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Vegan Men Say What? Part II of Review of The Big Fat Surprise: What I Find Troubling About the Book

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As you read in Part I of this review, there is much I like about Teicholz’ book.  However, now let me turn to the parts that I don’t like.  Her advice to eat more animals and animal products does not logically flow from her historical analysis of dietary fat.  And her rationale is fundamentally flawed.  Accordingly, I reject her advice that we should eat more animals and animal products.

Fundamental Flaws

The author’s primary conclusion is that our fear of saturated fats is unsubstantiated.   Therefore, we should go back to using animal fat to replace hydrogenated oils.  We should drink whole milk, eat cheese, butter, beef, and bacon.  According to the author, “none of these foods have been demonstrated to cause obesity, diabetes, or heart disease.”  Instead, “[s]ugar, white flour and other refined carbohydrates are almost certainly the main drivers of these diseases.”   The author attributes skyrocketing rates of obesity, diabetes, and the failure to conquer heart disease on the low-fat diet of Americans.  In fact, according to the author, saturated fats have the health benefit of raising HDL cholesterol, the so-called “good cholesterol.”

Fundamental Flaw #1 – Author Misses the Plant-Based Whole Food Option

The author sets up the proverbial straw man by pointing to the ill health consequences of switching from a high fat diet to a low fat diet consisting of sugar and refined carbohydrates.  However, eating a low fat diet does not require a diet of sugar and refined carbohydrates.   Perhaps the author is right that sugar and refined carbohydrates are culprits worthy of blame for obesity, diabetes, and the failure to conquer heart disease.  However, it does not logically follow that the only option is to revert to eating animal fat.

Instead, there is significant evidence that a plant-based whole food diet is the healthiest choice for diet.  As set forth in a new book,  Rethink Food – 100+ Doctors Can’t Be Wrong, Hundreds of doctors and health professionals have reported great results by switching their patients to a plant-based whole food diet.  Yet, the author barely mentions the option of a plant-based whole food diet.  When she does mention a vegan diet she seems to acknowledge that vegans are generally a healthy group, but she is inclined to attribute their health to exercise and other lifestyle choices other than diet.  She also dismisses a vegan diet as too hard to follow, which I know from personal experience is not true.  The fact that millions follow a vegan diet rebuts the assertion that it is too hard to follow.

The author discusses Dr. Dean Ornish’s success in reversing heart disease by prescribing a vegan whole food diet, but dismisses his success because his plan also requires smoking cessation, aerobic exercise, yoga and meditation.  According to the author, there is no way to know which part of Dr. Ornish’s program caused heart disease reversal and the fat reduction may be irrelevant.  In  short, the author seems to think that vegans incorporate too many healthy choices into their lives and therefore we cannot draw any conclusion from the health of vegans.  The author also concludes that vegans follow the advice of their doctors better than the average person, so we cannot draw any conclusions from the above-average health of vegans.  It seems to me that the author is trying a bit too hard to summarily dismiss a plant based diet as an alternative to animal and trans fats.

I was very frustrated by the author switching back and forth between the terms “vegan” and “vegetarian” as if they are interchangeable.  And the author coins the new term, “near vegetarian,” but never defines what the term means.  I found the author confusing when she discusses a vegan diet in one paragraph and then in the very next paragraph states that “[v]egetarian diets generally have not been shown to help people live longer.”  Of course, vegetarians eat eggs, milk and cheese.  Vegans forego these foods as they view them as unhealthy if not more unhealthy as meat.  The author never addresses whether vegans live longer or the quality of their lives.

I don’t take issue with the author placing some of the blame for America’s poor health on a diet consisting of low-fat refined-carbohydrate consumption—low-fat cookies, crackers and snacks.  But contrary to the author’s advice, that does not mean that cheeseburgers and bacon are the answer.  By failing to give serious attention to the alternative of a plant based whole food diet, a diet that has saved so many from all kinds of health ailments, I find the book fundamentally flawed.

Fundamental Flaw #2 – More Saturated Fat Will Make Us Healthier

The author states that Americans have eaten a low-fat, “near-vegetarian” diet for the past 50 years and that our ongoing health crisis proves the failure of such a diet.  Therefore, the author concludes that we should go back to eating animal fat.

The author does not define “near-vegetarian” but it certainly does not mean vegan.  People who eat a plant-based whole food diet are a very small percentage of the population.  Accordingly, the ongoing health crisis with obesity, diabetes and heart disease cannot be attributed to Americans eating a vegan diet.

And it would also appear that by using the term “near-vegetarian” that the author does not mean vegetarian because we know that the majority of Americans do not eat a vegetarian diet.  Instead, it would appear that the author coined the term “near-vegetarian” to describe someone who has reduced his consumption of animal fat.  I find this misleading since someone who has reduced his consumption of animal fat may be nothing near a vegetarian.  Most Americans are not anything near being vegetarian.

Nonetheless, regardless of the terminology used by the author, her premise seems to be that Americans have reduced their intake of animal fat over the past 50 years and yet obesity and diabetes have increased, and heart disease is still prevalent.  Therefore, we should go back to eating more animal fat.  This logic is fundamentally flawed.

The problem over the past 50 years isn’t that Americans have reduced their consumption of animal saturated fat, the problem is more likely that they have increased their consumption of processed foods and trans fats.  The author acknowledges this when she states that “[s]ugar, white flour and other refined carbohydrates are almost certainly the main drivers of these diseases.”  The author cannot cite to a single clinical trial that shows a diet high in animal products will decrease diabetes or obesity.  Just because trans fats are bad doesn’t mean that animal fats are good.

Perhaps even more importantly, I do not accept the author’s assertion that the decreased consumption of red meat in the U.S. over the past century (and therefore a decrease in saturated fat consumption) has contributed to our health crisis.  I have seen data that contradicts the assertion that we eat less red meat now than we did 100 years ago.  But for the sake of this review, I will give the author the benefit of the doubt and accept the premise that Americans are eating less red meat now than 100 years ago.

But the obvious problem that the author overlooks is that Americans have replaced red meat with animal food just as unhealthy.  Even the author admits that chicken consumption “has gone up astronomically since the 1970s.”  In fact, the author includes a chart that shows while red meat consumption has gone down, total meat consumption per person has gone up.  And the author makes no mention of the fact that in the past 30 years, consumption of cheese has tripled.

Just as replacing animal fat with trans fat was a bad idea from a health perspective, so too was replacing red meat with other animal products.  The health consequences from eating hormone and antibiotic laden chicken and dairy products is beyond the scope of this review.  My point is to merely point out the author’s logical flaw that our health crisis must due to our lack of saturated fat.  The health crisis is far more likely due to our total increased consumption of animals and animal products.  If Americans had replaced their red meat with a plant based whole food diet (with no trans fats) then I doubt we would be having this discussion.

Fundamental Flaw #3 – What about the Trans Fats Found in Cow Products?

As noted above, the author is to be commended on being a vocal opponent of trans fats.  Trans fats are now universally accepted as being dangerous.  But trans fats are also found in the meat and milk of cows.  Though the author devotes chapters to the evils of trans fats from hydrogenated oils, she devotes only one footnote (page 240) to the subject of trans fats found in cow products.

The author acknowledges that cow trans fats are comprised of exactly the same atoms as the trans fat found in hydrogenated oil, but states there is a “tiny difference–a matter of one double bond on a different side of the molecule.”  Without any scientific evidence, the author concludes that “[t]his tiny distinction is probably enough to make [cow] trans fats behave differently in the body.”

The author states that “subsequent research” has shown these cow trans fats “to be largely free of the damaging health effects that occur with industrially produced trans fats.”  There are two problems with this statement.  First, what research?  As a writer that demands scientific research it seems odd that she would not even cite to the research.  Second, she states the cow trans fats are “largely free” of the damaging effects.  In other words, cow trans fats have some of the same damaging effects as trans fats from hydrogenated oils.

If I were a beef eater and milk drinker, I don’t think it would make me feel better knowing that my beef and milk are “largely free” from the damaging effects of trans fats.  Again, this can all be avoided with a plant-based whole food diet.

Fundamental Flaw #4 – What About the Tropical Oils?

Coconut oil and palm oil are very high in saturated fat, and they are associated with other health benefits.  The author goes into great detail how these oils were unfairly vilified and removed from the American diet.  Yet, when the author offers her conclusions and dietary advice, she ignores these tropical oils.  If a reader were to accept the author’s conclusion that we need more saturated fat in our diet, coconut and palm oil seem like a much better way than hormone and antibiotic laden meat.

Even if we speculate that the author would argue that somehow meat saturated fat is better than tropical oil saturated fat, along with the meat saturated fats comes everything else such as hormones and antibiotics, not to mention the cruelty of factory farming.  So on balance, isn’t coconut oil and palm oil a better way to consume saturated fat if someone is inclined to do so?

Fundamental Flaw #5 – The Masai, the Eskimos and the Navajo Indians

The author admits that there is no long-term data or clinical trials on a diet high in animal products.  So instead she refers to “four millennia of human history . . . which make clear how animal foods made up the core of human meals for thousands of years.”   The author is especially fond of using the Masai in Africa, the Canadian Arctic Inuit, and the Navajo Indians as proof that carnivorous diets are healthy.  The author asserts that in the eighteenth century Americans ate three to four times more read meat than we do today.

I suppose all of these arguments are nice if we lived in the Canadian Arctic, but we don’t.  The author may want us to return to the eighteenth century, but we can’t.  The author completely ignores that fact that today over 95% of the meat eaten by Americans comes from factory farms.  Because animals raised on factory farms are in filthy, high-density and stressful conditions, the animals get sick in a predictable manner.  Accordingly, antibiotics are added into the animal feed to preempt outbreaks of disease.  70-80 percent of all antibiotics used in U.S. are fed to livestock.

Additionally, factory farms in the U.S. use hormones to promote growth and milk production in beef and dairy cows.  Six different hormones are used on beef cattle, three of which are synthetic.  Beef hormones have been banned in the European Union since the 1980’s after a study on their safety found that residues in meat could affect the hormonal balance of humans, causing reproductive issues and breast, prostate or colon cancer.

The primary growth hormone injected into dairy cows to increase their milk production was approved by the FDA in 1993 based solely on an unpublished study submitted by Monsanto.  Canada, Australia, Japan and the European Union have all prohibited the use of this hormone.  And organically produced dairy isn’t much better.  It contains naturally occurring steroids and hormones which can promote cancer growth.

And this is what the author is proposing to make America healthy?  The failure of the author to even address this issue should make the reader skeptical of the author’s dietary advice.

Fundamental Flaw #6 – What’s  Good for the Goose is Good for the Gander

The author spends a great deal of her book criticizing the epidemiological studies that have been used to show a correlation between saturated fat and heart disease.  These are studies where the diets of populations are not changed—they are simply observed over a period of time and researchers try to link disease and death to their subject’s dietary patterns.

Instead, the author asserts that controlled clinical trials are the better way to prove a connection between diet and disease.  In these studies the diets of the subjects are far more controlled and there are less variables to skew the results.

So what clinical trials does the author rely upon when she advises Americans to eat more meat, dairy and cheese for a healthier diet?  None.  What about the less-favored epidemiological studies?  None.

Instead, the author relies primarily on writings by a science journalist, Gary Taubes, and two papers published by Ronald Krause, the director of research at the Children’s Hospital Oakland Research Institute.  Taubes is clearly a gifted writer, but most would agree that dietary advice should be based on something more than a journalist’s writing. Krause is brilliant and is credited with the new biomarker for heart disease that I discuss above.  But he did not perform any clinical trials nor undertake any epidemiological studies.  Instead he reviewed the data from other epidemiological studies and clinical trials and then disputed their conclusions regarding the association between saturated fat and an increased risk for heart disease or stroke.

Disputing the conclusions of other studies and trials is very different than conducting studies and trials that prove Americans should eat more meat, cheese and milk.  With as brilliant a man as Krause is, I doubt he would leap from his conclusion to advising America to eat more meat, cheese and milk with all we know about growth hormones and antibiotics.  But that is what the author does.

In short, the author is guilty of exactly the same charges she levies against the anti-saturated fat community.  In fact, probably more guilty.  While she criticizes such studies and trials, at least her opponents have some studies and trials.

Fundamental Flaw #7 – What about the Rest of the Elephant in the Room?

The entirety of the book is focused on saturated fats and how Americans need to increase their consumption of saturated fats by eating more animals and animal products.  The author encourages us to eat whole fat dairy, eggs and fatty meat because “these foods are necessarily part of a healthy diet.”  But the author only addresses the effect that more saturated fat can have on heart disease, obesity, and diabetes.  It seems irresponsible to encourage people to eat more animals and animal products unless all the consequences of eating meat, dairy and eggs are considered.

Following is a list of conditions and diseases that many doctors are now associating with eating meat, dairy and eggs:

Acid Reflux Disease; Acne; Alzheimer’s Disease; Arthritis; Asthma; Autoimmune Disease; Beheta’s Disease; Breast Cancer; Canker Sores; Chronic Obstructive Pulmonary Disease (COPD); Colic; Colon Cancer; Constipation; Coronary Heart Disease; Crohn’s Disease; Dementia; Depression; Dermtitis; Diarrhea; Diverticulosis; Dysmenorrhea; Ear Infections; Endometrial Cancer; Eczema; Erectile Dysfunction; Fatigue; Fatty Liver Disease; Fibroids; Gastritis; Headaches; Hemorrhoidal Diseases; Hepatic Diseases; Hyperactivity; Hypertension; Inflammation; Inflammatory Bowel Disease; Irritable Bowel Syndrome; Kidney Disease; Liver Disease; Lupus; Metabolic Syndrome; Obesity; Osteoporosis; Ovarian Cancer; Parkinson’s Disease; Periodontal Disease; Prostrate Cancer; Psoriasis; Rheumatoid Arthritis; Sinusitis; Strokes; Type I Diabetes; Type II Diabetes; Ulcers; and Uterine Cancer.

So even if we were to adopt wholesale the author’s unsubstantiated arguments that eating animals will reduce our risk of heart disease and make us thinner, that is just where the discussion needs to start not end before Americans start doubling down on steaks and milk shakes.

Conclusion—“A Note on Meat and Ethics”

At the very end of her book, the author has a one page section captioned “A Note on Meat and Ethics.”  She states that she does not address “the profound ethical and environmental implications of the conclusions I’ve drawn from my research.”  She notes in passing the environmental issues caused by factory farming and the massive resources it consumes.  But she concludes that she has merely “tried to explore here what kinds of dietary fat are good for human health, period.”

In short, the author recognizes the inevitable if America increases it consumption of meat, dairy and cheese – more carbon dioxide, methane and nitrous oxide emissions.  Livestock production already contributes 37% of methane and 65% of all nitrous oxide emissions.  About 40% of the world’s cereal harvest is already used to feed animals.

The author offers her readers the “thought experiment” that if we returned to eating tallow and lard again it would reduce the demand we place on land to grow soybeans and seeds that are expressed into vegetable oils.  But from what land will the animal feed come from that will be necessary to feed the additional animals when the demand for more tallow and lard increases?    Why not just stop consuming vegetable oils?

By “ethics” I assume the author means the unimaginable cruelty that factory farmed animals suffer.  If Americans increase their consumption of animals and animal products such suffering will only get worse as factory farmers try to meet the increased demand.  The author seems concerned about the demand we put on land to produce vegetable oils.  What about the demand we put on factory farmed animals?

The author steps around the profound ethical and environmental consequences of her advice to eat more animals by saying it is “beyond the scope of this book.”  I don’t know how eating animals and the ethical and environmental consequences can be separated.  Surely the author could have devoted a chapter to the subject.

For a lawyer or doctor it would be malpractice not to advise a client or patient of all the likely consequences of following the lawyer’s or doctor’s advice.  A client or patient has the right to know all the consequences before taking a recommended course of action.  If I told my client to take a plea deal in a criminal action without telling him how many years he will likely serve in prison it would malpractice.  So too it is “malpractice” for the author to advise her readers to eat more animals and animal products without discussing all the likely consequences of such advice.  But then if she did she probably wouldn’t sell as many books.


The author will need to start a monthly newsletter to rebut the studies that come out each month which refute her advice to eat more animals and animal products.  Since her book was published a few months ago, here is a sampling of just some of the reports:

  • Journal of Family Practice (July 2014):  Out of 198 patients with cardiovascular disease (CVD), 176 followed a plant-based diet for a mean of 3.7 years. These patients eliminated dairy, fish, meat, added oil, fructose, caffeine, avocado, nuts, and excess salt from their diets.  Their core diet consisted of whole grains, legumes, lentils, vegetables and fruit.  Exercise was encouraged but not required.  Neither meditation nor yoga was part of the plan. Of those that did not eat a plant-based diet, 62% experienced an adverse event (e.g. stroke).  Of those that followed a plant-based diet, only .6% (that is less than 1%) experienced an adverse event.  93% of those that followed a plant-based diet experienced improvement or resolution of symptoms.  Disease reversal was documented in 22% of those that followed a plant-based diet.
  • Circulation: Heart Failure (June 2014):  Researchers followed the diets of 37,035 men for 12 years as part of the Cohort of Swedish Men Study.  For each 50 gram serving of processed meat (one hot dog), heart failure risk increased by 8%, and the chances of dying from heart failure increased by 38%.
  • Neurobiol Aging (May 2014):  Researchers examined the diets and brain health of 19,792 study participants.  They found that higher saturated fat consumption increased the risk for Alzheimer’s disease, dementia and cognitive decline.
  • Journal of Nutrition (Jan. 2014):  Researchers concluded that heme iron, which is found in meat, increased risk of heart disease by 57%.  Conversely, non-heme iron found in vegetables found no relationship to risk or mortality from heart disease.
  • Presentation at American Urological Association Annual Meeting (May 2014):  Researchers analyzed the dietary habits of almost 10,000 men at risk or suffering from prostate cancer.  Results showed that a diet high in complex carbohydrates and low in protein and fat reduced cancer risk by 60 to 70%.  Researchers also observed an association between drinking milk and advanced prostrate cancer.

Doug Meier is an attorney that practices in Lakewood, Colorado and writes this monthly column, Vegan Men Say What?


Author: Doug

Doug Meier is an attorney who practices in Colorado the area of insurance bad faith and legal malpractice. He became a vegetarian 13 years ago and went vegan approximately 2 years ago. He can be reached at or