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TMAO & Cardiovascular Disease
AlPater posted a topic in General Health and Longevity[Admin Note: I made this new thread as a collector for posts about the recently discovered and previously discussed apparent link between diet, micronutrients choline and carnitine, TMAO production by gut microbes that feed on these micronutrients, and elevated risk of cardiovascular disease. Four posts down is the new post (by me) on the topic. The first four posts come from a different thread. --Dean] In his post about supplements for vegetarians, Michael Rae said: For now, prudence seems to require that vegetarians err on the side of a generous and definitely supplemented intake of choline, ensuring that dietary (to the extent that it can be known) plus supplemental choline is meaningfully higher than the AI of 550 mg for men and 425 mg/day for women. Functional status is still tricky, but one obvious set of markers is the same panel used to establish signs of deficiency in Zeisel’s depletion-repletion study:iv a fivefold or more increase above normal of the muscle-damage enzyme creatine phosphokinase (CPK), or a one-and-a-half or more times normal reading of the liver enzymes aspartate aminotransferase (AST), gamma-glutamyltransferase (GGT), or lactate dehydrogenase (LD). Fatty liver, unfortunately, requires a harder-to-access MRI of fat deposits in the organ, to which your doctor is unlikely to consent. The below papers may be a reason dietary choline can be bad for us. NATURE | RESEARCH HIGHLIGHTS CARDIOVASCULAR BIOLOGY Gut microbes raise heart-attack risk Nature 531, 278 (17 March 2016) doi:10.1038/531278b Published online 16 March 2016 http://sci-hub.io/10.1038/531278b Subject terms: Microbiology Cardiovascular biology Gut microbes produce a chemical that enhances clotting in the arteries, increasing the risk of heart attack and stroke. Stanley Hazen of the Cleveland Clinic in Ohio and his colleagues treated human platelets, which form blood clots, with a compound called TMAO. This is made in the body from a waste product of gut microbes, and has been linked to heart disease. The team found that TMAO made the platelets form artery-blocking clots faster. The researchers increased blood TMAO levels in mice by feeding them a diet that was rich in choline, a TMAO precursor, and found that the animals formed clots faster than did those with lower TMAO levels. This effect was not seen in animals that lacked gut microbes or that were treated with antibiotics. When intestinal microbes from mice that produced high levels of TMAO were transplanted into mice with no gut microbes, the recipients' clotting risk increased. The results reveal a link between diet, gut microbes and heart-disease risk, the authors say. Gut Microbial Metabolite TMAO Enhances Platelet Hyperreactivity and Thrombosis Risk. Zhu W, Gregory JC, Org E, Buffa JA, Gupta N, Wang Z, Li L, Fu X, Wu Y, Mehrabian M, Sartor RB, McIntyre TM, Silverstein RL, Tang WH, DiDonato JA, Brown JM, Lusis AJ, Hazen SL. Cell. 2016 Mar 9. pii: S0092-8674(16)30113-1. doi: 10.1016/j.cell.2016.02.011. [Epub ahead of print] PMID: 26972052 http://sci-hub.io/10.1016/j.cell.2016.02.011 Abstract Normal platelet function is critical to blood hemostasis and maintenance of a closed circulatory system. Heightened platelet reactivity, however, is associated with cardiometabolic diseases and enhanced potential for thrombotic events. We now show gut microbes, through generation of trimethylamine N-oxide (TMAO), directly contribute to platelet hyperreactivity and enhanced thrombosis potential. Plasma TMAO levels in subjects (n > 4,000) independently predicted incident (3 years) thrombosis (heart attack, stroke) risk. Direct exposure of platelets to TMAO enhanced sub-maximal stimulus-dependent platelet activation from multiple agonists through augmented Ca2+ release from intracellular stores. Animal model studies employing dietary choline or TMAO, germ-free mice, and microbial transplantation collectively confirm a role for gut microbiota and TMAO in modulating platelet hyperresponsiveness and thrombosis potential and identify microbial taxa associated with plasma TMAO and thrombosis potential. Collectively, the present results reveal a previously unrecognized mechanistic link between specific dietary nutrients, gut microbes, platelet function, and thrombosis risk.
PROSTATE CANCER PREVENTION
Dean Pomerleau posted a topic in General Health and LongevityWell, since we've started a thread here on the "General Health and Longevity" forum dedicated to Colon Cancer Prevention, I figured we might as well have one for prostate cancer too, particularly since CR practitioners are overwhelmingly male, and because among US men, prostate cancer is the most common cancer and second leading cancer killer based on CDC Statistics. Plus, there is a new study  showing how good my favorite diet (vegan) is for prostate cancer prevention. The study followed ~26,000 men (obviously) who are participating in the famous Adventist Health Study-2, and recruited between 2002 and 2007. It found that men eating a vegan diet were 35% less likely to develop prostate cancer (HR: 0.65; 95% CI: 0.49, 0.85) relative to omnivores during the mean follow-up period of 7.8 year, even after adjusting for age, race, family history of prostate cancer, education, screening for prostate cancer, calorie intake, and BMI. The last is significant because it shows that it wasn't just a result of the vegans being thinner than the omnivores that protected them from prostate cancer. Interestingly, and distinctively from other studies of this population where health benefits relative to omnivores have been observed among all the categories of vegetarians, the benefits observed here for prostate cancer avoidance were entirely restricted to the vegan diet group. Below is the summary table of relative risks for the different diet groups, broken down by race. Looking at data for white men I've highlighted. None of the other vegetarian categories have even a hint of reduction in prostate cancer risk relative to omnivores, not even the pesky pesco-vegetarians - only the vegans: So if you want to avoid the most common form of cancer among men in the US, and the second leading cause of cancer death, go vegan! --Dean --------------  Am J Clin Nutr. 2015 Nov 11. pii: ajcn106450. [Epub ahead of print] Are strict vegetarians protected against prostate cancer? Tantamango-Bartley Y(1), Knutsen SF(2), Knutsen R(2), Jacobsen BK(3), Fan J(2), Beeson WL(2), Sabate J(2), Hadley D(4), Jaceldo-Siegl K(2), Penniecook J(2), Herring P(2), Butler T(2), Bennett H(2), Fraser G(2). BACKGROUND: According to the American Cancer Society, prostate cancer accounts for ∼27% of all incident cancer cases among men and is the second most common (noncutaneous) cancer among men. The relation between diet and prostate cancer is still unclear. Because people do not consume individual foods but rather foods in combination, the assessment of dietary patterns may offer valuable information when determining associations between diet and prostate cancer risk. OBJECTIVE: This study aimed to examine the association between dietary patterns (nonvegetarian, lacto-ovo-vegetarian, pesco-vegetarian, vegan, and semi-vegetarian) and prostate cancer incidence among 26,346 male participants of the Adventist Health Study-2. DESIGN: In this prospective cohort study, cancer cases were identified by matching to cancer registries. Cox proportional hazards regression analysis was performed to estimate HRs by using age as the time variable. RESULTS: In total, 1079 incident prostate cancer cases were identified. Around 8% of the study population reported adherence to the vegan diet. Vegan diets showed a statistically significant protective association with prostate cancer risk (HR: 0.65; 95% CI: 0.49, 0.85). After stratifying by race, the statistically significant association with a vegan diet remained only for the whites (HR: 0.63; 95% CI: 0.46, 0.86), but the multivariate HR for black vegans showed a similar but nonsignificant point estimate (HR: 0.69; 95% CI: 0.41, 1.18). CONCLUSION: Vegan diets may confer a lower risk of prostate cancer. This lower estimated risk is seen in both white and black vegan subjects, although in the latter, the CI is wider and includes the null. © 2016 American Society for Nutrition. PMID: 26561618
I actually listened to the video, short and sweet. 24 November 2021|Fitness Identical twins Hugo and Ross Turner are adventure athletes that are always trying to find ways to improve their performance. https://www.bbc.com/reel/video/p0b5x2z7/is-a-vegan-diet-healthier-than-eating-meat-and-dairy-
Chilled Vegan Sweet Bean Macarons
Dean Pomerleau posted a topic in CR RecipesAs most of your know, I'm not much of a cook - my regular diet is whole-food, plant-based, vegan and almost all raw. But occasionally I get a hankering for something sweet and crunchy that isn't a fruit or vegetable. By leveraging an amazing recent culinary discovery, coupled with a lot of tinkering in my basement laboratory/kitchen, I think I've finally succeeded. This recipe has got it all, as far as I'm concerned. Here are the main features it's got going for it: It is vegan. It has virtually zero calories. In its simplest form, it has only one quite healthy ingredient - but is infinitely adaptable. The "preferred embodiment" described below has only three, commonly available & healthy ingredients. Paradoxically, despite being healthy, this main ingredient is almost always discarded, even by CR folks who hate to waste food. The taste of the final product is hard to describe, but I find it to be an intriguing combination of sweet & savory. But it can go either way depending on your personal preference. It has a satisfying crunch when you bite into it, but then literally melts in your mouth. I hope that list of features has piqued your interest. Without further ado, here is the background and recipe for what I'm tentatively calling Chilled Vegan Sweet Bean Macarons. I bet you're wondering what the mystery ingredient is. It's the cooking water left over after boiling beans, or alternatively, the liquid from canned beans! I kid you not. This stuff is a culinary miracle. It's basically a near perfect vegan substitute for egg whites, particularly in recipes that call for whipping egg whites into soft or hard peaks. The chickpea variant of this cooking liquid even has a fancy haute cuisine name. It is called "Aquafaba" and it has entire websites and cookbooks devoted to using it in huge range of recipes. According to this article on Aquafaba from the May 9th, 2016 Food section of the NY Times, Aquafaba's miraculous culinary potential was discovered in 2015 by an Indiana vegan software engineer described as an "inveterate tinkerer" - a man after my own heart! But he says he got the inspiration from a french chef's cooking video using chickpea juice. See this detailed history of Aquafaba on the Aquafaba.com website if you're dying to know more about its history. The science behind this stuff, and in particular its ability to whip into hard peaks, is fascinating. Here is a brief description from the NY Times article, starting with how whipped egg whites hold their shape: The white is about 90 percent water and 10 percent protein. When whipped, those proteins unfold and bond together, trapping the air bubbles created by the whisk. This is what allows for relatively long-lived foams and, ultimately, delights like meringues, soufflés and angel food cakes. Apparently Aquafaba works similarly: How aquafaba works isn’t precisely understood. Mr. McGee said the key is its viscous mixture of protein and dissolved starch, which slows down the collapse of a foam, as well as chemicals called saponins. What a minute you might be saying, I've heard of saponins. Aren't they bad for you? Perhaps, if you're a cold-blooded animal or insect . They can also give ruminants indigestion, and may (potentially) explain part of the reason legumes don't agree with some people, if you know what I mean. If you're one such person, you might want to start out slow with this recipe... But on the other hand, studies of saponins have shown they have have anti-inflammatory, cholesterol lowering and anticancer properties - so aquafaba has got that going for it! Saponins are found in many healthy foods including (not surprisingly) legumes, yams, oats, spinach, and quinoa in concentrations from 2-6%. In contrast, chemical analysis of aquafaba determined that it contains less than 0.03% saponins. So don't worry about it. Other analysis shows it contains zero fat and very little in the way of sugars and starch: If we add up all the carbs for the unfiltered version, we get 0.85g of total carbohydrates per 100ml of aquafaba. I haven't found analysis that quantifies the amount of protein in aquafaba, but if assume that, like chickpeas, aquafaba has 1/3rd as much protein as carbs, that puts the total carbs + protein at just over 1g/100ml (or 4kcals/100ml) of aquafaba. As you'll see, just a little of this miracle bean juice goes a long way, so its calorie contribution is quite negligible in this recipe. Guess what. After all that deep dive into chickpea aquafaba, I'm going to tell you know I haven't tried using it yet. Nope. While I do cook and eat chickpeas, what I've cooked most recently, and therefore being using for my culinary experiments, is the cooking water from black beans. As you'll see, it has all the same culinary properties as chickpea aquafaba, and I'm assuming the same nutritional properties (i.e. calorie count) as well. So when I refer to "bean water" or "aquafaba" below, assume I mean either the water from cooked or canned chickpeas or black beans, although as you'll see from the photos I used black bean water from canned beans in this recipe demo. I do plan to try using chickpea water next time I cook them, since I expect chickpea aquafaba will have a little less bean taste to it that the water from black beans. A milder flavor might be advantageous in the sweet version of this recipe. Which finally, the moment you've been waiting for - the actual recipe! ------------------------------------------------------------------------------------------------------------ Chilled Vegan Sweet Bean Macarons Prep Time: ~25-30 minutes. Chill Time: Two hours minimum. Overnight recommended. Yield: Makes 24 1-inch macarons. Calories: Less than 0.5 kcal per macaron. About 2/3rd from the cocoa powder and 1/3rd from the aquafaba. Ingredients: Required Ingredient: ½ cup (125ml) Aquafaba - The liquid from canned or home-cooked chickpeas, black bean or other legume. Equivalent to the liquid from one standard 15-oz can of cooked beans. Optional (But Highly Recommended) Ingredients: ½ Tbsp Cocoa Powder - Other dry or liquid flavors should work too - experiment! See notes below. 1 pinch Stevia Powder - This is pure stevia powder, like this - not the stuff that comes in packets. A pinch is 1/16 tsp. Other sweeteners will work too. Pick your favorite and sweeten to taste. Note: This combination of cocoa and stevia results in a pretty chocolatey, not very sweet macaron, especially using black beans aquafaba. It is sort of like dark chocolate. I like them this way, but if you prefer a sweeter taste, adjust accordingly. Also, I've found the more extra flavoring ingredients you add, the less firm and crunchy the macarons will be in the end. Note: If you are going to try other flavors or sweeteners, here is one piece of advice. Watch out for acidic flavoring ingredients (like lemon juice) which I suspect will interfere with the foaming ability of the aquafaba. But I haven't tried it so I could be wrong. Equipment: Can opener - If using canned beans Small saucepan - For reducing the aquafaba Stove or Cooktop - For reducing the aquafaba Stand Mixer with Whisk Attachment - I highly recommend using a stand mixer (e.g. KitchenAid) rather than a hand mixer, both because the aquafaba will whip better, and your won't tire out your arm. But if all you've got is a hand mixer, that should work too I expect. Plastic Storage Bag - 1-qt or 1-gal size. For piping macarons. If you are a fancy baker and have a piping bag already, use it. Scissors - to cut corner off plastic bag to turn it into a piping bag. Large Spoon or Spatula - For scraping & scooping whipped aquafaba into piping bag. Cookie Sheet - Standard size. Non-stick. If you don't have one, or don't have room in your freezer for a full-size cookie sheet, you can use one (or two) 9x11 baking pans or equivalent. Make sure they are non-stick. If not, line the sheet/pan with a silicone baking mat, wax paper, or plastic wrap. Freezer - For chilling and hardening the final macarons. You'll need enough room in the freezer for the cookie sheet / baking pan(s). Instructions: Step 1: Pick Your Bean You need to decide what type of bean to use to make your aquafaba. Here are a few options, and considerations for each: Chickpeas - The traditional source for aquafaba. Lighter in taste and color than black beans Black Beans - Produces aquafaba with a bit more 'beany' tasting than chickpeas, and a darker color. Complements cocoa powder for a more savory macaron which I like. Other Beans - I've tried cannellini beans and they work fine too - very similar to chickpeas. I'm skeptical whether lentils would work, but I haven't tried them. Step 2: Pick Your Bean Preparation Method Aquafaba is the cooking liquid from cooked beans. Note - this isn't the soaking/rinsing liquid. There are two methods of getting aquafaba. One easy, and one more labor intensive. Here are your options: Canned Beans - By far the easiest. The liquid packed in one 15-oz can of cooked beans is exactly the right amount for this recipe. But for those concerned with excess sodium, watch out for it on the label. Most canned beans have a lot of added sodium, and much of it stays with the liquid in the can. The other possible downside is Bisphenol-A (BPA) exposure from lining of the can, which tends to leach into both the beans, and the liquid. Home-cooked Beans - I personally cook my own dry beans in big batches, and have always thrown out the cooking water, despite it appears to contain many of the brightly (or darkly) colored phytochemicals that have leached out of the beans. That was part of the motivation for developing this recipe in the first place. I cook my own dry beans largely to reduce the sodium and the cost of the legumes I eat. But for many people rinsing, soaking and then cooking beans from scratch is too big a hassle. If you do cook your own, you can generate a lot of aquafaba by saving the cooking liquid, and make this recipe several times over. The extra aquafaba stores well in the fridge for a week and pretty much indefinitely in the freezer. Homemade aquafaba has a lot less sodium than aquafaba from canned beans. Plus there is no concern about BPA with home-cooked beans. If you are using canned beans, continue to Step 3a. If you're cooking your beans yourself, jump to Step 3b. Step 3a: Make the Aquafaba - Canned Bean Version It's really pretty trivial to get aquafaba from canned beans, especially if you're using beans like chickpeas or cannellini beans, where the liquid is easy to pour off. Simply use a can opener to open the can most of the way, but don't go all the way around to completely remove the lid. With the lid still attached and over the beans, pour the liquid into a small saucepan, straining out the beans so they remain in the can. Save the beans for use in another recipe. They freeze well so don't worry about using them right away. I find that black beans have a much thicker liquid that clings to the beans, so the above "pour it off" method that works for chickpeas isn't enough to get all the aquafaba out of the can of black beans. So here is what you do. Once you've poured off the liquid that will come out easily using the above technique, simply pry open the lid and add about ½ cup (about ¼ of the can) of water to the can, which still contains the beans and the stubborn aquafaba. Bend the lid back down to cover the beans, and then put your hand over the lid to keep the liquid from escaping while you shake it vigorously to rinse the aquafaba off the beans. Pour this additional aquafaba into the saucepan with the rest. If you bother to measure it (I usually don't), a single 15-oz can of cooked beans should yield about a cup (240 ml) of aquafaba using the methods described above. Don't worry though, it doesn't have to be exact. Because next you're going to reduce the aquafaba on the stovetop to get the right amount and consistency. You're ready now to jump ahead directly to Step 4, skipping Step 3b. Step 3b: Make the Aquafaba - Home-cooked Bean Version Rinse and soak your dried beans using your regular protocol. Put them in the pot and cover them with twice as much water (by volume) as beans. Cook in your usual way until beans are tender (20-60 minutes depending on the bean). But rather than pouring the cooking liquid down the drain, pour it into an airtight container. It will keep for at least a week in the fridge and many months in the freezer. When you are ready to make this recipe, measure out 8oz (240 ml) of the cooking liquid and pour it into a small saucepan. It can be warm, room temperature, or refrigerator temp - it doesn't matter. Step 4: Reduce the Aquafaba Put the saucepan on a stove or cooktop. Turn on the heat to medium until the aquafaba starts to boil, and then turn the heat down to a simmer. It should look like this while it's simmering: Leave it simmering for approximately 5 minutes, stirring occasionally to prevent a 'skin' from forming on the surface. It should reduce down from an original 8 oz (240ml) to about half that, around 4 oz (120 ml). This step may not be entirely necessary, but I've found thicker, more viscous aquafaba makes for good final texture in the macarons. The reduced aquafaba should have the viscosity of heavy cream or half-n-half at this point. Remove from stovetop and go on to Step 5. Step 5: Whip the Aquafaba Now comes the fun part, where the aquafaba gets to do it's thing. First pour the reduced aquafaba from the saucepan into the bowl of your mixer: Starting on low to avoid splatter, slowly ramp up the speed of your mixer until it's maxed out. Let is whip on high for a couple minutes until it starts to thicken. Then pour in the cocoa powder and the sweetener: Starting on low again, ramp mixer back up to high making sure dry ingredients incorporate completely. Scrape sides of mixing bowl if necessary to incorporate. Continue mixing on high for 3-4 more minutes, or until 'stiff peaks' form in the whipped aquafaba. It should be the consistency of thick whip cream or ganache, and look something like this: Yum! In fact, you can stop right here and eat the aquafaba cream - at this stage it is a very tasty pudding! In fact, I encourage you to try a taste of it now to make sure the amount of cocoa powder and sweetener is the way you like it. If you need to make adjustments by adding more flavoring or sweetener, simply mix on high for a minute or two more to make sure your additions gets evenly incorporated. Don't worry about over whipping your aquafaba. Unlike egg whites, this stuff can be whipped all day and still maintain at stiff peaks. Step 6: Pipe the Cream to Form Macarons If you are going to use a plastic bag for piping, use a pair of scissors to cut about ½ " off one of the lower corners of the plastic storage bag: Now use a large spoon or spatula to scrape and scoop the aquafaba cream into the open end of the piping bag, like so: Seal the piping bag and gentle squeeze it to extrude approximate 24 1-inch turds dollops of the aquafaba cream onto the non-stick or lined cookie sheet / baking pan, like so: Here is what the cookie sheet should look like when you are done, depending on whether you are neat (top) or not (bot). These were two different batches. They had slightly different amounts of cocoa - hence the difference in color: Step 7: Chill The Macarons Slide the cookie sheet or baking tray(s) into the freezer. Leave them there to harden for at least 2 hours, preferably overnight. Then use a spatula to gently slide them off the sheet/tray. Store them in an airtight container in the freezer. Step 8: Enjoy! When you're ready to eat them, remove them from the freeze and enjoy! But do it quickly. They melt fast at room temperature, so you'll want to eat them while their are still frozen and have a nice crunch to them. Here is what the final product looks like, whole and with a bite taken out! I really like the way these taste and the mouthfeel. They are like chilled versions of the top and bottom shells of real macarons1. They crunch when you bite them and then quickly melt in your mouth. Even my wife, who has a discerning palate and usually hates what I eat, thought these were pretty good, and really liked the mouthfeel too. That's high praise from her! And at less than ½ kcal per macaron, they aren't going to break your calorie budget! ------------------ 1On the issue of whether these are real macarons. I will acknowledge for the serious chefs / bakers out there, that these are not complete macarons, which usually have two wafers like these with sweet ganache sandwiched between them. That's one difference. Another is that real macaroons are stable at room temperature☺. You could make these more like real macarons by reserving some of the whipped aquafaba, flavoring it differently, and keeping it in cream form rather than freezing. You could then spread it between two of these frozen wafers to make a little sandwich. But that seems like too much trouble, and the combination is going to melt pretty fast anyway, spoiling the effect. It might be worth a try though. Also, if you are interested in real macarons, there are plenty of recipes out there using aquafaba instead of egg whites. Like these or these - which look a whole lot fancier and authentic than this recipe. But most of them (including those two) have lots of sugar, almond or white flour and other ingredients that many obsessively healthy folks try to steer clear of. @ Copyright: 2016 Dean Pomerleau - All rights reserved. Please share this recipe with others but please include this copyright & attribution notice. -------------------------------------------------------------------------------------------------- I really hope people will give this recipe a try, both in its original form described above, and with alternative flavorings and sweeteners. I'll be very curious to see and try for myself what other combinations people discover. Please post about your results trying this recipe below. Also, if you've got suggestions for a better name, I'm all ears. Bon Appétit! --Dean --------  Tava A, Odoardi M Saponins from Medicago ssp.: chemical characterization and biological activity against insects In: Saponins used in Food and Agriculture. Waller GR, Yamasaki K (eds.), Advances in experimental medicine and biology, Vol. 405, 97-109  Cheeke PR Biological effects of feed and forage saponins and their impacts on animal production Saponins used in Food and Agriculture. Waller GR, Yamasaki K (eds.), Advances in experimental medicine and biology, Vol. 405, 377-385
All, Al Pater posted this paper  on the mortality rates of meat-eaters vs. vegetarians (and vegans) among participates in the EPIC-Oxford study of diet and health. The results were disappointing for us vegans (and vegetarians): There was no significant difference in overall (all-cause) mortality between the diet groups: HRs in low meat eaters, fish eaters, and vegetarians compared with regular meat eaters were 0.93 (95% CI: 0.86, 1.00), 0.96 (95% CI: 0.86, 1.06), and 1.02 (95% CI: 0.94, 1.10), respectively; P-heterogeneity of risks = 0.082. In a separate sub-analysis of the vegan's in the study, they found the same thing - no difference in all-cause mortality between vegans and any of the other diets. Given the distinct longevity advantage for vegans and vegetarians seen in the Adventists Health Study , what's the deal with these British vegans and vegetarians? One possible reason is social support. From the demographics in Table 1 of the full text of , the UK vegans and vegetarians were significantly less likely to be married or cohabitating than meat eaters (60.8% vs. 75.5%), and less likely to have kids (41.5% vs. 77.2%). Loneliness and social isolation are well-known contributors to ill-health and early mortality. In contrast, from the full text of , the Adventist vegans were slightly more likely to be married than the meat-eaters (75.6% vs. 70.3%). In addition, study  found the vegetarians and especially vegans in the Epic-Oxford study have significantly lower levels of vitamin B12 than meat-eaters, to the point of outright deficiency: Half of the vegans were categorized as vitamin B12 deficient and would be expected to have a higher risk of developing clinical symptoms related to vitamin B12 deficiency. Here is the graph of B12 levels in meat-eaters (open circles at top), vegetarians (closed circles in middle) and vegans (open triangles at bottom): So perhaps it is low B12 and/or other specific vitamin deficiencies among poorly planned diets of the EPIC-Oxford vegan / vegetarian participants that make them more prone to dying than the Adventists. Or perhaps it is simply overall diet quality that is worse in the UK vegans/vegetarians relative to the Adventists that makes them shorter-lived. Here is the table with diet information for the EPIC-Oxford cohort from : As you can see from the highlights in yellow, the vegans/vegetarians aren't much better than the meat eaters in terms of dietary saturated fat, fiber, fruit or vegetable intake. This contrasts markedly with the Adventists dietary data, from , shown in tabular form below: Notice among the Adventists, the vegans consumed 50% more fiber and about have the saturated fat compared with the Adventist meat-eaters, and over twice as much fiber as the vegans/vegetarians in the EPIC-Oxford cohort. Unfortunately, the table does not have explicit data on fruit or vegetable consumption, but the fiber numbers and higher Vitamin C numbers of vegans are probably a pretty good indication of higher consumption of fruits/veggies among the vegans. Also notice that B12 intake is actually higher for vegans than for meat-eaters among the Adventist, presumably due to supplementation by the vegans. So overall, it looks the the answer to the question in the title of this post, "Why Don't UK Vegans/Vegetarians Live Longer?", is likely to be that they have much lower overall diet quality than more carefully planned vegan and vegetarian diets, like those of the Adventists, and (hopefully) all of us CR practitioners! This comparison could also be thought of as support for the idea that dietary quality may be as important or more important for health and longevity than dietary quantity (i.e. CR), which I posted about yesterday, and previously in the context of comparing the Okinawans with the Adventists. --Dean ------  Mortality in vegetarians and comparable nonvegetarians in the United Kingdom. Appleby PN, Crowe FL, Bradbury KE, Travis RC, Key TJ. Am J Clin Nutr. 2015 Dec 9. pii: ajcn119461. [Epub ahead of print] PMID: 26657045 Free Article http://ajcn.nutrition.org/content/early/2015/12/07/ajcn.115.119461.long Abstract BACKGROUND: Vegetarians and others who do not eat meat have been observed to have lower incidence rates than meat eaters of some chronic diseases, but it is unclear whether this translates into lower mortality. OBJECTIVE: The purpose of this study was to describe mortality in vegetarians and comparable nonvegetarians in a large United Kingdom cohort. DESIGN: The study involved a pooled analysis of data from 2 prospective studies that included 60,310 persons living in the United Kingdom, comprising 18,431 regular meat eaters (who ate meat =5 times/wk on average), 13,039 low (less-frequent) meat eaters, 8516 fish eaters (who ate fish but not meat), and 20,324 vegetarians (including 2228 vegans who did not eat any animal foods). Mortality by diet group for each of 18 common causes of death was estimated with the use of Cox proportional hazards models. RESULTS: There were 5294 deaths before age 90 in >1 million y of follow-up. There was no significant difference in overall (all-cause) mortality between the diet groups: HRs in low meat eaters, fish eaters, and vegetarians compared with regular meat eaters were 0.93 (95% CI: 0.86, 1.00), 0.96 (95% CI: 0.86, 1.06), and 1.02 (95% CI: 0.94, 1.10), respectively; P-heterogeneity of risks = 0.082. There were significant differences in risk compared with regular meat eaters for deaths from circulatory disease [higher in fish eaters (HR: 1.22; 95% CI: 1.02, 1.46)]; malignant cancer [lower in fish eaters (HR: 0.82; 95% CI: 0.70, 0.97)], including pancreatic cancer [lower in low meat eaters and vegetarians (HR: 0.55; 95% CI: 0.36, 0.86 and HR: 0.48; 95% CI: 0.28, 0.82, respectively)] and cancers of the lymphatic/hematopoietic tissue [lower in vegetarians (HR: 0.50; 95% CI: 0.32, 0.79)]; respiratory disease [lower in low meat eaters (HR: 0.70; 95% CI: 0.53, 0.92)]; and all other causes [lower in low meat eaters (HR: 0.74; 95% CI: 0.56, 0.99)]. Further adjustment for body mass index left these associations largely unchanged. CONCLUSIONS: United Kingdom-based vegetarians and comparable nonvegetarians have similar all-cause mortality. Differences found for specific causes of death merit further investigation. KEYWORDS: diet; mortality; nonvegetarian; vegan; vegetarian --------   JAMA Intern Med.. 2013 Jul 8;173(13):1230-8.. doi: 10.1001/jamainternmed.2013.6473. Vegetarian dietary patterns and mortality in Adventist Health Study 2. Orlich MJ(1), Singh PN, Sabaté J, Jaceldo-Siegl K, Fan J, Knutsen S, Beeson WL, Fraser GE. Author information: (1)School of Public Health, Loma Linda University, Loma Linda, CA 92350, USA. email@example.com Comment in JAMA Intern Med.. 2014 Jan;174(1):168-9. JAMA Intern Med.. 2014 Jan;174(1):169. JAMA Intern Med.. 2013 Jul 8;173(13):1238-9. Dtsch Med Wochenschr.. 2013 Sep;138(39):1930. IMPORTANCE: Some evidence suggests vegetarian dietary patterns may be associated with reduced mortality, but the relationship is not well established. OBJECTIVE: To evaluate the association between vegetarian dietary patterns and mortality. DESIGN: Prospective cohort study; mortality analysis by Cox proportional hazards regression, controlling for important demographic and lifestyle confounders. SETTING: Adventist Health Study 2 (AHS-2), a large North American cohort. PARTICIPANTS: A total of 96,469 Seventh-day Adventist men and women recruited between 2002 and 2007, from which an analytic sample of 73,308 participants remained after exclusions. EXPOSURES: Diet was assessed at baseline by a quantitative food frequency questionnaire and categorized into 5 dietary patterns: nonvegetarian, semi-vegetarian, pesco-vegetarian, lacto-ovo-vegetarian, and vegan. MAIN OUTCOME AND MEASURE: The relationship between vegetarian dietary patterns and all-cause and cause-specific mortality; deaths through 2009 were identified from the National Death Index. RESULTS: There were 2570 deaths among 73,308 participants during a mean follow-up time of 5.79 years.. The mortality rate was 6.05 (95% CI, 5.82-6.29) deaths per 1000 person-years.. The adjusted hazard ratio (HR) for all-cause mortality in all vegetarians combined vs nonvegetarians was 0.88 (95% CI, 0.80-0.97).. The adjusted HR for all-cause mortality in vegans was 0.85 (95% CI, 0.73-1.01); in lacto-ovo-vegetarians, 0.91 (95% CI, 0.82-1.00); in pesco-vegetarians, 0.81 (95% CI, 0.69-0.94); and in semi-vegetarians, 0.92 (95% CI, 0.75-1.13) compared with nonvegetarians.. Significant associations with vegetarian diets were detected for cardiovascular mortality, noncardiovascular noncancer mortality, renal mortality, and endocrine mortality.. Associations in men were larger and more often significant than were those in women. CONCLUSIONS AND RELEVANCE: Vegetarian diets are associated with lower all-cause mortality and with some reductions in cause-specific mortality.. Results appeared to be more robust in males.. These favorable associations should be considered carefully by those offering dietary guidance. PMCID: PMC4191896 PMID: 23836264 -----------  Eur J Clin Nutr. 2010 Sep;64(9):933-9. doi: 10.1038/ejcn.2010.142. Epub 2010 Jul 21. Serum concentrations of vitamin B12 and folate in British male omnivores, vegetarians and vegans: results from a cross-sectional analysis of the EPIC-Oxford cohort study. Gilsing AM(1), Crowe FL, Lloyd-Wright Z, Sanders TA, Appleby PN, Allen NE, Key TJ. Author information: (1)Cancer Epidemiology Unit, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK. BACKGROUND/OBJECTIVES: Vegans, and to a lesser extent vegetarians, have low average circulating concentrations of vitamin B12; however, the relation between factors such as age or time on these diets and vitamin B12 concentrations is not clear. The objectives of this study were to investigate differences in serum vitamin B12 and folate concentrations between omnivores, vegetarians and vegans and to ascertain whether vitamin B12 concentrations differed by age and time on the diet. SUBJECTS/METHODS: A cross-sectional analysis involving 689 men (226 omnivores, 231 vegetarians and 232 vegans) from the European Prospective Investigation into Cancer and Nutrition Oxford cohort. RESULTS: Mean serum vitamin B12 was highest among omnivores (281, 95% CI: 270-292 pmol/l), intermediate among vegetarians (182, 95% CI: 175-189 pmol/l) and lowest among vegans (122, 95% CI: 117-127 pmol/l). In all, 52% of vegans, 7% of vegetarians and one omnivore were classified as vitamin B12 deficient (defined as serum vitamin B12 <118 pmol/l). There was no significant association between age or duration of adherence to a vegetarian or a vegan diet and serum vitamin B12. In contrast, folate concentrations were highest among vegans, intermediate among vegetarians and lowest among omnivores, but only two men (both omnivores) were categorized as folate deficient (defined as serum folate <6.3 nmol/l). CONCLUSION: Vegans have lower vitamin B12 concentrations, but higher folate concentrations, than vegetarians and omnivores. Half of the vegans were categorized as vitamin B12 deficient and would be expected to have a higher risk of developing clinical symptoms related to vitamin B12 deficiency. PMCID: PMC2933506 PMID: 20648045 ------------  J Acad Nutr Diet. 2013 Dec;113(12):1610-9. doi: 10.1016/j.jand.2013.06.349. Epub 2013 Aug 27. Nutrient profiles of vegetarian and nonvegetarian dietary patterns. Rizzo NS, Jaceldo-Siegl K, Sabate J, Fraser GE. Comment in J Acad Nutr Diet. 2014 Feb;114(2):197-8. J Acad Nutr Diet. 2014 Feb;114(2):197. BACKGROUND: Differences in nutrient profiles between vegetarian and nonvegetarian dietary patterns reflect nutritional differences that can contribute to the development of disease. OBJECTIVE: Our aim was to compare nutrient intakes between dietary patterns characterized by consumption or exclusion of meat and dairy products. DESIGN: We conducted a cross-sectional study of 71,751 subjects (mean age=59 years) from the Adventist Health Study 2. Data were collected between 2002 and 2007. Participants completed a 204-item validated semi-quantitative food frequency questionnaire. Dietary patterns compared were nonvegetarian, semi-vegetarian, pesco vegetarian, lacto-ovo vegetarian, and strict vegetarian. Analysis of covariance was used to analyze differences in nutrient intakes by dietary patterns and was adjusted for age, sex, and race. Body mass index and other relevant demographic data were reported and compared by dietary pattern using χ(2) tests and analysis of variance. RESULTS: Many nutrient intakes varied significantly between dietary patterns. Nonvegetarians had the lowest intakes of plant proteins, fiber, beta carotene, and magnesium compared with those following vegetarian dietary patterns, and the highest intakes of saturated, trans, arachidonic, and docosahexaenoic fatty acids. The lower tails of some nutrient distributions in strict vegetarians suggested inadequate intakes by a portion of the subjects. Energy intake was similar among dietary patterns at close to 2,000 kcal/day, with the exception of semi-vegetarians, who had an intake of 1,707 kcal/day. Mean body mass index was highest in nonvegetarians (mean=28.7 [standard deviation=6.4]) and lowest in strict vegetarians (mean=24.0 [standard deviation=4.8]). CONCLUSIONS: Nutrient profiles varied markedly among dietary patterns that were defined by meat and dairy intakes. These differences are of interest in the etiology of obesity and chronic diseases. Copyright © 2013 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved. PMCID: PMC4081456 PMID: 23988511
mccoy posted a topic in General Health and LongevityNow this is pretty weird. on October 15, 2016, I had a glucose + lipid panel done , when I was still a alcto-ovo vegetarian. By chance, I akready had a 12-days cronometer record, so, even if the timespan is not much, I remember it's pretty representative of my diet at the time. Since I recently had another lipid panel done, and since in the meanwhile I turned vegan, a comparison is in order. I compared 12 days lacto-ovo prior to the test to 3 months vegan, prior to the test. The results are a little surprising: Lacto-ovo Glucose: 86 Total cholesterol: 153 HDL : 59 Triglycerides: <70 LDL : 80-90 Vegan Glucose: 83 Total cholesterol: 170 HDL : 65 Triglycerides: 69 LDL : 94 My intake of cholesterol when lacto-ovo was 264 mg per day, whereas as a vegan it was 7 mg per day (the occasional tablespoon of butter on the cookies sometimes I indulge in). So, it appears very weird that, with almost no dietary cholesterol at all, my blood cholesterol increased almost by 20 mg/dl, whereas other values are about the same. Also, as a lacto-ovo I ate a daily average of 39 g saturated fats per day, whereas as a vegan I ate, prior to tests, 21 grams, about a half. As a lacto-ovo I ate 133 grams net carbs, whereas as a vegan 176. But fasting glucose was lower as a vegan than as a lacto-ovo. Another strangeness. As a lacto ovo I ate 250 less kcalories and 32 grams of fiber rather than the vegan 63 daily grams. I mentioned the cholesterol issue to another friend who eats mainly palnt-based. He had his blood tests doen every year and observed that, as soon as he stopped eating cheese, his cholesterol went up. He also told me about another friend who, as soon as started a stint of total fasts, some of which of significant length (10 days) his cholesterol went up. I also asked about my first test who was taken at teh local pharmacy. The pharmacist told me that the test is pretty accurate and that, according to him, cholesterol in the summer season may increase. The paradox remains as why a vegan diet with almost no dietary cholesterol and 63 g daily fibers should result in more blood cholesterol than a lacto-ovo diet with 264 mg cholesterols and 32 g fibers
CR: My StoryHi All, I've hung out on these forums for a little while now. Long enough that I'm pretty sure I have begun to understand some of its finer content - and important things like why Dean gives Michael a hard time. I'd like to share a little about my story. At 24 years old I was being monitored for cardiovascular problems. My family physician had detected a heart murmur on my annual checkup and I was showing some really strange blood pressure readings (regularly ~155/45). An echocardiogram revealed that I had a bicuspid aortic valve that was leaking quite significantly. This lead to the replacement of my aortic valve via open-heart surgery at 24. Unfortunately post-op I developed acute endocarditis, which become chronic endocarditis. I lived the next 27 months of my life in and out of hospitals visiting IV clinics for antibiotics 3x daily to find this heart infection. I had PICC lines installed, and was administered just about every kind of high-potency anti-biotic you can imagine, and for 27 months straight. I was hospitalized a total of 5 times and was probably close to death at a few points. Closer than I'd like to believe. Needless to say, antibiotics weren't working. So I required open heart surgery for a second time. I was 26 years olds at this point. Trans-esophegeal echocardiograms confirmed a large vegetation on my aortic valve and aorta. This is basically a mass of bacteria, platelets, white blood cells, etc. I had my aortic valve replaced again, along with my aorta. Additionally, arteries were reattached in different locations, so that future heart surgery doesn't have to be invasive - the current gear in my heart is believed to last 10-20 years - hopefully. I've talked to Dr. Essylstyn twice on the phone and he feels next time I need surgery, it will be done through trans-aortic valve implantation. He also said 'no one makes a habit out of sternotomies, they suck.' He's right. They are awful. The second surgery went well. And here is something that Dean and his ethical vegan spirit will like. I was profoundly impacted by this experience for many reasons. One of which was the fact that a cow had to die for me to live. Bovine tissue is used to construct the valve replaced in my heart. When I woke up from the second surgery and had no desire to consume animals ever again. I never had a bite of meat again. I almost immediately went vegan despite having never read a thing about it. (Technically speaking I've consumed animal products maybe once-twice a year when in a pinch, but that's really not significant to the story) I went to my local bookstore and picked up one of the first health books I saw. Which happened to be the Blue Zones. I often wonder what would have happened if I randomly grabbed an Atkins or paleo book. I thank whatever higher power is out there that it was the Blue Zones. That quickly lead to the assimilation of the China Study, Finding Ultra, Prevent and Reverse Heart Disease, The Spectrum, The CR Way, and so on. Pre-heart surgery I was just under 220 pounds, somewhat muscular too and consuming about 400g of protein per day - that is not a typo. After the second procedure I was about 185 pounds. This morning I was 149 pounds. 5.5 years after starting a WFPB vegan, lightly CR'd diet. (See photo attached from today - BMI is 20.7). You can also tell I don't have the perfect CR body, but it's been through a lot. I have a little loose skin, some big scars, and some mild man boobs. But whatever. I'm alive, happy, and contributing a lot to this world each day. In discussion of how I got the bicuspid valve in the first place, my cardiologist has 3 possible explanations: a) I was born with it b) I was hospitalized as an infant with a fever of unknown origin, which may have rheumatic fever c) I was hospitalized as an infant with a fever of unknown origin, which may have endocarditis. Though I will never know for sure, and I suppose there is the possibility it was something else. Here is the amazing thing. I had developed an enlarged heart since it was working so hard to re-pump blood that was flowing backwards through my valve. My heart returned to normal size, something my cardiologist said does not happen. Maybe the surgery was a great success, maybe it was the CR lifestyle, or some combination of the two. I personally think that if I returned to my old ways, my heart would not have shrunk down. The other biomarkers of mine are great. Fasting glucose is 79. BP is 110/60. Total cholesterol is 129. Triglycerides are 29. And so on. Interestingly, the one I have that doesn't add up to CR levels is IGF-1. Which came back at about 280 when I had it tested about a year ago. Anyway - I just had a nice breakfast of wild rice, barley, mango, raisins, flax, cocoa, almond butter, and about 5 oz of arugula. It's awfully cold outside, so it's time to go for a brisk walk in a tank-top and shorts to get some CE with my dog. Thanks for listening folks!