Vegetarians and Stroke Risk Factors—Vegan Junk Food?

"Vegetarians and Stroke Risk Factors
—Vegan Junk Food?" Plant-based diets are
associated with a lower risk of cardiovascular disease, mortality, and
dying from all causes put together. This study of a diverse sample
of 12,000 Americans found that “progressively increasing
the intake of plant foods by reducing the intake of
animal foods may be associated with beneﬁts on cardiovascular
health and mortality…”, but when it comes to plant-based diets
for cardiovascular disease prevention, all plant foods are not created equal. Were the vegetarians in the
British study that found the higher stroke risk just
eating a lot of vegan junk food? Any diet devoid of certain
animal food sources can be claimed to be a
vegetarian or vegan diet; so, it’s important to see
what they’re actually eating. One of the first things I look
at when I’m trying to see how serious a population is
about healthy eating is look at something undeniably, uncontroversially
bad: soda, liquid candy. Anyone drinking straight
sugar water obviously doesn’t have health top of mind. In the big study of plant-based
eaters in America, where people tend to cut down
on meat for health reasons far more than ethics… flexitarians
drink fewer sugary beverages than regular meat-eaters, as do
pescatarians, vegetarians, and vegans.

In the UK study, though, where the
increased stroke risk was found, where folks are more likely to go
veg or vegan for ethical reasons, the pescatarians are drinking less soda, but the vegetarians and
vegans are drinking more. I’m not saying that’s
why they had more strokes; it just might give us an idea of
how healthy the people were eating. In the UK study, the vegetarians and
vegan men and women were eating about the same amount of
desserts, cookies, and chocolate, and about the same total sugar.

In the U.S. study, the average
non-vegetarian is nearly obese, even the vegetarians
are a little overweight, and the vegans were the
only ideal weight group. In this analysis of the UK study, though,
everyone was about the same weight— in fact the meat-eaters
were skinnier than the vegans. The EPIC-Oxford study seems to
have attracted a particularly health conscious group of meat-eaters weighing substantially less
than the general population. Let’s look at some particular
stroke-related nutrients. Dietary fiber appears beneficial
for the prevention of cardiovascular disease
including stroke, and it appears the more the better. Based on studies of nearly a half
a million men and women there doesn’t seem to be any
upper threshold of benefit; so, the more, the better. More than
25 grams of soluble fiber, 47 grams of insoluble dietary
fiber and you can really start seeing a significant drop
in associated stroke risk. So, one could consider these
as the minimal recommendable daily intakes to prevent
stroke at a population level. That’s what you see in people
eating diets centered around minimally processed plant foods.
Dean Ornish got up around there with his whole food plant-based diet.

Maybe not as much as
we were designed to eat, based on the analyses of fossilized feces, but that’s the kind of neighborhood
where we might expect significantly lower stroke risk. How much were the
UK vegetarians getting? 22.1. Now, in the UK they measure
fiber a little differently; so, that may actually
be closer to 30 grams, but not the optimal level
for stroke prevention. So little fiber that the vegetarians
and vegans only beat out the meat-eaters by about 1
or 2 bowel movements a week, suggesting they were eating
lots of processed foods.

The vegetarians were only
eating about a half serving more of fruits and vegetables,
thought to reduce stroke risk in part because of
their potassium content, yet the UK vegetarians at
higher stroke risk were evidently eating so few greens and beans they
couldn’t even match the meat-eaters, not even reaching the
recommended minimum daily potassium intake of 4700 mg a day. And what about sodium? The vast
majority of the available evidence indicates that elevated salt intake is
associated with higher stroke risk. There’s like a straight-line
increase in the risk of dying from a stroke
the more salt you eat. Even just lowering sodium intake
by a tiny fraction every year could prevent tens of
thousands of fatal strokes. Reducing sodium intake to prevent stroke:
time for action, not hesitation, but the UK vegetarians and
vegans appeared to be hesitating, as did the other dietary groups.
All groups exceeded the advised less than 2400 mg daily sodium intake—
and that doesn’t even account for salt added at the table, and
the American Heart Association recommends under just 1500 a day;
so, they were all eating lots of processed foods.

So, no wonder
the vegetarian blood pressures were only 1 or 2 points lower;
high blood pressure is perhaps the single most important modifiable
risk factor for stroke. What evidence do I have that if the
vegetarians and vegans ate better their stroke risk would go down?
Well, in rural Africa where they were able to nail the fiber intake that
our bodies were designed to get by eating so many whole healthy plant
foods— fruits, vegetables, grains, greens and beans, their protein
almost entirely from plant sources, not only was heart disease, our
#1 killer, almost non-existent, so apparently, was stroke, surging
up from out of nowhere with the introduction of salt
and refined foods to their diet. Stroke also appears to be
virtually absent in Kitava, a quasi-vegan island culture
near Australia where diet was very low in salt and
very rich in potassium, because it was a vegetable-based diet.
They ate fish a few times a week, but the other 95% or so
of their diet was lots of vegetables, fruits, corn, and beans,
and they had an apparent absence of stroke, even despite their
ridiculous rates of smoking.

After all, we evolved eating
as little as less than an 8th of a teaspoon a day of salt
and our daily potassium consumption is thought to have been
as high as like 10,000 mg. We went from an unsalted, whole-food
diet to salty processed foods depleted of potassium
whether we eat meat or not. Caldwell Esselstyn at the
Cleveland Clinic tried putting about 200 patients with established
cardiovascular disease on a whole food plant-based diet. Of the 177 that stuck with the diet
only one went on to have a stroke in the subsequent few years
compared to a hundred-fold greater rate of adverse events—
including multiple strokes and deaths in those that
strayed from the diet.

“This is not vegetarianism,”
Esselstyn explains. Vegetarians can eat a lot
of less-than-ideal foods. This new paradigm is exclusively whole
food, plant-based nutrition. Now this entire train of thought,
that the reason typical vegetarians don’t have better stroke statistics
is because they’re not eating particularly stellar diets, may
explain why they don’t have significantly lower strokes rates,
but that still doesn’t explain why they might have higher stroke rates.

Even if they’re eating similarly
crappy, salty, processed diets at least they’re not eating meat,
which we know increases stroke risk; so, there must be something
about vegetarian diets that so increases stroke risk that
it offsets their inherent advantages? We’ll continue our hunt, next..

Video Transcript – As found on YouTube

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