You are what you eat?
May 8, 2024 7:20 AM   Subscribe

Perhaps you have heard of or watched the popular Netflix series You Are What You Eat: A Twin Study that launched earlier this year. The docuseries follows some participants in the Stanford Twin Nutrition Study (TwiNS): Vegan VS. Omnivore run by Dr. Christopher Gardner in which 22 pairs of twins ate an omnivorous or vegan diet for eight weeks. The results indicated improved metabolic health and received wide media coverage.

The study and series have received some critiques.The series and study both received funding from the finders of the rather ridiculous documentary Game Changers. Oddly, it includes interviews with NYC Mayor Eric Adams. Perhaps it is best described as flawed but intriguing. American Institute for Cancer Research asks ’Entertainment or Education?’

But what about the study itself? Shortcomings include that the study measured LDL-C instead of LDL-P of ApoB, measured that are more accurate but less well-known to the general public. It was fairly short, and the participants were mostly female. Dr Gardner discussed these choices and his interactions with the filmmakers in this interview with Simon Hill on the podcast The Proof

Did the participants continue their diets after the study was over?
posted by bq (29 comments total) 9 users marked this as a favorite
 
A long-ago short-term GF: "If you went vegan, you could add at least ten years to your life!"
My mother: "No, honey, it'll just feel like ten more years."
posted by outgrown_hobnail at 7:34 AM on May 8 [21 favorites]


Diet studies that run for 8 weeks?

Do we not yet understand that nothing can be learned from those (other than "this diet will not kill you outright in 2 months")? Nothing at all, not even in principle?
posted by Aardvark Cheeselog at 7:37 AM on May 8 [30 favorites]


8 weeks! You can't tell anything meaningful over 8 weeks.
posted by grumpybear69 at 7:40 AM on May 8 [3 favorites]


The omnivore menu for the first four weeks of the study is wild. Meat or eggs at literally every meal, and a whole lot of beef, on top of it. You can see that the meals are crafted with good nutrition in mind, but I don't know why "omnivore" has to mean that much meat. Jesus.

In any case, the rest of the writing suggests that (surprise!) the Netflix series is barely even entertainment-first, but maybe pushy-vegan-stereotype first (like, if your focus is "veganism is healthy!" you shouldn't need to show scenes of factory farming). There's no doubt that most vegan eating is better for the environment, better for the animals we don't eat, and in some ways probably better for our bodies, but agenda-driven Netflix documentaries are probably not the way to spread that message.
posted by uncleozzy at 7:50 AM on May 8 [3 favorites]


Although I didn't dig through all the documents, but I expect the real results would be:

At 8 weeks: The drastic change in diet had all of these amazing effects!

At 20 weeks: both subjects' bodies acclimated to the sudden catastrophic change in diet and returned to their original baselines, with some differences that may be within the margins of error.
posted by AzraelBrown at 7:52 AM on May 8 [11 favorites]


I am not a dietician, but it really feels like...

This Diet Is the One True Diet: You should eat this.
Next Cycle of This Diet Is the One True Diet: You should eat [differently].
The Next Next This Diet Is the One True Diet: You should eat [differently than both of the above].

Mediterraneans: [outlive all of these people]

(I don't mean this as snark or dismissiveness of anything else. I'm just noting that we seem to do a lot of work on what works for diet, when there are people who traditionally eating a particular diet who are well-documented to outlive other people.)
posted by DirtyOldTown at 7:55 AM on May 8 [7 favorites]


8 weeks! You can't tell anything meaningful over 8 weeks.


Oh you absolutely can. It’s just that you can learn a specific and limited set of things. Those things need to be tested with longer studies to be generalized to a larger population recommendation definitely. The results of this study would be important for, say, a set of people with heart disease trying to manage their lipids with diet because they can’t tolerate statins and PCSK9-I inhibitors aren’t doing enough. I’d love it if someone could run a study with three times as many people over a year but so would everyone else, just find the money for it….
posted by bq at 8:06 AM on May 8 [4 favorites]


most vegan eating is better for the environment

If you're doing the sort of vegan eating where it's just grains, beans, fruits and vegetables, yeah, you're right—but all those vegan faux "meat" products are not only abominations in and of themselves, but also have some serious environmental footprint.
posted by outgrown_hobnail at 8:07 AM on May 8 [3 favorites]


Is the environmental impact of the fake meats really competitive with real meat production?
posted by Selena777 at 8:11 AM on May 8 [4 favorites]


Diet studies that run for 8 weeks?

for me, it's gotta be a three month commitment, or else don't bother. It's something I heard long ago and it's definitely worked in my life. If you want to introduce a new habit into your life, commit to doing that "something" for three months. So yeah, I'm going to have to shrug at any conclusions reached here.

This Diet Is the One True Diet: You should eat this.

The one diet that I think could work toward both better overall health in the community is the "just eat less meat" diet. By all means, let's make the long term goal not ever treating animals (and thus ourselves) horribly. But let's not fool ourselves that it's easy (or even healthy) for most people to suddenly do this. I was raised on a two meat-based-meals-per-day diet. Now, that very rarely happens. Now, I'm meat maybe once a day, and even there the portions are way reduced -- an evolution in my eating that's taken decades.
posted by philip-random at 8:16 AM on May 8 [4 favorites]


I still think Pollan's axioms—eat food, not too much, mostly plants—are the best guiding principals for diet. I eat way too much dairy (it is hard for me to shake milk, eggs or cheese for breakfast), but other than that I generally try to stick to a mediterrean-ish diet. The big reason I like Pollan's rules is that you don't have to feel bad eating an occasional burger if you're at a friend or relative's house. It's not an absolute, just a baseline.

(Really, the biggest diet change one can make is cutting down on added sugar and sodium. It would not surprise me if the vegan menu had significantly less overall compared to the omnivore menu, and that's what is driving the short term improvements.)
posted by thecaddy at 8:19 AM on May 8 [5 favorites]


I find my best and happiest diet is somewhere between Pollan and Cena. Couple weeks of Pollan followed by a couple weeks of Cena. No, or very little, processed food, because it makes me feel gross.

Pollan: eat food, not too much, mostly plants

John Cena: if it's green or if it breathes, I eat it
posted by Cpt. The Mango at 8:30 AM on May 8


(Really, the biggest diet change one can make is cutting down on added sugar and sodium. It would not surprise me if the vegan menu had significantly less overall compared to the omnivore menu, and that's what is driving the short term improvements.)

For the first 4 weeks of the study, the participants were delivered meals with the same amounts of calories designed to be equally healthy. Here are the menus.
posted by bq at 8:35 AM on May 8


I eat way too much dairy

I could give up meat today and not miss it, mostly, but dairy? Absolutely not. Yogurt and cheese are staples of my diet that don't have acceptable-to-me vegan substitutes. Eggs too, unfortunately.
posted by uncleozzy at 8:35 AM on May 8 [3 favorites]


Is the environmental impact of the fake meats really competitive with real meat production?

Probably not, and it is a net good if people eat less meat, but those fake meats aren't good for you and have all sorts of issues regarding "what is in them, really" etc. They are functionally equivalent to chicken nuggets in that respect. Highly processed.
posted by grumpybear69 at 8:37 AM on May 8 [2 favorites]


just find the money for it…

I think a huge problem with nutrition research (and many other academic fields) is that there are too many researchers chasing too many hypotheses instead of throwing down on some big, expensive intervention studies. Scraping the same big observational datasets isn't getting us anywhere.

When I was a TB researcher, we had a national consortium of clinics that made sure that we were enrolling the limited number of TB patients and contacts into studies that were answering the most important questions.

Key differences: funded almost exclusively by the CDC and the clinics themselves, and as demand for principal investigators ebbed and flowed, the docs could just... go back to being docs. Whereas an academic nutrition researcher who has to wait ten years for the consortium to publish is screwed.
posted by McBearclaw at 8:39 AM on May 8 [1 favorite]


John Cena: if it's green or if it breathes, I eat it

Doesn't even allow for a tangerine once in a while? Poor fella.
posted by grubi at 8:40 AM on May 8 [5 favorites]


Give me bugs on my apples, but take away the DDT.

Also, fresh milk, straight from the goat--milk her yourself. Also also, goat cheese. Nummanumma. Yeah.
posted by mule98J at 8:54 AM on May 8 [1 favorite]


Is the environmental impact of the fake meats really competitive with real meat production?

No, not really. Plant-based meat substitutes have on average 50% lower environmental impact. From "Meat substitutes: Resource demands and environmental footprints" (Smetana et al 2023)

It's true that heavily processed plant-based meat analogs have a much bigger environmental impact than simple beans, but it's nowhere near as bad as eating meat.
posted by SaltySalticid at 9:05 AM on May 8 [11 favorites]


my partner, who first got her masters in public health and later her MD, only allowed me to watch fifteen minutes of this documentary before she was so frustrated with the dramatization, methodological issues, and just plain sensationalism that she asked me to turn it off because it was ruining her day

in general, it seems like anytime pop media intersects with science there's always going to be at minimum some amount of sensationalism though in this case it seems like Netflix just straight up has team in their documentary arm that goes hard out of their way to produce pro-vegetarian documentaries. the overall net effect of that seems fine - less meat consumption is better ethically and for the environment (which is also ethical considering where climate change will hit the hardest ie the Global South)

but! the reification of unskeptical emotional appeals within the realm of science is definitely a Very Bad Thing that we could all do with so much less of and which contributes to the rising tide of bullshit in the way of influencer advice (which often includes actual MDs providing advice well outside of their wheelhouse, the disgraced Andrew Wakefield most prominent amongst them). I really wish schools taught classes that focused less on, say, molecular bonds and started more with the philosophy of science - what is empiricism? how do we do it? why is methodology important? what is the hierarchy of evidence? because it really wasn't until I learned all of that after taking classes in the philosophy of science on a total whim that I finally started understanding just how completely full of bullshit most of the science that's communicated in popular media is, and how little of it can be trusted
posted by paimapi at 10:13 AM on May 8 [2 favorites]


it includes interviews with NYC Mayor Eric Adams.

Oh hell no. Nuh to the uh to the no no no. Biggest fucking red flag EVER.
posted by The Ardship of Cambry at 10:52 AM on May 8 [5 favorites]


started more with the philosophy of science - what is empiricism? how do we do it? why is methodology important? what is the hierarchy of evidence?

I couldn't agree more. And it IS bad for people. I used to hang out on r/cholesterol and people would come parrotting Dave-Feldman-adjacent talking points all the time. Someone posted a 'persuasive' half hour video from a pro-keto conference.. It was literally 30 minutes of cherry picked anecdotes one after another. Really distressing.
posted by bq at 11:01 AM on May 8


when there are people who traditionally eating a particular diet who are well-documented to outlive other people.

Just remember the Blue Zone research showed it wasn’t just diet. It was activity, diet, outlook, and people (social connections.)
posted by warriorqueen at 1:05 PM on May 8 [3 favorites]


One bit of vegan propaganda that I enjoyed recently was "How long do health influencers live?", parts 1, 2, and 3, comparing the ages at death of a hundred or so promoters of various diets.

The meat-diet folks did look fantastic before they died young, though, and it brought to mind the reproduction-vs-lifespan-tradeoff theory (in, y'know, spiders and whatnot). The theory probably doesn't apply to carnivore diets vs. vegan diets in humans - I suspect that this is one of those bullshit connections that my brains likes to make - but it could be true.
posted by clawsoon at 3:01 PM on May 8 [1 favorite]


Just remember the Blue Zone research showed it wasn’t just diet. It was activity, diet, outlook, and people (social connections.)

Or possibly, welfare fraud, identity theft, name-saking and criminal abuse of the pension system, or [...] genuine confusion over dates or lack of birth certificates.
posted by i_am_joe's_spleen at 3:53 PM on May 8 [3 favorites]


Wow, I hadn’t heard that. Good find.
posted by warriorqueen at 8:05 PM on May 8


Or possibly, welfare fraud, identity theft, name-saking and criminal abuse of the pension system, or [...] genuine confusion over dates or lack of birth certificates.
I dunno, I've been to the area in Sardinia, first time in 1984, and though there were and are all sorts of social issues, I don't think there was any reason to doubt people's longevity. For one: they had the children, grandchildren and great-grandchildren they couldn't have had if they weren't living at the time.

I liked the Netflix series. But then I didn't expect it to be science. I felt Dr. Gardner was quite meticulous in explaining repeatedly what they could learn and what they couldn't learn from the study. I saw it as a popularization of the knowledge we all need to live by: we need to eat more plants, preferably whole rather than processed plants. We need to do this both for our personal health and for the planet. In one of the episodes, there is an apt comparison with tobacco, and the influence of the tobacco industry. As with tobacco, the so-called food most of us eat now is not god-given or natural. We don't have to eat processed food. And as with tobacco, processed food is really bad for our health. 30 years ago, people smoked everywhere, and it seemed extreme to ban smoking from restaurants and bars. Now even people who enjoy tobacco in some form are nauseated when they enter a smoke-filled room.

I hope processed food will go in the same direction as tobacco. People still use it today, but far less.

In the series, they serve fake meat and cheese to the vegans, which is processed food. This disappointed me quite a bit, but I will concede that the industrial meat and fish industry is worse for the planet than processed vegetables and that giving up some dishes you love can be hard. I should know, I still eat meat and fish. But I have set up a rule for myself that it has to be sustainable and organic, which is so expensive that I can't afford to eat it more than at the very most once a week. And the portion sizes are small.
posted by mumimor at 3:26 AM on May 9 [1 favorite]


IMO, it's going to be kind of interesting as food returns to 10% of the median household's expenditure due to recent inflation, if it means median calories consumed falls, and therefore some measurable amount of weight falls. The main period of US weight gain (1970s-current) was when food fell from 10% to 7% of median household expenditure, and before that was even higher.

Of course, if inflation wanes and food falls back to 7-8% of expenditure, or food choices change to supplant the increased cost (ie: people buy more cheaper, processed food), the timeline will be far too short to get good measurements.

The future is always interesting.
posted by The_Vegetables at 8:56 AM on May 9


FWIW, the "centenarian fraud" thing seems to be an argument between Saul Newman and Dan "Blue Zones" Buettner. Newman's paper, "Errors as a primary cause of late-life mortality deceleration and plateaus," appeared in PLOS Biology in 2018; his 2019 follow-up, "Supercentenarian and remarkable age records exhibit patterns indicative of clerical errors and pension fraud," is at BioRXiv ["This article is a preprint and has not been certified by peer review"]. "Blue zones" have captivated health and longevity experts. But are they real or statistical grift? (Salon, Oct. 1, 2023)

Across 148 studies (308,849 participants) (per a meta-analysis in PLOS Medicine (2010)), "individuals with stronger social relationships were 50% more likely to live longer than those who lack them. These results were consistent regardless of age, sex, health status or cause of death." (Live Science, Feb. 14, 2023)
posted by Iris Gambol at 9:19 AM on May 9 [3 favorites]


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