Full Transcript Vegan Diet Health and Nutrient Gaps 0:00 So the claim everyone should aim to be vegan, you're happy with it? 0:02 No, and here's why. 0:04 So I am a third year med student and I will actually come out and say that the vegan diet tends to Be healthier. 0:10 Absolutely. 0:10 Great. 0:11 I don't think there's much dispute over that. 0:12 You can look at the evidence it is. 0:14 It is healthier, however, the biggest thing with the Vegan diet from a physician perspective to think about is and it's been mentioned a couple of times 0:22 is the micronutrient deficiencies that you can have. 0:24 B12 is one of them. 0:26 First off, kudos to him for at least acknowledging that vegans tend to have better health outcomes than meat eaters. 0:30 But I do take issue with framing micronutrient deficiencies as an issue of a vegan diet specifically. 0:36 All dietary patterns have some gaps. 0:38 Those gaps just change. 0:39 For example, vegains may need to ensure they're getting enough of certain nutrients like vitamin B-12, but then meat-eaters need focus more on getting 0:46 of things like magnesium and folate. 0:47 And this can be taken care of by making sure you're including certain food groups or supplements depending on the nutrient. 0:53 Why wouldn't you take the supplements? 0:54 Because why would I take supplements when I could just have lean meats like chicken and fish and turkey and things that I really enjoy? 1:00 Is that studied by Junie Wang in 2019 where she found the fortifieds and the supplement were more easily absorbed by the body because they're already taken 1:08 away from the fibers? 1:09 So that's why you say that. 1:10 So I actually disagree with that because, for instance, omega-3s. 1:14 This was very odd. 1:15 Dr. 1:16 Jack Symes cited this study in which consuming cereal fortified with vitamin B12, which is similar to taking a supplement, 1:22 resulted in higher B-12 levels in the body compared to consuming meat with the same amount of B 12. And that's without the cardiovascular risks of regularly 1:30 consuming me. 1:31 And the reason likely is that the vitamin B12 in a fortified food or supplement isn't bound to protein like it is in meat, 1:37 so its absorption doesn't rely as much on the health of the gut to be able to break the B-12 apart from the protein. 1:43 And after that, presumably without ever having actually read the study, the med student just disagreed because fish have omega-3s. 1:50 I'm really not sure what the relevance of that is to whether or not nutrients from supplements are absorbed as well or better than nutrients form foods. 1:57 Nevertheless, to indulge his concerns over vegans not getting the long-chain omega-3s, EPA, and DHA from fish, the importance of which is debated.
B12, Supplements, and Absorption 2:05 I'll mention that algae-based supplements exist. 2:07 They contain the same omega 3s and have been shown to be similarly bioavailable to fish oil. 2:13 He's just plain wrong here. 2:15 According to data from the Food Climate Resource Network, University of Oxford, and USDA database, 76% of global soy production is for animal feed. 2:20 Only 13% is oil meant for human consumption and 4% for industry use in the form of things like biodiesel. 2:43 It is literally the byproduct. 2:44 They grow the soy for the oil. 2:46 Even if it wasn't being fed to the animals, they would still grow soy. 2:50 That is true. 2:50 No, it's not true! 2:52 We can most generously call it a co-product or consider the OIL to be the bi- product. 2:56 The demand for soybeans is tied to global meat consumption. 2:59 If we didn't produce so much soy to feed to animals which can also be used to produce oils, we would just shift to producing other oils which could actually 3:07 save money and resources. 3:08 That's because soybeans actually have a lower oil yield than rapeseed, sunflower and palm oil, so he's got it completely backwards. 3:26 They're gonna have lower BMI if they're vegan. 3:28 They can get all the nutrients that they need. 3:30 Yes, kids can be healthfully raised vegan as long as some care is taken to ensure they are getting adequate nutrition. 3:35 Just like any other diet. 3:36 And like Dr. 3:37 Jack Symes highlighted, there may be some benefits. 3:40 For example, vegan kids tend to have a lower bmi and lower LDL cholesterol levels. 3:44 And if you're wondering why that even matters at that age, well, cardiovascular disease begins to develop in childhood or even earlier. 3:51 So yes, attention needs to be paid to certain nutrients like iron and vitamin B12. 3:55 But let's not write off the potential benefits of feeding kids at the very least a plant-predominant diet. 4:00 What are you gonna do about the calories? 4:01 Because you know, you get rid of the mineral, the meats, and you cut out that calorie, but you also cut a lot of calories that you need to survive.
Soy, Omega-3s, and Animal Feed Claims 4:08 Because if we become too malnutritioned and neurodivisioned, we will die." That escalated quickly. 4:13 Yes, if you eat far too few calories for far to long, You could die. 4:18 If you didn't know that, now you do. 4:19 But when we look at vegans and the general population, We tend to see better health outcomes than meat eaters. 4:24 In part because they tend consume somewhat less calories. 4:27 That can be a good thing. 4:29 Nuts, seeds, nut butters, plant-based meats, avocados, oils and grains. 4:30 And if you're more worried about getting enough protein, there's tofu, tempeh, seitan, fava beans, lentils, lental pastas, 4:35 and once again plant based meats. 4:36 Just to name a few. 4:52 Oh boy. 5:00 So in 2022, the FDA Modernization Act 2.0 was signed into law. 5:05 This allows for alternatives to animal testing in the preclinical phase of drug development. 5:10 In part because there's such a low translation of results from animal studies to human studies. 5:14 More on that. 5:15 This is well understood. 5:16 It's like she's never actually looked into the topic yet wants to debate it. 5:19 Here's another recent review, separate to what Jack is citing, stating that, on average, the translation rate of animal research to humans is about 5%. 5:41 He looked at 2,500 articles and he said, quote, most of the data is not worth publishing and most experiments are not worthwhile doing. 5:48 That was just cringy. 5:49 She asked who wrote the paper or where she could find the research, but I think it's pretty clear she doesn't actually care.
Children, Calories, and Vegan Nutrition 5:56 No matter which researchers were involved or were it was published, she was probably just going to respond with, oh, that's all you've got? 6:01 Accompanied by a fake laugh, of course. 6:16 And I'd be curious to know if she's even aware of the FDA Modernization Act that I mentioned earlier, replacing the old requirement for animal testing 6:23 from 1938. That aside, we currently live in a world where medications have historically been tested on animals. 6:29 However, moving forward, because of poor translation of animal research to humans and advancing technology like AI, I could see a transition, 6:37 albeit a slow transition away from animal-testing being the standard. 6:41 Please don't do this and don' use it as an argument against a plant-exclusive diet because how she practiced it is not what's recommended. 6:55 Yeah, I think any sensible nutritionist will say that you need to make sure you're doing it properly. 6:59 You need be doing carefully and that means first start taking a B12 tablet. 7:01 I don't think there's anything wrong with that. 7:03 We do lots of unnatural things, flying on planes, watching television. 7:06 Going straight to the source and having a b12 tablets absolutely fine. 7:08 Come back to life. 7:11 Take the B 12 tablet and become vegan. 7:13 But I'm not pro-aliopathic medicine. 7:15 These supplements are really beneficial. 7:16 The evidence that these supplements work is overwhelming. 7:19 You can take people with pernicious anemia, which is a form of anema caused by the inability to properly absorb vitamin B12 from food, 7:26 supplement them with B-12, and improve their blood markers. 7:29 And there are cases like this where B 12 deficiency manifests as dementia-like symptoms, but even then supplementing with b12 improved cognitive function 7:37 within weeks. 7:38 But of course, I prefer that people take the route of supplement in the first place so that they don't get to that point. 7:43 Especially since, if severe enough or left long enough, it may not be completely reversible. 7:48 So yes, this is a gap that exists within plant-exclusive diets, but we have a very cheap, very safe, and widely available solution.
Animal Testing and Drug Development 7:55 And vegans in the general population, who in more recent studies tend to have similar vitamin B12 levels to meat-eaters, 8:01 likely because of widespread supplementation and fortification, tend have lower risk of things like cancer and heart disease. 8:07 No big deal. 8:08 See these two here? 8:09 These are opposable thumbs. 8:10 We evolved these in order to hunt better. 8:12 These two pair of legs, bipedal. 8:14 They are bipetal to become better hunters. 8:16 Even communicating with each other, we've evolved to be better hunter. 8:19 Our entire existence as a human species has been around eating meat. 8:24 And for you to just say all of a sudden, to say you shouldn't do that anymore is kind of asinine. 8:29 We evolve these traits like opposable thumbs, bipedalism, and speech for reasons that extend well beyond just hunting. 8:35 So suggesting that hunting is THE reason is asinine. 8:38 That said, even if we had developed these trades primarily to make us better hunters, that wouldn't make engaging in that behaviour ethical. 8:44 Similar arguments can be presented around our evolutionary impulse to mate. 8:48 The fact that that impulse exists doesn't make it ethical to mate without consent. 8:52 In fact, one of the things that makes humans unique is our capacity for abstract moral reasoning. 8:57 So we can actually ask whether following our biological drive is morally justified. 9:01 And finally, adaptations that may help us survive in the short term, like procuring calorie-dense animal foods during times of scarcity, 9:08 can often be detrimental in long term. 9:10 This is something known as antagonistic pleiotropy. 9:13 For example, genetic variants that cause sickle cell anemia can help people survive long enough to reproduce in areas where malaria is endemic. 9:20 That's because the sickle cell trait protects against malaria, but then it can go on to cause cardiovascular issues later in life. 9:27 Similarly, Huntington's disease can increase fertility, then cause death within 20 years of symptoms arising. 9:32 These traits either increase the likelihood of living long enough to reproduce, or they improve fertility so they're more likely to pass their genes on,
B12 Supplementation and Vegan Safety 9:39 yet lead to long-term issues. 9:41 So, adaptations to meat consumption may have actually been beneficial in the short term when food was scarce. 9:46 But our ancestors didn't typically live long enough to deal with things like cardiovascular disease or colorectal cancer, 9:51 which usually appear at old age. 9:53 And those are some of the health reasons to limit red meat consumption today. 9:56 No you don't. 10:02 Or you can have the Mediterranean diet, where you could just have a good diet without those supplements or added things in it. 10:08 You know you don't need those five or six. 10:09 And the hard thing is that you have to be super, super careful about how much of the micronutrient you're consuming. 10:15 So as a vegan, you've got to make sure, okay, I'm having this many of this kind of food group, this one of that kind, because you want to ensure that your 10:21 getting those vitamins and those micronutsrients in. 10:23 Just like any other diet. 10:25 Where, as a Mediterranean diet, you wouldn't need to do that as much. 10:27 First off, a mediterranean diet is often defined by the consumption of certain food groups. 10:32 So, to follow a Mediteranean diet you inherently have to focus on which food group you consume. 10:36 Now, vegan or plant-exclusive diet are defined as the foods you don't consume, but to ensure it's nutritionally adequate, 10:42 yes, You need place some focus of which foods groups you're consuming. 10:45 Again, like the Mediterranean Diet. 10:47 And I'll even grant that more focus may need to be placed on certain micronutrients than with a Mediterranean diet, but to say that it's not an issue or 10:54 a very minor issue with the Mediterranean Diet is also questionable. 10:57 For example, adherence to a mediterranean diet is still associated with significant amount of vitamin D and vitamin E inadequacy, 11:03 and certainly doesn't guarantee adequacy of other nutrients like calcium. 11:06 But there's a simple solution. 11:08 It's called a multivitamin. 11:09 Now, I'm the first person to say that a Mediterranean diet is an excellent, super-healthy dietary pattern. 11:12 And yes, it may have some advantages over a plant-exclusive diet with regard to certain micronutrients, but let's not hand-wave away some of the advantages 11:17 that plant exclusive diets may offer.
Evolution, Meat Eating, and Ethics 11:34 If we look at the OmniVeg randomized crossover trial comparing a Mediterranean diet to a vegan Mediterranean where the animal foods were replaced with 11:42 plant-based foods with comparable protein and fat content, we see that the vegan diet led to lower total and LDL cholesterol levels, 11:48 an important cardiovascular risk factor. 11:51 And this is similar to an earlier trial where a whole foods-focused vegan diet resulted in lower body weight, lower LDL cholesterol, 11:57 and greater insulin sensitivity than the Mediterranean diet. 12:00 But again, I'm not going to use that to conclude that a vegan is inherently superior to a Mediterranean. 12:05 I'd say both can have their advantages and both lead to really good long-term health outcomes. 12:09 So let's not be one-sided and trash on a Vegan diet for the small advantages a mediterranean diet may have without considering the advantages that the 12:16 vegan may. 12:22 I couldn't find any studies with the 30% statistics specifically, but what most people cite is the epic Oxford study in which vegans had a 43% higher risk 12:32 of fracture, largely driven by hip fracture. 12:35 And that translates to about 19 more fractures per thousand people per 10 years. 12:39 However, I do take issue with using these data to suggest that vegains are inherently at higher-risk. 12:43 For starters, the risk was only statistically significant in post-menopausal women, not men or pre- menopause women. 12:49 As well as in inactive people and people with a BMI below 22.5. That last point is important because there were far more vegans below a bmi of 20 than 12:58 there where meat eaters. 12:59 And they did not adequately account for differences in Bmi among people who would be classified as underweight. 13:04 In essence, they could very well have been comparing some vegains who were very under weight to meat-eaters who barely classified under-weight And this
Mediterranean Diet vs Vegan Diet 13:11 is critical because fracture risk increases substantially once BMI gets below that level. 13:15 They also didn't adjust for vitamin D intake or status at all, and didn' t do adequately so for calcium. 13:21 Contrast this with the Adventist Health Study 2, which was published just months later. 13:34 These studies just highlight the importance of eating enough to maintain a healthy weight and ensuring adequate vitamin D and calcium from supplements 13:40 or fortified foods. 13:41 And fortunately, many plant-based milks today are fortify and contain as much or more calcium and vitamin d than their dairy counterparts. 13:54 Yikes. 14:10 I've seen doctors, I seen GPs, they've all put me on medications. 14:13 Notice how she didn't say she's seen a dietitian. 14:15 If you have concerns around your nutrition, or you're having health issues that may be related to what you eat, i highly recommend working with a dietician, 14:22 THEY are the nutrition experts. 14:24 And I hear this time and time again, where people will claim that a certain dietary practice didn' t work for them, but then they didn t actually work 14:30 with the people who are best equipped to help them with that. 14:32 But access to dieticians can also be limited, so there's definitely a systemic issue there as well. 14:37 Now obviously I can't diagnose her and I don't know her health history. 14:40 But it is interesting that, generally speaking, plant-based diets tend to be associated with substantially lower gastroesophageal reflux disease,
Fracture Risk, Bone Health, and Dietitian Advice 14:47 or GERD, prevalence. 14:48 but when it comes to individuals, people can have very different triggers, which is where, again, dietitians can come in really handy to help you navigate. 14:55 and I was on medication for over 10 years that actually ended up depleting my vitamin D levels. 14:59 It is true that the typical medications that are prescribed in this case can reduce absorption or affect metabolism of certain nutrients, 15:06 and long-term use is associated with lower vitamin d levels, but then a possible solution there is just a simple supplement like vitamin-d or a multivitamin, 15:13 which again can be discussed with a dietitian. 15:16 So if one's goal is to be vegan but there are concerns about some specific nutrients there, are likely solutions for that. 15:21 But it starts by working with the right professionals. 15:26 I've watched a lot of Jubilee debates and have never seen this happen. 15:30 The topic of veganism is so triggering that even the host jumped in to debate Dr. 15:34 Jack Symes.
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