Leptin – The “Fat” Hormone?

If you’re not familiar with leptin, it’s certainly familiar with you. Known by various nicknames, such as the ‘satiety hormone’ or ‘fat hormone’, leptin plays a leading role in daily dietary dramas. But, is it more responsible for over-eating (hyperphagia) and obesity than mere lack of will-power?

What is leptin?

In healthy, non-obese individuals, the hormone leptin controls appetite. After you’ve eaten a meal, this anorexigenic (appetite-suppressing) hormone gets released by adipose tissue (fat cells) and acts on the hypothalamus in the brain to produce a feeling of satiety (fullness) which then suppresses the appetite and (hopefully) stops you from over-eating. It also speeds up your resting metabolism, thereby increasing energy expenditure. 1

This is a pretty sensible mechanism, from an evolutionary point of view, since it would help stop members of our species from getting too fat to be able to run away from sabre-toothed tigers. 2

On the other hand, there were perfectly good reasons why we might have needed to store up as much fat as possible – to get through periods of famine, for instance. 3 This is why there are mechanisms, including the orexigenic (appetite-stimulating) hormone ghrelin (the “hunger hormone“) 4 , which act in the opposite direction from leptin, actively stimulating us to feel hungry. 5

However, evolution wasn’t so good at predicting the appearance of McDonald’s Whoppers or Chocolate Hobnobs. And this is where the problem starts with leptin. If we continue to eat the ‘wrong’ foods, the brain doesn’t realise we’ve actually had enough to eat.

Before looking into a bit more detail about why leptin might not be doing its job properly – evident by the widespread increase in obesity – it’s worth mentioning that other mechanism supposed to help us moderate food intake – namely, stretch receptors in the stomach 6 . If these are supposed to activate as the stomach expands in size, you can see from the above graphic that high-calorie/low-bulk foods will not stretch the stomach as much as low-calorie/high-bulk foods – that is, plant foods which are high in fibre content.

Such foods (mostly processed with high levels of sugar, saturated fat and salt) tend to be high in calories but low in nutrients (such as fibre, vitamins, minerals and phytonutrients). 7 . This is where we come across the differences between toxic hunger and real hunger, as discussed in a previous blog 8 . It’s called “toxic” because it can end up causing us to chronically over-eat and become obese, resulting in all the nasty associated problems like type 2 diabetes, heart disease and various cancers.

Leptin – Animal-Eaters vs Plant-Eaters

So, turning back to leptin, a recent study 9 took a small number of healthy women from three different dietary groups: omnivores, lacto-ovo-vegetarians, and vegans to see if there were any difference in leptin levels between them. What they found was in line with previous studies 10 11 12 , namely: “…people who adopted a vegetarian dietary pattern had lower plasma levels of leptin when compared to the meat consumers.” The mean plasma leptin levels were:

  • omnivores – 7.45 ng/ml
  • lacto-ovo-vegetarians – 3.87 ng/ml
  • vegans – 2.89 ng/ml

Leptin & Obesity

It’s well-established that meat-eaters are more likely than plant-eaters to become obese 13 14 . So, does this mean that meat-eaters don’t have enough leptin to inform their brains that they have eaten enough, and that plant-eaters have too much leptin? Oddly enough, quite the reverse.

Leptin Insensitivity/Resistance

What’s actually happening is that the abundance of swollen fat cells produce so much leptin that the hypothalamus starts to become insensitive and eventually resistant to leptin’s action. Thus, the brain keeps telling the obese individual “You’re still hungry!“. Eating plant-based diets – ideally WFPB diets, since vegan diets can still lead to obesity if they contain loads of junk food 15 – does not result in such fat storage in the body and, hence, leptin continues to do its job without the body getting “fed up of it”…

You’ve probably already drawn a parallel here with leptin resistance/insensitivity – namely, to type 2 diabetes. By definition, T2D is a condition which transitions through a stage where the pancreas still pumps plenty of insulin into the bloodstream, but cells become resistant/insensitive to it 16 .

It’s similar to how taste buds become insensitive to salt and sugar, how one can develop tolerance for cigarettes or alcohol, even though the body is silently screaming.

Do I Need To Increase Leptin levels?

Perhaps the more appropriate question should be “How do I make my body more sensitive to the already high levels of leptin in my body?”

The simplest and healthiest way is likely to be through changing to a plant-based diet. Not only is this likely to clear up any existing problem with leptin resistance, it will also help to reverse a huge range of diseases – including obesity 17 , type 2 diabetes 18 , cardiovascular disease 19 , and even many cancers 20 .

Final thoughts

The above brief analysis has suggested that, A. leptin works best within non-obese bodies and, B. that non-obese bodies are more likely to be inhabited by plant-eaters than by meat-eaters.

We also know that plant-eaters are less likely than omnivores to suffer from metabolic syndrome – a complex of conditions in which triglycerides, total cholesterol, low-density lipoprotein (LDL), blood glucose, blood pressure, waist circumference, and body mass index (BMI) are all increased to seriously unhealthy levels21 .

It’s The Fat!

And much of the problem is simply to do with the amount of fat within the body – not that we grow more fat cells, since we actually retain a reasonably constant number of fat cells throughout adult life 22 , rather the fat cells we have can grow and grow until they’re so stuffed full that they leach fat back into the bloodstream without us even needing to consume any dietary fat – a process known as “reintoxication23 Yuk!

So What About Will-Power?

It’s so easy to think that overweight/obese individuals lack sufficient will-power. However, it may be more likely that they are simply acting in accordance with what their brain is telling them or, rather, what their brain is failing to tell them.

How Do I Know If I’m Leptin Resistant?

It may sound too simple, but – just look in the mirror or see if you can grab a handful of fat around the middle of your body. Basically, there’s a really strong chance that leptin is not doing its job inside you if you are overweight.

How Do I Reverse Leptin Resistance?

I keep hammering away at this…but, all the evidence strongly suggests that the healthiest, most natural and sustainable diet for weight loss, general disease-resistance and healthy longevity is a wholefood plant-based diet. 24 25 . It’s also probably the healthiest for the rest of life on Earth, too 26 .

How about having a go at the short quiz below?


[qsm quiz=18]


References

  1. Waugh, Anne; Grant, Allison. Ross & Wilson Anatomy and Physiology in Health and Illness E-Book (p. 284). Elsevier Health Sciences. Kindle Edition. []
  2. The evolution of body fatness: trading off disease and predation risk. John R. Speakman. []
  3. A Nonadaptive Scenario Explaining the Genetic Predisposition to Obesity: The “Predation Release” Hypothesis. Literature Review. Cell Metabolism 6(1):5-12 · August 2007. []
  4. Ghrelin is the primary hunger hormone. It’s released from your stomach (with smaller amounts being released by the small intestine, pancreas and brain) into the blood and to the brain to stimulate hunger to alert you that you’re hungry. It has many functions throughout your body besides hunger. It also functions within the pleasure/reward centre of the brain, and plays a role in memory formation, immune function, and even sleep. []
  5. Curr Opin Clin Nutr Metab Care. 2013 Nov; 16(6): 619–624. Ghrelin: much more than a hunger hormone. Geetali Pradhan, Susan L. Samson, and Yuxiang Sun. []
  6. Paintal, A. S. (1954). A study of gastric stretch receptors. Their role in the peripheral mechanism of satiation of hunger and thirst. The Journal of Physiology, 126(2), 255–270. []
  7. Health = Nutrient Intake ÷ Calories []
  8. Toxic Hunger vs Real Hunger []
  9. Association between different types of plant-based diets and leptin levels in healthy volunteers. Gogga P, Śliwińska A, Aleksandrowicz-Wrona E, Małgorzewicz S. Acta Biochim Pol. 2019 Feb 15. doi: 10.18388/abp.2018_2725. []
  10. AmbroszkiewiczJ,Laskowska-Klita T,Klemarczyk W (2004) Low se-rum leptin concentration in vegetarian prepubertal children. Rocz Akad Med Bialymst 49: 103–105. []
  11. AmbroszkiewiczJ,Klemarczyk W,Gajewska J,Chełchowska M,Ro-wicka G, Ołtarzewski M, Laskowska-Klita T (2011) Serum concen-tration of adipocytokines in prepubertal vegetarian and omnivorous children. Med Wieku Rozwoj 15: 326–334 []
  12. Kim MH, Bae YJ (2015) Comparative study of serum leptin and insu-lin resistance levels betweenKorean postmenopausalvegetarianandnon-vegetarian women. Clin Nutr Res 4: 175–181. []
  13. Int J Obes (Lond). 2009 Jun; 33(6): 621–628. Meat consumption is associated with obesity and central obesity among US adults. Y Wang and MA Beydoun. []
  14. Vegetarian diets and childhood obesity prevention. Joan Sabaté Michelle Wien. The American Journal of Clinical Nutrition, Volume 91, Issue 5, 1 May 2010, Pages 1525S–1529S. []
  15. Greggs’ Vegan Sausage Rolls – Why Veganism Can Fail []
  16. Every vampire needs an invitation []
  17. CNS: Morbid Obesity Solution: A Long-Term Plant-Based Case Study. Roberta Russell. January 24, 2017. []
  18. J Geriatr Cardiol. 2017 May; 14(5): 342–354. A plant-based diet for the prevention and treatment of type 2 diabetes. Michelle McMacken and Sapana Shah. []
  19. J Geriatr Cardiol. 2017 May; 14(5): 317–320. A plant-based diet and coronary artery disease: a mandate for effective therapy. Caldwell B Esselstyn. []
  20. Surely Foods Can’t Fight Cancer []
  21. RizzoNS,Sabaté J,Jaceldo-Siegl K,Fraser GE (2011) Vegetariandietary patterns are associated with a lower risk of metabolic syn-drome: the adventist health study 2. Diabetes Care 34: 1225–1227. []
  22. NIH RESEARCH MATTERS. May 12, 2008. Fat Cell Numbers in Teen Years Linger for a Lifetime. []
  23. Br J Pharmacol. 2009 Nov; 158(5): 1330–1337. Reintoxication: the release of fat-stored Δ9-tetrahydrocannabinol (THC) into blood is enhanced by food deprivation or ACTH exposure. N Gunasekaran et al. []
  24. Which Diets Work for Weight-Loss? []
  25. Vegetarian Diets and the Risk of Diabetes []
  26. A Sustainable Diet for Our Planet []

Athletic Performance & Physical Damage on Plant-Based Diets

A January 2019 scientific review 1 by Dr Neal Barnard 2 and his team, entitled “Plant-Based Diets for Cardiovascular Safety and Performance in Endurance Sports“, looked at whether endurance athletes, who are at a higher-than-average risk of developing atherosclerosis and myocardial damage, have reduced health risks and improved performance if they eat a plant-based diet. The results are pretty compelling and should be considered by anyone within any age group who engages in regular physical exercise, not just those who undertake endurance sports.

Diet & exercise

It’s well-accepted 3 that diet in general plays a significant role in maintaining the health and improving the performance of athletes. In previous blogs, we looked in some detail at how plant-based diets may improve sports performance and reduce injury 4 5 6 , as well as how options such as the paleo diet 7 and consuming whey products 8 appear to do quite the opposite. Interestingly, and in relation to cancer risk, some research even showed 9 that the blood of a ‘couch potato’ eating a healthier than standard diet is likely to have better cancer-fighting abilities than the blood of someone who exercises regularly and strenuously but eats the standard diet – thus suggesting that diet may play a more significant role in overall health than exercise.

The study covered below deals in more depth with how choosing a plant-based diet can improve athletic performance as well as help avoid, and even reverse, serious and long-term health risks that both athletes and non athletes face.

What the study covers

The study considers that there is sufficient evidence to claim that plant-based regimes can achieve the following:

  • reduce cardiovascular risk factors
    • reverse existing atherosclerotic lesions
  • reduce plasma lipid concentrations, thereby:
    • reduce blood viscosity, and
    • increase tissue oxygenation
  • improve glycaemic control 10
  • reduce body weight (obesity)
  • increase glycogen storage
  • reduce blood pressure
  • reduce oxidative stress
  • reduce inflammation

Individually, or in combination, it’s suggested that the above benefits, which may result from plant-based dietary regimes, both protect the health of the athlete and improve athletic performance. The latter are discussed in more detail below.

Cardiovascular risk & plant-based diets

Studies have shown plant-based dietary patterns have particular benefits for heart health:

  • being able to reverse arterial plaque 11 12 13
  • significantly reducing the likelihood of developing coronary heart disease compared with meat eaters 14

But surely, you’d think, athletes are more or less immune to developing atherosclerosis 15 because of all the exercise they do. However, this has been shown 16 not to be the case. It may seem odd, but it’s been shown in several studies 17 18 19 20 that endurance athletes may have more advanced atherosclerosis and more myocardial damage than sedentary individuals, increasing as periods of sports endurance accumulate and as they age.

Even sudden sports-related sudden cardiac deaths among ostensibly ultra fit athletes have been shown 21 to be more common than you’d think, especially with increased age.

But is it the diet?

Of course, the question has to be answered: “Is the atherosclerosis and myocardial damage caused by the athletic activity itself or by the foods used to fuel it?”

This study considers that when consumption of animal products is increased, perhaps with the hope of supplying increased energy for increased athletic activity, the associated saturated fat and cholesterol (as well as the relative absence of antioxidants and fibre 22 ) may contribute to the atherosclerotic changes.

Atherosclerosis may also narrow arteries in the legs, brain, and other parts of the body which will reduce blood flow and potentially impair performance. This has certainly been shown 23 to be the case with diagnosed peripheral artery disease, and is considered as a factor for athletes with undiagnosed (i.e. subclinical) atherosclerotic disease.

Plant-based diets can address the key factors that cause atherosclerosis, namely:

  • dyslipidemia 24
  • elevated blood pressure
  • elevated body weight, and
  • diabetes

So it would appear that diet is key to protecting heart health and thus for enhancing athletic performance.

Atherosclerosis – exception or norm?

And while one may think that atherosclerotic disease is the exception rather than the rule, studies have shown 25 that in the modern Western world [with its modern Western diet] atherosclerosis can begin early in life, even in the womb.

A study 26 showed that the majority of American children have fatty streaks in the left anterior descending coronary artery by the age of 10 to 14 years.

Autopsies of U.S. soldiers with a mean age of 20.5 years who died in the Korean War showed that 6.4% of them had coronary atherosclerosis 27 .

Autopsies of soldiers with a mean age of 25.9 years who died in the Iraqi wars between 2001 and 2011 showed that 8.5% of them had coronary atherosclerosis 28 .

And it gets worse. In so-called ‘developed’ countries, by the age of 20, ~10% of the population have advanced atherosclerotic lesions in the abdominal aorta, which reduces blood flow and contributes to disc degeneration and lower back pain 29

So, if you’re from a country where the Western diet is the norm (and, of course, you’ve also eaten that diet), you’re very likely predisposed to such risks even before you run your first marathon.

Plasma lipid concentrations & plant-based diets

Diets rich in saturated fat and, to a lesser degree, dietary cholesterol promote dyslipidemia, and dyslipidemia is a major contributor to arterial disease. With dairy products and meat being the leading sources of saturated fat, removing these has predictably been shown 30 to improve plasma lipid profiles.

By including soluble fibre (e.g. oats, beans, barley), almonds, soy protein, and sterol-containing margarines [the latter being something no WFPB advocate would advocate!], it’s been shown 31 that low-density lipoprotein (LDL – the ‘bad’ cholesterol) can be reduced by around 30% in as little as 4 weeks.

It’s also important to point out that trans fats have detrimental effects on plasma lipids and, thus, increase cardiovascular risks 32 33 .

Blood viscosity/tissue oxygenation & plant-based diets

Blood viscosity is a key element in oxygen delivery to the muscles 34 – lowering viscosity improves both blood flow and athletic performance, increasing viscosity does the opposite 35 .

During athletic activity, fluid passing from the bloodstream into the tissues leads to haemoconcentration 36 . This gradual rise in blood viscosity results in progressive loss of tissue oxygenation which, of course in turn, degrades athletic performance 37 .

Diet affects this plasma viscosity. Because plants are typically low in saturated fat and have no cholesterol, plant-based diets are considered 30 38 to reduce plasma lipid concentrations, and hence reduce viscosity.

Reduced blood viscosity also improves tissue oxygenation, thereby potentially improving athletic performance. In one study 39 , brachial artery flow-mediated vasodilation 40 was assessed in a range of diets – low-fat vegetarian, low-carb/high-fat (Atkins), and high-fat (South Beach). The results were that the vegetarian diet improved brachial artery flow-mediated vasodilation compared with the other diets. Basically, the higher the saturated fat intake, the greater the impairment of flow-mediated vasodilation, with arterial compliance being impaired even by a single high-fat meal.

This impairment is not only caused through eating food high in animal fats, added oils appear 41 42 43 44 to have similar effects. The latter studies suggest that animal fats as well as meals made with added oils are harmful for arterial flexibility; on the other hand, they make it clear that there is benefit from consuming meals made from vegetables, grains, legumes, and fruits.

The food choices athletes make affect blood viscosity, arterial diameter, arterial compliance and arterial elasticity. All the latter factors can be expected to affect tissue oxygenation, endurance, and performance.

Glycaemic control & plant-based diets

Plant-based diets are known to boost insulin sensitivity 45 which, as we’ve seen 46 , is important for reducing the risk of type 2 diabetes and improving glycaemic control – a major contributor to atherosclerosis in individuals with diabetes. Indeed, even small amounts of animal food (such as just one cup of non-fat milk) are sufficient to reduce arterial diameter and can thus lead to major changes in blood flow.

Body weight (obesity) & plant-based diets

The risk of developing cardiovascular disease is, naturally, increased by becoming obese. Even when you ditch calorie-counting or portion-control altogether, vegetarian, and especially vegan, diets have been shown 47 to reduce body fat and thereby tackle obesity.

In a previous blog 48 , we looked at how plant-based diets are the easiest (and healthiest) way to lose weight and then maintain an optimal body weight. This study amplifies this point with reference to how plant-based diets are, thus, able to protect the health of athletes and improve athletic performance. This is achieved via a variety of mechanisms, including:

  • the low fat/high fibre content of plant-based diets reduces body fat (thereby reducing atherosclerotic risk and improving performance) 49
  • the reduced energy density of plant-based meals reduces energy intake (you get fuller quicker on less calories, partly because of the higher proportion of fibre in plants that doesn’t exist in animal-foods)
  • postprandial energy expenditure is shown 45 50 to be positively influenced by plant-based diets – possibly via changes in mitochondrial activity 51
  • the indirect effects of gut microbiome on cellular metabolism have been shown 52 to be negatively affected by a high-fat diet (such as is the norm with a meat-based diet) and positively affected by a low-fat diet (such as is the norm with a plant-based diet), partly through protecting the intestinal barrier and preventing the production of endotoxins which can then enter the bloodstream and, in turn, negatively influence cellular metabolism
  • plant-based (vegan more than vegetarian) diets have been shown 53 54 to increase sub-maximal/maximal aerobic capacity/endurance and reduce atherosclerotic/metabolic risk through eliminating excess body fat and, thereby, increasing max VO2 55 . This is important since it’s known 56 57 that an athlete with a higher VO2 max relative to their body weight will have better endurance and will outperform an athlete with a lower value, and that the effect of diet on VO2 max has a significant effect 58

Glycogen storage & plant-based diets

It’s known 59 that individuals who start plant-based diets typically increase intake of healthy carbohydrates (the primary energy source during moderate/high-intensity aerobic exercise) and it’s been shown 60 that endurance is enhanced by high-carbohydrate intake, not just immediately before athletic events, but also over the long term.

Blood pressure & plant-based diets

We’ve looked previously 61 at how the risk of atherosclerotic conditions reduces as blood pressure is reduced. This is good news for those on a plant-based diet, since both vegan and vegetarian diets have been shown 62 to reduce systolic and diastolic blood pressure. Reduced blood pressure is associated with three other ‘side-effects’ of a (healthy) plant-based diet:

  • a reduction in blood viscosity
  • an increase in blood potassium, and
  • a reduction in body weight

Oxidative stress & plant-based diets

When you exercise, your muscle tissue gets ‘damaged’ and produces reactive oxygen species (free radicals), partly as a result of the normal function of mitochondria and other intracellular organelles 63 64 . When your body is overwhelmed by these free radicals, and it can no longer neutralise them, the result is called oxidative stress.

This oxidative stress, in turn, boosts antioxidant defences and immune responses 65 66 .

If the amount of free radicals greatly exceeds the neutralising abilities of these defences, the following can occur 67 :

  • DNA damage – leading to mutations
  • plasma lipid damage – leading to atherosclerosis
  • protein damage – leading to cell damage and accelerated aging
  • muscle fatigue
  • reduced athletic performance
  • impaired recovery

How can being plant-based help?

When the physiological responses of omnivores and vegans/vegetarians were compared, it was found that vegans and vegetarians have increased antioxidant activity, due to:

  • higher intakes of beta-carotene (the precursor of vitamin A), vitamin C, vitamin E, and other antioxidants 68
  • higher antioxidant enzyme production 69

Whilst it’s the combination of plant foods that’s important, specific antioxidant foods have been found to have potentially beneficial effects, including:

  • beets 70 71
  • allium vegetables (e.g. onions, garlic, and leeks) 72
  • cherry juice 73

Inflammation & plant-based diets

Plant-based diets have been shown 74 to be helpful in reducing inflammation. This may be due to the following effects produced by plant consumption:

  • reduction in serum concentrations of C-reactive protein (a marker of inflammation)
  • increased antioxidant content
  • absence of products that may be inflammatory or sensitising [animal & processed food products]
  • absence of pro-inflammatory fats [mostly found in animal foods]

Again, whilst a healthy variety of plant foods provides the ideal diet, some studies have identified particularly high antioxidant ability within specific foods, including:

  • blackcurrants 75
  • blueberries76
  • pomegranates 77
  • tart cherries 78
  • watermelon 79

The above are all thought to decrease post-exercise inflammation and facilitate recovery.

Red meat & inflammation

A major study showed 80 that, as total red meat consumption increased, the following also increased:

  • C-reactive protein (a marker of inflammation)
  • haemoglobin A1c (an indicator of glycaemic control – raised blood sugar levels), and
  • stored iron (an excess of iron [specifically haem iron 81 ] is associated with heart disease, cancer, and diabetes)

Arthritis & plant-based diets

It used to be thought that osteoarthritis was attributable to simple “wear and tear”; however, it’s now known 82 that there’s an important inflammatory component which is aggravated by diabetes and by being overweight.

And it’s not just osteoarthritis that’s affected by diet – psoriatic arthritis 83 and many other similar conditions are also now known to be manifestations of inflammatory processes.

In one major ongoing study 84 , people who ate meat even once a week had higher levels of both degenerative arthritis and soft tissue disorders than individuals who avoided meat altogether.

A number of studies 85 86 87 88 89 on people suffering from rheumatoid arthritis have shown that changing to vegan and vegetarian diets can reduce C-reactive protein, as well as both subjective and objective signs of arthritis.

Whilst vegan diets, in particular, have been shown 90 91 92 to have anti-inflammatory effects by reducing C-reactive protein in patients with and without coronary artery disease.

Protein & plant-based diets

The usual red herring about plant-based diets being compromised in terms of protein and/or complete amino acid provision has been covered in considerable detail in previous blogs 93 94 ; however, it’s worth pointing out the following:

  • changing to plant-based has been shown 95 to provide an immediate improvement in nutrition levels (partly because fruits, vegetables, beans, and whole grains tend to be high in vitamins, minerals, and fibre, very low in saturated fat, and devoid of cholesterol)
  • pretty much every endurance athlete tested 96 met recommended protein intake
  • a varied plant-based diet is known 59 to easily provide adequate amounts of all essential amino acids for athletes

Calcium & plant-based diets

Another fallacy, addressed in previous blogs 97 98 , is that plant-based diets, because they don’t contain cow’s milk, will lack sufficient bone-building calcium for athletes and others.

However, calcium is abundant in many plant foods, especially green leafy vegetables and legumes 99 .

Iron and plant-based diets

As mentioned above, plants contain non-haem iron, which is considered to be a healthier form of iron than the haem iron in animal foods. It may come as a surprise that iron intake is often higher in those who eat plant-based diets than in those who eat meat-containing diets, with serum ferritin levels being typically within the normal range 100 . This is because of the large iron content of green vegetables and legumes. However, iron storage tends to be lower – a good thing since you don’t want rust inside your body! 101 102

Vitamin B12 & plant-based diets

Vitamin B12, covered in previous blogs 103 104 105 , is another area where confusion reigns. Whilst, of course, B12 is absolutely vital for nerve function and blood cell formation, and must be supplemented when on a plant-based diet 59 , B12 deficiency/insufficiency is surprisingly common throughout whole populations, regardless of their dietary regime. Thus, it’s advisable for everyone, particularly as we age 106 , to take B12 supplementation.

Study conclusions

Plant-based diets play a key role in cardiovascular health, which is critical for endurance athletes…and, as part of a healthful lifestyle, have been shown to reverse atherosclerosis. The possibility that such diets may also contribute to improved performance and accelerated recovery in endurance sports is raised by their effects on blood flow, body composition, antioxidant capacity, systemic inflammation, and glycogen storage. These attributes provide a scientific foundation for the increased use of plant-based diets by endurance athletes.

Final thoughts

When we looked at obesity and plant-based diets above, it was pointed out that calorie-counting and portion-control were not needed in order to reduce body fat and, thereby, reduce body weight and avoid the risk of becoming obese. In relation to this, there was a BBC documentary 107 recently by Hugh Fearnley-Whittingstall at the end of which he drew the unfortunate (in my opinion) conclusion that, whilst calorie-counting was not the way to go, the best way to keep the weight down was to apply strict control to portion size.

I tend to disagree with this approach. Just as it’s been shown that calorie-counting 108 and exercise alone 109 are ineffective means of maintaining a healthy body weight, I suspect that, in spite of some studies’ somewhat optimistic conclusions 110 , portion-control (or portion-sizing) is also a dietary method destined to fail in most cases 111 , albeit that it’s a whole lot better than doing nothing at all.

When you eat a non-SOS WFPB diet, you never need to worry about how many calories you are eating nor about what size your plate is. The very nature of the food itself will be regulated by your body’s appetite and requirement for nutrients, whether or not you’re an Olympic athlete.

Ever seen anyone becoming overweight who consistently eats a WFPB diet? If you do, let me know, since I haven’t come across one yet…


References

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  10. Glycaemic control involves the regulation and maintenance of blood glucose levels within normal ranges, and is the aim of the treatment of diabetes mellitus. Long-term glycaemic control reduces later incidence of secondary diabetic complications []
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A Sustainable Diet for Our Planet

An October 2018 study 1 entitled “Health and nutritional aspects of sustainable diet strategies and their association with environmental impacts: a global modelling analysis with country-level detail” has just been published in the Lancet. Will the findings show that there is any health/environmental benefit if populations around the world transitioned from an animal-based to a plant-based diet? Let’s find out…

Study background

There are considerable concerns about the negative impact that current trends in food production and consumption are having on human health and the environment we live in – including, of course, all the other species that share this planet with us. Thus, there’s increasing pressure to find sustainable diets that can address these issues.

This study looks at more than 150 countries, and examines the following four different diets:

  • flexitarian
    • no processed meat, small amounts of red meat (one serving per week), moderate amounts of other animal-source foods (poultry, fish, and dairy), and generous amounts of plant-based foods (fruits, vegetables, legumes, and nuts)
  • pescatarian
    • meat replaced with two-thirds fish and seafood and a third fruits and vegetables
  • vegetarian
    • meat replaced with two-thirds legumes and a third fruits and vegetables
  • vegan
    • all animal-source foods replaced with two-thirds legumes and a third fruits and vegetables

Study methods

To produce the wide-reaching global model they required, the researchers combined analyses of:

  • nutrient levels
  • diet-related chronic disease mortality
  • weight-related chronic disease mortality
  • general environmental impacts

They focused on three major objectives:

  • environmental
    • replacing 25-100% of animal-source foods with plant-based foods
  • food security
    • reducing levels of underweight, overweight, and obesity by 25-100%
  • public health
    • analysing the above-mentioned four dietary patterns (flexitarian, pescatarian, vegetarian, and vegan)

Their analyses took into account:

  • required nutrient content and sufficiency of supply
  • changes in mortality based on predicted changes in diet- and weight-related risk
  • country-specific and food group-specific footprints for:
    • greenhouse gas emissions
    • cropland use
    • freshwater use
    • nitrogen application
    • phosphorus application

These would help to analyse the relationship between the health and environmental impacts of any given dietary change.

Study findings

Replacing animal-sourced foods with plant-based ones was predicted to result in the following:

  • there would be an improvement in nutrient levels, particularly in high-income countries
  • premature mortality would be greatly reduced (more for a vegan than for a flexitarian diet)
  • a range of environmental impacts would reduce
    • for instance, greenhouse gas emissions could be reduced by up to 84%
  • freshwater use would:
    • increase by up to 16% if everyone ate a completely meat-free diet
    • reduce by 2-11% if meat-consumption was reduced greatly where it was energy-efficient to do so
  • nitrogen application could reduce by 23-25%
  • phosphorus application could reduce by 18-21%
  • cropland use could reduce by 8-11%
  • freshwater use could reduce by 2-11%

Study conclusion

A public health strategy focused on improving energy balance and dietary changes towards predominantly plant-based diets that are in line with evidence on healthy eating is a suitable approach for sustainable diets.

Final thoughts

Whilst this extensive study came up with the sort of conclusion most of us would expect, there are a few anomalies.

Firstly, the researchers consider that a meat-reduced diet would reduce greenhouse gases slightly more than a completely meat-free diet. I think this might in part be due to an increased need for transportation of plant-foods to areas where growing plants was not possible.

Secondly, the increased use of freshwater for completely meat-free diets, compared with largely meat-free diets where it is energy-efficient to do so, might be because eating fish and crustacea, where they are easily available, is more efficient than planting crops or having crops transported to the population concerned. This may also apply to areas where hunting wild animals, rather than planting crops, would have some energy-saving benefit.

Thirdly, in this study, there appears to be little recognition of the many negative effects of a meat-based diet on human health (and, of course, on the health of other species, not least the animals that act as our food). The harms to human health that animal foods produce, and which plant foods do not, is not mentioned in this study.

The authors’ final words are: “Finding effective combinations of policies and approaches that consider local characteristics will be essential for successfully upscaling initiatives and achieving reductions in the health and environmental burden at the population level and globally.

This may be taking into account those places where it is either impossible or impractical to grow crops 2 compared with either eating sea food, hunting wild animals or keeping some form of livestock that can exist on land that humans could not cultivate. This may account for the above findings related to the greater freshwater usage and slightly lower reductions in greenhouse gases if everyone adopted a completely meat-free diet.


References

  1. Lancet Planet Health. 2018 Oct;2(10):e451-e461. doi: 10.1016/S2542-5196(18)30206-7.
    Health and nutritional aspects of sustainable diet strategies and their association with environmental impacts: a global modelling analysis with country-level detail. Springmann M, Wiebe K, Mason-D’Croz D, Sulser TB, Rayner M, Scarborough P. []
  2. The main physical factors that make agriculture possible or impossible are: Climate. Some crops grow better in one climatic zone than in others. In general, plants cannot grow in areas with very high temperatures (above 45°C) or very low ones (below 10°C). They cannot grow in areas with too little rain or too much rain. Landscape. Relief (altitude and the gradient of terrain) influences agricultural activity. At higher altitudes, temperatures descend, and this limits species development. Gradients of terrain above 10° make it impossible to cultivate the land. Consequently, agriculture usually takes place on plains or in valleys. However, where it is necessary, hard work can transform mountain sides into cultivated terraces. Soil. Plants need soil with certain characteristics. The grain size and porosity of the soil affect the amount of oxygen the soil contains, and its ability to retain water. The chemical and biological composition of soil determines its degree of acidity, the quantity of mineral nutrients, and available organic matter. []

What’s the Psychology of Plant-Eaters?

A September 2018 review 1 , by Daniel L Rosenfeld from Cornell University Department of Development 2 , looked at the advances and possible future directions of research into the interesting subject of the psychology of vegetarians.

Daniel L Rosenfeld, Cornell University

I bet it’s not something you thought there would be much written about – and you’d be wrong (see huge list of books and publications at end of blog). So, assuming that plant-eaters are not all simply bonkers for giving up bacon sandwiches and succulent southern fried chicken, what does research tell us about those who are often regarded as preferring to eat “rabbit food“?

Main topics

Rosenfeld refers to a 2012 review 3 which highlighted seven main topics that are covered when looking into this field:

  • dietary variations of vegetarianism
  • vegetarians’ motivations
  • attitudes toward meat
  • vegetarians’ and omnivores’ values and worldviews
  • differences between vegetarians’ and omnivores’ well-beings
  • perceptions of vegetarians and omnivores
  • links between gender, vegetarianism, and meat consumption

It was pointed out that there’s a lot of subjectivity when discussing vegetarians since there’s no generally-accepted definition of what one is! Additionally, confusion can be caused because some people call themselves vegetarians when they actually eat meat on occasion, and vegetarians vary substantially in terms of which animal products they will or will not eat.

Motivation

There’s also variation in the motivations that vegetarians have for their dietary choices. These generally include:

  • personal health
  • concerns about animal cruelty
  • concerns about the environment
  • religion
  • taste (e.g. “I avoid meat because it disgusts me.“)

Worldview

The latter research 3 also mentions that there are differences between vegetarians’ and omnivores’ values and worldviews. Compared with omnivores, vegetarians tend to be:

  • more politically liberal
  • more empathetic
  • more opposed to capital punishment

And further differences exist between vegetarians and vegans, with vegans exhibiting stronger beliefs about:

  • meat consumption
  • animal welfare
  • environmental issues

Gender

The review 3 also looked at differences between women’s and men’s vegetarian views. Men generally seem to differ from women in the following ways:

  • men view meat as a more essential part of a proper diet
  • men eat more meat than women
  • men express fewer concerns about the effects of meat consumption on animals
  • men express fewer concerns about the effects of meat consumption on the environment

This is consistent with the fact that women are more likely to be vegetarian than are men.

Research explosion

Since the above-mentioned 2012 review by Ruby, there’s been an explosion of research into the psychology of vegetarianism. And while the general areas of research fit within the above 7 groupings, there’s been a widening and deepening of the analysis. So, for instance, regarding the differences in political outlooks and worldviews between omnivores and vegetarians, a lot more detail is now known about more specific variations in attitude.

This can be seen in the differences between veganism and other forms of vegetarianism. A 2017 study 4 found that vegans were approximately 15 times more likely to be politically liberal than conservative.

Furthermore, recent research 5 6 into the relationship between meat consumption and right-wing ideology (including right-wing authoritarianism, social dominance orientation and general conservatism) suggests that:

  • omnivores exhibit greater right-wing authoritarianism than vegetarians
  • omnivores exhibit greater and social dominance orientation than vegetarians
  • omnivores exhibit greater conservatism than vegetarians

From vegetarian back to meat-eater

A 2018 study 7 revealed an interesting detail about how conservatism predicts a greater likelihood of returning to eating meat after having been vegetarian. This is largely explained by lower feelings of social support and weaker social justice motivations (that is, less concern about animal welfare, the environment, and world hunger) when more conservative individuals initially decided to eschew meat.

Views about vegetarians

A 2017 8 and 2018 study 9 both revealed that people who endorse right-wing ideology also tend to exhibit more negative attitudes toward vegetarians and vegetarianism in general.

Charity and pets

It’s not just political orientation that seems to vary between the two groups, moral attitudes and behaviours beyond political orientation also appear to differ between vegetarians and omnivores.

A 2015 study 10 revealed the following differences:

  • vegetarians are more concerned about animal welfare than omnivores
  • vegetarians donate more money to animal-oriented charities than omnivores
  • vegetarians emphasise the moral foundation of animal harm/care more strongly than omnivores

A 2014 11 and 2018 study 12 suggested that interacting with a pet during childhood may shape one’s moral values and eating behaviours later in life. Specifically, children who own a variety of pets or become emotionally attached to a pet tend to eat less meat in adulthood. This may be attributed to their greater feelings of empathy toward animals and greater moral opposition to animal exploitation.

Further research

The foregoing is merely a taste of the range of research currently taking place in this interesting field of study. Future research will be really interesting if it deals with some of the following areas:

  • how people revise their moral values after altering their dietary habits
  • whether veganism associates with certain moral/political values to greater extents than do other forms of vegetarianism
  • the effect on food choices of different political-ideology norms across various geographical and cultural regions
  • given that health, animal welfare and the environment are shown to be the three main motivators in becoming vegetarian, it would be interesting to know which of these would be the best predictor of continuing to eat a plant-based diet
  • variations in attitude and behaviour of individuals adhering to a WFPB diet, as compared to both a vegan and a vegetarian diet
  • changes in a person’s outlook and motivation for being plant-based from when they first made the dietary change and throughout their life
  • how vegetarians with varying types of health motivations (e.g. general wellness, weight maintenance, recently having had a life-threatening health event or diagnosis) may differ from one another
  • identification of the extents to which greater emphases on harm/care, animal welfare, and liberal values are causal of and/or caused by the decision to eschew meat
  • an examination of how omnivores view vegetarians with different motivations – looking at the roles of cognitive dissonance, social comparison, social norms, and power dynamics in attitude formation

Again, these are just some of the possible areas of future research.

Final thoughts

I suppose it’s no surprise that there’s an increasing amount of research into the psychology of those who choose to eat plants instead of animals; after all, we spend hours every day of our life planning, talking about, and eating meals, and the media are covering more and more stories about how our dietary choices are affecting both human health and the health of the world we live in.

It’s hard to deny, merely from my own experience, that we hold on to our familial and cultural food habits like a drunk does his last bottle – and we are pretty much all just as reluctant as he is to accept criticism about, or to let go of, our acquired preferences about what we can/cannot or should/should not put into our stomachs.

It doesn’t seem so strange that those brought up on a plant-based diet from birth may have a different attitude towards their dietary choices than those who made the personal decision to move from eating animals to plants. Equally, it’s probably no surprise that those who choose to disavow all animal products for reasons other than personal health or dietary preferences (that is, because they are concerned about the environment and/or animal cruelty) are likely to have wider-reaching and stronger views on the veggie subject.

In my own experience, there do appear to be some psychological changes that parallel dietary changes. Being that we are basically animals with big brains, and that the body-brain system is inextricably linked together, what would be strange would be if there were no psychological changes when our bodies and brains are receiving a different class of dietary nutrients – and this is apart from those changes that would derive from alterations in philosophical outlook.

Appendix: Just some of the literature relating to the psychology of vegetarians

Adams, C. (1990). The sexual politics of meat: A feminist vegetarian critical theory. New York, NY: Continuum.

Agarwal, U., Mishra, S., Xu, J., Levin, S., Gonzales, J., & Barnard, N. D. (2015). A multicenter randomized controlled trial of a nutrition intervention program in a multiethnic adult population in the corporate setting reduces depression and anxiety and improves quality of life: The GEICO study. American Journal of Health Promotion, 29, 245-254.

Allès, B., Baudry, J., Méjean, C., Touvier, M., Péneau, S., Hercberg, S., & Kesse-Guyot, E. (2017). Comparison of sociodemographic and nutritional characteristics between selfreported vegetarians, vegans, and meat-eaters from the Nutrinet-Sante study. Nutrients, 9, 1023.

Anderson, E. C., Wormwood, J. B., Barrett, L., & Quigley, K. (2018). Vegetarians’ and omnivores’ affective and physiological responses to food. Food Quality and Preference, 71, 96-105.

Apostolidis, C., & McLeay, F. (2016). It’s not vegetarian, it’s meat-free! Meat eaters, meat reducers and vegetarians and the case of Quorn in the UK. Social Business, 6, 267-290.

Arbit, N., Ruby, M., & Rozin, P. (2017). Development and validation of the meaning of food in life questionnaire (MFLQ): Evidence for a new construct to explain eating behavior. Food Quality and Preference, 59, 35-45.

Arora, A. S., Bradford, S., Arora, A., & Gavino, R. (2017). Promoting vegetarianism through moralization and knowledge calibration. Journal of Promotion Management, 23, 889-912.

Asanova, A. (2017). Vegetarian diet as a risk factor for depression. Psychosomatic Medicine and General Practice, 2, e020490-e020490.

Barthels, F., Meyer, F., & Pietrowsky, R. (2018). Orthorexic and restrained eating behaviour in vegans, vegetarians, and individuals on a diet. Eating and Weight Disorders – Studies on Anorexia, Bulimia and Obesity, 23, 159-166.

Beardsworth, A. D., & Keil, E. T. (1991). Vegetarianism, veganism, and meat avoidance: Recent trends and findings. British Food Journal, 93, 19-24.

Beardsworth, A. D., & Keil, E. T. (1992). The vegetarian option: Varieties, conversions, motives and careers. The Sociological Review, 40, 253-293.

Beezhold, B., Radnitz, C., Rinne, A., & DiMatteo, J. (2015). Vegans report less stress and anxiety than omnivores. Nutritional Neuroscience, 18, 289-296.

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Bilewicz, M., Imhoff, R., & Drogosz, M. (2011). The humanity of what we eat: Conceptions of human uniqueness among vegetarians and omnivores. European Journal of Social Psychology, 41, 201-209.

Campbell T. C., & Campbell T. M. (2006). The China Study: The most comprehensive study of nutrition ever conducted and the startling implications for diet, weight loss and long-term health. Dallas, TX: Benbella Books.

Caviola, L., Everett, J. A., & Faber, N. S. (2018). The moral standing of animals: Towards a psychology of speciesism. Journal of Personality and Social Psychology. doi:10.1037/pspp0000182.

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Chuter, R. (2018). Finding companionship on the road less travelled: A netnography of the Whole Food Plant-Based Aussies Facebook group (Bachelor’s thesis, Edith Cowan University).

Cliceri, D., Spinelli, S., Dinnella, C., Prescott, J., & Monteleone, E. (2018). The influence of psychological traits, beliefs and taste responsiveness on implicit attitudes toward plantand animal-based dishes among vegetarians, flexitarians and omnivores. Food Quality and Preference, 68, 276-291.

Cole, M., & Morgan, K. (2011). Vegaphobia: Derogatory discourses of veganism and the reproduction of speciesism in UK national newspapers. The British Journal of Sociology, 62, 134-153.

Corrin, T., & Papadopoulos, A. (2017). Understanding the attitudes and perceptions of vegetarian and plant-based diets to shape future health promotion programs. Appetite, 109, 40-47.

Cramer, H., Kessler, C. S., Sundberg, T., Leach, M. J., Schumann, D., Adams, J., & Lauche, R. (2017). Characteristics of Americans choosing vegetarian and vegan diets for health reasons. Journal of Nutrition Education and Behavior, 49, 561-567.

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Dagevos, H., & Voordouw, J. (2013). Sustainability and meat consumption: Is reduction realistic?. Sustainability: Science, Practice, & Policy, 9, 60-69.

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De Backer, C. J., & Hudders, L. (2014). From meatless Mondays to meatless Sundays: motivations for meat reduction among vegetarians and semi-vegetarians who mildly or significantly reduce their meat intake. Ecology of Food and Nutrition, 53, 639-657.

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de Boer, J., Schösler, H., & Aiking, H. (2017). Towards a reduced meat diet: Mindset and motivation of young vegetarians, low, medium and high meat-eaters. Appetite, 113, 387-397.

DeLessio-Parson, A. (2017). Doing vegetarianism to destabilize the meat-masculinity nexus in La Plata, Argentina. Gender, Place & Culture, 24, 1729-1748.

Derbyshire, E. J. (2017). Flexitarian diets and health: A review of the evidence-based literature. Frontiers in Nutrition, 3, 55.

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Dyett, P. A., Sabaté, J., Haddad, E., Rajaram, S., & Shavlik, D. (2013). Vegan lifestyle behaviors. An exploration of congruence with health-related beliefs and assessed health indices. Appetite, 67, 119-124.

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Edwards, S. (2013). Living in a minority food culture: A phenomenological investigation of being vegetarian/vegan. Phenomenology & Practice, 7, 111-125.

Ensaff, H., Coan, S., Sahota, P., Braybrook, D., Akter, H., & McLeod, H. (2015). Adolescents’ food choice and the place of plant-based foods. Nutrients, 7, 4619-4637.

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Fiestas-Flores, J., & Pyhälä, A. (2017). Dietary motivations and challenges among animal rights advocates in Spain. Society & Animals. doi:0.63/5685306-34484.

Filippi, M., Riccitelli, G., Falini, A., Di Salle, F., Vuilleumier, P., Comi, G., & Rocca, M. A. (2010). The brain functional networks associated to human and animal suffering differ among omnivores, vegetarians and vegans. PLoS One, 5, e10847.

Filippi, M., Riccitelli, G., Meani, A., Falini, A., Comi, G., & Rocca, M. A. (2013). The “vegetarian brain”: chatting with monkeys and pigs?. Brain Structure and Function, 218, 1211-1227.

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Fox, N., & Ward, K.J. (2008a). Health, ethics and environment: a qualitative study of vegetarian motivations. Appetite, 50, 422-429.

Fox, N., & Ward, K. J. (2008b). You are what you eat? Vegetarianism, health and identity. Social Science & Medicine, 66, 2585-2595.

Gallimore, T. E. (2015). Understanding the reasons for and barriers to becoming vegetarian in prospective vegetarians and vegans (Doctoral dissertation, McGill University).

Gilsing, A. M., Weijenberg, M. P., Goldbohm, R. A., Dagnelie, P. C., van den Brandt, P. A., & Schouten, L. J. (2013). The Netherlands Cohort Study–Meat Investigation Cohort: A population-based cohort over-represented with vegetarians, pescetarians and low meat consumers. Nutrition Nournal, 12, 156.

Goffman, E. (1963). Stigma: Notes on a spoiled identity. New York, NY: Simon & Schuster. Graça, J., Calheiros, M. M., & Oliveira, A. (2015). Attached to meat? (Un)Willingness and intentions to adopt a more plant-based diet. Appetite, 95, 113-125.

Graça, J., Calheiros, M. M., & Oliveira, A. (2016). Situating moral disengagement: Motivated reasoning in meat consumption and substitution. Personality and Individual Differences, 90, 353-364.

Greenebaum, J. B. (2012a). Managing impressions: “Face-saving” strategies of vegetarians and vegans. Humanity & Society, 36, 309-325.

Greenebaum, J. (2012b). Veganism, identity and the quest for authenticity. Food, Culture & Society, 15, 129-144.

Greenebaum, J., & Dexter, B. (2017). Vegan men and hybrid masculinity. Journal of Gender Studies. doi:10.1080/09589236.2017.1287064.

Hartmann, C., Ruby, M. B., Schmidt, P., & Siegrist, M. (2018). Brave, health-conscious, and environmentally friendly: Positive impressions of insect food product consumers. Food Quality and Preference, 68, 64-71.

Haverstock, K., & Forgays, D. K. (2012). To eat or not to eat. A comparison of current and former animal product limiters. Appetite, 58, 1030-1036.

Hayley, A., Zinkiewicz, L., & Hardiman, K. (2015). Values, attitudes, and frequency of meat consumption. Predicting meat-reduced diet in Australians. Appetite, 84, 98-106.

Heiss, S., Coffino, J. A., & Hormes, J. M. (2017). Eating and health behaviors in vegans compared to omnivores: Dispelling common myths. Appetite, 118, 129-135.

Heiss, S., & Hormes, J. M. (2018). Ethical concerns regarding animal use mediate the relationship between variety of pets owned in childhood and vegetarianism in adulthood. Appetite, 123, 43-48.

Hibbeln, J. R., Northstone, K., Evans, J., & Golding, J. (2018). Vegetarian diets and depressive symptoms among men. Journal of Affective Disorders, 225, 13-17.

Hirschler, C. A. (2011). “What pushed me over the edge was a deer hunter”: Being vegan in North America. Society & Animals, 19, 156-174.

Hodson, G., & Earle, M. (2018). Conservatism predicts lapses from vegetarian/vegan diets to meat consumption (through lower social justice concerns and social support). Appetite, 120, 75-81.

Hoffman, S. R., Stallings, S. F., Bessinger, R. C., & Brooks, G. T. (2013). Differences between health and ethical vegetarians. Strength of conviction, nutrition knowledge, dietary restriction, and duration of adherence. Appetite, 65, 139-144.

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Janssen, M., Busch, C., Rödiger, M., & Hamm, U. (2016). Motives of consumers following a vegan diet and their attitudes towards animal agriculture. Appetite, 105, 643-651.

Joy, M. (2009). Why we love dogs, eat pigs and wear cows: An introduction to carnism. San Francisco, CA: Conari Press.
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Mullee, A., Vermeire, L., Vanaelst, B., Mullie, P., Deriemaeker, P., Leenaert, T., … & Huybrechts, I. (2017). Vegetarianism and meat consumption: A comparison of attitudes and beliefs between vegetarian, semi-vegetarian, and omnivorous subjects in Belgium. Appetite, 114, 299-305.

Mycek, M. K. (2018). Meatless meals and masculinity: How veg* men explain their plant-based diets. Food and Foodways, 1-23. doi:10.1080/07409710.2017.1420355.

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Rosenfeld, D. L., (2018a). A comparison of dietarian identity profiles between vegetarians and vegans. Manuscript submitted for publication.

Rosenfeld, D. L., (2018b). A comparison of omnivores who are open to becoming vegetarian with those who are not. Manuscript submitted for publication.

Rosenfeld, D. L., (2018c). Why some choose the vegetarian option: Are all ethical motivations the same? Manuscript submitted for publication.

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Rosenfeld, D. L., & Burrow, A. L. (2017b). Vegetarian on purpose: Understanding the motivations of plant-based dieters. Appetite, 116, 456-463.

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Rosenfeld, D. L., & Burrow, A. L. (2018b). Vegetarianism and beyond: Investigating how people construe meat avoidance. Manuscript submitted for publication.

Rothgerber, H. (2012). Real men don’t eat (vegetable) quiche: Masculinity and the justification of meat consumption. Psychology of Men & Masculinity, 14, 363-375.

Rothgerber, H. (2013). A meaty matter. Pet diet and the vegetarian’s dilemma. Appetite, 68, 76-82.

Rothgerber, H. (2014a). A comparison of attitudes toward meat and animals among strict and semi-vegetarians. Appetite, 72, 98-105.

Rothgerber, H. (2014b). Efforts to overcome vegetarian-induced dissonance among meat eaters. Appetite, 79, 32-41.

Rothgerber, H. (2014c). Evaluation of ingroup disloyalty within a multigroup context. Social Psychology, 45, 382-390.

Rothgerber, H. (2014d). Horizontal hostility among non-meat eaters. PLOS ONE, 9, e96457.

Rothgerber, H. (2014e). Carnivorous cats, vegetarian dogs, and the resolution of the vegetarian’s dilemma. Anthrozoös, 27, 485-498.

Rothgerber, H. (2015a). Can you have your meat and eat it too? Conscientious omnivores, vegetarians, and adherence to diet. Appetite, 84, 196-203.

Rothgerber, H. (2015b). Underlying differences between conscientious omnivores and vegetarians in the evaluation of meat and animals. Appetite, 87, 251-258.

Rothgerber, H. (2017). Attitudes toward meat and plants in vegetarians. In F. Mariotti (Ed.), Vegetarian and Plant-Based Diets in Health and Disease Prevention (pp. 11-35). London, UK: Academic Press.

Rothgerber, H., & Mican, F. (2014). Childhood pet ownership, attachment to pets, and subsequent meat avoidance. The mediating role of empathy toward animals. Appetite, 79, 11-17.

Rozin, P., Hormes, J. M., Faith, M. S., & Wansink, B. (2012). Is meat male? A quantitative multimethod framework to establish metaphoric relationships. Journal of Consumer Research, 39, 629-643.

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Ruby, M. B. (2012). Vegetarianism. A blossoming field of study. Appetite, 58, 141-150.

Ruby, M. B., Alvarenga, M. S., Rozin, P., Kirby, T. A., Richer, E., & Rutsztein, G. (2016). Attitudes toward beef and vegetarians in Argentina, Brazil, France, and the USA. Appetite, 96, 546-554.

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Ruby, M. B., & Heine, S. J. (2011). Meat, morals, and masculinity. Appetite, 56, 447-450.

Ruby, M. B., & Heine, S. J. (2012). Too close to home. Factors predicting meat avoidance. Appetite, 59, 47-52.

Ruby, M. B., Heine, S. J., Kamble, S., Cheng, T. K., & Waddar, M. (2013). Compassion and contamination. Cultural differences in vegetarianism. Appetite, 71, 340-348.

Schösler, H., de Boer, J., Boersema, J. J., & Aiking, H. (2015). Meat and masculinity among young Chinese, Turkish and Dutch adults in the Netherlands. Appetite, 89, 152-159.

Sedupane, G. (2017). A qualitative study exploring the experiences of Black South African vegetarians residing in the urban settings of Cape Town (Master’s thesis, University of Western Cape.

Singer, P., & Mason, J. (2006). The ethics of what we eat: Why our food choices matter. Melbourne: Text Publishing.

Sneijder, P., & Te Molder, H. (2009). Normalizing ideological food choice and eating practices. Identity work in online discussions on veganism. Appetite, 52, 621-630.

Sobal, J. (2005). Men, meat, and marriage: Models of masculinity. Food and Foodways, 13, 135-158.

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Vegetarian Diets and the Risk of Diabetes

A September 2018 review 1 looked at whether the dramatic worldwide increase in cases of type 2 diabetes (T2DM – type 2 diabetes mellitus) could be slowed down if individuals made simple dietary changes rather than seeking solutions through medication.

Summary

The reviewers note that vegetarian diets are inversely associated with risk of developing diabetes, and this is independent of the positive association of meat consumption with diabetes development.

Range of diets

Vegetarian diets range* from:

  • vegan (no animal products)
  • lacto-ovo-vegetarian (no animal meat, but consumes milk and eggs)
  • pesco-vegetarian (consumes fish)
  • semi-vegetarian/flexitarian (occasional meat consumption)

*N.B. This review does not look at WFPB or non-SOS WFPB diets.

The most important aspects of any of these types of diets is the emphasis on:

  • whole grains
  • fruits and vegetables
  • legumes
  • nuts
  • reduction of saturated and trans fats

Problem – what problem?

Oh there’s a big problem, alright. Diabetes has now reached epidemic levels, with an estimated 451 million cases worldwide in 2017 – a number that is predicted 2 to increase to 693 million by 2045.

Where’s the evidence?

About 90% of diabetes diagnoses are type 2 (T2DM) – all of these appear to be lifestyle-related 3 . Additionally, the lifestyle factor most linked to improvements in protection against, treatment of and cure for is diet – with the take-home facts being that animal foods encourage whist plant foods discourage T2DM 4 .

As countries develop a more Westernised diet (also known as the SAD or Standard American Diet), the rates of diabetes within those countries increases 3 .

Omnivores vs Vegetarians

A diet differing from the typical Westernised diet is a vegetarian one. The results of changing to a vegetarian diet is clear. For instance, research 3 shows that vegetarians in the US have a lower prevalence of diabetes than omnivores (that is, those who consume both plant and animal foods, although much more of the latter than the former foods in the case of modern Westernised diets). Other research 5 6 7 8 9 backs up the proposition that a vegetarian diet is significantly better for the prevention and treatment of diabetes than an omnivore diet.

To the heart of the matter

People with diabetes have a 2–4 times greater risk of suffering from CVD (cardio-vascular disease) 10 . Even those who just adhered to a lacto-ovo-vegetarian diet have been shown 11 to have significantly decreased CVD risk factors, specifically blood pressure, serum cholesterol, and blood glucose levels than those adhering to an omnivorous diet.

Another 2013 study 12 examined ischaemic heart disease risk of vegetarians versus non-vegetarians in a large British sample of 44,561 individuals. They found that vegetarians had a lower BMI, non-HDL cholesterol, and systolic blood pressure than the non-vegetarians.

Other risks with diabetes

When looking at other diabetes risk factors and comorbidities, a 2015 study 13 found that those adhering to a vegan diet supplemented with vitamin B12 had a significantly larger decrease in neuropathic pain 14 than the control group receiving just B12 supplementation.

A 1988 study 15 examined patients who had diabetic neuropathy 16 and renal failure who followed a vegan diet for 12 months found significant improvements in the following:

  • creatinine clearance 17
  • urine protein levels
  • cholesterol levels
  • blood glucose levels

Is it too late for me?

Okay, if you’ve eaten a vegetarian diet from childhood, you are less likely to have developed diabetes; but what if you’ve been stuffing in the eggs and bacon, doughnuts and cream cakes for most of your life – is it too late? Another 2018 study 18 found that adopting a vegetarian diet later on in life can greatly reduce diabetes risk, showing the benefits of using a vegetarian diet in an intervention. Other research studies 19 20 21 show the same positive results of dietary changes later in life.

Medication vs diet

There’s also evidence 22 23 24 25 supporting the suggestion that adopting a vegetarian diet is more effective than at improving diabetes symptoms than traditional medication. Of course, packing in smoking and getting lots of exercise are also significantly important lifestyle factors that can prevent and treat diabetes.

Physical and mental benefits

A 2013 study 26 looked at the psychological effects of adopting a vegetarian diet. The investigators assessed the following:

  • quality of life
  • eating behaviour
  • depressive symptoms

They divided diabetic subjects into vegetarian and non-vegetarian groups and found an increase in quality of life and decrease in depressive symptoms in the vegetarian group. Regarding dietary restraint, the vegetarian group was was able to show an increased ability to resist the ‘temptation’ to eat more food and more unhealthy food than the non-vegetarian group. This study showed that adopting a vegetarian diet has both physical and psychological benefits for T2DM patients.

Not all vegetarian diets are equal

Some vegetarians live on processed foods, crisps, chips and sweets. Some hate all vegetables (except fried white potatoes!) while others eat largely whole plant foods.

To examine the differences in type 2 diabetes risk of vegetarians who consume an unhealthy diet (characterised by refined grains, starchy foods, added sugars, low fruits and vegetables) or healthy diet (characterised by whole grains, fruits, vegetable, legumes), a 2016 review 27 categorised the latter as hPDI (a Healthful Plant-Based Diet) and uPDI (an Unhealthy Plant-Based Diet Index) in order to distinguish between healthy and unhealthy plant foods being eaten.

Thus, hPDI assigned positive scores to:

  • whole grains
  • fruits
  • vegetables
  • nuts
  • vegetable oils
  • tea and coffee

and reverse scores to:

  • fruit juices
  • sweetened beverages
  • refined grains
  • potatoes (white)
  • sweets
  • desserts
  • animal foods

The uPDI used the opposite approach.

The results were pretty clear: PDI and hPDI were inversely associated with T2DM, and the uPDI was positively associated with T2DM. This shows the benefit of following a vegetarian diet that is high in whole grains, vegetables, fruits, nuts, and legumes in preventing T2DM.

Study conclusions

The researchers in this September 2018 review 1 drew the following conclusions:

  • the role of all types of vegetarian diets in the prevention and treatment of diabetes is well established
  • clinicians and healthcare providers should feel confident in recommending a vegetarian diet to their patients who have pre-diabetes or T2DM
  • the type of foods that should be consumed while following this diet is critical to achieve the therapeutic effects
  • a vegetarian diet that is high in unhealthy foods such as refined grains, saturated fats, and added sugars is positively associated with T2DM
  • a vegetarian diet that is high in healthy foods such as whole grains, fruits, vegetables, nuts, legumes, and unsaturated fats is negatively associated with T2DM

Final thoughts

It’s pretty obvious to all reasonable people who’ve done even a bit of research that a significant solution to diabetes (prevention, management and cure) lies in simple dietary changes (as well as dropping the tobacco and picking up the weights instead).

However, while this review does look at different manifestations of vegetarian diets, it does not cover in detail how much more effective a completely WFPB (ideally a non-SOS WFPB) diet is when compared with the rest of the vegetarian offerings. Naturally, it hints at this through its mention of the above-mentioned 2016 review 27

If you look online or go to a vegetarian/vegan restaurant and look at what often goes into their recipes you will soon understand what I’m getting at. A quick glance at the menus of one vegan restaurant 28 local to me reveals the potentially unhealthy ingredients and cooking methods that can be both plant-based and unhealthy at the same time – ‘double fried chips and a pot of garlic mayo‘ and ‘Sticky Toffee Pudding served with a caramel glaze‘ will only offer limited assistance, if any, to diabetic customers looking for the healthy alternative to bangers and mash!

Of course, as evidenced in this review, going plant-based rather than relying on pharmaceuticals is a move in the right direction – but for the greatest protection against diabetes, a non-SOS WFPD has been shown repeatedly in additional research studies 29 30 to trump the more watered-down veggie versions.


References

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  12. Crowe FL, Appleby PN, Travis RC, Key TJ. Risk of hospitalization or death from ischemic heart disease among British vegetarians and nonvegetarians: results from the ePIC-Oxford cohort study. Am J Clin Nutr. 2013;97(3):597–603. []
  13. Bunner AE, Wells CL, Gonzales J, Agarwal U, Bayat E, Barnard ND. A dietary intervention for chronic diabetic neuropathy pain: a randomized controlled pilot study. Nutr Diabetes. 2015;5(5):e158. []
  14. What is neuropathic pain? Wikipedia. []
  15. Barsotti G, Navalesi R, Giampietro O, et al. Effects of a vegetarian, supplemented diet on renal function, proteinuria, and glucose metabolism in patients with ‘overt’ diabetic nephropathy and renal insufficiency. Contrib Nephrol. 1988;65:87–94. []
  16. What is diabetic neuropathy? Mayo Clinic. []
  17. What is creatinine and creatinine clearance? WedMD []
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  19. Nicholson AS, Sklar M, Barnard ND, Gore S, Sullivan R, Browning S. Toward improved management of NIDDM: a randomized, controlled, pilot intervention using a lowfat, vegetarian diet. Prev Med. 1999;29:87–91. []
  20. Turner-McGrievy GM, Barnard ND, Scialli AR. A two-year randomized weight loss trial comparing a vegan diet to a more moderate low-fat diet. Obesity (SilverSpring). 2007;15:2276–81. []
  21. Kahleova H, Matoulek M, Malinska H, et al. Vegetarian diet improves insulin resistance and oxidative stress markers more than conventional diet in subjects with type 2 diabetes. Diabet Med. 2010;28:549–59. []
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WFPB – Why Aren’t We Taken Seriously? Part 1

If you’re already aware of the overwhelming evidence showing the power of a plant-based diet to prevent and treat chronic diseases such as CVD (cardiovascular disease), do you ever wonder why on earth your family doctor, oncologist or cardiologist don’t recommend making simple dietary changes?

A big part of the answer is to do with human nature. Those qualified in modern medicine will have spent almost a decade studying pharmaceutical and surgical solutions and spent only a few academic hours looking at diet – even though overwhelming evidence has existed for over a century that dietary changes can prevent, halt and even reverse some chronic diseases.

If you’d devoted time, effort and money to qualifying as a medical expert in the above way, you wouldn’t want to be told that diseases like CVD, cancer, hypertension, obesity and diabetes can be avoided and dealt with by simply swapping broccoli for your bacon and eggs!

I came across the reality of this in practice quite recently while spending time in hospital as my mother was dying of urinary sepsis with other nasty complications – largely related to poor dietary and exercise choices. Chatting with nurses and doctors reaffirmed my suspicion that those “looking after” our health are more or less ignorant of all the research relating to plant-based diets and their power in preventing and treating disease. They go along with it to a certain extent (“…eat more fruit and veg and less red meat“) but treat any further claims as a joke.

Does this surprise you? If not, then maybe it’s more shocking than if it did surprise you.

Have we become so passive in our acceptance of the ignorance of those to whom we entrust the health of our loved ones that we just expect them – our doctors and surgeons – to continue handing out statins while not even enquiring about why the patient is obese? Offering stents and bypass surgery rather than advising the patient to replace the meat, dairy and eggs with beans, fruit and nuts? Worse than this, they are totally dismissive, and have even been known to refuse treatment, if the patient wants to try WFPB before having their chest ripped open and radioactive chemicals injected into their veins.

Sometimes, I slip into the above passivity and resign myself to the fact that we “WFPBers” are simply out of sync with the world. But at other times, a wave of outrage overwhelms me – particularly when I see a hospital ward full of elderly people who are dying ahead of time because of horrible diseases that could have been largely avoided if only their medical experts had advised them decades ago to cut out the foods that will damage their bodies.

I have studied and written about paradigms. The current medical paradigm involves a reductionist approach to research and treatment. I understand, therefore, that each successive generation of newly-qualified doctors has to appease their superiors and adhere to the methods and approaches they were taught.

I understand that there is much more emphasis on reductionist research rather than on population-wide research – the former is very specific and attracts huge funding; the latter can appear wishy-washy and so attracts almost no funding.

I know it’s human nature to do what you’re told. To practice a profession or trade in the way you were taught, even if there is new information that contradicts the “accepted” tenets you had drilled into your head during your hard-earned education. Equally, it’s clear that young doctors have to tow the line and not contradict their superiors or rock the boat with new ideas. And who would want to spend years training as a cardiologist to then find down the line that there were not enough patients to treat because people were eating foods that kept their hearts healthy?

There’s also the “hypocrisy barrier” to overcome. Which doctor can advise a patient to go home and eat beans and greens when they themselves are likely to pop in for burger on the way home? And this is not a trivial matter. Cast you mind back to how difficult it must have been for doctors to advise patients to quit smoking when they had their own packet of Benson & Hedges on the desk, sitting next to the stethoscope.

Financial profit within the paradigm of the current medical system cannot come from making people too healthy. It requires us to be ill – not too dead but also not too alive.

[su_quote]I hope we shall crush in its birth the aristocracy of our monied corporations which dare already to challenge our government to a trial of strength, and to bid defiance to the laws of their country. —THOMAS JEFFERSON [/su_quote]

And doctors who advocate a plant-based diet – how do they make a living in the our pharmaceutical-led health system? Where’s the profit in giving your patients a prescription to eat more fruit and veg and cut out animal and processed foods?

One of the greatest levers of power we have as individuals in our digital world is to access and read the facts-based research – past, present and future – that vindicates plant-based nutrition as a major solution to most of our chronic diseases. It’s all there on Pubmed, a continually-updated resource of published and peer-reviewed research papers from around the world, including an increasing number that relate to the benefits of a plant-based diet.

And this is the wonderful thing about the WFPB movement – hyperbole is not required. The facts speak for themselves. There is a wealth of research showing the health benefits of simple dietary change. But, unfortunately, for the vast majority of the medical profession, “simple” or “wholistic” solutions (even though shown to be highly effective) do not have the credibility of the more traditional pharmaceutical and surgical approaches which are not appearing to reduce the numbers of people ballooning in size and decaying from within.

It would be far too simplistic to put our health epidemic down to the toxic food choices we are being led to make – even if it were a completely credible explanation.

We need to make a fresh start and take a proactive approach to healthcare instead of a reactive one. We wait to be ill before the medical profession is interested in us. And even when the early stages of disease are detected, pills and potions are recommended as a knee-jerk response, rather than advising timely dietary and lifestyle changes.

We are dealing with the symptoms and not the cause. It’s like going to the doctor with a bad headache because we keep banging it against the wall. The doctor hands us paracetamols and advises the use of an expensive crash helmet, rather than calmly advising us to just stop the head-banging.

[su_quote]Doctors are the clergy for a secular age. Dr T Colin Campbell[/su_quote]

A single publication by Dr Kim A Williams et al is outlined below. It re-emphasises the need for the medical profession to take seriously the assertion that plant-based diets are a key adjunct in the prevention and treatment of diseases such as CVD. The list of research associated with this publication is also listed below.

Plant-Based Nutrition: An Essential Component of Cardiovascular Disease Prevention and Management. October 2017.

Major points from the research abstract:

  • Discussion of nutrition and the benefits of a plant-based diet should be highlighted during healthcare provider visits as an essential part of the overall CVD prevention and management care plan.
  • Evidence from prospective cohort studies indicates that a high consumption of predominantly plant-based foods, such as fruit and vegetables, nuts, and whole grains, is associated with a significantly lower risk of CVD.
  • The protective effects of these foods are likely mediated through their multiple beneficial nutrients, including mono- and polyunsaturated fatty acids, omega-3 fatty acids, antioxidant vitamins, minerals, phytochemicals, fibre, and plant protein.
  • Minimising intake of animal proteins has been shown to decrease the prevalence of CVD risk factors.
  • Substantial evidence indicates that plant-based diets can play an important role in preventing and treating CVD and its risk factors.
  • Such diets deserve more emphasis in dietary recommendations.

**************************

It may be worth your while spending a little while scanning through the list of research papers below (some particularly relevant ones marked in red type) and, if you have a spare hour or two, delve a little deeper into some of the research that already shows both the damage caused by an animal food-based diet and the health-giving power of a plant-based diet.

It’s great to see luminaries such as Dr Williams passing on the advice of a very wise old medical expert, who said centuries ago “Let food be thy medicine, and medicine thy food.”

 


References

(Taken from the above-mentioned publication by Dr Kim A Williams et al.)

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The Vagaries of Veganuary

“I cheated on being vegan, and it wasn’t even with a rasher of bacon”

She writes:

“…I failed. Nothing to do with the smell of bacon, in the end it was the Cool Doritos that proved to be my downfall.

Didn’t you know? Cool Doritos contain dairy products. As do muesli and Garibaldi biscuits and, as I’ve ranted before, there’s egg in Quorn and also a lot of vegetarian sausages. Some sugar-coated cereals contain hidden gelatin to make the sugar stay on.

I felt healthy and light after an indulgent December, but I simply couldn’t stay the course. Why? Because going vegan is gruelling. It requires a degree of application, vigilance and sheer 24/7 dedication that you can’t fake, not even for a month.

Because you can’t be a vegan and not mention it; in a meat-eating world it’s too central to your character to omit. And because people (like me, before this steep learning curve) tend to treat vegans as jokes, weird aberrations or dinner guests from hell, it inevitably makes them feel a bit defensive.

But numbers are growing, especially among young people, hence you can buy everything from vegan mayonnaise to vegan make up. An estimated 150,000 people will have taken part in Veganuary in the UK, I’m not entirely sure my attempt actually counts, but I hope so.

I tried to stay vegan, I really I did. Not eating meat was the easy part. I had no interest in roast chicken, but the loss of eggs was a blow and the absence of cheese really quite depressing.

Anyway, I have been happily making porridge with soya milk and will continue to do that regardless. I assumed my spouse was putting soya milk in my coffee too, and was very impressed at how much it resembled full fat dairy.

Then I caught him in the act of using real milk and demanded to know why. He showed me why; the soya milk separates in the hot drink and curdles. He felt it was too revolting to serve.

Apparently if you warm the soya gradually it’s less of a problem, which is why coffee shop soya flat whites are more palatable.

Anyway, this unwitting dairy transgression alone transformed me into a chegan (vegan who cheats) and I was already teetering on the brink when Dorito-gate happened.

I’m not even sure I’ll go back to eating meat; vegetarianism is a walk in the park compared to veganism which is more like struggling to reach Everest Base Camp in flip flops only to discover all they have to eat is custard and mince.

For me, Veganuary was an experiment, but in truth I was hobbled by my lackadaisical attitude from the start; “giving it a go” isn’t the same as believing in it as a cause and being prepared to make no compromises.

But some good has come of it: most notably I have not just a new tolerance, but an admiration for vegans.

It takes real strength of character to eschew all animal products, all the time, when so many foods are booby-trapped and irrationally indignant meat eaters constantly grill you about your life choices.

Would I try it again? For an occasional week, absolutely. But even if I don’t, I hereby solemnly swear to never (ever) ask a vegan where they get their protein from.”


Joe’s Comment

“…vegetarianism is a walk in the park compared to veganism which is more like struggling to reach Everest Base Camp in flip flops only to discover all they have to eat is custard and mince.” Brilliant!

However, the transition from being a vegan to eating a whole food plant-based diet (with no salt, oil and very little added sugar) is a whole new experience, and something that takes dedication and planning. Is it worth it? You bet ya! The health benefits of making the quantum leap from veganism (which includes those who tuck into the odd processed vegan sausage and ice-cream to those who hate veggies and “survive” on chocolate and chips) to a WFPB diet are profound and well-documented. (1.)

Eating the modern western diet it like setting a house on fire – but the fire is inside your body. And even if you go 6 days out of 7 without animal protein, on that 7th day of eating meat it’s like pouring petrol on flames that were nicely dying down.

As Dr. Michael Greger points out: “even in a population consuming a really plant-based diet with little meat and fish, true vegetarians who completely avoided animal flesh, while eating more healthy plant foods, have lower odds for prediabetes and diabetes after accounting for other risk factors.” (2., 3.)

References

  1. https://1440.org/case-whole-food-plant-based-diet-interview-t-colin-campbell/
  2. http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0088547
  3. https://www.ncbi.nlm.nih.gov/pubmed/21983060