What Most People Have Eaten For Most of History
The Common Denominator of Healthy Diets
Welcome to Part 6 (of 7) of our special series about holistic nutrition and some of the research behind the Whole Food Plant Based Diet.
To learn more about the series, check out the Introduction here, where I explain how this project is something very different than yet another polemic for or against veganism.
These posts are much longer and far more complex than what I usually post at The Healthy Jew. You might find them boring – or the most interesting thing you’ve read in months. (To keep things simpler, I’ve taken out the sources from the online post - you can find them in the PDF at the end.)
If this isn’t your cup of tea, we’ll be back soon with concise, practical guides for Jewish wellness and the Land of Israel.
In the meantime, here’s some dried-out giant fennel plants that our Healthy Jew class at Yeshivas Lev HaTorah picked up the other day. When they’re alive they’re slightly toxic for people (and very dangerous for the local Bedouins’ sheep and goats), but now they’re just a cool branch to take home. The second picture is a giant fennel that’s been adorning our living room for the past several years.
Now let’s get to business…
The China Study’s final suggestions are clear and categorical. In the chapter “How to Eat,” we are advised to try eliminating all animal foods from our diets, but not obsessively so. Don’t worry about a bit of chicken fat in soup, but don’t eat chicken wings for dinner.
What’s the summary of evidence? Read this telling passage:
The findings from the China Study indicate that the lower the percentage of animal-based foods that are consumed, the greater the health benefits – even when that percentage declines from 10% to 0% of calories. So it's not unreasonable to assume that the optimum percentage of animal-based products is zero, at least for anyone with a predisposition for a degenerative disease. But this has not been absolutely proven. It is true that most of the health benefits described in this book have been realized at low but non-zero levels of animal-based foods.
What a loaded caveat!
Dr. Campbell is apparently aware of some of the holes in the “plant based” part of his diet. He knows that the clinical studies he discussed didn’t eliminate animal foods completely but merely reduced them, some more and others less. Maybe he’s also disturbed by all the confounding factors we’ve discussed. Perhaps he’s also aware that the China Study, with its observational design and heavily confounded correlations, isn’t much “proof” that all animal foods are poison. Therefore, he can’t claim anything more than “it’s not unreasonable to assume” that at least for people already in danger of disease it’s worth eliminating all animal foods. Even for them, eating less animal foods might get just as far.
So can I retain several weekly servings of meat in my diet? Perhaps more than several servings of fish or eggs? The evidence of The China Study, even according to its author, can’t prove that I shouldn’t.
The book continues to suggest that we ought not purposely include any animal foods, based on psychological reasons such that it’s easier to let go of foods completely than to eat little of them, just like it’s easier to quit smoking than to smoke less.
My guess on that: maybe yes, maybe no. I think that’s a very individualized issue, and wouldn’t make any blanket recommendations. As we’ll see soon, the traditional culinary experience of vast swaths of the human race places animal foods squarely in the center of our diets, albeit in lower quantities than most people consume today. Why can’t someone get used to eating like that?
Essential Nutrients in Animal Foods
When reviewing The China Study’s clinical trials, we observed many times the important difference between reducing and eliminating animal foods. Although Dr. Campbell has no problem with repeatedly assuming from trials suggesting benefits of reduction that elimination would be even better, one of his critics, Chris Masterjohn, believes this “false equation” is his “most egregious error.”
The difference between a diet that is one hundred percent animal products and one that is two percent animal products is merely one of quantity, while the difference between a diet that is two percent animal products and one that is zero percent animal products is one of quality. A diet low in animal products and a diet devoid of animal products are simply two fundamentally different things.
Masterjohn goes on to describe how indigenous civilizations that had no easy access to animal products who would make sure to eat at least a little of them, particularly searching for nutrient-dense varieties like shellfish. There is no evidence of any human civilization that has ever maintained good health without any animal foods in their diet.
Denise Minger echoes this point, adding that promoting the WFPB diet as healthy assumes that we’ve identified all the nutrients that our body needs and know how to find them in plant foods only. We must be confident enough in biochemistry to know that such a diet has no deficiencies that would affect health over the period of decades, even generations. Given Dr. Campbell’s belief that true wholism means recognizing the impossible complexity of biology, a belief with which Minger concurs, we will never be able to achieve that.
This problem isn’t merely theoretical. Nutrition science has found an essential nutrient that is only in animal foods, vitamin B12. Many others, such as iron, zinc, iodine, vitamins A, D and K2, and several essential fatty acids, while possible to obtain while on plant diets, are much less available, leading to much higher risk for nutritional deficiencies. (For these and other reasons Red Pen Reviews gave the WFPB diet only a “moderate” score for healthfulness and a very low one for nutritional adequacy.)
This doesn’t mean that such a diet is certainly unhealthy; it’s possible to obtain these nutrients in other ways, whether from food or supplements. In fact, The China Study itself suggests supplements of vitamins B12 and D.
But this makes me wonder if that is the optimal way the human organism is supposed to live. Was the human race always doomed to need pills to find optimal health? Judging from Dr. Campbell’s deep criticism of the supplement industry, with its highly concentrated doses of isolated chemicals, as the quintessential opposite of true wholism, I’d assume that we were meant to find health from whole foods alone.
The Whole of Human Nutrition
These observations should give us pause, particularly if we’re looking for a wholistic approach to nutrition. Why shouldn’t that include a broad look at how people live, and have lived for millennia, all over the world?
From China to America and everywhere in between, the vast majority of human beings eat at least some animal foods. Even if we accept the shaky evidence of The China Study, we ought to conclude that in the West we are eating too many animal foods, or, more likely, as we’ll discuss soon, not the right kinds in the right way.
Much in the same way as “whole foods” suggests to eat foods in their whole state, I want to look at the “whole” of human culinary experience when deciding which foods to eat and how much of them.
Chris Masterjohn believes this attitude is the very definition of good nutrition, and is sorely lacking in the WFPB diet’s basis:
The best theory of nutrition is the one that is able to accommodate all observations, even those that appear on the surface to conflict with one another. The challenge before us is to reconcile these seemingly disparate pieces of evidence, not to ignore the ones we do not like. The theory that optimal health requires abstinence from animal products cannot even approach the ability to make this reconciliation. Any good theory of nutrition must accommodate the observation that every civilization maintaining superb health has used at least some quantity of animal products, and that many have used animal products in copious amounts.”
Indigenous Cultures
Dr. Campbell’s own approach to nutritional research, added Denise Minger, should focus on observing traditional approaches to eating.
We saw how most of The China Study’s clinician experiences didn’t eliminate just animal foods, but also the processed carbs and commercial oils that join them in the Western diet. Therefore, those trials show nothing about whole animal foods, which might be quite healthy when eaten together with whole plant foods. To learn about the healthfulness of animal foods would require comparing unprocessed plant diets with unprocessed omnivore diets, which hasn’t been done in clinical trials.
But considering The China Study’s propensity to look at observational studies as the optimal “whole” nutritional evidence, we ought to look at the closest thing we have to that: the many observational studies that have been done on indigenous cultures. All of these studies, many on populations that consume prodigious amounts of animal foods but no processed ones, have shown that they don’t suffer from the Western diseases that Dr. Campbell links with animal protein. In the civilizations that eat only whole foods, there isn’t any marked difference in health outcomes between those who eat lots of animals and those who subsist mostly on plants.
Here are some examples:
Australian aborigines eat lots of organ meats, animal fat, and bone marrow, together with vegetables, tubers, seeds and fruits. Yet they show no evidence of heart disease, diabetes, and obesity. But when they adopt a Western lifestyle, they suffer from unusually high rates of diabetes and obesity.
The Kitava of Melanesia eat tubers, fish, coconuts, and fruit. They have virtually no Western diseases.
The Masai in East Africa eat large amounts of meat and milk, but have low blood cholesterol and no evidence of heart disease, just like the plant-eating rural Chinese.
Alaskan Eskimos traditionally ate fish, sea and land mammals with their fats and oils, birds, and wild berries. When observed on this diet, they have all the blood markers of good heart health, but as they shift to Western “store-bought” foods their rates of heart disease rise.
Closer to home, the Seventh-day Adventists, a religious group that eat little or no meat, have been closely studied due to their good health. But they also have other healthy practices such as exercising and abstaining from alcohol, tobacco, and junk foods, and the ones who eat less meat tend to invest more in health in general. Moreover, another health-conscious group that does eat meat, the Mormons, have been shown to live as long as the Adventists.
Considering these examples, which are just a cross-section of the vast annals of human history, an approach to nutrition that “is able to accommodate all observations” must have space for animal foods.
Whole Foods – Plant or Animal Based
Concluding her academic-style critique of The China Study, Denise Minger begins to explore what such a theory might be by incorporating Dr. Campbell’s work with other, no less successful, approaches to nutrition.
The success of the Chinese on plant-based diets does not invalidate the experiences of other populations who evade disease while consuming animal products. Nor does individual success on a vegan program nullify the disease reversal seen by those adhering to specific omnivorous diets.
Rather than studying the dissimilarities between healthy populations, perhaps we should examine their areas of convergence—the shared lack of refined carbohydrates, the absence of refined sweeteners and hydrogenated oils, the emphasis on whole, unprocessed foods close to their natural state, and the consumption of nutritionally dense fare rather than empty calories or ingredients concocted in a lab setting. Modern foods, and the diseases they herald, have usurped the dietary seats once occupied by more wholesome fare. It is this commonality—the thread bonding healthy populations—that may offer the most meaningful insight into human health.
In her fascinating book on nutrition, Death by Food Pyramid, Minger develops this perspective in vivid detail.
Much of her book is devoted to displaying the political machinations behind the USDA’s now-defunct food pyramid. The saga revolves around a decades-long battle between two competing contenders for discovering the chief culprit for America’s heart disease woes. Throughout the second half of the twentieth century, Ancel Keys blamed the cholesterol and saturated fat found in animal foods, while John Yudkin accused sugar. All sorts of studies were conducted, academic papers galore published, and fierce barbs traded. Many valuable insights were discovered, but no final decision was reached by the scientific community. Why has this problem proven more intractable than space travel and wireless communication?
Dr. Campbell would probably say that both are right, as shown in the two halves of his diet. “Whole foods” will save us from Yudkin’s sugar, and “plant based” from Keys’ saturated fat and cholesterol (although he would probably modify Keys to focus on the animal protein itself, not its accompanying lipids).
But considering the evidence showing that animals foods don’t cause harm in a diet free of processed foods, Denise Minger believes that both approaches are incomplete. In her opinion, this controversy bears out recent research which has shown that neither of the suspected nutrients is the villain, but that it’s all about the context of the fat and sugar. Clinical evidence shows and biological plausibility explains that saturated fat can be harmless in a diet without processed foods, but when eaten together with the rest of the modern American diet, it acts on the body in unnatural ways and causes disease. Whatever the biochemical details are, the history of nutritional science seems to suggest that we won’t find health by looking at any single nutrient.
The Common Denominator of Good Diets
Instead of isolated macronutrients, suggests Minger, we should look at what successful ways of eating have in common. Among the zillions of popular diets running around, three general frameworks are the most promising for providing positive long-term health outcome.
The first is our very own WFPB diet, which for all its scientific shortcomings has proven beneficial in a variety of clinical settings. The second is the spectrum of paleo diets, sometime called “ancestral” due to their claim that this is how the first humans ate. These diets promote lots of animals and their fats, from both sea and land, together with vegetables, nuts, seeds, and some fruit. They mostly reject grains and legumes. Finally, the Mediterranean diet has lots of whole grains, fruits, vegetables, legumes, nuts, seeds, and olive oil, together with moderate amounts of dairy, fish, and poultry. This diet isn’t very fond of red meat and eggs.
Just like the WFPB diet, the paleo and Mediterranean diets have reams of research showing positive results, sometimes even spectacularly so – and an equal amount of caveats in the conclusiveness of that research, especially on how these diets are applied today outside of their original settings. It’s very hard to bring conclusive proof that a certain set of eating habits is the primary cause of all our ailments.
But if we can find common themes found in all three approaches, notwithstanding their numerous differences, that can shed much light on what does work in nutrition. We might finally reach a fully wholistic view on nutrition, a view that would bring together all of the time and clinically tested human diets.
Denise Minger believes these three approaches intersect around what they exclude: refined flour and sugar, processed vegetable oils, chemical preservatives and flavors, and “nearly any creation coming in a crinkly tinfoil package, a microwavable tray, or a McDonald’s takeout bag.” In other words, the “whole food” part Dr. Campbell’s WFPB diet.
In summary, an understanding of wholism quite similar to Dr. Campbell’s has brought one his main his critics to embrace all whole foods, plant and animal alike. Ms. Minger even invokes the very same old proverb with the blind men and the elephant that Dr. Campbell used in Whole to describe his theory of nutrition. Both Keys and Yudkin are blind men grasping at different parts of the “elephant,” one at the fat and the other at the sugar. Perhaps Dr. Campbell too is another blind man with his myopic focus on animal protein. In truth, they’re all right and all wrong. They see true parts of the puzzle but fail to view the full picture, the “whole” of a sedentary, stressed-filled life fueled mainly by highly processed foods. “Perhaps the greatest casualty of the diet-heart hypothesis… was its destruction of a once-holistic perspective of food.”
In a word, wholistic nutrition means eating what we call at The Healthy Jew “real foods,” and perhaps a few “almost-real foods,” while staying away from “food-like substances.”
Here’s a PDF version of this post along with all the footnotes:
.jpeg){kind=link}