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Dean Pomerleau

Why Don't UK Vegans/Vegetarians Live Longer?

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All,

 

Al Pater posted this paper [1] 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 [2], 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 [1], 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 [2], the Adventist vegans were slightly more likely to be married than the meat-eaters (75.6% vs. 70.3%).

 

In addition, study [3] 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):

zks1YPS.png

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 [1]:  

 

TfBC6Iy.png

 

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 [4], shown in tabular form below:

 

RCNl5QM.png

 

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

 

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[1] 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
 
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
 
--------
[2] [2] 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.
morlich@llu.edu
 
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
 
-----------
[3] 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

 

------------

[4] 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

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Hi Dean:

 

I cannot comment on this particular paper as I don't think I have seen it before.

 

However, a previous paper published several years ago - also from the same EPIC/Oxford study - I recall quite well.

 

It compared vegans/vegetarians with health-conscious omnivores - enlisting their subjects by advertising in health food stores.  It found no difference in mortality.

 

Since comparison of vegetarians with the overall population is comparing health-conscious individuals on the one hand with people who - on average - could not care one whit about preserving their health, it is easy to imagine that explains the difference.  In other words, to enlist metaphor, it is not the absence of animal products that explains the differences seen between vegetarians and the average couch-potato eating beer and potato chips (also vegetarian, incidentally) three meals a day.

 

So I think the information in the paper you reference is neither new nor surprising.  Exclusion of animal products does not, by itself, extend lifespan.

 

Rodney.

 

==============

 

"The unverified conventional wisdom is almost invariably mistaken."

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Rodney,

 

 

[The EPIC-Oxford study] compared vegans/vegetarians with health-conscious omnivores - enlisting their subjects by advertising in health food stores.  It found no difference in mortality.

 

You are both right and mistaken, it seems to me.

 

First, you are right that most of the EPIC-Oxford participants were recruited in a way that would tend somewhat to favor health-conscious people, vegan/vegetarians and omnivores. Here is how the vast majority of subjects in the study referenced above (PMID: 26657045) were recruited, from the full text of [1]:

 

Postal recruitment, aimed at those aged 20 years and over, was designed to recruit as many vegetarians and vegans as possible. The main questionnaire was mailed directly to all members of The Vegetarian Society of the UK and all surviving participants in the Oxford Vegetarian Study3.

 

Respondents were invited to give names and addresses of relatives and friends who might also be interested in receiving a questionnaire. In addition, a short questionnaire (or insert) was distributed to all members of The Vegan Society, enclosed in health/diet-interest magazines and displayed on counters in health-food shops. This was contained on a single A4 sheet, which could be folded and sealed for pre-paid return mailing to the study office. Questions on this insert were limited to four dietary categorisation questions, date and place of birth, sex, height, weight, age left school, smoking history, alcohol consumption and brief medical history. The main questionnaire was then mailed to all those who returned an insert indicating an interest in receiving this. Participants recruited by these postal methods and who completed the main questionnaire were asked if they would be willing to provide a blood sample. The participant’s GP was then approached to take a blood sample on behalf of EPIC–Oxford. These two postal methods recruited 58 050 participants, comprising 78.8% of the meat-eaters, 98.8% of the fish-eaters, 99.6% of the vegetarians and all of the vegans.

 

So yes - subjects were recruited by mailing members of the Vegetarian Society (or their friends & family) or who frequented health food stores - and thus might naturally be expected to be more health-conscious than the average person. But I'm sure we're also familiar with ethical vegetarians / vegans who eat a pretty crappy diet, and people who frequent so called "Health Food Stores" (e.g. GNC) who attempt to use 'pills and potions' to promote health, rather than pursuing a whole food, plant-based diet that is more effects at promoting health...

 

Look at the two tables of diets listed above, the first for the EPIC-Oxford subjects and the second for the Adventist subjects. The Adventist vegans were eating less than half the saturated fat (as a % of total calories), and twice as much fiber as the EPIC-Oxford vegans. 

 

In short, it looks like from a dietary quality perspective, the ranking goes something like this:

 

Adventist vegans >> Adventist Meat-eaters >= (EPIC-Oxford vegans ~= EPIC-Oxford meat-eaters)

 

So yes - the EPIC-Oxford vegans and meat-eaters weren't much different from each other as you suggest, but both these groups had what appears to be pretty sub-par diets compared with the Adventists, especially the vegan Adventists, and especially compared with most CR practitioners (either vegans or meat-eaters).

 

--Dean

 

-------------

[1] Public Health Nutr. 2003 May;6(3):259-69.

EPIC-Oxford: lifestyle characteristics and nutrient intakes in a cohort of 33 883

meat-eaters and 31 546 non meat-eaters in the UK.

 

Davey GK(1), Spencer EA, Appleby PN, Allen NE, Knox KH, Key TJ.

 

Author information:

(1)Cancer Research UK Epidemiology Unit, University of Oxford, Gibson Building,

Radcliffe Infirmary, Oxford OX2 6HE, UK. davey@iarc.fr

 

OBJECTIVE: To describe the lifestyle characteristics and nutrient intakes of the

Oxford cohort of the European Prospective Investigation into Cancer and Nutrition

(EPIC).

DESIGN: Cohort of men and women recruited through general practices or by post to

include a high proportion of non meat-eaters. Dietary, anthropometric and

lifestyle data were collected at baseline and four diet groups were defined.

SETTING: United Kingdom.

PARTICIPANTS: In total, 65 429 men and women aged 20 to 97 years, comprising 33

883 meat-eaters, 10 110 fish-eaters, 18 840 lacto-ovo vegetarians and 2596

vegans.

RESULTS: Nutrient intakes and lifestyle factors differed across the diet groups,

with striking differences between meat-eaters and vegans, and fish-eaters and

vegetarians usually having intermediate values. Mean fat intake in each diet

group was below the UK dietary reference value of 33% of total energy intake. The

mean intake of saturated fatty acids in vegans was approximately 5% of energy,

less than half the mean intake among meat-eaters (10-11%). Vegans had the highest

intakes of fibre, vitamin B1, folate, vitamin C, vitamin E, magnesium and iron,

and the lowest intakes of retinol, vitamin B12, vitamin D, calcium and zinc.

CONCLUSIONS: The EPIC-Oxford cohort includes 31 546 non meat-eaters and is one of

the largest studies of vegetarians in the world. The average nutrient intakes in

the whole cohort are close to those currently recommended for good health.

Comparisons of the diet groups show wide ranges in the intakes of major nutrients

such as saturated fat and dietary fibre. Such variation should increase the

ability of the study to detect associations of diet with major cancers and causes

of death.

 

PMID: 12740075

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The lack of mortality benefit seen in the EPIC-Oxford vegetarians/vegans might be due to bias from the "healthy volunteer" effect among the non-vegetarians/vegans. It looks like the vegetarians/vegans still managed around half the expected death rate of the general population[1]:

 

 

 

In the EPIC-Oxford study, there was no difference in all-cause mortality between vegetarians and nonvegetarians (HR: 1.05; 95% CI: 0.93, 1.19), although the overall death rate was only one-half that of the United Kingdom population as a whole

 

---

 

Dean, do you know about www.veganhealth.org? It's got to be one of the best science-based websites relating to veganism. Here's a veganhealth.org page that collected mortality data of vegans from several studies:

http://www.veganhealth.org/articles/dxrates

Edited by Brett Black

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Brett, Great stuff! I've visited veganhealth.org many times, but have somehow never come across that page on vegan/vegetarian health and mortality. Thanks for pointing it out.

 

I found this quote from the researchers who did the Adventist Health Study 2 to be really interesting and reasonably in line with what I said above comparing the EPIC Oxford cohort with the Adventists, namely that the Adventist vegans were more likely than the UK vegans to be motivated by health rather than ethical or environmental concerns, and therefore practiced a healthier form of vegan diet, explaining their lower mortality rate relative to their corresponding meat-eating comparison group: 

 
The lack of similar findings in British vegetarians remains interesting, and this difference deserves careful study. In both cohorts, the non-vegetarians are a relatively healthy reference group. In both studies, the nutrient profiles of vegetarians differ in important ways from those of non-vegetarians, with vegetarians (especially vegans) consuming less saturated fat and more fiber. It appears that British vegetarians and US Adventist vegetarians eat somewhat differently. For instance, the vegetarians in our study consume more fiber and vitamin C than those of the EPIC-Oxford cohort: mean dietary fiber in EPIC-Oxford vegans was 27.7 g/d in men and 26.4 g/d in women compared with 45.6 g/d in men and 47.3 g/d in women in AHS-2 vegans; mean vitamin C in EPIC-Oxford vegans was 125 mg/d in men and 143 mg/d in women compared with 224 mg/d in men and 250 mg/d in women in AHS-2 vegans. Individuals electing vegetarian diets for ethical or environmental reasons may eat differently from those who choose vegetarian diets primarily for reasons of perceived superiority for health promotion. We believe that perceived healthfulness of vegetarian diets may be a major motivator of Adventist vegetarians.
 
--Dean
 

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Thanks Dean:

 

Please correct me if I am wrong, but you seem to be saying that these data appear to show no difference in mortality between those on a:

 

'much-better-than-average-but-still-quite-some-distance-from-perfect-vegetarian diet'

 

and those on a:

 

'much-better-than-average-but-still-quite-some-distance-from-perfect-omnivorous diet'

 

If that is what you are saying, then does that not appear to confirm my suggestion that the absence of animal products does not by itself make a difference?

 

I find it very easy to accept that the diets being observed in the EPIC/Oxford studies were far from optimal because, apart from anything else, my impression is that restriction of calories is more important than everything else combined by, perhaps, nearly an order of magnitude, and it is likely that very few in either of the above groups will have been pursuing calorically restricted diets. 

 

So perhaps the question you have in mind is: "Does a 'perfect-CR-animal-product-free' diet have a mortality advantage over a 'perfect-CR-with-modest-to-moderate-quantities-of-carefully-selected-animal-products' diet?"

 

I think we can say for sure we do not have the evidence necessary to provide a definitive answer to that.  But I would be prepared to bet a case of beer that, when we do eventually find out, the answer will be that there is no appreciable difference either way  : ^ ))).

 

Rodney.

 

===========

 

"The unverified conventional wisdom is almost invariably mistaken."

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Rodney,

 

Please correct me if I am wrong, but you seem to be saying that these data appear to show no difference in mortality between those on a:

'much-better-than-average-but-still-quite-some-distance-from-perfect-vegetarian diet'

and those on a:

'much-better-than-average-but-still-quite-some-distance-from-perfect-omnivorous diet'

 

You're wrong :)xyz . What I'm trying to say can be summarized as follows:

  1. The Adventists (both omnivores and vegans) are much better datapoints when trying to extrapolate to CR folks, since they appear to eat much better diets, and have healthier lifestyles (not to mention increased longevity) relative to the EPIC-Oxford cohort. Not to mention, the Adventists are a much more homogeneous population (i.e. more similar social networks, exercise habits, belief systems, etc. across the various diet groups) that the EPIC-Oxford folks, making for a better comparison between omnivores and vegans. So it makes more sense to focus on the Adventist omnivore vs. vegan comparison than the EPIC-Oxford studies. I don't care (and don't want to speak to) the difference between any diets "still quite some distance from perfect", be they vegetarian/vegan or omnivorous - since its not relevant for us, especially when better data (i.e. the Adventists) is available.
  2. Vegans who don't eat a lot of fruits & veggies, and who allow themselves to be B12 deficient (as it appears many of the EPIC-Oxford folks do/did), are quite possibly worse off than an above average omnivores. Being a reasonably healthy vegan takes significantly more knowledge and planning being a reasonably healthy omnivore.
  3. But a reasonably well-planned and executed vegan diet, coupled with a healthy lifestyle, does appear to have a significant advantage relative to eating meat ( in at least modest quantities), as illustrated in PMID: 23836264 in which vegan Adventists had a 15% lower mortality rate than meat-eating Adventists after controlling for other risk factors.

This is not to deny that there are certain animals products which are more healthy than others. And I'll readily acknowledge it may even be the case that a small amount of the relatively healthy animal products could have either no detrimental effects on health, or even mildly beneficial effects relative to a vegan diet. I don't know of any studies that show this, but for example, a serving of fish once or maybe twice per week might have a net positive effect. However I wouldn't stake my health on it relative to a vegan diet with the equivalent DHA/EPA of one weekly serving of fish, given the widespread contamination of fish with heavy metals, pesticides, not to mention its (and other animal product's, esp. red meat's) tendency to produce heart-disease promoting TMAO via its carnitine content coupled with gut bacteria biochemistry. 

 

...my impression is that restriction of calories is more important than everything else combined by, perhaps, nearly an order of magnitude, and it is likely that very few in either of the above groups will have been pursuing calorically restricted diets. 

 

Rodney, I'm surprised. This seems like a wildly irrational perspective to me. "nearly an order of magnitude"!?!? Do you really think that? What evidence can you point to that in people (or primates) a healthy diet replete with calories is trumped at all (to say nothing of "trumped by an order of magnitude"!) by a calorie-restricted healthy diet? The NIA primates are a strong and perhaps the best counterexample, it seems to me.

 

The most parsimonious interpretation of the NIA monkey data (esp when coupled with the Wisconsin monkey data) is that once obesity is avoided, a healthy diet with (albeit only mild) calorie restriction is no better for primate longevity than the same diet without calorie restriction (or only enough CR to avoid obesity). For anyone who isn't familiar with these results (I'm sure you are Rodney) see Michael Rae's thorough analysis of the topic in this SENS research blog post

 

So perhaps the question you have in mind is: "Does a 'perfect-CR-animal-product-free' diet have a mortality advantage over a 'perfect-CR-with-modest-to-moderate-quantities-of-carefully-selected-animal-products' diet?"

 

Perhaps that is the question you have in mind. I'm first and foremost a vegan for ethical reasons, and so the question doesn't arise for me.

 

And I'd agree with you that we don't have enough data to answer it definitively, or even tentatively, since there are extremely few people eating either of those diets, and certainly no longevity data for them.

 

If you replace "modest-to-moderate" with "small" (e.g. carefully sourced fish once or twice per week), I'd say you'd be likely to win your beer bet - there wouldn't be an appreciable difference in mortality relative to a perfect CR vegan diet.

 

But I'd be willing to take the other side of the bet (i.e. betting the vegans would have an advantage) with your qualifier of "modest-to-moderate" as it stands, depending of course on how that term was defined (e.g. I'd accept modest-to-moderate = 'one serving (or more) of an animal product of your choosing per day').

 

I believe I'm right on this, but acknowledge that my willingness to take such a bet is in part due to the fact that the stakes are not very high, and that it is extremely unlikely that the bet will be definitively settled in either of our lifetimes, given how difficult and time-consuming such a mortality experiment among appreciable numbers of people eating perfect CR diets would be to conduct.  :)xyz

 

--Dean

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Hi Dean:

 

Thanks for your very comprehensive reply to my post.  My response will be less comprehensive.

 

You can pick apart details of the EPIC/Oxford studies.  But also, regarding the Seventh Day Adventists, it needs to be borne in mind that the SDA studies all started out with the conclusion they wanted to prove since it is pretty much a tenet of their religious views.  This must cast some doubt on the extent to which cherry-picking or other techniques may have crept in to their work in order to be sure to find what was considered vitally important to be found in the first place.  My point is not to condemn SDAs, but simply indicate that you cannot criticize EPIC/Oxford and just assume the SDA studies are all sweetness and light.  Both need to be very carefully scrutinized.  So, incidentally, should your own views, as you have also decided what conclusion it is you wish to prove, and might be tempted to try a little harder than the evidence will bear, to support it  ; ^ ))).

 

My mention of the expression "order of magnitude" refers to the fact that, as previously posted, curing all CVD and cancer (the cause of more than half of all deaths in many countries) would only extend the average lifespan by about five years, or 4% approximately.  CR, in every species where the studies have actually finished, and lifespans observed, the lifespan extension benefits have "almost invariably" been huge, as we all know. 

 

People can say - and quite a few do, with a degree of conviction greater than that supported by the evidence, imo - "but it will be different in humans" (even though no studies have yet been completed, and in the case of humans never will be, of course.)  But we do know, imo, that people who take little care of themselves by over-eating and not paying too much attention to what they eat and drink, often die around age 60 (including several personal contemporaries).  Those who eat just moderately well, (not obese, BMI = 27, and not hamburgers *every* night) are living these days to over 80.  The present male (average, obviously) life expectancy in Canada is now 80 years.  Females, 84.  And canadians are no more slim, nor eat any better, than americans.  I believe that were the general population, in addition, to implement full-scale CR (BMI=20.0), that the male lifespan could be extended well beyond 80 - who knows exactly how far, but very likely, imo over 90.  In support of this I submit a BMI down at 27, rather than ~33, has had an 'observed' effect of dying at age 80 instead of the 60 mentioned above.  And having a BMI of 20 instead of the current average of 27 would result in a further dramatic increase.

 

Again, ball-park numbers:  Age 95 is 59.3% greater than age 60.  So I believe the potential to improve lifespan - to which CR is a huge contributor - is substantially greater than the benefit that would accrue population-wide from the curing of all CVD and cancer.  We can discuss if you like why it is curing all CVD and cancer brings such a minor reward.  It has been discussed here previously.  So I suggest that in ball-park terms we are talking perhaps 59% increase compared with a 4% benefit from curing CVD and cancer, which is an almost 15 times greater benefit (but for curing just the two most common diseases, not all of them.).   So those are the kinds of numbers I have in mind when I mention 'order of magnitude' and why I suggest the life expectancy benefit of pursuing CR throughout the entire population, would likely be a large number of times greater than, even, curing the most frequent causes of death.

  

I regard the present popularity of the idea that 'CR will make minimal difference to human lifespan' as denial.  In the context of which, another issue I have been following quite closely for several years, demonstrates the extent to which denial can catch on and become popular no matter the evidence to the contrary.  The pollution-free and massive energy generating potential of LENR is, and has long been, denied (not infrequently ridiculed) by the overwhelming majority of scientists, journalists, and anyone else who ought to be paying attention to it.  In which regard, since you are half-retired and may have 30 minutes to spare to read it, you may find the following link of interest:

 

https://aeon.co/essays/why-do-scientists-dismiss-the-possibility-of-cold-fusion

 

Of course, it may turn out that I am mistaken about the benefit of CR in humans, and that it will turn out to be near-negligible.  There have been previous occasions where I have turned out to be wrong  ;;; ^ )))

 

Rodney.

 

===========

 

"The unverified conventional wisdom is almost invariably mistaken."

Edited by nicholson

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Rodney,

 

This is not to deny that there are certain animals products which are more healthy than others. And I'll readily acknowledge it may even be the case that a small amount of the relatively healthy animal products could have either no detrimental effects on health, or even mildly beneficial effects relative to a vegan diet. I don't know of any studies that show this, but for example, a serving of fish once or maybe twice per week might have a net positive effect. However I wouldn't stake my health on it relative to a vegan diet with the equivalent DHA/EPA of one weekly serving of fish, given the widespread contamination of fish with heavy metals, pesticides, not to mention its (and other animal product's, esp. red meat's) tendency to produce heart-disease promoting TMAO via its carnitine content coupled with gut bacteria biochemistry. 

 

 

--Dean

Bullshit, Dean!

 

You're quoting the biased statements of Dr. Gregor (however you spell his name).  Fish is no more (and no less) contaminated than vegetables, fruit or beef -- it depends on the quality of what you're eating.

 

Also, I had myself tested for heavy metals in my urine (I made a recent post about that), and I came out vanishingly low in all heavy metals in my urine (except, weirdly, for arsenic -- that came out int he safe range, but not vanishingly low.

 

Dean, we'd all like to think that our diet is optimal -- but we should avoid making a religion of it.

 

(Anyway, thanks for being so prolific in your posting -- you've possibly been the main force in getting the Forums moving.  :)xyz )

 

  -- Saul

 

P.S.:  What you say about carnitine has merit.

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 But also, regarding the Seventh Day Adventists, it needs to be borne in mind that the SDA studies all started out with the conclusion they wanted to prove since it is pretty much a tenet of their religious views.  This must cast some doubt on the extent to which cherry-picking or other techniques may have crept in to their work in order to be sure to find what was considered vitally important to be found in the first place.

 

I agree we all have our biases, and carefully scrutiny is always warranted. Regarding the Adventists, it has been my understanding that vegetarianism is encouraged, but not required, and many Adventists chose not to follow a strictly plant-based diet. Regarding bias, it doesn't seem fair to impune the integrity of a study or the researchers who conducted it without evidence. All I did was point out from the data about both populations (EPIC-Oxford and Adventists) that the Adventists eat healthier, and live longer, whether meat-eaters or vegans/vegetarians in each group. All we can do is stick to the facts available to us. If there are specific shortcomings / biases you can point out in the Adventists studies, I'm all ears.

 

 

So, incidentally, should your own views, as you have also decided what conclusion it is you wish to prove, and might be tempted to try a little harder than the evidence will bear, to support it  ; ^ ))).

 

Agreed - that's why it's valuable for people with different perspectives to engage in healthy and vigorous debate about the evidence. Again - I wish you would counter with evidence, rather than innuendos.

 

 

My mention of the expression "order of magnitude" refers to the fact that, as previously posted, curing all CVD and cancer (the cause of more than half of all deaths in many countries) would only extend the average lifespan by about five years, or 4% approximately.  CR, in every species where the studies have actually finished, and lifespans observed, the lifespan extension benefits have "almost invariably" been huge, as we all know. 

 

Hmmm.... Didn't you just ignore the longest running, most relevant animal study of CR conducted to date (and likely ever) - the CR primate study I pointed to in the post you are responding to? In that, the CR longevity benefits weren't simply not huge, they were, sadly, non-existent.  Until better evidence comes a long that at least as relevant to humans, that's the best we've got. Extrapolating from rodents doesn't compare, particularly since CR benefits appear to vary from very positive to quite negative, depending on the strain of mice. Michael might argue some of those strains were particularly prone to early death, but we humans are a heterogenous population as well!

 

 

Again, ball-park numbers:  Age 95 is 59.3% greater than age 60. [Compare that with 4% for curing cancer and CVD]. ... So those are the kinds of numbers I have in mind when I mention 'order of magnitude' and why I suggest the life expectancy benefit of pursuing CR throughout the entire population, would likely be a large number of times greater than, even, curing the most major diseases.

 

That's really gaming the numbers Rodney. Adventists who  eat a healthy vegetarian diet without restricting calories except to avoid obesity live an average of 87 years. You can speculate all you want about how many extra years they might gain from adding CR on top of their healthy diet & lifestyle, but it's pure speculation, and not going to be anything like an order of magnitude greater than 4% - i.e. an average lifespan of 122 (= 140% of 87).

 

 

 

I regard the present popularity of the idea that 'CR will make minimal difference to human lifespan' as denial.

 

In contrast, it seems to me that ignoring the most relevant and controlled data of CR in a species close to humans that we have and likely will ever have during our lifetimes, the disappointing CR primate studies, an example of denial of the likelihood that CR will have modest benefits at best in humans.

 

 

 

Of course, it may turn out that I am mistaken about the benefit of CR in humans, and that it will turn out to be near-negligible.  There have been previous occasions where I have turned out to be wrong  ;;; ^ )))

 

I could certainly be wrong as well, it certainly wouldn't be the first time and I'm hoping that will be the case. Unfortunately it will be many years until we know...

 

 

--Dean

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Bullshit, Dean!

 

You're quoting the biased statements of Dr. Gregor (however you spell his name).  Fish is no more (and no less) contaminated than vegetables, fruit or beef -- it depends on the quality of what you're eating.

 

Ah Saul,

 

I wasn't quoting anyone. We've had this debate several times before, and I'm not going to engage you again in it, since you always seem to refuse to look at evidence, while continuing to insist on spelling Dr. Greger's name wrong.

 

Refusing to acknowledge that carnivorous fish are the top predators in the ocean food chain, and as a result bioaccumulate the crap we've been dumping in the ocean, along with naturally occurring heavy metals, doesn't mean it is not true.

 

Dean, we'd all like to think that our diet is optimal -- but we should avoid making a religion of it.

 

I pride myself on following the evidence when it comes to diet. For example, based on Michael's evidence-based argument that tofu is suspect, I recently eliminated it from my diet, after several years of consuming it.

 

Lashing out with profanity when someone points to evidence-backed information that's widely acknowledged but that contradicts your strongly held beliefs seem more like the sign of a dietary zealot to me.  :)xyz

 

I'm happy you personally don't appear to be bioaccumulating heavy metals except arsenic (which as I pointed out studies suggest could come from your salmon - although perhaps not be a harmful form), but that doesn't mean it is not a problem for others. That's why the FDA warns women who are or could become pregnant, and young children, not to eat more than two meals a week of fatty fish like salmon, tuna etc.  You don't see that kind of warning for vegetables, or even beef.

 

--Dean

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Dean, we'd all like to think that our diet is optimal -- but we should avoid making a religion of it.

 

I pride myself on following the evidence when it comes to diet.

 

Saul, I don't get your -- pardon -- beef with Dean's claims about veganism, and, most especially, the claims about contaminants in most fish. From everything I've seen, Dean's statement above is 100% correct: he follows the evidence. The evidence suggests that the fish available today in say North America, is, in general, on per calorie basis, more contaminated than other foodstuffs people on CR tend to eat.

 

Zeta

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Dean, It seems like your position on this is that a well balanced lifestyle without CR, such as exemplified by by the SDA group, is the optimal for life extension.  My question is do you think that it's also the best for disease avoidance?  Are the SDA disease rates for heart disease, cancer, alzheimers and diabetes comparable to the to the rates shown by CR studies in both people and the recent monkey studies.  If I recall correctly, the monkey studies clearly showed that disease was less common in the CR group, even though it didn't translate into extra longevity compared to the control group.  I wouldn't trade more food for a sicker life myself.  CR hasn't been shown in the monkey studies to shorten life after all.  Thoughts?

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Keith,

 

If we use the NIA AL (but reasonably thin) and NIA adult-onset CR monkeys as the two comparison groups, it appears that the AL monkeys didn't do any worse than the CR monkeys in terms of common diseases of aging - diabetes, heart disease or cancer. See the section labeled "Inter-Cohort Health and Disease" in Michael Rae's thorough analysis of the CR monkey trials.  Here are a couple highlights from Michael's analysis:

 

At NIA, 5/64 AL animals (7.8%) developed CVD, and 3/57 CR animals did so (5.2%). [Difference not significant].

 

When broken down by age of onset, young-onset CR afforded very substantial protection against malignant neoplastic disease at NIA (6/46 AL cases, of which 5 were fatal, vs. 0/40 cases in CR), while old-onset CR did not (6/18 vs 7/17).

 

The CR disease avoidance advantage in the monkey study you are thinking of may have been in the Wisconsin monkeys, where both the AL and CR monkeys ate a crappy diet and the AL ones were allowed to become obese - so it is not very relevant. Or you may be thinking of the young-onset results in the NIA study, which did find a (non-significant) trend in the CR monkeys to avoid diseases of aging for longer than the AL monkeys. Here is the graph, which looks pretty promising:

 

nihms-528393-f0011.jpg

 

While the young-onset NIA CR monkeys didn't live significantly longer, this disease avoidance trend is promising desirable, as you suggest. Unfortunately, the lack of such a morbidity advantage in the NIA adult-onset CR monkeys suggests that to benefit from this ourselves would require turning back time and starting our own practices of CR when we were young children...

 

BTW, merry Christmas and happy holidays to everyone!

 

--Dean

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Hi Dean:

 

ME:  "I regard the present popularity of the idea that 'CR will make minimal difference to human lifespan' as denial."

 

YOUR RESPONSE:  "In contrast, it seems to me that ignoring the most relevant and controlled data of CR in a species close to humans that we have and likely will ever have during our lifetimes"

 

Perhaps you have more up to date information than I do?  You seem to be under the impression that the evidence from the monkey trials is cut and dried.  My impression is different.  My understanding is that recently both groups have been pointing out the inadequacies of the other's experimental procedures.  One noting that the other's ad lib control monkeys were actually also calorically restricted; the other saying that just a single component of the other group's diet may entirely explain the extended lifespan found among the restricted animals (incidentally, and very ironically, a component widely consumed by the majority of humans!)  So, based on those arguments I don't see that clear conclusions can be drawn.

 

However, I do think some very interesting speculations can be made about the fact that, at the last count I am aware of, the 'naturally slimmest' Wisconsin CR monkeys - that is, those in the lowest tertile of body weight when being fed ad lib at the outset, before being put on CR - had a mortality rate 2.5 times higher than the top two tertiles (those not naturally slim and exhibiting 'very healthy' natural appetites.)

 

This has been discussed here previously.  It strongly suggests to me that unusual juvenile slimness (very probably in humans as well as in monkeys, imo) is a symptom of sub-clinical health issues; and that the mortality data for the top two (healthy) tertiles of CR monkeys would have been far lower than has been reported for the entire group.

 

'For a number' (based, as you will realize, on very casual observation) 'healthy-appetite' humans who make no effort to restrict are obese and generally die in their lower 60s.  Those with large appetites who seriously restrict may live to their high 90s.  90 divided by 60 is a pretty impressive difference.  I am restricted and neither am prescribed, nor take, any prescription medications.  Seventy-year-old canadians, on average, are presently taking SIX prescription medications (and I am reliably informed that some of them are on a dozen or more) many of them for potentially terminal afflictions.  While yer never know what may happen tomorrow, as things stand it does look likely that I will exceed the average lifespan by an appreciable margin, while many of my unrestricted contemporaries have already ruled themselves out of that possibility.

 

And do not forget that a country's 'average age at death', which is not often seen reported, is several years less than the widely reported 'life expectancy'.  And average age at death is a more realistic number for people who can no longer take advantage of the life-extending benefits that have recently accrued to those aged 20 to 65.   In very round numbers (since I have not seen the number for some years) I am now about at the average age at death for males in Canada.  And the seeming lack of signs of my imminent demise I attribute principally to CR.

  

But maybe every organism, starting with yeasts, going all the way up to, and including, the great majority of mammals, benefit dramatically from CR, and within the entire animal kingdom, it is only a couple of the very highest primates that do not.  Maybe.  But I very much doubt it.  I estimate you, Dean, are likely to live to 110.  Especially if you were to shift your exercise routine onto a cyclical weekly schedule  : ^ )))

 

Rodney.

 

===========

 

"The unverified conventional wisdom is almost invariably mistaken."

Edited by nicholson

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Rodney,

 

Perhaps you have more up to date information than I do?  You seem to be under the impression that the evidence from the monkey trials is cut and dried.  My impression is different.  My understanding is that recently both groups have been pointing out the inadequacies of the other's experimental procedures.  One noting that the other's ad lib control monkeys were actually also calorically restricted; the other saying that just a single component of the other group's diet may entirely explain the extended lifespan found among the restricted animals (incidentally, and very ironically, a component widely consumed by the majority of humans!)  So, based on those arguments I don't see that clear conclusions can be drawn.

 

No, I don't have any insider information about the primate CR trials. But I disagree with you that on the point we are discussing, there is very much to quibble over. My point is that the monkey trials strongly suggest that when fed a reasonably good diet (i.e. like the NIA monkey diet, and not like the Wisconsin monkey diet), in an amount that avoid obesity/overweight given the monkey's (minimal) level of physical activity, additional calorie restriction (on top of that which avoids obesity) does not appear to convey additional health / longevity benefits, when begun in adulthood.

 

Are you suggesting this interpretation of the primate CR results in incorrect?

 

You are perfectly correct that the average American or Canadian does a terrible job of taking care of themselves, and dies far sooner than they need to. But that doesn't mean that CR or any other available intervention will get you much past 90, about the age the Adventist have shown possible with a healthy diet, lifestyle, social support, etc. but without significant calorie restriction.

 

I estimate you, Dean, are likely to live to 110.  Especially if you were to shift your exercise routine onto a cyclical weekly schedule  : ^ )))

 

I really wish you were right, but see no basis for your optimism. Given the extreme rarity (i.e. 1 in 6 million) of having the genes necessary to enjoy such a lifespan, I find it highly unlikely I'll live that long, regardless of my diet and exercise routine, barring significant advances in anti-aging interventions over the next couple (maybe few, if I'm really lucky/careful) decades, as we are discussing over on this thread.

 

--Dean

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Diet, Life Expectancy, and Chronic Disease : Studies of Seventh-Day Adventists and Other Vegetarians

Gary E Fraser. Oxford: Oxford University Press, 2003, pp. 371, £39.95 (HB). ISBN: 0-19-511324-1.


 

 

Int. J. Epidemiol. (2004) 33 (3): 620-621. doi: 10.1093/ije/dyh157

A Ness


 

 ‘For instance, I have here a prospectus from another summer school which states its terms per week and then asks me to say ‘whether my diet is ordinary or vegetarian’. They take it for granted, you see, that it is necessary to ask this question. This kind of thing is itself sufficient to alienate plenty of decent people. And their instinct is perfectly sound, for the food-crank is by definition a person willing to cut himself off from human society in hopes of adding five years on to the life of his carcass; that is, a person out of touch with common humanity’

 

George Orwell in The Road to Wigan Pier, 1937

 

...

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All,

 

Al pointed me to this new meta-analysis [1] of the various vegetarian/vegan studies wrt health markers and mortality. It doesn't add too much to the discussion above in this thread so I won't analyze it in detail.

 

It includes several studies of Adventists, and of the various UK populations of vegetarian/vegans we've been discussing here. From the full text, vegetarians and vegans were better off than health conscious omnivores on virtually all the major risk factors for our major diseases, including BMI, total & LDL cholesterol, triglycerides and fasting glucose. Vegetarians and vegans had a lower risk of getting heart disease and cancer, but were not statistically significantly less likely to die from them. Here is the most interesting figure from the paper, a forest plot comparing vegetarians (top) and vegans (bottom) to omnivores in terms of the rates of various diseases and causes of death.

 

t8mbRVO.png

 

 

As you can see, the vegetarians & vegans were doing better (left of center), but often the confidence interval spanned the 1.00 risk midline, indicating for most of them the effect wasn't statistically significant. Blame it on the those darn Brits again :-). When they separately analyzed the Adventist studies from non-Adventist, or US vs. non-US, the Adventists, and the US vegetarian / vegans saw much stronger effects, and the non-Adventists / non-US vegetarian / vegans didn't seem much of any benefits relative to omnivores. 

 

The likely reason for this has been discussed extensively above in this thread, but boils down to the observation that the Adventists (vegetarians and omnivores) take much better care of themselves than the UK cohorts, and eat more fiber, more fruits & vegetables, less saturated fat, and avoiding B12 deficiency. Here is the diet quality ranking as I interpret the available data (taking from a post near the top of this thread):

 

Adventist vegans >> Adventist Meat-eaters >= (EPIC-Oxford vegans ~= EPIC-Oxford meat-eaters) > Standard American Diet

 

Since the Adventist vegans enjoy a health & mortality benefit relative to meat-eating Adventists, this seems to support the conclusion that a well-planned vegetarian / vegan diet beats out a healthy obesity-avoiding omnivorous diet for health and mortality.  But a lower-quality vegetarian or vegan diet has little (if any) advantage relative to a reasonably healthy omnivorous diet like that eaten by the relatively health-conscious Epic-Oxford meat-eaters.

 

--Dean

 

--------------

[1] Crit Rev Food Sci Nutr. 2016 Feb 6:0. [Epub ahead of print]

Vegetarian, vegan diets and multiple health outcomes: a systematic review with
meta-analysis of observational studies.

Dinu M(1,)(2), Abbate R(1), Gensini GF(1,)(3), Casini A(1,)(2), Sofi
F(1,)(2,)(3).

Author information:
(1)a Department of Experimental and Clinical Medicine , University of Florence ,
Italy. (2)b Unit of Clinical Nutrition, University Hospital of Careggi , Florence
, Italy. (3)c Don Carlo Gnocchi Foundation Italy , Onlus IRCCS , Florence ,
Italy.

 

Full text: http://sci-hub.io/10.1080/10408398.2016.1138447

BACKGROUND: Beneficial effects of vegetarian and vegan diets on health outcomes
have been supposed in previous studies.
OBJECTIVES: Aim of this study was to clarify the association between vegetarian,
vegan diets, risk factors for chronic diseases, risk of all-cause mortality,
incidence and mortality from cardio-cerebrovascular diseases, total cancer and
specific type of cancer (colorectal, breast, prostate and lung), through
meta-analysis.
METHODS: A comprehensive search of Medline, EMBASE, Scopus, The Cochrane Library
and Google Scholar was conducted.
RESULTS: Eighty-six cross-sectional and 10 cohort prospective studies were
included. The overall analysis among cross-sectional studies reported significant
reduced levels of body mass index, total cholesterol, LDL-cholesterol, and
glucose levels in vegetarians and vegans versus omnivores. With regard to
prospective cohort studies, the analysis showed a significant reduced risk of
incidence and/or mortality from ischemic heart disease (RR 0.75; 95% CI, 0.68 to
0.82) and incidence of total cancer (RR 0.92; 95% CI 0.87 to 0.98) but not of
total cardiovascular and cerebrovascular diseases, all-cause mortality and
mortality from cancer. No significant association was evidenced when specific
types of cancer were analyzed. The analysis conducted among vegans reported
significant association with the risk of incidence from total cancer (RR 0.85;
95% CI, 0.75 to 0.95), despite obtained only in a limited number of studies.
CONCLUSIONS: This comprehensive meta-analysis reports a significant protective
effect of a vegetarian diet versus the incidence and/or mortality from ischemic
heart disease (-25%) and incidence from total cancer (-8%). Vegan diet conferred
a significant reduced risk (-15%) of incidence from total cancer.

PMID: 26853923

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I like the below paper because it used prospective studies only and did an analysis for people who were following the diet more than five years.

 

Mortality in vegetarians and nonvegetarians: detailed findings from a collaborative analysis of 5 prospective studies.
Key TJ, Fraser GE, Thorogood M, Appleby PN, Beral V, Reeves G, Burr ML, Chang-Claude J, Frentzel-Beyme R, Kuzma JW, Mann J, McPherson K.
Am J Clin Nutr. 1999 Sep;70(3 Suppl):516S-524S.
PMID: 10479225 Free Article
 
Abstract
 
We combined data from 5 prospective studies to compare the death rates from common diseases of vegetarians with those of nonvegetarians with similar lifestyles. A summary of these results was reported previously; we report here more details of the findings. Data for 76172 men and women were available. Vegetarians were those who did not eat any meat or fish (n = 27808). Death rate ratios at ages 16-89 y were calculated by Poisson regression and all results were adjusted for age, sex, and smoking status. A random-effects model was used to calculate pooled estimates of effect for all studies combined. There were 8330 deaths after a mean of 10.6 y of follow-up. Mortality from ischemic heart disease was 24% lower in vegetarians than in nonvegetarians (death rate ratio: 0.76; 95% CI: 0.62, 0.94; P<0.01). The lower mortality from ischemic heart disease among vegetarians was greater at younger ages and was restricted to those who had followed their current diet for >5 y. Further categorization of diets showed that, in comparison with regular meat eaters, mortality from ischemic heart disease was 20% lower in occasional meat eaters, 34% lower in people who ate fish but not meat, 34% lower in lactoovovegetarians, and 26% lower in vegans. There were no significant differences between vegetarians and nonvegetarians in mortality from cerebrovascular disease, stomach cancer, colorectal cancer, lung cancer, breast cancer, prostate cancer, or all other causes combined.

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I'm posting briefly here mostly because Todd wanted to discuss the topic in another thread and Dean pointed him here ;)

You can look at studies of vegetarians and vegans, the one mentioned above by Al seems like a good place to start.  But will you find a group of vege/vegans that also don't eat a lot of junk food (refined sugar/white flour/saturated fats/corn syrup/processed foods) AND get all of the nutrients they need for optimal health from food and supplements?  It seems rare to even find such a cohort... despite that, the stats still looks good for the groups that have been studied.

 

Health reasons for avoiding meat include - inflammatory, typically high in AGES, high in protein, spikes IGF-1, low nutrient density, lack of phytochemicals, possible negative consequences to gut bacteria, saturated fat, cholesterol, link to cancer.  Main health reasons in favor of meat -- getting B12, iron, and Omega 3s.  When you consider the science, posted in this thread, and the long list of negatives, it makes more sense to me to not eat meat, and make sure I get my B12, iron, and Omegas from other sources (which reminds me, I still need to get tested to see if my iron is actually too high).

 

Regarding the ethical aspect, I am not judgemental. I was a big time meat eater for most of my life.  At one point I decided it would be a good idea to get a hunting license of my own.  I did the mandatory training and testing required by my state, and hit the woods.  My first year I killed over 20 animals.  I gotta be honest, I felt remorse over every life I took.  I started watching lots and lots of hunting videos, and found it fascinating that most hunters actually felt the same way (remorseful) and often expressed this in their videos, any internet search will tell you this is a common theme.  Some would get down on a knee and pray over their kills, one guy put blood on his face as a reminder of the sacrifice the animal made for him.  A friend had a perfect opportunity but didn't take the shot simply because he decided he didn't want to kill the animal in his sights (this has happened to me as well).  

 

Anyway, despite doing quite a lot of hunting, I knew from the start I didn't like killing animals.  Funny story, my kids had always been meat eaters, but when I was hunting, they got to see the whole animal and how it was processed, which obviously is quite a bit different from a piece of meat you buy in a store.  After some time, my youngest child said "Dad, I don't want to eat dead animals anymore" and my older child immediately agreed.  This was really surprising to me since I had never spoken that way to my family and I'm certain they never heard that type of talk from anywhere else either, it just came out of them naturally.  Slowly we just all started eating less and less meat without much discussion about it until I stopped eating it altogether.  My biomarkers of health have soared since changing my diet, but I can't attribute that only to the lack of meat, I give credit mainly to the plant based whole food diet, I have no idea if my markers would be just as good with a little bit of meat (say twice a week for example)?

Edited by Gordo

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Thanks Gordo.  I do want to discuss this further along with a ton of other things such as the tradeoffs of intermittent short duration intense boosting of GH/IGF1/VEGF/BDNF in the context of a calorie/carbohydrate restricted diet which ought to counter balance the cancer risks to some extent.  I need to look into whether there are increased AGE risks from animal proteins as I was under the impression AGE was more an issue with food preparation practices than what kingdom the food came from.

 

I've been largely absent here lately due to more intense experimentation on my body trying to decipher what is going on with my muscles, nerves, synapses, etc. through rigorous exercise and the effects of blood glucose levels, ketones and a wide variety of supplements as well as fasting and other interventions.  It's an all consuming roller coaster ride with enough good moments to inspire more effort.  Btw, here's a video of a man a couple years older than myself whose physical condition is only a bit worse than mine was 4 months ago and I was in a rapid spiral of deterioration.

 

I'm currently targeting being able to run again within 2 months time when I'll be attending a conference for my disease in San Diego but I won't succeed spending much time typing.

Edited by Todd Allen

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Gordo, if you are avoiding red meat to live longer as opposed to a philosophical belief here's another item to add to the tradeoffs balance sheet.

 

From Al Pater's CR research review postings:

 

The relationship between peripheral blood mononuclear cells telomere length and diet - unexpected effect of red meat.

Kasielski M, Eusebio MO, Pietruczuk M, Nowak D.

Nutr J. 2016 Jul 14;15(1):68. doi: 10.1186/s12937-016-0189-2.

PMID: 27418163

Free PMC Article

https://www.ncbi.nlm...les/PMC4944490/

Among nine food types (cereal, fruits, vegetables, diary, red meat, poultry, fish, sweets and salty snacks) and eight beverages (juices, coffee, tea, mineral water, alcoholic- and sweetened carbonated beverages) only intake of red meat was related to T/S ratio. Individuals with increased consumption of red meat have had higher T/S ratio and the strongest significant differences were observed between consumer groups: "never" and "1-2 daily" (p = 0.02).

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First, for what it's worth, mean telomere length is useless as an indicator of aging and unreliable as a prospective indicator of future health.
 
I'm surprised to see that this thread is still going on. As was pointed out by Rodney Nicholson in the second post in the thread, the reason for the contrast between the superior health outcomes of vegetarians in the original Adventist Health Study cohort (and to a lesser extent Adventist Health Study 2 group) and the UK EPIC-Oxford vegetarians as compared with their respective omnivorous control groups is in large part due to the quite different kinds of omnivores to which the vegetarians in the various studies were compared. in AHS and AHS-2, the vegetarians were a health-conscious group being compared to omnivores who were not particularly health-conscious, and thus were eating diets that were not simply teh same kinds of diets with vegetarian protein sources but more nutritious overall, and also with lower BMI and smoking rates and more exercise. Indeed, this is true of vegetarians generally speaking (as a whole — there are always anecdotal exceptions, as Dean notes).
 
By contrast, in EPIC-Oxford, there was a deliberate effort to recruit health-conscious vegetarians and omnivores, making for a more chicken-to-Chik'n comparison. Under those conditions, the health benefits of a vegetarian diet largely evaporate, due to the omnivores eating more similar levels of vegetables and saturated fat, and also enhancing the relative importance of some of the problems common in vegetarian diets, such as lack of B12, zinc, or iron once many of the other inter-cohort differences are attenuated.
 
This was pointed out by Rodney, was met with some initial skepticism from Dean, was backed up by Brett Black. and ultimately acknowledged by Dean. See also here, here and here.

 

An additional factor, which I've not seen actually evaluated, is that amongst Adventists adherence to a vegetarian diet is a religious prescription, and thus vegetarian status is not just a personal lifestyle choice but in part a proxy for religious adherence. Although the effect size, conditions, and above all the explanations for the effect are contested, it's reasonably clear that religious adherence improves long-term health outcomes, likely due to a mixture of social support and infusing the adherent's mind with a sense of meaning. Thus the health effects associated with vegetarian diet status amongst Adventists will to some degree be confounded by its close association with religious adherence.

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