Veganism: do the Anecdotes Hold Answers?

Veganism, seen as an extreme form of vegetarianism, is a lifestyle based on complete flesh-avoidance that can be traced back to ancient Indian and eastern Mediterranean societies (Suddath, 2008). The terms was first coined in November 1944 by British woodworker named Donald Watson, announcing that because vegetarians ate dairy and eggs, he was going to create a new term called "vegan," to describe people who did not.

Watson's cause was fueled by the emergence of tuberculosis, which had been found in 40% of the United Kingdom's dairy cows the year before.

Thus, the primary purpose of veganism was to protect people from tainted food. It is pronounced "vee- gan", and and by 2005, there were 250,000 self-proclaimed vegans in Britain with an additional 2 million in the U.S. It is useful to note that strict veganism prohibit the use of animal products in clothing, prescribed medicine, and supplements and prohibits foods made in the same facility as animal products.

Vegan diets have become increasingly popular. The diet claims to offer various health benefits, ranging from weight loss and reduced blood sugar to prevention of heart disease, cancer and premature death. Prior to its western popularity, most studies on vegan diets were observational. This made it difficult to decide if the observational benefits were caused by the vegan diet or from unaccounted factors. However, recently have we seen an influx of scientific data on the lifestyle with most data suggesting sound benefits to flesh avoidant lifestyles.

For a concentrated analysis, I specifically examined diet and weight loss. Ten popular randomized controlled trials examined the effects of a vegan diet on weight loss. Seven out of the 10 studies reported that a vegan diet were more effective than the control diet at helping participants lose weight. In the most impressive study, the vegan diet was able to help participants lose 9.3 more pounds than the control diet over an 18-week period. This effect persisted even when the vegan participants were allowed to eat until fullness, while the control groups had to restrict their calories.

When looking at diet, despite being generally higher in carbs, vegan diets were up to 2.4 times more effective at improving blood sugar control in diabetics, compared to control diets. In fact, seven out of eight randomized controlled studies reported vegan diets to be more effective than conventional ones, including diets recommended by the American Diabetes Association and the American Heart Association. The one study that didn't find a vegan diet to be advantageous, reported it to be just as effective as the control diet. In sum, based on the best recent available evidence, a vegan diet can be very advantageous, if adopted wisely.

Doctors seem hesitant thus far to validate or invalidate vegan diets. Though research has shown large benefits to adopting veganism, researchers and doctors don't believe that the sole factor of flesh consumption has made measured difference. For example, some studies show that consuming fruits and vegetables decrease stroke risk and lowers ischemic heart disease mortality, while increasing cardiovascular health regardless of meat consumption.

Meanwhile, other studies show that lots of fruits and vegetables along with regular exercise influence cardiovascular health, blood pressure, triglycerides, and cholesterol levels just as much as a vegan diet. In taking these (in addition to the findings above) into consideration, doctors generally advise eating more plant foods and living healthier, not necessarily entirely avoiding meat, as the the best path to longevity. As a result, medical practices have not changed to support this nutritional belief as either invalid or valid.

While I do believe that health practices such as these should be supported by some research, I do not think that health practices need to be irrefutably backed by research and adopted as standard advice by western medicine before practiced. Contradictory medical findings and constant changes in medical stance consistently demonstrate just how unreliable the data that fuels western medical advice can be. This is most often the case with controversial dietary recommendations. Take for example red wine and coffee: while not too long ago both were considered a major avoidance for a risk groups, an overwhelming amount of new evidence point to a slew of health benefits ranging from improved gut, heart, and brain health to reducing risks for cancer. Some studies even deem red wine safe during pregnancy.

There are many factors to consider when evaluating an article for credibility. We can conduct an effective analysis by remembering the acronym CCAP, or content, currency, authority and publisher. In content, we are comparing who the author's intended audience is with how appropriate the tone and treatment of the information for that audience is. In currency, we are examining how current the information that we are looking at should be in respect to the date the event occurred, the currency of the original references that the source uses, and the date of publication of the source.

In authority, we consider the author's academic credentials and his experience/expertise of the topic in research. Finally, in publisher, we investigate the publisher or sponsor for bias by researching who the publisher or sponsor is and what kinds of materials they typically publish, determine if the sponsor is suitable to address this topic, and take a look at the name and site address for information regarding the credibility and bias of the publisher/ sponsor.

I think it is important for us a community of medical providers to take our patients belief systems and practices into the utmost consideration. Let's face it: medical intervention is only as effective as it's adherence. And while in an ideal world, all of our patients would subscribe to our recommendations without hesitation, this is just not the case. So in remembrance that we are tasked to serve all people, regardless of color, creed, religion or belief, and that we aim to do good above all, it would implore us to find ways to fit medicine within our patient's lives and beliefs and not the other way around.

To do this, we need to first understand our patient population(s) or simply put, whom we are serving. To answer that questions we specifically need to know our patient's or population's medical predispositions (is this population hereditarily or environmentally predisposed to hypertension, diabetes?), what they believe, and how these beliefs interact with how they think about healthcare.

From there, we can begin to determine how to medically advise them within the acceptable realm of their beliefs. Most times, this takes a lot of planning in the "prevention" stage. For example, a patient who is adamantly against taking pharmaceutical medications has a higher likelihood of finally adhering to a prescribed intervention only AFTER exhausting all homeopathic routes. Therefore if I knew said patient held such beliefs, knew they were genetically predisposed to hypertension and knew they had a slowing elevating blood pressure over the years, I would first educate and advise them on dietary and homeopathic interventions that could positively influence healthy blood pressure early on in the prognosis. If this intervention is effective- great.

If not, I have already built trust in my patient (by respecting and attempting their preferred method of intervention) and given time, can now recommend a medical intervention that they are likely to adhere to before the diagnosis progresses. In this one example, I prevented another patient from suffering the consequences of hypertension by simply knowing my patient and adjusting my approach. I think that if practices such as these were more widely and systematically utilized, we would see greater success in our practice and improved longevity and quality in our patient's lives.

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