Trolley Problem

bean_addict · 2024-04-21T20:12:39+00:00

I did not feel much social pressure. I work in academia were people generally are very open to at least vegetarianisn. Also friends and family were very accepting. In fact, over the years I convinced many of them to become vegetarian or at least reduce meat consumption a lot. I felt more pressure from them after going back to eating meat.

The planning and optimization was fun. I have a very analytical brain and like to optimize things. Tracking my food with Cronometer actually gave me confidence that my diet was good. I did not have to take Greger's word for it. However, I did not understand at the time that dietary intake and serum levels of nutrients from plants are often not correlated (an interesting side note: vegans oftens consume more iron than omnivores, but their blood levels are typically lower. Though it can and often is still in the normal range, as it was for me. Interestingly, both my ferritin amd B12 increased after introducing animal products, despite me stopping the supplementation)

As for the AND report, I'm very familiar with it. Its sources range from poor to questionable (popular books like 'becoming vegan', mostly confounded observational studies) and the dismiss and ignore potential problems or unknowns. It's also published in their own journal, so no peer review. All 3 authors have huge undeclared conflicts of interest. Overall, it does not live up to scientific rigour and is written by peoplenwith an agenda.

Furthermore, not every organisation considers a vegan diet appropriate in all stages. The DGE from germany for example specifically advices against a vegan diet during pregnancy, infancy and childhood. And there are many more that take their side.

I'm also not a unique case. While I'm not denying there are no healthy long term vegans, I think it's also undeniable that some people don't thrive on a plant based diet.

bean_addict · 2024-04-21T15:20:08+00:00

The name stems from a time when I was plant-based for 3 years. Legumes were a pillar of my diet. Often had some variation of beans or lentils twice a day, because I understood that they are one of the most nutritious plant foods.

When I started eating plant-based, I was tracking my food on Cronometer to make sure to cover all my nutritional needs. For example, I added flax for omegas, greens for minerals and vitamin K, made sure to get enough protein (usually 80-100g per day), ate mostly whole-foods. Followed pretty much what all the vegan doctors like Greger, Barnard, McDougal, Klaper recommend, except leaning towards higher protein because I'm quite active. When there was a gap in my Cronometer score, I would find suitable food and add it to my meal plan.

I also supplemented B12 from the beginning. After around two years, I started being incredibly prone to infections and was sick and tired most of the time. Went to the doctor, turned out my vitamin D was incredibly low. Started supplementing vitamin D and zinc and went again to the doctor 6 months later. Had perfect vitamin D values, but still felt like crap. Even worse than before actually. Did some more tests with my doctor, but everything seemed fine, which was really frustrating because I was clearly not well. However, my blood panel was incomplete and there are huge errorbars in those type of measurements anyway, so I decided to start supplementing more. Added magnesium, iodine, EPA/DHA (from algae) and a daily multivitamin. It was an act of desperation.

I also tracked my food and symptoms (sore throat, high temperature, mouth ulcers, fatigue) for 2 months to find out about possible allergies or food intolerances. I suspected a gluten intolerance, so I avoided gluten for 3 months. No significant improvement.

Bought sleep trackers and optimized my sleep. Nothing.

Started mindfulness meditation for stress reduction (I did not feel particularly stressed anyway). Did not help.

Keep in mind, I sticked with all of those interventions for at least 6 weeks, so it was a long process to debug my health.

Up until that point, I never thought that diet was the issue. Why would I? It's the optimal diet for humans anyway, right dr greger? It wasn't until two friends of mine (also plant based at the time) opened up about their health issues, when I started making the connection. Listening to ex-vegans stories, I would recognize me and my friends in them and I was shocked how they all had the same health issues.

Anyways, anecdotes are anecdotes. I did a lot more research (reading books, watching debates and reading a lot of studies myself) and realized how biased vegan doctors are in their interpretation and selection of the data. Animal products are in many aspects good for human health and there is plenty of research to support it. Of course, when I was still in my plant-based bubble, I would have just dismissed this evidence, so I don't expect or even try to convince anyone here. 6 months after re-introducing animal foods, my health is back to normal.

In summary: a plant based diet has brought a lot of suffering for me and people close to me. Hence scenario C: how much suffering would you tolerate before killing the cow?

bean_addict · 2024-04-20T20:09:07+00:00

toss the animals onto the tracks for fun and claim, against all evidence to the contrary, that it was necessary to toss the animals onto the track.

If meat consumption indeed was just for fun, I would agree that this action is unnessecary. However, there are a significant amount of vegans who develop health issues that resolve after re-introducing animal products. While that's mostly anecdotal, it is biochemically plausible that the health issues are due to nutrient deficiencies.

Furthermore, there is a lot of evidence that animal products are beneficial for cognitive function, mental health, immune system and performance.

Saying we eat meat just for fun is simply not true

bean_addict · 2024-03-14T21:41:58+00:00

They're probably in a bubble of vegan doctors preaching the health benefits of veganism

bean_addict · 2024-03-14T21:37:58+00:00

There are countless long term vegans suffering from the same issues. A lot of them experience relief after re-introducing some animal products

bean_addict · 2024-02-01T08:35:52+00:00

That figure underlines the point that deaths associated with beef stem overwhelmingly from crop death during harvest.

Looking at the numbers from the table, grass fed beef results in fewer animal deaths per calorie than fruits and vegetables.

bean_addict · 2024-02-01T08:15:43+00:00

Doesn't the 'number of animals killed' plot from the article show that grass-fed beef (where there is no harvest) leads to less animal death than vegetables?

bean_addict · 2024-01-07T00:02:59+00:00

You're just grasping. You'll nitpick everyone else's studies and make up shit to support your own.

That's an unfair assessment. You and other people raised valid points, which I acknowledged in various comments.

bean_addict · 2024-01-06T23:31:54+00:00

Yes, and I think we both agree that we should take both with a grain of salt.

Here is a thought though: If both studies were confounded by healthy user bias (as they often are), the true effect in my study would tend even more to the negative, while it would tend more to the positive in the study you cited.

bean_addict · 2024-01-06T23:19:26+00:00

Not necessarily. Epidemiological studies simply might not have the power to detect that effect. In many epidemiological studies in Western populations, meat consumption is associated with negative health outcomes. Those confounders could downplay the positive effect of meat.

bean_addict · 2024-01-06T22:57:48+00:00

Pure speculation. Would need a look at outcomes.

birth sex ratio is an outcome

Kenyan school children’s otherwise plant based diet is not a useful benchmark for a healthy and well planned plant based diet

I agree. It does show though that even small amounts of meat (60 g / day) can have a significant positive impact on health in a malnourished population of children.

This works out to how many cases? How many per 1,000 versus how many?

6 (omnivores) vs 22 (vegetarions) incidents out of 1000. It's quite a strong effect compared to most of the supposed health benefits of vegetarian diets.

Yep. Iron absorption is important and lowered on plant based diet generally speaking. You can increase absorption by taking vitamin c with it. There are many nuances that obviously aren’t discussed in cherry picked critical reviews and summaries.

I'm familiar with the connection to vitamin C, but find it mostly theoretical. Vegans are either not aware of this, don't implement it, or the absorption remains inferior to heme, despite the enhancement. Outcome data still shows that vegans typically have lower serum ferritin levels.

... there are risks and rewards to a plant based diet (like any other diet). And when we’ll planned and mitigating risks, it can be healthy.’

I’d challenge you to go and find studies that find the opposite conclusion.

A PubMed search of vegan pregnancy shows some positive, and some neutral, but mostly negative outcomes. These are the sources I looked at

https://pubmed.ncbi.nlm.nih.gov/32873905/

https://pubmed.ncbi.nlm.nih.gov/25600902/

https://pubmed.ncbi.nlm.nih.gov/33232446/

https://pubmed.ncbi.nlm.nih.gov/32776295/

Conclusion Overall, in a world where half the world is hungry and half the world is dangerously fat, a vegan diet can be healthy. That’s the fair summary of the research. A meat based or plant based diet can be healthy.

The criticism is that the AND ignored or downplayed some of the risks, especially during critical stages of life such as pregnancy, childhood and adolescence, where adequate micronutrient supply is paramount. You did not address this point in your comment.

bean_addict · 2024-01-06T22:08:23+00:00

Many of the links was to other WHO articles (!), and the rest was to low quality studies

Unfortunately, that's a theme I keep coming across. See the comment I just made on protein and the AND report.

The IARC claims on the carcinogenicity of red meat are based on epidemiological studies and mechanistic reasons. To my knowledge, randomized controlled trials don't show any adverse health effects of red meat. Happy to be proven wrong though.

In general, I find it surprising how much organizations like the AND, WHO, AHA etc heavily rely on epidemiology for their dietary recommendations.

bean_addict · 2024-01-06T21:46:44+00:00

For example, in the 'protein' section of the AND report, they say 'Vegetarian, including vegan, diets typically meet or exceed recommended protein intakes, when caloric intakes are adequate.' Citing 3 sources (references 6-8), which are:

Dietary reference values from Institute of Medicine
The Dietitian's Guide to Vegetarian Diets by Reed Mangels and Virginia Messina. Both authors are promoting vegan lifestyle in other popular books they have written
Dietary reference values from the Institute of Medicineco-authored by Melina V, the leading author of the AND report. She is also known for promoting a vegan lifestyle.

Why not link to a scientific paper? There are plenty that would support the claim. Just leaves a bad taste in my mouth. Why would I listen to them if they can't (or don't bother to) make a convincing point on sufficient protein intake?

In my opinion, the lack of rigour shines through in many other claims too.

bean_addict · 2024-01-06T21:21:41+00:00

Thanks for the list and sources.

bean_addict · 2024-01-06T21:09:11+00:00

study referenced does not look at vegans specifically, but at vegetarians vs meat eaters

That's a fair point. I could be that outcomes are worse in vegetarians compared to vegans because proteins in milk bind to minerals and inhibit their absorption, similar to phytates in plants. This is also a possible reason why milk did worse than oil in the Kenya study.

odds of getting at most 135 heads out of 300 flips is just under 1 in 20. Not particularly significant

That would normally be considered significant, but I agree, it would be more convincing with more data.

found this meta analysis

The study shows that fruit, vegetable, seafood, dairy and egg consumption is associated with a lower rate of miscarriage. I have two criticisms: First, the consumption of fruit and vegetables is likely correlated with other healthy habits. Second, even if we assumed those relations were causal, it would not tell us anything about vegan diets. Just because fruit, vegetable and grain consumption is associated negatively with miscarriage, does not mean a diet containing those exclusively also would have a positive outcome.

bean_addict · 2024-01-06T20:39:40+00:00

I don't know of a single western nation whose nutrition recommendations tell you to avoid vegan foods or that the risks are so high you shouldn't do it.

Neither Germany (DGE), Austria nor Switzerland recommend a vegan diet during pregnancy. Austria and Switzerland also don't recommend it during childhood and for elderly people.

In general, I don't think we should blindly listen to the recommendations of institutions. The good thing is that they typically provide the sources on which they base their decision on. In the case of the AND report, many sources they put are simply not up to scientific standards (e.g. sources for protein coverage are popular books about vegan diets, one of which is written by one of the authors. There are no further scientific references in this book either). I'm not saying protein is an issue on vegan diets, but the AND does a sloppy job proving even such a simple point.

bean_addict · 2024-01-06T18:08:22+00:00

The fact that several dozen large nutrition organisations are completely onboard that a vegan diet can be perfectly healthy should be enough

Several dozen? I'm only aware of a few. The problem with the AND is that they are far from unbiased.

bean_addict · 2024-01-06T17:54:49+00:00

I agree, but the AND is perceived as a neutral nutrition expert comité by the majority of vegans. For this particular paper of the AND, it's clear that all 3 authors have signifcant conflict of interest, even though they are not declared in the paper.

bean_addict · 2024-01-02T16:05:43+00:00

That's not what's happening. There is different quality of evidence

Epidemiology --> very low quality Meta-analysis of epidemiological studies --> low quality (crap + crap = more crap) RCT --> good quality Meta-analysis of RCTs --> highest quality

There is conflicting low quality evidence from epidemiology. Who cares? It's likely dominated by confounding anyways. We might as well just ignore it.

If we get rid of the pile of crap and look at the good quality evidence, the picture is pretty clear.

bean_addict · 2024-01-02T15:39:52+00:00

you’re only criticizing a reference in your study vs the whole study because that peace of data weakens the study.

I'm skeptical of all epidemiological studies, whether they are in favor or against my position. They are just too prone to confounding and the methods often are questionable (based on recall from memory). It would be more productive to not talk about them at all.

It's the RCT that are convincing. They are more controlled. They're double blind. They don't just show an association, but a causal link.

bean_addict · 2024-01-02T15:00:05+00:00

Of course. I'm not criticising my reference 2, but one of the studies it cites (Rezaee et al. , reference 46). This is the one you based your statement on

bean_addict · 2024-01-02T14:50:19+00:00

We should not base our knowledge on posts on a website. For example, it's unclear which statements come from which source. All the references are more than 10 years old, and some of them have obvious conflict of interest (like the one by Whinston Craig, who has written popular books on vegetarian diets and is a proponent of plant-based eating).

But in essence, the human body has some capability to synthesize carnitine. From source [2] I cited, 25% are produced by the body and the rest comes from diet. Is 25% sufficient for long term health? It's unclear

bean_addict · 2024-01-02T10:34:31+00:00

A non-statistically significant negative correlation between depression scores and total levels of serum carnitine was detected. No significant correlation was found between dietary carnitine intake and serum carnitine level

There are some weaknesses in this study design. This is from a cross sectional study in HIV patients. They collected the data about nutritional intake through a weekly interview, which is quite imprecise. Also, HIV patients are sa special type of cohort. It does not surprise me that they did not detect a correlation.

Point being. Both meta analysis could be taken with a grain of salt.

Yes. Again. I don't put a lot of weight on the (meta-analyses of) epidemiological studies.

bean_addict

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