Chapter 65
Replace the Meat
Most people don’t actually want to live longer if they can’t remain mentally and physically healthy. Beyond their high life expectancy, Adventist vegetarians also appear to be healthier, as shown by the fact that they take fewer medications and need X-rays, surgeries, and hospital stays less often. Vegetarians also enjoy the higher quality of life that results from having fewer chronic diseases. A study of 15 000 American vegetarians found that they had significantly less coronary heart disease, fewer strokes, less high blood pressure, less diabetes, less diverticulosis, fewer allergies, and were overall significantly less sick—even after the study was adjusted for factors unrelated to diet, such as smoking. In addition, the researchers found that nonvegetarians were more likely to have had to undergo a wide variety of surgeries, from varicose veins to hemorrhoids to hysterectomy. In addition, they took lots of medications. It was twice as likely that meat eaters took aspirin, sleeping pills, tranquilizers, antacids, pain relievers, blood pressure medications, laxatives, and insulin.
All of this means that vegetarians incur significantly lower treatment costs. Compared with nonvegetarians who neither smoked nor drank, vegetarians required significantly less inpatient or outpatient treatment, and their costs related to depression were almost 50 percent lower. One reason participants in plant-based diet intervention studies adhered to the protocol so well is that not only do their measured values improve, but they usually also feel much better. Those randomized to the plant-based diet reported a significantly higher quality of life and better mood than those eating a conventional diet, which likely encourages them to stick with the plant-based diet over the longer term.
Success breeds further success. A few days or weeks after switching, patients feel the benefits of a plant-based diet beyond improvements in blood sugar values and weight, which reinforces their new eating habits and motivates them to continue. In fact, plant-based foods can sometimes work a little too well. In studies where subjects are supposed to eat plant-based only temporarily, they sometimes feel so much better when they eat healthier that they don’t follow the study protocol, instead refusing to return to their original diet.
What do you think is more efficient? Asking patients to make larger or smaller dietary changes? Paradoxically, studies have shown that prescribing larger changes leads to larger changes, which is why researchers concluded: “Perhaps we should replace the usual ‘everything in moderation’ with ‘big changes lead to big results.’” But it doesn’t have to mean “all or nothing.”
Replace the Meat
In the United States, the American diet is the biggest factor in mortality risk. It is linked to the most deaths, mostly from cardiovascular disease, and every year about half a million mothers, fathers, sisters, brothers, and friends die from it—just because of what they ate. Plant-based diets are very different: They are associated with a lower risk of cardiovascular disease, as well as a lower risk of dying from it, and actually with a lower overall mortality risk. By gradually increasing our intake of plant foods and reducing animal products, we can live longer, healthier lives—and it’s really that simple.
As mentioned earlier, the largest cohort study on diet and health in history, the NIH-AARP study, found that if just 3 percent of daily caloric intake comes from plant proteins rather than animal proteins, overall mortality drops by 10 percent, in both men and women. Meat intake alone was associated with greater risks of dying from heart disease or cancer and, in general, with a higher likelihood of earlier death. An article about the study in Archives of Internal Medicine, the journal of the American Medical Association, was titled “Reduced Meat Consumption Has Multiple Benefits for Global Health,” and it called for a “far-reaching reduction in meat consumption.”
Among animal protein sources, eggs were the worst. If 3 percent of daily calories came from plant proteins rather than egg protein (especially from egg whites), the benefit was twice as great as replacing meat protein, and mortality for men and women fell by more than 20 percent. Eggs are therefore probably worse than red meat. The researchers concluded that the finding of the superiority of plant proteins also demonstrates that “dietary changes with respect to the selection of protein sources can promote health and longevity.”
How does eating animal versus plant protein affect aging? Healthy aging is defined as the “process of developing and maintaining the functional ability that enables well-being in older age.” Higher intake of plant proteins was associated with a lower accumulation of deficits, in terms of functional impairments, respondents’ self-reports of health and vitality, mental health, diseases, and use of medical services.
Getting just one percent of one’s calories from plant rather than animal proteins led to a significantly lower accumulation of deficits. Now one might think that animal protein and animal fat occur in the same foods, so the benefit of this shift is simply from leaving out saturated fats. But even after accounting for the fat, there is still something going on with animal protein sources compared with plant sources. It is not yet entirely clear whether the health benefit results from eliminating the negative effects of animal foods or from the positive effects of plants; perhaps it is a bit of both.
Eat Plants
Because the benefits of the Mediterranean diet apparently come primarily from the added plant foods, the scientists behind the PREDIMED study developed a “provegetarian” scoring system to observe the effect of the ratio between plant and animal foods. They knew that “pure” vegetarians lived longer, but figured that the recommendation to “eat more plants and less animal foods” would be easier for participants to swallow. Would moving along the scale toward plants enable people to live longer? There’s more about this at see.nf/flexitarian, but it appears to yield a 40 percent lower risk of early death, evidence that “the simple advice to increase the consumption of plant foods and, in return, reduce that of foods from animal sources yields a survival advantage.”
Although there is interest from various sides in maintaining the status quo, for example from the food and pharmaceutical industries, there is one sector of business that benefits when people stay healthy: insurance. Kaiser Permanente, the largest managed-care company in the USA, published an update on nutrition about ten years ago in its own medical journal, in which it urgently reminded its nearly 15 000 physicians that healthy eating is “best achieved with a plant-based diet.” The update read as follows:
Too often physicians ignore the potential benefit of good nutrition and prescribe medications right away, rather than giving patients the opportunity to cure their disease with healthy eating and an active lifestyle … Physicians should recommend plant-based diets to all their patients, especially those with high blood pressure, diabetes, cardiovascular disease, or obesity.
In other words, physicians should give their patients the opportunity to address their diseases themselves first. Kaiser Permanente cited as the biggest downside in its update the fact that a plant-based diet might work a little too well. If people change their diet while they are still taking medications, their blood sugar or blood pressure could fall so much that physicians may need to adjust their medication or discontinue it entirely. Ironically, a “side effect” of changing one’s diet could be that you no longer need to take any medications at all.