What Is The Pegan Diet?

Written by Dr. Steve Chaney on . Posted in Pegan Diet

Is The Pegan Diet Healthy?

Author: Dr. Stephen Chaney

 

pegan diet newsJust when you thought you had heard about every possible diet, along comes a new one called the Pegan diet. What is the Pegan Diet and is it healthy?

The Pegan diet was introduced by Dr. Mark Hyman in his new book, “Food: What the Heck Should I Eat?”. I don’t agree with Dr. Hyman on everything (which will become apparent when I review his diet), but I hold him in high regard. He is much more credible than most of the doctors who are writing popular blogs and diet books.

Basically, the Pegan diet is a combination of the Paleo and Vegan diets (hence the name). It
was meant to combine the best features of each while eliminating their drawbacks.

 

What Are The Pros & Cons Of The Vegan And Paleo Diets?

 

pegan diet fruits and vegetablesPros And Cons Of The Vegan Diet:

Dr. Hyman listed the following pros:

  • The diet ideally incorporates mostly whole, plant-based foods.
  • It provides lots of vitamins (especially antioxidants and most of the B vitamins), fiber, and healthy fats (monounsaturated and polyunsaturated fats).
  • It avoids what he calls the “baggage that comes from feedlot meat”. He is, of course, referring to the inhumane way that most of the animals that end up on our plates are treated. It also avoids the saturated and trans fats associated with the meats most Americans prefer.

I would add that Vegan diets are very healthy. As I discuss in my book, “Slaying the Food
Myths” (https://slayingthefoodmyths.com). we know that people who consume whole food
Vegan diets over a period of many years weigh less and have lower incidence of heart
disease, diabetes, and cancer than the general population.

Dr. Hyman listed the following cons:

  • Vegan diets are likely to be deficient in vitamin B12, iron, zinc, copper, and vitamin D.
    Of these deficiencies, B12 is the most serious because B12 only comes from animal
    foods.
  • Vegan diets will not provide enough of the heart healthy omega-3s, EPA and DHA.
    Again, that’s because these omega-3 fatty acids come primarily from animal sources.
  • Vegan diets may not provide enough protein, especially for seniors because they have
    increased protein requirements. It is possible to get enough protein from Vegan foods,
    but some diligence is required.
  • The food industry provides plenty of highly processed, junk food versions of “Vegan”
    foods. So, it is possible to be Vegan and eat an unhealthy diet.

I would concur and add that calcium is another likely deficiency for Vegans

Pros & Cons Of the Paleo Diet:

pegan diet meatDr. Hyman listed the following pros:

  • The Paleo diet eliminates most sugars and grains. That eliminates sodas, junk foods, and most processed foods, which is a very good thing.
  • It is a low-glycemic diet, which is helpful for people with diabetes. He went on to say that it could reverse type 2 diabetes.

I would concur and add that it has a healthier profile of fats than most low-carb diets.

However, I would also note that a low-carb version of the Mediterranean diet is also helpful for people with diabetes, and a whole food, very low-fat version of the Vegan diet has also been shown to reverse type 2 diabetes.

Dr. Hyman listed the following cons:

  • The Paleo diet is essentially a myth. There were many types of diets in prehistoric times.
  • Many people following the Paleo diet consume too much meat and too little plant-based foods.
  • Our prehistoric ancestors may have consumed as much as 100-150 grams of fiber a day. The average American consumes 8 -15 grams a day, and people on a Paleo diet may consume even less. (Note: The estimate of 100-150 grams of fiber per day is based on the same type of faulty evidence that lead to the Paleo diet in the first place. Our prehistoric ancestor’s fiber intake probably varied tremendously depending on their local food supply. However, it is safe to assume they ate much more fiber than we do.)

I would concur and add:

  • Studies have shown that women consuming the Paleo diet have low intakes of calcium, magnesium, iodine, thiamin, riboflavin, and folate.
  • The Paleo diet relies heavily on red meat, which an agency of the World Health Organization has classified as a probable carcinogen. Reliance on grass-fed beef in the Paleo diet does not reduce this concern.
  • There is no evidence that the Paleo diet is healthy long term. In fact, there is no evidence that any meat-based, low-carb diet is healthy long term.

For more about the pros and cons of the Vegan and Paleo diets – plus which diets I consider healthy – see my book “Slaying The Food Myths.

What Is The Pegan Diet?

In the words of Dr. Hyman: “…the best versions of both diets [Paleo and Vegan] are built on the same foundation: Eat real, whole food. Vegan and Paleo diets focus on foods that don’t raise our blood sugar, plenty of fresh vegetables and fruits, healthy protein and [healthy] fats, and no crap [junk foods].” Dr. Hyman started with that foundation for the Paleo diet.

Here are Dr. Hyman’s 12 characteristics of his Pegan diet with my comments:

 

#1. Stay away from sugar. My comment: He gets an A+ for this one because, unlike many of today’s diet gurus, he is not telling you to avoid all sugars. He is focusing on the sugars and refined carbohydrates that cause spikes in blood sugar and insulin levels. As I point out in my book, there is the same amount of sugar in an 8-oz soda and a medium apple. It’s the sodas, refined carbs, and sugary foods you want to avoid, not apples.

pegan diet plant-based#2: Eat mostly plants. My comment: Again, he gets an A+ for this one. He recommends covering half your plate with a variety of colorful fruits and vegetables.

#3. Easy on the fruits. My comment: This one is an A-. He is correct in pointing out that some fruits like grapes and melons are higher in sugar and/or lower in fiber than other fruits. He is missing the point that blood sugar response to foods is a very individual characteristic. Some people do well on most fruits. Other people need to be more careful about which fruits they eat.

#4: Stay away from pesticides, antibiotics, hormones, and GMO foods. My comment: Another A+, especially because he included artificial additives, preservatives, dyes, and sweeteners.

#5: Eat foods containing healthy fats. My comment: I give him a B- for this one. He is right on the mark when he talks about polyunsaturated omega-3 fats and the monounsaturated fats found in nuts, seeds, olive oil, and avocados as being healthy. He is a bit off-base when he starts talking about “healthy” saturated fats in grass-fed beef and butter. He also advocates coconut oil despite the fact there is no good long-term evidence coconut oil is healthy.

#6: Stay away from most vegetable, nut, and seed oils. My comment: He gets a C- for this one. These oils are a good source of omega-6 polyunsaturated fats, which are essential for the human body. There is nothing inherently unhealthy about them. However, I do agree with him that we consume way too much of these oils in relation to monounsaturated and omega-3 polyunsaturated oils. If he had said “reduce consumption of” rather than “stay away from” those oils, I would have upgraded him to an A-.

pegan diet dairy#7: Avoid or limit dairy. My comment: He gets a B for this one. The statement that dairy “doesn’t work for most people” is a myth. Avoiding or limiting dairy is excellent advice for anyone who is dairy-sensitive. I would also agree that we should not necessarily be aiming for 2 to 3 servings of dairy per day for everyone. However, dairy is a major source of calcium, magnesium, and vitamin D in the American diet. If dairy is to be eliminated or limited, consideration should be given to where people will get those important nutrients.

#8: Think of meat and animal products as condiments – not the main course. My comment: He gets an A+ for this one. As I say in my book, fruits and vegetables can neutralize many of the toxic effects of meats. One or two ounces of meat in a green salad or a stir fry is much healthier than a 6-ounce steak with fries.

#9: Eat sustainably raised or harvested low-mercury fish. My comment: He gets an A- for this one. I downgraded him because he ignored contamination of fish with PCBs and other industrial chemicals. Once you take that into account, most farm-raised and some sustainably harvested fish are eliminated from consideration.

#10. Avoid gluten. My comment: He gets a C- for this one. It is good advice if you are gluten sensitive. If you are not, gluten-containing foods are not generally a problem. The real focus should be on the blood sugar response to the food, not on whether the food contains wheat or another gluten-containing grain.

#11: Eat gluten-free whole grains sparingly. My comment: This one rates a D. Whole grains are a good source of some nutrients like vitamin E. They are also an excellent source of fiber. It is important to realize that there are many types of fiber and each plays a different role in intestinal health. The fibers found in whole grains are different than those found in fruits and vegetables. They are an important part of a healthy diet. Dr. Hyman states that whole grains also raise blood sugar. That is an overstatement. Their effect on blood sugar may not be zero, but it is less than that of refined grains. Moreover, when eaten as part of a healthy meal, their effect on blood sugar is minimal.

#12: Eat beans only once in a while. My comment: He gets a D- for this one. He has already limited meat to a condiment. If you are also only eating beans every once in a while, you will have trouble meeting your protein requirements, especially as you get older.

You will find more details about the science behind many of the comments I made above in my book, “Slaying The Food Myths.”

 

Is The Pegan Diet Healthy?

The simple answer is that no long-term studies have been done, so we have no evidence that the Pegan diet is either healthy or unhealthy. However, the Pegan diet incorporates many of the best features of the Vegan diet, and we know the Vegan diet is very healthy long term. We also know that a semi-vegetarian diet is almost as healthy as the Vegan diet, so incorporating small amounts of meat into the Pegan diet is unlikely to make it unhealthy. On the basis of those considerations, the Pegan diet would appear to be healthy.

However, we have 5 food groups for a reason. Any time you eliminate food groups you introduce potential nutritional deficiencies that can affect your health. That is why I have concerns about statements like “Stay away from most vegetable, nut, and seed oils”, “Avoid dairy”, “Eat…whole grains sparingly”, and “Eat beans only once in a while”. If you removed those limitations, the Pegan diet would likely be very healthy. However, as it is currently described, the Pegan diet has too many questionable restrictions to be considered as healthy.

 

The Bottom Line

 

Dr. Mark Hyman has combined the best features of the Paleo and Vegan diets to create a new diet, which he calls the Pegan diet.

I have analyzed the Pegan diet in great detail in the article above:

  • It has many characteristics of a healthy diet.
  • However, it also has several unwarranted dietary restrictions that are likely to create nutritional deficiencies which may have adverse health consequences.
  • There are no long-term studies to tell us whether the Pegan diet is healthy or unhealthy.

In summary, the diet has some good features and some bad features. Because it has both good and bad features, one cannot predict whether the diet will be healthy or unhealthy long term. Until there is long-term experimental evidence that it is healthy, I cannot recommend it.

For more details, read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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Latest Article

Can Plant-based Diets Be Unhealthy?

Posted September 10, 2019 by Dr. Steve Chaney

Do Plant-Based Diets Reduce Heart Disease Deaths?

Author: Dr. Stephen Chaney

 

plant-based diets vegetablesPlant-based diets have become the “Golden Boys” of the diet world. They are the diets most often recommended by knowledgeable health and nutrition professionals. I’m not talking about all the “Dr. Strangeloves” who pitch weird diets in books and the internet. I am talking legitimate experts who have spent their life studying the impact of nutrition on our health.

Certainly, there is an overwhelming body of evidence supporting the claim that plant-based diets are healthy. Going on a plant-based diet can help you lower blood pressure, inflammation, cholesterol and triglycerides. People who consume a plant-based diet for a lifetime weigh less and have decreased risk of heart disease, diabetes, and cancer.

But, can a plant-based diet be unhealthy? Some people consider a plant-based diet to simply be the absence of meat and other animal foods. Is just replacing animal foods with plant-based foods enough to make a diet healthy?

Maybe not. After all, sugar and white flour are plant-based food ingredients. Fake meats of all kinds abound in our grocery stores. Some are very wholesome, but others are little more than vegetarian junk food. If you replace animal foods with plant-based sweets, desserts, and junk food, is your diet really healthier?

While the answer to that question seems obvious, very few studies have asked that question. Most studies on the benefits of plant-based diets have compared population groups that eat a strictly plant-based diet (Seventh-Day Adventists, vegans, or vegetarians) with the general public. They have not looked at variations in plant food consumption within the general public. Nor have they compared people who consume healthy and unhealthy plant foods.

This study (H Kim et al, Journal of the American Heart Association, 8:e012865, 2019) was designed to fill that void.

 

How Was The Study Done?

plant-based diets studyThis study used data collected from 12,168 middle aged adults in the ARIC (Atherosclerosis Risk in Communities) study between 1987 and 2016.

The participant’s usual intake of foods and beverages was assessed by trained interviewers using a food frequency questionnaire at the time of entry into the study and again 6 years later.

Participants were asked to indicate the frequency with which they consumed 66 foods and beverages of a defined serving size in the previous year. Visual guides were provided to help participants estimate portion sizes.

The participant’s adherence to a plant-based diet was assessed using four different well-established plant-based diet scores. For the sake of simplicity, I will include 3 of them in this review.

  • The PDI (Plant-Based Diet Index) categorizes foods as either plant foods or animal foods. A high PDI score means that the participant’s diet contains more plant foods than animal foods. A low PDI score means the participant’s diet contains more animal foods than plant foods.
  • The hPDI (healthy plant-based diet index) is based on the PDI but emphasizes “healthy” plant foods. A high hPDI score means that the participant’s diet is high in healthy plant foods (whole grains, fruits, vegetables, nuts, legumes, coffee and tea) and low in animal foods.
  • The uPDI (unhealthy plant-based diet index) is based on the PDI but emphasizes “unhealthy” plant foods. A high uPDI score means that the participant’s diet is high in unhealthy plant foods (refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts) and low in animal foods.

For statistical analysis the scores from the various plant-based diet indices were divided into 5 equal groups. In each case, the group with the highest score consumed the most plant foods and least animal foods. The group with the lowest score consumed the least plant foods and the most animal foods.

The health outcomes measured in this study were heart disease events, heart disease deaths, and all-cause deaths. Again, for the sake of simplicity, I will only include 2 of these outcomes (heart disease deaths and all-cause deaths) in this review. The data on deaths were obtained from state death records and the National Death Index. (Yes, your personal information is available on the web even after you die.)

 

Do Plant-Based Diets Reduce Heart Disease Deaths?

plant-based diets reduce heart deathsThe participants in this study were followed for an average of 25 years.

The investigators looked at heart disease deaths over the 25 years and compared people with the highest intake of plant foods to people with the highest intake of red meat and other animal foods. The results were:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods (whole grains, fruits, vegetables, nuts, legumes, coffee and tea) had a 19-32% lower risk of dying from heart disease than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods (refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts) had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

When the investigators looked at all-cause deaths over the 25 years:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods had an 11-25% lower risk of dying from any cause than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

What Else Did The Study Show?

The investigators made a couple of other interesting observations:

  • The association of the overall diet with heart disease and all-cause deaths was stronger than the association of individual food components. This underscores the importance of looking at the effect of the whole diet on health outcomes rather than the “magic” foods you hear about on Dr. Strangelove’s Health Blog.
  • Diets with the highest amount of healthy plant foods were associated with higher intake of carbohydrates, plant protein, fiber, and micronutrients, including potassium, magnesium, iron, vitamin A, vitamin C, folate, and lower intake of saturated fat and cholesterol.
  • Diets with the highest amount of unhealthy plant foods were associated with higher intake of calories and carbohydrates and lower intake of fiber and micronutrients.

The last two observations may help explain some of the health benefits of plant-based diets.

 

Can Plant-Based Diets Be Unhealthy?

plant-based diets unhealthy cookiesNow, let’s return to the question I asked at the beginning of this article: “Can plant-based diets be unhealthy?” Although some previous studies have suggested that unhealthy plant-based diets might increase the risk of heart disease, this study did not show that.

What this study did show was that an unhealthy plant-based diet was no better for you than a diet containing lots of red meat and other animal foods.

If this were the only conclusion from this study, it might be considered a neutral result. However, this result clearly contrasts with the data from this study and many others showing that both plant-based diets in general and healthy plant-based diets reduce the risk of heart disease deaths and all-cause deaths compared to animal-based diets.

The main message from this study is clear.

  • Replacing red meat and other animal foods with plant foods can be a healthier choice, but only if they are whole, minimally processed plant foods like whole grains, fruits, vegetables, nuts, legumes, coffee and tea.
  • If the plant foods are refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts, all bets are off. You may be just as unhealthy as if you kept eating a diet high in red meat and other animal foods.

There is one other subtle message from this study. This study did not compare vegans with the general public. Everyone in the study was the general public. Nobody in the study was consuming a 100% plant-based diet.

For example:

  • The group with the highest intake of plant foods consumed 9 servings per day of plant foods and 3.6 servings per day of animal foods.
  • The group with the lowest intake of plant foods consumed 5.4 servings per day of plant foods and 5.6 servings per day of animal foods.

In other words, you don’t need to be a vegan purist to experience health benefits from adding more whole, minimally processed plant foods to your diet.

 

The Bottom Line

A recent study analyzed the effect of consuming plant foods on heart disease deaths and all-cause deaths over a 25-year period.

When the investigators looked at heart disease deaths over the 25 years:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods had a 19-32% lower risk of dying from heart disease than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

When the investigators looked at all-cause deaths over the 25 years:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods had an 11-25% lower risk of dying from any cause than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

The main message from this study is clear.

  • Replacing red meat and other animal foods with plant foods can be a healthier choice, but only if they are whole, minimally processed plant foods like whole grains, fruits, vegetables, nuts, legumes, coffee and tea.
  • If the plant foods are refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts, all bets are off. You may be just as unhealthy as if you kept eating a diet high in red meat and other animal foods.

A more subtle message from the study is that you don’t need to be a vegan purist to experience health benefits from adding more whole, minimally processed plant foods to your diet. The people in this study were not following some special diet. The only difference was that some of the people in this study ate more plant foods and others more animal foods.

For more details on the study, read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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