The World Health Organization (WHO) reports that 16.7 million deaths occur worldwide each year due to cardiovascular disease, and more than half of those deaths occur in developing countries where plant-based diets high in legumes and starches are eaten by the vast majority of the people.
Yet “everyone knows” plant-based diets prevent heart disease. Indeed this myth is repeated so often that massive numbers of educated, health-conscious individuals in first world countries are consciously adopting third world style diets in the hope of preventing disease, optimizing health and maximizing longevity. But if the WHO statistics are correct, plant-based diets might not be protective at all. And today’s fashionable experiment in veganism could end very badly indeed.
A study out August 26 in the journal Nutrition makes a strong case against plant-based diets for prevention of heart disease. The title alone — “Vegetarianism produces subclinical malnutrition, hyperhomocysteinemia and atherogenesis” — sounds a significant warning. The article establishes why subjects who eat mostly vegetarian diets develop morbidity and mortality from cardiovascular disease unrelated to vitamin B status and Framingham criteria.
Co-author Kilmer S. McCully, MD, “Father of the Homocysteine Theory of Heart Disease,” is familiar to WAPF members as winner of the Linus Pauling Award, WAPF’s Integrity in Science Award, and author of numerous articles published in peer-reviewed journals as well as the popular books The Homocysteine Revolution and The Heart Revolution. In 2009 Dr. McCully was one of the signers of the Weston A. Price Foundation’s petition to the FDA in which we asked the agency to retract its unwarranted 1999 soy/heart disease health claim. (http://www.westonaprice.org/soy-alert/soy-heart-health-claim)
Dr. McCully teamed up with Yves Ingenbleek, MD, of the University Louis Pasteur in Strasbourg, France, which funded the research. Dr. Ingenbleek is well known for his work on malnutrition, the essential role of sulfur to nitrogen, and sulfur deficiency as a cause of hyperhomocysteinemia.
The study took place in Chad, and involved 24 rural male subjects age 18 to 30, and 15 urban male controls, age 18-29. (Women in this region of Chad could not be studied because of their animistic beliefs and proscriptions against collecting their urine.)
The rural men were apparently healthy, physically active farmers with good lipid profiles. Their staple foods included cassava, sweet potatoes, beans, millet and ground nuts. Cassava leaves, cabbages and carrots provided good levels of carotenes, folates and pyridoxine (B6). The diet is plant-based there because of a shortage of grazing lands and livestock, but subjects occasionally consume some B12-containing foods, mostly poultry and eggs, though very little dairy or meat. Their diet could be described as high carb, high fiber, low in both protein and fat, and low in the sulfur containing amino acids. In brief, the very diet recommended by many of today’s nutritional “experts” for overall good health and heart disease prevention.
The urban controls were likewise healthy and ate a similar diet, but with beef, smoked fish and canned or powdered milk regularly on the menus. Their diet was thus higher in protein, fat and the sulfur-containing amino acids though roughly equivalent in calories.
Dr. McCully’s research over the past 40 years on the pathogenesis of atherosclerosis has shown the role of homocysteine in free radical damage and the protective effect of vitamins B6, B12 and folate. Indeed, many doctors today recommend taking this trio of B vitamins as an inexpensive heart disease “insurance policy.”
In Chad, both groups showed adequate levels of B6 and folate. The B12 levels of the vegetarian group were lower, but the difference was only of “borderline significance.” However, as the researchers point out, ”A previous study undertaken in the same Chadian area in a larger group of 60 rural participants did demonstrate a weak inverse correlation between B12 and homocysteine concentrations in the 20 subjects most severely protein depleted . . . It is therefore likely that the hyperhomocysteinemia status of some of our rural subjects in the present survey might have resulted from combined B12 and protein deficiencies. The correlation of B12 deficiency with hyperhomocysteinemia could well reach statistical significance if a larger groups of subjects were studied.”
Clearly it’s wise for people on plant-based diets to supplement their diets with B12, but protein malnutrition must also be addressed. And the issue is not just getting enough protein to eat, but the right kind. Quality, not just quantity. The bottom line is we must eat protein rich in bioavailable, sulfur-containing amino acids — and that means animal products. (Vegans at this point will surely claim the issue is insufficient protein and trot out soy as the solution. Soy is indeed a complete plant based protein, but notoriously low in methionine. It does contain decent levels of cysteine, but the cysteine is bound up in protease inhibitors, making it largely biounavailable. (For more information, read my book The Whole Soy Story: The Dark Side of America’s Favorite Health Food, endorsed by Dr. McCully, as well as our petition to the FDA noted above.)
So what did Drs. Ingenbleek and McCully find among the study group of protein-deficient people? Higher levels of homocysteine, of course. Also significant alterations in body composition, lean body mass, body mass index and plasma transthyretin levels. In plain English, the near-vegetarian subjects were thinner, with poorer muscle tone and showed subclinical signs of protein malnutrition. (So much for popular ideas of extreme thinness being healthy. )
The plant-based diet of the study group was low in all of the sulfur-containing amino acids. As would be expected, labwork on these men showed lower plasma cysteine and glutathione levels compared to the controls. Methionine levels, however, tested comparably. The explanation for this is “adaptive response.” In brief, mammals trying to function with insufficient sulfur-containing amino acids will do whatever’s necessary to survive. Given the essential role of methionine in metabolic processes, that means deregulating the transsufuration pathway, increasing homocysteine levels, and methylating homocysteine to make methionine.
Ultimately, it all boils down to our need for sulfur. As Stephanie Seneff, PhD, and many others have written in Wise Traditions and on this website, sulfur is vital for disease prevention and maintenance of good health. In terms of heart disease, Drs. Ingenbleek and McCully have shown sulfur deficiency not only leads to high homocysteine levels, but is the likeliest reason some clinical trials using B6, B12 and folate interventions have proved ineffective for the prevention of cardiovascular and cerebrovascular diseases. Over the past few years, headlines from such studies have led to widespread dismissal of Dr. McCully’s “Homocysteine Theory of Heart Disease” and renewed media focus on cholesterol, c-reactive protein and other possible culprits that can be treated by statins and other profitable drugs. In contrast, Drs. McCully and Ingenbleek research suggests we can better prevent heart disease with three inexpensive B vitamins and traditional diets rich in the sulfur-containing amino acids found in animal foods.
In the blaze of publicity surrounding Forks Over Knives and other blasts of vegan propaganda, few people are likely to hear about this study. That’s sad, for it provides an important missing piece in our knowledge of heart disease development, a strong argument against the plant-based fad, and a bright new chapter in what the New York Times has called “The Fall and Rise of Kilmer McCully.”
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Thanks to Sylvia Onusic PhD who was able to access a full text copy of this article to share with me.
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Kaayla, I found the article but you brought it to life- what a great explanation backed by high levels of knowledge and analysis. We are grateful for your numerous contributions to the field of health!
thanks so much.
Sylvia Onusic
Would eating sulfur rich foods like kale and broccoli offset this for vegans? Just a simple question concerning the overall conclusion of the article that the high homocysteine and poor health boiled down to a lack of dietary sulphur…
Much of the articles on vegans not getting Sulphur or B-12 is not truely beneficial in the discussion of vegan vs. meat eaters! B-12 may be attained through many foods, Nutritional yeast provides B-1, B-3, B-6, B9, B-12 and a lot of flavors added to soups and pasta, there are many fruits containing B-12 as well as a variety of other foods, vs people who eat dead animal who receive heart conditions, heart ailments, heart attacks, heart arrythmia, angina as well as any of 88 different forms of cancer, Alzheimer’s which is from bacon, dementia, a host of ailments as well, such as arthritis, rheumatism, I could go on but I think you get the point, people who eat dead animal are essentially doing their best to attack vegans and vegetarians why? I do not know why, however this is a fact vegetarians live an average of 7 years longer than those who eat dead animal, and vegans live 12 years on average longer. I tell those who want to know what to do to get B-12 and Sulphur ask the Internet and find the answer, its there!
When studies, meat eaters who eat healthy meat diets ie grass fed beef, wild game, and eggs….and live otherwise healthy lives live just as long if not longer than vegans.
I think an important subject left out from your discussion is a healthy intestinal flora. Whenever your digestive tract has the proper balance of healthy microbes, they will produce vitamin B12! If you are an educated vegan, and eat the proper sulfur containing compounds (from organic, high mineral cruciferous veggies for example), your gut will produce more than enough B12 for you and and them! Although most people, vegan or not, don’t have the properly aligned flora and require animal products for their dose. If you take into consideration that eating a serving of fermented food such as Kombucha or sauerkraut daily will add not only more healthy probiotics but also a more than adequate dose of B12 to your diet, the need to worry about this deficiency is minimal. It truly comes down to what kind of veganism someone is practicing. There will be massive nutritional differences between a probitoic popping raw foodist and a “pasta-tarian” who eats little fresh produce. Bear in mind that a raw food diet also completely cuts out foreign, animal cholesterol from our diet (which humans can’t process anyway), and this could surely cut down the risk of heart disease. Thank you!
Maxwell LaBonte
Chemical Engineer B.S.
Maxwell,
In regards to finding out if a Vegan ( I am a plant-based eater, but also a pescatarian, as I understand our body’s inability to make those PUFAs), what blood work would be recommended to find out if my body has high or low Homocystein levels? And are there tests to see what our sulfur and iodine levels are as well?
Thank you for this article. I am not a one size fits all type of thinker in terms of nutrition, as I myself battled the idea of “it’s natural then it must be good for me” thinking when it came to RAW foods and Fermented foods or Kombucha. I have a crazy histamine response to certain RAW veggies and night shade ones as well, in addition to fermented foods. For the life of me I was literally hurting myself by eating and drinking things that were claimed to be “good and natural” but for my body they were wreaking havoc on my system and in the end causing my POTS and EDS to flair like CRAZY!!!!!! In the ER ALL THE TIME! I had the best med team at Stanford University and they too could not put their finger on it. I finally educated and researched and realized those certain foods and drinks were not for me. I am also not in the Vegan or plant-based world to put other types of dietary regiments down. I think there is a place for all of them. What might be good for one may not be for another. But they all serve a generally good purpose. However, I do think about my heart and my organs and systems since I have become more Vegan-ish type of eater; as mentioned earlier I maintain a more plant-based diet but also pescatarian.
Best regards
Hello Monique. I am a fellow EDSer and plant based eater. My homocysteine level is high but the amino acid NAC lowers homocysteine levels. Trouble is, FDA is trying to take it off the market. If you go to the website, Biologix Center, under the Ehlers-Danlos section, it talks about how many of us need to have a low-histamine diet and to stay away from fermented foods. It discusses at length, many of us have trouble processing iron and copper, which leads to the failure of many important biochemical reactions.
2019 This is the diet suggested from the World Health Organization
Key facts
A healthy diet helps to protect against malnutrition in all its forms, as well as noncommunicable diseases (NCDs), including such as diabetes, heart disease, stroke and cancer.
Unhealthy diet and lack of physical activity are leading global risks to health.
Healthy dietary practices start early in life – breastfeeding fosters healthy growth and improves cognitive development, and may have longer term health benefits such as reducing the risk of becoming overweight or obese and developing NCDs later in life.
Energy intake (calories) should be in balance with energy expenditure. To avoid unhealthy weight gain, total fat should not exceed 30% of total energy intake (1, 2, 3). Intake of saturated fats should be less than 10% of total energy intake, and intake of trans-fats less than 1% of total energy intake, with a shift in fat consumption away from saturated fats and trans-fats to unsaturated fats (3), and towards the goal of eliminating industrially-produced trans-fats (4, 5, 6).
Limiting intake of free sugars to less than 10% of total energy intake (2, 7) is part of a healthy diet. A further reduction to less than 5% of total energy intake is suggested for additional health benefits (7).
Keeping salt intake to less than 5 g per day (equivalent to sodium intake of less than 2 g per day) helps to prevent hypertension, and reduces the risk of heart disease and stroke in the adult population (8).
WHO Member States have agreed to reduce the global population’s intake of salt by 30% by 2025; they have also agreed to halt the rise in diabetes and obesity in adults and adolescents as well as in childhood overweight by 2025 (9, 10).
Overview
Consuming a healthy diet throughout the life-course helps to prevent malnutrition in all its forms as well as a range of noncommunicable diseases (NCDs) and conditions. However, increased production of processed foods, rapid urbanization and changing lifestyles have led to a shift in dietary patterns. People are now consuming more foods high in energy, fats, free sugars and salt/sodium, and many people do not eat enough fruit, vegetables and other dietary fibre such as whole grains.
The exact make-up of a diversified, balanced and healthy diet will vary depending on individual characteristics (e.g. age, gender, lifestyle and degree of physical activity), cultural context, locally available foods and dietary customs. However, the basic principles of what constitutes a healthy diet remain the same.
For adults
A healthy diet includes the following:
Fruit, vegetables, legumes (e.g. lentils and beans), nuts and whole grains (e.g. unprocessed maize, millet, oats, wheat and brown rice).
At least 400 g (i.e. five portions) of fruit and vegetables per day (2), excluding potatoes, sweet potatoes, cassava and other starchy roots.
Less than 10% of total energy intake from free sugars (2, 6), which is equivalent to 50 g (or about 12 level teaspoons) for a person of healthy body weight consuming about 2000 calories per day, but ideally is less than 5% of total energy intake for additional health benefits (6). Free sugars are all sugars added to foods or drinks by the manufacturer, cook or consumer, as well as sugars naturally present in honey, syrups, fruit juices and fruit juice concentrates.
Less than 30% of total energy intake from fats (1, 2, 3). Unsaturated fats (found in fish, avocado and nuts, and in sunflower, soybean, canola and olive oils) are preferable to saturated fats (found in fatty meat, butter, palm and coconut oil, cream, cheese, ghee and lard) and trans-fats of all kinds, including both industrially-produced trans-fats (found in baked and fried foods, and pre-packaged snacks and foods, such as frozen pizza, pies, cookies, biscuits, wafers, and cooking oils and spreads) and ruminant trans-fats (found in meat and dairy foods from ruminant animals, such as cows, sheep, goats and camels). It is suggested that the intake of saturated fats be reduced to less than 10% of total energy intake and trans-fats to less than 1% of total energy intake (5). In particular, industrially-produced trans-fats are not part of a healthy diet and should be avoided (4, 6).
Less than 5 g of salt (equivalent to about one teaspoon) per day (8). Salt should be iodized.
For infants and young children
In the first 2 years of a child’s life, optimal nutrition fosters healthy growth and improves cognitive development. It also reduces the risk of becoming overweight or obese and developing NCDs later in life.
Advice on a healthy diet for infants and children is similar to that for adults, but the following elements are also important:
Infants should be breastfed exclusively during the first 6 months of life.
Infants should be breastfed continuously until 2 years of age and beyond.
From 6 months of age, breast milk should be complemented with a variety of adequate, safe and nutrient-dense foods. Salt and sugars should not be added to complementary foods.
Practical advice on maintaining a healthy diet
Fruit and vegetables
Eating at least 400 g, or five portions, of fruit and vegetables per day reduces the risk of NCDs (2) and helps to ensure an adequate daily intake of dietary fibre.
Fruit and vegetable intake can be improved by:
always including vegetables in meals;
eating fresh fruit and raw vegetables as snacks;
eating fresh fruit and vegetables that are in season; and
eating a variety of fruit and vegetables.
Fats
Reducing the amount of total fat intake to less than 30% of total energy intake helps to prevent unhealthy weight gain in the adult population (1, 2, 3). Also, the risk of developing NCDs is lowered by:
reducing saturated fats to less than 10% of total energy intake;
reducing trans-fats to less than 1% of total energy intake; and
replacing both saturated fats and trans-fats with unsaturated fats (2, 3) – in particular, with polyunsaturated fats.
Fat intake, especially saturated fat and industrially-produced trans-fat intake, can be reduced by:
steaming or boiling instead of frying when cooking;
replacing butter, lard and ghee with oils rich in polyunsaturated fats, such as soybean, canola (rapeseed), corn, safflower and sunflower oils;
eating reduced-fat dairy foods and lean meats, or trimming visible fat from meat; and
limiting the consumption of baked and fried foods, and pre-packaged snacks and foods (e.g. doughnuts, cakes, pies, cookies, biscuits and wafers) that contain industrially-produced trans-fats.
Salt, sodium and potassium
Most people consume too much sodium through salt (corresponding to consuming an average of 9–12 g of salt per day) and not enough potassium (less than 3.5 g). High sodium intake and insufficient potassium intake contribute to high blood pressure, which in turn increases the risk of heart disease and stroke (8, 11).
Reducing salt intake to the recommended level of less than 5 g per day could prevent 1.7 million deaths each year (12).
People are often unaware of the amount of salt they consume. In many countries, most salt comes from processed foods (e.g. ready meals; processed meats such as bacon, ham and salami; cheese; and salty snacks) or from foods consumed frequently in large amounts (e.g. bread). Salt is also added to foods during cooking (e.g. bouillon, stock cubes, soy sauce and fish sauce) or at the point of consumption (e.g. table salt).
Salt intake can be reduced by:
limiting the amount of salt and high-sodium condiments (e.g. soy sauce, fish sauce and bouillon) when cooking and preparing foods;
not having salt or high-sodium sauces on the table;
limiting the consumption of salty snacks; and
choosing products with lower sodium content.
Some food manufacturers are reformulating recipes to reduce the sodium content of their products, and people should be encouraged to check nutrition labels to see how much sodium is in a product before purchasing or consuming it.
Potassium can mitigate the negative effects of elevated sodium consumption on blood pressure. Intake of potassium can be increased by consuming fresh fruit and vegetables.
Sugars
In both adults and children, the intake of free sugars should be reduced to less than 10% of total energy intake (2, 7). A reduction to less than 5% of total energy intake would provide additional health benefits (7).
Consuming free sugars increases the risk of dental caries (tooth decay). Excess calories from foods and drinks high in free sugars also contribute to unhealthy weight gain, which can lead to overweight and obesity. Recent evidence also shows that free sugars influence blood pressure and serum lipids, and suggests that a reduction in free sugars intake reduces risk factors for cardiovascular diseases (13).
Sugars intake can be reduced by:
limiting the consumption of foods and drinks containing high amounts of sugars, such as sugary snacks, candies and sugar-sweetened beverages (i.e. all types of beverages containing free sugars – these include carbonated or non‐carbonated soft drinks, fruit or vegetable juices and drinks, liquid and powder concentrates, flavoured water, energy and sports drinks, ready‐to‐drink tea, ready‐to‐drink coffee and flavoured milk drinks); and
eating fresh fruit and raw vegetables as snacks instead of sugary snacks.
How to promote healthy diets
Diet evolves over time, being influenced by many social and economic factors that interact in a complex manner to shape individual dietary patterns. These factors include income, food prices (which will affect the availability and affordability of healthy foods), individual preferences and beliefs, cultural traditions, and geographical and environmental aspects (including climate change). Therefore, promoting a healthy food environment – including food systems that promote a diversified, balanced and healthy diet – requires the involvement of multiple sectors and stakeholders, including government, and the public and private sectors.
Governments have a central role in creating a healthy food environment that enables people to adopt and maintain healthy dietary practices. Effective actions by policy-makers to create a healthy food environment include the following:
While I understand that eating a solely plant based diet is not ideal, and I follow an ancestral diet, I often wonder: how much of my diet should be plants? What ratio of plants to animal fats to proteins should I be eating? Is it based on individual preference and how my body feels? Or is there an optimal balance?
Of course it’s ideal! Ideal for your human system, ideal for the planet too. Our Andes toes were mainly eating stuff they gathered not meat. The modern “amaéstrale” diet is not relevant. Nobody in past hunter gather times had they much access to meat. You’re probably eating animal foods 3 times a day. CANCER DIABETES HEART DISEASE CHRONS DESEASE ETC. TERRIBLE DIET. Eat plants, mostly raw fruit and salad. Organic.
This article and the one just before it, Sulfur Deficits in Plant Based Diets, seem to have identical texts? Except for the very last sentence thanking Sylvia.