Health Demographics (Epidemiology) in a Vegan Context

Context is king.

Is a survey of diet, disease and risk of death enough to advise the public? (Photo: vvaniasantoss / Pixabay)

In the field of population health statistics (i.e. epidemiology), context allows scientists/medics to confidently assign explanation(s) for the trends they discover. Context is needed in all research fields, but is especially important in epidemiology. Otherwise we could mistakenly conclude that everyone who gets gum disease tends to have teeth, so teeth cause gum disease, as an extreme example.

John Snow, the recognised founder of modern epidemiology (i.e. population health statistics), famously tracked down the spread of a cholera pandemic down to the usage of a single London water pump in the 19th century [1]. As a sceptic of the prevailing “bad air” theory of contagious disease transfer, John Snow gave some context to the “germ theory” of disease by determining that the cholera patients all fetched water from a potentially contaminated source. Officially the theory of “miasma” (bad air) was the recognised cause of the outbreaks at the time, despite John Snow’s analysis. It is thought that the fear of political consequences from letting the general public know that their trusted water source had been contaminated by human faeces could have led to a delayed acceptance of John Snow’s work by the relevant authorities.

The study on “Diet, Lifestyle and Mortality in China” showed an association with a mainly plant-based, traditional Chinese diet (essentially a vegan diet) and protection from cancer and cardiovascular disease [2]. When the China study was published (i.e. 1990) other studies that had similar observations [3, 4], and several experiments provided a contextual precedent to attribute protective properties to a plant-based diet [5], following the principles outlined by Sir Austin Bradford Hill [6].

Were there any hidden factors in the “China study” that were the real cause of protection from chronic disease? Maybe people who ate mainly whole plants exercised more, for example? Even when the possible contribution of factors like exercise were mathematically “removed” or “accounted for”, a clear statistical link (i.e. correlation) still indicated that a plant-based diet conveyed protection from cancers and cardiovascular disease. In other words, additional known factors like exercise were unlikely to be the hidden cause of the diet-disease correlation observed. Multiple diet and lifestyle factors, including exercise in certain chronic diseases, have been associated with a lowered risk of death [7].

Veg and Exercise, a winning combo! (Photo: zuzyusa / Pixabay)

The proper context of epidemiology studies is to find statistical links (i.e. correlations) to build a hypothesis/theory. Experimental evidence, like a dietary intervention for sick patients, is needed to prove causation. But robust correlations are too significant to ignore, and deserve proper exploration. Otherwise, before we have sturdy experimental data, we chase the hypothesis of “miasma” during a cholera pandemic and ignore relevant, solid studies of a contemporary “John Snow”.

In recent times, the plant-based diet has now been tested and proven effective at the level of population studies and diet intervention trials for protection from many cancers [8, 9, 10], cardiovascular [11, 12] and metabolic diseases [11, 13, 14]. A comparison of studies involving over 1.6 million participants highlighted that, when tested, the “plant-based”/vegan diet is associated with the highest protection from risk of death, diabetes, cardiovascular disease and overall cancer incidence [7]. “Plant-based studies” have evolved even further to indicate that specific plant foods are effective protection against specific chronic diseases:

The book “How Not to Die” by Michael Greger and Gene Stone thoroughly details an impressive amount of scientific data behind plant-based health [19].

Confidence in the plant-based diet’s protective nature against many chronic diseases is bolstered in the context of all the experimental evidence that confirms it. Diet and health have many confounding variables, especially if you factor in lifestyle and psychological influences. But whether you are healthy or not, another day alive is another dice roll at life, statistically speaking. Why not “load the dice” and pile on all the dietary factors you can (at your own pace) to improve your chances at good health?

Play to Win! (Photo: Peter-Lomas / Pixabay)

Disclaimer: If you have medical concerns, please consult your doctor before implementing the opinions in this article.

N. Baiden PhD.

(References)

1. Snow, J. (1855) On the Mode of Communication of Cholera.

2. Chen, J., Campbell, T. C., Li, J. and Peto, R. (1990) Diet, Life-Style, and Mortality in China: A Study of the Characteristicsof 65 Chinese Counties. Oxford University Press, Cornell University Press, and People’s Medical Publishing House

3. Wynder, E. L. and Shigemat.T. (1967) Environmental factors of cancer of colon and rectum. Cancer. 20, 1520-&

4. Drasar, B. S. and Irving, D. (1973) Environmental factors and cancer of colon and breast. British Journal of Cancer. 27, 167–172

5. Campbell, T. C. and Jacobson, H. (2013) Whole: Rethinking the Science of Nutrition. BenBella Books, Inc.

6. Hill, A. B. (1965) Environment and disease — Association or Causation? Proceedings of the Royal Society of Medicine-London. 58, 295-&

7. Fields, H., Millstine, D., Agrwal, N. and Marks, L. (2016) Is Meat Killing Us? Journal of the American Osteopathic Association. 116, 296–300

8. McCarty, M. F. (1999) Vegan proteins may reduce risk of cancer, obesity, and cardiovascular disease by promoting increased glucagon activity. Medical Hypotheses. 53, 459–485

9. Barnard, R. J., Kobayashi, N. and Aronson, W. J. (2008) Effect of diet and exercise intervention on the growth of prostate epithelial cells. Prostate Cancer and Prostatic Diseases. 11, 362–366

10. Dewell, A., Weidner, G., Sumner, M. D., Barnard, R. J., Marlin, R. O., Daubenmier, J. J., Chi, C., Carroll, P. R. and Ornish, D. (2007) Relationship of dietary protein and soy isoflavones to serum IGF-1 and IGF binding proteins in the Prostate Cancer Lifestyle Trial. Nutrition and Cancer-an International Journal. 58, 35–42

11. Barnard, N. D., Cohen, J., Jenkins, D. J. A., Turner-McGrievy, G., Gloede, L., Jaster, B., Seidl, K., Green, A. A. and Talpers, S. (2006) A low-fat vegan diet improves glycemic control and cardiovascular risk factors in a randomized clinical trial in individuals with type 2 diabetes. Diabetes Care. 29, 1777–1783

12. Appleby, P. N., Davey, G. K. and Key, T. J. (2002) Hypertension and blood pressure among meat eaters, fish eaters, vegetarians and vegans in EPIC-Oxford. Public Health Nutrition. 5, 645–654

13. Malik, V. S., Li, Y., Tobias, D. K., Pan, A. and Hu, F. B. (2016) Dietary Protein Intake and Risk of Type 2 Diabetes in US Men and Women. American Journal of Epidemiology. 183, 715–728

14. Wright, N., Wilson, L., Smith, M., Duncan, B. and McHugh, P. (2017) The BROAD study: A randomised controlled trial using a whole food plant-based diet in the community for obesity, ischaemic heart disease or diabetes. Nutrition & Diabetes. 7

15. Thomson, C. D., Chisholm, A., McLachlan, S. K. and Campbell, J. M. (2008) Brazil nuts: an effective way to improve selenium status. American Journal of Clinical Nutrition. 87, 379–384

16. Thompson, C. A., Habermann, T. M., Wang, A. H., Vierkant, R. A., Folsom, A. R., Ross, J. A. and Cerhan, J. R. (2010) Antioxidant intake from fruits, vegetables and other sources and risk of non-Hodgkin’s lymphoma: the Iowa Women’s Health Study. International Journal of Cancer. 126, 992–1003

17. Lv, J., Qi, L., Yu, C., Yang, L., Guo, Y., Chen, Y., Bian, Z., Sun, D., Du, J., Ge, P., Tang, Z., Hou, W., Li, Y., Chen, J., Chen, Z., Li, L. and China Kadoorie Biobank, C. (2015) Consumption of spicy foods and total and cause specific mortality: population based cohort study. Bmj-British Medical Journal. 351

18. Gao, X., Cassidy, A., Schwarzschild, M. A., Rimm, E. B. and Ascherio, A. (2012) Habitual intake of dietary flavonoids and risk of Parkinson disease. Neurology. 78, 1138–1145

19. Greger, M. and Stone, G. (2015) How Not To Die. Flatiron Books

20. McAnulty, L. S., Nieman, D. C., Dumke, C. L., Shooter, L. A., Henson, D. A., Utter, A. C., Milne, G. and McAnulty, S. R. (2011) Effect of blueberry ingestion on natural killer cell counts, oxidative stress, and inflammation prior to and after 2.5 h of running. Applied Physiology Nutrition and Metabolism-Physiologie Appliquee Nutrition Et Metabolisme. 36, 976–984

21. Fraser, G. E., Sabate, J., Beeson, W. L. and Strahan, T. M. (1992) A possible protective effect of nut consumption on risk of coronary heart disease. The Adventist Health Study. Archives of internal medicine. 152, 1416–1424

22. Washio, M., Mori, M., Sakauchi, F., Watanabe, Y., Ozasa, K., Hayashi, K., Miki, T., Nakao, M., Mikami, K., Ito, Y., Wakai, K., Tamakoshi, A. and Grp, J. S. (2005) Risk factors for kidney cancer in a Japanese population: findings from the JACC study. Journal of Epidemiology. 15, S203-S211

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