Do Vegetarians Live Longer?

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

What Are The Health Benefits Of A Vegetarian Diet?

Author: Dr. Stephen Chaney

“Vegetarians don’t live longer, it just seems that way.” Many of you have probably heard that joke, but is it true? Are vegetarians healthier? Do vegetarians live longer? Is meat going to kill you? Let’s take a deep dive into the pros and cons of vegetarianism.

What Is Vegetarianism?

Vegetarianism encompasses a wide range of diets. At one extreme is the vegan diet. Vegans eat only plant derived foods. They don’t eat fish, meat, milk, eggs, or honey. It also goes without saying they eat only whole foods (whole grains, plant proteins, and fruits & vegetables) and avoid things like sodas, sugary foods, junk foods, and convenience foods. The most extreme form of veganism, popularized by such recent movies as “Eating You Alive” and “What the Health,” also eliminates all oils. This keeps fat at <10% of total calories.

do vegetarians live longerTo avoid confusion, I will refer to this as a “very low fat vegan diet.”  I will use the term “vegan diet” to refer to the more common veganism that includes vegetable oils in the diet. The vegan diet is still 100% plant based. It is also still relatively low in fat, generally in the 20-30% range. Since the fat comes from plants, it is predominantly the healthy monounsaturated and polyunsaturated fats.

Lacto-ovo vegetarians add low fat dairy foods and eggs to a plant based diet. The Ornish diet is a modified lacto-ovo vegetarian diet that also eliminates all oils and keeps fat at <10% of calories. Pesco-vegetarians add fish to a plant based diet, and semi-vegetarians add limited amounts of meat to a plant based diet.

Can Vegetarian Diets Reverse Atherosclerosis?

Let me start with studies on the very low fat vegan and Ornish diets. In addition to the diet, both programs emphasize regular exercise and stress reduction practices. Adherents to both plans generally achieve a serum total cholesterol of 150 or less. The Ornish diet and lifestyle program was designed to reduce the risk of cardiovascular disease, and it has been very well studied from that perspective. In studies of patients with severe atherosclerosis (clogged arteries) for periods of up to 5 years, the Ornish program results in a significant reduction in the degree of atherosclerosis (unclogs the arteries), inflammation, cardiac events (heart attack, stroke, etc.), and cardiac deaths (H.S. Dod et al, American Journal of Cardiology, 105: 362-367, 2010 ). vegetarianism good for the heartStudies with the very low fat vegan diet are more limited, but suggest that it also reverses atherosclerosis and reduces cardiac deaths (C.B. Esselstyn et al, Journal of Family Practice, 63: 356-364, 2014 ).

Before moving on to other forms of vegetarianism, let me make the point that these are the only diets that have been shown to actually reverse atherosclerosis. That is a big deal.

 

The Seventh-Day Adventist Studies

Perhaps the largest group of studies on the health effects of vegetarians has been conducted on the Seventh-day Adventist population located in Southern California. Seventh-day Adventists believe that “God calls us to care for our bodies, treating them with the respect a divine creation deserves.” The Adventist church advocates a vegan diet consisting of legumes, whole grains, nuts, fruits, and vegetables. However, it allows personal choice, so a significant number of Adventists choose lacto-ovo vegetarian, pesco-vegetarian, or semi-vegetarian diets.

That diversity has not only allowed studies of the Adventist population to not only compare a vegetarian diet to the standard American diet of the non-Adventist population living in the same area, but also to compare the various forms of vegetarian diets. There are dozens of published studies and several reviews on this topic. I will cite only the most recent review here (L.T. Le  and J. Sabate, Nutrients, 6: 2131-2147, 2014 ), but I will provide a complete list in my upcoming book.

This and other reviews have concluded that vegetarians weigh less, have less inflammation, have lower cholesterol levels and have lower risk of diabetes, heart disease, and hypertension than non-vegetarians. When we compare the various forms of vegetarianism, vegan diets appear to offer somewhat greater protection against obesity, hypertension, diabetes, and cardiovascular mortality than lacto-ovo and semi-vegetarian diets. The health benefits of vegetarian diets also seem to be somewhat greater for men than for women. One might speculate that might be because the average American male has a worse diet than the average American female. So, when men adopt a vegetarian diet, it may represent a greater improvement.

The reviews also looked at the nutritional adequacy of vegetarian diets. Vegetarian diets in general are very rich in antioxidants, most B vitamins, and polyphenols. Nutrients of concern for vegan diets are vitamin B12, vitamin D, calcium, iron, zinc, and long chain omega-3 fatty acids. Of those, vitamin B12 and long-chain omega-3 fatty acids are the ones most likely to require supplementation. Adequate levels of the other nutrients can be achieved by a well-designed vegan diet.

I would add protein to the list. Don’t misunderstand me. It is possible to get adequate protein on a vegetarian diet that includes beans and other legumes as a protein source. However, vegan advocates have been telling people they get all the protein they need from broccoli and other vegetables. That is incredibly bad advice, especially for seniors who are likely to suffer from sarcopenia (age related loss of muscle mass). Broccoli only provides 3 grams of protein per serving. You would need 15 servings to meet the protein RDA for women and almost 19 servings for men. Unfortunately, I often run across seniors who think they are getting all the protein they need from green salads and steamed vegetables. The bad advice from vegan advocates may be condemning them to unnecessary frailty in their old age.

What about the health claims of the low carbohydrate diets? Most of those “health benefits” are inferred from changes in blood parameters that occur over the first few weeks or months someone adopts those diets. There are no long-term data showing that low carbohydrate diets reduce the prevalence of diabetes, heart disease or cancer. Moreover, the few studies that compare low carbohydrate and vegetarian diets suggest the vegetarian diet is superior. For example, a recent study (M. Miller et al, Journal of the American Dietetic Association, 109: 713-717, 2009 ) compared the Atkins diet (the granddaddy of the low carb diets) with the Ornish diet. People on the low-fat Ornish diet had significantly lower LDL-cholesterol, apoB, and C-reactive protein (a marker of inflammation) and had better arterial function than people on the high fat Atkins diet.

Do Vegetarians Live Longer?

What about the original question. Do vegetarians live longer? The answer isn’t clear. The Adventist Health Studies have reported that Adventist men live 6-7 years longer and Adventist women live ~4 years longer than their non-Adventist neighbors. However, the Adventist population may have other characteristics that contribute to their longevity. I will cover that in the section on “Blue Zones” in my upcoming book. In contrast, a very recent Australian study(S. Mihrshahi et al, Preventive Medicine, 97: 1-7, 2017 ) concluded that all-cause mortality was virtually identical for vegetarians and non-vegetarians. However, the authors of this study speculated that vegetarians in Australia have become less healthy in recent years because they are now consuming more high-sugar, processed “vegetarian” foods. Remember what I said about “Big Food Inc.” not being your friend.

What Does This Mean For You?

do vegetarians live longer or notThere are a few simple take-home messages from the research on the various forms of a vegetarian diet:

  • The Ornish diet and the very low fat vegan diet are the only diets shown to reverse atherosclerosis. If you have serious heart disease and would like to minimize your reliance on drugs and surgery, you should consider them. You will, of course, want to let your doctor know what you are doing.
  • Vegetarians are leaner and significantly healthier than non-vegetarians.
  • Vegans are slightly healthier than lacto-ovo and semi-vegetarians, but even vegetarians who include some dairy, eggs & meat in a primarily plant-based diet are much healthier than most Americans.
  • Vegetarians may not live longer, but they do live healthier longer.

There are also several subtle, but equally important, implications from these studies:

  • You can forget the claims you must be a vegan purist to obtain any health benefits from vegetarianism.If you watch movies like “Eating You Alive” or “What the Health”, you are led to believe you will suffer terrible health consequences if you add any dairy, eggs, or meat to a vegan diet. In fact, the evidence for reversing atherosclerosis is stronger for the Ornish diet, which is a lacto-ovo-vegetarian diet, than it is for a pure vegan diet. For several other health outcomes, the vegan diet is slightly more effective, but both lacto-ovo-vegetarian and semi-vegetarian diets are much healthier than the standard American diet.
  • Vegetarian diets are whole food diets.If you start adding in processed and convenience foods, even if they are labeled “vegan,” you are likely to lose all the health benefits of a vegetarian diet.
  • You can forget claims that you get all the protein you need from vegetables like broccoli. That is incredibly bad advice which is likely to condemn seniors to unnecessary frailty in old age.
  • You can forget the claims that you must avoid carbs at all costs. The proponents of the low carb diets will tell you that recommendations to limit fat are based on a lie. They tell you that fat is good for you and carbs will cause you to gain weight, increase inflammation, and increase your risk of diabetes, heart disease, and cancer. You are told to avoid grains and any other foods containing carbohydrate, including some fruits and vegetables. The “danger” of carbohydrates is only true for the refined grains, sugary sodas and junk foods in the standard American diet. Vegetarian diets emphasize whole grains, fruits and vegetables. They are high in carbohydrate and low in fat, and they reduce weight, inflammation, diabetes, heart disease, and some cancers.
  • You can forget most claims of weight loss. Most low carb diets tout rapid initial weight loss. Unfortunately, most of that weight comes back a year or two later. Only vegetarian diets are associated with lower weight over a period of many years.

In summary, a pure vegan diet is probably the healthiest form of vegetarianism, but it is difficult to follow. Vegetarian diets that are primarily plant based, but contain small amounts of dairy, eggs, or meat are also very healthy, and may be easier for the average American to follow.

 

The Bottom Line

 

Vegetarianism encompasses a wide range of diets. The standard vegan diet is entirely plant-based. There is a very low fat version of the vegan diet that also eliminates all oils. Lacto-ovo-vegetarian diets include some dairy and eggs. Semi-vegetarian diets include some meat. The Ornish diet is a very low fat version of the lacto-ovo-vegetarian diet.

There are a few simple take-home messages from the research on the various forms of a vegetarian diet:

  • The Ornish diet and the very low fat vegan diet are the only diets shown to reverse atherosclerosis.
  • Vegetarians are leaner and significantly healthier than non-vegetarians.
  • Vegans are slightly healthier than lacto-ovo– and semi-vegetarians, but even vegetarians who include some dairy, eggs & meat in a primarily plant-based diet are much healthier than most Americans.
  • In a head to head comparison, the Ornish diet was significantly healthier than the Atkins diet.
  • Vegetarians may not live longer, but they do live healthier longer.

There are also several subtle, but equally important, implications from these studies:

  • You can forget the claims you must be a vegan purist to obtain any health benefits from vegetarianism. Primarily plant-based diets with small amounts of dairy, eggs or meat are also very healthy.
  • Vegetarian diets are whole food diets. If you start adding in processed and convenience foods, even if they are labeled “vegan,” you are likely to lose all the health benefits of a vegetarian diet.
  • You can forget claims that you get all the protein you need from vegetables like broccoli. That is incredibly bad advice which is likely to condemn seniors to unnecessary frailty in old age.
  • You can forget the claims that you must avoid carbs at all costs. That is only true for the refined grains, sugary sodas and junk foods in the standard American diet. Vegetarian diets are high in carbohydrate, low in fat, and  very healthy.
  • You can forget most claims of weight loss. Only vegetarian diets are associated with lower weight over a period of many years.

In summary, a pure vegan diet is probably the healthiest form of vegetarianism, but it is difficult to follow. Vegetarian diets that are primarily plant based, but contain small amounts of dairy, eggs, or meat are also very healthy, and may be easier for the average American to follow.

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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Comments (6)

  • eroca

    |

    What a refreshing common sense overview. I do not hesitate to share this REAL NEWS. Thanks, Dr Chaney, I appreciate your wisdom.

    Can you imagine living a world not poisoned and also having the great innovations to manage bringing up our vibration?

    Keep on keeping on, thank you.

    Reply

  • Caroline

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    Having studied Oriental Medicine with several, I found them sick more, and their teeth, lacking calcium,turning grey to black. Some were thin but others were FAT. What bothered me was treating their babies and small children on either a vegan or vegetarian diet. The plant protein does not have the same health effect on the body. Even Dr. Scala, a vegan, ate a hamburger patty monthly simply because red meat does many health needs in the body, especially getting calcium to the bones. In all my years as a health consultant, I would never ever recommend a vegan/vegetarian diet as too risky with good vibrant health. They do tend to eat more sweets and way too much fruit which is hard on the liver, AND they never want to hear about good nutrition and I think this means they will never (and many have not) make great Chinese medicine whether at Master’s level and definitely NOT at the doctoral level and we are obliged to talk nutrition in CA as acupuncturists but many avoid talking nutrition. Sure glad I studied nutrition because at 80 and my spouse at 85 we are in great condition due to Shaklee nutrients and eating what our bodies need and want. AND we have good teeth, complexion, energy and don’t look our ages (vanity is good!) and I started Youth just less than 3 weeks ago due to product delays but am noticing some good happenings already.

    Reply

  • Caroline

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    Sad to say but the Adventists I knew for years both died of cancer and not pretty deaths either. The vegans I studied with wound up with darken teeth and one with absolutely black teeth, gray hair in their 30’s and constantly down with something. Sorry, but the body does need red meat for many purposes. We grow and eat a lot veggies along with good proteins and thus far in our “older years” have our teeth, I have very little gray hair, and we have energy! Those vegans I knew had been getting FAT and not a lot of energy. We have choices for sure, but I will stick to a diet that gives real health including some flesh and not just all veggies which ruin the yin/yang of soil in which to grow them healthily. We use no chemicals on our garden nor trees either.

    Reply

    • Dr. Steve Chaney

      |

      Dear Caroline, One can always pick individual stories to “prove” or “disprove” any diet. What I report on is clinical studies. They provide evidence for what diet works best for most people.. If you have been following “Health Tips From the Professor” for a while, you would know that I also recommend primarily plant-based diets that include some animal protein, like the Mediterranean or DASH diets.
      Dr. Chaney

      Reply

  • Diana

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    I enjoyed reading this article. I am part of the Vegan Living Group here on Long Island. Most “Pure Vegans” I know have become so because of animal Advocacy-To save the animals, the rainforest and other Eco environmental factors. We know that Factory farming and even Grass fed smaller farming are ruining the environment. (Cowspiracy is a film that shows us the ills of factory farming.) A lot of these consciencious people eat oreos and tofudogs and other processed vegan foods. So I dont like the label Vegan because it doesnt necessarily mean healthy . I prefer the term Whole Foods Plant Based inspired by Dr T Colin Campbell and Dr. Essylstein featured in films such as Forks over knives and Plant Pure Nation. Although I myself am not 100% consistant, when I am-I feel amazing. Thank You.

    Reply

    • Dr. Steve Chaney

      |

      Dear Diana,
      You are right. Any diet can be corrupted if we start eating processed foods and goodies. Whole unprocessed, foods are the cornerstone of any healthy diet.
      Dr. Chaney

      Reply

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Latest Article

High Protein Diets and Weight Loss

Posted October 16, 2018 by Dr. Steve Chaney

Do High Protein Diets Reduce Fat And Preserve Muscle?

Author: Dr. Stephen Chaney

Healthy Diet food group, proteins, include meat (chicken or turkAre high protein diets your secret to healthy weight loss? There are lots of diets out there – high fat, low fat, Paleolithic, blood type, exotic juices, magic pills and potions. But recently, high protein diets are getting a lot of press. The word is that they preserve muscle mass and preferentially decrease fat mass.

If high protein diets actually did that, it would be huge because:

  • It’s the fat – not the pounds – that causes most of the health problems.
  • Muscle burns more calories than fat, so preserving muscle mass helps keep your metabolic rate high without dangerous herbs or stimulants – and keeping your metabolic rate high helps prevent both the plateau and yo-yo (weight regain) characteristic of so many diets.
  • When you lose fat and retain muscle you are reshaping your body – and that’s why most people are dieting to begin with.

So let’s look more carefully at the recent study that has been generating all the headlines (Pasiakos et al, The FASEB Journal, 27: 3837-3847, 2013).

The Study Design:

This was a randomized control study with 39 young (21), healthy and fit men and women who were only borderline overweight (BMI = 25). These volunteers were put on a 21 day weight loss program in which calories were reduced by 30% and exercise was increased by 10%. They were divided into 3 groups:

  • One group was assigned a diet containing the RDA for protein (about 14% of calories in this study design).
  • The second group’s diet contained 2X the RDA for protein (28% of calories)
  • The third group’s diet contained 3X the RDA for protein (42% of calories)

In the RDA protein group carbohydrate was 56% of calories, and fat was 30% of calories. In the other two groups the carbohydrate and fat content of the diets was decreased proportionally.

Feet_On_ScaleWhat Did The Study Show?

  • Weight loss (7 pounds in 21 days) was the same on all 3 diets.
  • The high protein (28% and 42%) diets caused almost 2X more fat loss (5 pounds versus 2.8 pounds) than the diet supplying the RDA amount of protein.
  • The high protein (28% and 42%) diets caused 2X less muscle loss (2.1 pounds versus 4.2 pounds) than the diet supplying the RDA amount of protein.
  • In case you didn’t notice, there was no difference in overall results between the 28% (2X the RDA) and 42% (3X the RDA) diets.

Pros And Cons Of The Study:

  • The con is fairly obvious. The participants in this study were all young, healthy and were not seriously overweight. If this were the only study of this type one might seriously question whether the results were applicable to middle aged, overweight coach potatoes. However, there have been several other studies with older, more overweight volunteers that have come to the same conclusion – namely that high protein diets preserve muscle mass and enhance fat loss.
  • The value of this study is that it defines for the first time the upper limit for how much protein is required to preserve muscle mass in a weight loss regimen. 28% of calories is sufficient, and there appear to be no benefit from increasing protein further. I would add the caveat that there are studies suggesting that protein requirements for preserving muscle mass may be greater in adults 50 and older.

The Bottom Line:

1)    Forget the high fat diets, low fat diets, pills and potions. High protein diets (~2X the RDA or 28% of calories) do appear to be the safest, most effective way to preserve muscle mass and enhance fat loss in a weight loss regimen.

2)     That’s not a lot of protein, by the way. The average American consumes almost 2X the RDA for protein on a daily basis. However, it is significantly more protein than the average American consumes when they are trying to lose weight. Salads and carrot sticks are great diet foods, but they don’t contain much protein.

3)     Higher protein intake does not appear to offer any additional benefit – at least in young adults.

4)     Not all high protein diets are created equal. What some people call high protein diets are laden with saturated fats or devoid of carbohydrate. The diet in this study, which is what I recommend, had 43% healthy carbohydrates and 30% healthy fats.

5)    These diets were designed to give 7 pounds of weight loss in 21 days – which is what the experts recommend. There are diets out there promising faster weight loss but they severely restrict calories and/or rely heavily on stimulants, they do not preserve muscle mass, and they often are not safe. In addition they are usually temporary.  I do not recommend them.

6)    This level of protein intake is safe for almost everyone. The major exception would be people with kidney disease, who should always check with their doctor before increasing protein intake. The only other caveat is that protein metabolism creates a lot of nitrogenous waste, so you should drink plenty of water to flush that waste out of your system. But, water is always a good idea.

7)     The high protein diets minimized, but did not completely prevent, muscle loss. Other studies suggest that adding the amino acid leucine to a high protein diet can give 100% retention of muscle mass in a weight loss regimen – but that’s another story for another day.

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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