A Case For Veganism

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It’s tough out there for a vegan. For decades, vegans have been espousing a lifestyle that has biological, environment and ethical benefits, but to this day many vegans are still pooh-poohed, criticized, or ridiculed for being too extreme, for being reckless, for being uptight, for being impossible dinner dates, for eschewing foods that the rest of us claim humans “need” to eat, and replacing those foods with non-animal products that we meat-eaters claim taste like crap.

But in the past couple of months, a pair of studies has given new strength to the vegan argument — to a group of people who have, it seems to me, been right all along. The first study, reported in the New York Times in April, suggests that it is not the saturated fat or cholesterol found in red meat that contributes to heart disease risk. It may actually be a type of bacteria released in the intestines after meat is eaten. The second study suggested that there is a similar process behind egg consumption.

According to the Cleveland Clinic researchers behind the meat study, the bacteria released by our guts after eating red meat is converted by our livers into another form of bacteria called TMAO. TMAO can predict a heart attack risk in humans, the researchers say; it’s also been shown to cause heart disease in mice. The hero of this study turned out to be long-term vegans. The researchers looked for an increase in TMAO after study participants consumed a steak. Sure enough, the regular meat eaters saw a release of TMAO in their bloodstream after eating the steak, but the vegans in the study did not display a “burst” of TMAO, the Times wrote, even after eating the steak.

“Researchers had hypothesized that vegans would not have as many of the gut bacteria needed to make TMAO,” it added, “and indeed virtually no TMAO appeared in the vegan’s blood after he consumed a steak.”

This report piqued my interest partly because I was diagnosed with celiac disease six years ago, and have often found that my digestion is terrible after I eat red meat. The terribleness is significantly lessened if I take a potent daily probiotic from a brand called Udo’s Choice. Is there a connection between the three things — meat, bacteria and celiac? Maybe not, but it’s hard not to think that meat consumption could somehow be affecting my small intestine, the organ damaged by celiac disease, not to mention increasing my risk of heart disease, if these researchers are right. Of course, I’ve tried not to eat even a crumb (or drop) of gluten since I was diagnosed, but my doctor also prescribed me the probiotics and told me to stay away from lactose, coffee and chocolate because they tend to inflame the intestines of people with celiac (I can confirm that coffee does indeed do that; I now drink tea religiously).

It seems there is probably much more that our bodies are not fond of besides meat (and — increasingly — gluten); we just don’t fully understand yet what processes are behind the discomfort. The studies on meat and eggs seem to point to at least one of them, and the researchers suggested that in the future, meat eaters could be treated with an antibiotic. But antibiotics wind up killing some of the good bacteria in our guts, too. So is that really a solution, or just another quick fix and potential boon for the pharmaceutical industry?

And what else is the bacteria in our gut — good and bad bacteria — up to? A few months back, there was yet another article about gluten intolerance in the Times (even I, curious celiac sufferer, tire of the subject). But this article was different than most: it discussed new research about, well, gut bacteria, and how levels of a good bacteria known as bifidobacteria, common in probiotic supplements including Udo’s Choice, have been shown to be lower in children with celiac disease. (Bifidobacteria is found in breast milk, and, as this article points out, researchers are now attributing a spike in celiac disease in Swedish children 30 years ago to a national movement away from breastfeeding just preceding that spike).

As the article notes, research by Dr. Alessia Fasano at Massachusetts General’s Center for Celiac Disease Research and Treatment has also shown that a “poor microbial environment” in children’s intestines can precede a diagnosis of at least two autoimmune diseases: celiac and Type 1 diabetes. But as the Times explains, this is a bit of a “chicken/egg” scenario: the children in question had the genes for diabetes and celiac, so, “which came first, the aberrant microbial community, or the aberrant immune response?”

What was I doing before I was diagnosed with celiac? I suddenly wondered. I was drinking more, I know that. I was eating pretty poorly (or adventurously, depending on your viewpoint). I’d always loved food and never abstained from anything — spice, meat, salt, fat, sugar. I’d trained for a marathon the previous summer and fall, during which I’d only cut out ice-cream and alcohol other than low-calorie beer, and then, once I crossed the finish line, I’d gone a typical New York binge of thai takeout, cocktails, and overpriced lunches at work.

One good thing I started doing (or so I thought) was to eat oatmeal for breakfast. It was the oatmeal that first revealed the celiac (oats are a cousin of wheat, but they are often contaminated by wheat in the milling process, especially if you’re buying them from a big wheat-loving corporation like General Mills, as I was). And as the Times story on bifidobacteria explains, it’s possible for intestinal inflammation to compound — for inflammation to increase with the continued presence of something the intestine doesn’t like, and in turn cause a decrease in the production of good bacteria like bifidobacteria. There’s a tipping point, or so the theory goes, and suddenly celiac symptoms emerge. Well, emerge they did, in the summer of 2008. In the office bathroom. About five to eight times a day.

Heart disease is worrying on a whole different level than celiac disease — it’s the leading cause of death for both American men and women, according to the CDC — but undiagnosed celiac or gluten intolerance can cause years of discomfort, malnutrition, bone density loss, and, in the long-term, cancer. Millions of Americans now suffer from either celiac or non-celiac gluten intolerance. Why? I would argue that inflammation and a decrease in good bacteria is the culprit. For those who are gluten intolerant, gluten causes inflammation in the gut, contributing to a “poor microbial environment,” but not so poor that the situation snowballs into celiac disease. We know from William Davis’s bestseller Wheat Belly that many enriched flour products contain more gluten than they once did, which helps explain the increase in gluten intolerance and celiac.

Which is all to say: ever heard of a properly washed, organic vegetable causing intestinal inflammation and creating a “poor microbial environment”? Ever heard of a vegetable causing the gut to “burp out,” in the delicate words of the Times, bacteria that increases a risk of heart disease? Me neither. Yet I continue to push vegetables to the periphery of my nutritional view. A few times a week at home, we make a “green smoothie” of pulverized vegetables in a Vitamix. But most meals, I’m lacking in some (or a lot of) the fiber, vitamins, minerals and micronutrients I’m supposed to eat on a daily basis. The smoothie provides a lot, but I don’t drink it every day.

I’d sooner eat a hunk of mozzarella cheese than roast some beets or make a kale salad. I know that lentils and beans are great for you, and I enjoy both, but that doesn’t mean I eat them more than say, twice a month. I can’t not make a sandwich with cheese in it. In fact, I pretty much eat cheese in very meal except for breakfast. If meat and eggs are found to release the bacteria that converts to TMAO, it’s only a matter of time before the same studies are replicated with cheese, not to mention turkey, pork, chicken, lamb, sausage and bacon. I love all these things, particularly the pig’s offerings, but I can’t help but feel that science is increasingly on the side of the vegans.

The vegans are so sick of this stuff. They’re already enlightened, and they have every right to roll their eyes when a few of us tentatively latch on to what for many of them has been a years-long commitment. My friend Jonathan responded thusly when I posted a Facebook link to the article on the egg study: “Well, the obvious solution is for food scientists to just synthesize an egg lacking the offensive agents in question. Then people can say it’s healthier than the real thing! Haven’t heard that one before.” Ouch. But there are some who are pushing past their frustrations with the faddiness of veganism and trying to make it stick.

One such person is Scott Jurek, one of the world’s most accomplished ultrarunners and the bestselling author of Eat and Run, a memoir about his path to ultra running and veganism, which was just released in paperback. The book contains dozens of vegan recipes for things like lentil burgers, vegetable chili, pizza, burritos, and other foods you’d normally associate with animal-eaters. This important work proves once again that the key to a healthy diet is pretty simple: home cooking with quality ingredients. The types of vegan foods you can buy at a good grocery store (if you’re lucky enough to live near a good grocery store) don’t compare to the things you can make at home by investing in a few vegan staples (such as miso paste, nutritional yeast, nuts, legumes and whole or sprouted grains).

But cooking requires time, I hear you say, and most people don’t have a lot of time to cook anything, much less a vegan burger (Jurek’s delicious-sounding lentil burger nonetheless contains about 25 ingredients). But hopefully the more science tells us about the effects of animal products, the more curious and open-minded we’ll become about what people like Jurek and millions of others are doing. Maybe it will cause us to think more about what we eat. To eat less cheese, in my case, or more lentils. Not for reasons of vanity, but for reasons of long-term health.

Jurek has helped silenced another common grumbling about the vegan diet: that it can compromise one’s physical health. He has the medals and course records to prove this is not the case. Properly adhering to a vegan diet does require discipline and care. But the only thing really standing in our way is our own patience. Our brains tell us that we want things like bacon and cheese (or both at once). My excuse lately has been that I’m running 50 to 60 miles a week training for summer trail races. I can eat whatever I want! I say. But after reading Eat and Run, that excuse goes out the window, too: Jurek probably runs 100 miles a week or more.

Until I started paying attention to science and good books like this one, I never stopped to think why exactly my doctor told me six years ago to avoid lactose, coffee and chocolate and to take probiotics. It “upsets digestion” he said briskly, before shuffling my file together and hurriedly sliding out the examination room door like Kramer and moving on to his next patient. What did that even mean? I thought: OK, gas, bloating, irregular bathroom trips, maybe. But what was the process behind those symptoms? Did my doctor even know — or have the time to find out? Nope. But I do. Or at least, I need to make the time to.

I’m still not fully converted to the vegan cause; as an athlete and woman, I still have reservations about the protein, calcium and iron part of the equation, though Jurek has plenty of evidence to show that a) Americans, on average, eat too much protein anyway and b) that certain plants and nuts are excellent, even superior, sources of nutrients including calcium and iron. But I have so much more respect for the vegan movement now. As someone with celiac, I feel a kinship for vegans. We’re on the margins, but we shouldn’t be. Even if it takes more time, money, and spins of the Vitamix, I plan to try to incorporate vegan meals into my diet just the way I try to incorporate other things into my life that I know to be good for me.

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