Vegan Activism

The Huffington Post is at it again- by promoting a nutrition quiz from the Physicians Committee for Responsible Medicine (PCRM).  One would think that a group like PCRM would be a responsible group, with a website that would have credible information. However, PCRM is a vegan organization that promotes an anti-dairy, anti-meat, anti-seafood, anti-egg diet, and the purpose of their quiz was to help evoke those ideas.  They have also sent out news releases that are bias to  a vegetarian diet and argues for it with half-truths that do little to advance their position, and a lot to reduce their credibility.

Recent breaking news quoted a paper in that indicated that fish oil did not prevent recurrence of heart problems and “evidence fails to support their use.”  PCRM did not include the conclusion:

“However, a diet high in fatty fish (≥2 servings of marine fish per week) should continue to be recommended for the general population and for patients with existing CVD because fish not only provides omega-3 fatty acids but also may replace less healthy protein sources, such as red meat.”

PCRM is anti-fish, as well as anti-dairy, and they fail to note that the American Heart Association recommendations for two meals a day being replaced by fish.

Recently PCRM released another study showing E. Coli was in 48% of chicken bought in 10 cities by their group. What they failed to state was that the E.Coli was not the type that causes humans illness.  Further, the major outbreaks of food-borne illness have recently come from produce and peanuts – as they are grown in soil that contains E. Coli. and can be contaminated with salmonella.  There are many types of bacteria in the soil, and E. coli is a common soil bacteria, but it is not the same type as that which comes from feces.

If you were a Vegan this might be your view of food

Here is their quiz with Science and Evidence based medicine rebuttal:

(1) Skim milk has the same amount of calories as cola

Yes, they are anti-dairy, and this is suppose to scare people into thinking that dairy is bad. For those who can tolerate milk, those who are not lactose intolerant, milk is a great source of nutrients.  Cola, not so much. They say all you need is water, nothing else – and we agree, however,  milk can have plenty of nutrients in them and should not be over looked.

(2) Cheese and steak have the same amount of cholesterol.

The first question you should ask is- so what? Dietary cholesterol has a minimal effect on the blood level of  the body’s cholesterol, we have known this since I was in medical school ( 1980’s). You can see my last post about fats to see more. That different amounts of cheese as well as a porterhouse steak have the same amount of cholesterol means nothing.  Very few physicians look simply at the cholesterol level, unless it is either very high >250 – and then we look at the underlying lipid profiles.

(3) Cheese is 70% fat.

Some cheese is, but again, cheese in moderation is not a bad thing. Some cheese is not  70% fat. By the way, most nuts, which this group advocates, are also 70% fat. They go on to say that Americans are eating three times the cheese we did in the 1970’s – probably not the case for some. Cheese is something that should be used in moderation – as it is dense with calories

(4) Frequent consumption of hot dogs and bacon makes it more likely you will get colon cancer.

In the one study, that has many flaws, if you eat a diet rich in processed meats your risk of cancer is higher- by a small amount. But that is a correlation, and not necessarily a causation, and when you work out the statistics, your chance of eating that much (a lot ) is not much, and your chance of getting cancer from it is – well, we don’t know. We don’t advocate eating a lot of processed any food. They state that the recommended amount of processed meats would be “none” – we would disagree, as do bacon lovers everywhere.  The correlation is so small with this as to be stretched.

(5) Women who regularly eat soy have a lower cancer risk.

This is not necessarily so.   Comparison studies have been mixed- so the answer is, we don’t know.  PCRM based their information about population studies from Asia- but other factors these women have include (a) less obesity (b) more physically active (c) drink less alcohol (d) eat more fruits and vegetables. Until the issue becomes clearer, many doctors recommend that women who take hormonal therapy or who have estrogen-receptor-positive breast cancer avoid soy supplements because they contain high concentrations of isoflavones. But in general, it’s fine to eat moderate amounts of soy foods as part of a balanced diet. One to 3 servings of soy a day (a serving is about a half cup) is similar to an average Japanese woman’s daily soy intake. If you are taking hormonal therapy to fight off a hormone-receptor-positive breast cancer, and you are concerned about any phytoestrogen effects, ask your doctor or registered dietitian about how much soy you can eat.

(6) Salmon has cholesterol and fat

Ah yes it does, and to repeat- consuming cholesterol is not the issue. Salmon fat is high in omega-3 fatty acids and quite healthy. Eskimos and maritime Native Americans had a diet rich in salmon and the lowest rate of heart disease on earth.  There is not convincing evidence to advocate taking fish-oil capsules, there is still evidence that replacing two meals a week with fish is protective for the heart.

(7) An egg has more cholesterol than a Big Mac

Cholesterol is not an issue in diet but the 540 calories in a Big Mac compared to the 90 calories in a large egg is. The calories in a Big Mac come from 29 grams of fat, while only 5 grams of fat from an egg. While PCRM has an issue with dairy, as do some from the Paleo diet, eggs are a healthy source of protein.  If you get rid of the yolk you can get rid of a lot of the calories also. The amount of cholesterol is less important than the lower calories- and you could always use egg whites which have less fat, much less cholesterol, but a great source of protein.

(8) Milk, Beans, and broccoli are all high in calcium

This is true, and for those who need a good source of calcium but do not drink milk, there are some good alternatives. They point out that the calcium in the beans and broccoli is absorbed at a rate of  50-60%, while milk is just  32%. What they fail to point out is that 1/2 cup of broccoli contains 21 mg of calcium while 8 oz of nonfat milk contains 300 mg. That means from broccoli you get 11 mg of Calcium which is about 1 percent of the daily requirement. If you get non-calcium enriched milk you are still getting 100 mg of calcium or ten times the amount you would with broccoli.

Vegetarians may absorb less calcium than omnivores because they consume more plant products containing oxalic and phytic acids . Lacto-ovo vegetarians (who consume eggs and dairy) and non-vegetarians have similar calcium intakes. However, vegans, who eat no animal products and ovo-vegetarians (who eat eggs but no dairy products), might not obtain sufficient calcium because of their avoidance of dairy foods.

In the Oxford cohort of the European Prospective Investigation into Cancer and Nutrition, bone fracture risk was similar in meat eaters, fish eaters and vegetarians, but higher in vegans, likely due to their lower mean calcium intake.  It is difficult to assess the impact of vegetarian diets on calcium status because of the wide variety of eating practices and thus should be considered on a case by case basis.

(9) Fish and Beef have no fiber

Quite true- there is no fiber in meats. This is why a balanced diet contains fruits and vegetables. However, fish and beef contain better sources of fat absorbable vitamins, calcium, B12, protein, and other nutrients than vegetables do.

(10)  A skinless roasted chicken breast has more calories per ounce than soda or white rice

This is quite true- and mainly because of the fat content of the chicken. But chicken has more nutrients than white rice and more than soda.

PCRM also was responsible for the comments that E. Coli was found in many of the chicken products.  What they didn’t say was that the E. Coli they found were not the same as responsible for food borne illness.  In fact, the E. Coli they found was the kind commonly found in the soil, where the very plants grow that they advocate consuming. The pro-Vegan group also neglected to mention that the majority of Salmonella infections that have caused major outbreaks have come from agricultural products, including peanuts, that they advocate for a healthy diet.

It appears that PCRM is more propaganda than science. If you are going to advocate for a position, your position is diminished when you don’t tell the full story. If cornered in press conferences they avoid the answers to the questions. This is not a place to get information at all.

In the case of diet and lifestyle, there is a lot we do not know- but PCRM as a source of nutritional information is less than adequate, in that often it does not tell the whole story.  As a website for health and information it is more like a political party than a resource for those looking for evidence based medicine or science based medicine.

One of the misleading advertisements from PCRM

Dr. Terry Simpson About Dr. Terry Simpson
Dr. Terry Simpson received his undergraduate and graduate degrees from the University of Chicago where he spent several years in the Kovler Viral Oncology laboratories doing genetic engineering. He found he liked people more than petri dishes, and went to medical school. Dr. Simpson, a weight loss surgeon is an advocate of culinary medicine. The first surgeon to become certified in Culinary Medicine, he believes teaching people to improve their health through their food and in their kitchen. On the other side of the world, he has been a leading advocate of changing health care to make it more "relationship based," and his efforts awarded his team the Malcolm Baldrige award for healthcare in 2011 for the NUKA system of care in Alaska and in 2013 Dr Simpson won the National Indian Health Board Area Impact Award. A frequent contributor to media outlets discussing health related topics and advances in medicine, he is also a proud dad, husband, author, cook, and surgeon “in that order.” For media inquiries, please visit www.terrysimpson.com.

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Latest Comments

  1. Lynn says:

    They have some good and some bad on their site. The good is that their recipes have the calories and other nutrient values listed. The bad is that some of what is on their site concerns animal rights rather than human health. While I would agree that animals should be protected from cruelty, I don’t see what that has to do with responsible medicine for people

  2. Lynn says:

    I would also add that they put a testimonial in their cancer column from a woman who became a vegan after being treated for DCIS. She blames the cancer on 47 years of carnivorous eating and is crediting veganism for her good check-ups after cancer treatment. Often DCIS has a low rate of recurrence or at least a low rate of immediate recurrence. Women are also given 5 years of treatment with either tamoxifen or arimidex which further cuts the risk. Usually a test (Oncotype DX) is done on the tumor to determine it’s strength for recurrence or metastasis.
    It is now estimated that 70% of women diagnosed with breast cancer have no risk factors. They have a statement elsewhere on their site that breast cancer is 73% environmental. This could be true but in today’s world, we are being exposed to much more radiation than previous generations were so it is hard to blame any one factor. If a woman has a strong family history of breast cancer or is brca one or two positive, what she eats will probably have zero influence on whether or not she develops the disease.
    Food could be the culprit for some women but that would be very hard to prove, given so many other environmental factors. Scaring cancer patients into becoming vegans is a bad policy.

  3. thedoc says:

    Animals do not have rights. We have a duty to care for animals, but they do not have rights

  4. thedoc says:

    DCIS is a precursor to, but is not cancer. Anecdotes and testimonials are common in the vegan world- much like someone who converts to some faith. Somehow I don’t think that food can over power genetics-

  5. Lynn says:

    DCIS is treated like invasive cancer because no one is sure which DCIS will eventually become invasive cancer. Eventually doctors hope to be able to determine which DCIS will be able to just be left alone.

  6. thedoc says:

    As someone who has done research in and written about DCIS – we say it is a marker for people prone to get breast cancer – but it is not a cancer. We do know the types that are worse – comedo v. cribiform, and are working on the genetic variations.

  7. Lynn says:

    I am probably wrong about the oncotype score for DCIS. I had both a stage one invasive ductal carcinoma and a comedo type DCIS. The oncotype was done on the tumor itself.

  8. Jerry Jones says:

    Recently, Dr. Melanie Joy, PhD came to our little Vegan group and made a presentation where she coined a term, “carnism.” Being a political conservative I am very sensitive to all things “left-leaning.” So, when I noticed that Dr. Joy’s quotes of famous people in history were left-leaning I began to notice how much Animal Rights is connected with Veganism. I would now say that Veganism has more to do with the cruelity of animals than it does with heath.

  9. The Doc says:

    How people eat is quite personal- deeply so for some. There are correlations – but they are not causative. There are some exceptions- the early largest group of vegetarians in the United States were the 7th Day Adventists. Veganism itself is only 70 years old, and that movement was a part of a larger lifestyle issue.
    One can be a carnist, and yet appreciate animals. My Native American ancestors were aware that the animals gave their lives so they could live, and honored them. Cruelty to animals is not justified, in any manner. So our household goes out of the way to purchase from ranches that we are familiar with, and have visited, and support them.

  10. Ashwani Garg MD says:

    Whatever you may say about PCRM, I agree with the fact that they promote a vegan agenda, and select information that supports that agenda. However, numerous other organizations are on board with the “plant based” diet, including Kaiser Permanente, see the article in their journal: https://www.thepermanentejournal.org/issues/2013/spring/5117-nutrition.html as well as Dr. Joel Fuhrman (who by the way does not promote a vegan agenda but is very clear about the nutritional value of Kale vs Chicken) – I challenge you to substitute the chicken/fish with an equal caloric amount of Kale, and compare the nutrients, fiber and calories. Similarly if you replace the chicken / fish with an equal amount of lentils, what would happen? I believe you would prevent cancer and heart disease, and have extraordinary digestion and improved health. I can tell you from personal experience, having done a plant based diet purely for my health 2 years ago. Many of my patients are also following suit. One recently came with prostate cancer, and dropped his PSA in half with a plant based diet. One recent Type 1 diabetic at 16 years old, cut his insulin requirement by 2/3rd’s! He never felt better in his whole life. A healthy, balanced plant based diet can be nutritionally complete, result in great health, and one need not be “vegan” to be plant based. However I do give respect to PCRM for their research and articles, and free CME at nutritioncme.com – they were instrumental in showing me a different way to help patients non-surgically. In the Seventh Day Adventist health study, only the vegan group was of normal average BMI. I challenge those that are 100-200 lbs overweight to try a plant-based diet and lose weight – they do! For a plant-based eating plan that is NOT vegan, you can go to http://www.fullplateliving.org and find great resources there, or try Dr. Fuhrman’s “Eat to Live” plan.

  11. Dr. Terry Simpson says:

    That they endorse a plant based diet does not mean that all things plant are good. In terms of what you “believe” is not borne out by what is known. Why still do people who are vegetarian die of heart disease and cancer? In terms of equal amounts of plants to meat- you may be true in terms of the chemicals as they are broken down in a laboratory, but it is what is bioavailable. Yes, you can get a lot of iron from plants, but what is available for uptake is a completely different story.
    In terms of anecdotal experience – it is typically not something that anyone with science training would say has any value. For example – you will see people say HCG helped them lose weight, even though it was the diet and not the HCG. You will hear people tell how chiropractic saved their backs – even though the evidence for that never has risen to the level accepted by science. You will hear lots of great data.
    For your patient whose PSA levels fall – well, that means zip- if they have prostate cancer, they have prostate cancer and if it is not making PSA that isn’t a good thing, and may be a sign of the cancer devolving to a worse cell type.
    Yes- when people pay attention to their diet, when they cut out junk food- no matter which diet they choose- paleo, vegan, pescatarian, they will feel better, and they will improve.
    Facts remain- the longest living people on the planet use fish as their source of protein – not plants.
    But to say it is all one diet or another is both primitive and lacks critical thinking.

  12. Byte Me says:

    Joel Fuhrman DOES have a vegan agenda.

    He cherry picked an outdated citation in his book Eat To Live, claiming that broccoli has more protein than beef

    His ANDI scoring chart doubles the numbers for plants and does not count fat soluble nutrients

    Yes, Fuhrman, like the others at the PCRM, has a very clear vegan agenda, and he will torture the evidence any which way he can so others will adopt his beliefs.

  13. Ashwani Garg MD says:

    As far as the protein thing, let’s say that broccoli has a significant amount of protein but also a much higher concentration of fiber and micronutrients, and probably more nutritional value than beef. If Dr. Fuhrman’s greatest fault is being off by a few grams on the protein in broccoli, that is forgivable. Broccoli will go cleanly through your digestive system, feeding the good bacteria in the gut, while sirloin will likely cause slowdown, not feed the good bacteria, and cause colorectal cancer. Even if Dr. Fuhrman is off on the protein numbers, his message has value to it. Clearly many doctors promote a plant based diet, because it’s the right thing to do. Try Dr. Dennis Burkitt, Dr. Dean Ornish, Dan Buettner of Blue Zones – one does not have to be 100% vegan to be healthy; According to Dan Buettner’s work, the longest lived and healthiest populations are about 95% plant based. The problem with the standard American diet is not enough fiber and micronutrients. A very miniscule amount of Americans don’t get enough protein but the majority get much more than needed, along with saturated fat and too many calories. However the vast majority don’t eat enough fiber and micronutrients to stay healthy. Why do you think that every American in the USA is recommended to have a screening colonoscopy? It’s not from eating too much broccoli.

  14. Terry Simpson says:

    First, most beef is digested in the first food of small bowel. In terms of bio-availability there is more in meat than there is in plants. When you say the longest living and healthiest populations -well, actually that isn’t true- the longest living are mostly eating fish for their protein and not plants. According to WHO the longest living are fish eaters, with heavy meat eaters and vegans coming in last. I agree that we need more vegetables in our diet, but plant based nutrition is anecdotal at best. Besides- right now we are one of the longest living species on the planet – so as much as you want to think we are in horrible shape, we are actually in pretty good shape – although a bit round. So I agree with part -we need more vegetables in the diet- but beef has better bioavailable nutrition, and most plant based diets weight loss is from malnutrition, not from healthy eating.

  15. Dr. Terry Simpson says:

    I am not on anyone’s payroll – I receive no compensation from any corporation, and the opinions are mine, and mine alone. They are not for sale. I go where the science leads me, and not where anecdotes range.

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