Change my mind: Veganism entails trade-offs, and health is one of the axes

I appreciate the extensive time and effort you've put into this post/project, and I also find the framing odd and potentially misleading. Health risks change when someone stops eating animal products, but the health risks of a vegan diet are substantially less bad than the health risks of a standard diet.

I believe you overstate the risks of nutrient insufficiency generally and largely fail to engage with the health ramifications of animal product consumption. The "trade-off" is a possible increased risk of nutrient deficiency and decreased risk of a host of pervasive and debilitating health issues. If option A is "the nutrient deficiencies you found in previous research, such as iron and Vitamin D, which can have palpable effects if left unaddressed" and option B is "the standard risk of nutrient insufficiencies/deficiencies and an increased for cardiovascular disease, cancer, diabetes, obesity, and foodborne illness," I think most people would readily opt for option A. All else equal and ethics aside, I'd personally rather take some supplements than increase my risk of cancer or salmonella or E. coli.

The "trade-off," as a result, ends up skewing in a positive direction for most people switching from e.g. the Standard American Diet to a vegan diet; the vegan diet just comes with new, readily addressable, and substantially less scary risks.

People should pay attention to their nutrition. They should e.g. get blood tests at their yearly checkups. And no one should act like veganism is a silver bullet to all health issues. But I find this post overall misleading.

My major concern is that this article is too one-sided: it mentions the difficulties/trade-offs of vegan diets, without mentioning difficulties/trade-offs of non-vegan diets. Eating a non-vegan diet is also not easy. Some examples of what you have to tell to people who want to eat animal products:

• Don’t eat too much meat, that is unhealthy. You can look on some websites how much gram per day is too much, according to your age and bodily needs.
• Fry the meat well enough, because (almost all) meat can contain harmful bacteria. Also wash well enough all the cutlery, the knife, the chopping board and everything that was in contact with the meat, because of contamination risks.
• But don’t fry your meat too much. Frying meat can produce carcinogenic substances. Especially when there is a dark or black crust visible, the meat was fried too much. For the same reason, avoid barbeque and flambé. Heating up meat in the microwave oven is not good enough to kill the bacteria. If you don’t know how to cook your meals properly, you can eat vegan meat alternatives: they can be safely eaten even uncooked (or used in the microwave oven).
• Don’t drink unpasteurized milk.
• Animal products don’t contain dietary fiber, so make sure to eat a proper source of dietary fiber. 
• Meat doesn’t contain vitamin C, so make sure to eat a proper source of vitamin C. There are websites that tell you which products contain vitamin C. 
• Avoid processed meat: that is unhealthy. You can look on some websites what counts as processed meat. I think bacon and ham also count as processed.
• Many meat products, especially fresh products, don’t show an expiration date on the package. You can look for some information on the internet how to learn to detect when your meat is expired. If you don’t know how to smell expired meat, don’t keep your meat too long in the fridge, or eat plant-based meat alternatives as they show a best before date on the package.
• In many cases, cheaper meat products may be unhealthier than more expensive meat products. There is often a trade-off between price and health/quality of the meat product. Consult a nutritionist to figure out the best diet according to your budget. 
• Almost none of the meat eaters had a recent blood test to check if they have for example too much bad cholesterol that could be the result of eating too much animal products. They also don’t know if their bodies can properly absorb for example the iron in the meat. It is recommended to visit a nutritionist and ask for a blood test. 
• Some people are allergic to milk, fish, and other animal products. You can consult your doctor if you don’t know about your potential allergies.

These examples should be enough to show that eating animal products is equally difficult as eating vegan. My worry is that focusing too much on vegan nutrition issues (telling people a lot about how to eat a healthy vegan diet), might give people the impression that veganism is difficult, and then they continue eating animal products and causing harm to animals. But focusing too little might be counterproductive as well, because then people don’t eat enough healthy vegan diets, they become ill and revert back to animal products. 

So I recommend that when you tell potential vegans how to eat a healthy vegan diet, you also mention the health concerns related to animal products, to make clear that eating a healthy non-vegan diet is equally difficult or easy. 

Animal products are incredibly nutrient dense.

I agree with many points in this essay but was surprised by this claim. The claim is definitely not true if by "nutrient density" you mean "nutrients per calorie", which is how that expression is generally understood in the scientific literature. I think this is also the most relevant metric when comparing how much "bang for your buck" you get from eating different types of food: if you approach this as a problem of constrained optimization, where you are optimizing for health and nutrient content is regarded as the measure of healthfulness, energy (as measured in calories) rather than, say, volume or weight is ultimately the constraint you are dealing with.

Perhaps you meant something vaguer by "nutrient density", like "the degree to which a person's diet would move closer to meeting their nutritional needs if a portion of this particular food were added to it". Depending on how this idea is made more precise, the claim that "animal products are incredibly nutrient dense" might become more defensible. But this would need more elaboration and supporting evidence.

Elizabeth @ 2023-06-06T00:27 (+13)

I indeed didn't quite mean "nutrients per calorie".

The following is a chart I made for some common animal vs. plant protein sources. All the values come from the cronometer database. To get everything in the same units I converted everything to % daily need. 

To create this chart I copied over the calories, protein, and micronutrients for several common sources of protein from animals and plants. The animal sources were off the top of my head, the plants were primarily from the first list I found on google, + Impossible Burgers. To get everything in the same units, I used % daily value.^[1]. This was all done using the cronometer food database

First I assumed 100g of each food product, and summed the % target values together for a nutritional score. But it doesn't make sense to credit them for vitamins no one needed, so I capped the values at 100% of target value (excluding protein, for now). I also 0ed out biotin, because only a few foods have filled out that value and I didn't want to unfairly penalize ones that didn't. From there I calculated [nutrient score/calorie], both with and without protein.

 

Spreedshet available here.

For total score (not normed/calorie, excluding protein), excluding Impossible Burger which I want to talk about separately, the least nutritious animal product (eggs) is still more nutritious than the most nutritious plant product (edamame), although not by much. If you norm per calorie, edamame eeks ahead of eggs, who are now tied with lentils. Norming per calorie kills cashews.

Including protein (as % of DRI) doesn't change much, so I'm going to ignore it. 

But this kind of assumes the daily targets (which are based on DRI but somewhat personalized to me) are right, and that you're not eating anything else. In practice (and excluding Impossible Burger), the nutrients that beans/edamame/non-nut sources are rich in are things anyone with a halfway decent plant diet should already be doing well in. This is much less true of nuts, but nuts have far too many calories for most people to use as a major source of anything. 

Which is why I think the median meat eater would benefit nutritionally from swapping in one of those plant protein sources, and the average vegan would benefit from swapping in an animal product. Similar to what you described, it's about the density of what a particular person needs.

I said I wanted to handle Impossible Burger separately. It scores pretty well; above eggs but below steak, salmon, and liver (same ranking whether you include protein or not). For who people who like and can absorb nutrients from Impossible Burger and other fortified products, they seem pretty good, although not quite as dense. And for people who can digest IBs more easily than meat, seems great. I'm still pretty worried about unknown unknowns, and the health nuts have concerns, but I think both of those are beyond the scope of this post, which is about satisficing not optimization.

You might ask "why focus on high protein foods?"  Because protein is the hardest and most valuable macronutrient for most diets, and because it's correlated with the subset of vitamins that's richer in meat sources. There are plant sources that are rich in other vitamins (kale is looking at these nutrient/calorie scores and laughing), but except maybe for nuts nothing unfortified is rich in this set. It's mostly fixable, by you have to tetris together the missing nutrients from multiple sources.

In the reverse situation I would 100% describe kale as nutrient dense to someone eating the Stanard Shit American Diet. I expect it to be less helpful to them than an egg is to a vegan, but for reasons that reflect well on plant-based diets: most of the problems from meat-based diets aren't nutritional deficiencies that can be fixed by eating more things. Many SSAD problems  (cholesterol, calorie excess) are an accumulation of problems from what you do eat, and can't be fixed by throwing in more vegetables.^[2]

 

 

 

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   This is tricky on a few levels. First, the RDA is too high for most people. Second, I didn't use RDA, I used my personal targets, which I've modified for some nutrients (roughly: (vitamin A (x1.5), riboflavin (x2), niacin (x0.3), folate (x0.5)). I eyeballed it and didn't feel like the shift was giving animal products an unfair advantage, and it would have been a huge pain to correct, so I didn't fix this.

2. ^{^}

   My personal opinion is that people would eat less shit if they were getting enough vitamins, and so forcefeeding them kale would eventually lead to less bad stuff, but it's a more complicated process. 

Pablo @ 2023-06-06T12:55 (+7)

Thanks for the extended reply. I understand your position much better now.

On a meta note about communication, I think "Substituting non-animal protein with animal protein likely gets you closer to meeting all the Dietary Reference Intakes for vitamins" is more informative, less likely to be misinterpreted, and probably more persuasive than "Animal products are incredibly nutrient dense". (I offer this as a constructive criticism focused on one relatively minor point of how your post is written rather than as an objection to its substance.)

Dhruv Makwana @ 2023-06-08T18:08 (+5)

I think emphasising protein is totally the wrong track, since it's just not that important (and also if you're getting enough calories near impossible to have a deficiency in)

https://nutritionfacts.org/video/the-great-protein-fiasco/

I also think your general model of "satisfying" is built off of myths which just are not supported by the evidence

https://nutritionfacts.org/video/evidence-based-weight-loss-live-presentation/

See especially 38:41 where he talks about a review with meat industry funding

"In general, these data confirm a modest satiety effect with protein-rich meals but do not support an effect on energy intake at the next eating occasion."

Lastly your omission of leafy greens is suspicious - from memory spinach has about 40% of its calories from protein, and (dry) soya chunks/mince around 66%, far exceeding most animal products (due to fat), and legumes.

Elizabeth @ 2023-09-20T06:27 (+7)

I'm really confused that you'd invoke a paper to tell people their experience of their own hunger is wrong. 

Dhruv Makwana @ 2023-09-21T22:25 (+1)

Before I reply, I'd like to acknowledge that my original comment from 3 months ago, much before our recent, cordial and respectful exchange elsewhere on this post, was probably a 6-6.5/10 in terms of tone and clarity, and could have been made more conducive to discussion: sorry. 

I'd also like to say upfront that I am very reluctantly spending 150+ minutes getting nerdsniped into writing this comment during a week when I'm aiming to address a sleep deficit, and as I said in my other comment, "For the sake of my time, this should hopefully be my last comment on this post.", but this time for real.

I realise making a point and walking away can come off frustrating/rude, but that's not my intention here, it's just self-preservation. If that's objectionable, you may ignore the rest of this comment.

But to your basic point - my point is not that "people are wrong about their feelings of hunger" (which off the top of my head, and my experience, I think they can be - for example mistaking stress/discomfort/boredom for hunger - but this is besides the point). 

My point is about the primary attribution of the cause of the subjective feeling of hunger to a not easily perceptible thing such as protein. My intuition comes from subjective wellbeing (e.g. Stumbling on Happiness by Dan Gilbert) and also perception/embodied cognition research (e.g. rubber hand illusion). The attribution is an empirical claim, and that's what I was (very poorly) getting at.

As part of this empirical attribution, there's two different concepts at play here: satiation and satiety (yes, silly naming). Satiation is how much of food can be consumed in one sitting. Satiety is how much a given food will delay or decrease calorie intake in the next meal.

From the post:

But there isn’t a satisfying plant product that is as rich in as many things as meat, dairy, and especially eggs. 

But there isn’t a satisfying plant product that is as rich in as many things as meat, dairy, and especially eggs. Every “what about X?” has an answer, but if you add up all the foods you would need to meet every need, for people who aren’t gifted at digestion, it’s far too many calories and still fairly restrictive.

From the comment:

Because protein is the hardest and most valuable macronutrient for most diets, and because it's correlated with the subset of vitamins that's richer in meat sources.

It looks like there's two aspects to this: (a) judging plants using meat as the standard (b) an implicit assumption that protein is (b) important, (c) especially "satisfying"-ness, i.e. satiation and satiety. 

[Tangent: I think others have pointed out that (a) is a little unfair - meat doesn't have many health promoting things like Vit C, fibre, antioxidants, easier to regulate absorption of nutrients, lack of cholesterol, less saturated fat etc.]

In response to (b) the first video about the very low protein requirement for humans I think covers the major aspects (babies need the most protein and human breast milk is 1% protein by weight, 5-7% by calories, adults need around 0.8g/kg of body-weight, maximum up to 1.5-1.8g/kg for strength training etc).

In response to (c), a whole host of other factors influence satiation and satiety (as mentioned in video 2 and elsewhere^[1]).

• Calorie density, influenced mostly by lack of fats and increased water. Quoting Dr. Greger, "When dozens of common foods, pitted head-to-head for for their ability to satiate appetites for hours, the characteristic most predictive was not how little fat or how much protein it had, but how much water it had." (https://pubmed.ncbi.nlm.nih.gov/7498104/). Whole fresh fruit & veg generally fall in at < 100 calories per cup, whereas meats are 300-600 calories per cup.
•  Fibre. Fibre limits the absorption of calories, meaning that you can eat more but still absorb the same amount of calories.
• Absorbability. Conversely, processing (e.g. turning peanuts into peanut butter) separates the peanut's calories from the fibrous cell walls and thus making it more vastly more absorbable. Animal product do not have a fibrous cell walls, meaning they are absorbable off the bat. This means lower satiation per calorie - you eat more calories in a stomach full.
• Thylakoids. The thing that makes leaves green slows down fat absorption in the gut. Slowing down fat absorption means that un-absorbed calories can reach the end of the intestine (ileum). When this is detected, appetite is decreased dramatically.
• Hardness of food. Same food, presented hard or soft (e.g. carrots) leads to fewer calories being consumed but no extra calories as compensation in the next meal.

To be clear, I am willing to grant the premise that "protein > carb > fat" in terms of satiation. But this would not be the end of the matter, because cardinality matters too. I don't want to spend an hour digging for numbers at this stage, but I can illustrate what I mean with an example:

• Chicken/beef roughly 45% calories from protein (rest from fat).
• Chickpeas roughly 22% calories from protein (rest from carbs incl. fibre).
• Dry soya chunks rougly 57% calories from protein (rest from carbs incl. fibre).

Based only on macros (let's say you blitzed the chickpeas into ultra fine hummus and equalised the water content), which of these is going to be more satisfying is going to depend on the ratio of how much less satisfying carbs and fat are (per calorie) compared to protein. And it's not clear to me based solely on protein being most important that meat has a slam dunk advantage here.

Anyways, as I said in the other comment, I'm going to signpost Chris MacAskill as a source of information and potential collaborator. Toodles!

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   Chris MacAskill's https://youtu.be/zOAapJo9cE0?feature=shared high-protein, animal keto vs low-fat, plant-based diet especially the section on satiety vs satiation, which is the source of my information in this comment.

Elizabeth @ 2023-09-28T23:36 (+2)

First, I want to apologize. I didn't realize you were the same commenter I'd been talking to and had asked to bow out. I'm not sure what the right way to handle this was, but I should have at least acknowledged it.

I have some disagreements with some of your claims here, but mostly they feel irrelevant to my claims. This feels like an argument against a heavily meat-based diet, not against small amounts of meat in an otherwise plant-based one.

Elizabeth @ 2023-06-05T01:43 (+9)

This is a really good question. It's taking a fair amount of time to formalize my answer but I wanted to let you know I was working on it.

I think it would have been more fair if you hadn't removed all the links (to supporting evidence) that were included in the quote below, since it just comes across as a string of unsupported claims without them:

Beyond the environmental effects, there are also significant health risks associated with the direct consumption of animal products, including red meat, chicken meat, fish meat, eggs and dairy. Conversely, significant health benefits are associated with alternative sources of protein, such as beans, nuts, and seeds. This is relevant both collectively, for the sake of not supporting industries that actively promote poor human nutrition in general, as well as individually, to maximize one’s own health so one can be more effectively altruistic.

I think this evidence on personal health is relevant in the ways described. I don't think it's fair to say that the quote above implies that “[health benefits] will definitely happen with no additional work from you, without any costs or trade-offs”; obviously, any change in diet will require some work and will involve some tradeoffs. But I agree that it's worth addressing the potential pitfalls of vegan diets, and it's a fair critique that that would have been worth including in that essay (even though a top link on the blog does list some resources on this).

FWIW, in terms of additional work, tradeoffs, and maximizing health, I generally believe that it is worth making a serious investment into figuring out how to optimize one's health, such as by investing in a DNA test for nutrition, and I think this is true for virtually everyone. Likewise, I think it's worth being clear that all diets involve tradeoffs and risks, including both vegan and omnivore diets (some of the risks associated with the latter are hinted at in the links above: "red meat, chicken meat, fish meat, eggs and dairy").

Writing this as a separate comment to my earlier one, since it's on a different tack.

A crux for me, which isn't in the post, is the effect of a vegan diet on productivity.^[1] (I imagine this effect routes through health.)

A not-unreasonable chain of reasoning, in my view: if one works in x-risk reduction, and one knows that consuming meat improves one's productivity, then one could see oneself as morally permitted—obligated, even—to eat meat.

I'm aware that this argument is profoundly icky and arrogant, and that someone who employs it in their dietary choices may be falling foul of motivated reasoning. However, I also think there's something true here which calls into question the strength of some claims, including above—currently the top comment—in this comments section: "The idea that the potential human health benefits of meat consumption could possibly be decisive on the question of whether it's ethical to eat meat is a fantasy." (To be clear, I do empathize with the emotion behind the claim.)

1. ^{^}

   I'm a little worried that I'll receive some backlash for this comment. Especially given how I expect those who self-select into reading this post, and engaging in the comments, will be disproportionately vegan, even by EA standards. Nevertheless, I think if nobody speaks up to surface this crux then that will be to the detriment of our community's scout mindset. (Edited to add: A friend points out that I could have used an anonymous account. This did not occur to me. My friends are wiser than I.)

“The human health gains are small relative to the harms to animals” 

I'd argue further that even if the human health benefits are large in the space of human health outcomes, they are so tiny in comparison to the harm an omnivorous diet causes to animals that they are scarcely worth discussing.

It takes a few seconds to taste a bite of a dish. Let's assume that a portion of chicken is eaten in 24 bites. If, in order for us to eat such a portion, there is a chicken that has had to suffer 9 days, and has been deprived of 2 years of life, how much harm is inflicted on the chicken for each of those 24 bites? Doing the math, the result is as follows. In exchange for each brief moment of tasting its flesh, the chicken has had to suffer on average for about 9 hours on a farm. And it has been deprived of a month's life. That's just for every single bite. Every second of our taste pleasure is very expensive for the animal that is eaten.

• Oscar Horta, Making a Stand for Animals (2022)

This isn't hyperbole. Here's a description of the experiences of the chickens most people eat:

Broiler chickens are the chickens raised for meat, rather than the ones raised to lay eggs. Chickens are endure cruel transport right from the moment of birth, in small crates. They’re sent to overcrowded sheds where they have no space to turn around. They have nothing interesting to do, and not enough space to do it. They express none of their natural behaviors and are subject to constant horrifying disease, injury, and artificial lighting that leads to torturous sleep deprivation. They spend their days unable to move much, living in feces and ammonia, subject to constant violence, and with horrifying diseases. Then, they’re cruelly slaughtered, wherein they’re crammed into small crates, leading to many chickens dying, and many more enduring bone-breaking injuries and weather extremes. Then, those that haven’t died yet are brutally slaughtered, some stunned, some with their throats slit while they’re conscious, and some boiled alive while fully conscious.

Source

The idea that the potential human health benefits of meat consumption could possibly be decisive on the question of whether it's ethical to eat meat is a fantasy.

If we found out that torturing a baby for 9 hours created a cup's worth of baby tears which, when drank regularly, extended the human lifespan by 20 years, we would obviously not do it.

Thankfully, we can eat chicken and cause the same harm to a being of similar intelligence, with far less positive impact on our health.

I'll be completely honest and say I came into this post expecting to be annoyed, mostly for reasons you address (especially the "you're singling out veganism" and "sick of concern trolls" issues). However, after reading I agree with pretty much all of your cruxes. 

Particularly, I would agree that most [current] vegans [living in omnivorous cultures] are sacrificing one of health/taste/cost/convenience.

I have been vegan for 2.5 years and have had no negative health effects (at least that I'm aware of, or that I didn't have while omnivorous), but I would also consider myself decently well-educated in vegan nutrition.

I think there are some health issues that may make it too difficult for some people to eat plant based* (ex. genetic difficulties with converting provitamin beta-carotene into proper vitamin A, or simultaneous soy & gluten & nut allergies). I don't think a perfect 100% of humans today could eat entirely plant based* with the agricultural and nutritional knowledge we currently have.

However, I strongly believe:

• The number of people who could be healthy vegans [EDIT: on a plant-based diet] is far, far higher than the number that are currently vegan [EDIT: plant-based]. It's not 100%, but if forced to make a numerical estimate I'd say >=80% (if cost was not an issue), or >=50% of the U.S. at their current income.
• People who are unable to be fully plant-based should ideally still reduce their contributions to animal suffering, insofar as is possible & practical for them. A lot of people seem to commit to failing with abandon if they can't be perfectly plant-based. [This is difficult to judge from the outside though, and I don't feel comfortable passing this judgement on anyone I don't know extremely well, and very few of those I do.]
• If cultured meat production and/or nutritionally comparable meat replacement continues to advance, most objections will be pretty much irrelevant. I would be very suspicious of people who say they can't eat plant-based for health reasons, but then don't switch to cultured meat (/ nutritionally comparable meat replacements) if it becomes easily available.
• There are no negative health effects to avoiding buying leather, for example. You can debate leather ethics on its own merits, but people who say "I think we should stop farming animals but I can't be vegan for health reasons" who also buy leather seem like they are just searching for free virtue points.

All of the vegan places I've hung out in (that talk about practical veganism, not just the broad philosophical argument) have pointed toward the important bits of vegan nutrition. Ex. B12 being a running joke on VCJ. I don't think general philosophical arguments should be required to contain implementation details, but I would consider any practical veganism guides that didn't include at least info on B12 supplementation & preventing iron deficiency irresponsible.

Not sure we actually disagree much, but feel free to let me know. Honestly my biggest disagreement would just be that I don't run into "there are no downsides!!!" messaging much and therefore this seems like a non-issue. Though I don't spend much time reading about EA-specific vegans, so maybe it's more of a local issue?

[*] - retaining a distinction between a plant-based diet (zero animal-origin products in food) and vegan (philosophical framework that extends beyond the diet but also allows more leniency when full abstention isn't possible)

I appreciate this post: I think it makes progress in a conversation that can sometimes be an elephant in the room.

An experience I once had, which I bring up to illustrate how the state of this conversation has real effects on the ground, involved an EA—someone in a hiring position—saying that they are suspicious of x-risk-focused people who aren't vegan. Attitudes like this within EA are harmful, in my opinion. The thesis put forward in this post, that veganism entails at least some trade-offs, seems clearly true to me, and I think that a dynamic—I'm not sure how prevalent this dynamic might be—of EAs feeling pressured into being vegan when really the trade-offs for them aren't worth it, is unhealthy.

(For what it's worth, I'm not a vegan, though I was vegan in the past for around a year.)

This is a very long piece and also a lot of comments, and so I apologise if I've missed something relevant by skimming.

I think my main disagreement is that I would frame it as few weeks of adjustments rather than lasting tradeoffs (except for logistics and social pressure). My model of the adjustment period is nutrition education and body adjustment. Everyone should do the first, and some have the second, with a small minority needing some help (e.g. these case studies from this nutritionist).

Here's an RCT https://www.nature.com/articles/nutd20173 it's across 6 months, and also looks at 'quality of life' variables, 

Between-group differences favouring intervention were significant at 6 months for both the physical component summary (P=0.03) and the mental component summary (P<0.01) (Table 4). At 6 months no significant between-group differences were seen for: average daily exercise, food enjoyment or food costs (Table 4). Statistically significant differences favouring the intervention were seen at 6 months for general self-efficacy (P=0.01), nutritional self-efficacy (P<0.0001) and self-esteem (P<0.01).

There are a few claims that were asserted and I found very surprising; maybe I've spent too much time on nutritionfacts.org. I think the bar of evidence you ask for, whilst would be conclusive, seems a little high and unrealistic given the practicalities around most nutrition research.

It's not clear that the claims your baselines (in particular the one below) are based on the same high bar: most of the "I found veganism difficult" anecdotes I come across are incredibly vague and describe no systematic investigation of what actually went wrong (e.g. Cronometer/food diary, blood tests, SIBO tests etc), and usually just attribute it to "no animal products".

People are extremely variable. This includes variation in digestion, tastes, time, money, cooking ability… 

Most people’s optimal diet includes small amounts of animal products, but people eat sub-optimally for lots of reasons and that’s their right.

but if you add up all the foods you would need to meet every need, for people who aren’t gifted at digestion, it’s far too many calories and still fairly restrictive.

Especially the last claim (have you come across "How Not to Die?" and "How Not to Diet?"); the daily dozen has around 1200-1500 calories in it; it's not clear that someone is 'gifted at digestion' or not, with no ability to change (in fact, the opposite seems to be true, and there seems to be some evidence documenting the shifts, across admittedly short-timescales).

https://slatestarcodex.com/2019/12/11/acc-is-eating-meat-a-net-harm/?utm_source=substack&utm_medium=email

(a good number of people feel just as fine on a vegan diet as a non-vegan one [example] - most of the potential "costs" are in terms of energy/vitality which they will feel if they feel it). I am ovo-vegetarian and I have reasonably high iron levels myself. From the limited studies available, vegans have lower ACM than even vegetarians do.

It's important for people to get an ION Panel to test for amino acid deficiencies (these are hard to order w/o a doctor)

Scientists found three genes linked with vegetarianism and another 31 genes that are potentially associated.

Several of these genes, according to the study, are involved in lipid (fat) metabolism and/or brain function including two of the top three (NPC1 and RMC1).

“My speculation is there may be lipid component(s) present in meat that some people need. And maybe people whose genetics favor vegetarianism are able to synthesize these components endogenously,” Dr Yaseen said.

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4.2. Long Term Health Outcomes

Estimating the long-term health outcomes of eating certain things is difficult because food is highly bound up in the culture we live in and culture correlates to just about every health outcome you could possibly imagine. Even less conveniently, nutritional science is highly anti-inductive; if a particular food group is identified as being healthy people with an interest in being healthy flock to that food group, and people with an interest in being healthy are likely to be healthy for a bunch of reasons regardless of diet.

So here’s a nice headline result: vegetarians have less heart disease with extremely high certainty, and probably less cardiovascular disease and cancer too. Most of the studies in that meta-analysis have had some of the really obvious stuff adjusted away (race, income, etc.) but not all studies adjust for all confounders, and we should be cautious about trusting studies that ‘adjust for confounders’. If you ignore confounders then the answer is clear; eating vegetarian is good for you in every single way we can measure (including, possibly, circulating testosterone in defiance of stereotypes about meat eaters!).

If you are interested in confounders: There are a handful of cool natural experiments, taking groups with reasons to eat certain food but not bother with the associated healthy lifestyles, which are the closest we are likely to come to a true experiment in this area. In particular, the American Adventist Health Studies are pretty much state of the art in the field from what we can see. Adventists have quite unique dietary habits, brought about by religious prohibitions on certain foodstuffs which some Adventist churches follow and some don’t. Consequently, if you are an Adventist you are functionally ‘randomized’ into different food-eating conditions depending on which church you attend, and this randomization can be exploited by researchers.

Based on the Adventist Health Studies, a vegetarian diet increases life expectancy by around 3.6 years. The less meat you eat, the healthier your BMI and the less likely you are to get diabetes.

Overall we might expect lacto-ovo vegetarians to have a health related quality of life around 10% better than a meat eater, with most of this benefit being apparent 20 years after making the switch to a vegetarian diet.

You could complicate this picture a lot (especially by introducing future discounting) but we think the general principle that if you value life-years towards the end of your life you should likely go vegetarian is well demonstrated by the data:

One final point on how meat might affect your lifespan; there is a growing awareness of the fact that industrially produced meat is an ideal breeding ground for zoonotic disease, and that those diseases can mutate and jump to humans very quickly. Previous pandemics such as H1N1 (‘swine flu’) and H5N1 (‘bird flu’) may have originated with farmed animals, and were rapidly spread by the close contact of unhealthy animals and global nature of the meat supply chain. At the margin, eating meat probably increases the probability of a global pandemic but there isn’t good evidence on how much your individual consumption affects things at the margin.

In the model we take the Adventist study result at almost face value, estimating that eating vegetarian will increase your lifespan by 3 years, and include constant low costs due to possible nutritional deficiency and moderate benefits to health that appear later in life.

Points of agreement:

I agree that it is important to refrain from claiming that a vegan diet is the optimal choice for overall health.

It is crucial to emphasize the need for careful planning and the inclusion of necessary supplements when making people vegan.

Points of disagreement:

I don't see conclusive evidence that a vegan diet is less healthy than some other diet. While it is plausible that consuming small quantities of animal products could be more healthy compared to a strictly vegan diet, the evidence supporting such claims doesn't seem conclusive to me. The studies I have encountered predominantly compare average meat eaters with average vegans. My conclusion from the existing body of evidence is that "whole foods plant-based diets are sufficiently healthy. We don't know yet what precise diet is optimal for most people"

I do not agree that we are obligated to highlight the non-health-related costs of veganism. The inconveniences associated with this lifestyle are already apparent to most individuals based on their firsthand experiences. Furthermore, my personal experience suggests that people generally overestimate the difficulties involved and often find it easier than anticipated after trying it. Reiterating the challenges may actually lead to further misconceptions.

In other contexts, such as promoting alternative diets or lifestyles, it does not strike me as dishonest if people omit mentioning the non-health costs. For instance, consuming berries is healthy, despite them being among the more expensive fruits. If someone doesn't mention the costs of berries when they say "you should eat 1 portion of berries everyday" that seems OK to me.

In that context it seems more important to not deny the costs rather than actively bringing them up.

Things I'm not sure whether we agree about:

We should stick precisely to the statement of Academy of Nutrition and Dietetics, and keep mentioning this in our conversations about veganism:

"It is the position of the Academy of Nutrition and Dietetics that appropriately planned vegetarian, including vegan, diets are healthful, nutritionally adequate, and may provide health benefits for the prevention and treatment of certain diseases."

This is the first decent post I’ve read on the subject on this forum. Thank you, it gives me hope that EA has not completely lost the plot when it comes to the intersection between animal advocacy and diet.

I would add that for those of us that eat a Mediterranean diet, Veganism presents a significant trade-off in terms of diet quality.

For those of us in Southern Europe, it also has a trade-off on environmental impact due to the nature of agro-silvo-pastoralism here (although that is outside of the scope of a mere forum comment).

Some people are already struggling to feed themselves on an omnivore diet, and have nothing to replace meat if you take it away.

This statement seems a bit exaggerated and emotionally charged. Do you think that having literally “nothing to replace meat if you take it away” is a serious problem for more than, say, one in 10k^[1] people? Meat is not known for being particularly cheap or easily available. It doesn’t grow on trees. More than a billion people live without it. Even when it comes to protein, grains and legumes are a cheaper source than meat. 

Does this sentence refer to people like the small percentage of Inuit who still hunt for most of their food? Vegan outreach is not targeted at such people, so it doesn’t seem relevant to bring it up.

Maybe by “some people” you did mean something like “one in 10k” or way fewer people in which case the claim could be true. But then it’s useful to make that clear. The way it’s written, it sounds like the purpose of the sentence is mostly to generate an emotional reaction in the reader. A vegetarian could say “a single bite of meat can kill you.”  It would be a true sentence because you can get fatal food poisoning from a single bite of meat. But it would have little place in serious, level-headed discussions. And again, people who actually have the problem you described are not the target of vegan advocacy, so it's not clear why you're bringing this up.

Maybe what you meant to say was “some people would have a harder time following a healthy diet without animal products.” But if so, why didn’t you write that instead?

Animal products are incredibly nutrient dense. You can get a bit of all known nutrients from plants and fortified products, and you can find a vegan food that’s at least pretty good for every nutrient, but getting enough of all of them is a serious logic puzzle unless you have good genes. 

This claim also seems to be a bit overstated and emotionally charged. I guess it could be technically true if the vast majority of people “have good genes” according to your definition, but the way you write it makes it sound like having “good genes” is an exception.  What nutrients specifically are you concerned about? B12 and multivitamins are extremely cheap. This pea protein powder with good reviews is as cheap per gram of protein as chicken breast at my local Costco, and very protein-dense. This makes it cheaper than almost all animal protein sources. Grains and legumes are even cheaper per gram of protein but less protein-dense. Eating a few cheap pills each day and a scoop of protein powder or legumes doesn't sound like “a serious logic puzzle.”

Also, how are animal products “incredibly nutrient dense”? What nutrients are you referring to? Do you mean per calorie, or per dollar, and compared to what? Micronutrients are much cheaper in supplements than in animal products. 

Food allergies and digestion issues mean lots of people struggle to feed themselves even with animal products; giving up a valuable chunk of their remaining options comes at a huge cost.

This sentence has the same hyperbole problem. “Struggle to feed themselves” conjures images of people who literally struggle to get enough calories to survive. Some people do struggle to get enough calories to survive because they’re allergic to a lot of foods, but they're not the target of vegan advocacy. This problem is incredibly rare among wealthy young Westerners. What you probably meant to say is that some people have a hard time having a perfectly healthy diet because of their food allergies. In which case you should just have said that instead. 

1. ^{^}

   I would be surprised if the claim was true for anywhere near that number of people.

Thanks for this - this and an earlier post you wrote have made me, as it were, examine my privilege, since I'm one of the lucky vegans who genuinely seems to pay minimal costs, of any kind, from being vegan. This might be a combination of being taught good nutrition principles by my (pescatarian) parents, lucky genetics, living in vegan-friendly places, and having a reasonable budget for food. I'm in favour of people going some but not all of the way to vegan, if full veganism is massively costly and especially if it gives them health issues or makes them feel bad and undernourished day to day. I'm interested to hear people's stories (both positive and negative) about dietary change and what was hard about it, what they wish they'd known, etc

I agree with some of this post and more of the comments, but I want to focus on one thing. The "veganism has tradeoffs" frame isn't helpful; it's much too ambiguous.

Three main claims can distilled here. You may be claiming that 

1. Advocacy orgs focusing on diet change should be de-emphasized on the margin.

and/or

      2. *I* the reader, the audience of this post should de-emphasize the urgency of diet change in my personal life on the margin.

and/or

      3. Systemically and/or individually, some sort of non-vegan diet change should be focused on, eg vegetarianism, no-chicken diet, reductarianism, meat-free mondays, etc

I usually assume that blog posts, unless otherwise specified, are meant to be targeted to their readership. If this was just explicitly directed around 1, I may have a different response.

I don't think most vegan EAs have the problems listed. I won't exclude the possibility of a few rare cases, people who have peculiarities of some sort that makes veganism unhealthy, but lets focus on 3 for the next best thing then!

If I was to bet on it, I'd say that +90% of vegan EAs are aware of B-12 deficits and either take supplements or seek out supplemented foods.  

Insofar as there are vegan diets not "properly planned" they occur among the health crowd (which outnumber the pro-animal vegans), those who believe it to be some sort of panacea for their ills or distrust the medical establishment. I could be wrong about this general claim, but I think it's roughly correct. (I agree about the need for better studies which control for supplement use!)

Back to number 3. I appreciate that you mention the issue with concern trolls and you briefly allude to "vegetarianism being much nutritionally closer", but I really wish people would be more explicit about this. Far, far, to many (purposefully or not) use criticisms of veganism as a way to avoid personal responsibility.