Top critical review
40 people found this helpful
Not as good a book as it appears at first blush
on April 5, 2015
Denise Minger has a lot to say that’s worth saying, but she doesn’t say it as well or as clearly or fairly as she could or should. If you did not know it already, there is no single diet that is best for all people. Most of the corporate and federally funded research is grossly distorted in its design and interpretation to support pre-existing pro-industry commercial goals. When research results are at odds with these goals they are typically ignored and suppressed. All of the federal food and health regulatory agencies are victims to various degrees – usually severe – of “regulatory capture,” i.e., instead of protecting the public they are routinely staffed and run by professionals with strong economic and professional ties to the industries they are supposed to regulate, and so instead they often promote and protect these industries at the expense of the truth and the public’s health. The less familiar the reader is with the details of such unhappy facts before reading this book, the more important and stunningly revelatory it will seem. For readers familiar with this terrain, Minger’s narrative is too often tedious and overwrought.
Minger conveys the important fact that even well-intentioned system-bucking scientists like Colin Campbell, and many of the whole-food plant-based (WFPB) diet gurus, ignore individual differences that have obvious heredity bases and routinely ignore the deficiencies that their dietary regimens invite (e.g., A, B12, D3, K2, Omega3/6 imbalances). Both Minger and Chris Masterjohn have fruitfully critiqued Campbell’s scientific research online and Campbell has often been pompous and off-point in his responses. As someone who is an almost WFPB vegan, I too find Campbell’s universal prescriptions offensive. This is my second effort to go vegan and after a year on an almost WFPB my total cholesterol dropped from 178 to 126 while the critical Total/HDL dropped from 4.8 to 3.2. A friend who went 100% WFPB for the same period had her cholesterol stuck between 190-200 (but with a very good ratio of 3.0), while another friend has repeatedly felt tired and weak and when she “stuck to it” anyway experienced mild muscle wasting. So perhaps the point about individual differences – and Minger gives some genetic components that explain it – needs to be said again and again.
Still, Minger wastes a lot of space. For example, she cites a study from Great Britain showing that longevity for vegetarians/vegans was no greater than that of the general population. But this result is sloppy and unfair since it includes what WFPB supporters correctly label “junk-food vegans” full of processed sugar and hydrogenated potato chips. More importantly, the vegan physician Michael Greger, M.D., addressed this study – and the then-recent death from heart attack of 63-year-old Jay Dinshah who had been a vegan for 40 years – in a 2003 video watchable on YouTube and pointed out how woefully deficient in B12 and how horribly imbalanced in Omega 3/6 these vegetarians were and how these deficiencies impacted cardiac health. So much of what Minger has to say is not especially new.
But a major difficulty is that that time after time Minger reduces research results to confusing incoherence by imaging a possible counterfactual – another possible interpretation, or offering a counter-example. As someone trained in statistical inference and scientific methodology, I kept thinking that she should instead take the data and re-analyze it, or else look for other good studies that would resolve between competing interpretations. This she repeatedly fails to do – perhaps because as a very smart autodidact she lacks the training to do so, and perhaps because of a bias to reach no conclusions about which diets are generally best so that any diets that are free of refined and processed foods and oils will stand on an equal footing, i.e., WFPB, Paleo, and Mediterranean. To read Minger, one would not know that there is available evidence to choose amongst them.
Minger’s bias is most clear when she discusses the Seventh Day Adventists of Loma Linda, California. These are one of a very small number of “Blue Zones” in the world where centenarians are found to concentrate, and overall health and longevity are remarkably common (male vegetarian SDA’s aged 30 live 9.5 years longer than non-SDA males and SDA females live 6.1 years longer). Their religion urges them to eschew meat, fish, eggs, alcohol, tobacco and coffee. In "The China Study," Campbell notes that even the Adventists who eat meat do so moderately but that “the Adventist vegetarians are much healthier than their meat eating counterparts” with half the rates of obesity and diabetes. (p.150) Dan Buettner in The Blue Zone elaborates this theme. Vegetarian Adventists live about two years longer than their non-vegetarian cohorts, and had half the risk of developing heart disease. (p. 129) Thinking that the saturated fats in meat might be the culprit, the researchers studied nut consumption (with a high unsaturated/saturated fat ratio) and to their surprise found that Adventists who ate a handful of nuts five or more times a week (i.e., whole food vegan-sourced mostly unsaturated fats) lived two years longer than those who ate very few nuts. (p.130) Since nuts are loaded with Omega 6 fatty acids, this pushes the Omega 3/6 ratio in the unhealthy direction, but apparently the natural vegan source and the process by which the body assimilates them has a very different effect than when they are consumed from highly processed commercial vegetable oils. This is darned interesting data, so what does Denise Minger do with it? She tells a catty story about how the religion’s founder, Ellen Gould White, has her face smashed by a rock, went into coma that critics felt left her with a permanent traumatic brain injury and then started having visions “to abstain from all forms of flesh food.” (p.190) But what about the research data you ask? When Minger finally gets around to that she writes:
"Indeed, even within the Adventist population, stark [sic] differences emerge between folks of different meat-eating persuasions. One analysis found that Adventists following a true vegetarian diet consumed less coffee and doughnuts, and more tomatoes, legumes, nuts and fruit than the more liberal meat eaters." (p.194)
This is plain silly: this is not a research finding, but almost a definitional difference between the two groups. And that is all Minger says about the relevant data outlined by Campbell and Buettner showing superior health for vegetarians within the Adventist community – in other words she entirely ignores it, which is hardly intellectually honest, especially after mocking its founder. She might have contacted the Adventists researchers and learned whether the meat-eaters were eating unhealthy cuts of processed bologna, for example, so she could argue for grass-fed buffalo meat as good-for-you, but she did not. The only effort she makes to take account of the data is to argue that meat-eating Mormons live as long as Adventists, and that those who abstain from alcohol, tobacco, tea and coffee have far above average health, but this does nothing to address the data she wishes to dismiss. In fact she underscores that the non-meat-eating Adventist strict vegetarians with better health consumed “more tomatoes, legumes, nuts and fruit than the more liberal meat eaters,” and not junk donuts, which is just the WFPB vegan’s point, isn’t it?
Such biased exposition is commonplace. Being an advocate of fleshy foods that raise blood cholesterol levels, Minger attempts to dismiss the relevance of serum cholesterol to total health by strongly suggesting that the research supports the conclusion that higher levels of serum cholesterol are associated with greater longevity (pp.106-111). A simple web-search of “cholesterol and mortality” finds as the first choice a 1994 article entitled “Low Serum Cholesterol and Mortality, Which Is the Cause and Which Is the Effect?” Minger never considered the question of what caused what in her book, and this article concludes that death from catabolic diseases lowered total cholesterol (TC) prior to death, not that lower TC increased total mortality. Although the association of lower TC with death is genuine for those whose cholesterol fell prior to death, “By contrast, there was no significant increase in all-cause mortality risk among cohort men with stable low TC levels. Nonillness mortality (deaths caused by trauma and suicide) was not related to either TC change or the average of TC levels in exams 1 and 3.” So again as so often Minger is very careless, not skilled enough, or not intellectually honest.
Minger, like Chris Masterjohn, is enamored of the nutritional philosophy of Weston Price: that what matters most is eating (organic) nutrition-dense foods no matter what the type. I too find it appealing, and some of it is self-evident. But when she speaks of Price’s study of healthy primitive societies, there is not a word as to the longevity in these communities; she reports only his observations of their splendid teeth, dental arches, and general good health – at least in those communities that enjoy it; as she notes others are sickly and riddled with parasites. But the fact that human beings over the course of evolution may adapt themselves genetically to a variety of nutrition-rich diets of widely different types says very little about the benefits of a (mostly) WFPB diet vs. anything else for many (not all) of us. Nor does it suggest that a healthy Eskimo could move to the tropics and thrive on their local diet. And for those like my friend who cannot digest even properly complemented vegetable protein and must have fish, we’ve found that she does best when the rest of her diet is as close as possible to a WFPB diet (with idiosyncratic modifications along the way).
The final great disappointment of Minger’s book is her conclusion that each of us must find his or her own path, as though little or nothing has been learned from nutritional research except what to avoid. As someone who has worked hard to do so, I still recommend a WFPB diet – warts and all – as the starting point with the obvious caveats to those with Celiac disease, gluten intolerance or gluten allergies, etc., with all the necessary supplements, and with the liberty to add occasionally some vitamin and mineral-rich animal flesh for its possible benefits. With the arguable exception of the Loma Linda Seventh Day Adventists, there are no vegan centenarian blues zones – but most of the centenarians eat very little meat, do eat primarily nutrient-dense and nutrient-rich WFPB fare, with the right smattering of very nutritious non-vegan exceptions.