at basically cardiovascular risk

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Speaker 1: factors for the different groups. And now there's a little

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Speaker 1: bit of a flaw in this study because it was

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Speaker 1: basically looking at vegetarianism versus meat eaters. But they actually

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Speaker 1: am lumped in fish eaters with vegetarians, which I find

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Speaker 1: really weird. It's like, why not just have plant beast

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Speaker 1: or vegetarians. But what they find after they adjusted for

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Speaker 1: lifestyle confounders, which is really important, is that both fish

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Speaker 1: eaters and vegetarians a thirteen percent lower rate of ischemic

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Speaker 1: heart disease than meat eaters. Right, But what happened was

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Speaker 1: that the vegetarians, not the fish eaters, but just the

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Speaker 1: vegetarians had a twenty percent higher rate of total stroke,

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Speaker 1: right than meat eaters. Now, what are these equivalent? Because

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Speaker 1: we always hear that and we think, hey, Jesus, twenty

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Speaker 1: percent higher risk, that's really significant. So if we take

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Speaker 1: the thirteen percent reduce risk of a schemic heart disease

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Speaker 1: in the vegetarians and the fish eaters compared to the

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Speaker 1: meat eaters, that actually is equivalent to ten fewer cases

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Speaker 1: of heart disease per thousand people over a ten year period. Right,

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Speaker 1: So this is the difference between absolute and relative risk.

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Speaker 1: So the absolute risk reduction was thirteen percent. And we've

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Speaker 1: heard before all this stuff about red meat increase your

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Speaker 1: risk by eighteen percent. But when you look at what

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Speaker 1: does that mean for people on the street, It means

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Speaker 1: that if people were to stop eating meat and transition

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Speaker 1: to either vegetarian diet or vegetarian plus fish pescatarian, one

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Speaker 1: person fewer per thousand per year would have heart disease.

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Speaker 1: And then when it comes to the other way, that

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Speaker 1: twenty percent higher risk of stroke in the vegetarians, what

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Speaker 1: that translates as is basically three people having less having

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Speaker 1: a stroke per thousand people over eighteen year period. So

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Speaker 1: the real world impact of these things are absolutely minuscule

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Speaker 1: whenever you look at it in detail. So let me know,

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Speaker 1: I talk about looking at things from another side, which

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Speaker 1: is looking at mental health risks. So this is a

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Speaker 1: study and the taitleist a meta analysis is well. So

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Speaker 1: again lots of data combined. They identified twelve hundred and

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Speaker 1: forty nine publications and basically got rid of the vast

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Speaker 1: majority of them because they were really not well designed.

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Speaker 1: So there was thirteen included, but it had seventeen eight

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Speaker 1: hundred and nine individuals, so what reasonable amount. And then

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Speaker 1: what they did was they looked at the associations between

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Speaker 1: their diet and continuous to spread depression scores, stress well being,

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Speaker 1: or cognitive imperment. And what they found is that the

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Speaker 1: vegans and vegetarians were at an increased risk for depression.

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Speaker 1: So their ODDS ratio was two point one four. That

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Speaker 1: meant they were one hundred and forty or sorry, one

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Speaker 1: hundred and fourteen percent more likely to suffer depression than

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Speaker 1: meat eaters. But they also had lower anxiety scores, so

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Speaker 1: they were about fifteen percent and less likely to have anxiety.

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Speaker 1: So unfortunately they didn't translate that into the reductions or

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Speaker 1: increases in incidents over the years, but the increased risk

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Speaker 1: of depression is pretty significant one hundred and fourteen percent

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Speaker 1: increased risk of depression. The anxiety at fifteen percent lower

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Speaker 1: is really unlikely to have clinical relevance. So that then

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Speaker 1: leads us to in terms of conclusions, what I would

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Speaker 1: conclude from this is it really doesn't matter very much

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Speaker 1: at all in terms of cardiovascular risk. It does matter

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Speaker 1: in terms of nutrients status, and potentially in terms of

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Speaker 1: depression if you are a vegetarian or a vegan, and

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Speaker 1: then that brings us into why right, and the other

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Speaker 1: thing I want to talk about here are kids. So

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Speaker 1: I always say I don't mind what people what diet

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Speaker 1: they prefer, and my job is to kind of support people.

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Speaker 1: So what we know if you are a meat teater

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Speaker 1: is as I said earlier on, and there are a

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Speaker 1: number of nutrients in meat eaters that are significantly lower.

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Speaker 1: So you definitely need to increase your amounts of vitamin

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Speaker 1: D well Probably the best way to do that is

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Speaker 1: getting out into some sunshine, but also for a media

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Speaker 1: that you need to probably eat more fiber on average

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Speaker 1: and more pollen and saturated fatty acids, a bit more

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Speaker 1: alphalinelaic acid, a bit more foliate, bit more calcium, a

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Speaker 1: bit more magnesium. If you're a vegetarian or a vegan, definitely,

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Speaker 1: it is the essential fatty acids that are particularly important

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Speaker 1: for the brain. So the EPA, the DHA, and vitamin

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Speaker 1: B twelve, as well as iodine and iron, they're the

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Speaker 1: ones that are really important to a lesser extent zinc.

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Speaker 1: So I think what's pretty clear is that everybody needs

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Speaker 1: to supplement. But now let's talk about kids, because my

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Speaker 1: real concern kids are not small adults, right. People think

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Speaker 1: that they're just small adults, but you've got to think

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Speaker 1: about this. Kids are growing rapidly and their brands particularly

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Speaker 1: are growing very very rapidly, and they have a greater

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Speaker 1: need per kilogram of body weight for nutrients so that

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Speaker 1: they can develop properly. Now, some of the issues, and

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Speaker 1: I'm pretty strong on this, is that I'm not a

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Speaker 1: big fan of kids being brought up vegetarian and particularly vegan.

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Speaker 1: I get that people have they have belief systems, and

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Speaker 1: it's an ethical issue and I get it. So if

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Speaker 1: you do, if it is really really strong from an

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Speaker 1: ethical perspective, I think particularly for kids. There has to

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Speaker 1: be has to be, has to be, has to be

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Speaker 1: supplementation things that we really have to supplement our deity,

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Speaker 1: which is the faty acid. It is hugely important for

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Speaker 1: Brian development and bit them in B twelve. Right, they

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Speaker 1: are the two that absolutely one hundred percent have to

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Speaker 1: be supplemented. But I would also say calcium iron iodine

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Speaker 1: because it's important for Brian development. I mean, we just

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Speaker 1: need to look at goister with iodine deficiency and it's

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Speaker 1: a pretty horrendous condition where the Brian just and the

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Speaker 1: central nervous system doesn't develop properly. So those are nutrients

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Speaker 1: that absolutely have to be supplemented, and there is some

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Speaker 1: data around this. Now again they are not that common,

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Speaker 1: but the impact is absolutely catastrophic. I'm going to send

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Speaker 1: a link to a study that showed a Brian scan

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Speaker 1: of a twelve month old baby boy that was born

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Speaker 1: from a vegan mother exclusively breastfed and you know low EPA,

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Speaker 1: DSA and other and particularly vitamin B twelve and coaling

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Speaker 1: and this bran in was massively retarded in terms of development.

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Speaker 1: But then they actually because they founded got the baby

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Speaker 1: boy early, they supplemented with those nutrients, the EPA, the

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Speaker 1: DJ and the B twelve. Unfortunately, the child responded well

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Speaker 1: to the treatment with intramuscular B twelve and those other nutrients,

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Speaker 1: and so things to really look out for. And by

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Speaker 1: the way, there are a number of KIOS studies. There's

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Speaker 1: now been more than forty different KIOS studies that have

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Speaker 1: been published over the years, going back for a forty

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Speaker 1: year period where young kids who have been on a

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Speaker 1: vegan diet have actually been hospitalized because of severe nutrient

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Speaker 1: deficiencies and particularly vitamin B twelve. So that is something

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Speaker 1: to really be aware of for anybody who's a vegetarian

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Speaker 1: or vegan, and particularly who's thinking about becoming pregnant, is

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Speaker 1: that you have to supplement with those essential fatty acids,

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Speaker 1: which you can actually get from plant sources, but they

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Speaker 1: are just need to be aware that conversion in the

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Speaker 1: body is pretty poor, so you need eed a bucketload

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Speaker 1: of those from supplements, and you absolutely absolutely have to

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Speaker 1: supplement with vitamin B twelve. So the last thing I

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Speaker 1: wanted to talk about in this So my conclusion overall

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Speaker 1: is it doesn't particularly make that much difference to health

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Speaker 1: outcomes if you are an adult, but there's certainly a

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Speaker 1: significant impact on health outcomes if you're a kid, So

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Speaker 1: just again reiterating the importance of supplementing. And then the

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Speaker 1: last thing that I wanted to talk about was an

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Speaker 1: interesting study that has just come across my dead the

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Speaker 1: one that I just read that actually showed that plant

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Speaker 1: piest diets are thirty four to forty five percent more

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Speaker 1: expensive when trying to meet the same nutritional needs as

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Speaker 1: diets with meats in them. So you know, the question

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Speaker 1: is that are plant piest diets just something for wealthy

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Speaker 1: people and certainly probably not appropriate for third world countries

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Speaker 1: where they get a lot of their nutrients from meat

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Speaker 1: because it is much more nutrient dense, particularly if it

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Speaker 1: is grass fed. So that's just one other thing to

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Speaker 1: take into consideration whenever you are considering your diet. And

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Speaker 1: like I always said, if it's about ethical issues, then

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Speaker 1: knock yourself out, but make sure you're supplement But the

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Speaker 1: meat eaters we should be supplementing as well. So hopefully

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Speaker 1: that gives you a little bit of an insight onto

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Speaker 1: the pros and cons of vegetarian, vegan slash plant based

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Speaker 1: diets and diets that contain meat. That's it. For this

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Speaker 1: time folks. Catch up next time. H