I’m 20 minutes into the @joerogan debate with @chriskresser and @lightningwilks.
All this time spent on whether Kresser was misleading for grouping 71% no association and 13% inverse into 84% no or inverse is ridiculous.
All this time spent on whether Kresser was misleading for grouping 71% no association and 13% inverse into 84% no or inverse is ridiculous.
If the claim is dairy causes cancer, there’s nothing misleading about grouping the figures together to say 84% of the meta-analyses of the observational evidence contradicts it.
And if you has no effect, you’d expect some to find increased risk and some to find decreased risk. If most find nothing and 10-15% find increased and decreased on each end, that’s consistent with no effect.
Rogan’s point at 31 minutes is good. Lactose intolerance contributing to intestinal inflammation and that playing a role in intestinal cancer seems like a worthy hypothesis.
A lot of time is getting wasted on plant-based versus vegan versus omnivore. It could have much more quickly narrowed in on the question of whether animal foods are important enough for including them to be superior to excluding them.
Wilk’s makes a fair point at 50 minutes that Kresser is essentially low carb if what he considers high carb for his patients is low carb by mainstream standards.
Wilks made a completely erroneous point earlier that the logical fallacy of appeal to authority depends on the legitimacy of the authority. Any appeal to any authority to argue that a position is true or false is a logical fallacy.
However, that does not mean that no one should ever appeal to authority. Wilks is right that it makes sense to seek expertise and that it makes sense to seek the interpretation of data from experts in the field of that data.
It’s just that doing so is not a logical justification in favor of or against any position.
I can’t argue my surgeon was correct for where he inserted staples in my shoulder because he’s a surgeon. But I’m not stupid enough to put staples in my own shoulder.
A little lost on why they’re spending so much time debating Kresser’s carb guidelines when that has nothing to do with the film.
At ~55:50 Wilks makes an EXTREMELY misleading argument and takes advantage of no one else knowing what a forest plot is. The paper being discussed found that the pooled results of non-American studies did not show a significant correlation between heme iron and red meat.
In America, such an association was found.
See table 3 in this paper: cyber.sci-hub.tw/MTAuMTAxNi9qLm…
Here’s the data 
The risk ratio is double for America and only America is significant. This is despite 2.5 times more studies done outside of America. Kresser was right.
Wilks asks Kresser if he knows how to read a forest plot. He catches him off guard. He hesitates. He says know. Neither does Rogan. Wilks then pulls a fast one and shows Kresser a study in the Forrest plot that was non-American and was significant.
This is very misleading. The point of a meta-analysis is to pool the results together to see the overall trend. The point of the sub-group analysis is to see that trend inside and outside America. Kresser represented that trend correctly.
At 1:05 Wilks claims that you get “pro-oxidation” from animal foods and “anti-oxidation” from plant foods. This is said in the context of discussing how plant compounds could prevent heme iron from contributing to oxidative stress in the gut.
In that isolated context it’s a completely sensible hypothesis. But as a general statement it’s ludicrous. Once iron is inside the body, when utilized properly at the right dose, it is essential as an antioxidant. Heme iron is a cofactor for catalase, which concerts H2O2 to water
Further, sulfur amino acids, which are twice as abundant in animal protein as plant protein (on top of animal foods having more total protein), are used to make glutathione, the master antioxidant.
Wilks goes on to say that if you work out, you will generate oxidative stress, and you want the plant foods to neutralize *that* oxidative stress instead of the oxidative stress in your gut caused by heme iron. This is getting more and more ludicrous.
First, the oxidative stress generated by exercise is required for the fitness response induced during recovery. You don’t want to completely neutralize it.
Second, endogenous oxidative stress is exactly what the meat is good at protecting against, through glutathione, zinc, riboflavin, and, in the right dose, even iron.
In fact exercise and vegetarianism both decrease riboflavin status. Meat is a very good source of riboflavin, and riboflavin is critical to antioxidant protection.
In the discussion around 1:08ish, I haven’t looked at the research Wilks is using for this but he seems to be saying that animals get B12 from soil bacteria and those bacteria are gone now.
I believe this is false. They get it from eating other animals or from pre-gastric bacteria. In ruminants, grain-fed rumen most likely have dysbiosis that can hurt their B12 status because their rumen can make B vitamin antagonists.
If soils are deficient in cobalt, supplements will be necessary. If chickens can’t eat insects, maybe that necessitates supplements.
Wilks seems to be arguing that cows need B12 supplements for the same reason that carrots don’t have B12: because the bacteria that used to be in the soil aren’t anymore. I’m quite certain that’s just wrong.
Ok Wilks later does acknowledge the rumen contribution.
It’s clear that Kresser was wrong about saying B12 is never fed to cattle in the first debunking episode.
While Wilks is probably right that sanitation, hygiene, and modern soil treatments have reduced exposure to B12 outside of animal foods, he says there was a time where we didn’t need animal foods for B12 because of this.
Where are the zero-animal food traditional diets that achieved this? When Weston Price searches the globe looking for one, the closest he found was a Pacific island where those living in the inland mountains believed they needed animal foods at least once every 3 months.
Because of that, they would hunt the fisherman on the coast and eat their livers, believing that the livers of the fishermen, who ate the most shellfish, were the most nutrient dense.
Not wanting to be eaten, the coast-dwellers appeased the mountain-dwellers by trading shellfish for plant foods, even when at war.
Weston Price Looked for Vegans But Found Only Cannibals westonaprice.org/weston-price-l…
They spend a lot of time caught up on whether Kresser misrepresented the issue when saying that Wilks didn’t have a reference for a statement about omnivores having B12 deficiency, and Wilks points out that Kresser had similar information in his ebook on B12 deficiency.
But the stronger point here is that head to head comparisons of omnivores vs vegans and vegetarians have much higher rates of B12 deficiency. If everyone became vegan, B12 deficiency rates would likely soar.
It’s very misleading for Wilks to point to a lack of correlation between plasma B12 and meat intake. It’s much more relevant that diagnostic cutoffs for deficiency for functional markers are found in 70-90% of vegetarians and vegans and only ~15% of omnivores.
For example: ncbi.nlm.nih.gov/m/pubmed/15720…
For another example: ncbi.nlm.nih.gov/m/pubmed/12816…
The forrest plot issue was unfortunate lack of preparation on Kresser’s part. Wilks’ point wasn’t fair, but he skillfully latched on to it and hammered it repeatedly to detract from Kresser’s credibility.
Just before the 2h timepoint, Wilks dismisses the recent paper exonerating red meat based on funding by the International Life Sciences Institute (ILSI), which accepts food industry funding.
Part of my doctoral dissertation was funded by ILSI. It was a vitamin E supplementation study and there was no logical connection with food industry interests, nor did the funding source ever have any say in anything about the conduct or publication of the research.
Food industry funding is all over the place in nutrition science. In my experience it feels more like a subtle branding effect of wanting to create a general sense of alliance, sort of like how corporations fund both political parties, rather than any kind of quid pro quo.
Not even any sense of pressure. I do think conflicts of interest are important to bring to light, but dismissing evidence because it’s funding source takes funding from food industry companies is not good reasoning.
Wilks says industry-funded studies manipulate study designs and gives an example: 10-12 eggs doesn’t raise your cholesterol but 0 vs 1 does. Probably correct, but somewhat misleading.
Maria-Luz Fernandez at UConn did multiple trials comparing 3-4 eggs/d vs 0-egg placebo on the background of a National Cholesterol Education Program diet. Cholesterol intake in the egg group in one study was 764 mg and in 0-egg was 167 mg.
Funding was from the American Egg Board (industry), the UConn Research Foundation (academic) and USDA (government).
For example: twin.sci-hub.tw/6775/8cbf954f1…
General findings were that 2/3 of people have little to no response, 1/3 have a moderate increase but the LDL/HDL ratio doesn’t change, and 1% have a very bad lipid response.
I say Wilks was partly misleading because he implies that they deliberately use irrelevant doses such as 10 vs 12 eggs a day, which is above the threshold where responses are seen. That’s false. 4 eggs vs zero eggs on a moderately cholesterol-restricted diet is highly relevant.
However, there is probably a kernel of truth in that a vegan will have 0 mg/d, not 118 mg/d. That probably does lower cholesterol. Mine was 106 instead of 140-160 when I was vegan.
However, a lacto-ovo-vegetarian diet can easily be very high in cholesterol, and experiments studies showing veganism lowers cholesterol are lacking as far as I know.
The 2:05 discussion of specific food industry ties in researchers on the red meat exoneration seems much more important than the previous point about funding indirectly coming from food industry via ILSI.
HOWEVER... a debate about conflicting meta-analyses should focus on the inclusion/exclusion criteria! You of course can’t discuss every study. But you can focus narrowly on the decisions that made one meta-analysis come to a different conclusion than another.
Quite often this comes down to one study or a few studies being included or excluded. The proper debate is about that specific decision. Which one made a more scientifically sound decision about which studies they included?
2:13 I would like to know why Wilks believes that evidence about food should not be graded on its quality in the same way as evidence about pharmaceuticals.
He says this is not representative of scientific consensus. However, how does he explain the massive shift taken by the National Academy of Medicine to redo all of the DRIs by evidence-based medicine guidelines where only RCTs of clinical effects can be used for RDAs?
This started in 2017 preparation for the sodium and potassium guidelines that came out this year.
Unfortunately, at 2:19 the entire panel agrees that people who “talk about the anti-nutrients in food don’t know what they’re talking about.” This includes major organizations of scientific consensus such as the World Health Organization and the National Academy is Medicine!
Recent public health paper on the role of phytate in setting public health policy: sci-hub.tw/10.1093/nutrit…
Reference 89 in that paper is to a World Health Organization algorithm that takes into account phytate (anti-nutrient) and ascorbic acid in predicting iron absorption.
The RDA for zinc lists vegetarianism and alcohol intake as its only entries under “special considerations.” ncbi.nlm.nih.gov/books/NBK22231…
Quoting the DRI report, written in 2001: “The requirement for dietary zinc may be as much as 50 percent greater for vegetarians and particularly for strict vegetarians whose major food staples are grains and legumes and whose dietary phytate:zinc molar ratio exceeds 15:1.”
“At this time there are not sufficient data to set algorithms for establishing dietary requirements for zinc on the basis of the presence and concentration of other nutrients and food components.”
7 years later, models were developed to revise the next RDA for phytate intake, doubling it for 1000 mg phytate and tripling it for 2000 mg phytate: ncbi.nlm.nih.gov/pmc/articles/P…
In the 2018 paper I cited above, these conclusions about phytate are maintained.
So far at 2:48 I agree with everything Wilks says about protein requirements and Kresser seems mainly agreed. I would add that weight loss requires the high end of the protein range to minimize lean mass loss.
I think it’s fair to say that vegans can get enough protein, and I wouldn’t list that as a primary objection to veganism.
At 3:02, Wilks criticizes the protein quality measurement as being designed for populations vulnerable to kwashiorkor. All kinds of things were designed for a strong need and then had their utility broadened. Protein quality is protein quality.
At 3:13 I’m still trying to figure out where Wilks is going with the protein quality issue. He says it’s not relevant in the western world because of high total protein intakes.
But he himself had minutes earlier said that you need 20-25 g protein to maximize muscle protein synthesis acutely and you could get it down to 17 g with an egg. That’s very relevant!
I think he’s correct that if total protein intake is high enough, the quality score becomes irrelevant. But a vegan diet isn’t automatically high in protein. Vegan foods can provide enough protein, but you have to be more careful to get enough than if you animal protein.
I think the discussion of endothelial function at the end misses how some of the important factors interact and would change between acute and chronic measurements.
Nitric oxide production requires that nitric oxide synthase be stabilized as a functional two-unit complex bound by zinc and sulfur. Oxidative stress breaks the bonds. Arginine is needed to donate nitrogen.
So you need protein, and that explains why Kresser’s studies showed plant and animal proteins to be beneficial, while Wilks had a study showing dairy fat is harmful. The *protein* supplies the arginine. Fundamental important but not discussed.
Then you have an acute plant-based diet. It’s rich in antioxidants that acutely stabilize the zinc-sulfur clusters that hold the enzyme together.
However, what happens if you eat a lower-zinc diet over time? You’ll have less zinc to hold the enzyme together, regardless of oxidative stress.
That’s not fundamentally an argument for or against veganism, but it’s misleading to focus on acute postprandial studies, and not discussing the mechanisms involved leaves our important perspective needed to properly interpret the studies.
Ok, finished the analysis. Hope you enjoyed it. 😊
