Food Fights: Are Vegan Diets Healthier for the Brain?

How do vegan diets affect the brainHow brain-healthy is YOUR diet?

We think a lot about how plant-based diets and animal-based affect our hearts, our blood sugar levels, or our risk for cancer, but how do our dietary choices affect our brains? What do we actually know about vegan diets and mental health? As a psychiatrist who specializes in nutrition, this question is near and dear to my heart, and one that richly deserves our attention.

Those of you familiar with my work know that I eat a highly unorthodox mostly-meat, low-plant diet, but that was not always the case. In my 20s and 30s I ate a low-meat, low-fat, high-plant diet because that’s what I was told was best for me. In my early 40s, numerous mysterious symptoms descended upon me—chronic fatigue, fibromyalgia, IBS, migraines, etc.—forcing me to experiment with my diet in hopes of finding relief. The diet that completely resolved all of those issues and more, was a high cholesterol, high-fat, low-fiber diet. Naturally, I was worried that this strange new diet would slam my arteries shut, so I began to study the science behind the headlines.

We are all doing our best with the information we have to make healthy choices. It’s just that the information we have can be really confusing and is often divisive. I’d like to challenge some assumptions on both sides of the great plant vs. animal diet debate that are often overlooked, in hopes of finding common ground and creating a foundation for meaningful dialogue. Yes, I will be making the case for meat (red meat, poultry, and/or seafood), and no, I am not funded by the meat industry. My sincere intention is to support everyone in making their diet of choice healthier by providing useful information.

My reading of nutrition science over the past ten years has led me to conclude that vegan diets are hard on the human body… but I will argue below that omnivorous diets can be hard on the body, too.

The plant-based foods movement

Vegan diets contain no animal foods whatsoever, and are therefore naturally cholesterol-free and typically low in saturated fat. An ever-growing number of influential individuals and powerful institutions actively promote diets rich in plant foods and low in animal foods—from health care professionals like physicians and dietitians to government agencies like the USDA and the World Health Organization. No wonder more and more consumers believe a vegan diet is the holy grail of human health.

This, despite the undisputed fact that un-supplemented vegan diets are nutritionally incomplete. This alone should give one pause about the merits of vegan diets. Even with supplementation, it is challenging for people who choose plant-based diets to meet their nutritional requirements using strictly whole foods. In fact, even though the plant-rich diet recommended by the USDA allows some animal foods, it is so nutritionally weak that the US Dietary Guidelines specifically recommend that EVERYONE eats refined carbohydrates like flour and cereals, because they are fortified with essential nutrients:

“Refined grains, such as white flour and products made with white flour, white rice, and de-germed cornmeal, are part of the intake recommendation because they are commonly enriched with iron and several B vitamins, including thiamin, niacin, and riboflavin…Since 1998, enriched grains also have been fortified with folic acid and are thus an important source of folic acid for women of childbearing potential…The 2015 DGAC concluded that consumption of only whole grains with no replacement or substitution would result in nutrient shortfalls.” [Part D, chapter 1, lines 1088-1156]

The USDA recommends that grains and legumes serve as staple protein foods, despite the awkward fact that those foods are such poor sources of vital nutrients that they need to be artificially fortified…and you can’t fortify a whole food. [Dairy is arguably an exception, but we’ll get to dairy further below…and vegan diets exclude dairy products]. In contrast, red meat, poultry and seafood are naturally nutritionally dense and have been part of the human diet for nearly two million years–why not specifically recommend these as staple sources of protein?.

Are vegan diets good for the brain?

The short answer? Un-supplemented vegan diets lack key nutrients required for human cells to operate, and therefore are incompatible with human life. Of course they will cause brain malfunction, but exactly what that will look like in different individuals is hard to predict.

In my next post, Your Brain On Plants, I delve into the details of how plant-based and animal-based diets compare in terms of vitamins, minerals, protein, cholesterol, and essential fatty acids—and how those differences affect the brain and various psychiatric conditions. Even I was surprised to learn some of the things that came to light as I worked on that article. Spoiler alert: there is strong, irrefutable scientific evidence that un-supplemented and improperly-supplemented vegan diets jeopardize overall mental health. One of the most concerning things I learned in my research is that most vegans are not properly assessed for critical deficiencies and most do not supplement correctly. Whether carefully supplemented vegan diets can sustain excellent mental health is a different question altogether. I honestly don’t think anyone knows the answer. Vegan diets are a relatively new phenomenon in world history. Completely removing animal foods from the diet is a risky human experiment—although, to be fair, so is eating the standard American diet…

Eat and Let Eat

On the surface, the definitions are simple—vegan diets contain no animal products whereas omnivorous diets contain both plant and animal foods. However we can’t lump all vegan diets together, just as we can’t lump all omnivorous diets together. Not all vegans eat the same way, just as not all omnivores eat the same way.

To fairly and objectively evaluate the health effects of these dietary patterns, it is not enough to sit on our respective mountaintops and make sweeping judgments and proclamations from a distance. Thoughtful people on both sides of the plant-based vs animal-based debate must do the hard work of analyzing the ingredients within these diets. If we truly care about the health and well-being of our fellow human beings, we owe it to ourselves and others to stay curious and open-minded. We must take the time to learn and appreciate how the foods we choose to eat operate within the human body, to understand and be honest about the real risks and benefits of the diets we personally eat and professionally recommend, and to acknowledge the limitations of our knowledge.

In my personal life, I am considered crazy—“orthorexic,” to use the clinical term—for eating a mostly-meat diet by a good many people, including some of my best friends and most highly-educated colleagues. As a result, my instinct is to rush to the defense of vegetarian and vegans who are similarly judged for their dietary choices.

In my clinical experience I have certainly worked with people with obsessive-compulsive tendencies and/or eating disorders who adopted a vegan diet because removing meat appealed to their desire to feel in control, virtuous, safe, or perfectly clean and healthy. However, with the slowly rising popularity of low-carbohydrate, Paleo, and elimination diets, I have witnessed the very same motivating factors among some who are using extreme versions of these diets to optimize their body composition, sense of safety, macronutrient ratios, or ketone readings, sometimes to the detriment of their well-being.

Vegans vs Omnivores—surprising common ground

All vegan diets are not alike, just as all carnivorous diets are not alike. To make matters more confusing, vegan and vegetarian diets are often lumped together in scientific studies, yet vegetarian diets are a different kettle of fish substitute altogether, and deserve to be considered separately from vegan diets.

It is also important to be clear about definitions. As part of every initial intake, I ask my patients the same question about food: “Do you eat a special diet of any kind?” I cannot tell you how many people have told me they eat a vegetarian diet…that includes FISH. Numerous people report they “don’t eat meat” by which they mean they don’t eat RED meat. Lots of people say they “don’t eat carbs,” meaning they don’t eat foods with added sugar. Unfortunately, all too many people these days identify as “carboholics” (their term)—eating a diet consisting almost entirely of sugar, starch, and sweetened dairy products—unable to recall the last time they ate whole foods like eggs, chicken, non-starchy vegetables, or unsweetened nuts. Many of these people don’t identify as vegetarians, but are in essence eating a primarily vegetarian diet, having either lost interest in or developed an aversion to non-dairy animal foods.

Yes, a few of my formerly vegan and vegetarian patients have told me that their mental and/or physical health improved after adding animal foods to their diets. However, some of my patients who used to be omnivores report feeling better after removing animal foods. And I have seen countless patients over the years with severe depression and other serious mental health problems despite eating meat regularly.

What’s going on here?

These anecdotes prove nothing, but they do illustrate an important point: good mental (and physical) health is not simply about whether you eat animal foods. It is also about what else you are eating. Most vegans and omnivores eat many of the same foods, some of which make the brain very unhappy.

What ELSE is in YOUR diet?

There are dozens, if not hundreds of variables within any given diet and any given individual that influence one’s health and sense of well-being. I offer these important examples for your consideration:

Refined carbohydrates

Removing refined carbohydrates, such as sugar, flours, fruit juice, and cereals, makes ANY diet healthier. This is the most likely reason why plant-based diets appear healthier than meat-based diets in some clinical studies. All of the studies I’m aware of claiming that plant-based diets are superior to omnivorous diets suffer from the same tragic flaw. Researchers conducting these studies NEVER simply ask people to remove animal foods from their diet. They always change more than just that single variable—such as lowering fat content or adding exercise—and they always instruct people in the plant-based group to eliminate refined carbohydrates and processed foods. In almost every case, these special “plant-based” diets are then compared to a junky omnivorous diet loaded with sweets, baked goods and manufactured foodstuffs.

This is not a fair fight. How do we know whether it was the removal of the meat, refined carbs, industrially-produced oils, or artificial additives that was responsible for the benefits? I’ve engaged in countless social media conversations with plant-based diet experts in which I politely ask for scientific evidence that simply removing animal foods from the diet—without making any other changes—results in health benefits. None of them have ever been able to cite a single article for me. A good example is this exchange I had with Pritikin nutritionist James Kenney, PhD FACN, in the comments section of this MedPage article.

To attempt to address the plant vs animal question in a meaningful way, we would need to compare a whole foods plant-based diet to a whole foods animal-based diet in clinical human trials. To the best of my knowledge, this has never been done. I cannot emphasize this strongly enough: there are NO studies I am aware of demonstrating that simply removing animal foods from the diet results in any health benefits whatsoever. If you know of any, please notify me—I would love to read them!

Until we have studies comparing whole foods plant-based diets to whole foods omnivorous diets, we will have to rely on human history, physiology, biochemistry, and common sense to tell us that meat is not only harmless but healthy for humans. I have looked long and hard for evidence that meat endangers human health, to no avail. Here are a few examples of what I found instead:

WHO Says Meat Causes Cancer

Does Carnitine from Red Meat Cause Heart Disease?

The History of All-Meat (or mostly-meat) Diets

What both sides can say with tremendous confidence is that refined carbohydrates are extremely unhealthy. As for mental health in particular, processed carbohydrates literally cause brain damage in at least three specific ways:

  • Hormonal instability. I explain how refined carbohydrates put the brain and body on an invisible internal roller coaster in my Psychology Today article Stabilize Your Mood with Food.
  • Inflammation and oxidation. Most psychiatric disorders are now understood to be associated with increased markers of inflammation and oxidation in the bloodstream. (A description of these is beyond the scope of this post, but I’ll write more about it in the near future).
  • Insulin resistance of the brain. Insulin resistance (aka pre-diabetes) now affects more than 50% of Americans! Emerging evidence suggests that insulin resistance can contribute to symptoms of depression, bipolar disorder and psychosis, but the study of insulin resistance and psychiatric disorders is in its infancy. However, when it comes to Alzheimer’s Disease, it’s another story. We have powerfully compelling evidence that insulin resistance is the driving force behind most cases of garden-variety Alzheimer’s Disease, and that the brain damage caused by sugary diets begins decades before any memory symptoms become obvious. To learn more, please see “Preventing Alzheimer’s Is Easier Than You Think.”

For all of these reasons, avoiding refined carbohydrates is the single most important thing any of us can do to protect our mental health, regardless of what dietary pattern we choose.

Grains, beans, nuts and seeds

Grains and legumes are seeds—precious plant embryos—cloaked in indigestible armor, and stocked with chemical weapons to protect them from the hungry creatures and harsh environmental conditions they may face while waiting to sprout. Lectins, protease inhibitors and phytic acid are just some of the surprises lurking inside all seeds that pose serious risks to human health. This is why I believe that ANY diet—whether vegan or carnivorous—that contains significant amounts of these foods is far from optimal. This may help explain why simply adding meat to a vegan diet, or simply removing the refined carbohydrates from an omnivorous diet, doesn’t always bring the health benefits one is hoping for.

Food sensitivities

When people adopt a vegan diet they don’t just remove meat, poultry and seafood from the menu—they also eliminate eggs and dairy products, which are among the top nine most common culprits in food sensitivity and allergy syndromes. Could the reason why some people feel better on a vegan diet be an unrecognized dairy, egg, or shellfish sensitivity? On the other hand, included in the top nine food culprits are also nuts and soy, so switching to a plant-based diet may unmask these sensitivities in certain individuals and make them feel worse.

People embarking on Paleo, low-carb or ketogenic diets may find themselves consuming more cured, smoked, and fermented animal foods high in biogenic amines which can trigger complicated histamine intolerance symptoms, including anxiety and insomnia. Vegan diets are generally far lower in biogenic amines, so those with histamine issues may feel better on a vegan diet. Food sensitivities can cause a whole host of symptoms that can vary from one individual to another, including psychiatric symptoms, so it’s always worth exploring at least the common culprits if you’re not feeling up to snuff.

Omega-3/omega-6 status

Omega-3 and omega-6 fatty acids are essential to brain and body function, and since our bodies cannot make them from scratch, we must eat them regularly. Most experts agree that omega-3s and omega-6 should be roughly in balance in order for our brain cells and our immune system to work properly. The vast majority of us, whether we eat a plant-based or animal-based diet, consume FAR more omega-6 than omega-3s. Some studies estimate that most Americans eat 20 to 30 times more omega-6 than omega-3s! This is because the foods that naturally contain omega-3s—fats from naturally-raised animals, for example—are hard to find in the typical modern diet. On the other hand, omega-6 is a major component of refined seed oils like canola and soybean oil, found in nearly every processed food in the grocery store.

To achieve a healthy ratio of these essential fatty acids, we must eat foods or take supplements rich in omega-3s AND dramatically reduce the amount of omega-6 we consume. It is entirely possible that vegans who take an algae-derived supplement and avoid refined seed oils may have better fatty acid profiles than omnivores who eat lean white meats and pour canola-based dressings on their salads. We’ll dive deeper into these essential fatty acids in the next article, paying special attention to how they affect brain health, but if you can’t wait to know more, please see my detailed FATS page or try one of my short omega-3 quizzes.

Dairy products

Milk is a growth formula designed to turn a little baby cow into a bigger baby cow. All milks are naturally rich in growth hormones, growth promoting agents, and proteins specific to each species. For example–the primary protein in cow’s milk, casein, cannot be properly digested by human infants because their digestive tract doesn’t contain rennet, the enzyme required to break it down. Mammals drink milk during infancy when growing rapidly, and then are naturally weaned on to other foods. I would argue that it is metabolically and hormonally risky for us to be consuming a bovine growth formula on a regular basis throughout our lifetimes. Dairy products can cause acne, digestive problems, weight gain, gynecological issues, and other kinds of distress, depending on how sensitive you are. For more details, please see my dairy page.

Digestive disorders

Some people with gastrointestinal problems—such as Crohn’s, ulcerative colitis, or IBS—feel better when they switch from a vegetarian or vegan diet to a “Paleo” diet because grains and legumes all have tremendous potential to irritate the gastrointestinal tract. Others feel better when they switch from an omnivorous diet to a vegan diet because dairy can cause digestive problems for so many people. It should be noted that nuts and many vegetables that most Paleo folks enjoy can also cause problems for sensitive individuals. For more information, please see see my IBS article.

Contrary to popular belief, animal fat, red meat, seafood and poultry are highly digestible, easily absorbed, and non-irritating to the gastrointestinal tract. If you question the truth of this statement, simply think to yourself how often you witness undigested animal foods…shall we say…exiting your body? How about undigested plant foods? I rest my case😊

The Bottom Line about Vegan Diets and Mental Health

Every person’s diet is different, every person’s system is unique, and there are many factors to consider when evaluating the health of any given diet. I am convinced that including some animal protein and fat in the diet is very important, but many will disagree. Even if I could convince everyone of the importance of animal foods to human health, I’m sure some would continue to exclude them from their diets for other important personal reasons. My reading of the evidence is that removing refined carbohydrates and processed foods is what makes plant-based diets appear healthier in clinical studies, so regardless of what you choose to keep IN your diet, make sure you get the junk OUT.

When you’re ready to learn how vegan and animal-based diets compare when it comes to essential nutrients like iron, vitamin A, and omega-3s, read the next post in this series: Your Brain On Plants: Micronutrients and Mental Health. To be notified when future articles in this “Food Fights” series become available, please sign up below.

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  • Deborah Gordon, M.D.

    Thanks for the brilliance I expect from you, and look forward to the next part of this post!

    • Thanks so much for reading, Dr. G–I should have the next article ready within a couple of weeks. Hope you’re having a wonderful summer!

  • Jim Jozwiak

    I wonder if, considering mental problems may sometimes be characterized as diabetes of the brain,
    perhaps many digestive problems are diabetes of the enteric nervous system.

    • Hi Jim

      This is a very interesting thought! I haven’t personally looked into it, but maybe others have? I wouldn’t be surprised at all. I I like the way you think!

      • Jim Jozwiak

        As someone born before the earth “cooled,” I try to refrain from pointing out to the rabid carb enthusiasts that carbohydrate tolerance is a youthful adaptation to allow reproduction under conditions of inappropriate nutrition and that expression of these mutations rapidly diminishes after the age of 40.

        • Also fascinating! Where can I learn more?

          • Jim Jozwiak

            I don’t know of any book that synthesizes everything, but it seems to be a commonplace of anthropological thinking that agriculture increased human fertility although the farmers’ fossilized remains show much more disease and malformation than skeletons of the hunter-gatherers they consorted with. The religions that popped up with the invention of agriculture, such as Judaism and Buddhism, seem to be concerned with a real problem that human existence is not consistent with the ultimate reality and that there needs to be a priesthood and special modalities to correct this terrible problem. Well, that sounds like mental illness to me, doesn’t it to you? And what changed fundamentally? They were eating a lot of carbohydrate.

          • Hi Jim

            A very interesting hypothesis–many possibilities–it could have been that they were eating more carbohydrate (although I’m not sure how they would verify that–there may be a method but I haven’t looked into it), but post-agricultural societies were eating grains, legumes and dairy products as staple foods–and these foods were not a significant component of pre-agricultural societies to the best of our knowledge. Carbohydrate is one thought–and an interesting one–because insulin levels may have been higher, and insulin is a growth-promoting regulatory hormone that essentially tells the body: “grow! store! reproduce!” Dairy is another thought, because it puts the body in growth mode too. As a psychiatrist I have often thought about the fascinating history of religion and spirituality and how that might have been influenced by diet. Thank you for sharing these interesting ideas!

    • Inflammation from hyperinsulinemia affects so many organ systems: why not the brain, too?

  • It definitely gets confusing…even among the “experts.” I look forward to your analysis of how plant and animal foods compare when it comes to essential vitamins, minerals, protein, cholesterol, and fat. And if you have a suggestion for the test(s) which would provide the best feedback re actual levels of nutrients in the body, please do include that as well. I really appreciate your voice of reason in this ongoing “food fight. “

    • Hi Cyndi

      Yes, SO confusing, agreed! In the next post I summarize how various nutrients stack up and do include bits of information about testing and supplementation, but a full exploration of testing a supplementation would make the post quite long and also take a lot more time to complete. I will include as much as I can in the next article, but if it’s not sufficient, stay tuned for more in the future!

  • charles grashow

    What about raw goat milk?

    • Hello, Charles

      Raw goat milk is a superb option…if you are a baby goat:)

      • doug

        After years of feeling bloated I finally realized I was allergic to cheese. I miss cheese and last week tried goat cheese. The bloating was worse.

        By the way, my wife lost 30 pounds in six months and eventually was told to see a psychiatrist by the last two MDs. We eventually found a NaturalPath Doctor who figured out in 15 minutes that she had multiple food allergies that didn’t show up in scratch tests. She had blood drawn and sent off to ImmuneLabs in Florida. A couple of weeks later the report came back that my wife was allergic to all dairy, most grains, and many spices. The day after she went on her new diet she said, ‘I can think, the fog is gone.”
        It took two years to get her body back to almost normal and she still has some problems. I am writing this because I now run into people who have problems and the doctors don’t know why and can’t fix them. I am not mad at MD’s but the are trained to proscribe drugs. I read a lot of stuff that five years ago I thought was pseudo science and now search the internet for science based blogs like yours. So, again, Thank You.

  • valerie

    You write: “Casein, for example, the primary protein in cow’s milk, cannot be digested by humans because our digestive tract doesn’t contain rennet, the enzyme required to break it down.”

    This sounds like vegan propaganda to me. Do you have any reference?

    • Hi Valerie

      I’m not sure what you mean by vegan propaganda, but regardless, your question about references is a very good one, of course!

      One of the best sources I have found describing differences between human and cow milk digestibility is:

      Also, here is a short excerpt from a different article for those not interested in reading the technical reference above:

      “Human and bovine caseins clot differently under the acidic physiological conditions. Loose clot or no clotting occurs for human caseins in infant stomach, while bovine caseins form large dense clots under the physiologically relevant condition of infant stomach (Li-Chan & Nakai, 1988). Clot formation would limit the accessibility of peptide bonds in casein to digestive enzymes, resulting in a lower rate of gastric emptying and also a lower efficiency of gastrointestinal proteolysis.” Liu 2016

      • valerie

        So, infants younger than 6 months old should drink human milk instead of cow milk because they (possibly) get delayed gastric emptying and incomplete proteolysis with cow milk casein.

        There’s quite a stp from that to saying that humans cannot digest casein, wouldn’t you say?

        • Hi Valerie
          A fair point, to be sure! I haven’t read all of the dairy literature–not by a long shot–and I’ve been diving into it more deeply lately with the goal of writing a more comprehensive post about dairy and metabolism. It’s proved quite the challenge due to the complexity and diversity of dairy foods and the strangeness of the assumptions I’m encountering. I have looked for but have not yet been able to find any scientific articles stating that adult humans digest dairy normally or completely, which is why I made that statement, but I agree that just because I haven’t found it, doesn’t mean it’s not out there. Researchers care a lot about whether babies digest cow’s milk but apparently don’t care whether or not the rest of us can:) Regardless, I do not want to mislead people or overstate anything, so I am happy to reword the sentence in this article and on my dairy page to better reflect what I have found. Thank you for pointing this out to me!

          • Barbara

            Dr. Ede, this statement of yours goes a long way, in my mind, to building trust for you and your statements.

            How refreshing to read your honest words – that you believe your original statement to be true, but you might have phrased it a little differently for greater clarity, and that as usual you were waiting for more studies, and more clinical results.

            Good for you. And keep up your blog please! There is so little information from qualified people, especially people who testify with their knives and forks.!!!

          • w1975b

            I’ve heard that goat milk is easier for humans to digest. Is it possible goat milk would also not cause as many issues because they’re smaller animals so contain fewer natural growth hormones?

    • Alaric the Vis

      Valerie, in the article Dr Ede says she that a high proportion of her food is meat. Does that sound like someone who writes vegan propaganda?

      • valerie

        I was not talking about the entire article (nor about Dr Ede in general), but about the specific statement.

        Reminds me of the “meat cannot be digested, it just rots in your intestines” vegan BS. Maybe there was a tiny scientific factoid behind it somewhere, but it was blown way out of proportion and presnted in a misleading manner.

        • Alaric the Vis

          Well, Valerie, I completely agree that some in the vegan movement will say anything to further the cause. Science is pretty much irrelevant.

    • w1975b

      Another issue with dairy milk is the morphine factor of casein, refer to the book Devil in the Milk by Keith Woodford. Here’s the summary –

      This groundbreaking work is the first internationally published book to examine the link between a protein in the milk we drink and a range of serious illnesses, including heart disease, Type 1 diabetes, autism, and schizophrenia.

      These health problems are linked to a tiny protein fragment that is formed when we digest A1 beta-casein, a milk protein produced by many cows in the United States and northern European countries. Milk that contains A1 beta-casein is commonly known as A1 milk; milk that does not is called A2. All milk was once A2, until a genetic mutation occurred some thousands of years ago in some European cattle. A2 milk remains high in herds in much of Asia, Africa, and parts of Southern Europe. A1 milk is common in the United States, New Zealand, Australia, and Europe.

      In Devil in the Milk, Keith Woodford brings together the evidence published in more than 100 scientific papers. He examines the population studies that look at the link between consumption of A1 milk and the incidence of heart disease and Type 1 diabetes; he explains the science that underpins the A1/A2 hypothesis; and he examines the research undertaken with animals and humans. The evidence is compelling: We should be switching to A2 milk.

      A2 milk from selected cows is now marketed in parts of the U.S., and it is possible to convert a herd of cows producing A1 milk to cows producing A2 milk.

      This is an amazing story, one that is not just about the health issues surrounding A1 milk, but also about how scientific evidence can be molded and withheld by vested interests, and how consumer choices are influenced by the interests of corporate business.

  • charles grashow

    I read the exchange you had with Pritikin nutritionist James Kenney, PhD FACN. I find his arguments more persuasive. BTW – this comment is more revealing

    3.25.2017— Jacques Koerfer
    I assisted at the conference of Dr Yusuf in Davos.

    Can somebody and for example somebody like Dr D Katz explain me, what for the hell, eating less than 50% of caloric intake as carbohydrate and at least 12% saturated Fats has to do with ketogenic diet or low carb or are against eating vegetables.

    The data which Yusuf presented shows that in excess of 40% CH of total Cal intake the rate of CDC explodes exponentially, but below the effect was neutral. What mean only an excess of CH are harmful.

    Same for saturated fats, if you look at the figures you see that the striking protective effect of saturated Fats are in the low digit between 0-4%, after its neutral.
    And for fruits and vegetables, he clearly shows, the more you eat the better it is.”

    Seems to recommend a low SFA, high complex carbohydrate diet or am I wrong?

    • Dear Charles,

      Yusuf’s data is epidemiological, and therefore without the ability to show cause and effect relationships between any aspect of diet and any aspect of health.

    • tkent26

      With the usual caveats for epi studies, saturated fat “per se” has not been shown to be harmful in any context. _Absence_ of sat fat appeared harmful if cut below 4%, but this could be do to lack of nutrition from foods which contain sat fat in addition to other nutrients. Higher sat fats intakes are neutral (or beneficial if sat fats are replacing refined carbs).

      Sure, make those 40% of carbs from beans, veggies, and actual whole grains. No protective effect observed from eating more than 40% of diet as carbs, no harm from cutting carbs below 40%, possible harm from greater than 40% (again careful with the epi data), and clear harm if those 40+% of carbs are refined flours and sugars.

      At least that’s how I’m interpeting the comment from Jacques Koerfer. AFAIK, the Yusuf study has not been published yet.

    • LA Chefs column

      James Kenney like so many other plant based doctors clings tenaciously to the diet heart hypothesis even though LDL-C has been repeatedly demonstrated to be a very poor marker of heart disease. As lipidologist Thomas Dayspring demonstrates in this video at approximately the 21:50 min/sec mark with two graphs, higher levels oxidized LDL (oxLDL) levels correlate with coronary disease whereas higher levels of LDL-C do not. Now what types of fats easily oxidize and produce free radicals? Polyunsaturated fats, not saturated fats. Most seed oils are primarily PUFU’s. Most animal fats are a mixture of mono-unsaturated, polyunsaturated and saturated fats, though primarily mono-unsaturated and saturated fats.

      Nowadays it seems there are two camps that cling to outdated science like the diet-heart hypothesis: plant based vegan doctors and statin pushers. The first group’s religion relies on this outdated science, while the second group’s motivation is billions of dollars of profits.

    • Alaric the Vis

      Charles, you’re always wrong. But it’s good to see you write something that doesn’t include a personal comment about Jimmy Moore’s weight.

      • charles grashow

        What am I wrong about this time? Please let me know so I can craft a response.

  • carlito

    Thank you for this article. I’ve been on a high fat diet since 2004. I am 66 years old. I feel good and very active. I am still working and i will go on working.

    • May you feel good and stay active for many decades, Carlito!

      • carlito

        Thanks. I’ll keep on reading your articles for new developments.

  • Gareth Morrow

    hi-so do you use anything as a milk substitute for cereal (if you EVER eat that) or for tea/coffee?

    • blue moon

      Homemade almond milk tastes great as a substitute. Making it from almond butter is very simple and fast.

    • Hi Gareth

      I don’t eat any grains, so no cereals…and I am unfortunately sensitive to nuts, coconut and soy, so, sadly, no white liquids for me!

  • Niel Rasmussen

    Thank you for the great information!!! As a family physician who uses carbohydrate restriction with focus on animal protein/fats to treat the many manifestations of insulin resistance / metabolic syndrome in my daily practice, I just want to say thank you for providing such objective information. I look forward to your future posts and your interviews/lectures you so graciously allow people to have access to. I’m not sure that people realize the value of this time consuming donation of your thoughts and reviews of the confusion data in the field of nutrition research. I think we are at an exciting time in healthcare with regards to nutrition. There is more than ever a growing focus on the impact both in a therapeutic way and in a harmful way that nutrition/food can have on our health. Your efforts to provide a non-biased source of information is appreciated. I especially appreciate your willing to stand up for animal based nutrition when the mainstream nutritional forces promote plant based nutrition as the standard. Thanks again for your time!!!

    • Dear Dr. Rasmussen,

      Thrilled to hear that you use meat/fat-positive lower carb diets in your practice!!! How did you come to that approach, and how is it working for your (lucky) patients? Thank you for your kind words about my work. It IS extremely time-consuming (which gets challenging during the academic year when I’m doing clinical work) and it’s expensive to travel to conferences and such, but I love it and it makes it all worthwhile when people find it valuable. I’m at a nutritional psychiatry conference right now, and am speaking up at every opportunity to challenge the anti-meat/pro-plant-based diet beliefs that are common in the field. We have a long way to go, but thanks to thoughtful physicians like you, worldviews and the health of individuals are both improving! Thanks for taking the time to boost my motivation:)

      • Niel Rasmussen

        I found the low carb way of eating when I needed to personally lose weight back in 2002. It worked well for me but it was only around 2009 that I began at first to offer it as an option for my patients with metabolic syndrome. It was an article I read about Dr. Eric Westman and his Lifestyle clinic at Duke that gave me confidence to use this tool in practice. I went down the “rabbit hole” of the low carb world then and read many of the books your site recommends, including Gary Taubes work (Good Calories Bad Calories, Why We Get Fat) and Phinney, Volek (The Art and Science of Low Carbohydrate Living and Performance, The New Atkins for New You). I have found it very challenging to implement nutrition (and lifestyle – not to leave out exercise, stress reducing habits and sleep) into my practice but it has become my primary emphasis when treating the many faces of metabolic syndrome. I excessively use handouts I’ve made along with monthly support classes (free to my patients but seemingly still overpriced.haha) to help my patients who are interested (the minority unfortunately). My staff are all involved in this so my nurses can freely talk to patients during their time in the clinic also, which helps. I practice in a small town and I try to live the lifestyle so I will say most of my patients see me and my family living it which I hope validates it. I think a huge challenge for practitioners is to self educate on how to actually prescribe nutrition as an intervention. I was not taught this and I doubt current training places any emphasis. As you know, it is not as easy as sending an electronic Rx. It requires time and effort to learn how to discuss it quickly and also how to assess quickly what the patient is doing and is willing to try. In a small primary care clinic, I do not have resources of ancillary staff that can do this patient education so I do most of it and offer after hours support for those interested. I will say it has invigorated my practice personally however. Nothing boosts my passion for this more than when I am able to deprescribe diabetic, hypertension, statin medications and see patients take back control of their healthcare. I see this as the true healthcare reform needed in our system. Sorry to ramble. I happen to be on vacation this week so I apologize. Thanks again for what you do. Your work goes to support the work of myself and others likeminded in the “trenches”!!!

        • Fantastic journey–I agree with the clinical challenges and with the power of example! If you do not already belong to a low-carb clinician network that can offer support, insights, and ideas about how to manage cases, I would be happy to invite you to join one that I belong to. If you’re interested, please message me on my facebook page (GeorgiaEdeMD) and I’ll send you an invite. [It’s a free, closed facebook group.]

  • Charl Brink

    Interesting. Is the China Study not proper scientific research? Probably the best we will ever get.

    • Unfortunately the China study is an epidemiological study–an observational study that, at best, can only generate guesses about what the connection might be between a food and a health problem.

      Human clinical trials (experiments) are the way to test those hypotheses, and the clinical trials we have so far have not been designed in a way that can tell us whether plant-based diets are healthier for us or not (described in the refined carbohydrates section of the post above).

      • charles grashow

        There have been metabolic ward studies showing reversal of T2D within 21 days on HCLF macrobiotic diets. Your thoughts.

        • reference please–the devil is in the details of the diet

      • carbnfatncarb

        It’s amazing how people use epidemiology to suit their agenda.

        Study: “Meat causes cancer.”

        Answer: “Epidemiology is pseudoscience and proves nothing.”

        Study (Yusuf): “Sat Fat is good”

        Answer: “Yey! We were right all along!”

        All this just shows an ignorance towards epidemiology and statistical modelling. No epidemiologist will tell you that a study proves cause and effect, but that doesn’t mean that epidemiology proves nothing. Epidemiology is not just throwing a few dots on a graph in Excel. It involves using huge, complex statistical models that are validated across various scenarios. How do you think we know smoking causes cancer? Do you think that we should have held back advising the public no to smoke until we’d done long term RCTs? No, but this is what the tobacco industry tried to argue.

        The china study was the work of many researchers from three universities in three countries, working with a massive data set generated across multiple decades. This wasn’t one person’s vegan agenda as people like to believe. Models were generated and tested against that data based on cancer research models. There have been many journal papers published based on these analyses. But, of course, if it suits your agenda, you can always take comfort in a blogger, that knows nothing about epidemiology and statistics, but does know how to draw simple graphs in Excel, and say “ah, correlation doesn’t equal causation.”

        • Barbara

          Really? Check out the people who were the front men of this study – vegans and vegetarians.

          • carbnfatncarb

            Really? Can you list all the researchers from all three institutions that conducted the study and prove that they are all vegan/vegetarian?

            Instead of trying to find week reasons to prove bias, whilst keeping your own obvious biases intact, why not show the actual flaws in the methodology of the multitude of papers produced by the study?

          • w1975b

            One point about cholesterol contributing or causing atherosclerosis (which is hardening of the arteries, for anyone who doesn’t know) – cholesterol is a waxy, flexible substance, used to patch holes in blood vessels. Cholesterol on its own does not become hard, but mixed with calcium (aka concrete) it will. So…cholesterol is not the bad guy. Everyone needs cholesterol for proper brain function and hormones, and to patch blood vessels (you don’t want internal bleeding, right?), etc. Learn how to reduce inflammation (cholesterol is anti-inflammatory, bonus fact for ya) and put calcium where it belongs (bones and teeth mostly) instead of in blood vessels and too much in muscles (heart attack risk!). Morley Robbins has done lots of research on this.

        • tkent26

          Nutritional epidemiologists have told us for decades that fat, saturated fat, and cholesterol _caused_ heart disease, obesity, etc. With 100% certainty. All of these claims have turned out to be false. Weirdly, there is no admission of error or re-formulation of hypotheses from the nutritional epi crowd.

          When we’re talking about smoking, the relative risk increase of lung cancer among smokers was _huge_, 15-20x, the effect was dose-dependent across all populations studied, a mechanism of damage was established, and there were no other known mechanisms to account for the increased lung cancer. _None_ of these criteria have been met for the supposed damage of fat/sat fat/cholesterol, and relative risk factors are almost always _less than 2x_.

          On the Yusuf thing, even though I like the results, I have the same criticism. Observational study based on self-reported food surveys. Now we can ask an interesting “philosophy of science” question — does the absence of correlation _disprove_ causality?

          • carbnfatncarb

            All the claims haven’t turned out to be false. Only those misrepresenting the science, like Taubes and Teicholz, claim this in order to sell contrarian stories and diet books. The actual science supports it very well. Only when you read their books and junk science produced by meat industry/Atkins Foundation sponsored science does it look any different.
            The mechanism of saturated fat raising cholesterol is well established and the mechanism of high cholesterol causing atherosclerosis is also well established.
            And, yes, Yusuf’s study is yet another observational study from FFQs, but it’s findings are still more or less in line with diet guidelines. What it really shows is socioeconomic status’ effect on health and when it refers to carbohydrates it refers to REFINED carbohydrates, which no diet guidelines recommend.

          • tkent26

            Claim #1 “Dietary cholesterol raises blood serum cholesterol and causes heart disease” – false.
            Claim #2 “Total fat intake is responsible for obesity, diabetes, heart disease, everybody will be healthier if they limit fat intake” – false.
            Claim #3 “Saturated fat causes heart disease, everybody will be healthier if they limit saturated fat” – false.
            Claim #4 “High cholesterol causes heart disease” – false.

            Sat fat consumption raises total cholesterol (meaningless), but also raises HDL-C (positive marker) and shifts LDL-P to beneficial particle distribution (positive marker). However, “cholesterol games” are all just markers/indicators, we don’t know that any of these things _cause_ heart disease directly. But they sure are profitable to medicate! Perhaps you could find a job promoting statins.

            Please tell us what you think the mechanism is for “high cholesterol causes heart disease.” Bonus points if you use the phrase “clogged arteries” in your answer.

            Yusuf’s study finds that there is no particular harm associated with high(er) fat and saturated fat, and that there is harm associated with high(er) carbohydrate. They did attempt to correct for socio-economic status, although we can debate how successful those types of adjustments work.

            Starting in the 1980, the dietary guidelines _specifically recommended_ eating more bread, pasta, and cereal. To get you caught up, yes these are all refined carbohydrates.

  • PenAndSword

    Oh my word! The wisdom this good doctor dishes up on food and mood. Delicious! Thanks again, Dr Ede.

    • Thanks, P&S! Come back for seconds anytime:)

  • Maria Christiernin

    Have you calculated how many people this earth can sustain on your preferred diet? Do you seriously think that 7-10 000 000 000 can eat mostly meat or fish? Have you considered what will happen as climate change continues and land suitable for farming diminishes? Maybe I should add that I eat everything, thus I am not advocating any diet. This earth can simply not sustain it´s population eating the way you recommend. Have you ever considered working out a sustainable diet? that would be a good contribution. To simply work out have the super wealthy can have an even better body/health without considering the impact this will have overall do not impress.

    • Alaric the Vis

      Maria, animals grazing in open fields, eating grass and producing protein is a big contribution to feeding people. Crops can grow in 4% of the world’s land, often sustained by pesticides, scarce water and with no regard for wildlife.

      The diet Dr Ede advocates saves me money. I eat less, but better quality. I encourage better and more ethical food production by buying food produced in this way.

      • Maria Christiernin

        Maybe look at cowspiracy from 2014. I don´t agree with the filmmaker but he has certain points. I try to eat ethically as well which is easier if you have a balanced diet. I am Swedish and all of Europe has a very strict legislation on pesticids which make me confortable with European plant products. In Sweden we have a ban on using antibiothics for animals unless a veterinarian prescribes it for a sick animal (on individual basis) . We also have a ban on giving animals growth hormones so overall Swedish agriculture is rather sustainable, but I am sure we could get better.

      • Barbara

        Yes, and as well, there are verifiable projects in Africa that show when animals are put back on land made barren by over-farming, they fertilize it and plough it up with their hoofs. Sheep and goats will eat many things that we would have to pull up for planting. Properly rotated animal feeding will keep grasses growing forever.

        Look up Alan Savory on Ted Talks. Most people in the world could eat meat if we took proper care of our land. Growing mono-crops of wheat, corn, soybeans etc. is not sustainable without massive intervention.

        Grow meat, eat meat!

    • Dear Maria,

      I share your concerns about the environment and about food sustainability. I am not advocating that everyone eat a mostly-meat diet; it just so happens that I need to eat a mostly-meat/seafood/poultry diet because of my countless food sensitivities, but I do think that most people can safely include a variety of plant foods in their diets. I should also clarify that, while I am convinced by the science that we are probably healthiest if we include some animal protein in our diets, that doesn’t mean that we need a lot of it. In fact, even if we ate a 100%-meat diet, most of us would only need on average about a pound or so of meat, seafood, or poultry per day. We can get by with less if we are eating other sources of protein (eggs, dairy, nuts, insects, etc)

      It may certainly be the case that the planet couldn’t provide enough animal protein for everyone on earth to eat some high quality animal protein every day, but my goal is not to solve the world’s socioeconomic and environmental challenges–I wish I could! I am simply trying to get to the bottom of the question about what constitutes the healthiest diet for human beings so that people have the information they need to try to improve their health if they can. I don’t think one needs to be super wealthy to afford at least one serving of animal protein per day as part of an omnivorous diet. In fact, some of the most nutritious animal foods are the least expensive–chicken thighs, pork butt, and stew beef are just a few examples.

      • Maria Christiernin

        One pound of meat/fish is a large amount. If one eats inect protein, that is probably a more sustainable diet, but that is not really available yet. Even though this diet works for you, you are presenting it as something that may increase everyones health that is why I point out it will not work if everyone tries to follow it. A lot of people are convinced that their diets is the grand solution for everyone, so far I think the only proof I have ever seen on diets are that Japanese and Mediterranean diets make people live long and yes low carb high fat can reduce weight. Maybe check out the documentary cowspiracy from 2014. Even though I think the filmmaker see everything through his rather vegan lens and his insights into how you can grow crops is nonexisting it´s still quiet an eyeopener with respect to American meat industry.

        • Trudy

          Good points. If the best diet for humans includes animals as food, perhaps the fundamentalists need to stand down so that effective contraception can be disseminated among all humans. Perhaps also corporations need to stand down so that small family farmers can stay on their plots instead of being forced into cities to serve as industrial slave labor. This isn’t rocket science; we are in control of our destiny. Simply demanding to find a way to feed ever-growing numbers to accommodate religious or economic models flies in the face of science and reality.

  • Katrin Mager

    Thanks for your work!

  • AC

    Well, we can guess who paid her to write this article. It’s not based on any “science” at all.

    • Dear AC,

      Nobody paid me to write this article. I have no ties of any kind–financial or otherwise–to any food-related industry.

      • AC

        Regardless of who is or isn’t paying you (& we have only your word), your article here is NOT based on “facts” at all re: vegan diets. Vegan dietary regimens, when executed “correctly” (which includes the proper amount of “good” fats), are associated with longevity, lower cancer rates, less incidence of Alzheimer’s disease, reversal of diabetes/heart disease/hypertension, sustained weight loss/weight maintenance, & certainly no adverse reactions where “brain health” is concerned. As a physician you can easily contact the world “expert” M.D.s in this subject – Dr Joel Fuhrman, Dr Neil Barnard, Dr Michael Klaper, & Dr Ellsworth Wareham (vegan, currently age 103 & fully functional, performed heart surgery until age 95) to substantiate & verify this information. They would be more than happy to confer with you as a professional courtesy, physician-to-physician, & share with you the plethora of research over the last 50+ years indicating the safety & efficacy of a well-executed vegan diet. Your misinformation would then be corrected & not spread to otherwise unsuspected readers.

        • tkent26

          Well-formulated vegan diets are associated with better health outcomes than a standard junk food diet, true. Don’t you think that’s a low bar of comparison? There are multiple confounders in those observational studies, including exercise, smoking, stress management, and social/cultural/religious ties.

          There’s another huge confounder that Dr. Ede has remarked upon several times: every vegan diet that produces health benefits also removes _sugar_ and _refined seed oils_ at the same time as removing meat, fish, and eggs.

          Humans have been omnivores for literally millions of years. A vegan diet is a modern luxury afforded by access to supermarkets with year-round produce, supplements, and soy products. Even then, not everybody will thrive on a vegan diet because it is evolutionarily inappropriate to our species.

          • LoveYouBaby

            The thing about evolution is that it is continually happening and the “odd balls” are usually the ones who are paving the way. Tomorrow is a very different place my friend.

        • Trudy

          I read tkent26’s post below.I agree with it, and would like to add that most of the studies have an additional fallacy–adult vs. birth to death veganism. Children ages birth to puberty thrive best on whole foods with some fish or meat in their diets. Soymilk babies do not thrive as well as breastfed ones, for example, and the need for animal proteins and fats doesn’t stop on a dime the day after weaning. Teens are healthier with some meat or fish than without. Veganism is best tolerated after age 50, but can be managed, if well-planned, after age 20 or so. Each of the studies I’ve reviewed from the websites of the doctors you list (all of them great docs, btw) follow a pattern of rescuing adults who have been consuming a lot of processed food, salt, sugar, extra fat and simple carbs.

  • tkent26

    Without reading all the links, I predict that all of these interventions reduced sugar, reduced refined seed oils, and/or restricted calories.

  • tkent26

    What inflames the endothelium, and how do those LDL particles enter the artery wall and become lodged under the endothelium? Do LDLs exist only to give us heart disease, or do they have some adaptive purposes?

    “No cholesterol in arteries – no atherosclerosis.” I highly doubt this, but also no cholesterol in arteries – death.

    Dayspring is compromised by the pharma industry, and wants to sell you more statins and other cholesterol-lowering drugs.

    • carbnfatncarb

      No one is saying you should have no LDL in your blood. LDLs are necessary for life, but too much promote atherosclerosis. Too much of anything is bad. Too much water will kill you. Even too much oxygen will kill you.

      • tkent26

        Describe the mechanism by which too much LDL _causes_ atherosclerosis. I’ll grant that too much LDL-C is sometimes an _indicator of risk_, although it’s not a very useful or predictive indicator compared to insulin, blood pressure, H1Ac, HDL, TGs, etc.

        But LDL sure is profitable to medicate!

  • Kenning

    Dear Dr Ede,
    Thanks for putting this fascinating and important information out in the public domain. I believe this case study of two people whom I have known well since 1990 must be relevant to these discussions. Please see below.

    E & J have, have for almost forty years, led exemplary lives in terms of health and wellbing. They have eaten only home grown and cooked organic, seasonal fresh fruit and vegetables, baked their own bread, eaten only pastured, organic meats (in small amounts) they kept free-range chickens for good quality eggs, ate only unprocessed European cheeses, locally line-caught-fresh-fish, they consumed minimal sugar, no processed foods at all and only one small glass of wine a day. They have always kept physically active by doing gardening, walking and sailing, have had good levels of sunlight, have slept well and led mainly unstressful lives. Now in their mid seventies, they both look slim, young and healthy, yet – E was diagnosed with adult onset celiac disease and osteopenia two years ago and J has just recently been diagnosed with colon cancer. These diagnoses have been terribly frightening for obvious reasons but also they have shaken our faith in our understanding of what it means to live a healthy life. I would really appreciate any insights you might have in what might have caused their illneses. Is it just fate, bad luck, genes or what? Is there anything at all we do to protect our health?

    Kind regards,


    • Hi Valerie,

      Thank you for sharing the stories of E and J here with us. I’m so sorry to hear that they are confronting these serious health conditions. Of course we can’t definitively say what caused their health issues, but I can say that I hold post-agricultural foods in high suspicion when it comes to all “diseases of modern civilization.” There are certainly plenty of potential causes having nothing to do with diet (environmental toxins, etc), but where diet is concerned, post-agricultural foods, even “whole” foods that are considered by many to be healthy, such as grains and legumes, may play a significant role. This is why I advocate for a pre-agricultural whole foods diet that eliminates these two food groups–what many refer to as a “Paleo” type diet. I differ from many in the Paleo community in that I also advise avoiding dairy, particularly for those with autoimmune, gastrointestinal, or insulin-resistant conditions.

      Under my “FOODS” tab I have a section dedicated to dairy and a section dedicated to grains/beans/nuts/seeds if you are curious to learn more. I have heard and read many stories of people with conditions such as E’s and J’s who have been able to make health improvements by reverting to a more ancient dietary pattern. I don’t know if that would be the case for E or J, but certainly worth a try?

  • lou

    Where are the studies and the proof about all the arguments. For instance, if you look up Dr, Gregor who promotes a whole food plant based diet. He just doesn’t provide opinions like you. He sites countless studies by reputable organizations and institutions with facts and statistics. your article provides no facts just opinions that are suspect. For instance isn’t eating eating fortified food the same as taking vitamins?? I know lots of whole food plant based eaters and they all take vitamins. Additionally, all vegans don’t eat healthy just as all meat eaters don’t as well. I find it reckless to not specify healthy choices and just say eating meat is good for you. Sorry not impressed with the writing. The bottom line is mont people share more in common with nutrition than differences and cholesterol and high fat diets are the major contributor to hear attacks!!!
    The USDA supports vegans!!! REALY!!! they are in the pocket of the dairy and meat industry!! Perhaps someone else is too.


    • Robert Dabob

      Well said Lou. Anybody can make convincing claims but as Dr Gregor points out, the only truly conclusive research are randomized, double blind, placebo controlled ‘human’ studies, to which he provides all the relevant studies, and from which the dietary recommendations are clear.

  • Anne Phelps Hamilton

    Thank you for the very comprehensive article! I decided to eliminate red meat because of the risk of prion disease and I am astonished no one ever mentions this as a concern. The recent studies are very alarming and I have seen sick animals make it through inspection.

    • w1975b

      Wouldn’t it be better to find a farm which you know only produces healthy animals?

  • w1975b

    As someone who has suffered with hypoglycemia since childhood, of course this is anecdotal but, high carbs and low fat do NOT agree with me. If someone eats correctly, they don’t need snacks. Our digestive systems get exhausted by always eating, digestion requires a ton of energy. That’s why some people fast often and see great results.