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#16 – The Game Changers Movie Review: Should We All be Vegan?

Your favorite celebrity has gone Vegan, but should you? The answer is a resounding yes according to James Wilkes, a former UFC fighter who went plant based after suffering an injury in the Octagon. James tells his story of recovery using a strict plant based diet in the new documentary The Game Changers. Many of us have seen What the Health and Forks Over Knives, plant based documentaries that highlight the short term benefits of a Vegan diet for advanced stage chronic illness. The Game Changers adds a new wrinkle to the Vegan documentary game by focusing on athletes. Featuring big names like Arnold Schwarzenegger and members of the Tennessee Titans, The Game Changers has a simple message: go Vegan for optimal performance in the gym (as well as the bedroom). But is The Game Changers, and it’s message of “Veganism for all” based in sound science? We brought back Dr. Aaron Gardner to break down the scientific claims made by the filmmakers as well as the pros and cons of Vegan diets in general.

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This Episode Covers:

  • Breaking down the epidemiology behind The Game Changers [5:00];
  • Industry funded studies – an example [14:00];
  • Nate Diaz isn’t Vegan [20:00];
  • Vitamin B12, nutrient deficiency and Veganism [22:00];
  • The limits of nutrition science [32:00];
  • The China Study and meat consumption [36:00];
  • Plant vs. animal protein [42:00];
  • Endotoxins, TMAO, heterocyclic amines, heme iron, NEU5GC [56:00];

Transcript

John: I see these low carb high fat, like, for example, a carnivore diet, the danger of excess, whereas I see with vegan diets, the danger of deficiency. I think you’re going to put way too much protein through on your system, it’s going to have a burden on your kidneys, it’s going to have a burden on your liver. For a lot of people, it’s going to have a burden on their heart. And then with vegan diets, there’s like the vegan trap you get into you on the vegan diet for the first three, four or five weeks, or even the first four or five, six months and you feel amazing. And then you get to a point where month seven, month eight, or even year eight, and you have major problems.

Welcome to “The GeneFood Podcast.” I’m your host, John O’Connor. Hey, everyone. Today we are talking about “The Game Changers” movie, the new vegan documentary about James Cameron. It tells you that if you want to be a highest performing athlete you can be, you need to eat nothing but plants all the time, plants, plants, plants. It’s vegan protein powders, soy, all that, it’s all good for you. It’s the newest in a long line of vegan films like “Forks Over Knives” and “What the Health.” And today Dr. Aaron Gardner, who’s the head geneticist, helps us in the research at GeneFood. And we, basically, just dive into the pros and cons of the movie, what the movie got right, what the movie got wrong. Some of the studies that they cite.

We talk about a lot of the different features of the movie, also just vegan diets in general. So what we’re trying to do here is give a nuanced perspective on the movie. A lot of these review shows are going to say, “That movie is 100% garbage. Nothing good there to see. Move on. It’s complete crap.” That’s not our take. We think that there’s some good there with “The Game Changers.” But there are some pieces that are misleading that we want to shed a little bit of nuance and a little bit of light on. So without further ado, here is Dr. Aaron. Big show. Here we go. You saw “The Game Changers” movie. I saw “The Game Changers” movie. I’ve seen it three times now. And I was really excited for this movie to come out because I love these vegan propaganda movies. I think they’re fun and usually well done. So we have a lot of stuff we’re going to get into kind of walk people through.

For people that haven’t heard of the movie or who haven’t watched it yet, there’s a whole genre of movie, you have “What the Health,” “Forks Over Knives.” What are some other ones that are really popular? There’s like one called like “Plant Powered Way.” They’re all kind of the same genre of film, though. And they basically follow people, usually people that have chronic illness, and then they put them on a plant-based diet and they completely recover. And it just shows these miraculous recoveries This one took it out of the whole sickness mentality, and, instead, wanted to highlight elite athletes that are eating exclusively plant-based diets and how they’re just crushing the world. And it’s a film by James Cameron who did “Avatar” and he’s a really famous producer, director, movie person. So how many times have you seen the movie, Aaron?

Aaron: I watched it twice, twice on YouTube because it wasn’t in any of the cinemas near where I am, unfortunately.

John: Yeah, they only did a quick screening of the movie in theaters even here in New York, I think, only for a couple nights and then it pretty much moved to streaming. I mean, but even I don’t know if…are you are “Breaking Bad” fan?

Aaron: I started about three or four times and I’ve never actually managed to make it through the first series. It just never really sticks with me, but I keep meaning to try it and get all the way through.

John: Yeah. Because there’s a new movie that’s actually out now on Netflix with Jesse. Jesse Pinkman is the character in “Breaking Bad.” He was the kind of the right hand man to Walt, who’s the school teacher turned meth dealer and meth cook. And that’s just launched exclusively on Netflix. So it’s really not that uncommon for movies to just kind of go the streaming path this time, and that’s what “The Game Changers” did.

Aaron: I don’t know, especially when it’s got a kind of a niche audience maybe as well and they know it’s not gonna be a massive one.

John: Yeah, I wonder. I really wonder. I would love to see just viewership wise and analytics wise like how a movie like that does. But it was well done, it was entertaining. It’s got the UFC angle. We have an outline where going to run through here, just touching on a bunch of the different issues that we kind of noted when we were watching it. Had a Google Doc that we shared. And the film kind of starts off, you have this this guy, total badass, this guy, James Wilkes, he won a season of “The Ultimate Fighter,” which is a reality TV show that follows UFC fighters.

And he was the contestant that made it all the way through the ranks and actually won the show. And then through his fighting career, he gets injured. And the movie basically starts with him saying, you know, “I sat down and I did it over 1,000 hours of reading on peer reviewed nutrition science and on recovery. And because of all that reading I did, I’ve come to the conclusion that every single human for the rest of time should be a vegan.” Yeah. I mean, that was basically it.

Aaron: A pretty good synopsis.

John: The first thing I had for you though, Aaron, is, as somebody who’s, you know, a scientist and has a PhD in research and all this, he talks about nutrition science. He read all this peer reviewed nutrition science. And that means epidemiology for the most part, correct? Is that fair? I think that’s fair. And so, can you tell the listeners who aren’t aware kind of when he was reading this peer reviewed science, like, what was he reading?

Aaron: Yeah, I mean, this isn’t just a problem with people pushing vegan diets. It’s the problem with nutrition science as a whole, is there’s so many variables with people. So that then if you want to do a study, you’re going to need lots and lots of people. And the downside is, is that you can’t measure…you can’t sort of record information on lots of people over a long period of time going forward. So it’s typically done retrospectively. People fill in their sort of a, you know, maybe a diary of the food that they eat over that period of time. They may be coming at the end and have a few variables measured, but basically epidemiology is the sort of the study of incidence, distribution, identifying factors that may have a possible association with something. So in this case, you know, things that may lead…what type of diet gives you a better sort of health outcome.

But there’s no actual mechanics in there. So they can’t say that if you follow a vegan diet, you will be healthier, because it’s just that if you follow a vegan diet, you may have slightly improved cardiovascular outcomes or whatever the different measures that they are. So it’s a really powerful thing to do when you’ve got really big studies. A lot of epidemiology studies aren’t that big. You know, you see epidemiology studies with 20 people. And once you’re getting down to that sort of size, a lot of stuff can get lost in the noise. And then you start thinking about, well, actually, how relevant is this study?

John: Well, but for these plant-based studies, a lot of the epidemiology that they’re citing are big sample sizes over many, many years. I think it’s like the nurse’s health study and some of these big population studies. What do you make of those studies?

Aaron: Unfortunately, they’re the best that we have because they have that huge number of people, but they weren’t designed to look at the difference between a vegan diet and a keto diet and a standard Western diet. The researchers are having to sort of go through the data that’s being collected and extrapolate things to make it fit. So, you know, they might say this is a vegan diet or vegetarian diet, but then as we’ve sort of seen in some of them, these studies, they actually, when they classify it, they are allowing a very small portion of meat in on a diet. And so you’re sort of thinking, “Well, hold on, is this actually a vegan diet that you’re talking about, these findings that you’re talking about, say, veganism or whatever other study, keto diet produces this?” Then you actually dig into what they’ve assigned as a vegan or a keto diet, and it doesn’t really match up with what most people would think in the world. So there’s kind of that disconnect. And it’s the best studies we have, but they’re not the best studies for what we’re really interested in.

John: Right. And that’s one thing that you and I have talked about quite a few times, is in some of the studies that are offered in support of very strict vegan diets, which the people James Wilks and a lot of the people that are in the movie are following, the data that they use to support that strict veganism routinely includes people who eat meat very rarely. So they’re using people that eat meat rarely as an argument in favor of strict veganism. And that’s one of the nuance topics that we want to get into a little later in the show, is just what would be…look, if you’re not eating meat and you’re vegan for ethical reasons, totally understand and respect that.

The way I’ve answered that question is, you know, for me, this is the decision I’ve come to. I don’t think it’s unethical, in my view, to eat clams and salmon and sardines and some oysters and things like that. But if that’s you, then that’s one thing. But the thing about “The Game Changers” is they’re making these claims very aggressively in health. And they’re talking about that you’re going to have excellent health if you eat a vegan diet. And then they’re using “nutrition science,” and a lot of the nutrition science that they’re using actually doesn’t have clean vegan data. In other words, the people that are putting the vegan category are people that are eating meat, just they’re doing it very rarely. That’s a fair point. Correct, Aaron. I mean, that’s basically what you’re saying.

Aaron: Yeah, exactly that.

John: And that’s where, I think, a lot of the commentators out there who are pushing back against veganism like Nina Teicholz, and even, you know, somebody like Joe Rogan or Chris Kresser have a pretty good point, which is that a lot of the studies that are used in support of veganism are epidemiological and they don’t show huge increases in risk based on eating meat in some cases. I think that’s the case with one of those colorectal cancer studies that we saw, Aaron, with a risk increased from 5% to 6%.

Aaron: Yeah. I mean, these risks are obviously quite a tricky thing to talk about. And, you know, obviously a 5% to 6% risk is still an increase in the risk, but then when you think about, there’s probably a lot of other things that are increasing. And we’ve looked at studies where things, other health outcomes, you know, get worse when you follow a vegan diet. So it’s kind of that balance that you have to take out when you look at these studies. Unless we see like a really major shift, so not that 5% to 6% increase. If you suddenly go from like a 5% to a 20% increase, then that’s something that you would look at and go, “Okay, this is something really major and we should probably avoid this in my diet or start doing it in my studies.” But that 5% to 6% is almost meaningless, really.

John: Yeah, because that’s something where you have a lifetime risk of getting colorectal cancer of 5%, and then some of the epidemiology that’s cited in “The Game Changers” movie shows that there’s an increased risk of developing that form of cancer. But when you actually shake out the data and you look at it, it increases your lifetime risk from 5% to 6%, if you’re eating some of these processed meats. And that’s not to say that eating processed meats is healthy for people, it probably depends on the person, certainly not making them a staple. It’s just to say that the vegan community is presenting the science as though this is a closed case. That’s what they kind of want everybody to believe is that this is game set match. It’s over. And there’s quite a bit more nuance in that world than, I think, is led on by movies like this.

Aaron: Yeah. I mean, that’s kind of the problem with the epidemiology as well as that there’s so much noise in these studies. And the ultimate aim is you want to basically get every single person in the world, you know, fully genome sequenced and be able to look at what food they’re eating in real time and get their blood chemistry in real time for every single person in the world. And then we’d probably be able to answer that question of which diet is best for a particular person. And even then you wouldn’t find out that, you know, veganism is the best diet for everyone. You’d find out that some people might do really well on it. Some people would do really well on a standard Western diet. It’d just be that that whole mix in there. So that angle that they’re coming out with, that every single person should go on a vegan diet and will do well on it is just not true.

John: Yeah, 100%. And this morning, went to the gym and I was listening to a couple podcasts. I was kind of like flipping back and forth, listening to Tim Ferriss’ podcast for a little bit. And I don’t know if you’ve heard of Tim Ferriss, Aaron, but he’s kind of like a growth hacker. Almost like a self-help startup kind of a guy but he’s very insightful, and his podcast is popular. Listening to him in his show, he’s talking…basically telling his audience how to go on a ketogenic diet. Then I flipped over to this woman, Danielle LaPorte, I believe, she’s an MD. She has a podcast. She’s talking about people going on plant-based ketogenic diets.

And across the whole spectrum, veganism, you know, ketogenic diets, plant-based ketogenic diets, what I start to think is just all these diet philosophies are cutting out so many foods for people. And, you know, we had on Chris Masterjohn back…a few episodes back, PhD in nutrition science. And one of the things that he does a really good job of highlighting, just talking about, I really admire his message in this way is, he says, “Look, the more foods you cut out, the greater your risk for nutrient deficiency. It doesn’t matter what diet you’re on.” But the problem with a strict ketogenic diet or a strict vegan diet is you’re heading down a path for a long period of time where you’re going to be just excluding so many different foods from your diet and you’re going to have to get those foods from some other source.” The movie is like “The Game Changers” are so adamant in their messaging, they want you to be vegan so bad that they don’t warn you that there are potential pitfalls as you get one year, two year, three years into a diet like that.

Aaron: Yeah. And then the other thing is that we also, a lot of it, we don’t really know, in the longer term how some of the diets will affect people because the data is not out there at the moment.

John: Right. But it’s funny. I had my notes here. This is something that I know you tipped your hat to the scientists that did this paper because you said it was very well designed and very well done. But I shared with you in our Google Doc that lipoprotein (a) study that was funded by the dairy industry because this is part of what just… I’m trying to walk a diplomatic fence here and kind of give both sides of the puzzle. We talked about epidemiology. One of the things that “The Game Changers” highlights is the fact that a lot of these studies, these nutrition studies are industry funded.

So I would see in these like high fat, low carb blogs, this study thrown around about a specific type of lipoprotein called lipoprotein (a). For people that are kind of not in the nerd world on lipids, these lipoproteins, they’re kind of like taxis that carry fats around the body. And they can be damaging to our heart health under certain circumstances. One of them is lipoprotein (a). It has a special structure that is thought to make it more dangerous to people’s heart health. Well, there’s a study that was done that was funded by the dairy industry that said, “Hey, eating low carb actually lowers lipoprotein (a), and it did.”

But here’s the problem. They started with people that had really low lipoprotein (a), which means that those were people that probably didn’t have the genetic marker for lipoprotein (a), which would cause them to have, you know, lipoprotein (a) in the 40 milligrams per deciliter and up category. And so it’s kind of misleading for this dairy funded study to come and say, “We dropped people’s lipoprotein (a).” Yeah, you dropped it from like three milligrams per deciliter to two, but the people that have heart health risks are not those people. Those are the people that have lipoprotein (a) that’s really high. So even well done studies can be misleading in their conclusions.

Aaron: Yeah. We’ve used that as a good example. And this is true of the vegan ones as well. I don’t think there’s any…I mean, there probably are some scientists out there that have, you know, been nefarious and happy to take the money if they’re pushing a certain angle. I think a lot of science is funded by industry bodies because they’re the only people who are going to pay for it. You still have to trust the outcome. But it’s always about going the devils in the detail and actually reading into the paper to spot the things, like John’s mentioned there, you know, that the population that we’re working with maybe isn’t the ideal population, but it’s possibly the only population that they could get.

And then the other bit is a lot of the time is you’ll see these studies, and when you actually go and read that paper, it’s relatively benign. You know, they don’t make any really huge claims about it. But then people on the internet and food bloggers, in particular, will take that relatively benign paper and they will make a huge statement about it. So you might see a small uptick in, you know, your health following a vegan diet. That becomes vegan diet to the best for everyone. Or you might see that, you know, actually a low carb diet is okay for LPA, but, you know, that’s everyone takes it, is that everyone should just, you know, ignore the standard dietary rules and should eat as much fat as we want. You have to kind of separate the actual science from the message that other people are peddling about it.

John: I know you liked the design of that study. What I hear you saying is basically that somebody has got to do these studies. So even though it may have been funded by the dairy industry and maybe there’s still something we can take away from it, but I think you’re right. I mean, what happens is, it does make it to the blogs and then people are like, “Oh, well, didn’t you know, a low carb diet actually lowers lipoprotein (a)?” But again, the problem is, I’m confident that the people that are walking around with a lipoprotein (a) have four milligrams per deciliter, which is considered very low.

And again, lipoprotein (a) being just a dangerous type of, I guess you could say, “bad cholesterol.” Those people are not the people that carry that SNP LPA that we report on in our nutrition plans. Right? Because it’s just a very low number. So we’ve kind of, you know, given a little tour into…this is the land of studies. These are kind of the grievances that some people have with using this epidemiology on behalf of vegan diets. And then the plant-based community and these movies kind of strikes back and says, “Well, a lot of these studies are industry funded.” I guess the lesson there is there’s really no perfect studies. But they get into then like this whole idea of the gladiators. And they kind of try to draw this parallel between the Roman gladiators ate a mostly plant-based diet and then they have this fight between Nate Diaz and Conor McGregor, and they’re two famous UFC fighters. And the message is clear. Nate Diaz beat Conor McGregor because he was vegan.

Aaron: Yeah. I mean, that is kind of the message that you get from the film, that was a very light… It was quite an interesting little bit and like you say it was well produced. And if you take it from that, you’re not going to argue with someone like Nate Diaz. If he says it’s vegan, you know, it’s very difficult to argue. But then once you delve into it a little bit, and it’s not just us doing it, there’s lots of other people have talked about this as well. It doesn’t really hold up as being a sort of a scientifically proven fact. This is what gladiators ate. And this is, you know, historically, what we used to eat and this is how we were so much healthier in earlier life. That doesn’t really stack up.

John: No, I mean, and the thing is also as Nate Diaz, I follow UFC, I like the UFC, and Nate Diaz is one of the most interesting characters, if not the most interesting character in the UFC, Nate Diaz and his brother, Nick Diaz. Nick Diaz doesn’t fight anymore. These are guys who come press conferences. They’re smoking blunts at press conferences. They’re just crazy, basically, but you can’t keep your eyes off them. But Nate Diaz, though, has come out in a number of different interviews and said, “Look, I’m not 100% vegan. I am vegan before fights.” But I don’t know why we can’t have nice things out there? Why we can’t have a situation where the…? The movie tells us Nate Diaz is vegan as he prepares for fights. He’s not 100% vegan, he eats eggs, he eats some other foods. He’s not vegan, okay, he’s not. So why are we trying to tell people that he is?

Aaron: That’s the problem with a lot of it was, you know, they’re bringing all these cool people. So, you know, they’ve got Nate Diaz. And then there’s the people who are sort of actually behind it. So people like Lewis Hamilton, the tennis player, I’ve forgotten his name.

John: Djokovic?

Aaron: Djokovic, yeah. And they’re sort of holding these guys up as vegans who are sort of, you know, this is… If you go vegan diet, you’ll be a world beater. And yeah, okay, those guys are, but then it neglects to talk about all the other world beaters who aren’t vegan. So I don’t really follow UFC much. But, you know, I know that Conor McGregor is obviously really highly rated and people like…I’m never even going to attempt to say his name. And these guys aren’t vegan. You look at other F1 drivers, they’re not vegans. And then you look at people like Roger Federer, who’s probably the sort of the most famous, you know, possibly best tennis player that has ever been, again, he’s not a vegan. So it’s just that really selective messaging that they’re putting out or maybe you go vegan, you’ll become a world beater and it doesn’t really stack up.

John: More than that, in the case of the Nate Diaz thing, it’s misleading. Again, I wish the movie would have just come out and just been really honest about what Nate Diaz’s protocols are because what he says is he goes vegan before a fight, score one for vegans. He seems to think that leading up to a fight, a diet that’s high in carb works better for him. Great, cool. But when he comes out of the fight, he starts eating eggs and he does incorporate fish, needs foods like that, presumably because he feels he’s healthier when he does. And then you have Morgan Mitchell who’s the just gorgeous track athlete, Australian track athlete, who’s just setting all these records, and she’s vegan and she’s clearly crushing it and just performing at a really high level and they kind of give her the mic for this whole B12 and iron thing.

She’s kind of a passing message, but she says something to the effect of, you know, “People told me my iron and my B12 would be a problem but they’re all great on this diet.” And that’s one of the big traps that I see for veganism is, look, you can have adequate levels of B12 years after you go vegan, you’re not going to become deficient in B12 or deficient in iron like in the first like three, four, or five months. So when you’re pushing this message of, it used to be back in the day that we could get all of our B12 from the dirt, and both vegans and omnivores alike are B12 deficient, and it’s really not something you need to worry about, their levels are fine, how did that strike you?

Aaron: Yeah, I mean, I did a little bit of digging into how long it takes for B12 deficiency to develop. And there’s a sort of idea out there that if you’re getting continuously under your daily amount, it takes about two to four years to deplete your stores. So if you go into a vegan diet and don’t supplement with B12, obviously, I know a lot of them, a lot of guys do supplement would B12, and that forms a sort of a key part of the diet. But if you don’t supplement the diet, you’re probably not going to see an effect for at least a couple of years on that aspect. And then the other bit that you’re sort of talking about there, you know, about, do we actually get enough in our foods anyway? The answer is depending on what you eat, probably actually not.

It’s probably something that we should really all take notice of, which is basically, you know, trying to measure our intake and adjusting accordingly. Some people probably do, but on a sort of standard Western diet with this type of foods that people eat, the whole process, they’re sort of coming from, you know, overworked farms and farm animals, you’re also probably not getting your levels of B12. But you’re probably doing better than people on a vegan diet without supplementing still.

John: Right. These, unfortunately, I don’t know how it is in England, but here in the U.S., you know, the reality is, is that corporate America has…I wouldn’t say ruined, but really diminished the nutritional value of the food supply. It’s not like people that are eating a standard American diet are necessarily going to be in better shape than going vegan. And to be fair, the diet I choose to eat based on what works best for me is probably 92% vegan. I eat a lot of plant-based meals. I mean, the fact that I eat a lot of plant-based meals, does that mean that somebody listening should be eating a lot of plant-based meals? No, not necessarily.

I’m not sure that what I eat… The more I get into this world, I don’t really think that what I eat has too terribly much bearing and what the next person should necessarily. Although I do think there are these principles, and “The Game Changers” just pushes vegan junk food, too, big time. Like especially at the end of the movie, the vegan strong man is like, “I eat burgers. I eat sometimes burgers and pizza at the same meal and they’re pushing these plant-based burgers.” The plant-based burgers are just…you’re basically just eating canola oil. That’s what usually the second ingredient in a plant-based burger is, is canola oil.

Aaron: And we know that there’s a lot of issues with sort of the polyunsaturated fats and things like that and inflammation risk. So if you’re going to go vegan… But that’s also true of any diet, if you’re going to go for a particular diet, it’s always try and eat the best quality that you can. There’s two things that you’ve been talking about there that I think are really interesting. I think it’s a sort of thing that if there’s going to be studies done on these diet types, I think there’s a couple of really cool things that can be done. That sort of idea of cycling on and off veganism, I mean, in a way, when you say you have a 92% plant-based diet, you’re probably could put yourself in that category of being a cyclical vegan. You know, maybe you eat meat once a fortnight, once a month. I don’t know exactly, you know, the breakdown of that and it’s just been my…

It’s doing that is a better way than going purely vegan, you know. Maybe having that one piece of meat or seafood every fortnight, is that actually a better way of doing it than just going purely vegan 100% of the time? And then going back to the other bit, talking about how the plants and the animals that we eat and how these might actually be nutritionally deficient because of our farming techniques. It’d be really cool to see like a long-term study of the nutritional like quality of plants coming from organic farms. I know they’ve done like short-term studies, and they say that there’s not really any difference between them. But it’d be cool to see a farm that’s been organic for, you know, 20 years, allowed the soil to recuperate, is the nutritional content of the plants and the animals on that land better? That would be a really cool study for me.

John: I would love to see that. I don’t know. I think they’ve done this. Correct me if I’m wrong here if I’m getting too far out in front of my skis with this, but I’m pretty sure that in the alphalinoleic acid studies that I’ve looked at where they use tracers to see how much alphalinoleic acid converted into EPA and DHA. And I would be really curious to see…I wish there was a way where you could take 20 people, take the nutrient value of the foods you just outlined and then have a way to measure and see in real time just how much of that food… The nutrients in that food was being absorbed and utilized by the body.

Because that’s the way that these different groups are clashing all the time, constantly just saying back and forth with each other, like, you know, I listened to a few different vegan bodybuilders just because I think their content is really interesting. Then I’ll listen to more paleo people, listen to like a Robb Wolf or like a Mark Sisson, and literally what they are shouting…Chris Kresser, they’re shouting back at each other is you can get all the amino acids you need by combining plant foods, all the nutrients you need are in plant foods. There’s plenty of calcium in plant foods. There’s plenty of healthy fats in plant foods. It’s all there. What are you talking about? It’s all there.

And then what these other commentators are saying is, it’s not bioavailable, your body can’t access those nutrients. And I would imagine that if you took the calcium in spinach or in some plant food and you fed it to 20 people, I don’t think that the amount of calcium that they would be getting from that food, whatever that food maybe, would be uniform, right? I’m sure some people would get, you know, we look at them and be like, “Wow, you’re getting it. You do a great job of getting calcium from these plant foods.” And then somebody else might get next to none.

Aaron: It’s going to be so many factors. We talked about 20 people that have huge genetic variation and how they can digest food, you know, things going from like their stomach pH to how well they can absorb calcium through their intestinal wall. And then my whole sort of pet project as well about like the gut microbiota is going to be incredibly different. You know, you’ve got different bacteria in your stomach lining that can break down that plant matter and release the nutrients and make it more bioavailable, then, of course, you’re going to be able to absorb more calcium from your spinach than other people might be.

It’s just how we identify those people that are going to do well and those people that will do less well. And that’s kind of our sort of ethos really, isn’t it? We look at all these different studies. We say, “Well, yeah, that might work with some people, that might work with some people.” And we try and identify the factors that might push you towards one particular type of diet.

John: Yeah, and that’s in a nutshell why we’re using the genetic piece as, again, we said it before, we say it again, it’s a foundational tool. It’s not the entire end-all-be-all of these conversations, it’s just your genetics. It’s a really good foundational tool to start to get an idea of, “Okay, is a ketogenic diet a good idea for me?” I see these low carb, high fat, like, for example, a carnivore diet, it’s the danger of excess. Wherase I see with vegan diets the danger of deficiency. I think you’re going to put way too much protein through in your system. It’s going to have a burden on your kidneys, it’s going to have a burden on your liver. For a lot of people, it’s going to have a burden on their heart. We talked to Gerald Holbrook a couple shows back, and he was a perfect example of that, and it just wasn’t working for him.

And then with vegan diets, there’s like the vegan trap you get into. You’re on the vegan diet for the first three, four, or five weeks or even the first four or five, six months and you feel amazing. And then you get to a point where month seven, month eight, or even year eight, and you have major problems. I’ve talked to a lot of people, again, N equals one, but you know, this is a podcast, so we’re chatting. I mean, I’ve had ex-girlfriend, number of different friends who said that they’re…and also my friend’s ex-wife whose hair started falling out when they were on a vegan diet. Just as an aside, I hate to put you on the spot, but any idea why you’d have hair loss on a vegan diet and also any conjecture on that?

Aaron: I mean, [inaudible 00:30:57] is a common sort of side effect with veganism. I know that hair follicles are really sensitive to blood flow, you know, they need that blood flow into the…running under the sort of the papilla, where the hair grows out of. If that blood supply is interrupted, then that hair follicle can die and your hair falls out. I don’t know if that’s the reason why it happens with some people when they follow a vegan diet, but that possibly would be my hypothesis.

John: I’ve heard it more and more. If there’s somebody who’s listening who’s like, “Well, you don’t have a study to support that.” I mean, fair enough. That’s true. We’re evidence-based. Anything that we do, Aaron is doing the research on and coming up with frameworks based on the latest science. Sciences are total guideposts. The thing about those is, I think, anybody that starts following this can realize, if you’re going to live your life based on scientific probability from epidemiological studies, that’s going to leave a lot of people behind. Epidemiology can tell you something in a probabilistic way for a general population.

It doesn’t really have any bearing on what’s going to happen with one unique individual. You could have a field of stones and you could measure their weight and you could average out the field of stones. And the average weight could be, say, 44 pounds for a field of stones. You could go through that same field of stones looking for a stone that weighed 44 pounds and not to find a single one that did. So, you know, I mean, those are limits to what you can take away from these studies.

Aaron: Yeah. I mean, you know, we do all that sort of our GeneFood reports about our nutrition types, and I came out with quite luckily as a sort of mosaic, which was me, probably the most flexibility in the things that I can eat but I know from personal experience that I don’t do well if I eat absolutely loads of meat. If I tried to go on one of these carnivore diet or something with a really high meat, I just know I start feeling unwell. I start feeling lethargic, all this sort of stuff. It just doesn’t work for me. Whereas if I push more towards a plant-based one, probably not as high as you’re talking about, John, but you know, maybe I probably eat meat and fish once a week. But it’s always really good quality stuff. That works really well for me. I feel energized. I feel good. But you wouldn’t pick up from an epidemiological study. There’s no way you could pick that up for that individual person.

John: Yeah. And that’s all the nutrition world. You know, at some point, I’m just going to burn right out on the nutrition world. And I’m just going to go on to something else because it just gets so discouraging to hear people beating each other over the head with these studies as if…you know, we have on our about page of our website quote from Carl Jung, “The moral law lays claim to universal validity, the less it does justice to the individual facts.” One of the problems with science, science is an incredible thing that we’re all grateful for. The progression of science is something that enriches and betters people’s lives routinely all the time and it’s something that is amazing and that I admire greatly.

Having said that, in this context, science can rob people of their insights. It can rob people of their individuality. It pushes everybody into these boxes. Well, the studies say this. So therefore, you have to conform to the studies. You know, if you have an individual insight that bucks that trend, well, you know, you must be wrong. People not realizing that none of these studies prove anything. They give you probability, there’s no proof in any of them. There’s not even causality in any of them.

Aaron: Yeah. And that’s partially to do with how scientists talk about science and how non-scientists understand science. You know, we always sort of talk about ideas before a podcast and we sort of bounce things back. And I’m always probably a bit more on the fence about things than you are and than you’re probably likely to be. And I also understand that from people in the public, they want do X, get Y. Whereas I know it’s never quite that simple. So I’m always thinking, “Well, okay, do X and then add in this and that and that and then maybe you get Y.” It’s just understanding that message that it’s not often directly linked in science. You know, there’s always other things influencing it, and you just have to kind of try and figure out what those ones are. Put that into your model and then test it again, find something else, put it in, test it again. And you just build up your knowledge and probably the story gets less exciting because it’s not so simple, but you get a better understanding by expanding it.

John: For sure. No, I always get where you’re coming from because your job is just to stick to the research and not try to sell the research. I think one of the problems is that there’s a lot of selling of research. And you know, it creates issues. Back to this whole high protein diet thing, though, because I want to kind of get through this idea of cyclical veganism before we touch on a couple of these other issues that are brought up in the movie. T. Colin Campbell, he wrote…you mentioned that you eat meat about once a week you said, a couple times a week?

Aaron: Yeah, yeah.

John: So T. Colin Campbell, he’s the author of “The China Study.” “The China Study” is a massive epidemiological study where they actually were given access to populations across China. Researchers at Cornell, T. Colin Campbell’s a Cornell researcher, and he partnered with people in China. And they mapped for years and years and years using these population-based epidemiological food frequency type models. And they charted all these different places where disease was prevalent in China. And what they’ve shown over and over again is that when somebody from rural China or Chinese lifestyle, eating the way that they do move to the U.S., their risk for heart disease, all this stuff goes way up. I’m not here to say, look, this whole podcast, we’ve been kind of casting shade at veganism and I don’t believe that a vegan diet is…when we’re talking about health, I don’t believe a vegan diet is healthy for most people, strict vegan diet.

Having said that, I think a plant-based diet that incorporates a lot of plant meals is. But T. Colin Campbell found that what was the amount of meat that these rural Chinese residents that were so healthy in his view were eating? It wasn’t none. The answer is it was seven grams a week. So in “The China Study,” which is the study that is used to advocate for strict vegan diets, if you actually read it, you’ll see that in T. Colin Campbell, by his own admission, shows that the average meat intake for these healthy populations was seven grams a week.

And then they talk about…which is about a three to four ounce piece of meat a week. And then they talk about the gladiators being mostly eating plants. Well, what if for human health, there was that delta where you were getting nutrient density from those animal foods in that quantity that actually kept you in an optimal state for some people, whereas excluding all of those nutrients and not being able to get them from plant foods was starting to cause problems? I don’t know the answer, but I think it’s important to highlight those “China Study” stories.

Aaron: Yeah, and we’ve read a couple of other ones as well. Like it’s actually, if you really break it down, it’s often not vegan but vegetarians. Like a pescatarian diet often flags up as being the most, you know, beneficial to health. Taking the eating just a small amount of fish, not really any red meat or very rarely any red meat, mainly plant-based. That’s often the one that flubs up as being the healthiest type.

John: Yeah. And in our case, just to tie back to the nutrition plans, we have a number of different diet types that are very predominantly plant-based diets. You have the Okinawan diet type, YON. YON diet type is based on macrobiotic school of eating at the institution called Casa de Luz” in Austin, Texas. Shout out to Casa de Luz. Yeah, vegetarian villager. Lean machine is a more like Gerald’s diet is a more plant forward diet. But what we’re trying to do with each one of those people when they come to us is we’re trying to be strategic about how we keep their lipid markers in range without depriving them of important nutrients and basically starving them, you know, is what we really don’t want to do.

So, if somebody is going to eat a piece of wild-caught fish once a week, if they’re going to have…assuming they don’t have issues with histamine, they’re going to have some shellfish here and there. Maybe they have some oysters here and there. And just supplement their diet as they feel their body needs. Like Aaron saying, I mean, he feels like he’s getting a lot just from those small little top-offs of animal products for his health.

Aaron: Yeah. I mean, that’s based on stuff that we’ve been doing quite recently is…and there’s lots research into EPA and DHA and things that we’ve done. So I’ve kind of made a pivot in my diet towards getting some more of that into my diet. Not through supplement, just by changing the food that I eat. And I think that is probably trying a large part of the sort of the beneficial…the increased mood energy that I have. And we’ve kind of talked about how you can get these foods, you know, vegan supplements, but they’re just not as nutrient dense. So it’s a lot more difficult to get them whereas I can get them by eating one piece of fish in a week. You know, it’s just you probably can do on a vegan diet. It’s just really difficult.

Chris Kresser said this and, look, I don’t agree with everything Chris Kresser says. I think Chris Kresser, first of all, I think he’s a very admirable, very well-thoughtful commentator on nutrition. So I’m a fan of his, where I would disagree with him on some of these dietary fat issues. I think in his case, he tends to really downplay how dyslipidemic some people can get when they eat high fat diets and how that can be really a problem for their cardiovascular health because I’m somebody who doesn’t believe…I believe in the lipid hypothesis. You know, I do believe that it’s not the sole determining factor. But I think if you have elevated LDL and some of these elevated lipid markers, and you combine them with some other inflammatory markers that’s dangerous for heart health.

One of the ways people get there is they get there they’re eating too much in the way of animal protein, animal saturated fat. But, right, one of the things he says is you have to eat a perfect vegan diet for it to be successful over a period of time and you probably have to have the genetics for it as well. And no one tells people that. “The Game Changers” says just the opposite. It says, “Hey, eat the vegan plant-based veggie burgers. Everything is fine. You’re going to be good. This is going to be your one stop shop for perfect health.” And I think it’s good to push back on that a bit. Let’s move in, Aaron, to this whole animal versus plant protein and amino acid profiles. What’s your top level message on that issues that’s getting a lot of run right now.

Aaron: So amino acids, they’re like the building blocks of proteins. And that’s really important for pretty much life. You know, all of our cells in the body need these proteins to function and therefore we tend to function. So there’s 21 amino acids in total. And out of thosem nine are considered essential, meaning that they can’t be made in the body. And so when people talk about protein sources, they often talk about them being complete or incomplete. So complete ones have everything that we need and incomplete ones with maybe missing things.

So most of the complete sources are animal based. So things like whey and eggs are particularly good because they’re also easily digestible than things like red meat. Basically any sort of animal product is complete, but the meat is slightly less digestible and available. Obviously, this becomes important if you’re not eating any of these animal-based products. And a lot of foods are used to replace meet, you know, plant-based foods are used to replace meat maybe aren’t…not maybe aren’t, aren’t essentially amino acid complete. Of all of the ones available, soy is probably the best plant source if you want to get as much of your amino acids as possible.

But it has low levels of methionine and lysine too, you know, essential amino acids, which you can find abundantly in animal sources. So the thing with the vegan diet is if you want to get all of these amino acids, you have to eat a very varied and very mixed plant-based diet. So you can’t just focus on your soy. You can’t just focus on wheat or your corn or whatever type of…what your major plant-based protein is. You have to mix it up. If you can do it, that’s great. But that becomes difficult, especially for people on limited budgets or they need sort of like we talked about these process burgers, the vegan burgers, they’re not going to have that wide range that you need to get those as essential amino acids. Whereas if you follow a meat-based diet or even have meat, like you said, once a week, once a fortnight, you’re just going to be able to get these amino acids in that single stop.

John: Right. So essentially, using animal products, not as even a staple of the diet, but using them strategically so that you can maintain health by not becoming deficient in key nutrients.

Aaron: Yeah, yeah. So I mean, like I said, you can do it on a vegan diet but it’s difficult. And that’s the bit that I always…you know, it comes back to for me is that, yeah, I almost could go vegan. But I just feel like I would struggle to maintain, to stay as healthy and as happy and as active as I am on it with the amount of time that I have to dedicate to it. I feel like if I had all the time in the world, I probably did, but I don’t have all the time in the world. Sometimes I need that quick fix to get my nutrients from somewhere and that’s where things like meat and fish come in and they work for me in my lifestyle. And I think a lot of people would be in that same boat.

John: There are a couple of things to talk about there. One is I don’t know how it is in England, but in the U.S. we have a major issue with factory farming. So the way that these animals are treated is really just absolutely abysmal. And I don’t think you even need to eat pork or beef or even necessarily poultry. I think if you just focused on shellfish and some wild caught seafood, for a lot of people, if you have an inclination to go vegan, even just incorporating some clams, some oysters, some shrimp into your diet, some wild salmon, that could go a long way towards protecting a vegan diet, and maybe the occasional egg. Just as you have to calibrate the vegan diet perfectly to maintain health in our view, that is. You also can trade around with different animal foods, the ones that for you are lowest impact environmentally or lowest impact or no impact ethically. So there’s not a one way to do this. It doesn’t mean you need to go out and start eating bacon for every meal either, right?

Aaron: Yeah, I mean, it’s odd when I hate to talk about the grass-fed beef. Because for ages I was thinking, “Well, what’s grass-fed beef? Surely, that’s just what all beef is. Because the vast majority of it in the UK is just grass-fed. It’s only once, you know, you actually look into it from other angles, and you see, you know, in America they’re basically stuffing them for corn. And that’s why that grass-fed beef thing comes out and obviously it’s in a big factory farm. But you’re entirely right that you don’t even need to eat pork. You don’t have to eat beef. You can get that from shellfish, other types of seafood or, you know, you don’t have to… If it’s from an ethical or environmental standpoint, there are still animal products that you can eat that meet those thresholds.

John: Okay, so we have a couple more kind of important things to get to here. One thing I want to say before we do is just back to the amino acid piece, we talked about T. Colin Campbell’s work in “The China Study” and how his epidemiological findings were that these residents of rural China were still eating about seven grams of meat a week, which is a very low amount, but they were eating meat so they were not vegan. But when you take T. Colin Campbell’s work in terms of the cancer-promoting impact of meat and then you pair it up with Valter Longo’s work, Valter Longo is the head of longevity at USC. He’s been very popular on the podcast “Circuit.”

A lot of people have talked about him and seen his work. He’s done the fasting mimicking diet. But he’s big on the inflammatory nature of some of these amino acids and animal proteins as playing a role in cancer promotion. So just to give equal time and equal sides of the issue, when I look the epidemiology of T. Colin Campbell in “The China Study” saying the regions of China where the most animal protein was eaten were the highest incidence of cancer. And then I look at Valter Longo’s research, where he’s talking about the specific amino acids and how they turn on cancer and could promote disease and autoimmunity, it does make me circumspect and kind of sober about how I consume these foods. I consume them the way I do because I think that I need to for my own health, as you said. But I do think that there is a body of research out there that does line up in terms of disease risk as well when you overdo it. I’m not discounting that.

Aaron: We’ll kind of get to it a little bit later on as well, I think. But we’ll talk about, it’s how you prep food as well can have a huge impact on, you know, what the nutrients do once they’re inside your body, how you cook them and things like that, and where they’re sourced from, that can all have a big impact on it.

John: Yeah, so “The Game Changers,” what they do, there’s a few things we’re going to get into right now. One of the things they want to tell you is, if you eat meat, you’re never gonna be able to have sex again. If you eat meat, you have fat in your blood. That’s really dangerous on the burrito experiment. And then they give you these cast of characters of, you know, endotoxins, TMAO, heterocyclic amines, heme iron, AGEs. All these stuff. What did you even make of that burrito experiment?

Aaron: So there’s the two really odd bits in the film, the burrito on, and then the bit that we’ll talk about at the end, but that burritos thing, it was just really… Obviously, I get why they did it because it’s a very dramatic shot, you know, and hold up the two tubes and the people who are eating there. And meat burrito, it’s cloudy, and you can say, “Oh, that doesn’t look as healthy and stuff.” I don’t think there’s anything out there that actually says that this is an unhealthy thing. It’s kind of well-known that if you eat a fat-heavy meal before doing a blood draw, you’re going to be seeing lipids in it. The problem is, is if those liquids last for a long, long time because you’re eating so much of them that they’re never cleared from your blood.

So we actually look at a lot of guidelines for people doing blood draws. They recommend like a 12-hour fast before doing it for that very reason. And then the other thing that I found a bit funny, and I kind of went in and looked at it a little bit more is, you know, the details of the study. So the meat, it was a chicken burrito. And then the veggie one was a black bean burrito. So know that chicken has about 10 times more fat than black beans. It would be really interesting if they did the study with a burrito made from a plant source that had like an equal amount of lipid. So, you know, an avocado, where it has about the same amount of fat, would you still see that same cloudiness in the blood draw, you know, after the same period of time?

John: But they had the avocado in the burrito, though?

Aaron: It wasn’t a major source of…

John: Okay.

Aaron: Yeah, you know, it was mainly black beans in there.

John: Because they had the one NFL player.

Aaron: Yeah, it’d be cool to see like if you gave it… Probably the proper way to do is take it away from being a burrito. What happens if you eat 200 grams of chicken and 200 grams of avocado? What does your blood look like at that point if you take away everything else? And then if it is still different, you know, that you see in this high level of fat in the meat one, then that becomes a really interesting story because you’ve got a high level of fat on the planet one, which is seemingly absorbed much more quickly from the blood, that would be a really interesting study, but they didn’t really show it there.

John: One of the things I had to note is that basically just the body trafficking triglycerides as energy after eating the chicken.

Aaron: Yeah. If you eat a lot of fat, it has to get trafficked around the body and that’s what your circulatory system is. It’s basically the heartway of your body. It sends thing around there. As long as it’s cleared, fine. You know, as long as it’s cleared within a reasonable amount of time, it’s not sitting in your blood for ages and ages and ages, or because either you can’t clear it properly or because you’re just constantly eating high levels of fat, it shouldn’t be a problem.

John: Yeah. It’s just an interesting little experiment in the movie to mention. I think getting into the next piece here, which is more interesting to me, is they really steered clear of saturated fat in this movie. I think it seems to me that that was probably strategic because there’s so much controversy and so much individuality in terms of how people are responding to saturated fat. And it’s clear that for some people, saturated fat has been probably improperly demonized. You know, there’s been a lot of commentators out there that are really banging those drums. I think they’re banging those drums just as in a very similar way to these vegan movies. And what I mean by that is, they’re saying, “Well, saturated fat is just fine for everybody, just like veganism is just great for everybody,” which I don’t think is true. But they did steer clear of the saturated fat angle in this in this movie.

Aaron: Yeah, it’s quite interesting. And you say it’s probably because it is so up for debate and it’s kind of a really hot topic. You hit the nail on the head, though, is that it probably has been over demonized for the population as a whole. But then when you hear these guys talking about, you know, saturated fat for everyone, we should all be eating, you know, two steaks a day, that’s also not the case. You know, there’s a happy medium in between there. That’s probably where most people actually need to sit.

John: Yeah, well, it comes down to… I mean, there’s a few things. One, you have Nina Teicholz. She’s listed like the Minnesota Coronary Survey, which was a huge metabolic ward study, which, today, my understanding is, is it would be unethical to perform. But they took people who were patients in mental health facilities, mental illness facilities, and they just gave them different diets for years. And they gave them a diet that was a little bit higher in saturated fat, and then one that was a little bit higher in polyunsaturated fat, and there was no difference in disease between those two populations. And that’s one of the studies that Nina Teicholz loves to cite in favor of diets that are high in saturated fat.

I think really what it shows not as so much that as much as it shows that eating a lot of vegetable oil isn’t good for you. And the diet in the Minnesota Coronary Survey wasn’t like some scandalous amount of saturated fat. It wasn’t like these people are in ketosis. They have, I think, I can’t remember the percentages, but it was not some huge diet, high in saturated fat.

Aaron: It’s that overinterpretation again that we’ve talked about. You know, yeah, you can see that there’s no effect on that. But that doesn’t mean that because there’s no effect that we should all eat loads of saturated fat all the time.

John: Yeah. I mean, get your lipids down. It’s like, on our about page we linked to the Retterstøl study, which is a study that was done in Oslo. We’ve talked a lot about, they take…I think, at the end of the study was only 30 people because some dropped out because they got ill, but they tested their lipid markers before and after and all these inflammatory markers on a high fat, low carb diet. And some people’s lipids looked great and other people’s lives looked terrible. And figure out what where you sit on that. If you can eat a diet that’s high saturated fat, and it keeps your triglycerides low and you feel better and your lipids and your inflammatory markers reflect that, okay, fine.

But if you’re one of these people who go on a diet that’s super high in saturated fat, and then you’re a “lean mass hyper responder,” one of these other groups, and then your lipids look really terrible, and your blood pressure is creeping up, and then you’re going to basically have to pretty much bet your health on people who say that elevated lipids aren’t causal or aren’t a factor in heart disease, even though there’s quite a bit of evidence out there that that’s not the case. That’s a little bit of a stickier spot to be in. So it’s really just comes down to figuring out what’s happening with your body when you eat these foods. Really, the best way to do that is to get your blood work done fairly regularly.

Aaron: And keep a food diary and tie it all together and see, you know, if there’s changes out for you, then how does that make you fit in with the epidemiology that’s out there, and then you can kind of start figuring out what’s going to work for you.

John: Exactly. And that’s what we touched on last episode with Gerald, Gerald Holbrook. We don’t have an unlimited amount of time, I know. So I do want to touch on a couple more things. So they steered clear of saturated fat. And the big thing that they started pointing out in terms of mechanistic reasons not to eat meat, we got them listed here, endotoxins, trimethylamine N-oxide, heterocyclic amines, heme iron, AGEs, and this one, Neu5Gc. I’ve heard Dr. Khan talk about but I’m not familiar. So we’re gonna have Aaron run through each of these and address in turn kind of what they mean.

Aaron: Yeah, so I mean, we’ll start with endotoxins. So an endotoxin is something produced by a type of bacteria. And it’s these things called typical lipopolysaccharides, or LPS. So these are produced by Gram negative bacteria in your gut. And if they get into your circulatory system or into other organs, then you can basically generate an inflammatory response. And one of the ways that you’d be measured is this thing called the lipopolysaccharide-binding protein. If you have more LPS in your blood supply, LBP goes up. And so it can be like a good readout for, you know, how much LPS is actually getting into your bloodstream.

And then really interestingly, there’s a quite a few studies out there that show that meat can actually be protective for this. So if you eat meat, and especially things like milk, it can actually lower the levels of this LBP protein found in the gut and the circulatory system. Admittedly, this is in the rat model. It’s not shown in humans. But it actually seems that meat is possibly more protective. And then they kind of think, well, you know, how is meat being protective? And they look into it. And one of the things that they go into is that how this could be associated with the composition of the gut bacteria. So if you follow a plant-based diet or if you have a bit of meat in your diet, the bacteria that live in your gut are going to differ.

And they found that one particular bacterial species typically preferred to grow when meat was present, and that this was a kind of a protective bacteria prevented the release of LPS or other bacteria releasing LPS, and that kind of lowered the levels overall. So it’s really interesting seeing that mentioned in the film because then when you actually go out and look in the research, it almost seems like it’s the other way around, and that meat can be protective. But then the counter argument is, could it be the type of meat? You know, maybe there’s certain types of meat cause the worst response, you know. If it’s high quality organic meat, then maybe you don’t see that same effect. If it’s really processed, really fatty meat then maybe you do have a negative effect. It’s something that needs a little bit more look into, but it didn’t really stack up with what they were saying in the film.

John: Right. And I always thought that lipopolysaccharides were also tests that were run in more integrative clinics to try to measure for intestinal permeability and leaky gut as well.

Aaron: Yeah. And the thing is, is that endotoxins, there’s not really any reason why they’d be present on animal products but not plant products because, you know, they’re all going to be covered in bacteria, basically.

John: So endotoxins is one that probably wasn’t portrayed in an objective light. You’ve written a lot on the blog. I’ve written a little bit on the blog about this, about TMAO. I mean, in fairness, my blog that I wrote on TMAO was discussing why some people probably wouldn’t do as well eating a whole lot of eggs. But your post got into dioxins and a whole bunch of other factors. And I’ve had my serum TMAO levels tested while I’ve been eating meat, while I’ve been eating seafood, and my serum TMAO levels are perfectly normal. So what do people need to know about TMAO?

Aaron: So it’s kind of a really interesting story. So it’s thought to be bad when it’s present at high levels, but then the converse of that is that the areas where people have a really high intake of it actually often have better cardiovascular health. So kind of that idea that really high levels…probably it’s not just really high levels, it’s really high levels dependent on your diet. So the areas where they have a really high intake, it’s kind of that sort of Mediterranean diet. And so it may be that other factors in their diet negating the negative impacts of it. So as long as you are eating a diet that is negating the high levels of TMAO, you should be fine.

But then the thing that really flagged up is that maybe it’s not TMAO in itself that’s actually the harmful thing, it’s actually dioxins present in the food chain, and dioxins typically elevated in poor quality meat. So if you eat poor quality meat, it’s been highly refined or, you know, factory farmed, it’s probably likely to be higher in dioxins than meat which hasn’t been farmed in that way. So it’s more, again, it’s about the quality and the quantity of meat that you eat. So if you’re going to eat meat, don’t eat loads of it, and if you do eat any, eat the high quality stuff.

John: Yeah. For people that hadn’t heard, I should have introduced this, TMAO is a compound that’s produced in the gut by certain species of gut bacteria when we eat carnitine and choline and different amino acids and fats that are found in animal foods. And it was actually a “New England Journal of Medicine” study that identified this issue, kind of put it on the radar. And you definitely don’t want to be walking around with high levels of TMAO. So if you have high levels of TMAO, and you get them tested, that’s when you might want to look at trying to do some gut repair or possibly stop eating some of those foods that are super rich in choline and carnitine and try to draw back on that.

Aaron: Yeah, cutting back is obviously a good way of doing it. But then it’s thinking about what you’re eating around the food that tie in TMAO, you know, what are the things that you’re eating at the same time because maybe that could be modulating how you’re dealing with it as well.

John: Right. So the next one on the list, this is one that comes up on nutritionfacts.org all the time, heterocyclic amines, heme iron, AGEs. Let’s lump all these in together and just kind of give an overview of what people need to know about these toxic compounds as well.

Aaron: So heterocyclic amines, they’re one of the ones that does really stuck up. That’s a really good reason to cut out eating large quantities of meat. So it’s basically what happens to your food when you cook it and often actually overcook it. So you char meat, especially red meat, you generate a large amount of these compounds. And these, basically, they have inflammatory aspects. They’ve been strongly linked with cancer. So whenever you read studies about, you know, red meat equals cancer, a lot of the time it’s driven by these compounds. So it’s the way, if you’re worried about them, the ways to avoid it are obviously eat less meat as a whole, but then the way you cook it, don’t cook it at especially high temperature. Don’t char it.

And again, eat the higher quality meat if you can afford it. That’s the best way to deal with it. And that the interesting ones is that, again, the kind of legacy with the other one, is the certain types of food that you can eat at the same time, as meats that are rich in these heterocyclic amines that may actually have a protective effect. So I think there’s a study that we sort of found, whenever you eat avocados at the same time, these are protective because they’re kind of…we assume that the fats present in the avocados are protecting the endothelial lining. They’re mopping up these compounds and excreting from the body. So that one, that did stack up with what they were talking about in the film.

John: And that’s something, the heterocyclic amines, it’s also when you’re just on the grill and you have black in the meat, that’s where that comes up the most, I believe.

Aaron: Yeah, basically, just don’t char your meat is the way to avoid that.

John: Yeah, don’t eat black meat. So that passes the smell test. I wrote this blog post on the Impossible Burger, which was so surprisingly controversial. A lot of people got very angry with me for writing a negative review of the Impossible Burger. But the whole heme issue came up there. They’re using soy leghemoglobin or soy heme combination. What do we need to know about this whole thing?

Aaron: So heme iron, there’s like two sources of iron, heme iron and heme non-iron. And heme iron is basically all animal-based. And it only really becomes an issue if you eat a lot of meat or have the disorder known as hemochromatosis where you absorb iron very easily. And when we’re talking about a lot of meat, we’re talking about over 160 grams per day. So that’s quite a considerable amount of meat per day, if you factor that over a week. So as long as you’re under those limits, then there’s not really any issue to worry about with your heme iron. You probably don’t also…you know, you should consider your iron because it can be toxic and you over-supplement with it. So if you’re taking an iron supplement and you’re eating meat, then maybe you want to look into whether you actually need to take that supplement at all, and then, you know, maybe adjust the levels of that supplement. But on a normal diet, which is relatively low in meat, you shouldn’t worry about heme iron.

John: Okay, so that’s a carnivore diet issue for the carnivore dieters?

Aaron: Yeah, basically. Yeah. So if people on the carnivore diet, you know, they will be people having an issue with that. And people with hemochromatosis, which is a sort of a well-established disorder, but for the average person, as long as they keep their meat intake down below a reasonable level, and I think 160 grams per day is actually quite a lot really when you think about it.

John: That’s a ton. No, it’s a ton. I mean, one’s seven grams would be like a three to four-ounce piece of chicken. I mean, that would be…you’re just eating insane amount of meat every day for that to reach that threshold.

Aaron: I mean, I know when I buy steak and do like a stir fry for everyone, I tend to buy about like 150 grams and we split into 3 and have 50 pounds each. And that still seems like a lot of meat. So that 160 grams a day does seem really high.

John: AGEs and Neu5Gc.

Aaron: Well, I’ll skip on to the last one because that one was new to me, and then it was kind of interesting as well. So Neu5Gc, it’s a type of acid that we as humans can’t produce, but pretty much every other mammal can. So all the red meat sources, they can produce it. And then this becomes really interesting because although we can’t produce it, our immune system will detect that and, say, “Well, actually, you know, this isn’t something that should be here.” And it’ll start thinking this as a foreign compound. And then that generates an inflammatory response, the immune systems generate, and you get all the symptoms which we have with inflammation.

That’s really interesting actually to me. But then the other side of it is that there’s lots of plant-based proteins that can generate, you know, intolerances and immune responses. So things like gluten, you know, that’s a really well known one. People have soy intolerance. And it’s that same problem that, you know, unfortunately, you can’t really control whether you’re going to be intolerant to it or not. But you can find out relatively quickly. Every time you eat meat, it makes you feel ill, then it’s possibly that your body is recognizing this component as a foreign particle and your immune system is being triggered, and maybe that just says to you that you need to cut out red meat.

John: It’s funny, that’s now setting off a light bulb for me because that’s what…I interviewed a mast cell researcher last episode, Dr. Theoharides, and he talked about that, especially in the context of autistic children, how some autistic children in his work have real sensitivity to that compound. And so that’s one of the things that he’ll test these kids for, is sensitivity to the Neu5Gc.

Aaron: Yeah. You can call it like a meat sensitivity marker really. You know, have you go in and you have your gluten intolerance tests they’ll do a certain test where you can almost look at it as a meat intolerance marker.

John: So we’re going to kind of close out the show talking about some of the kind of, you know, a little more fun stuff here. We’re going to talk about Arnold. I saw Arnold Schwarzenegger, he’s in the movie for those of you haven’t seen it, he’s in the movie. He’s talking about how basically repenting for when he was in his bodybuilding days, he was eating a ton of meat. And then they show the commercials for fast food chains saying you’re not a real man if you don’t eat meat. And he says, “Look, that’s just garbage. That’s marketing. That’s BS,” which I think is probably a pretty message that a lot of people would benefit from hearing. But then he goes on to say how he’s been in a plant-based diet and his cholesterol is at 109 milligrams per deciliter.

You, in your research looking through Framingham, which is the biggest heart health study that’s out there. It’s basically a study that’s looked and measured people in the town of Framingham, Massachusetts for generations and they have the largest bank of data in cardiovascular health. A large part of the reason why we associate certain biomarkers at certain levels with disease states is because of Framingham. And, Aaron, you found that super, super, super optimal, at least for cardiovascular health, according to Framingham is 150 milligrams per deciliter. I wouldn’t want my cholesterol to be at 109 milligrams per deciliter. Would you?

Aaron: No, it’s one of these things where most biological things, they form a J curve. You know, there’s like a little sweet spot where things work really well and then things get worse on either side. So, I’d say between 125 to 175 total cholesterol is probably the sweet spot for most people. Once you start getting on either side of that, so even going lower than 125, a lot of people may have you believe that, you know, basically you can drop your cholesterol to 0 and that would be a really beneficial thing. It’s not true. We do need it in our bodies with things. So that level that you’re talking about, 109, I mean, it’s obviously working for him. Again, that’s the thing. You’re not really going to look at Arnold Schwarzenegger and say, “Well, it’s not working for you.” You know, he’s clearly in good health. He’s clearly sort of enjoying his vegan diet and can live with it at that level. But maybe targeting 109…I think it’s 109 milligrams per deciliter he talks about, so total cholesterol for everyone…

John: That’s what he said his numbers were. He said his numbers were 109 milligrams per deciliter.

Aaron: Try getting that for everyone, I feel like it’s pushing it too far. That’s taking most people too low.

John: Because of the fact that the body needs cholesterol to produce sex hormones and neurotransmitters and every cell in the body forms literally the substrate about every cell in the body, etc., etc. People have talked about that quite a bit. I guess the message is…well, it’s just like this JAMA study that we have in our notes. It’s a meta analyses of, I think, it was close to 280,000 people. And the low carb people have to say, “Well, the lowering of LDL cholesterol studies, they don’t make an impact on all-cause mortality.” The interesting thing about that is that when you really dig into it, first, they’re right in many cases. But the problem is, is that these are diseases that progress over the course of 50, 60, 70 years. I mean, they were biopsying Korean War soldiers, American-Korean war soldiers who died in that war, and finding atherosclerotic plaques in their arteries when they were, you know, 19, 20 years old.

So you take a disease that’s been progressing for that long, you put people on a statin for two years, and I’ve come around to the way of thinking where any dropping all-cause mortality in two years based on just one intervention to me seems actually pretty freaking amazing. That’s just my take. I want to get yours on that, Aaron. But to give the data on that, to synthesize the study, the greatest benefit for these people that were put on the statins was when they drop their LDL cholesterol from 160 to 130, and then from 130 to 100. They didn’t see any benefits in all-cause mortality when they continued to drop the LDL cholesterol beneath 100. That’s where the benefits seem to stop in that study. But the thing about that study is it’s looking at 280,000 people. And this is not epidemiology. This is intervention controlling from one variable, standardizing people, and then looking at how they perform over time.

Aaron: Yeah. I mean, so the interesting is you hit the nail on the head there, at the end is that they were giving people statins as well as part of this study. So you kind of have to try and extrapolate around that as well. But then, again, it kind of fits in with the other studies that we’ve seen. It’s not just that study, it’s also the Framingham study as well. That does seem to be a point below…if you go below a certain level, you’re not going to see any benefit. And I would probably even go further and say it starts to become hump below a certain level. So maybe in those people weren’t on the statins, it would be interesting to see, you know, what’s a good level for their total cholesterol as well?

John: Yeah. I think another good thing that people can do because not everybody has access to these blood tests. And before I dive into that, you make a good point there, this is… Bcause you’re looking at these statins and trying to tie them back to nutrition because nobody is going to do a randomized control trial like that for nutrition. That’s why we love Retterstøl so much because nobody does these studies.

Aaron: Retterstøl, I love it. It’s a great study. It’s small. That’s the unfortunate aspect of it. And part of the fact that small gives us the cool because they report on the individual values that people have, whereas when it’s a huge stud, there’s no way they could really report every individual value. So it all gets lumped together. But it’s about seeing those differences in the groups, and maybe when you look at those figures, you can see that there’s the sort of the average and then there’s the variation around that. And, you know, I’d love to know what’s pushing someone to the top of that variant and someone to the bottom of that variant because that’s quite a big difference that you can have. And that could have a big impact for you as individual whereabouts within that group you might fall.

John: Yeah, and sort of to finish off the point I was going to make just for something really practical at home. So if you’re looking at these LDL cholesterol numbers and you want to have like another factor that you can start tracking in addition, just measure your blood pressure, see what your blood pressure looks like. If your LDL cholesterol is going through the roof or your lipid markers look really poor, if your blood pressure is also bad, that could be a sign that there’s something going on there that’s not very healthy for your heart. Your heart is having to pump harder to get blood to certain places, which brings us to the closing issue that we’re going to talk about, which is “The Game Changers” and the boner experiment, and basically telling everybody that if you don’t eat plant-based, you are not going to have a good sex life, and you need to get on the plant-based train for optimal sexual performance.

They took these kids from these college athletes and they strapped down these devices on their penises, and they measured their frequency and strength of erections. And they did it, you guessed it, where they gave them a plant-based meal and they had better strength, better… Really what it was is they had a lot more erections at night. And then they gave them a meat-based meal and the number of erections that they had went down by like 400%, 500%, something like that.
So, that’s why I mentioned blood pressure. That’s why we’re mentioning these lipid markers, is they’re all supposed to tie back and be proxies for what’s happening in your endothelium, like what’s happening with your heart health. Is your heart health good? If your heart health is good, you can pump blood to the extremities. If your heart health isn’t good, you can’t. And Dr. Joel Khan, who we had on the podcast, he wore a T-shirt on the mind body green speaker stage a few years ago and it had, I mentioned this to Dr. Amy, who we interviewed when we did our sexual health episode, and it had one big circle, which was like, I think, your normal artery, and then it had another small circle next to it and then underneath it said, “Feeling lucky.”

And the small circle was meant to represent how small penile artery is. And if you’re damaging your heart health upstream, then you’re never going to be able to get blood flow to the penis, and eating meat is doing that. So therefore, you know…anyway. To the extent you want to talk about this, Aaron, which I’m not sure you do, what’s your first take on that whole study? Because, frankly, it’s been a huge part of the marketing behind the movie. Everybody is talking about it.

Aaron: Well, let’s say, it’s gonna work, isn’t it? Yeah, it’s a really cool…if you’re going to try and sell it to guys, in particular, you know, it’s the number one thing to target. Basically, go vegan, be better in bed. It’s just going to work. I mean, you can kind of see…I would hope that most people watching it would realize that it’s not the best study out there. There wasn’t…

John: It’s not a study at all.

Aaron: It’s not a study at all. It was a kind of a little bit at the end of the film. I mean, it would be really cool to investigate. It’s such a weird experiment, though, the little machines that they’re strapping on and stuff. It was kind of quite funny watching it at the end. I was thinking, “How much are these guys getting paid to take part in this study?” Because you’d have to pay me quite a bit to sort of have that recorded.

John: Yeah. No, for sure. I mean, they’re in college. Who knows?

Aaron: Yeah. You can’t really take anything from it because they didn’t really control things properly. It would be really interesting to see what effect diet has on, you know, sexual health. I guess that is quite an important thing. But if they’re going to do it, it kind of needs to be done properly, really.

John: Yeah. But the thing is, is you can kind of take a middle ground there and say, “Look, if diet is affecting your endothelial health, meaning if you’re on a diet that’s not right for your heart health, it could detract from your sexual abilities.” For sure. That’s not something that’s speculative. I think that’s a pretty solid point that they’re making. The problem is it doesn’t mean that everybody needs to go vegan, it doesn’t mean that it even applies to most people. And, you know, I did a post on my mentors in this health and wellness world, there’s a guy named Dr. Steven Brody, he’s a endocrinologist in San Diego, and I started doing all my blood work. I list him on my bio on the GeneFood site.

And one of the things that he always impressed upon me was just how important it is, if you’re having an anti-aging practice, to really understand what’s going on with your prostate. And one of the interesting things, it’s kind of not a topic that really comes up a lot, but I think it’s important to share. For anybody that’s made it this far through the podcast that’s interested, there’s actually a pretty good study out there that gives you a little window into what the latest state of urology is. The guy who administered these tests to these athletes is a famous urologist.

And it says, “Look, in younger men who had a condition called prostatitis, which is inflammation of their prostate gland, at like an earlier time, who had also been on antibiotics, who’d been given antibiotics, because that’s something that you can track basically is like an STD. The more sexual partners you’ve had, the more likely it is that you could have that issue.” And so they give them antibiotics over and over again to take care of it. And when your prostate is not healthy, that’s something that can impact on your sexual health, especially comes up in older men with BPH and stuff, like your grandfather or somebody who’s older, just having to wake up like a million times during the night to pee. It’s because their prostate’s inflamed and it’s getting larger and it’s basically impacting on the ability for them to, you know, be healthy in that part of their body.

But what they found is that in men who’d had this antibiotic treatment, who then also had low PSA, they were dealing with a fungal issue. And the regimen that they put them on was not a vegan diet, the regimen that they put them on, they put them on flucanazole, which is an antifungal, and then they put them on a low carb, high protein diet. And they had high rates of success in terms of beating back that disease based on that. When I see these movies like “The Game Changers,” I feel really happy for the people that are going to take the advice and have it work for them. And then I feel really bad for the people that are just going to be put totally off the scent on some important issue for their health and their quality of life based on these movies. I’m guessing you probably aren’t up on that study, Aaron.

Aaron: Yeah. I mean, I guess, as long as you take the movie as what it is, just a movie, then that’s fine. But like you say, there’s going to be people who don’t take it like that and, you know, who’s possibly having, you know, poor health and they’re going to take it at face value and just go on it and it’s maybe not the best thing for those guys.

John: Yeah. One of the couple episodes ago, we were really hard on paleo diets. I just think that anytime there’s anybody that’s out there that’s advocating for a one-size-fits-all diet, it raises red flags for me. I think that’s what I take away from this.

Aaron: I mean, I did actually enjoy the film. You know, I enjoyed watching it and it’s quite interesting. I was at a wedding last weekend. And we’re just sitting around the table talking about it because, you know, we sort of talked about watching it and think that. I was telling everyone at the table, “You should give it a go. You know, just have a watch of it. See what you think.” And so quite a few of them went away to watch it and they came back with the same…you know, a lot of people at the table were scientists so they came back…yeah, it’s a bit funny and stuff like that. But then it did make people think that maybe I’m not going to go towards a vegan thing, but it’d be interesting to look into that more plant-based diet approach. So from that angle, it probably did work. And like I say, it was a well-made, easily watchable film, but just don’t take it as hard science.

John: Yeah, it’s a really fun film to watch. I think what’s happening is there’s a growing number of people who are really waking up to the fact that there’s these creeping environmental issues. And rather than taking those environmental issues and tackling them head on, they’re trying to backdoor and say, “What they really want is they really want you to not eat meat for the environment because they believe that that’s the best way to stop this trend of the planet warming.” But they’re not respecting the audience and telling them that in a straightforward way. Instead they’re saying it’s healthiest thing to be vegan. It’s not the best thing for the planet.

If they’d come out and done a documentary like “Cowspiracy,” where they say, “Look, raising of these beef in these farms is pretty bad for the environment.” That’s one thing. But telling people that a diet that’s probably not healthy for a lot of them, that it is the healthiest diet for them, I think that’s…I take issue with that and your science friends might have read it off. I don’t think a lot of people do. I don’t think a lot of people view that movie in this way. I think a lot of people view this movie as something that’s actionable and something that’s substantive and something that they should take seriously.

Aaron: Yeah. I mean, the environmental point is a really good one. And I guess the counterpoint from a lot of people is, I think, everyone knows what factory farmed meat, you know, how it’s produced ethically and the impact it has on the environment, but I think most people just don’t care. So maybe the angle is that, well, maybe we have to try a different approach, and it’s not about veganism is better for the planet. It’s veganism is better for you. And that’s the approach that they’re going to have to…that they want to go on to get as many people to sign up as possible.

John: Yeah, I think so. The irony is there’s gonna be a lot of people that would go on a diet like this, or a template of a diet like this and do really well. So it’s been fun chatting about the movie, Aaron. We’re looking forward to hosting you in New York just a few short weeks, and it’s going to be a great time.

Aaron: Looking forward to it as well.

John: Thanks for coming on.

Aaron: I’ll see you in person in a few weeks.

John: All right, buddy. Sounds good.

Aaron: See you later.

John: The “GeneFood Podcast” is our attempt to synthesize the latest developments in the fields of genetics, nutrition, and medicine, and offer you practical tips and stories you can use in your own unique health journey. If you enjoy this podcast, you can find more information online at mygenefood.com.

John O'Connor

John O'Connor is the founder of Gene Food. Read his full bio here.

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