Hey, everybody, Welcome to another edition of Wisdom Wednesdays. Today, I want to talk about the pros and cons of having plant based diets. Now I have kind of skirted around the issue a little bit before. I have talked about some studies that have been published around plant based diets and highlighting some of the in inadequacies I should say in these studies just because they were pretty poorly designed and they got a lot of media attention. But I haven't actually given my thoughts comprehensively, and some people have accused me of being anti vegan, anti plant biaist. I'm not at all. I'm just about having good research. So actually, what I thought I would do is look into this in a bit of detail. And I have talked many occasions about the limitations of observational research and how it's really hard to draw conclusions of that. But I have also talked about then when we have systematic reviews, which poos all the data from lots of different studies, that we start to get a bit stronger evidence. So I want to talk about a couple of systematic reviews, one looking at the impact of either meatators, vegetarians or vegans on certain cardiovascular outcomes, particularly the nutrient intakes, because that's really really important, is just looking at those nutrients and any deficiencies. And then there's another systematic review that talked about the mental health outcome. Now there have been other studies and I just want to reference them nigh. So there's lots of bias in nutritional research. I think I've talked about that before. I think there's probably more bias in nutritional research than most other branches of science. And I have highlighted previously a number of studies that have come out and have been particularly critical of these ones from Harvard and a guy called Walter Willard who's a very senior researcher, and Harvard Nutritional department is great, but they've produced a number of what I call shit house studies lately. They did this design, which in concept was a great design, where they took a bunch of twins and had half of them eating a plant piut diet or vegan diet and then the other half on a diet that included meat, and then they compared cardiovascular outcomes. They published a paper on that, and then they compared reductions in biological leads and they published a paper on that. But the massive issue with this gloring issues one. And when they did the study on cardiovascar issues, they measured lipids and things like that, so they measured saturated fat and stuff like that, but they didn't do I think was fasting glue, coaster, tragleistritz one or the other or maybe both, which have a big impact, and they didn't include them. And they we know tend to be a little bit higher in vegetarian and vegan diets. But the main issue with these ones was that the vegans had two hundred calories a day less and they lost more weight, and that could mix. Basically, you can't draw any conclusions because when you have two groups of people, one are having two hundred calories a day less over eight weeks and they're losing more weight, you cannot draw any inferences at all. And the reason I highlighted these things is because it's Harvard University and they push it out there. They were all over the newspapers, and that's why I highlighted these as really poor studies. And the other issue that they didn't really mention is that the vegans lost their shitload of muscle, which as you know, is one of my major concerns, particularly as we euching. But anyway, let's get back to these good studies that were published. So one of them was published in the journal Nutrients, and it was a systematic review and the title was Nutrient Intake and Status in adults consuming plant beat stats compared to meat eaters, A systematic review. Now that just leads me into something that this whole concept of plant beest has confused me a little bit because it is interchangeably used by people who are vegans, people who are vegetarians, but also some people who eat fish and some people who eat a little bit of meat. So like, what is the criteria for plant beast? This is the thing that kind of concerns me when we're looking at the literature is that there's no defined criteria because my diet from some stand points is actually plant best because I probably eat more plants in terms of volume, in fact, I would than meat. If we're talking about calories, would I be plantius I'm not really sure. I'd have to do an analysis. But if you're talking about the from a purest perspective, then I'm not plant beast if plant be means vegetarian or vegan. So that's a little bit that kind of confused me to start with. But anyway, this study compared the three groups vegans, vegetarians, and people who at meat, and they looked at nutrient intake. So I'm just going to drive straight to the conclusions. Actually really good paper in that they measured lots of different nutrients and compared them in the three different groups and what they find. So I'll just go from the table, reading it out right from from top to bottom. And the nutrients were it was fevorable those who had a vegan diet have higher amounts of fiber and puffers, polyon saturated fatty acids alphalinilaic acid, and the vitamins vitamins B one, B six, vitamin C, vitamin E, foliate, and magnesium. Vegetarians tended to have high amounts of poofas alphalinilaic acid, vitamin C, folio and magnesium, and then the meat eaters tended to have higher amounts of protein niasin, vitamin B twelve and zinc. The ones were there was in terms of nutrients at risk of inadequacy or deficiency. The vegans, it was basically EPA and DHA and two of the essential fatty acids, vitamin B, twelve, vitamin D, calcium, iodine, zinc, and just in women, iron as well. The vegetarians had low amounts or suboptimal amounts of fiber, which is a surprising one, but also EPA, DHA, vitamins B, twelve, D, calcium, iodine, zinc, iron in women, but also vitamin E, so very similar to the vegans or other than vegetarians had less fiber, which I find surprising. And also the other difference was vitamin E intakes. And then the metators had suboptimal amounts of fiber, polyon saturated fatty acids alphaalinellaic acid only in men, and then vitamin's D E, foliate, calcium, and magnesium. So across the board there were suboptimal levels of vitamin D and calcium across all three groups, but deficiencies were particular to that. And I will actually post a link to the research paper. So this is a good paper, it's a systematic review, and it's actually looking at nutrient intakes. Now, we do need to be aware that part of the problems with these studies, with these observational studies, is they're asking people what they eat through food frequency questionnaers and they are inherently oh well, there's inherent problems with those sorts of things. But they do look at one hundred and forty one studies from across the world, mostly from Europe, southdc IS, and North America. So that's a pretty good indicator, or it's at least the best that we have currently about nutrient status in those different groups. So it didn't look about outcomes, but it did look about nutrient status. Now what we know in terms of outcomes is that there's another systematic review that looked at basically cardiovascular risk factors for the different groups. And now there's a little bit of a flaw in this study because it was basically looking at vegetarianism versus meat eaters. But they actually am lumped in fish eaters with vegetarians, which I find really weird. It's like, why not just have plant beast or vegetarians. But what they find after they adjusted for lifestyle confounders, which is really important, is that both fish eaters and vegetarians a thirteen percent lower rate of ischemic heart disease than meat eaters. Right, But what happened was that the vegetarians, not the fish eaters, but just the vegetarians had a twenty percent higher rate of total stroke, right than meat eaters. Now, what are these equivalent? Because we always hear that and we think, hey, Jesus, twenty percent higher risk, that's really significant. So if we take the thirteen percent reduce risk of a schemic heart disease in the vegetarians and the fish eaters compared to the meat eaters, that actually is equivalent to ten fewer cases of heart disease per thousand people over a ten year period. Right, So this is the difference between absolute and relative risk. So the absolute risk reduction was thirteen percent. And we've heard before all this stuff about red meat increase your risk by eighteen percent. But when you look at what does that mean for people on the street, It means that if people were to stop eating meat and transition to either vegetarian diet or vegetarian plus fish pescatarian, one person fewer per thousand per year would have heart disease. And then when it comes to the other way, that twenty percent higher risk of stroke in the vegetarians, what that translates as is basically three people having less having a stroke per thousand people over eighteen year period. So the real world impact of these things are absolutely minuscule whenever you look at it in detail. So let me know, I talk about looking at things from another side, which is looking at mental health risks. So this is a study and the taitleist a meta analysis is well. So again lots of data combined. They identified twelve hundred and forty nine publications and basically got rid of the vast majority of them because they were really not well designed. So there was thirteen included, but it had seventeen eight hundred and nine individuals, so what reasonable amount. And then what they did was they looked at the associations between their diet and continuous to spread depression scores, stress well being, or cognitive imperment. And what they found is that the vegans and vegetarians were at an increased risk for depression. So their ODDS ratio was two point one four. That meant they were one hundred and forty or sorry, one hundred and fourteen percent more likely to suffer depression than meat eaters. But they also had lower anxiety scores, so they were about fifteen percent and less likely to have anxiety. So unfortunately they didn't translate that into the reductions or increases in incidents over the years, but the increased risk of depression is pretty significant one hundred and fourteen percent increased risk of depression. The anxiety at fifteen percent lower is really unlikely to have clinical relevance. So that then leads us to in terms of conclusions, what I would conclude from this is it really doesn't matter very much at all in terms of cardiovascular risk. It does matter in terms of nutrients status, and potentially in terms of depression if you are a vegetarian or a vegan, and then that brings us into why right, and the other thing I want to talk about here are kids. So I always say I don't mind what people what diet they prefer, and my job is to kind of support people. So what we know if you are a meat teater is as I said earlier on, and there are a number of nutrients in meat eaters that are significantly lower. So you definitely need to increase your amounts of vitamin D well Probably the best way to do that is getting out into some sunshine, but also for a media that you need to probably eat more fiber on average and more pollen and saturated fatty acids, a bit more alphalinelaic acid, a bit more foliate, bit more calcium, a bit more magnesium. If you're a vegetarian or a vegan, definitely, it is the essential fatty acids that are particularly important for the brain. So the EPA, the DHA, and vitamin B twelve, as well as iodine and iron, they're the ones that are really important to a lesser extent zinc. So I think what's pretty clear is that everybody needs to supplement. But now let's talk about kids, because my real concern kids are not small adults, right. People think that they're just small adults, but you've got to think about this. Kids are growing rapidly and their brands particularly are growing very very rapidly, and they have a greater need per kilogram of body weight for nutrients so that they can develop properly. Now, some of the issues, and I'm pretty strong on this, is that I'm not a big fan of kids being brought up vegetarian and particularly vegan. I get that people have they have belief systems, and it's an ethical issue and I get it. So if you do, if it is really really strong from an ethical perspective, I think particularly for kids. There has to be has to be, has to be, has to be supplementation things that we really have to supplement our deity, which is the faty acid. It is hugely important for Brian development and bit them in B twelve. Right, they are the two that absolutely one hundred percent have to be supplemented. But I would also say calcium iron iodine because it's important for Brian development. I mean, we just need to look at goister with iodine deficiency and it's a pretty horrendous condition where the Brian just and the central nervous system doesn't develop properly. So those are nutrients that absolutely have to be supplemented, and there is some data around this. Now again they are not that common, but the impact is absolutely catastrophic. I'm going to send a link to a study that showed a Brian scan of a twelve month old baby boy that was born from a vegan mother exclusively breastfed and you know low EPA, DSA and other and particularly vitamin B twelve and coaling and this bran in was massively retarded in terms of development. But then they actually because they founded got the baby boy early, they supplemented with those nutrients, the EPA, the DJ and the B twelve. Unfortunately, the child responded well to the treatment with intramuscular B twelve and those other nutrients, and so things to really look out for. And by the way, there are a number of KIOS studies. There's now been more than forty different KIOS studies that have been published over the years, going back for a forty year period where young kids who have been on a vegan diet have actually been hospitalized because of severe nutrient deficiencies and particularly vitamin B twelve. So that is something to really be aware of for anybody who's a vegetarian or vegan, and particularly who's thinking about becoming pregnant, is that you have to supplement with those essential fatty acids, which you can actually get from plant sources, but they are just need to be aware that conversion in the body is pretty poor, so you need eed a bucketload of those from supplements, and you absolutely absolutely have to supplement with vitamin B twelve. So the last thing I wanted to talk about in this So my conclusion overall is it doesn't particularly make that much difference to health outcomes if you are an adult, but there's certainly a significant impact on health outcomes if you're a kid, So just again reiterating the importance of supplementing. And then the last thing that I wanted to talk about was an interesting study that has just come across my dead the one that I just read that actually showed that plant piest diets are thirty four to forty five percent more expensive when trying to meet the same nutritional needs as diets with meats in them. So you know, the question is that are plant piest diets just something for wealthy people and certainly probably not appropriate for third world countries where they get a lot of their nutrients from meat because it is much more nutrient dense, particularly if it is grass fed. So that's just one other thing to take into consideration whenever you are considering your diet. And like I always said, if it's about ethical issues, then knock yourself out, but make sure you're supplement But the meat eaters we should be supplementing as well. So hopefully that gives you a little bit of an insight onto the pros and cons of vegetarian, vegan slash plant based diets and diets that contain meat. That's it. For this time folks. Catch up next time. H

Hey, everybody, Welcome to another edition of Wisdom Wednesdays. Today, I want to talk about the pros and cons of having plant based diets. Now I have kind of skirted around the issue a little bit before. I have talked about some studies that have been published around plant based diets and highlighting some of the in inadequacies I should say in these studies just because they were pretty poorly designed and they got a lot of media attention. But I haven't actually given my thoughts comprehensively, and some people have accused me of being anti vegan, anti plant biaist. I'm not at all. I'm just about having good research. So actually, what I thought I would do is look into this in a bit of detail. And I have talked many occasions about the limitations of observational research and how it's really hard to draw conclusions of that. But I have also talked about then when we have systematic reviews, which poos all the data from lots of different studies, that we start to get a bit stronger evidence. So I want to talk about a couple of systematic reviews, one looking at the impact of either meatators, vegetarians or vegans on certain cardiovascular outcomes, particularly the nutrient intakes, because that's really really important, is just looking at those nutrients and any deficiencies. And then there's another systematic review that talked about the mental health outcome. Now there have been other studies and I just want to reference them nigh. So there's lots of bias in nutritional research. I think I've talked about that before. I think there's probably more bias in nutritional research than most other branches of science. And I have highlighted previously a number of studies that have come out and have been particularly critical of these ones from Harvard and a guy called Walter Willard who's a very senior researcher, and Harvard Nutritional department is great, but they've produced a number of what I call shit house studies lately. They did this design, which in concept was a great design, where they took a bunch of twins and had half of them eating a plant piut diet or vegan diet and then the other half on a diet that included meat, and then they compared cardiovascular outcomes. They published a paper on that, and then they compared reductions in biological leads and they published a paper on that. But the massive issue with this gloring issues one. And when they did the study on cardiovascar issues, they measured lipids and things like that, so they measured saturated fat and stuff like that, but they didn't do I think was fasting glue, coaster, tragleistritz one or the other or maybe both, which have a big impact, and they didn't include them. And they we know tend to be a little bit higher in vegetarian and vegan diets. But the main issue with these ones was that the vegans had two hundred calories a day less and they lost more weight, and that could mix. Basically, you can't draw any conclusions because when you have two groups of people, one are having two hundred calories a day less over eight weeks and they're losing more weight, you cannot draw any inferences at all. And the reason I highlighted these things is because it's Harvard University and they push it out there. They were all over the newspapers, and that's why I highlighted these as really poor studies. And the other issue that they didn't really mention is that the vegans lost their shitload of muscle, which as you know, is one of my major concerns, particularly as we euching. But anyway, let's get back to these good studies that were published. So one of them was published in the journal Nutrients, and it was a systematic review and the title was Nutrient Intake and Status in adults consuming plant beat stats compared to meat eaters, A systematic review. Now that just leads me into something that this whole concept of plant beest has confused me a little bit because it is interchangeably used by people who are vegans, people who are vegetarians, but also some people who eat fish and some people who eat a little bit of meat. So like, what is the criteria for plant beast? This is the thing that kind of concerns me when we're looking at the literature is that there's no defined criteria because my diet from some stand points is actually plant best because I probably eat more plants in terms of volume, in fact, I would than meat. If we're talking about calories, would I be plantius I'm not really sure. I'd have to do an analysis. But if you're talking about the from a purest perspective, then I'm not plant beast if plant be means vegetarian or vegan. So that's a little bit that kind of confused me to start with. But anyway, this study compared the three groups vegans, vegetarians, and people who at meat, and they looked at nutrient intake. So I'm just going to drive straight to the conclusions. Actually really good paper in that they measured lots of different nutrients and compared them in the three different groups and what they find. So I'll just go from the table, reading it out right from from top to bottom. And the nutrients were it was fevorable those who had a vegan diet have higher amounts of fiber and puffers, polyon saturated fatty acids alphalinilaic acid, and the vitamins vitamins B one, B six, vitamin C, vitamin E, foliate, and magnesium. Vegetarians tended to have high amounts of poofas alphalinilaic acid, vitamin C, folio and magnesium, and then the meat eaters tended to have higher amounts of protein niasin, vitamin B twelve and zinc. The ones were there was in terms of nutrients at risk of inadequacy or deficiency. The vegans, it was basically EPA and DHA and two of the essential fatty acids, vitamin B, twelve, vitamin D, calcium, iodine, zinc, and just in women, iron as well. The vegetarians had low amounts or suboptimal amounts of fiber, which is a surprising one, but also EPA, DHA, vitamins B, twelve, D, calcium, iodine, zinc, iron in women, but also vitamin E, so very similar to the vegans or other than vegetarians had less fiber, which I find surprising. And also the other difference was vitamin E intakes. And then the metators had suboptimal amounts of fiber, polyon saturated fatty acids alphaalinellaic acid only in men, and then vitamin's D E, foliate, calcium, and magnesium. So across the board there were suboptimal levels of vitamin D and calcium across all three groups, but deficiencies were particular to that. And I will actually post a link to the research paper. So this is a good paper, it's a systematic review, and it's actually looking at nutrient intakes. Now, we do need to be aware that part of the problems with these studies, with these observational studies, is they're asking people what they eat through food frequency questionnaers and they are inherently oh well, there's inherent problems with those sorts of things. But they do look at one hundred and forty one studies from across the world, mostly from Europe, southdc IS, and North America. So that's a pretty good indicator, or it's at least the best that we have currently about nutrient status in those different groups. So it didn't look about outcomes, but it did look about nutrient status. Now what we know in terms of outcomes is that there's another systematic review that looked at basically cardiovascular risk factors for the different groups. And now there's a little bit of a flaw in this study because it was basically looking at vegetarianism versus meat eaters. But they actually am lumped in fish eaters with vegetarians, which I find really weird. It's like, why not just have plant beast or vegetarians. But what they find after they adjusted for lifestyle confounders, which is really important, is that both fish eaters and vegetarians a thirteen percent lower rate of ischemic heart disease than meat eaters. Right, But what happened was that the vegetarians, not the fish eaters, but just the vegetarians had a twenty percent higher rate of total stroke, right than meat eaters. Now, what are these equivalent? Because we always hear that and we think, hey, Jesus, twenty percent higher risk, that's really significant. So if we take the thirteen percent reduce risk of a schemic heart disease in the vegetarians and the fish eaters compared to the meat eaters, that actually is equivalent to ten fewer cases of heart disease per thousand people over a ten year period. Right, So this is the difference between absolute and relative risk. So the absolute risk reduction was thirteen percent. And we've heard before all this stuff about red meat increase your risk by eighteen percent. But when you look at what does that mean for people on the street, It means that if people were to stop eating meat and transition to either vegetarian diet or vegetarian plus fish pescatarian, one person fewer per thousand per year would have heart disease. And then when it comes to the other way, that twenty percent higher risk of stroke in the vegetarians, what that translates as is basically three people having less having a stroke per thousand people over eighteen year period. So the real world impact of these things are absolutely minuscule whenever you look at it in detail. So let me know, I talk about looking at things from another side, which is looking at mental health risks. So this is a study and the taitleist a meta analysis is well. So again lots of data combined. They identified twelve hundred and forty nine publications and basically got rid of the vast majority of them because they were really not well designed. So there was thirteen included, but it had seventeen eight hundred and nine individuals, so what reasonable amount. And then what they did was they looked at the associations between their diet and continuous to spread depression scores, stress well being, or cognitive imperment. And what they found is that the vegans and vegetarians were at an increased risk for depression. So their ODDS ratio was two point one four. That meant they were one hundred and forty or sorry, one hundred and fourteen percent more likely to suffer depression than meat eaters. But they also had lower anxiety scores, so they were about fifteen percent and less likely to have anxiety. So unfortunately they didn't translate that into the reductions or increases in incidents over the years, but the increased risk of depression is pretty significant one hundred and fourteen percent increased risk of depression. The anxiety at fifteen percent lower is really unlikely to have clinical relevance. So that then leads us to in terms of conclusions, what I would conclude from this is it really doesn't matter very much at all in terms of cardiovascular risk. It does matter in terms of nutrients status, and potentially in terms of depression if you are a vegetarian or a vegan, and then that brings us into why right, and the other thing I want to talk about here are kids. So I always say I don't mind what people what diet they prefer, and my job is to kind of support people. So what we know if you are a meat teater is as I said earlier on, and there are a number of nutrients in meat eaters that are significantly lower. So you definitely need to increase your amounts of vitamin D well Probably the best way to do that is getting out into some sunshine, but also for a media that you need to probably eat more fiber on average and more pollen and saturated fatty acids, a bit more alphalinelaic acid, a bit more foliate, bit more calcium, a bit more magnesium. If you're a vegetarian or a vegan, definitely, it is the essential fatty acids that are particularly important for the brain. So the EPA, the DHA, and vitamin B twelve, as well as iodine and iron, they're the ones that are really important to a lesser extent zinc. So I think what's pretty clear is that everybody needs to supplement. But now let's talk about kids, because my real concern kids are not small adults, right. People think that they're just small adults, but you've got to think about this. Kids are growing rapidly and their brands particularly are growing very very rapidly, and they have a greater need per kilogram of body weight for nutrients so that they can develop properly. Now, some of the issues, and I'm pretty strong on this, is that I'm not a big fan of kids being brought up vegetarian and particularly vegan. I get that people have they have belief systems, and it's an ethical issue and I get it. So if you do, if it is really really strong from an ethical perspective, I think particularly for kids. There has to be has to be, has to be, has to be supplementation things that we really have to supplement our deity, which is the faty acid. It is hugely important for Brian development and bit them in B twelve. Right, they are the two that absolutely one hundred percent have to be supplemented. But I would also say calcium iron iodine because it's important for Brian development. I mean, we just need to look at goister with iodine deficiency and it's a pretty horrendous condition where the Brian just and the central nervous system doesn't develop properly. So those are nutrients that absolutely have to be supplemented, and there is some data around this. Now again they are not that common, but the impact is absolutely catastrophic. I'm going to send a link to a study that showed a Brian scan of a twelve month old baby boy that was born from a vegan mother exclusively breastfed and you know low EPA, DSA and other and particularly vitamin B twelve and coaling and this bran in was massively retarded in terms of development. But then they actually because they founded got the baby boy early, they supplemented with those nutrients, the EPA, the DJ and the B twelve. Unfortunately, the child responded well to the treatment with intramuscular B twelve and those other nutrients, and so things to really look out for. And by the way, there are a number of KIOS studies. There's now been more than forty different KIOS studies that have been published over the years, going back for a forty year period where young kids who have been on a vegan diet have actually been hospitalized because of severe nutrient deficiencies and particularly vitamin B twelve. So that is something to really be aware of for anybody who's a vegetarian or vegan, and particularly who's thinking about becoming pregnant, is that you have to supplement with those essential fatty acids, which you can actually get from plant sources, but they are just need to be aware that conversion in the body is pretty poor, so you need eed a bucketload of those from supplements, and you absolutely absolutely have to supplement with vitamin B twelve. So the last thing I wanted to talk about in this So my conclusion overall is it doesn't particularly make that much difference to health outcomes if you are an adult, but there's certainly a significant impact on health outcomes if you're a kid, So just again reiterating the importance of supplementing. And then the last thing that I wanted to talk about was an interesting study that has just come across my dead the one that I just read that actually showed that plant piest diets are thirty four to forty five percent more expensive when trying to meet the same nutritional needs as diets with meats in them. So you know, the question is that are plant piest diets just something for wealthy people and certainly probably not appropriate for third world countries where they get a lot of their nutrients from meat because it is much more nutrient dense, particularly if it is grass fed. So that's just one other thing to take into consideration whenever you are considering your diet. And like I always said, if it's about ethical issues, then knock yourself out, but make sure you're supplement But the meat eaters we should be supplementing as well. So hopefully that gives you a little bit of an insight onto the pros and cons of vegetarian, vegan slash plant based diets and diets that contain meat. That's it. For this time folks. Catch up next time. H