Friday Favorites: Is Vegan Food Always Healthy?

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

In my video on flexitarians, I talk about how the benefits of eating a plant-based diet are not all-or-nothing. “Simple advice to increase the consumption of plant-derived foods with [parallel] reductions in the consumption of foods from animal sources [was found to] confer a survival advantage,” a live-longer advantage. They call it a pro-vegetarian eating pattern, just moving in that direction, as a more gradual, gentle, doable approach.

If you’re dealing with a serious disease, though, like diabetes, avoiding some problem foods completely may be easier than attempting to moderate your intake. It’s like clinicians would never tell alcoholics to simply cut down on alcohol. Avoiding alcohol entirely is more effective and, ironically, easier for a problem drinker.

“Paradoxically, asking patients to make a large change may be more effective than making a slow transition. Diet studies show that recommending more significant changes increases the changes that patients actually accomplish. It may help to replace the common advice, ‘all things in moderation’ with ‘big changes beget big results.’ Success breeds success. After a few days or weeks of major dietary changes, patients are [more] likely to see improvements in weight and blood [sugar] levels—improvements that reinforce the dietary changes. Furthermore, they may enjoy other health benefits of…plant-based [eating]” that may give them further motivation.

Those who choose to eat plant-based for their health say it’s mostly for general wellness and disease prevention, or to improve their energy levels or immune function. They felt it gave them a sense of control over their health, helps them feel better emotionally, improves their overall health, and makes them feel better. Most felt it was very important for maintaining their health and well-being. For the minority that used it for a specific health problem, it was mostly for high cholesterol or weight loss, followed by high blood pressure and diabetes. Most reported they felt it helped a great deal.

But others choose plant-based diets for other reasons, like animal welfare or global warming, and it looks like they’re more likely to be eating things like vegan doughnuts, and sugary and fatty foods, compared to those eating plant-based because of religious or health reasons.

I mean the veganist vegan could bake a cake (using soda instead of eggs), with frosting, covered in marshmallow fluff and chocolate syrup, topped with Oreos, with a side of Doritos dipped in, vegan bacon grease. But fruit for dessert… in the form of Pop Tarts and Krispy Kreme pies? This, is a vegan meal.

Yes, plant-based diets have been recommended to reduce the risk of type 2 diabetes. However, not all plant foods are necessarily beneficial. Like in that pro-vegetarian scoring system, you got points for eating potato chips and French fries, just because they were technically plant-based, but Harvard researchers wanted to examine the association of not only an overall plant-based diet, but both healthy and unhealthy versions. So, they created the same kind of pro-vegetarian scoring system weighted towards any sort of plant-based foods, and against animal foods, and then also created a healthful plant-based diet index, where at least some whole plant foods took precedence, and Coca-Cola was no longer considered a plant. Then lastly, they created an unhealthful plant-based diet index by assigning positive scores to processed plant-based junk, and negative scoring healthier foods and animal foods.

And, they found that a more plant-based diet in general was good for reducing diabetes risk, but eating especially healthy plant-based foods did better––nearly cutting risk in half, while those eating more unhealthy plant foods did worse. Now, but is that because they were also eating more animal foods? People often eat burgers with their fries; so, they separated out the effects of healthy plant foods, less healthy plant foods, and animal foods. And, healthy plant foods were protectively associated, animal foods were detrimentally associated, and less-healthy plant foods were more neutral when it came to diabetes risk. Here’s what the graph looks like: higher diabetes risk with more and more animal foods, no protection whatsoever with junky plant foods, and lower and lower diabetes risk associated with more and more healthy whole plant foods in the diet. So, they conclude that yes, plant-based diets are associated with substantially lower risk of developing type 2 diabetes. But it may not be enough to just lower the intake of animal foods, but also less healthy plant foods as well.

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• Martínez-González MA, Sánchez-Tainta A, Corella D, et al. A provegetarian food pattern and reduction in total mortality in the Prevención con Dieta Mediterránea (PREDIMED) study. Am J Clin Nutr. 2014;100 Suppl 1:320S-8S.
• Trapp C, Barnard N, Katcher H. A plant-based diet for type 2 diabetes: scientific support and practical strategies. Diabetes Educ. 2010;36(1):33-48.
• Cramer H, Kessler CS, Sundberg T, et al. Characteristics of Americans choosing vegetarian and vegan diets for health reasons. J Nutr Educ Behav. 2017;49(7):561-567.e1.
• Radnitz C, Beezhold B, Dimatteo J. Investigation of lifestyle choices of individuals following a vegan diet for health and ethical reasons. Appetite. 2015;90:31-6.
• Dyett PA, Sabaté J, Haddad E, Rajaram S, Shavlik D. Vegan lifestyle behaviors: an exploration of congruence with health-related beliefs and assessed health indices. Appetite. 2013;67:119-24.
• Satija A, Bhupathiraju SN, Rimm EB, et al. Plant-based dietary patterns and incidence of type 2 diabetes in US men and women: results from three prospective cohort studies. PLoS Med. 2016;13(6):e1002039.
• Satija A, Bhupathiraju SN, Rimm EB, et al. Supplemental Info. Plant-Based Dietary Patterns and Incidence of Type 2 Diabetes in US Men and Women: Results from Three Prospective Cohort Studies. PLoS Med. 2016;13(6):e1002039.

Image credit: Miguel Andrade via unsplash. Image has been modified.

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