By Michael Janson, MD (Copyright 2002)
The following is a rebuttal of an article found elsewhere in this issue of the newsletter. You can view that article here.
Let me respond to both Dr. Byrne's response and Dr. Mercola's introduction to my article supporting the health value of a vegetarian or mostly vegetarian diet. In my initial piece, I mentioned the "small amount of organic eggs, low-fat organic dairy, and wild fish" in my own diet and my recommendations.
I did not by any means intend to suggest that I recommend or eat a lot of these foods, and the scientific data only suggest that you need a small amount of these to provide adequate vitamin B12 to cover basic human needs (as I recommend supplements of most nutrients, including B12, whether you choose to be vegetarian or not, higher doses from foods become a moot point). The essential fatty acids may not be adequate for some people who need EPA or DHA, but commercial meat will not provide them, only certain cold-water fish, preferably wild.
Dr. Byrnes accuses me of using an anecdote in the next to last paragraph of my article. He says in his defense that vegetarian authors do this all the time, but that does not refer to me, and has no bearing on my presentation. Also, I am not sure to what in the paragraph he refers, unless it is the comment that "Healthy vegetarians have successful pregnancies all the time ... " This is based on scientific literature, but for some reason my reference was left out. In that reference (Sanders T, Good nutrition for the vegetarian mother. Mod Midwife 1994 Apr;4(4):23-6), the conclusion of the author was that "Vegetarian mothers do not show a higher incidence of complications of pregnancy."
Why Dr. Byrnes refers to this as an anecdote I am not sure. In addition, I am not opposed to using anecdotes, only to using them as support for a position that is not documented in the medical literature. They are certainly reasonable starting points for scientific research or to illustrate the weight of scientific evidence.
When I state that miscarriages happen all the time, it is particularly misleading for Dr. Byrne to suggest that it is only in the women that I deal with. Of course, I see many women who have had miscarriages, but it is not because they are vegetarian or exclusively because of the one reason that Dr. Byrne suggests.
Many of my patients have had miscarriages and then begin healthy, mostly-vegetarian diets and go on to have healthy children. In most cases they had eaten a lot of meat before seeing me, but that does not mean that meat caused their miscarriages, any more than that Dr. Byrnes' case is a reflection of the scientific literature. The body manufactures vitamin A from carotene, which is abundant in a diet high in fruits and vegetables.
Flaxseeds are a rich source of omega-3 oils, and in healthy people they are usually converted in adequate amounts to their derivative EPA and DHA, although having some fish in the diet would be beneficial for those people who have conversion defects as Dr. Mercola suggests.
Other animals with similar metabolism to humans, such as gorillas, derive all their essential fatty acids from their mostly vegetarian diet. In addition to this, supplements of EPA and DHA might be even better than food sources, due to the common risk of contamination of these foods with mercury and other environmental toxins. Commercial fish farming is becoming just as much a problem as commercial land-animal production in terms of food safety.
While my diet is not-quite-correctly described by Dr. Byrne as an omnivorous one (I do not recommend meat or chicken), the animal products that I do recommend, such as organic eggs, organic low-fat dairy, and wild fish are very small parts of the diet recommendations as a whole, as vegetables, fruits, grains, legumes seeds, and nuts make up the bulk of the diet.
In addition, the literature that I cited shows that a vegetarian or lacto-ovo-vegetarian diet is healthiest, and this is a reflection of the vast weight of the available scientific data. This is easily verified by a MedLine search on the word "vegetarian," and seeing what comes up. If Dr. Byrnes can find an occasional article that shows that meat in the diet is not harmful, this is simply a reflection of the vastness of the medical literature, where you could probably find articles that show smoking is not harmful to health either.
If Dr. Byrnes had many scientific articles that are contrary to the ones I cited in my article, he did not share them with us.
Dr. Price's research is not unequivocal as Dr. Byrnes suggests. No medical research is unequivocal, and we have to look at the vast weight of the medical literature as I indicated above. Price's observations have been both backed up and refuted by different nutritional anthropologists, and the best evidence we have so far is that we can't really be sure of the prehistoric diet, although a lot of tooth-structure and wear-pattern evidence suggests that early hominids ate large amounts of vegetarian foods in addition to low-fat animal products.
A look at the diet of the Kalahari bushmen seen in the film "The Gods Must Be Crazy" reflects primitive non-agricultural diets, and shows that while the occasional snake or rare elephant is seen in the diet, the bulk of their nutrition comes from tubers, leaves, fruits, and seeds. However, even if we were to grant that Dr. Byrnes is right about prehistoric diets among human ancestors, they lived a much different lifestyle, which was extremely physically vigorous.
In addition, just because cave-humans ate meat is not an argument to continue doing so if the benefits of science reveal that we are would be healthier eating less meat and more vegetables, fruits, whole grains, and beans. And that is just what the science shows, so why should we ignore the advances that science provides us. I have yet to see a scientific refutation of the mortality and disease incidence data that I presented in my article.
Dr. Byrnes claims that the nutrients needed to detoxify pesticides, drugs, and hormones are present in the meat laden with those toxins and hormones, but this is unlikely, and Dr. Byrnes presents no references that this is the case. These toxins are above the levels found naturally in foods (and are often toxins not present in nature at all), and an additional burden on detoxification mechanisms.
The unreferenced claim that they would be detoxified by nutrients found in meat is contrary to the literature showing that antioxidant status is consistently better in plant-based diets, and antioxidants are the most likely protective nutrients against environmental carcinogens and other toxicity.
Also, the hormone residues in meat are not managed as toxins by the body, but as hormones, and they have hormonal effects, especially in children, and long-term exposure is a highly suspect cancer promoter (Epstein SS, The chemical jungle: today's beef industry. Int J Health Serv 1990;20(2):277-80; Andersson AM, Skakkebaek NE, Exposure to exogenous estrogens in food: possible impact on human development and health. Eur J Endocrinol 1999 Jun;140(6):477-85).
The antibiotic residues lead to the development of resistant bacteria, and they transfer their resistance when the meat is eaten. The claim that meat contains the means to detoxify any toxins present is dangerous and unsupported by scientific data. That lettuce also is treated with pesticides in the growing process is unfortunate, but not an argument for eating meat instead, as animals concentrate the toxins that are either added to or naturally present in meat.
While it is better to eat organic vegetables than the commercial variety, it is still better to eat plant-based foods rather than animal products with their higher concentration of toxins.
Once again, Dr. Byrnes presents no references to support his position or to refute mine, while the data consistently support my statements.
Diets high in whole grains and legumes are consistently beneficial in reducing risks of cancer, diabetes, and heart disease, and animal fat increases cancer risk, among other health problems (Bazzano LA, et al., Legume Consumption and Risk of Coronary Heart Disease in US Men and Women. Arch Intern Med. 2001;161:2573-2578; Liu S, et al., A prospective study of whole-grain intake and risk of type 2 diabetes mellitus in US women. Am J Public Health 2000 Sep;90(9):1409-15; Grant WB, An ecologic study of dietary and solar ultraviolet-B links to breast carcinoma mortality rates. Cancer 2002;94:272-281.) Dr. Byrnes' response presents no critique to the data presented in the scientific research.
I am relieved that Dr. Byrnes' agrees that meat is not essential in the diet. However, he goes on to reject my statements that vegetarians are healthier and have lower mortality from heart disease, cancer, diabetes, stroke, hypertension, and, indeed "all causes." Why he rejects this is not documented, as he never refutes any of the many references that I provided that report exactly that.
He says some of the studies support my view, but that is not a fair representation - in fact, the vast majority of them support my position that a mostly vegetarian diet is the healthiest choice, while he may find a few that do not, and these, he says "are the ones that need to be looked at ... " Why one would look at a minority of the research and ignore the vast majority is not clear. This is especially true when choosing one study on tuberculosis among Asian immigrants in South London to support the anti-vegetarian position. Other articles described some confounding socioeconomic factors in studying a poor immigrant population from regions with endemic tuberculosis. (Hayward A, et al., Reasons for increased incidence of tuberculosis. Large immigrant population may have confounded study. BMJ 1995 Aug 26;311(7004):570-1).
Another study showed that vegans had the same immune function as non-vegetarians. (Haddad EH, et al., Dietary intake and biochemical, hematologic, and immune status of vegans compared with nonvegetarians. AJCN 1999 Sept 70(3); 586S-593S).
Dr. Byrnes says that I " ... seem to be under the impression that only animal foods give rise to various food pathogens ... " This is not true. I realize that other foods can harbor pathogens, but far and away the risk is higher with meat and chicken than with vegetables, and often the vegetables are only contaminated because of their contact with flesh foods that are covered with invisible fecal material.
Recently the USDA sought to retract inspection certification from a company that had frequent failures of its salmonella tests, and the USDA lost, apparently because it was never proved that the contamination came from the plant itself (the pathogens in their finished product might have arrived at the food processor from the slaughterhouse). I mentioned that feeding grains to animals contributes to environmental and soil decline, and I cited references to this effect.
I did not make the argument that feeding grain to animals causes world hunger, so Dr. Byrnes has no grounds to criticize my article on that basis.
I am amused that Dr. Byrnes is amused by my analysis, but I don't know how he can say there is not one scientific reference to support my position, as I presented a large number of them. I have put some more here directly in the text so they can't be as easily ignored. Dr. Byrnes might discount the validity of some of them, and he might deny the validity of all of them, but he would be out of touch with the scientific literature, of which these are only a sampling.
It appears that Dr. Byrnes prefers to ignore the scientific data to hold fast to his unscientific position. It is said that faced with evidence that creates a choice between changing one's mind and proving that you do not have to do so, most people start working on the proof. It appears that Dr. Byrnes falls into that category.
I recommend a mostly vegetarian diet because that is what the weight of the scientific literature shows is beneficial for health, not because of a preconceived notion, and I have the documents that support it.
Regarding Dr. Byrnes' second myth, I agree that vegans have a difficult time getting any vitamin B12, and it is possible that if a known essential nutrient is missing from the diet, others that are unknown may also be deficient.
However, based on the current science, B12 is the only known missing nutrient, and it can easily be found in eggs, dairy, and fish, and only small amounts are needed. If someone wants to be a vegan, based on the evidence to date, it is wise for them to take supplements of B12 for safety, and they can find all the other known required nutrients in their diets.
One study shows that vegans can get B12 from a seaweed, but it is hard to assume that this is completely reliable source (Suzuki H, Serum vitamin B12 levels in young vegans who eat brown rice. J Nutr Sci Vitaminol (Tokyo) 1995 Dec;41(6):587-94). In that study, vegan children showed no signs of B12 deficiency (although it can take years to develop) and there was no difference in their serum B12 compared to omnivore children. I would not personally rely on this source of B12.
The conclusion is that while vegan diets are more difficult to practice healthfully, the diet I recommend, which is mostly vegetarian, whole, natural foods (mainly vegetables, fruits, legumes, whole grains, seeds, and nuts), with small amounts of organic eggs, dairy and wild fish, are maintainable, healthy, and well documented in medical literature.
Michael Janson, MD
Michael Janson, M.D., is past-president of both the American College for Advancement in Medicine and the American Preventive Medical Association. He founded one of the first complementary/alternative medical practices in New England in 1976. He has lectured widely on the subjects of nutrition, complementary/alternative medicine, vitamin supplements, and chelation therapy. He has been on a mostly vegetarian diet since 1975.
Dr. Janson is the author of: The Vitamin Revolution in Health Care; Chelation Therapy and Your Health; All About Saw Palmetto and Prostate Health; and Dr. Janson's New Vitamin Revolution (Penguin-Putnam-Avery, 2000). He has written articles for many health magazines and newspapers, and he is a regular radio-show guest. He publishes a monthly newsletter, Dr. Michael Janson's Healthy Living, available free by Email (newsletter@drjanson.com) by placing "text newsletter" in the subject line. His website is www.drjanson.com.