Thursday, May 19, 2011

Can Spinach Save America?

Last weekend I saw “Forks Over Knives: How A Plant” the documentary arguing that the key to health and longevity is a plant-based diet. Joining the emerging genre of food-centric documentaries over the past few years the film focuses on the work of Dr. T. Colin Campbell, author of The China Study, and Dr. Caldwell D. Esselstyn, Jr. a physician at the Cleveland Clinic. Based on the epidemiologic findings of the China study, and Dr. Esselstyn’s clinical findings, the movie argues that a change in diet is all that’s necessary to combat the current “diabesity epidemic.” It examines the research, the (already well-mined) history of agricultural policy in the United States, the problematic position of the USDA in serving to protect farmers but also determine dietary guidelines andthe role of the media in disseminating dietary recommendations to the public. The film also follows several individuals as they transform their diets from animal-based and processed foods to a whole foods based, primarily (although not exclusively) vegan diet. The result is an imperfect but impassioned polemic against the Standard American Diet that raises many interesting points (I never considered erectile dysfunction as an early sign of heart disease!) and undoubtedly many eyebrows.

Certainly there are those who argue that the film’s claims rely too heavily upon epidemiological research that cannot necessarily be applied clinically. Personally I don’t see this as a problem when the proposed intervention involves no prescription medication, nosurgery, no calorie restriction – it simply recommends that people eat less meat and dairy and more fruits and vegetables, less processed foods and more whole foods. As the movie states, “it’s so simple, it’s criminal.” So what are the problems then? One might argue that the cost of such a diet would be significantly more, but with proper education and smart shopping, that need not be the case. And if it is the case, that’s certainly incentive to get cracking on the Farm Bill coming up next year. Another argument voiced in the film is that people cannot get the amount of protein they need from a plant-based diet. Sadly this position is stated by
Connie Diekman, former president of the American Dietetic Association, and advisor to the National Dairy Council (and also a professor of nutrition). The ADA calls itself “the food and nutrition experts” and is the accrediting body of nutrition programs nationwide. In July I will begin a dietetic internship, not because I want to incur more student debt and work full-time with no pay, but because the ADA requires that dietetic students do so in order to sit for the exam to become a registered dietitian. As a student member of the ADA I am professionally insulted that this woman with a clear conflict of interest was highlighted to convey the views of dietitians nationwide. In fact, in its position paper on vegetarian and vegan diets, the ADA states:
It is the position of the American Dietetic Association that appropriately planned vegetarian diets, including total vegetarian or vegan diets, are healthful, nutritionally adequate, and may provide health benefits in the prevention and treatment of certain diseases. Well-planned vegetarian diets are appropriate for individuals during all stages of the lifecycle, including pregnancy, lactation, infancy, childhood, and adolescence, and for athletes.
Furthermore, as someone who limits consumption of animal-based foods and focuses on whole grains, legumes, fruits and vegetables, I am personally offended by this misinformation. But the segment was just the latest attack on the ADA, which is increasingly under fire for its dubious support of and from the food industry. And I find myself increasingly frustrated with the leading organization in my profession…but that’s a topic for another day.

“Forks Over Knives” is not nearly as sleek and professional as Food, Inc. but unlike that more politically charged documentary, it asks its audience to seriously consider shifting toward more unrefined, whole foods plant-based diet and for that I greatly applaud its effort. The film indicts the meat (protein!) and dairy (calcium!) industries for driving the increased consumption of these foods over the past few decades to which they link increased chronic disease. The filmmaker also mentions oils as harmful, he then glosses over it without addressing it any further– a somewhat problematic oversight since not all oils are created equal and certain oils can be extremely beneficial and necessary for the body.

And while the doc’s vignettes of people altering their diets provided a softer human element, these portions of the film had the weakest production values and might have been better compiled and more tightly edited. Still, they were important points in demonstrating that it is possible to eat and live the way Dr. Campbell and D. Esselstyn suggest and dramatically alter your health for the better in a surprisingly short period of time. The film was weakest when showing graphic images of coronary bypass surgery, reminding me of the anti-smoking videos I watched in high school. It was also very defensive about the “manliness” of eating a vegan diet. More compelling were the graphs showing correlations between meat consumption and chronic disease over time in various parts of the world.

For many people diet and lifestyle are the “on/off” switch in our genes. We may be genetically predisposed to weight gain, diabetes, cancer and heart disease but a plant-based diet may prevent the expression of these conditions. It may not be enough, but it is the part that we have within our power to control. There has been tremendous backlash against the film, with many calling it vegan propaganda. And it's true that ardent vegans and animal rights activists hail its message as supporting their own. I am not vegan but thought it made a strong case for reducing animal product intake and I’m comfortable with that idea, from a nutritional, environmental and ethical standpoint. Apparently it’s a touchy subject. Maybe people see what they want to see. The film’s bottom line: choose wisely with your fork and you may spare yourself from going under the knife.