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What The Health?! – #MeatProblems, Vegan Vs. Paleo, The Origins of Disease, Cherry Picking, And Why Can’t We All Be Friends?

­­­­­­It's very pretty, very passionate, and brings up some very good points. Oh, it's also very misleading.

Ok, I know I'm super late to the party here, but better late than never, am I right? (I blame writing a book - which managed to squash any free time I thought I once had.) Even if you haven't watched the documentary on hand (which – dare I promote - is free on Netflix), What The Health nevertheless brings up #allthethings I've been wanting to tackle when it comes to (spoiler alert!) the meat-forgoing, vegetable-romancer side of the dietary sphere.

Basically, this post analyzes a multitude of topics I’ve been meaning to address forever, so there's that.­­

So without further adieu, here are my thoughts on prevalent anti-meat arguments, saturated fat, refined sugar, degenerative disease, processed foods, veganism, and #allthethings. Bon appetite!

HOW IT ALL STARTED

I attempted to go into What The Health as blind as possible, colored only by "It's going to make you so mad" sentiments from friends echoing in my mind. Not gonna lie, it was super hard to NOT prematurely read the various blog post critiques from my Paleo peops popping up my inbox, like Robb Wolf’s A Wolf’s Eye Review  and Dave Asprey’s The Science Behind the Top 10 Claims from What the Health. Yet I resisted! Bias would not color this girl's interpretation! As I hit "play" on What The Health (once again dreaming of the day I could afford to upgrade my internet speed), I waited with baited breath...

Things actually started out pretty promising, with an admittedly cleverly edited clip of American Diabetes Chief Scientific & Medical Officer Dr. Robert Ratner refusing to discus the relationship between diet and diabetes. Next, narrator/director Kip Anderson began relaying his historical health obsession, including hypochondriacness and fixations on bodily functions (right there with ya!), all while following a seemingly healthy diet. With such vibes that the film would tackle the connection between diet and health, I was feeling pretty positive.

Then things quickly took a turn for the worse.

Sooner rather than later, What The Health began rapid-firing "facts" in passionate cinematic color, and I felt myself constantly scratching my head, pausing, and looking around my empty room to imaginary friends with raised eyebrows, in a Wait... did they just say that? - type way, sighing at the effort I knew it was going to take to dig up the casually referenced studies.

Let's jump in the nitty gritty, shall we?

MEAT AND CANCER

If What The Health does one thing, it paints a wonderfully disgusting picture of something we've been eating for arguably 2.5 millions years: meat. Before we even hit the 5 minute mark, our navigator Kip grows suspicious of modern food choices when an oh-so-shocking study (Carcinogenicity of consumption of red and processed meat)  and its summarized findings by the World Health Organization (WHO) sensationalizes the media.

Supposedly according to the findings, processed meat is highly linked to cancer, as is (apparently) red meat. The WHO defines processed meat as anything "that has been transformed through salting, curing, fermentation, smoking, or other processes to enhance flavor or improve preservation" and is categorized as a Class 1 Carcinogen: the same category (made very clear by Kip) as cigarettes. The WHO also concludes that red meat is "probably carcinogenic to humans" (Group 2a). What The Health, however, "simplifies" this with a small but extremely notable terminology shift, saying the WHO "classifies red meat as a Group Two carcinogen." It's like the difference between saying "he was classified as a murderer," compared to "he was classified as probably a murderer."

Big. Difference.

Now to start, I'm in total agreement that processed foods are a key constituent of modern heath maladies, welcoming toxins into our bodies and encouraging autoimmune conditions. The scientific support in the original study is also pretty valid. Problems arrive, however, in What The Health's further interpretation and application of the findings. In a quick sleight of hand which would make many of my magician friends jealous (Shout out to the Magic Castle!), the scientifically-supported problems with processed meat and the potential for problems of red meat quickly becomes the problems for all meat. Casually watch What The Health and you'll soon be convinced all meat causes cancers, no questions asked, as you run to your nearest Whole Foods to purchase salvation via a veggie smoothie.

So what did the original Carcinogenicity of consumption of red and processed meat study supposedly find?

Not exactly what you might expect.

While the study did find that processed meats strongly correlate to cancer, the connection with red meat was not exactly the same. At all. In fact, the researchers couldn't even concretely link red meat to cancer, saying, "Chance, bias, and confounding could not be ruled out with the same degree of confidence for the data on red meat consumption, since no clear association was seen in several of the high quality studies and residual confounding from other diet and lifestyle risk is difficult to exclude. The Working Group concluded that there is limited evidence in human beings for the carcinogenicity of the consumption of red meat."

Furthermore, the findings note that "there is inadequate evidence in experimental animals for the carcinogenicity of consumption of red meat and of processed meat. In rats treated with colon cancer initiators and promoted with low calcium diets containing either red meat or processed meat, an increase in the occurrence of colonic preneoplastic lesions was reported in three and four studies, respectively." Ok, hold on a minute. So in order to get substantial evidence of red meat causing cancer in rats (not even humans), we have to first set up their system to already be cancerous, strip away their calcium, and then feed them red meat. Cards stacked against you much??

So where do the WHO researchers get their evidence for red meat causing cancer? With mechanistic evidence for how red meat could possibly cause cancer. Translation: We couldn't substantially support the idea that red meat causes cancer, but here's how it could.

Yet despite the tenuous nature of these conclusions surrounding red meat and cancer, What The Health quickly and confidently parades the idea that all meat causes. It'd be like finding a study (NOTE: THIS IS A FAKE STUDY I'M MAKING UP AS AN EXAMPLE) on orange and processed vegetables and cancers, which found that processed vegetables were linked to cancer, but orange vegetables were not concretely to cancer, although orange vegetables could potentially cause cancer if you thought about the mechanisms. It'd then be like taking this study, and being like, "All vegetables cause cancer. Do not eat vegetables."

OTHER MEATY MATTERS

Our first overwhelmingly negative meat impression sets the stage for further #meatproblems, aided by lovely imagery like putting a fish in a blender: because we all do that, obvi. While What The Health makes a lot of claims as it cultivates its anti-meat manifesto, I'll briefly address some of the biggies.

THE SINISTER NATURE OF SATURATED FAT

This likely comes as no surprise, but saturated fat (common in animal products) isn't too welcome in What The Health waters, with its many waves of artery-clogging claims. This is despite the fact that the demonization of saturated fat likely involved a historical scheme of cherry picked evidence lead by Ancel Keys, as I discuss in How Fat Got A Bad Rap (Or Why You Choose The Salad Over The Steak. Furthermore, recent research continues to paint a more complicated picture of saturated fat, often vindicating it. As discussed in a 2017 British Journal of Sports Medicine review of the topic, "Coronary artery disease pathogenesis and treatment urgently requires a paradigm shift. Despite popular belief among doctors and the public, the conceptual model of dietary saturated fat clogging a pipe is just plain wrong. A landmark systematic review and meta-analysis of observational studies showed no association between saturated fat consumption and (1) all-cause mortality, (2) coronary heart disease (CHD), (3) CHD mortality, (4) ischaemic stroke or (5) type 2 diabetes in healthy adults. Similarly in the secondary prevention of CHD there is no benefit from reduced fat, including saturated fat, on myo cardial infarction, cardiovascular or all-cause mortality."

Of course, it'd be a farce on my part to accuse What The Health of cherry picking, and then cherry pick myself. Studies arguably show different results regarding saturated fat, and context is likely key. Saturated fat from whole foods in the context of a healthy diet is much different from consuming it with high (particularly refined) carbohydrate intakes, and/or in the form of processed foods. In such inflammatory situations, you will, indeed, likely store such dietary fat and further encourage inflammation. Saturated fat also encourages the release of transport molecules called chylomicrons (my recent research obsession) which can transport endotoxins (more on those in a bit!) into the bloodstream, so if you're eating an inflammatory diet (Hi processed foods!), saturated fat may enhance that inflammation - though it's not necessarily "coming from" the saturated fat.

There is a ton more I could say on the subject, but I shall leave it at that for now. In any case, saturated fat is likely benign, if not health supporting, in the proper context, and labeling it as an automatic killer is almost inexcusable. Speaking of inexcusable... let's move on to more pressing matters.

ANIMAL PRODUCTS AND CHOLESTEROL

What The Health’s interviewees consistently posit the idea that eating meat and animal products raises cholesterol levels. We've even got fun statements like Kip’s observation, “I found a study suggesting that eating just one egg a day can be as bad as smoking five cigarettes per day for life expectancy,” and Dr. Michael Klaper’s insight that the “yolk of a hen’s egg is the most concentrated glom of saturated fat and cholesterol. It is made to run a baby chicken for 21 days with no outside energy. It is pure fat and cholesterol. And when we put that into our bloodstream, it coats our red blood cells. Our blood gets thicker and more viscous. It changes our hormone levels. It raises our cholesterol levels. There’s nothing healthy about eating the yolk of the egg.”

For starters, there doesn't seem to be a study showing Kip’s (borderline ludicrous claim) that one egg = 5 cigarettes per day claim. (If you find it, please do let me know!) As for the later, an egg is notably only about 1/3 saturated fat, so that’s a smidge misleading. But more importantly, I’d like to know what’s unhealthy about eating something rich in 18 fat-soluble vitamins and minerals (including A, D, E, K, and B12, the elusive zinc, selenium, and chorine) as well as protein, omega-3s, monounsaturated fats, DHA, and lecithin? Oh hi nature’s multivitamin in an easily assimilated form!

But even all that aside, I'm almost (but not quite) shocked these claims managed to stay in. Why? Because it's becoming increasingly well known that dietary cholesterol does not automatically encourage bad cholesterol. Like, we know this guys. Furthermore, low carb diets – despite being rich in saturated fat and cholesterol – are typically quite beneficial for cholesterol levels and ratios. While modern Americans consume around 260 mg of cholesterol per day, historical hunter-gatherers consumed approximately 480 mg... yet experienced lower blood cholesterol and were largely free of cardiovascular disease (CD). Speaking of that last one, A 2015 review of forty cholesterol studies analyzing the role of cholesterol's relations to CD, noted that dietary cholesterol was "not statistically significantly associated with any coronary artery disease... ischemic stroke... or hemorrhagic stroke." Of course, the study ultimately concluded that the findings on cholesterol are mixed, and more research is needed. But that's the thing: context is everything, and it's definitely not black and white, like What The Health would have you believe.

What The Health’s proclamations that dietary fat and cholesterol lead to diabetes are also becoming increasingly questioned, if not debunked. As noted in a 2017 evaluation of the topic looking at initial non-diabetics over 20 years, "Those consuming the highest (vs. lowest) amounts of [dietary cholesterol] had the lowest [fasting blood sugar levels] levels at baseline and lowest throughout the 20 years of follow-up." The researchers found the high cholesterol eaters had a 22% lower risk of developing type 2 diabetes, and concluded that the “results suggest that higher intakes of [dietary cholesterol] do not adversely affect fasting glucose levels or risk of T2DM and may even be beneficial when consumed in combination with a healthy diet."

We'll circle back to the whole fat/blood sugar thing in a bit!

MEAT & BACTERIAL TOXINS

What The Health  cultivates wonderful imagery of meat rotting in the intestines, breeding a bacterial storm of toxins and yuckiness. Dr. Alan Goldhamer refers to meat as “dead decaying flesh,” while Dr. Michael Greger, founder of NutrtionFacts.org, says, "When we eat these kind of dead meat bacteria toxins, within minutes, you get this burst of inflammation within your system…”

Dead meat bacteria toxins. What a lovely picture! Dr. Greger is actually referring to endotoxemia - the toxic byproducts created by gut bacteria. Now, as a girl who's suffered with SIBO and IBS and basically all the problems of toxic bacterial byproducts, I'm pretty familiar with this, and can pretty confidently say that What The Health takes massive liberties in its oversimplification and interpretation of diet's relationship to the gut microbiome.

A variety of special diets - such as Low FODMAP, Fast Tract, and the Specific Carbohydrate Diet - all aim to identify which foods provide potential fermentation food sources for bacteria, which is what ultimately leads to bacterial byproducts. (You can get my free IBS comparative guide here!) This becomes likely in the case of gut dysbiosis, like the wrong types of bacteria, or even the right types of bacteria in the wrong place, particularly the small intestine. All these diets, depending on their personal fermentation philosophy, identify different types of various carbohydrate and fiber sources as the primary problem, bearing one thing in common: meat is pretty safe. This is because meat is not the go-to food of choice for our gut buggers, and is actually very unlikely to ferment. Our small intestine (which should be relatively free of bacteria) is pretty adept at assimilating meat. More on that in a bit!

So what does lead to bacterial fermentation? Definitely sugars and oftentimes fibers. As noted in “Comparison with ancestral diets suggests dense acellular carbohydrates promote an inflammatory microbiota, and may be the primary dietary cause of leptin resistance and obesity,” (talk about a doozy of a title!), “The present hypothesis suggests that… acellular flours, sugars, and processed foods produce an inflammatory microbiota via the upper gastrointestinal tract, with fat able to effect a “double hit” by increasing systemic absorption of lipopolysaccharide.”

And where do we get sugars and fibers? In plants. If you want to encourage endotoxemia, chow down on grains, legumes, beans, and lots of processed foods and sugar. And while this may or may not be a valid argument (I’ll leave that up to you), I bet you’ve never seen undigested meat floating around in your stool – because it’s so wonderfully digested!

Of course, meat in the context of improper food combining or in an unhealthy diet can definitely slow the digestive process and exacerbate fermentation. And while dietary fat itself does not provide an easy fuel substrate for bacteria, it can notably transport toxins generate from bacteria feasting on sugars and processed foods, across the intestinal wall, thereby increasing systemic inflammation, as mentioned. But it’s simply the messenger in this case, not the cause, and an anti-inflammatory whole foods diet tends to render the issue irrelevant. Again, context is everything!

CHICKEN AND FISH

As if the complicated topic of red meat weren't enough, What The Health also takes a sling at white meat chicken and even... wait for it… fish!

On the poultry side of things, the doc does discuss many of conventional chicken’s actual problems, including injected sodium, and toxic byproducts often formed in the cooking process. However, What The Health ultimately uses processed forms of chicken (particularly fast food chicken), as representative of all chicken, which is making a huge leap. As Dr. Neal Bernard says, “We sent researchers into fast food and family restaurants. Not only were there carcinogens in every single restaurant, but, we found them in every single chicken sample that we took. If somebody brings their family in, and they’re buying a bucket of chicken, nobody tells them that there are carcinogens. If you’re selling carcinogens to people, you’ve gotta warn them that they’re in there."

Again, context is everything. Fast food chicken is not the same as pastured, organic, real chicken. While I don't know which fast food chains the researchers visited, let's take a brief look at the ingredients of many common fast food chickens:

  • Subway Chicken Patty: Chicken breast with rib meat, water, chicken flavor (sea salt, sugar, chicken stock, salt, flavors, canola oil, onion powder, garlic powder, spice, chicken fat, honey), potato starch, sodium phosphate, dextrose, carrageenan.
  • Subway Rotisserie-Style Chicken: White meat chicken, water, soybean oil, seasoning (chicken broth powder, chicken powder, onion powder, natural flavor), salt, sunflower oil, dextrose, sodium phosphate, rotisserie chicken flavor (chicken broth, chicken skins, salt, natural flavor, xanthan gum, maltodextin, gum arabic), spice extractives.
  • McDonald’s Chicken McNuggets: White Boneless Chicken, Water, Food Starch-Modified, Salt, Seasoning (Autolyzed Yeast Extract, Salt, Wheat Starch, Natural Flavoring [Botanical Source], Safflower Oil, Dextrose, Citric Acid), Sodium Phosphates, Natural Flavor (Botanical Source). Battered and Breaded with: Water, Enriched Flour (Bleached Wheat Flour, Niacin, Reduced Iron, Thiamin Mononitrate, Riboflavin, Folic Acid), Yellow Corn Flour, Bleached Wheat Flour, Food Starch-Modified, Salt, Leavening (Baking Soda, Sodium Acid Pyrophosphate, Sodium Aluminum Phosphate, Monocalcium Phosphate, Calcium Lactate), Spices, Wheat Starch, Dextrose, Corn Starch. Prepared in Vegetable Oil (Canola Oil, Corn Oil, Soybean Oil, Hydrogenated Soybean Oil with TBHQ and Citric Acid added to preserve freshness). Dimethylpolysiloxane added as an antifoaming agent. (Sidenote: If you’re gonna get something at McDonald’s get the hamburger, and just eat the patty, which simply contains “100% pure USDA inspected beef; no fillers, no extenders. Prepared with grill seasoning (salt, black pepper)”)
  • Chic-fil-A Grilled Chicken: (whole breast filet, seasoning [water, apple cider vinegar, soybean oil, yeast extract, salt, modified corn starch, palm oil, dehydrated garlic, dehydrated onion, corn maltodextrin, sea salt, natural flavor, sugar, chicken stock, cane molasses, chicken fat, spice, natural flavor {including smoke}, dextrose, lemon peel, citric acid, red bell pepper, orange juice concentrate, grape juice concentrate, natural flavor, paprika, vinegar, xanthan gum, ascorbic acid, and spices]).
  • Burger King Grilled Chicken: (whole breast filet, seasoning [water, apple cider vinegar, soybean oil, yeast extract, salt, modified corn starch, palm oil, dehydrated garlic, dehydrated onion, corn maltodextrin, sea salt, natural flavor, sugar, chicken stock, cane molasses, chicken fat, spice, natural flavor {including smoke}, dextrose, lemon peel, citric acid, red bell pepper, orange juice concentrate, grape juice concentrate, natural flavor, paprika, vinegar, xanthan gum, ascorbic acid, and spices]).

And the problem here is the chicken?

In fact, a recent Canadian study even found subway chicken is only about 50% meat. Yikes! Analyzing such fast food renditions of chicken and using them to paint a picture of all poultry is ridiculously misleading, akin to using a 3 year old’s painting (no offense) as indicative of the quality of paintings in general. Saying that choosing red meat or chicken is, in the words of Dr. Caldwell Esselystn, "a question of whether you wanna be shot or, hung," is just a bit absurd.

As for fish, What The Health once again suitably points out the many problems with today’s modern fish supply: pesticides, herbicides, and antibiotics in farmed versions, heavy metal accumulations and toxins in wild caught. Again, totally agreed, but using the problems added to fish as an argument for why fish itself is unhealthy, is, again, a faulty train of thought, logic-wise. Especially since fish tends to be the one “meat” overwhelmingly embraced for health, and a pescatarian diet can provide nutritional benefits beyond a vegan diet, like omega-3s, iodine, and iron. While I'd love to dive deeper into this topic (no pun intended),  I'll save such detailed discussion for another day.

SUGAR, FAT, AND DIABETES

Right alongside its a­nimal products cause high cholesterol and clogged arteries thesis, comes a similarly sinister claim: It's actually meat, not sugar, which causes diabetes. Oh my... where to even begin? Well, to start, perhaps we should define what diabetes is.

Diabetes occurs when sugar from carbohydrates - which is toxic to the body in high amounts - reaches unhealthy levels in the blood. This occurs when the body loses its ability to properly deal with it. In a human with healthy blood sugar control, the pancreas releases the hormone insulin to remove excess blood sugar from the bloodstream, and usher it into cells. In the case of type 1 diabetes (which is typically genetic) the person lacks insulin in the first place. Type 2 diabetes, on the other hand, occurs with insulin resistance, in which the body’s cells stop responding to insulin, and don't "accept" the sugar from the bloodstream. As such, diabetes is ultimately about blood sugar and insulin dysregulation, which we'll discuss in a bit. That said, seeing as how diabetes can only manifest with excess blood sugar, you'd think too much sugar (which we primarily get from dietary carbohydrates) would somehow be involved in the whole thing. But according to What The Health, that's not necessarily the case.

SUGAR DOESN'T RELATE TO DIABETES?

We first board the sugar-vindication train with Dr. Neal Bernard. In his words, "Diabetes is not and never was caused be eating a high carbohydrate diet, and it’s not caused by eating sugar. The cause of diabetes is a diet that builds up the amount of fat into the blood. I’m talking about a typical meat-based, animal-based diet. You can look into the muscle cells of the human body, and you find that they’re building up tiny particles of fat that’s causing insulin resistance. What that means is, the sugar that is naturally from the foods that you’re eating can’t get into the cells where it belongs. It builds up in the blood, and that’s diabetes.”

Ok, let's unpack this a bit.

Even though sugar is the primary instigator of insulin, Dr. Bernard posits that it is not taking in too much sugar which constantly raises blood sugar and causes insulin resistance (a generally accepted theory), but rather that fat in the blood is messing everything up. This is despite the fact that, when we constantly eat sugary foods, we constantly release insulin, which can encourage the cells to downregulate their responses to insulin. Dietary fat bares little influence in that whole matter. (Of course, when you're in a high sugar, insulin-rich mode, the cells also enter a fat storage mode, meaning the fat you eat alongside the sugar will be easily stored as body fat. No arguments there.)

In any case, to support Dr. Bernard's claim, What The Health's online “Facts” list provides 4 sources, only two of which are studies. One is titled "Impaired Mitochondrial Activity in the Insulin-Resistant Offspring of Patients with Type 2 Diabetes," which compares insulin-resistant and insulin-sensitive individuals to analyze the foundational mechanism for diabetes, proposed to involve problems with insulin regulation. This is where I'm assuming Dr. Bernard is getting the support for his fat-builds-up-in-the-blood-and-causes diabetes claim, since the study discusses the hypothesis that "insulin resistance in these young people is due to dysregulation of intramyocellular fatty acid metabolism, which may be caused by an inherited defect in mitochondrial oxidative phosphorylation.” Translation: Insulin resistance may involve an inability to properly metabolize fatty acids, thanks to genetic factors.

So this sort of, but not really, supports Dr. Bernard's statement, as he completely misattributes the cause of the fat build up in the blood and resulting diabetic problems. He states that it is too much dietary fat which somehow makes the cells resistance to accepting glucose, which is not what the study shows. In fact, the study doesn't even address what the patients are eating! Rather, it implicates genetic factors causing improper breakdown of fats, not too much dietary fat. Big. Difference. And even if the root cause of diabetes were, in fact, a "diet that builds up the amount of fat into the blood," (which is a possibility!) is that necessarily a meat-based, animal-based diet? No. Low carb diets are consistently linked to reduced blood sugar levels, and are often shown to encourage insulin sensitivity. So. Much. Sighing.

So as is increasingly the case in What The Health, things aren't quite as they appear. Yet Kip quickly crystallizes the intended takeaway of these likely faulty interpretations for us, saying, "I had never heard that meat was associated with causing diabetes. We had always been told that sugar or obesity caused it."

SUGAR REDUCES DIABETES RISK?

But have no fear, dear friends! Things get even more gnarly (and increasingly incredulous), as we welcome in Dr. Garth Davis, who makes some statements I'm, quite frankly, shocked didn't end up on the cutting room floor.

In discussing carbohydrates, Dr. Garth provides a wonderfully debunkable statement that "Carbs cannot make you fat in and of themselves," explaining that they're either stored as glycogen or burned for energy. While this is often the case, it is not a completely true statement. Yes, the glucose from carbs in our diet is immediately burned for energy or converted to glycogen for storage in the muscles and liver. However, when our limited glycogen stores are full (which is often the case on a diet high in carbs), carbs can be converted to fat (and yes, that would be saturated fat, by the way). This process has even got a name: de novo lipogenesis. It's just a thing. This means Dr. Garth's absolute statement is, to put things bluntly, a lie. True, in a high carb diet situation, you'll likely burn the carbs and primarily store the fat ingested alongside them, but this does not make Dr. Garth's statement any less untrue.

But it gets Even. Worse.

To support his carbs-do-not-cause-diabetes hypothesis, Dr. Garth references an EPIC study of "500,000 people" which apparently showed that "the more carbs someone ate, the less diabetes they had."

Ok, for starters, I'm scratching my head trying to figure out where he got his half a million people figure. (If you find it, please do let me know!) The EPIC study referenced on the official What The Health “Facts” page for this segment, recruited 25,639 people to start, and ultimately analyzed 749 cases. Last time I checked, 749 was NOT 500,000? (Nor is 25,639, which would have been a stretch as well.)

But moving beyond such technicalities, did this study truly support Dr. Garth's claim that the more carbs someone ate, the less likely their chance of diabetes?

Not so much.

The study - “Dietary intake of carbohydrates and risk of type 2 diabetes:he European Prospective Investigation into Cancer-Norfolk study” - begins by stating the lack of conclusive evidence for sugar's role in diabetes. In its words: "Several cohort studies have found a positive association between the risk of diabetes and total carbohydrates and starch, while others have found a non-significant inverse association. Few studies have found a significant or non-significant inverse association of diabetes risk with total sugars and sucrose, while others have reported a non-significant positive association. Furthermore, two studies have found a strong positive association of diabetes risk with glucose and fructose, while others have reported no association."

I wouldn't exactly interpret that as evidence that sugar encourages no diabetes, would you? Of course, that's just the study's summary of prior findings. It then turns to its current hypothesis: that different types of carbs - like starch, sucrose, glucose, fructose, and maltose - may influence diabetes risk on different levels. Of course, this is different than Garth's blanket statement that all sugar is not associated with diabetes, but again... technicalities.

And (surprise!) the findings end up being insanely less-than-clear. For example, the study often will find things like diabetes "was inversely associated with a standard deviation higher intake of total carbohydrates, total sugars, sucrose, glucose and fructose in models adjusted for age and sex."  Stop there, and Dr. Garth may be onto something: higher carb intake can correlate to decreased risk of diabetes! Until you read the very next sentence:"However, in multivariable analyses, total sugars and sucrose were no longer associated with diabetes risk, but there was a significant inverse association of diabetes risk with fructose and a borderline significant inverse association with glucose and total carbohydrates."

In other words, things aren't so clear.

This is a common theme throughout the entire study, which utilizes a variety of interpretative models to analyze the various types of sugars and their relation to diabetes. Ultimately, the only true consistency ends up being a lack of consistent findings.

The study also points out some other convoluting factors:

  • While some forms of carbohydrates correlate to reduced risk of diabetes when given the proper interpretative model, those participants who consumed more carbohydrates "were more likely to be female, tended to be older, were slightly leaner, were less likely to smoke, had lower levels of alcohol intake, were more physically active, were more likely to have a family history of diabetes and had a lower total energy intake." So basically, those who ate higher carb and experienced less diabetes, also tended to do #allthethings to discourage diabetes in the first place.
  • The study notes that some research suggests that glycemic control may involve overconsumption of calories in general, rather than the type of carb per se. This is huge, as calorie overconsumption easily occurs in hyperpalatable diets rich in sugar and fat. Demonizing solely sugar or solely fat in relation to diabetes quite possibly misses the entire boat completely.
  • The study notes that some research suggests that diets low on the glycemic index tend to control diabetes. This noteworthy for What The Health’s claims, since higher carb diets tend to be higher GI compared to lower carb diets. (GI only measures carbs, and fat minimally affects blood sugar.)
  • The study also notes that its findings of fructose and glucose discouraging diabetes risk in certain models, may be due to the fact that these forms of carbohydrates are abundant in produce: More specifically, fruits and vegetables are likely to account for the observed associations, as they are the main sources of fructose and glucose and have been shown to be inversely associated with the risk of incident diabetes."

In the end, when all is taken into account, the study finds that all carbohydrates do not consistently associate with "less" diabetes, and in fact, the only significant sugar-diabetes association (given certain models), involves glucose and fructose. This is, of course, despite the fact that many other studies find just the opposite, particularly when it comes to fructose.

I'm pretty sure all this does not support Dr. Garth's associated claim that "the more carbs someone ate, the less diabetes they had....The starch is, the carbs are good for you. They’re not bad for you. This idea that carbs make you fat is utterly ridiculous." If anything is ridicules here, I'm afraid it's Dr. Garth's conclusions. And as a final note, he also says the study found that "meat was strongly correlated" to diabetes. Again. Not true. In fact, the word "meat" isn't even in the study. So again, I'm not sure where in the world he's getting this from. My best guess is he's inferring this from the studies finding that replacing 5% of energy from fructose with saturated fatty acids (which can be found in meat) increased diabetes risk. But that's not even remotely the same thing...

A BIT MORE SUGARY GOODNESS

To wrap up our analysis of What The Health's not so sweet take on sugar, let's briefly look at a few of its other "facts."

SUGAR AND INFLAMMATION

Dr. Davis does give a brief nod to the idea that sugar may not be ideal, but quickly brushes it away with some more misleading claims: "It’s not that sugar’s good for you. There’s no nutrients in it. It’s excess calories. But, when you eat sugar, you don’t get inflammation right away. When you eat sugar, you’re not getting plaques forming in your vessels. When you’re eating sugar, your body’s gonna store most of it as glycogen or burn it as calories. And so this focus on sugar has taken all the focus off meat, dairy, eggs, pork, turkey, chicken."

This analysis of sugar contains an idea which I am 99% sure is simply not true. Studies most definitely show that sugar instigates inflammation. No way around it! For example, glucose has been shown to encourage free radicals and oxidative stress, and also halt the body's clean up system known as phagocytosis. I also refer you to:

Or just Google "sugar" and "inflammation" and go to town.

SUGAR VS. FAT

Dr. Bernard also makes a misleadingly analogy as epic as its Greek references: "If I eat a sugary cookie, the sugar lures you in like the Trojan horse, but waiting inside that cookie is a huge load of butter or, shortening. And that’s what fattens you up. And that’s the part that leads to the diabetes, it’s the fatty foods, not really so much the sugar."

This is a woefully reductionist view of what occurs when a cookie makes you store fat, as it is likely the complex interaction of sugar + fat (and a myriad of other factors) which is the problem. Think of it like the color purple. You need both red and blue to make purple. Not just red. Not just blue. At the risk of oversimplifying (like Dr. Bernard has arguably done): without the sugar in the cookie, you're unlikely to store the fat as fat. On the slip side, without the fat, the sugar would likely be less detrimental, with no fat to be stored. It's a very complicated process, with a sugar cookie’s hyperpalatability only further influencing the matter. (People don't tend to just binge on pure sugar, or pure fat). If I were Dr. Bernard, I'd rethink such a simplistic interpretation.

THE SUGAR TAKEAWAY

I find the What The Health's almost flippant approach to sugar not only sorely misguided, but more importantly, arguably irresponsible in its implications. It paints the picture that if you simply cut out meat, you'll be spared from diabetes. This is despite the fact that studies overwhelmingly show sugar intake correlates to diabetes, while low carb diets (containing meat! Gasp!) can benefit insulin sensitivity and diabetes risk. I'm actually ok with entertaining the argument that sugar does not "cause" diabetes. But saying it bears absolutely no role in the matter? That's borderline absurd.

COOKING PROBLEMS

What The Health highlights common problems with cooking methods (yey!), only when it conveniently supports its anti-meat hypothesis (not yey!) As Dr. Bernard notes, "Heterocyclic amines are clear-cut carcinogens, and they can form in any kind of meat as it’s heated, as it’s cooked.” Yep. Totally true. This is actually a reason I go into great detail regarding cooking methods in What When Wine, (and probably drove celeb chef Ariane Resnick crazy in my obsession on cooking temperatures and methods). I completely advocate cooking meals at lower temperatures, and also embracing accompanying plants and drinks (Oh hey garlic and wine!) which can help mitigate toxic byproducts. That said, the problem here is not the meat itself, it’s the cooking process. Big difference.

Watch What The Health, and you’ll be convinced only cooking meat leads to bad things. But this isn’t even remotely true! Cooking plants (and particularly plant oils) at high heat yields its own overwhelming share of toxic byproducts, like advanced glycation endproducts (AGE’s). Grilling, flash frying, and even sautéing veggies can lead to many a toxic, carcinogenic compounds. Yet all mention of this is shockingly absent in the film. Compare, for example, raw sushi, tartar, a rare (or even medium rare) steak, to grilled vegetables or vegan French fires: Which one will have more toxic byproducts from cooking? I’ll give you a hint: It’s probably not the meat. In fact, saturated animal fats like butter, ghee, and tallow, tend to be highly more stable and less prone to oxidation than their vegan plant oil counterparts.

Rare meat also contains arguably no toxic compounds, and is easily assimilated by the human body, whereas many veggies, legumes and grains feature an abundance of antinutrient compounds in their “natural” state, such as gluten, lectins, phytates, saponins, and more!

PESTICIDES, HERBICIDES, GMOs

Similar to its cooking problem discussion, What The Health emphasizes the issues of modern growing practices… when it’s convenient for an anti-meat thesis. The documentary spends a vast amount of time outlaying the problems with pesticides, herbicides, GMO feed, antibiotics, and other environmental toxins accumulating in our animal food supply, and highlights the growing problem of antibiotic resistance.

The problem? In an almost shocking "oversight," the creators only look at how this applies to animal products. Yes, the accumulation of these toxins is a huge problem, since such compounds can accumulate in an animal’s fat, and thus end up in us! I’d even wager it’s a key reason animals products today are linked to disease. Yet in focusing on animals only, What The Health completely ignores the fact that pesticides, GMOS, and toxins are overwhelmingly present in conventional produce as well. Like hardcore. While animals have to eat the problematic food sources (which is the root of the problem – no pun intended - rather than the animals themselves), fruits and vegetables can be straight up genetically engineered from the beginning, and even doused with the stuff. Talk about immediate entrance into your body!

Forgoing animal products will not automatically protect you from environmental toxins. Compare, for example, two potential diets: a Paleo diet featuring organic, sustainable, meat, versus a vegan diet awash in conventional produce. Which one will harbor more problematic toxins? True, conventional produce is likely not the approach advocated by the filmmakers (of course it’s hard to tell, since they never discuss it), but the point is that simply eschewing animal products does not automatically free you environmental toxins. Nor do animal products or produce equal environmental toxins. Using environmental toxins as a mechanism to support an anti-meat hypothesis is beyond frustrating. It’s basically: Environmental toxins are bad ergo meat infused with environmental toxins are bad ergo meat is bad.

See where we skipped a step?

It'd be like saying cursing is bad so boys who curse are bad so boys are bad. If that's not faulty logic to start, it's like then saying, so girls are good. Even though girls can curse too!

As a final note of frustration, What The Health even argues that choosing organic doesn't solve meat’s toxic problems, because the toxins are so pervasive in our environment. Well guess what folks, this goes for produce too… and arguably much more so!

DAIRY

I'm actually on board with What The Health's overall take on dairy – a grey area in the Paleo world. As discussed throughout the film, dairy products are technically hormonal growth fluids intended to, for example, grow a calf into a cow, making dairy’s application to human consumption worthy of debate. Dairy can also be rich in toxins and growth hormones which accumulate from the animal’s conventional food supply, while the casein protein found in dairy can be quite inflammatory for many, and notably addictive. I also agree with the documentary's proposition that calcium from milk is not "required" to build strong bones, as studies do indeed find the link to be tenuous, and calcium retention likely has more to do with one's overall dietary composition and balance of nutrients, rather than concentrated calcium supplementation per say.

That said, What The Health damns all dairy, and I do believe organic, raw cultured dairy products may work for (and even benefit) some people. Many long-lived populations consume their fair share of dairy, and some studies find that vegetarians who include dairy and/or eggs in their diet experience significantly increased mortality rates and health biomarkers. The film also fails to account for the difference between A1 and A2 dairy milk, which involves a genetic change making most modern milk products (particularly in the US) more inflammatory, and associated with more health issues.

VEGAN IDEALISM

Let me commence by saying that I am not anti-vegetarian nor anti-vegan. Unlike What The Health's proclamation of a one-size-fits-all dietary panacea, I believe we are all unique, and many people thrive on many different dietary approaches, thanks to varying genetic, environmental, and other lifestyle factors. Some people can rock the entirely plant-based world like non other. Others likely fare better with some animals represented in their diet. With that in mind, I'd like to address the film’s main problematic veganesque assertions, and encourage you to adopt a more nuanced diet worldview.

ADEQUATE NUTRITION

In response to the question of "Will I get the nutrition that I need on a plant-based diet?”, Dr. Bernard skirts the question with a completely misleading and borderline preposterous claim: “The fact is, you’re not getting the nutrition you need on a meat-based diet, and you’re gonna get dramatically better nutrition on a plant-based diet." And then later: “If you think about it, there is nothing in an animal-based diet that you can’t get in a healthier form somewhere else.”

Ok, I’m trying to keep my cool here, I really am.

Overall, a plant-based diet can, indeed, provide most nutrition. It can definitely provide adequate protein, which is often the go-to first nutrient questioned by vegetarian doubters, and which What The Health addresses.

That said, Dr. Alan Goldhamer does discuss the adequate amount of protein you would get if you just ate a diet composed entirely of broccoli and brown rice. (“If you ate a diet that was calorically adequate and even things like brown rice and broccoli and you got enough of it, you’d get enough, both quantity and quality of protein. 2,000 calories of brown rice and broccoli is gonna be about 80 grams of protein a day, including the essential amino acids that you need in order to maintain optimum health.”) Now, as mentioned, I’m not debating if we can get adequate protein from plants, which we can. However, I would like to briefly note that if What The Health can make the argument that you can get adequate protein from a diet composed entirely of rice and broccoli, which would not provide adequate ­amounts of other nutrients like EFAs and B vitamins (to be discussed in a bit), I would like to point out you could survive entirely on a diet of just meat, especially if non-conventionally raised, with arguably no deficiencies. While I’m not saying this is ideal (it’s an extremist diet suitable for arguably a relatively select few), many people actually do, indeed, do this. Just check out the related zero-carb Facebook groups like Principia Carnivora, spearheaded by Esmée La Fleur of https://zerocarbzen.com.

And historically, Arctic populations like the Inuit consumed a near entirely meat-based diet with extremely little plant mater, yet experienced no vitamin deficiency problem, including scurvy from vitamin C deficiency. I recommend reading this excellent article: The Inuit Paradox How can people who gorge on fat and rarely see a vegetable be healthier than we are?  Of course, the historical Inuit diet featured things like liver and brain, and the same can likely not be said for a diet based on conventionally-raised meat more rich in saturated fats and toxins. But if What The Health can “just say”, then I argue I can “just say.”

But back to more pressing, less fringe dietary matters.

An entirely plant-based diet does not automatically provide adequate B vitamins. It’s just a thing. B vitamins, specifically the key B12, are found in high amounts in animal products. They’re super important for proper energy production and cellular metabolism, red blood cell formation, the nervous system, synthesis of DNA, and cellular detox. B12 deficiency can result in low energy, fatigue, cognitive dysfunction, memory loss, oxidative stress, inflammatory homocysteine, and an inability to properly detox, among other issues. There’s a reason we’ve been eating meat for millions of year! We simply cannot acquire adequate B12 on an entirely veggie diet without supplementation – which is pretty good evidence that we are omnivores, not herbivores. (To be addressed in the next point.)

Another nutrient underrepresented in a vegan approach is omega-3s fatty acids, which are vital for health, particularly cell membranes and brain function. While you may not need them in massive quantities, you need them in consistent quantities. While plant lovers are often quick to point out the abundance of omega-3 fatty acids found in nuts like flaxseed, this ALA form is not the usable, vital form of DHA and EPA needed by the body. In fact, the conversion rate is estimated to be below 5%. Yikes. Today’s abundance of omega-6s found in grains and processed foods further encourages an inflammatory omega-3:6 ratio, and vegan diets tend to be quite high in omega-6s, due to their plant-based nature.

These missing nutrient problem are why I recommend in What When Wine that vegetarians and vegans supplement with methylated forms of B vitamins (see my post MTHFR Mutations: Do you have this hidden kryptonite?  for why methylated!) and algae-based omega-3 supplements. And there’s nothing wrong with supplementing! But let’s please don’t pretend an entirely plant-based diet does indeed provide 100% of one’s nutritional needs, when it simply doesn’t. Arguably, the only diet which can 100% provide all nutritional needs, is an unprocessed whole foods diet inclusive of plant and animal products, like we’ve been consuming for eons! (Did I just make an absolutist statement? It happens.)

DIGESTIVE SYSTEMS: HERBIVORES AND FRUGIVORES AND OMNIVORES, OH MY!

What The Health makes the familiar vegetarian argument that we are not omnivores, but rather “frugivores” – animals who consume almost all fruits. This is all despite the fact that nearly everything in our biology points to us being overwhelmingly omnivore. In Kip’s words:

Humans’ closest living relatives are chimps who get 97 percent of their calories from plants and the remaining three percent mostly from insects. Comparing the anatomy of true omnivores like bears who eat both meat and plants to frugivores like primates­­ who eat almost exclusively plants, the differences are pretty clear. Frugivore teeth have flat molars for chewing plants, where omnivore teeth are serrated for stabbing and tearing flesh. Frugivore jaws can move forward and back and side to side, omnivore jaws cannot. Omnivores have much stronger stomach acid for digesting meat compared to less acidic stomach acid of frugivores. The intestines of frugivores is nine times their body length compared to three times for omnivores. This is because meat will putrefy in the gut unless it is moved through quickly. If humans were indeed true omnivores, we would need to change our physiology and appearance quite a lot. But, we fit every requirement of a frugivore. We may behave like omnivores, but, anatomically, we’re frugivores.

Ok, let’s unpack this a bit.

Terminology

The doc uses the “frugivore” terminology - which insinuates a primarily fruit-based diet - while primarily prescribing to the spirit of “herbivore” terminology involving all plants in general, which makes qualifications a smidge difficult. In any case, while I suppose humans could technically be called frugivores by the general definition (“an animal that feeds on fruit”), omnivore (or perhaps “omnivores who are sometimes conscious frugivores”) just makes so much more sense. An omnivore is an animal adapted to eat a mixed plant and animal diet, which is exactly what we are, as we shall discuss. Why struggle to make us fit one model, when we more obviously fit another? 

Our Similarity To Chimps

 At first glance, our genetic similarity to chimps seems like a valid point, as humans bear an estimated 96% genetic similarity to chimps. However, we also feature around 40 million genetic differences, with a couple being pretty significant. On the digestion/fuel side of things, it’s sort of like if we were to compare a gas oven, an electric oven, and a gas grill. While the two ovens would seemingly be most “genetically” similar, they use different fuel sources, while the grill actually uses the same fuel source as one of the ovens. In other words – it’s the specific adaptations for utilizing a fuel source, rather than the historical “category,” which determines what the appliance best runs on. Would you walk up to an electric oven and argue that it actually was made to use gas? Have fun with that.

It simply makes much more sense to look at our current digestive state, rather than our relative’s digestive state. Chimps have also not evolved the ability to use fire, cook, talk, etc. More on that in a bit! As a final note, humans share about 90% similarity to cats, just saying.

Our Teeth

What The Health points to our teeth as evidence that we’re not meant to eat meat. In addition to Kip’s previously mentioned dental comments, Dr. Milton Mills says, “Human beings, unlike bears and raccoons and to some extent, dogs, don’t have that mixed anatomy and physiology that you see in the true omnivores, and thus, we are not true omnivores. In humans, the canines have become really small and rounded and actually function like accessory incisors. They’re utterly useless for ripping and tearing anything other than an envelope.”  To illustrate this point, Kip mockingly attempts to “eat” his cat – a wonderfully subtle way to further foster negative associations with meat eating.

While I personally do eat meat just fine with my teeth, even in its raw (I mean “rare”) tartar form, I’ll let the filmmakers have this argument from a purely practical perspective. That said, there’s a reason we don’t have crazy sharp canine teeth. Thanks to our evolutionary history and advancements in using tools and fire, we no longer need typical carnivorous teeth. Because we figured out to cook and all that. Our teeth make perfect sense for eating both plants and cooked meat, per our new skill set. So when Kip says,“I always thought my canines were for meat, but, what kind of animal could actually kill and eat raw with these tiny teeth?”, he’s making a completely true yet completely irrelevant point. We don’t need teeth for killing animals and eating them raw, because we don’t need to do that! And if we’re making comparisons anyway, please look at the razor sharp canine teeth of the largely herbivorous pandas, gorillas, and baboons: Clearly we can’t judge diet completely off of teeth! (I would honestly love to hear What The Health’s Response to this!)

As a final note, I’d like to point out that teeth function for the mechanical breakdown (compared to chemical breakdown) of food. Meat is primarily digested chemically in the intestines, whereas plant matter – rich in fiber – does require more mechanical digestion up front. As omnivores, we don’t really need intense teeth for meat which is primarily chemically digested in our adept intestines (up next!), whereas we can definitely still benefit from maintaining our herbivoreaceous molars for the plants we eat, especially given our lack of truly epic plant digestion like “true” frugivores/herbivores. As for meat “putrefying” in the intestines, please see “Meat and Bacterial Toxins."

Speaking of digestion…

Our Stomachs/Intestines

Our digestive system does not most closely mimic that of a frugivore/herbivore. Vegetarian animals feature a dominant large intestine for proper fermentation of plant matter by gut bacteria, which generate fatty acid energy production as a byproduct - a primary reason they can grow so strong on such a diet. This also means herbivore animals on “low fat” diets composed of plants are, in a way, actually living on a high fat diet. As discussed in Dr. Steven Gundry’s The Plant Paradox, gorillas, for example, ultimately “consume” a diet of around 65% fats thanks to their digestive system, despite eating nearly fat free vegetation fare! Humans, on the other hand, feature a shortened large intestine and elongated small intestine. While we can still ferment plant matter in our bacteria-rich large intestine, our dominant small intestine is relatively free from bacteria (or should be – I’m looking at you SIBO!), and is primed for digesting and assimilating protein and fat, presumably from animal products. We notably evolved to this state, away from the typical herbivore digestive structure, in order to specifically digest meat. Why else would our small intestine have “grown”, and large intestine have “shrunk”? (Side note: Unlike herbivore and frugivore ruminants, including the Colobinae monkey subfamily, we also can’t digest cellulose.)

Kip also quotes the frugivore intestinal tract as 9 times their body length, compared to an omnivore’s digestive tract being 3 times their length. Well, a human’s total intestinal length is around 25 feet, making it around 5 times our height, closer to the 3 times omnivore than 9 times frugivore. Argument fail.  And as discussed in the teeth section, our advancements in cooking further supported this intestinal transition. Plus, our transition to a meat-rich diet supported the evolution of our brains, as we could more easily extract energy from food, while consuming fats vital for cognition.

“Is” Versus “Should”

 While you can certainly make the argument that consciously living as an herbivore equates to a heightened state of being or supports more environmentally-friendly practices (more on that in a bit), such philosophical discussions of what we “should” be simply do not change what we are. It does not change our nutritional requirements, or our current digestive state. We can feed chickens, for example, vegetarian feed till the cows come home (and charge more for it!), but it doesn’t change the fact that chickens are naturally omnivores which eat insects, fruits, grasses, and leaves. Yet nobody is arguing that chicken are naturally vegetarian. (If you find someone who is, please let me know!) Environment may change these poor chicken’s diet, but it does not change their biology (or at least hasn’t yet!)

It’d be like finding a vending machine which can accept both cash and credit card, and saying, “Actually this vending machine is only meant to accept credit cards.”  While you can certainly argue that one of those accepted currencies is safer, cleaner, or better, it does not change the fact that the machine can accept both. It doesn’t make it any less suited for one or the other. (I could go on a tangent about how trying to feed a vending machine euros when it accepts dollars is like us trying to eat incompatible foods, like grains, but I’ll save that argument for another day. #Focusing)

The Strongest?

As one last potential throwaway yet often noteworthy point, Dr. Milton Mills also claims that "the largest, strongest terrestrial animals on the planet are all herbivores. The biggest, strongest animals are all herbivores." Again, truth is sacrificed in the face of absolutism. I invite the producers of What The Health to go look up the definition of “all,” and re-evaluate this statement. Yes, many strong animals are herbivores, such as elephants, gorillas, and rhinoceros. But not all. What about the carnivorous jaguars, crocodiles, polar bears, eagles, or, dare I say, the honey badger? Yes. I went there. All carnivores. And why does it even have to be a contest? I mean, if truly the only strong animals were herbivores, or even almost all were herbivores, I’d get it. But that’s not even remotely the case. It’s just like there are strong vegan and omnivore humans (though you could argue most body builders do consume animal protein.) Ultimately, the strongest among us humans are those who have found the diet which supports their body. To that point, if we do use comparison as an argument, what should we use as our parameter for determining the best diet for a strong human? The majority of strong humans, or the majority of strong animals?

One final note on the topic: As discussed, humans don’t even need to be the physically strongest animal, thanks to the advancement of brain power (from a meat-based diet) allowing us to build tools and weapons which replace the need for outright strength.

DISEASE ORIGINS

What The Health makes the argument that current degenerative diseases stem from eating meat, processed or not. In Kip’s words, “All these diseases I had learned about were from eating a diet our body wasn’t designed for. What would happen if we started eating a diet our body actually was designed for?”

Ironically, I hardcore agree with Kips’ underlying theory: Yes, a majority of modern diseases most likely come from eating things we weren’t designed to eat! Exactly! But… we are designed for meat! Meat and plants, as discussed in the prior section. Just consider the fact that degenerative diseases (in comparison to infectious diseases), are a relatively “recent” phenomenon, and Paleolithic man was largely free of the former, despite munching on a diet quite inclusive of meat. As noted in the previously discussed study on acellular carbohydrates and an inflammatory microbiota, “[A]nalyses of modern hunter-gatherers have suggested that intake of unprocessed meat does not produce poor metabolic or cardiovascular health, in agreement with the reported historical diets and health of the Masai, Kavirondo, and Turkhana.” 

And as discussed in a 2002 review of 13 dietary studies of “The paradoxical nature of hunter-gatherer diets: meat-based, yet non-atherogenic”:

Field studies of twentieth century hunter-gathers (HG) showed them to be generally free of the signs and symptoms of cardiovascular disease (CVD). Consequently, the characterization of HG diets may have important implications in designing therapeutic diets that reduce the risk for CVD in Westernized societies…. [A]nimal food actually provided the dominant (65%) energy source, while gathered plant foods comprised the remainder (35%). This data is consistent with a more recent, comprehensive review of the entire ethnographic data (n=229 HG societies) that showed the mean subsistence dependence upon gathered plant foods was 32%, whereas it was 68% for animal foods. Other evidence, including isotopic analyses of Paleolithic hominid collagen tissue, reductions in hominid gut size, low activity levels of certain enzymes, and optimal foraging data all point toward a long history of meat-based diets in our species... The high reliance upon animal-based foods would not have necessarily elicited unfavorable blood lipid profiles because of the hypolipidemic effects of high dietary protein (19-35% energy) and the relatively low level of dietary carbohydrate (22-40% energy). Although fat intake (28-58% energy) would have been similar to or higher than that found in Western diets, it is likely that important qualitative differences in fat intake, including relatively high levels of MUFA and PUFA and a lower omega-6/omega-3 fatty acid ratio, would have served to inhibit the development of CVD. Other dietary characteristics including high intakes of antioxidants, fiber, vitamins and phytochemicals along with a low salt intake may have operated synergistically with lifestyle characteristics (more exercise, less stress and no smoking) to further deter the development of CVD.

Now, it makes a whopping ton of sense to me that, in order to ascertain what caused a major shift to degenerative disease, we should look and see what changed at the time these changes occurred. So what was that? What are we not “designed” for? Simple: The things we haven’t been eaten as our digestive system evolved. Were we not eating meat and then we started eating meat? That’s a definite no. Were we eating plants and then we stopped eating plants? Again, nope. So what did change? Well, foundationally food wise, we started eating grains. And after that, processed and refined foods.

All along, through everything, we typically ate plants and animals, so I highly doubt degenerative disease’s root is one or the other. I'd argue degenerative disease primarily started with agriculture. NOT MEAT EATING. Where were all these disease when we caveman were chowing down on animals?

As a last point: since What The Health rages on about fat, not sugar, causing disease, I would like to point out two major things: 1. Sugar is overwhelmingly linked to disease. 2. The one fat overwhelmingly linked to disease is actually totally vegetarian: trans fat. Just. Saying.

THE PALEO ATTACK

Perhaps my biggest personal headache with What The Health occurs when it takes uber low ball jabs at "Paleo," without ever defining what Paleo is - at least not accurately. Unfortunately, the film paints a stereotypical picture of Paleo as an overwhelmingly carnivorous diet consisting mostly of meat – a common problem of society’s interpretation of “Paleo” at large. Worse yet, it does so with an almost bullying tones. (For example: Dr. Michael Klaper’s snarky comment about his “Paleo friends” consuming “a flesh based diet.”)

The spirit of Paleo, however, has nothing to do with meat at all, despite the food pyramid graphic I created for the original What When Wine Diet, birthed in my early Paleo years, and which I have since revised. Rather, Paleo is about eating whole foods in line with our constitution and digestion, which support personal health. This tends to be overwhelmingly inclusive of fruits and vegetables.

What the film does fail to mention is how Paleo cuts out inflammatory processed concoctions and grains (though I get why they wouldn’t care about the later). In the utmost of ironies, the films brands Paleo as "inflammatory," when the goal of Paleo is to eliminate inflammatory foods. {So. Much. Sighing.} You could even be Paleo and vegan, as long as you cut out fake, processed vegan foods and inflammatory grains, making Paleo (in my opinion) arguably superior to exclusive veganism.

When Dr. Klaper posits that “Paleo folks are setting them-self up for an epidemic of clogged arteries, colon cancers, autoimmune diseases,” he’s overwhelmingly misleading and, dare I say, just plain wrong. The studies (notably few and with small sample sizes, but overwhelmingly consistent and supportive) simply don’t show this. Consider the following:

  • A 2009 study found that a Paleo-style diet instigated beneficial blood glucose and insulin responses in nine healthy individuals in a mere ten days. Metabolic and physiologic improvements from consuming a Paleolithic, hunter-gatherer type diet." 
  • A 2009 randomized controlled crossover study of thirteen diabetic patients compared a similar Paleo diet to a diet recommended by the American Diabetes Association (whole-grain bread, cereals, vegetables, tubers, fruits, and decreased fats). It found that the Paleo diet produced better results than the ADA diet for managing diabetes and improving glycemic control.
  • A 2007 randomized controlled trial compared a Paleo diet (lean meat, vegetables, fruit, nuts, tubers, and eggs) to the Mediterranean diet (whole grains, low-fat dairy, vegetables, fruits, oils, and margarine) in twenty-nine individuals with heart disease, diabetes, or glucose intolerance. It found the Paleo diet reduced glucose AUC (which refers to the body’s glycemic response) by 26 percent, compared to a paltry 7 percent in the Mediterranean diet!

As a final note, What The Health also fails to define veganism, which is another major problem. Why? Because you could technically be vegan and consume all processed foods. You could be vegan and eat inflammatory grains for every meal.

In any case, if you're going to bash a diet, you should at least pay it enough respect to define it.

HIDDEN MOTIVES & AGENDAS

What The Health fosters further frustration as it accuses certain health organizations of skewing evidence and parading hidden agendas, when it, in fact, does the exact same thing.

In the film’s “shocking” revelation which would make any prime time murder re-enactment show jealous, (“What if... And there it was!”), Kip discovers many a nefarious sponsor behind key “health” organizations, imparting the impression they’re 90 if not 100% funded by the processed food, meat, and dairy industries. While I actually wholeheartedly agree that biased funding is a quite a problem (don’t even get me started on the USDA, FDA, an­d pharmaceutical industri­es!), the film’s presentation of this conspiracy nevertheless misrepresents the whole picture in its vegan agenda. While presumably true at the time of Kip’s initial “discovery,” many of the highlighted “secret” sponsors are no longer sponsors (which would have been nice to clarify), and also constitute an overwhelming small percentage (and thus representation) of the total sponsors at large. Here are Kip’s “discoveries,” followed by the actual breakdown, as of October 2017.

Claim #1:The American Diabetes Association was taking money from Dannon, one of the world’s largest dairy yogurt producers, Kraft Foods, makers of Velveeta processed cheese, Oscar Meyer processed meats, Lunchables processed kids’ meals, and Bumble Bee Foods, makers of processed canned meats.”

Current Reality: While Dannon is still a national sponsor of the ADA, I cannot find any source for Kraft. What The Health’s only “Facts” references for Kraft include a 2011 article listing the company as one ­of 5 sponsors for the ADA’s free 12 month “Living With Type 2 Diabetes Program” (which I do not believe they still sponsor), a 2006 article discussing Kraft’s sponsorship (noted to have expired that year), and finally a few “Everyday Recipes” available only by the What The Health link, and not through the current ADA Recipe section of the website. These recipes themselves refer to a dead link for “more information about Kraft Foods’ support”: “kraftrecipes.com/ada. In other words, I’m thinking Kraft is no longer in the picture. Even if Kraft were still a supporter, and even though they do overwhelmingly produce processed cheese products like Velveeta, they’re also behind the meatless, vegetarian-friendly Boca Burgers. Just saying.

As for the others, Lunchables are produced by Kraft, so I’ll stop with that. Bumble Bee does list their support of the ADA on their website (but not vice verse), however the ADA itself recommends seafood and does not caution against canned versions of such. While some Bumble Bee products do, indeed, contain quite a bit of additives (like their “Snack Kits” line), others are simply canned, pouched, or frozen seafood with minimal additives (some just contain water and salt), and the company also creates some sustainable and wild caught lines as well. (Though I know What The Health isn’t down with that.)

In any case, the majority of the ADA’s 30+ sponsors include pharmaceutical, energy, insurance, and clothing companies, hotels, banks, etc. Talk about a lot of hidden agendas! In fact, the entirety of the 10 top Banting Circle Supporters, noted as the ADA’s “highest level of recognition” pledging the most money, are all pharmaceutical industry related. The second tier “National Strategic Partners” are Colgate toothpaste, CVS, and NRG Energy. Of the 12 “National Sponsors, only 3 are food related: the aforementioned Dannon, Merisant Company (which produces the What The Health-unfriendly sweetener brand Equal, but also the arguably What The Health-friendly sweetener brands Pure Via and Whole Earth), and then…. wait for it….Wonderful Pistachios. Which just speaks for itself.

Claim #2:American Cancer Society was taking money from Tyson, one of the world’s largest meat producers and Yum! Brand, owner of Pizza Hut, KFC and Taco Bell.

Current Reality: Neither Tyson nor Yum! are listed on the American Cancer Society’s website for their current ~25 sponsors. The only listed food related sponsors are the super vegetarian-friendly Fresh Thyme Farmers Market, the vegetarian-friendly Pampered Chef, and the not-so-vegetarian friendly Long John Silver, making 2/3 of the vegetarian friendly.

Claim #3: Susan G. Komen, who was supposed to be fighting breast cancer, was corporate partnering with KFC, Dietz Watson processed meats and Yoplait yogurt.

Current Reality: I can’t find KFC or Yoplait listed in Susan G. Komen’s 50+ sponsors (What The Health’s online referred Yoplait source is from 2010.) The only current food-related sponsors appear to be Nature Sweet Tomatoes and Farm Fresh Eggland’s best. So half of those are kosher in What The Health’s eyes. And again, that’s out of over 50 sponsors.

Claim #4: “And the American Heart Association was probably the most disturbing of all, taking hundreds of thousands of dollars from the beef industry, poultry and dairy producers and millions from fast food and processed food manufacturers.

Current Reality: Most disturbing of all… and potentially most vague of all. Out of around 30 sponsors on the AHA’s main sponsor page, only two relate to food: Haas avocado and Cheerios. One vegan-friendly and the other vegetarian friendly. (Cheerios contain honey). What The Health’s online sources provide links to a page with Cargil – a producer of meat products – as one of 12 local sponsors of the AHA’s “Go Red For Women” program in Colorado Springs." In other words, Very. Specific. The other sources refer to 3rd party references to the Texas Beef Council (TBC) and Kentucky Beef Council supporting the AHA. The former lists their desire to partner with the AHA “to share with consumers the many ways beef can be part of a heart-healthy diet.” So this is tricky, since, in What The Health’s perspective, red meat is damning to health, though I beg to differ, and the original red beef source linking beef to cancer, is, as we analyzed, a bit misinterpreted.

So why am I analyzing all this ad nauseam if I agree with the problems of influential funding, especially the pharmaceutical industry, which actually do form a majority of the sponsorships? Simply to illuminate What The Health’s incessant cherry picking to prove a point. It makes it seem like health organizations are entirely funded by the meat and dairy industry, when they're actually funded by commercial industries in general (particularly pharmaceutical-related which, are, unfortunately, quite commercial here in the US. {Sigh.}) Furthermore, since these sponsorships constantly change, I’d encourage focusing on the supporters of particular campaigns, studies, programs, and resources, rather than any one organization as a whole. (Until there comes a time when, say, the AHA actually is funded 90% dairy or meat industry.)

It’s also worth noting that What The Health was crowd funded by 3,157 individual internet supporters pledging various amounts of money. Do you think all these financial supporters of the film were vegetarian? I highly doubt it. Do you think the What The Health producers accepted money from meat eaters? Probably. While I suppose the entirety of the Indiegogo funded $273,428 could have come from the pockets of meat-abstainers, something tells me that’s unlikely. How can What The Health attack an organization’s funding, when it itself accepted money from anyone?

In the end, What The Health commits an equally “secret” motive-driven crime, incessantly twisting information to support a vegan agenda. Almost all the interviewees are vegan (or at least biased towards such). An overwhelming number of the film’s online references come from the heavily featured Michel Greger’s own website: NutritionFacts.org. I'm pretty familiar with Dr. Greger, as many of his DVDs covering recent studies were mandatory material for my certification in holistic nutrition from the AFPA. While I totally appreciate his dismantling of studies (It’s nice to see a doc reading them!), he definitely embraces an uber vegan bias, for better or worse. Additionally, half a dozen of the referenced studies are by Neal Bernard, some of which contain instances of data correction. While you could argue these interviewees are not financial supporters, they nevertheless center their careers around their websites, books, and ideas, and I’ll betcha benefited financially from the film’s release.

CONCLUSIONS

Ok, I know I went sort of super overboard with this post. For reals. And if you read all of this and are still with me these 11,500+ words later, we should probably be friends. Or lovers. Or both. Or maybe roommates? In any case, here are my (relatively) brief conclusions. I’ll start with what I like about What The Health. (Gasp!)

I agree 100% that disease is fundamentally tied to diet. I mean, that’s sort of my thesis in life. As Dr. Klaper says, "It's the food!" Yep, you bet your sweet (though I contextually use that word cautiously) life, it’s the food! I also totally agree that our common medical system simply treats symptoms and perpetuates problems, unlike preventative lifestyle (particularly dietary) approaches which can discourage disease in the first place. And as we just discussed, many industries and studies are funded by biased sources to further breed this problem.

I also love What The Health’s discussion of genetics vs. epigenetics - the idea that diet and lifestyle are what primarily turn our genes “on” or “off”. (For example, the film points out that only 5% of cancer is a genetic mutation.) And I’m overwhelmingly concerned with the vast problems of pesticides, GMOS, and environmental toxins, and am sickened (mentally and literally) by conventional livestock farming methods. Also down with the problems and negative health effects of processed foods and modern dairy.

So. Much. Agreement.

Actually, if What The Health could argue such theses without cherry picking, misleading, and ultimately supporting a not-so-secret agenda, I could even passionately recommend the film for viewing, lack of animal products in the prescribed diet or no!

But such is not the case.

Ultimately, What The Health takes the insanely complicated topics of health and nutrition – a world replete with grey areas and individuality – and turns it as black and white as Casablanca. Suddenly every study supports vegetarianism. Suddenly every illness comes from meat. Suddenly we weren’t sick until we started eating animal products. Suddenly our digestive system is not made to process animals, despite digesting them for millions of year. Suddenly plants can do no wrong for our digestive system, despite their often resilient ability to attack our digestive systems with a slew of antinutrients. Suddenly meat can only do wrong, processed or no.

Even if you go to What The Health’s website to look up its references, which you'd think would be under a section called, I dunno, perhaps "Studies" or "Sources" or “Support,” instead you get the page title of "Facts." Yep. Facts. Because self-proclaimed hypothesis studies clearly count as facts. Because evidence clearly count as facts.

And so in the end, What The Health commits the very crime it condemns: it cherry picks, skews, and misleads to champion a particular lifestyle. And while a plant-based diet is typically an insanely healthy alternative to the Standard American Diet, such a diet (like many “health” diets, including certain manifestation of “Paleo”) still comes with potential detrimental health effects. What about the overwhelmingly problems linked to grains (which I barely even touched on?) What about those needing more B12 for proper methylation? What about mothers needing adequate omega-3s for pregnancy? Now it’s safe for those prone to diabetes to ingest sugar? Now we should avoid low toxin, wild caught fish and sustainably-raised livestock rich in nutrition?

I simply wish What The Health could address the problems of our modern food supply (toxins, chemicals, hormones, GMOs, etc.), and then posit a logical, unbiased argument for a plant-based diet. I’d be all ears. Skewed sensationalism, however, typically wields more harm than good.

Why can’t we all be friends? Why can’t we join hands in supporting our health and the environment? (I didn’t even go into my thoughts on sustainable farming methods, and the environmental taxations of a plant-based system reliant on grains, which we shall save for another day! In the mean time, check out The Vegetarian Myth: Food, Justice, and Sustainability by former 20 year vegan Lierre Keith for more on the topic.) I so deeply wish we could fight together against today’s toxic food, farming, and medical industry practices, and support a sustainable diet inclusive of all the foods we’re naturally meant to eat, and have been eating for centuries. I wish we could sit in peace around the proverbial and literal dinner table, and engage in thoughtful discussion about “ideal” diets – if such even exist.

But such requires an honest evaluation of the “facts,” an openness to research, and a welcoming of new findings. And perhaps most importantly, the ability to change when appropriate.

Ok, now I’m just getting emotional. Perhaps the time has come to make my own film on the matter. (Shout out to USC School of Cinematic Arts!)

How about you? Where do you stand in the animal and/or plant debate? Paleo and/or vegan? I'd love to hear your thoughts in the comments below!

REFERENCES

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