What Happened to the Plant-Based Movement?

Plant-Based Movement Origins 0:00

The plant-based movement didn't start as a movement about healthy eating. It started as a movement about reversing disease. Those are not the same thing. Nobody was arguing about seed oils on podcasts. People were dying. But somewhere along the way, something changed. The question stopped being what diet reverses disease and became, "What diet is healthiest? Show me the long-term outcomes." Because that's what built this movement, not theories. Personally, I think the movement was strongest when it was focused on disease reversal because that's where the evidence was strongest.

>> Hi everyone, this is K from the PBM podcast. I'm with Sarah. >> Hi. >> And Shadnam. >> Hi. >> So today we are going to be speaking about Jeff Nelson who's come out with an interesting video on his YouTube channel. He's been more active on his YouTube channel. I'll link it down below. And just as a bit of background, in 2016, Jeff invited me out to his healthy lifestyle expo event in California is brilliant. It was responsible for PBN certainly on YouTube growing a huge amount. I was given the opportunity to interview luminaries in the space such as the late Dr. John McDougall, Dr. Neil Bernard, Dr. Alan Goldhammer, and it was just fantastic.

But Jeff in a recent video has said the plant-based movement has lost its way. So, let's go to some of the clips and we're going to break it down. >> I've been thinking about something lately. I've been involved in this movement for a very long time. Not as a doctor, not as a researcher, but as someone who spent decades interviewing the people who built it. One thing strikes me today. The plant-based movement didn't start as a movement about healthy eating. It started as a movement about reversing disease. And that's a very important distinction because those are not the same thing.

When Nathan Pritikin began his work, nobody cared about avocado toast. Nobody was debating whether olive oil was a superfood. Nobody was arguing about seed

Jeff Nelson's Critique of the Movement 1:56

oils on podcasts. People were dying. Heart disease was killing enormous numbers of Americans. And Pritikin asked a simple question. Can this disease be reversed? Could the disease that he was personally suffering from, could it be reversed? Not managed, not slowed, but actually reversed? The idea that you could change the course of chronic disease with food was astonishing. But somewhere along the way, something changed. The conversation slowly shifted. The question stopped being what diet reverses disease and became what diet is healthiest? Then what diet is sustainable? Then what diet will people actually follow? Now those are legitimate questions, but they're different questions. And once you change the question, you often change the answer. A diet designed to maximize disease reversal may not be the same diet designed to maximize compliance. A diet designed to maximize compliance may not be the same diet designed to maximize popularity. A diet designed to maximize popularity may not be the same diet that produced the clinical outcomes that made the movement famous in the first place. So he is basically saying the reason the plant-based movement and I think he's talking about he's not talking about the environment. He's purely talking about plant-based in the context of a healthy healthful foodbased intervention to improve people's health.

That's what he's concentrating on. That's what I know his audience is focused on and that's what his conferences were about as well. Um obviously Jeff and his family have broader views. I think they got into vegan plant-based through John Robbins. Care about the environment, care about ethics. But I think this video that he made is focused around health. And I think what he's saying is that back in the day, 10 or 20 years ago, uh the plant-based movement was bold. It was uh clearcut on its objectives. There was evidence from, for example, Dr. Ornish showing in 1990 he could reverse the progression of heart disease and then subsequently early stage prostate cancer and type two diabetes. And this was through a a quite a rigid ambitious protocol. So it encouraged people to completely eliminate animal products, completely eliminate oil for the most part, eliminate salt and processed sugar. And the results were tremendous. They're amazing results. And I think what he's saying is now you go online and when people talking about plant-based in the context of health, the message is often more watered down.

>> Yeah. I want to hear Shamnam's perspective because obviously you're working in a field of trying to get people to adopt the diet. So it's be interesting to hear what your thoughts on are on it. >> I mean I think he makes incredible points here and what I really like that he acknowledged was that well if you keep on changing the research question you're going to get different outcomes and and that seems to be like what is happening here. We're changing the framing of what we're messaging as a plantbased diet to get more engagement. I I'd argue that the opposite of the risk is kind of what's happening right now, right? Some corners of the plant-based space have drifted towards identity and this purity signaling like, you know, I'm vegan and if you're not vegan, you shame on you and that's not going to help. What we're finding is this identity based signaling is deterring people from entering this type of behavior change, right? And what we find is the actual disease risk data is still really strong for plant forward eating, right? Lower cardiovascular uh mortality, lower cancer incidences, but that message does tend to land so much better when it's evidence first instead of ideology first. And so I think enticing people into the

Disease Reversal vs Health Optimization 5:43

plant-based sphere has required some pivoting, has required some shifting of the research question to see how many more people we can engage. But I think for those that are really still seeking healthier lifestyles, healthier alternatives, the longitudinal evidence there is to support a plant-rich diet. >> He rode the same mountain bike route over and over. At first he had to stop seven times because of chest pain. Then six times, then five 4 3 2 1. Eventually he no longer had to stop at all. Within 6 months his angina was gone. 9 months later he was off all medications. He eventually traveled from England to Los Angeles to thank Dr. in person. >> When I said I saw Dr. in this taxi, I said, "I'm here because of you." >> Now Peter's story is not a randomized control trial. is one person's experience. But it raises an important question. If reducing risk is the goal, one conversation follows. If reversing established disease is the goal, that's a different conversation entirely.

Modern cardiology often asks, "What diet will lower my risk?" And the reversal pioneers, they added a more ambitious question. What diet gives a patient the best chance of avoiding another cardiac event altogether? And that's the conversation I want to have today. Jeff seems to think that we've gone too far and we've lost our way. But I'm wondering if you do think that or do you think it was necessary to evolve that way? >> I don't think we've gone too far. I don't think we've lost our way. I think we're adapting and that's exact exactly what science is, right? I think Jeff comes from a time of like the China era study, these these Framingham adjacent data studies where um these big population studies, but nutritional science and behavioral science has gotten significantly more granular since then. Um, and I don't believe >> I think that's a good thing though.

Sorry to interject. Is that a good thing for people that are on YouTube or they just want to get healthier? Do they need they surely need that that north star, right? I don't know if it's I don't know. Maybe it's why we disagree. >> I don't really think it's the field losing its way. I think it's just science being science and it's just studying another variable and aspect of food dietetics and behavior change. Like it's it's changing. Populations are changing. The way we think about food is changing. Our food systems have changed.

The way we grow food has changed. The way we we get food has changed. And so the science of that has to also adapt with the times. >> Over the last decade, we've seen increasing examples on what are often called healthy fats. Olive oil, avocados, nuts, nut butters, seeds, Mediterranean style eating patterns. And I understand why. They're appealing. They're enjoyable. Most people find them easier to stick with. But here's the question I don't hear often enough. Where is the disease reversal evidence?

Not the epidemiology, not the associations, not the food frequency questionnaires, not the people who eat nuts seem healthier. And yes, I know about the trials. Predamin Leon, the Mediterranean studies that people love to cite. But look at what they actually showed. Fewer events, not reversed arteries. Nobody opened a patient back up and watched the disease retreat. Ornish did that. Esleston did that. Show me where olive oil did that. Where are the clinical outcomes? Where are the equivalent results to what Ornish published? What Esleston published? What Pritiken published? What Kempner observed and published? Show me the patients. Show me the angiograms. Show me the reversal. Show me the long-term outcomes because that's what built this movement, not theories, actual results. I can see his point, don't get me wrong, but I also feel like as scientists, we need to be showing the differing the differing levels and values that we see when it comes to consumer choices and behavior change. It's not didactic. It's not it's not black and white, right?

There's a significant amount of gray matter and if we're not studying and researching that, we're doing our populations a massive disservice. Now, is it information overload? potentially. Absolutely. And I think we we have that with with elements like YouTube where people can put out copious amounts of content based off of opinion and anecdotes versus evidence-based literature. >> I I remember you said something before about the approach at your at your job at Greener by default. It was something like, you know, you were getting more people to adopt it by making the food

Simple Messaging and Behavior Change 10:20

taste good rather than talking about specifically what it was. So, it wasn't like the plant-based whatever. It was just like a a tofu teriyaki something. Do you know what I mean? Um, and I can kind of see that because we spoke about this before also, Claus, that as soon as you put plant-based or vegan in front of something, then people just go la. I don't want to hear it. >> I agree. I agree. I think 10 or 20 years ago, the term plant-based was less stigmatized than it is now. And this is something that I think perhaps Jeff missed out of his video. There's a lot more headwind in the space. So 10 20 years ago, if you said you're plant-based, you probably met with less suspicion and criticism and what's the word hate than if you [clears throat] if you say vegan or plant-based now. So yeah, I think there's something to be said about science changing in terms of its message from the plant-based community. 10 or 20 years ago, it was very black and white, very clearcut. It was a clear prescription of what to do to increase your health. Whereas now, people like Dr. Greger's approach where the science has become more specific, more fragmented. If you add these nutrients in these superfoods, it can really help health outcomes. People like Professor Tim Spectre saying if you eat 30 different plants a week, this is great for your microbiome. And what Jeff is saying is like guys hold on there's people like Dr. John McDougall Dr. Neil Bernard, these luminaries who had been for the last 30, 40 years just saying rice, beans, frozen veggies, microwave, cycled the same four or five dishes for 2, three, four, five, six months. It's very simple. You don't need to complicate it. You don't need to add any of these superfoods or crazy ingredients and you get amazing health outcomes. And I think Jeff misses the glory days of his healthy lifestyle expose in the early 2000s where that message, that recommendation, that simplicity wasn't questioned. It was the default. Whereas now, you go on to Tik Tok and social media and as I said, the message being watered down. It's been perhaps over complicated. Maybe in the name of trying to inspire, but I think Jeff would argue, and I kind of agree, that it just uh muddies the water in terms of giving people a clear, easy to follow message.

you know, for the everyday person, you're not going to have the time and the ability to do the granular, you know, sort of micromanaging of the food and all that stuff. So, if there's like a more basic way to describe it, which is basically like, you know, don't eat animal products, [laughter] which is what I do. Um, that might encourage people to get into it. And then once you're in, then you can become more granular, I guess, because I think also once people adopt a plant-based diet, they get way more into like the ethical side, the environmental side, you know, reversing their diseases or whatever.

And if that has happened to you, you're going to be like an advocate for it and you're going to like start getting more into it. But I feel like the entry point maybe is the hard part for people. >> And you have to remember now like taste par is a thing when we're talking about consumer research and consumer science. What we're looking at is do they like it? Does it taste good? Is it flavorful? I I mean, you want instant gratification? And like you said, Sarah, when we get dive down into the the rabbit hole of why I decided to go plant-based or vegan, right, that comes after the fact of serving the ego, >> right?

It's very rare that we see people enter the vegan space based off of what they need to do for others first. >> Right. Right. Right. >> Right. The majority will enter for how does this benefit me first? And even that framing of how do I improve my health >> is about me first. When we talk about identity politics, what it does is it is it separates those from who already identify as that from those who feel otherred from that. And if someone feels otherred from that, often times the one thing that they don't want to do is to fight to be part of that group. Of course, >> I also think 20 or 30 years ago, uh, arguably you had bigger personalities leading the space. How can you recreate the personalities of Dr. Neil Bernard, Dr. John McDougall? These guys were formidable. They were forced to reckon with. I also think the simple message that was put out 15 20 years ago was more effective even if it wasn't technically 100% accurate. China study for example published in 2005 you could probably look back through that book and go wasn't perfect there it wasn't perfect there but overall because it had such a clear message of lowfat whole foods plant-based and made it very easy for people to follow even though it might not have been exactly on the money and in retrospect we can say well certain data has come out that's made us question a little bit here and there that clear message really just has helped people, inspired people. It's kind of like um the mind body community, right? I've been reading some books recently about neuroscience and like how to tackle had a bad neck. I've been reading books on like how to tackle neck pain. I read this book in the 20th century by Dr. John Sano and this guy, if you don't know him, you got to look him up. If you got back pain or neck pain or anything like that, you need to look this guy up. This guy's book healing back pain was phenomenal, right? It was because it was written in 20 cents. simple message and it healed my neck pain within a couple of weeks. But you can now go through that book and you can say, "Well, it was wrong here, was wrong there." But it gave me a simple message how to de-stress my life and it worked. And I think the same thing can be said of some of these healthy lifestyle pioneers in plant-based space in the early 21st century and the late 20th century.

People like Nathan Pritiken, Dr. John McDougall, Colin Campbell, they were just so dogmatically clear about the message. And yes, and now you might you might be able to say, well, they weren't quite perfect here and there, but it was

Stories, Science, and Audience Engagement 16:40

clear for people to follow. >> Do you think that's also why the carnivore movement has had so much success? Because it's so simple. It's just like just eat meat. That's basically all it is. And then they're talking about their own disease reversal. I haven't had this chronic pain. And it's kind of enticing for people and they're like, "Oo, that sounds easy. I could do that." >> People just want a simple message. People are busy. They want a simple thing to do to improve their health. It has to be simple, right? It just makes sense.

>> People love entertainment. They love entertainment. They love stories. They love to be like zazzed. You know what I mean? Like the And I think the carnivore group does that really well. And I also think that, you know, the way that we market things, they do that really well. Like marketing advertising geniuses, and we know Plant-Based News has some of the best of the best on the planet. It works. So, um, stories sell. And I feel that if we really want to realign with the movement, then maybe we should be sharing more stories laden with our scientific evidence. And I and I feel like this is where Dr. Neil Bernard like excels.

>> The US government when it was formulating the dietary guidelines, the advisory committee said, "Let's go along with that. Cholesterol is not really such a big deal." And we showed that on the committee there were four people that had economic ties to the egg industry and they were in charge of this policy. We filed suit and as this was percolating the government itself said wait cholesterol is a problem. I don't care if it's egg funding or or who it's funding cholesterol is a problem. You eat cholesterol from eggs your blood cholesterol rises. And the way it came down was the government said you should eat as little cholesterol as possible. How do you do that? plant-based diet is as little cholesterol as possible as >> I think his most recent book it was just laden with stories and then supported by research and I'm like these are the types of books that people need to read because they can relate to Sally who's their same age and has the same type of career that they have but they're not going to relate to large population studies like the China study because it is too abstract act much like the concept of like you try and tell a meat eater that they're the reason why the Amazon is burning. The concept is just too abstract for the individual to piece that together. Does that make sense? So, it's almost like teaching an alien to make a peanut butter and jelly sandwich.

You have to break it down to the most simplest of simplest terms, right? You can't just say like put peanut butter on the knife and spread it on the bread without telling them to unscrew the top because stab the knife through the top. Anyways, I'm going off on a tangent here and none of this should actually be on our podcast. >> No, it's a good point though. It is a good point. We've said this before. It's a delivery issue. >> It's a massive delivery issue. >> Delivery can be combined with the science and you've got the best of both worlds. So, let's hope we have more figures like Neil Barard coming to the front. And like, yeah, it's a different time. We've we've moved on from the old days of the plant-based movement, but that doesn't necessarily need to be bad. >> And that's what I'm saying. I don't think it's bad. I think it's just different. It's shifting. And we have to recognize the environment around us of what's causing that to shift.

>> I sometimes wonder if younger people entering the plant-based world if they realize whose shoulders they're standing on. John McDougall recently passed away and losing him felt significant. Not just because he was brilliant, not just because he was entertaining, but because he represented a direct connection to that earlier era. An era when doctors were still discovering these ideas. An era when nobody knew whether any of this would work. An era when people risked their careers arguing that chronic disease could be reversed through food.

Those men were giants. John McDougall is the reason that we're all here this weekend. >> I've been in this business for 44 years and I'm the [music] luckiest doctor in the world because my patients get well and anyone who says differently is distorting my message. The facts are absolutely clear but there's a blindfold here and they lie about it. That blindfold is full of dollar bills because that's how you make >> they changed the conversation and they changed it through evidence. That's why I think the most important question for the plant-based movement today is not whether olive oil is healthy or whether avocados are healthy or whether nuts are healthy. The more important question is what is our goal? If our goal is simply to eat better than the standard American diet, okay, that's one conversation. If our goal is to maximize longevity, that's another. If our goal is to reverse chronic disease, that's another. And those goals may not produce identical recommendations. Personally, I think the movement was strongest when it was focused on disease reversal because that's where the evidence was strongest.

>> And what were the um what were the comments like on this video? Were people in favor of Jeff or against him? >> Actually, they're saying, you know,

Legacy of the Pioneers 22:00

about their examples. So, for example, someone said, "It's true. Dr. Eslestein and all these incredible doctors reversed my hypertension and my high cholesterol, not to mention all the other health issues that I wasn't even hoping to fix. That was 10 years ago. I'm 65 years old. nomads because of these heroes. So, you know, it it does work for sure. And then there's someone else who said, "My husband would be dead now if he didn't decide to turn plant-based to a plant-based lifestyle in 2011 after watching Forks Over Knives." In October that year, he proposed immediately to make the switch and I jumped at the chance. He told me one year later why because he had angina every time he ate a pizza, which was too frequent. It said [clears throat] solved most of our health issues and most importantly reversed his heart disease medical test to prove it. We thank Eselstein Caldwell for all their work along with other pioneers in the field. And it's also why we love your content Jeff. Thank you from the depths of my heart. So, you know, it's mostly people just saying yes, those doctors had it right. It actually did work for them.

But [clears throat] yeah, it's like you said, Chapdam, can we get that added into some more exciting storytelling to get more people to come along with us? And I but listen to all of what the comments are saying like in and I I I'm getting an understanding of the kind of demographic that is responding to this video, right? Um and it's very clear, like I said, the disease risk data is is really strong for plantforward eating. That's not what I'm trying to say. But we're trying to entice 18y olds to eat to eat plantforward to go away from an indulgent t-bone steak or a or an Angus beef burger to something a little bit more environmentally friendly, ethically friendly. These are not the same type of individuals that are making comments on Jeff's YouTube. And I need to be very clear here about that. And so when we're talking about bringing in the flexitarians, the omnivores into plantforward eating, that's what the research is trying to focus on now. How do we get more of those individuals to start eating more plants? Somebody said, someone has finally said out loud, I work in a hospital and people sick of the net, but the machine keeps on churning. Many in the plant-based community have lost sight of this point. Thank you for your commitment to the space. I'm vegan in my 60s, never taking a pill. Got my mother to go vegan when she was 80. She loves Asselin. She's 19, never been on meds. >> Yeah, it kind of just further backs up what Shaman was saying. It's a different demographic, isn't it? It's the people who found them maybe back at the time that they were the height of their careers. But we also as well as those people need to get on board. The people who are now saying, "I can't be vegan or plant-based because it's too processed.

I'm flexitarian. I I love bacon." And you know, we need to get everybody on board with the message that plant forward is how you actually get the health outcomes that you're looking for and live >> without sacrificing. >> Yes. Exactly. >> It's not a sacrifice. And I think that's the important thing that we're finding in our research is that when we're when we're encouraging behavior change, we want people to feel like that they're making that choice for themselves and they're doing it without feeling like they're making a sacrifice because that is what here's long-term behavior change. [music] [music]