Any Plant Based Eaters Here? Share Your Story!

[Jennifer]

Did it work for you?Needing more absorbable Protein to feel grounded sounds problematic tbh,lack of Protein was so high/bad that you could actually feel it?Getting SIBO essentially from Fruitarianism,and adrenal and thyroid issues?Would you still choose to Diet like so if you could?

Yep, after 3 years fruitarian, I was needing more and more calories just to feel grounded -- before adding back meat I was up to 3500 daily, which I felt was insane given I'm only 45 kg and fairly sedentary. With meat, I feel good with 2500 - 3000 (3000 usually only around my period), which makes me think I was becoming more catabolic over time while fruitarian. But no, I didn't get SIBO or hypothyroid from a fruitarian diet. The SIBO happened long before fruitarianism while eating a dairy-based diet, though, I suspect it was actually the result of undiagnosed hypothyroidism and the overgrowth may have only helped to keep me hypo once established. Honestly, it's hard for me to say with any real certainty. I followed the diet because fruit was all I could digest at the time and unlike most other foods, particularly animal protein, it didn't cause extreme pain in my spine where I sustained major injury. Fruit is still my main source of calories -- around 250 come from animal protein -- so I still consider my diet fruit-based.

 

[Tristan Loscha]

Yep, after 3 years fruitarian, I was needing more and more calories just to feel grounded -- before adding back meat I was up to 3500 daily, which I felt was insane given I'm only 45 kg and fairly sedentary. With meat, I feel good with 2500 - 3000 (3000 usually only around my period), which makes me think I was becoming more catabolic over time while fruitarian. But no, I didn't get SIBO or hypothyroid from a fruitarian diet. The SIBO happened long before fruitarianism while eating a dairy-based diet, though, I suspect it was actually the result of undiagnosed hypothyroidism and the overgrowth may have only helped to keep me hypo once established. Honestly, it's hard for me to say with any real certainty. I followed the diet because fruit was all I could digest at the time and unlike most other foods, particularly animal protein, it didn't cause extreme pain in my spine where I sustained major injury. Fruit is still my main source of calories -- around 250 come from animal protein -- so I still consider my diet fruit-based.

i see.

 

[CLASH]

Here is the study I mentioned:
https://www.cell.com/cell-metabolism/fulltext/S1550-4131(14)00062-X?_returnURL=https://linkinghub.elsevier.com/retrieve/pii/S155041311400062X?showall=true

...and here is a short article talking about it:
Meat and cheese may be as bad for you as smoking

"A high-protein diet during middle age makes you nearly twice as likely to die and four times more likely to die of cancer, but moderate protein intake is good for you after 65. But how much protein we should eat has long been a controversial topic -- muddled by the popularity of protein-heavy diets such as Paleo and Atkins. Before this study, researchers had never shown a definitive correlation between high protein consumption and mortality risk."

This is from the study, which is observational/ association focused, specifically in regards to the human portions of the study:

"On average, subjects consumed 1,823 calories, of which the majority came from carbohydrates (51%), followed by fat (33%) and protein (16%), with most of it (11%) derived from animal protein. The percent of calorie intake from protein was used to categorize subjects into a high protein group (20% or more of calories from proteins), a moderate protein group (10%–19% of calories from proteins), and a low protein group (less than 10% of calories from proteins).
Mortality follow-up was available for all NHANES III participants through linkage with the National Death Index up until 2006 (DHHS, 2001)."

I find it wierd that the average caloric intake of the participants is only 1800 kcal. If you consider that the low protein group was only 8.5% of kcal of protein (data found in table s1) on average while the moderate protein group was only 14.9% kcal of protein on average and the high protein group was 23.7% on average that leaves the low protein group with about 41g of protein per day, the moderate protein group with about 69g of protein per day and the high protein group with 94g of protein per day. In the low protein group, that is slightly more than one 4oz chicken breast per day. In the moderate protein group that is about two 40z chicken breast per day and in the high protein group that is about three 4ox chicken breast per day. This is assuming that the entirety of the protein in the diet is from an animal source. The study implies that its not and discusses plant sources. This is important because the plant sources of protein such as soybean protein have pretty poor protein quality scores. If we take into consideration that only 38g of protein was eaten and much of it was from plant sources, or even only a small portion of it was from plant sources, then we have to assume the actual protein absorbed and utilized is significantly lower than the 38g which may actually be putting someone in the range of severe protein deficiency. Furthermore, if we put this into context purely between the low protein group and the moderate protein group, the article is basically implying that eating 4oz of chicken breast or steak or shrimp or whatever animal protein source can be substituted a day increases the risk of diabetes and diabetes mortality. I personally find this a bit funny. Even with that said the as you'll see below, even if said chicken breast did increase the risk of diabetes and diabetes mortality it did so marginally as the diabetes mortality rate was only 1% on average for all the groups.

"This provided the timing and cause of death. The follow-up period for mortality covered 83,308 total person-years over 18 years, with 40% overall mortality, 19% cardiovascular disease (CVD) mortality, 10% cancer mortality, and about 1% diabetes mortality."

Its interesting to note that there is only 1% diabetes mortality for all the groups on average. If we break it out by group thanks to table S1 we find:

Low protein: 42.9% died of all cause mortality, 21.3% died of CVD, 9.8% died of cancer, 0.2% died of diabetes.

Moderate protein: 39.6% died of all cause mortality, 18% died of CVD, 10.1% died of Cancer, 0.9% died of diabetes.

High protein: 42.9% died of all cause mortality, 20.7% died of CVD, 9.0% died of cancer, 2.0% died of diabetes

Also interesting to note was the low protein group had a sample population of n=432, which was much lower compared to the n=4798 in the moderate protein group and the n=1146 in the high protein group.

If anything the moderate protein group seems to have faired the best, especially considering it had the largest sample size and the lowest total mortality. Again, keep in mind, the low protein group only had a sample size of n=432; paltry compared to the other two sample sizes. The differences in sample sizes make the data a bit sketchy. The researchers even state this:

"We underline that our hazard ratios and confidence intervals may be inflated due to our sample size and the extremely low incidence of diabetes mortality in the low protein group. Overall, there were only 21 diabetes deaths among persons without diabetes at baseline, only 1 of which was from the low protein group."

Furthermore in the low protein group, the history of diabetes was only 2.6% at baseline, compared to the 10.3% in the moderate protein group and the 17% in the high protein group. That alone should be enough to skew the date. Again, the data set is questionable here, especially considering the results they produced. The researchers go on to imply this as well by saying:

"An alternative explanation for the elevated diabetes mortality in the higher protein group is that, following a diabetes diagnosis, some individuals may switch to a diet comprised of higher protein, lower fat, and low carbohydrates. To test this, we examined the association between protein intake and diabetes mortality in participants who had no prevalence of diabetes at baseline (Table S7)."

Taking this quote into consideration its interesting when you look at table s1 and see that 22.4 % of the moderate group and 29.5% of the high protein group changed their diet due to a health reason whereas only 15% of the low protein group changed their diet due to a health reason. Furthermore, if you then look at table S7 you see some interesting hazard ratios with some pretty large confidence intervals. This at least for me further brings the data into question. The confidence interval shows that we are 95% sure that the protein intake and diabetes mortality among participants with no diabetes at baseline in the high protein group is somewhere between 4.47x more likely to 1209.7x more likely and in the moderate protein group is somewhere between 1.31x more likely and 400.7x more likely. These confidence intervals are pretty huge, at least if I'm reading the statistics correctly. With such as large confidence interaval I wonder how strong the actual data is...

So, to be clear the biggest trend being highlighted in the study was an increase in diabetes and diabetes mortality with an increase in protein consumption. If we put this in to context of the overall causes of mortality we see that diabetes mortality was of negligible percentage in all the groups compared to things like all cause, CVD and cancer mortalities, as mentioned above. The three most major causes of mortality were similar for all of the groups. The researchers even state this:

"Using Cox Proportional Hazard models, we found that high and moderate protein consumption were positively associated with diabetes-related mortality, but not associated with all-cause, CVD, or cancer mortality when subjects at all the ages above 50 were considered. Results showed that both the moderate and high protein intake groups had higher risks of diabetes mortality compared to participants in the low protein group."

However, to be fair they stratified the data into 50- 65 years and then 66 years and above and the results supposedly changed for them:

"Based on these results, we stratified the population into two age groups, those ages 50–65 (n = 3,039) and those ages 66+ (n = 3,342), and re-examined relationships between protein and cause-specific mortality. Among those ages 50–65, higher protein levels were linked to significantly increased risks of all-cause and cancer mortality (Table 1). In this age range, subjects in the high protein group had a 74% increase in their relative risk of all-cause mortality (HR: 1.74; 95% CI: 1.02–2.97) and were more than four times as likely to die of cancer (HR: 4.33; 95% CI: 1.96–9.56) when compared to those in the low protein group."

"Compared to subjects reporting a low protein diet, subjects who consumed moderate levels of protein also had a 3-fold higher cancer mortality (HR: 3.06; 95% CI: 1.49–6.25), which was not accounted for by either percent calories from fat or percent calories from carbohydrates, but was marginally reduced when controlling for percent calories from animal protein (HR: 2.71; 95% CI: 1.24–5.91), although the size of the effect was not as large as for those in the high protein group."
5% for high protein.

The thing with this though is that the confidence intervals aren't very supportive of their statements. With the exception of mortality from cancer we see confidence intervals less than 1. The confidence interval indicates that we are 95% sure that the association lies in this particular range, so its possible the associations may have run less than 1, which means an actual decreased risk. We also don't get any data on the low protein groups which actually had the highest history of cancer with 11.7% compared to 7.5% for moderate protein and 5% for high protein. Also if you look at the % of mortality causes I discussed earlier you see that with the exception of diabetes, the causes of death amongst all three groups, by percentage are very similar. This makes me question how valuable the associations these researchers are finding actually are.

Lastly, the study relied on one single 24 hour recall, take what you will from this:

"First, the use of a single 24 hr dietary recall followed by up to 18 years of mortality assessment has the potential of misclassifying dietary practice if the 24 hr period was not representative of a participant's normal day."

To summarize we have a few issues with the most prominent correlation the researchers tried to tease out:
1) The low protein groups data set is minuscule compared to the other groups, skewing the data
2) The low protein group had a much smaller prevelance of diabetes as a health history compared to the moderate protein group and the high protein group further skewing the data. Comparing a group of people that starts with 10% diabetes prevalence to start, to a group that is significantly smaller with only 2% diabetes prevelance to start and then trying to draw associative conclusions is folly in my personal opinion.
3) Even if their is a relationship, the mortality numbers are much smaller compared to the other major causes of mortality and the low protein group faired worse in some areas, such as CVD mortality compared to the moderate protein group.
4) The context of the relationship is a bit hilarious, especially between the low and moderate protein groups. The relationship implies that eating an extra 4oz of animal protein a day may be associated with diabetes and diabetes mortality.

Other issues with the study include:
1) Many hunter gatherer populations have accounts of diets with protein levels in the moderate range yet they lack diabetes and diabetes mortality.
2) There is quite a bit of evidence showing a certain requirement for a decent amount of protein to maintain positive nitrogen status, lean muscle mass etc. 38g per day definetly won't cut it, especially for populations that perform any type of physical activity.
3) The human digestive system is anatomically and physiologically set up to digest animal protein and animal fat. I dont personally understand what the mechanism would be for animal protein to cause diabetes, especially considering the explosion of diabetes has occurred recently in this past century and protein has been consumed in varying quantities across multiple populations for centuries before this explosion of diabetes.

Here is a link to the supplementary material where I pulled the data from:
https://www.cell.com/cms/10.1016/j....ecd5a518-46d4-4873-a749-78efb3ae9778/mmc1.pdf

 

[Goobz]

Wow, thanks for the very detailed reply! It is just one study of many (which I haven't spent close to the same amount of time going through as you have) and Valter Longo has been involved in many studies supporting the idea of a plant based diet + fish being healthy.

But I'm a bit under the pump at the moment, hopefully I get the time later to go through all that and respond properly.

 

[CLASH]

@Goobz
No worries. As I said earlier, I'm not against plant based as far as how I previously defined it. As far as the study goes I just dont personally think it makes sense that animal protein specifically causes disease, especially at moderate levels (10-20% of calories with an average of 14.5% as defined by the study). I can see where upwards of 25-30% can possibly cause an issue long term.