Shocking! Watch for yourself

[PurpleAlligator]

Not arguing anything. Whether you take it to the extreme of veganism or not, there is a large body of evidence showing that increases in fruit, vegetable and nut consumption correlate with decreases in all cause mortality. You are right, the study is not a cross population prospective or retrospective cohort analysis as Oscar requested, but those types of studies are given a pretty low clinical evidence level by the major clinical evidence hierarchies. There are too many uncontrolled cultural differences that can introduce bias in cross country comparisons. The first paper posted uses data from the nurses health study/ health professionals study. It is one of the best constructed prospective cohort trials ever done. The number of participants is very high, data is collected from participants for the entire time they are in the study (so it can capture changes in diet over time) and it has been running for decades. Because of the in depth followup from periodic questionnaires it can capture not only absolute risk and mortality, but also age of onset and severity of disease. Many studies use only a single starting point (say a 5 day food record) and a single end point (say cardiac death). So you are basically stuck reporting the incidence of disease, when the rate and severity are most useful especially if you are trying to figure out disability adjusted life years which are more relevant than years of life lost.

The second study is a larger more recent systematic review of prospective cohort studies. I couldn't find any systematic reviews of randomized control trials available for diet studies, so that study has the highest clinical evidence level of any I could find on pubmed/medline/embase/cochrane review. So again not a cross country analysis but it it is a very high level of evidence.

The question at the end was to highlight the fact that after 3 pages of discussion there has not been a good source of evidence presented that strongly supports some of the other diets that have been studied (atkins, keto, paleo, assorted low carb). If you want to have an interesting read on the in depth modelling of various calorie density and macronutrient ratios and thier effect on ageing,  mortality,  reproductive health and body composition check out the geometric framework mapping studies coming out of the university of sydney.

Finland and Inuit populations have low fruit/veg intake and poorer health outcomes, but there are so many other factors at play. Hazda tribesmen have been used as an example of a population that has very low plant intake but good cardiac outcomes, but in that study the oldest tribesman recorded was 72. So you would have to argue whether ir not you can compare heart disease between the hazda and western nations when they don't even live to be the age where most westerners would start to develop heart disease.

Expert opinion is relegated to the lowest level of clinical evidence, and you'd probably need to get a shovel and start digging to get low enough to find the rung of the evidence ladder that a shockumentary sits at. Knew I shouldn't have stuck my toe in to test the waters on this one.

Read this book.

https://www.amazon.com/gp/aw/d/B01LYGP469/ref=mp_s_a_1_1?ie=UTF8&qid=1501841018&sr=8-1&pi=AC_SX236_SY340_QL65&keywords=the+china+study

Also it's funny to hear a vegan diet called extreme when it only consists of eating simple fruits, vegetables, nuts, and seeds. A carnivore diet that consists of eating dead animal flesh from factory farmed animals, and pus and blood tainted milk, hormone and antibiotic laden animal  products is not extreme?

Fruitlovers- while I completely agree with you that stress will shorten a persons life and impair their health regardless of diet, I don't get the assumption that vegans are stressed out over diet more than carnivores leading to higher stress levels in vegans that negate any benefits of a vegan diet.

[Mike T]

It is perhaps possible to scan the plant world and find just about every one of the important nutrients that are more abundant in animal products and rare in plants. They might not always be in the same form or as easily accessible to the body but no doubt a vegan diet which is nutritionally excellent without any nutrient deficiencies is possible. With a vast array of foods from all over the world to select from these days it probably has never been easier to be vegan and healthy.It is even possible to be a body builder or athlete but I wonder what the diet is of most champions. It would have been a tough and unhealthy gig even 50 years ago. It is however compensating for missing animal products as our digestive system, metabolism, enzymes and teeth suggest meats, eggs etc have long formed a significant portion of our diets. I am sure a vegan diet is way better than one with lots of junk food or huge amounts of red meat. I am not convinced a vegan diet is better or more healthful than the same diet if a modest addition of a range of animal products were added.
I think there are great ethical reasons for a variety of diet choices and what I have seen in scientific papers or articles seems pretty flimsy. Even finding out what the diets of the longest lived people are isn't easy. That is those proven to have had long lives. 

[Future]

Purslane won't stop growing in the seams between bricks in my driveway.  It is another omega 3 source, the richest non-seed one for plants.

There are too many myths about what vegans can't get.  I have been vegan 20 years and my bloodwork verifies the approach. B12, D3, free and total testosterone, FSH, T3 and T4 hormones, prolactin, insulin, blood sugar, c reactive proven, tumor necrosis alpha, interluekine 6...everything is in the right range to live to 125.  Evidence beats opinions every time.

Anyone here under 44 years old is invited to my 125th....

Invitation accepted
I do not really care to know details of your diet, but I'm wondering if any other not nutritional "hacks" are utilized for such readings?

DL
Can you clarify the question?

[echinopora]

Sucked in!
Extreme -Reaching a high or the highest degree; very great.
So yes, by definition veganism is the upper extreme limit of a plant based diet, conversely carnivory is the lower extreme.

[DurianLover]

Purslane won't stop growing in the seams between bricks in my driveway.  It is another omega 3 source, the richest non-seed one for plants.

There are too many myths about what vegans can't get.  I have been vegan 20 years and my bloodwork verifies the approach. B12, D3, free and total testosterone, FSH, T3 and T4 hormones, prolactin, insulin, blood sugar, c reactive proven, tumor necrosis alpha, interluekine 6...everything is in the right range to live to 125.  Evidence beats opinions every time.

Anyone here under 44 years old is invited to my 125th....

Invitation accepted
I do not really care to know details of your diet, but I'm wondering if any other not nutritional "hacks" are utilized for such readings?

DL
Can you clarify the question?

Well, nutrition is one thing. But there is absorbtion retention, utilisation etc. Certain mitochondrian and bodily functions can be greatly increased using certain techniques. Sauna, ozone, intermitten fasting are just few examples. But if you are doing everything solely through vegan diet, than congrads. You are doing great!

[fruitlovers]

Not arguing anything. Whether you take it to the extreme of veganism or not, there is a large body of evidence showing that increases in fruit, vegetable and nut consumption correlate with decreases in all cause mortality. You are right, the study is not a cross population prospective or retrospective cohort analysis as Oscar requested, but those types of studies are given a pretty low clinical evidence level by the major clinical evidence hierarchies. There are too many uncontrolled cultural differences that can introduce bias in cross country comparisons. The first paper posted uses data from the nurses health study/ health professionals study. It is one of the best constructed prospective cohort trials ever done. The number of participants is very high, data is collected from participants for the entire time they are in the study (so it can capture changes in diet over time) and it has been running for decades. Because of the in depth followup from periodic questionnaires it can capture not only absolute risk and mortality, but also age of onset and severity of disease. Many studies use only a single starting point (say a 5 day food record) and a single end point (say cardiac death). So you are basically stuck reporting the incidence of disease, when the rate and severity are most useful especially if you are trying to figure out disability adjusted life years which are more relevant than years of life lost.

The second study is a larger more recent systematic review of prospective cohort studies. I couldn't find any systematic reviews of randomized control trials available for diet studies, so that study has the highest clinical evidence level of any I could find on pubmed/medline/embase/cochrane review. So again not a cross country analysis but it it is a very high level of evidence.

The question at the end was to highlight the fact that after 3 pages of discussion there has not been a good source of evidence presented that strongly supports some of the other diets that have been studied (atkins, keto, paleo, assorted low carb). If you want to have an interesting read on the in depth modelling of various calorie density and macronutrient ratios and thier effect on ageing,  mortality,  reproductive health and body composition check out the geometric framework mapping studies coming out of the university of sydney.

Finland and Inuit populations have low fruit/veg intake and poorer health outcomes, but there are so many other factors at play. Hazda tribesmen have been used as an example of a population that has very low plant intake but good cardiac outcomes, but in that study the oldest tribesman recorded was 72. So you would have to argue whether ir not you can compare heart disease between the hazda and western nations when they don't even live to be the age where most westerners would start to develop heart disease.

Expert opinion is relegated to the lowest level of clinical evidence, and you'd probably need to get a shovel and start digging to get low enough to find the rung of the evidence ladder that a shockumentary sits at. Knew I shouldn't have stuck my toe in to test the waters on this one.

Read this book.

https://www.amazon.com/gp/aw/d/B01LYGP469/ref=mp_s_a_1_1?ie=UTF8&qid=1501841018&sr=8-1&pi=AC_SX236_SY340_QL65&keywords=the+china+study

Also it's funny to hear a vegan diet called extreme when it only consists of eating simple fruits, vegetables, nuts, and seeds. A carnivore diet that consists of eating dead animal flesh from factory farmed animals, and pus and blood tainted milk, hormone and antibiotic laden animal  products is not extreme?

Fruitlovers- while I completely agree with you that stress will shorten a persons life and impair their health regardless of diet, I don't get the assumption that vegans are stressed out over diet more than carnivores leading to higher stress levels in vegans that negate any benefits of a vegan diet.

I wan't trying to imply that vegans are more stressed. Anybody can feel stress regardless of diet. My point is that it's not only what you eat, but also your state of mind while you eat it. Like i said, diet is important, but it's not the only important thing for good health.

[raimeiken]

This movie have been making the rounds on facebook and everyone seems to be just taking it all as fact without doing much research or questioning any of it for themselves.

This movie is clearly biased and a propaganda film full of BS that isn't science based.

When you do simple search on google about it and the results are full of "debuking...fact checking...etc" articles, you know that the documentary is BS.

https://www.google.com/search?q=what+the+health+documentary


pretty much everyone on the vegan sub-reddit take the documentary as gospel, while people from the "Keto" sub-reddit are the ones questioning and fact checking it.

https://www.reddit.com/r/vegan/search?q=what+the+health&restrict_sr=on&sort=relevance&t=all

https://www.reddit.com/r/keto/search?q=%22what+the+health%22&restrict_sr=on&sort=top&t=month

[Future]

Purslane won't stop growing in the seams between bricks in my driveway.  It is another omega 3 source, the richest non-seed one for plants.

There are too many myths about what vegans can't get.  I have been vegan 20 years and my bloodwork verifies the approach. B12, D3, free and total testosterone, FSH, T3 and T4 hormones, prolactin, insulin, blood sugar, c reactive proven, tumor necrosis alpha, interluekine 6...everything is in the right range to live to 125.  Evidence beats opinions every time.

Anyone here under 44 years old is invited to my 125th....

Invitation accepted
I do not really care to know details of your diet, but I'm wondering if any other not nutritional "hacks" are utilized for such readings?

DL
Can you clarify the question?

Well, nutrition is one thing. But there is absorbtion retention, utilisation etc. Certain mitochondrian and bodily functions can be greatly increased using certain techniques. Sauna, ozone, intermitten fasting are just few examples. But if you are doing everything solely through vegan diet, than congrads. You are doing great!

Ah ok. Yes I do supplement, eat clean, intermittent fast, periodic real fast, HIIT and much more.

[StPeteMango]

Saw the documentary What The Health recently. There's another one worth looking at, "Forks Over Knives."
What led me to the vegan path is the bestseller book "How Not To Die" by Dr. Michael Greger. He runs a nonprofit via the website nutritionfacts.org, backs up his advice for plant-based whole food with scientific studies, and admits when the jury is out on some claims. Much of what's in Dr. Greger's  book is also available in short clips on YouTube and on podcasts.
Other doctors whose work I have been following are Joel Fuhrman, Colin Campbell and Caldwell Esselstyn.
I've been a vegan for 7 months (the preferred description is plant-based whole food), and have never felt better. I'm leaner, more energetic, sleep better, my blood tests show a big improvement in my lipid and other profiles.
Yes, Americans are living longer, but that's more due to modern medicine than any other factor. They're living miserable lives in poor health. The obesity rate is horribly high, and the number of prescription meds Americans take seems to be going up.
I used to eat mostly white meat (chicken and fish). I gave that up in January.
So, no meat, no oils, no eggs, no dairy, no salt and no sugar.
Lot of beans and greens, quinoa, whole gains, home-cooked food. Lots of spices to add flavor to the food, lots of nuts, avocado seeds for the fat. And I exercise 5-6 days a week, between 40-75 minutes a day.
As a vegan, I do need to take a B12 supplement. But that's not just for vegans. Meat-eaters also tend to be low on B12. I have to make sure to add seaweed to my smoothie or salad to ensure I get sufficient iodine since I don't add salt to my food.
I was, and remain, hypothyroid; my doc will decide over the next few months whether the dose can be safely reduced.. At 58, I have no cholesterol or BP issued, no diabetes. My hair's snow white, but it started turning gray when I was in my 20s. It's still there, but I expect it will start thinning as I age.
Life shouldn't just be about living longer, it should also be more fulfilling. Don't tell me people with their guts hanging out have a good quality of life, not when they are panting climbing up a few stairs, can't turn fast on their feet, have to drive short distances because their knees and legs are taking a beating. The number of people getting knee and hip replacements is going up. Why are those joints giving out? Why, despite a big increase in dairy consumption (more as cheese and ice cream than milk) are more people, specially women, getting osteoporosis? Why isn't the calcium in milk protecting them?

[fruitlovers]

Saw the documentary What The Health recently. There's another one worth looking at, "Forks Over Knives."
What led me to the vegan path is the bestseller book "How Not To Die" by Dr. Michael Greger. He runs a nonprofit via the website nutritionfacts.org, backs up his advice for plant-based whole food with scientific studies, and admits when the jury is out on some claims. Much of what's in Dr. Greger's  book is also available in short clips on YouTube and on podcasts.
Other doctors whose work I have been following are Joel Fuhrman, Colin Campbell and Caldwell Esselstyn.
I've been a vegan for 7 months (the preferred description is plant-based whole food), and have never felt better. I'm leaner, more energetic, sleep better, my blood tests show a big improvement in my lipid and other profiles.
Yes, Americans are living longer, but that's more due to modern medicine than any other factor. They're living miserable lives in poor health. The obesity rate is horribly high, and the number of prescription meds Americans take seems to be going up.
I used to eat mostly white meat (chicken and fish). I gave that up in January.
So, no meat, no oils, no eggs, no dairy, no salt and no sugar.
Lot of beans and greens, quinoa, whole gains, home-cooked food. Lots of spices to add flavor to the food, lots of nuts, avocado seeds for the fat. And I exercise 5-6 days a week, between 40-75 minutes a day.
As a vegan, I do need to take a B12 supplement. But that's not just for vegans. Meat-eaters also tend to be low on B12. I have to make sure to add seaweed to my smoothie or salad to ensure I get sufficient iodine since I don't add salt to my food.
I was, and remain, hypothyroid; my doc will decide over the next few months whether the dose can be safely reduced.. At 58, I have no cholesterol or BP issued, no diabetes. My hair's snow white, but it started turning gray when I was in my 20s. It's still there, but I expect it will start thinning as I age.
Life shouldn't just be about living longer, it should also be more fulfilling. Don't tell me people with their guts hanging out have a good quality of life, not when they are panting climbing up a few stairs, can't turn fast on their feet, have to drive short distances because their knees and legs are taking a beating. The number of people getting knee and hip replacements is going up. Why are those joints giving out? Why, despite a big increase in dairy consumption (more as cheese and ice cream than milk) are more people, specially women, getting osteoporosis? Why isn't the calcium in milk protecting them?

"avocado seeds for the fat" You eat the avocado pits? I tried it and found it quite bad tasting. How do you eat them, mixed in other foods? And what type of avocado are the pits from? Maybe some taste better than others, like the mexican (anise scented) types?

[StPeteMango]

Ha! Sorry, NOT avocado seeds. Avocados, and seeds (sesame, sunflower, etc) and nuts (almonds, walnuts, a Brazil nut a day).

[StPeteMango]

There was one thing in "How Not To Die" that I particularly noted: Dr. Michael Greger points out that nutrition, or food as a health option, is rarely taught in med schools. He attended Tufts University because it offered a course, but even that was minimal, he says.
Most doctors are trained to prescribe meds, not to discuss diet. Unless your blood tests show you are at an extreme one way or another, they won't discuss it.
Maybe, as my doc says, patients mostly blow the talk away, or would rather get one more med prescribed than make the hard choices of taking responsibility for their lifestyles.
After seeing my last blood tests, he's adopting more of my diet; we plan to discuss it more at my next appointment!

[fruitlovers]

There was one thing in "How Not To Die" that I particularly noted: Dr. Michael Greger points out that nutrition, or food as a health option, is rarely taught in med schools. He attended Tufts University because it offered a course, but even that was minimal, he says.
Most doctors are trained to prescribe meds, not to discuss diet. Unless your blood tests show you are at an extreme one way or another, they won't discuss it.
Maybe, as my doc says, patients mostly blow the talk away, or would rather get one more med prescribed than make the hard choices of taking responsibility for their lifestyles.
After seeing my last blood tests, he's adopting more of my diet; we plan to discuss it more at my next appointment!

You're absolutely right. Most doctors don't know anything about diets, don't talk about diet, because they are not taught that as part of their training. I researched this topic once and found out that a medical association recommends that doctors have a small number of units (i believe 6) in nutrition before being allowed to graduate. That is a tiny number compared to all the dozens of units they take. But when this association went back to check they found out that 85% of the schools did not meet even these super low standards!