Viva! USA Guides - The Healthiest Diet of All

Offical Position / Heart Disease / Cholesterol / Saturated Fat / Clogged Arteries / Blood Pressure / Strokes / Cancer / Diabetes / Gallstones / Obesity / Osteoporosis / Anemia / Protein Deficiency / B12 Deficiency / Zinc Deficiency / Eating Disorders / Rickets / Free Radicals / Antioxidants / Folate / Fiber / Dairy / Mother & Babies / Children / Conclusion / References

In the American Dietetic Association’s 1997 Position Paper on Vegetarian Diets, they stated that, "scientific data suggest positive relationships between a vegetarian diet and reduced risk for several chronic degenerative diseases and conditions, including obesity, coronary artery disease, hypertension, diabetes mellitus, and some types of cancer.”

The better health statistics for vegetarians and vegans (a vegan diet consists of no animal products) aren't peripheral - a percentage point advantage here or there - but are quite profound. The usual argument put forward to explain these dramatic improvements in health - often by doctors with little nutritional training or by those with a vested interest in the meat industry - is that veggies are non-drinking, non-smoking, self denying, puritans so no wonder they live longer. And who wants to be like that?

Studies that have controlled for lifestyle variables still show that a vegetarian diet is more healthy than a non-vegetarian diet. It is this solid, reputable science that will be quoted throughout this guide, much of it obtained from some of the world's most authoritative and prestigious health advisory bodies.

Why is diet so important? Well, if you live an average life span of about 72 years, you will plow your way through an astonishing 30 tons of food. It's the fuel that keeps you going and it's the nutrients in food that make you what you are. Your heart beats on them, your muscles, kidneys and liver depend upon them. Food keeps you warm, repairs the bits of damage that inevitably occur and it even helps you think. Food is pretty important stuff- but not just any old food.

If you were to eat the same diet as a lion - mostly meat and no fruit and vegetables - you would die and probably quite quickly. Similarly, a lion would be unable to survive on the average vegetarian diet. The reasons for the difference is that, after millions of years of evolution, all animals have adapted to their different environments. Meat contains no vitamin C so lions have the ability to manufacture (synthesize) it internally. We, on the other hand, are higher apes and have evolved to eat fresh fruit and vegetables, shoots, seeds, nuts and leaves - a diet rich in vitamin C - on a daily basis. Throughout our evolution there was an abundant supply of vitamin C in virtually everything we ate so our bodies have never had to manufacture it.

"But chimps eat meat", is the usual cry. Chimps' eating habits have been closely studied over many years and the amount of meat they eat is minuscule - about the size of half-a-pea a day, mostly made up of insects. Indeed, they eat so little that their hands and nails, teeth and digestive tract are those of a predominately vegan animal. The genetic difference between a chimp and a human is only 1.5%.

Some people claim our teeth are those of a carnivore, which is obvious nonsense and a quick look inside the mouth of a cat or dog will show you why. Our teeth, with their predominantly flat surfaces, are designed to grind and crush tough vegetable matter and are incapable of eating meat unless it's cooked first. And we haven't got the canines of a killer - we'd all look like Dracula if we had! Human teeth are not designed for holding or killing prey and they certainly couldn't bite through the hide of a large animal.

Why does all this matter? Because sensible eating is about distinguishing between healthy and potentially unhealthy foods - for us! Take lions, for instance. No matter how much meat they eat, no matter how fatty it is, their arteries don't clog up. Ours, on the other hand, do and the damage can start as young as two or three years old. The result is high blood pressure and heart attacks later in life. These deadly diseases are at epidemic proportions: For example, according to the American Heart Association (AHA), coronary heart disease is the single leading cause of death in the United States today (1). Moreover, they are almost all diet related - caused by animal products. And some people still claim we're meant to eat meat!

Dr. T. Colin Campbell, of Cornell University, organized a massive piece of dietary research called the China Study - one of the most important ever undertaken. When its findings were published, he said: "We're basically a vegetarian species and should be eating a wide variety of plant foods and minimizing our intake of animal foods. Animal foods are not really helpful and we need to get away from eating them” (2).

The Official Position
The world's most important health advisory bodies are now in complete agreement - a vegetarian diet is one of the healthiest possible. And it seems the fewer animal products it contains, such as milk and cheese, the healthier it is. In other words, the closer it is to being vegan, the healthier it becomes. These are some of the health statements that have been made over the past few years. We will expand on each of the terms used later in the guide.

The British Medical Association (BMA)
The BMA was one of the first to distill the growing volume of research on diet and health in its 1986 report (3). It said:
“Vegetarians have lower rates of obesity, coronary heart disease, high blood pressure, large bowel disorders, cancers and gall stones. Cholesterol levels tend to be lower in vegetarians.”

It went on to say that when meat eaters change to a vegetarian diet it can actually lower their cholesterol levels. It concluded by saying that vegetarians obtain all the minerals they need and that folate levels are higher than meateaters.
The China Study
The initial results of this combined Chinese -U.S. - British study, which began in 1983, were announced in 1989 (4). It was a massive piece of work which looked at the health and eating habits of 6,500 people in real life situations. Its conclusions were accurately summed up a New York Times headline on May 8, 1990: “Huge Study of Diet Indicts Fat and Meat.” In short, it found that the greatest single influence on the growth of degenerative diseases such as coronary heart disease, cancer and diabetes was the amount of animal fat and protein eaten - the more you eat, the greater your risk.
It highlighted some extraordinary dietary differences between affluent and not so affluent societies. Animal protein itself raises the risks of cancer and heart disease.

These are the two biggest killers in the West but there are others, such as diabetes, strokes, obesity and high blood pressure which are associated with the West's affluent lifestyle. They are degenerative diseases and the China study found that they increased alarmingly as people changed from a more simple, predominantly vegetarian or vegan diet, to a Western diet based on meat and dairy products.

The study also found that the West's preoccupation with promoting meat as the main source of iron was wrong. The Chinese diet was predominantly vegetarian and yet adults consumed twice as much iron as an adult in the U.S. The Chinese diet also contained three times more fiber than a U.S. diet but there was no evidence that these high levels interfered with absorption of iron or other essential minerals.

The conclusions were unequivocal - that a plant-based diet is more likely to promote good health and reduce the risk of degenerative diseases.
The World Health Organization
Next came an even more detailed report from the WHO in 1991. It was interpreted by many as a call for the world to go vegetarian - and that's precisely what it was (5). It stated that a diet rich in animal products promotes heart disease, cancer and several other diseases. It confirmed the BMA's and China Study's list of degenerative diseases and added others - osteoporosis, and kidney failure as being related to meat eating.
It said that diets associated with increases in chronic diseases are those rich in sugar, meat and other animal products, saturated fat and dietary cholesterol, and added: “If such trends continue, the end of this century will see cardiovascular (heart) disease and cancer established as major health problems in every country in the world.” And, of course, its predictions have been proved true.

But it went even further and condemned the years of public urgings by governments to eat animal products. It went on to say that in future: “Policies should be geared to the growing of plant foods, including vegetables and fruits, and to limiting the promotion of fat containing products.”

The large quantities of cheap meat, which have adversely affected health, are only available because of intensive, factory farming and the WHO also had plenty to say about that:

“Farming policies which do not rely on intensive animal production systems would reduce the world demand for cereals. Use of land could be reappraised since cereal consumption by the population is much more efficient and cheaper than dedicating large areas to growing feed for meat production and dairying.” That advice has also been ignored.

In fact, as development takes place in previously undeveloped countries there is a shift towards a more affluent diet, the report says. As a consequence, there is a dramatic increase in the incidence of diet related diseases.
The Oxford Study
In early 1995, an interim report was issued by Oxford University scientists working on another huge piece of research, commonly known as the Oxford Study (6). It is ongoing and is examining the diets of 11,000 people over a period of 13 years. The interim report confirmed lower rates of cancer and heart disease among vegetarians but added a new twist - 20% lower premature mortality.
Physicians Committee for Responsible Medicine (PCRM) PCRM is a highly-respected group of 5,000 doctors. It includes William Roberts, editor of the American Journal of Cardiology, as well as the late Benjamin Spock (7). In 1995, PCRM confirmed the lower rates of disease among vegetarians and urged the government to recommend a vegetarian diet to U.S. citizens. Before this, the U.S. Dietary Guidelines had never made any mention of vegetarianism. The following year they did so for the first time, stating:
“...vegetarians enjoy excellent health: Vegetarian diets are consistent with the Dietary Guidelines and can meet Recommended Daily Allowances for nutrients. Protein is not limited in vegetarian diets ...” (8).

The PCRM report reviewed over 100 pieces of published work from across the world and was in no doubt about what we should be eating: “The scientific literature supports the use of vegetables, fruits, legumes (peas, beans, chick peas) and grains as staples. Meats, dairy products and added vegetable oils should be considered optional.” It was another clear and unequivocal statement that humans do not need to eat meat and are healthier for not doing so.
American Dietetic Association
The ADA is probably one of the most respected health bodies in the world and, in its most recent report on vegetarianism, it kicked off with the words: “Studies indicate that vegetarians often have lower morbidity and mortality rates from several chronic diseases than do non vegetarians” (9). It confirmed that vegetarians are less at risk from the major degenerative diseases, including kidney disease and diabetes, and states that a vegetarian diet can arrest coronary artery disease.
The ADA spells out the reason for this by saying that vegetarian diets offer disease protection benefits because of their lower saturated fat, cholesterol and animal protein content and often higher concentrations of folate, antioxidants such as vitamins C and E, carotenoids (vitamin A) and phytochemicals (plant nutrients).

The combined conclusions of this huge volume of research from these different sources is overwhelming. Vegetarian diets are the healthiest possible and the most natural for the human race. So why isn't the fact more widely known? Government silence on the subject speaks volumes about the power and advertising spending of the meat industry and the government cowardice. Politicians are terrified to tackle the vested interests of a huge industry, just as for decades they were terrified to effectively tackle the tobacco industry. You, of course, don't need anyone's permission to change your diet.

Coronary Heart Disease
Heart disease is the leading cause of death in the United States. The numbers associated with it are staggering: Almost one of every two Americans will die from heart disease, and approximately 1.5 million a year suffer heart attacks. An important factor in this epidemic is our consumption of animal products. In a 1990 report, the American Heart Association stated that “The evidence linking elevated serum cholesterol to coronary heart disease is overwhelming (10).” A 1990 study in Lancet
and a 1995 study in Journal of the American Medical Association (JAMA) both showed that a low-fat vegetarian (almost vegan) diet was part of an effective treatment for reversing heart disease. Other diets, including eating low-fat meats, have not been shown to reverse heart disease (11).

The heart is a pump that circulates blood around the body; to stay healthy it needs a generous supply of oxygenated blood, supplied by the coronary arteries. If any of the coronary arteries become blocked and the supply is interrupted, permanent damage to the heart can occur - in fact the affected part can die (myocardial infarction). In the following weeks this dead muscle is replaced by scar tissue which, unlike the rest of the heart, can't contract and the heart becomes less efficient. If the damage is severe enough it can be fatal. Heart attacks can be silent and painless or they can be painful and deadly.

With angina, the artery is narrowed to a degree where it will allow enough blood to the heart when a person is resting but not enough to provide sufficient oxygen for physical activity, which can result in acute pain (12).

How arteries become blocked is explained in the following sections -

Cholesterol, Clogged Arteries
Just about every large-scale study of people and their day-to-day living (epidemiological studies) have found vegetarians to be considerably less at risk of heart disease. The percentage by which the risk drops varies from study to study but many estimate it between 25 and 50% (13, 14, 15). One study in the American Journal of Clinical Nutrition found it to be 60% less, the Oxford study found it to be 25 percent, England’s Imperial Cancer Research Fund puts it at 24% (16).

All the main researchers are in agreement that animal products are the principal cause of degenerative diseases. What is surprising is how quickly the health advantages of a plant-based diet disappear once people start to consume animal products as their national prosperity grows. Heart disease and cancers are nearly as great in newly developing countries as they are in wealthy, developed countries with national incomes three times higher. The country of Mauritius, an island nation in the Indian Ocean, is a good example . In the 1940s, only two% of the population died from heart disease, but by 1980 it had dramatically increased to 45% (WHO).

Despite the astounding nature of these findings and their implication for the health of the nation - and all nations - governments still refuse to act on them with any real enthusiasm.

There are other factors involved in heart disease, so if you wish to avoid one, as well as changing to a predominantly plant-based diet, there are other actions you should take. Cut down or cut out alcohol, begin an exercise program, stop smoking, cut down on salt (sodium) - which essentially means to cut down on processed foods - and increase magnesium intake (found in green vegetables, nuts, whole grains and yeast extract). Exercise is important not just for the workout it gives the heart and lungs but because the lymph system, the body’s self-defense mechanism, works far more efficiently when the pulse rate is raised.

In a statement which should worry everyone in the West, the WHO says that most coronary heart disease happens to people in the medium risk category. So, in the wealthy countries of the world, virtually the whole population can be considered at risk. Such a situation, they say, begs for mass intervention designed to protect the entire population rather than just treating individuals at very high risk. The only way that can be achieved is through diet. But unfortunately, that isn't happening.

Saturated Fat/Cholesterol
Cholesterol is manufactured by the liver and is present in every cell in an animal's body, including human animals. Animal products, including dairy, are the only source of cholesterol and the main source of saturated fat in the average U.S. diet. Plant foods contain none. It is not the body's ability to manufacture cholesterol that creates health problems but the saturated fat and the cholesterol in the food we eat. These raise cholesterol levels in the blood, and this is the primary cause of heart disease. There is no need to include cholesterol in the diet (WHO) and vegetarians have much lower levels than meat eaters (17,18,19,20).

According to the American Heart Association, 99.5 million American adults have total cholesterol levels above recommended levels (21).

Dietary cholesterol is particularly prolific in the fatty parts of animal products - lard, fat on meat, and the range of dairy products. Although it is easy to cut away obvious white fat from meat, there is still a proportion of fat laced with cholesterol marbled throughout the meat. The WHO and many leading heart researchers now believe that the ideal amount of cholesterol in the diet is zero, which can only be achieved on a vegan diet (22,23).

The process through which cholesterol damages arteries is thought to be caused by oxidation - the action of molecules called free radicals. They can be stabilized by other molecules called antioxidants, found largely in fruit and vegetables. Taking vitamin supplements and looking for magic cures to counter high cholesterol levels hasn't worked. According to Dr. Lori Mosca of Michigan University (and many other researchers): “The best scientific evidence we have is that eating a diet rich in fruits and vegetables is protective against heart disease.” (24).

Amazingly, despite the large amount of evidence that a vegetarian diet is the best way to avoid high cholesterol levels and the diseases which go with them, the official advice is not to go vegetarian but to switch to a lower fat diet - avoiding fatty cuts of red meat, favoring white meat and fish and swapping butter for margarine. Research from the U.S. shows this advice to be largely ineffective. Cholesterol levels of people on this 'official' diet tend to drop by only about five% while changing to a vegetarian diet reduces levels to a much greater degree (25,26,27,28).

Clogged Arteries
The official name is atherosclerosis. It can begin in childhood and starts when certain fats stick to the lining of the artery, gradually building up plaque and constricting the flow of blood through the artery. Over time they grow and form what's called plaques by collecting droplets of fatty substances, in particular tiny particles of cholesterol (low density lipoproteins). The more cholesterol in the blood, the faster the plaques grow. As they swell, they protrude into the artery restricting the flow of blood. If a chunk of plaque breaks off it could form a clot in the already narrowed artery causing a heart attack or stroke.

As with all heart-related diseases, vegetarians and vegans tend to suffer less than meat eaters and the more meat you eat, the more likely you are to end up with clogged arteries. It's a very serious condition, but fortunately, recent research shows that an animal-free diet can actually heal some of the damage done to the arteries. A low-fat, vegetarian (almost vegan) diet is part of the only program that has been shown to reverse heart disease and that can actually reverse blockages, resulting in an improved blood flow (29).

If you still doubt that simple fruit and vegetables can have such a dramatic effect, it's worth listening to William C. Roberts, distinguished editor-in-chief of the prestigious American Journal of Cardiology:

“Although human beings eat meat we are not natural carnivores. No matter how much fat carnivores eat they do not develop atherosclerosis. When we kill animals to eat them, they end up by killing us because their flesh, which contains cholesterol and saturated fat, was never intended for human beings who are natural herbivores.” (30).

High Blood Pressure
The scientific term is hypertension and the condition is directly linked to heart disease and clogged arteries and the higher the pressure the greater the risk. One in five U.S. citizens has high blood pressure and, according to the American Heart Association, the condition caused or contributed to the death of about 210,000 people in 1997 (31). Blood pressure is measured both when the heart is actually beating (systolic) and between beats - the resting rate (diastolic) - and hence is always quoted as two figures; e.g. 120:80.

Blood pressure rises as we get older but some people defy this seemingly inevitable development. Good physical activity, not getting overweight, low levels of animal fat in the diet, and limiting the amount of salt eaten all have an effect. But even allowing for all that, the blood pressure of vegetarians does not increase as much as meat eaters - in fact it goes up little with age. It's not surprising, then, that a vegetarian diet can be used to treat high blood pressure (32).

There is an inescapable link with meat, and a Californian study as long ago as 1926 showed this. The blood pressure of vegetarians was raised by 10% simply by feeding them meat - and it happened in only two weeks (33). Other studies have produced similar results and a whole range of studies have shown vegetarians to have considerably lower blood pressure than meat eaters (34,35,36). It is also the finding of the WHO and ADA. Perhaps just as importantly, many studies have found that changing to a vegetarian diet can significantly lower blood pressure (37, 38, 39, 40). A Swedish study found that blood pressure could not only be lowered with low fat vegetarian diets but the distressing symptoms associated with it could be reduced or totally eliminated. At the end of the trial period it was found that most patients had been able to give up their medication: 50% felt 'much better,’ 15% felt 'better' and 30% felt 'completely recovered' (41).

The lower risk to vegetarians is considerable and can be anywhere between 33-50% and evidence shows that it is the totality of the vegetarian diet that works, not any specific ingredient.

Salt also plays an important part in causing high blood pressure. In the U.S. we consume about 4 to 7 grams of salt a day.

There is also strong evidence that a substance called plasma homocysteine increases the risk of high blood pressure and consequently death. Because vegetarian diets tend to be higher in folate, which reduces homocysteine levels, vegetarians may be protected.

Strokes
Constant high blood pressure has the ability to weaken blood vessels, which can eventually rupture and hemorrhage (aneurysm) and this can kill nerve cells in the brain. Similarly, a blood clot (thrombus) or the detached fibrous cap of an arterial plaque (embolism) may cause a blockage in the brain. The outcome can be loss of speech, memory or movement or, frequently, death. The higher the blood pressure the higher the risk of stroke, and pressures at the top of the range can increase that risk tenfold (WHO). All the advantages of a vegetarian diet in reducing blood pressure may apply to reducing the risk of strokes.

Cancer
There are three separate factors which contribute to causing cancer - heredity, environmental pollution and diet. It's difficult to put percentages on them, but diet ranks high and accounts for possibly 30-50% of all cancers. One thing is certain, cancer is very much a Western disease. One half of all cancers in the world afflict just one-fifth of the population - the fifth that lives in the industrialized countries (42).

One set of figures which illustrates this is for colon cancer. People in the U.S. are four times more likely to develop it than Japanese. But when researchers looked at Japanese people who had moved to the U.S., they found that their risk of colon cancer shot up to near that of people in the U.S. The main difference between the two groups was identified as diet - a traditional Japanese diet is low in animal products while a typical U.S. diet is very high in them. Japanese Americans tended to adopt the U.S. style of eating once they moved to our country (43).

One scientific method of looking at diseases such as cancer is to establish how different foods affect them, both good and bad - those foods that may cause the disease (positive) and those that may prevent it (negative). They're called correlation studies.

One of these studies looked at 37 countries
and established a strong positive link between meat and meat protein and intestinal cancer while vegetable protein was negative - it provided protection (44). Another correlation study carried out in Israel followed the growth of the population from 1.17 million to 3.5 million. Over this period, meat consumption increased dramatically by over 400% and cancers doubled (45).

Two other studies, one of breast cancer and one of cancer of the uterus, found similar links between animal protein and fat and cancers. When complex carbohydrates - starchy vegetable foods - were considered, the result was negative (protective) (46, 47). In 1981, a massive study looked at cancer in 41 different countries and found that diets based on beans, maize and, to some degree, rice were good at preventing both breast and colon cancer while meat promoted both (48).

In 1990, the diets of 88,000 women were examined and it became clear that those who eat beef, pork or lamb as a main dish every
day are two-and-a-half times more likely to develop colon cancer than those who eat meat only once a month (49). In 1994 came the Oxford Study (mentioned earlier) and its conclusion that vegetarians have a 40% less chance of dying from cancer than do meat eaters. There are many other studies that show vegetarians are less at risk (50, 51) by between 25 and 50 percent. The ADA and BMA have both found that vegetarians are less likely to develop cancer.

Interestingly, other studies have found that eating increased amounts of fruit and vegetables contributes to vegetarians' better chances but doesn't fully account for it. In other words, there appears to be something in meat which actually causes cancer (52, 53).

The WHO has produced a list of dietary pluses and minuses which affect cancer. Fat, it says, plays a part in breast, colon, prostate and rectum cancer while fruit and vegetables offer protection from lung, colon, bladder, rectum, oral cavity, stomach, cervix and esophagus cancers. On breast cancer it says there is a direct association between the numbers who die and the intake of high quantities of calories and dietary fats such as milk and beef.

In a test carried out in the U.S., researchers investigated the cancer forming compounds (carcinogens) produced in cooking. All foods when heated to cooking temperatures produce these agents but some produce more than others. Researchers compared soy-based burgers, beef burgers and bacon, which were all cooked until well done. The beef burger produced 44 times more carcinogens than the soy burger and the bacon produced 346 times more (54). According to predictions by the American Cancer Society, a third of the 563,000 cancer deaths in 1999 will be nutrition related (55).

Diabetes
Diabetes mellitus is a condition in which the mechanism that allows the body to use sugar for energy no longer functions properly. The outcome is that the body can't control the amount of sugar in the blood. In virtually every developing country in the world, diseases associated with affluence are becoming the new health problem. As processed and fat-rich animal foods are increasingly seen as desirable foods so the diseases develop. And they follow a pattern, according to the WHO. One of the first to show itself is diabetes, followed several decades later by heart disease and gallstones, then cancer, and finally chronic disorders of the gastrointestinal tract.

A major risk factor is obesity and about 80% of non-insulin dependent diabetics are obese. People who are moderately overweight are twice as likely to develop the disease as people of normal weight (WHO).

In a little over a generation, diabetes mellitus has increased six-fold and there are factors at work other than obesity - including heredity. However, heredity wouldn't account for the fact that almost all Sumo wrestlers are diabetics - but their weight and extraordinarily high-fat diet might.

Diabetics can benefit from a high-fiber, vegetarian diet and people who are already eating this kind of diet have a 45% reduced chance of developing the disease. Heavy meat eaters on the other hand - those who eat meat six or more times a week - are nearly four times as likely to develop diabetes (56). The ADA states that diabetes is much less likely to be a cause of death in vegetarians than it is in meat eaters and puts it down to vegetarians' higher intake of complex carbohydrates (starchy foods) and the fact that they tend to be lighter. Again, the science consistently shows that diabetes is up to 90% higher in meat-eating men and 40% higher in women. Even allowing for the fact that vegetarians tend to be lighter than meat eaters, they still face less risk (57, 58, 59).

Diabetes usually begins in middle age and strongly increases the risk of developing coronary heart disease, kidney failure, eye and neurological (nerve) damage (WHO). More good news for vegetarians is that plant-based diets often eliminates or reduces a diabetic's need to take medication and reduces the chance of developing both nerve and eye (retina) damage (60, 61, 62, 63, 64). According to the AHA, in 1997 diabetes killed 62,636 people in the U.S (65).

Gallstones
Gallstones are formed when bile becomes saturated with cholesterol - they are, in fact, composed of cholesterol crystals. They can go undetected for years but can also lead to serious conditions - infection, inflammation, colic, peritonitis and even gangrene. They are much more common in women than in men. The WHO states that the condition affects meat eaters considerably more than it does vegetarians. A study of 800 women established that meat eaters are two-and-a-half to four times more likely to have gallstones than vegetarians (66).

Obesity
It isn't just a question of being overweight; obesity is linked with many diseases, according to the WHO. It is, in fact, the same string of degenerative conditions associated with meat eating. Obese women face an increased risk of cancers of the gallbladder, breast and uterus, and in men, the cancer risk increases in the prostate and kidneys. Most worrying of all is when fat is deposited around the abdomen.

Obesity is much less common among vegetarians than it is among meat eaters (67, 68). In fact, vegetarians tend to be approximately 10% leaner (69, 70, 71, 72, 73, 74, 75) and most overweight people shed pounds when they change to a veggie diet (76, 77). According to the Department of Agriculture, one-third of adults and one-fifth of adolescents in the U.S. are overweight, and the rate has increased across all race and sex groups since the
1970s (78).

Osteoporosis
All kinds of names have been given to this condition, including widow stoop and brittle bones. It is, in fact, the loss of bone mass - essentially calcium - leading to more fragile bones. It is a very serious disease and accounts for more deaths - mostly from fractured hips - than cancers of the cervix, breast and uterus combined (79).

The advice that you must drink milk in order to prevent osteoporosis has more to do with marketing than good dietary advice, because preventing osteoporosis isn't that simple and some studies have shown eating dairy products did not protect against osteoporosis in women (80). Acid-forming foods cause the body to excrete calcium, while alkaline-forming foods allow the body to conserve calcium. Fruits and vegetables are the foods which are significantly alkaline-forming. A diet containing large amounts of fruits and vegetables should significantly decrease urinary calcium excretion (81).

The ideal scenario for improving bone mineral density is to have a good intake of calcium in the diet paired with a minimal excretion rate. On the intake side, kale, broccoli and collards are excellent sources of calcium, and the calcium is absorbed at about the same rate as from milk (82, 83, 84, 85). Legumes, figs, and fortified foods are also good sources of calcium. Fruits, vegetables, and fruit juices are good for bones because they are the most alkaline-forming of all foods. Of course, these plant foods sources also provide other important minerals, antioxidants and complex carbohydrates.

Unfortunately, most medical advice concentrates only on the intake side of the equation and ignores the reasons for calcium loss. These include salt, caffeine, tobacco, lack of exercise, and possibly alcohol and animal protein. Dr. Colin Campbell, of the China Study, says: “Osteoporosis tends to occur in countries where calcium intake is highest and most of it comes from protein-rich dairy foods” (86). However, sufficient calcium can be obtained from plant foods (87).

A recent study showed that a trace element called boron plays an important part in helping to prevent calcium loss. When a group of menopausal women included it in their diet, calcium losses were cut by 40% (88). The natural sources of boron are not dairy products but apples, pears, grapes, nuts, leafy vegetables and legumes.

Vegans just like everyone else, need to make sure that they get an adequate amount of calcium in their diet and engage in weight bearing exercises to keep their bones healthy.

Iron Deficiency Anemia
The myth that you can only get iron from meat has been so prevalent that the public unquestionably believes that you need to it to obtain iron. So successful have they been that it has almost entered the public's consciousness that to avoid iron deficiency you must eat meat. It's simply not true. Vegetarian diets which include vegetables, legumes, fruits and grains provide all the iron necessary (89, 90, 91, 92,
93, 94).

Iron deficiency is, however, the biggest nutritional problem facing the world and the WHO estimates that 750 million people have it - most of them women and most of child-bearing age. The cause is therefore fairly obvious - blood loss and not just diet (95). The proportion of Western women who experience it is around 20% - and it occurs with the same frequency in meat eaters and vegetarians!

All the main health bodies - ADA, BMA, WHO, PCRM - agree that vegetarians are no more likely to suffer deficiency than meat eaters. However, that doesn't alter the fact that it is a problem for many women, and all should ensure they have good sources of iron in their diet, particularly during and shortly after their periods.

A criticism sometimes leveled at vegetarian diets is that plant-based iron (non-heme) is poorly absorbed by the body. It may be more slowly absorbed, but studies show that vegetarians have high intakes of iron and their hemoglobin levels are normal (96). Plant foods rich in vitamin C help absorption and vegetarians tend to eat more of these vital fresh fruit and vegetables. Iron intakes are particularly high in vegetarians and vegans whose staple food is wholemeal bread (97), so this is another reason for sticking to whole products rather than eating processed, mass-produced foods.

So misguided have been the concerns over iron deficiency that they have diverted public attention away from the problems of iron overload, more common and possibly more dangerous (98). If you have too much iron in your diet, the body has no way of getting rid of it. The only control over it is how slowly or quickly it is absorbed from the intestines into the blood (99, 100). Heme iron (from meat) is absorbed quickly and easily, whether the body needs it or not. This encourages iron overload. Non-heme iron (from plants) is absorbed more slowly (101) and as a result, vegetarians' stores of iron tend to be lower than meat eaters. Meat-based (heme) iron has been linked with heart disease (102, 103) and high iron stores have been linked with cancer (104, 105, 106) and poor responses to infection (107, 108).

Protein Deficiency
This is not a problem for vegetarians. If you eat a variety of foods and enough calories you will automatically obtain enough protein.

You occasionally still see references saying that meat is a complete protein and that plant protein is incomplete. What it means is that meat contains all the necessary amino acids that make up protein, while a vegetarian diet obtains its amino acids from a variety of plant sources. Vegetarians obtain more than enough of all the amino acids and all the world's health bodies agree on this - it is not necessary to eat specific combinations of foods at the same meal (109).

The real problem is not too little protein but too much, particularly for meat eaters. Animal protein is associated with many of the degenerative diseases while vegetable protein isn't. Meat protein is also believed to play an important part in causing osteoporosis and kidney disease, according to the WHO.

Vitamin B12 Deficiency
This is a very important vitamin - made by bacteria - essential for the development of blood cells and for nerve function. A lack of it can lead to collapse of the nervous system and eventually death. However, the liver can store it for years and only minute traces are needed - two micrograms per day. Vegans should be sure to get a daily supply from fortified foods such as soy milk, mock soy meats (TVP), and breakfast cereals.

B12 – producing bacteria live mainly in the colon, past the point where it can be absorbed (110). However, some may possibly be absorbed and this may be why the incidences of B12 deficiency among vegans who do not supplement with B12 is somewhat rare (111).

Zinc Deficiency
Vegetarian diets provide enough zinc even though plants tend to contain less than meat (112). Partly it's because people on plant-based diets lose less zinc in their urine. (113, 114). Slightly lower levels of zinc in the blood have been identified in vegetarians and vegans and may be due to lower absorption, caused by their higher intake of fiber (115) - but it is unlikely that this has any medical significance. Studies have consistently failed to show that they are any less healthy because of it. According to the ADA, zinc levels in hair, blood and saliva of vegetarians and vegans are all within the normal range. There is strong evidence that people with low zinc intake simply adapt to the situation (116). Zinc can be obtained from rice, corn, oats, peas, potatoes, spinach.

When researchers talk about ‘normal’ levels, it’s important to remember that this is an average range in a meat-eating society. In fact it may well be the vegans who have a normal level and meat eaters whose levels are too high.

Eating Disorders
Because a vegetarian diet excludes common foods, it can be used as an excuse to avoid eating by some people suffering from anorexia nervosa. However, there is no link between becoming a vegetarian and subsequently developing anorexia nervosa as a result. The ADA has looked for such a link and has found none. Research from the U.S. and Australia shows that prior to the onset of anorexia the number of patients claiming to be vegetarian is no more than the national average.

Rickets
A disease in children where softening of the bones is caused by a deficiency of vitamin D. This is not a problem in vegans as long as the child gets plenty of sunlight and/or vitamin D fortified foods and soymilks, or in supplements. (118). Humans make vitamin D from the action of sunlight on the skin. It has been calculated that exposure of hands and face to sunlight for 10 to 15 minutes a day is enough to prevent rickets for light skinned people and people living in cloudy climates and dark-skinned people need up to six times this amount of sun (119). Extra amounts are stored over the winter.

Saturated Fats
More accurately, these are saturated fatty acids and their main source is animal products! They have a direct and major impact on blood cholesterol and therefore promote heart disease. Saturated fats have also been linked with cancers of the colon and breast, according to the WHO, which states that they are not needed in the diet.

Free Radicals
They weren't discovered until the early 1980's. They're thought to play a part in causing some 60 diseases and are capable of wreaking havoc on healthy cells. Free radicals are unstable molecules, a product of oxidation and, in a sense, the rust of the body. In stable molecules, electrons normally associate in pairs, providing a balance. Everyday functions such as simply breathing, digesting food or moving about can remove one electron from a molecule, creating a free radical. This now unstable molecule tries to regain an electron by snatching one from another molecule. When it succeeds, another free radical is created and a chain reaction is set up in which the DNA, the body's vital genetic information, may be damaged.

Then the damaged DNA can produce cancer or other disease causing cells. The Solgar Nutritional Research Center puts it this way: “Imagine if someone scrambled all the area codes in your telephone book; all your calls would result in wrong numbers. In the same fashion, jumbled genetic codes in your cells make you vulnerable to any one of the 60 different serious physical illnesses” (120).

As well as bodily functions, cigarette smoke, pollution, ultraviolet light and stress can create free radicals; but so can cooking - in particular meat. Researchers in the U.S. cooked beef burgers, bacon and soy-based burgers and found that both the beef burgers and bacon produced significant amounts of the most damaging free radicals while the soy burger produced none (121). The remedy for free radicals are molecules called antioxidants.

Antioxidants
All the world's health advisory bodies agree that antioxidants are part of the body’s vital self-protection mechanism, which actually defend you against 60 or more diseases, including the big killers of heart disease and cancer. They were almost unknown until somewhat recently and knowledge is still growing.

The three big saviors are vitamins - the beta carotene form of vitamin A, vitamin C, and vitamin E. None of them are in meat but the number of different plant foods which contain them is enormous. A recent discovery by Glasgow University, in Scotland, added another powerful antioxidant to the list - flavonol. It also is not in meat but predominantly in fruits and vegetables.

Folate
The importance of folate in the diet is beginning to be appreciated, particularly by pregnant women. Lack of folate has been linked with serious birth defects but it is also associated with increased levels of cancer and heart disease. Folate also has an essential role in the formation of DNA and in manufacturing blood cells and it contributes to the formation of heme - the iron-binding portion of hemoglobin. It's pretty important stuff!

The major sources of folate are all plant based and so most vegetarians have considerably higher intakes than meat eaters (122, 123). In fact, some studies show that only vegetarians and vegans achieve the recommended intake of this vitamin (124). A recent discovery links lack of folate with heart disease. Most people suffering a heart attack (myocardial infarction) have normal cholesterol levels - so what's helping to cause the disease if cholesterol isn't the sole culprit? Inadequate folic acid intake, it seems, allows a substance called homocysteine to prosper and contribute to carotid artery thickening. Some 40% of the population is not consuming enough folate to keep homocysteine levels low and this may well account for a fair proportion of heart disease (125).

Increased levels of homocysteine in the blood raises the risk of heart disease to levels equivalent to smoking and increases the risk associated with high blood pressure (126). Again, vegetarians come out well on top.

Fiber
Fiber is the substance that makes up the cell walls of plants and passes through the body without being digested. It provides the bulk that ensures food is processed quickly through the bowels and because of the nature of their diet, vegetarians have a higher fiber intake than meat eaters.

The fact that fiber speeds waste products through the body it reduces the time that 'noxious agents' - possibly cancer forming agents - spend in the intestines. It also affects the rate at which glucose (sugar) is released and absorbed and so helps reduce the chance of diabetes. Fiber also reduces the urge to eat and so it helps with appetite control - according to the WHO. Not surprisingly, diets high in fiber give a lower risk of heart disease and cancer.

Dairy
Milk is largely made up of animal fats, animal protein, and lactose - none of which is required by the body. Difficulty in digesting lactose is extremely common throughout the World, and in Africa it can range between 65-100% of the population; in Latin Americans it ranges between 45-94% - and is even higher among Asians. Most people can tolerate small quantities but research is being undertaken into its possible connection with ovarian problems and cataracts (127, 128).

Often the inability to digest lactose goes unnoticed, particularly in children, but can lead to iron deficiency because of the intestinal bleeding it can produce.

In an article published in Good Medicine, the late Dr. Benjamin Spock wrote, “Dairy products contribute to a surprising number of health problems. They can impair a child’s ability to absorb iron and in very small children can even cause subtle blood loss from the digestive tract. Cow’s milk proteins are a common cause of colic, and now the American Academy of Pediatrics has concluded that there is evidence that cow’s milk may well contribute to childhood-onset-diabetes (129).”

It’s worth remembering that there are about 5,000 species of mammals in the world and only humans consume milk after weaning - and that of another species, one whose offspring grow four times faster than children.

Mothers and Babies
Viva! is continually receiving reports of poor medical advice in pregnancy, particularly from general practitioners (GP) - although fortunately they are getting less frequent. Often women are told they should eat some meat during their pregnancy. This poor advice possibly reflects the fact that most GPs receive almost no nutritional education throughout the whole of their training nor subsequently.

In fact, dietary choices are linked to 70% of all diseases affecting people in the U.S., yet only 30 of the 125 U.S. medical schools require doctors to take a nutrition course. In four years of school, the average physician gets only 2.5 hours of nutritional training (130).

Vegetarian and vegan diets can easily meet the nutrient needs of pregnancy (131). In fact, vegetarian mothers have a much lower incidence of pre-eclampsia, a serious convulsive disorder that occurs near the end of pregnancy, and cesarean section than meat eaters; and, they have reduced levels of contaminants in their breast milk (132, 133). One of the most worrying of these contaminants is the residue from pesticides.

The ADA states that vegetarian diets are suitable for every stage of the life cycle, including pregnancy and lactation.

There is currently some concern that there may be a link between the proteins in cows milk and other dairy products and diabetes in the fetus and newborn baby.

All pregnant women and mothers, particularly vegan, should carefully watch their intake of iron and vitamin B12, increasing their intake of foods which contain them. Although incidents of vitamin B12 deficiency are rare, when they are seen it is mostly in babies. It is therefore vital for vegan mothers to eat a good supply of fortified foods, and if they don't like those, to take B12 supplements.

Children
Something deeply depressing is happening to the diet of our children. For many, fresh fruit and vegetables are completely alien, fiber is almost unknown, and the consumption of denatured processed foods is a daily event. We are deep into the burger, chips, and sweets culture and obesity is booming. Effectively, children's consumption of sugar and fat - much of it animal fat - is out of control.

These diets are far worse than those their parents ate, and so the prognosis for future cases of cancer and heart disease, already at epidemic proportions, is worrying. The first signs of atherosclerosis have been identified in children - babies - as young as three years old.

In this context, the doom-laden warnings that some journalists give to teenagers about the risks of a vegetarian diet are nothing short of laughable. Many, if not most, young people eat an extremely poor diet. Of course, anyone can eat a poor diet, including vegetarian children, but the science shows that giving up meat and animal fats is one of the healthiest moves anyone can make, regardless of their age.

Vegetarian children grow and develop in exactly the way they should (134, 135) and developmental tests show their mental age to be over a year in advance of their chronological age (136). There is also evidence that they enter puberty later, which has shown to reduce their risk of developing breast cancer later in life (137, 138).

Studies done in the 1940s, shortly after the war when little meat and dairy was available, showed that children grow and develop quite normally on a diet consisting of plenty of bread and vegetables with minimal amounts of milk and meat (139). In fact, a whole string of studies have shown that vegetarian and vegan children develop normally (140).

The BMA states that vegetarian diets contains all the necessary nutrients and are suitable for infants. The ADA agrees that infants, children, and adolescents all grow and develop normally and that vegetarian diets are 'healthful' and satisfy all their nutritional needs.

Conclusions

Virtually the whole of the West's public education on diet has encouraged people to consume increasing amounts of animal-based nutrients. We're now finding that there is not just a minimum nutrient intake for good health but a maximum. Most of these policies were formulated in the 1940s and are all about preventing deficiency diseases. There was little knowledge of the damage that could be caused by too many nutrients and so these policies are completely out of touch with modern knowledge and modern living. They're not designed to protect people from the over-consumption of meat, dairy, sugar and fat.
Most affluent countries now show a high risk profile for some of the world's biggest killers and intervention on a mass scale is needed to change dietary patterns and make them healthier, says the WHO.

So what does the WHO believe we should be eating? Fat should be reduced to 15% of total energy instead of the nearly 40% it is at present - most of it animal fat. There doesn’t need to be animal fats in the diet at all as they are not essential nutrients. Neither do we need cholesterol.

The bulk of our diet should be complex carbohydrates, starchy foods - potatoes, bread, pasta, rice, yams, etc. They should account for between 50 and 70% of all calories. Protein should provide between 10-15% but can readily be met by a varied diet based predominantly on cereals and legumes.

The key component of a healthy diet is, therefore, complex carbohydrates - with as wide a range of fresh fruit, vegetables, grains, legumes, seeds and nuts as possible - in other words, a sensible vegetarian/vegan diet. There is a wealth of evidence, according to the WHO, that foods rich in starch are really good for health and give protection against several diseases. They improve the chemistry of the digestive system and are a rich source of many minerals and vitamins, including essential fatty acids, calcium, zinc, iron, and water-soluble vitamins - all known to have a clear and positive effect on health.

That is a pretty astounding statement from the world's leading health advisory body and a clear call to the entire globe to go veggie. It dismisses those who are constantly harping on about vegetarians having a 'restricted' diet. In fact, vegans and vegetarians often have a wide variety of plant foods and their diets tend to contain many choices.

There is little doubt that the WHO's report is quite profound. It calls for a complete revision in agricultural policy to promote fruit and vegetables instead of meat and to grow cereals instead of producing meat and dairy. It goes on to say that its proposed nutritional objectives will have immense implications for the economics of farming, for government, industrial and social policies and for international trade, and can thus be expected to meet with considerable opposition. How right they are.
By going vegan, you can take control of your own health and in the process you will help to bring an end the horrors of factory farming, help diminish the onslaught that is destroying the world's oceans. You will begin to offer hope to the world's starving, and you will help the environment to recover. It is one of the most important actions you can take in a world that is in frighteningly rapid decline, much of it caused by livestock production, fishing, and fish farming.

Today, physicians understand the vital links between nutrition and health better than ever before. We can put this powerful knowledge to work in our lives with food choices that keep us healthy, active and vibrant. What many of us have become accustomed to eating for breakfast, lunch and dinner - high-fat, high-cholesterol, ‘convenience foods’- has taken a serious toll in the form of obesity, heart disease, diabetes, stroke, and certain cancers. There is nothing convenient or easy about living with these difficult conditions. But it is never too late to put nutrition to work.

At last, many health care providers and their patients are taking a closer look why this has occurred at a time when medical wisdom seems so profound. It appears that we’ve simply abandoned many basic and simple truths in favor of ‘quick fixes’—that is, prescription drug therapies, even heart surgeries, and the like, which have proved to be neither ‘quick’ nor total ‘fixes’. We’ve simply forgotten the phenomenal power that wholesome foods can provide.

The healing nutrients found in a variety of vegetables, whole grains, fruits and legumes are the best dose of preventive medicine we can find. The world’s leading health organizations agree. For nearly a decade, the World Health Organization has said that a diet rich in sugar, meat, and other animal products will cause heart disease and cancer to continue as the world’s major health problems. It has also urged the government to bolster its plant food industries, including vegetables and fruits and to limit those known to contribute to chronic disease - the meat, dairy, and egg industries.

Amongst the deluge of ad campaigns promoting terribly unhealthy foods, the challenge lies in educating consumers with valuable information. The Healthiest Diet of All is a wonderful resource that does precisely that. Supported by scientific studies and a pleasure to read, it explains how a plant-based diet can decrease the risk for many chronic illnesses, encourage weight loss, promote longevity and provide the perfect balance of nutrients.

My advice to anyone seeking to gain the most benefit possible from foods is to throw away the animal products and embrace vegetarian meals—not in small steps, but entirely. Immediate changes may be apparent; long-term changes will be significant. My work as a physician and that of my colleagues, would be easier if all of our patients embraced healthy eating habits. The Healthiest Diet of All will help you on your way.

Neal D. Barnard, M.D. President Physicians Committee for Responsible Medicine Washington, D.C.

Neal Barnard, M.D., is president of the Physicians Committee for Responsible Medicine and serves on the faculty of George Washington School of Medicine. He is a popular speaker and the author of Foods That Fight Pain; Eat Right, Live Longer; Food for Life; and other books on preventive medicine.