What the Health was a surprise hit for Netflix, but the documentary is enraging some dietitians.
Directed by Kip Andersen, it's the followup to Cowspiracy: The Sustainability Secret, which made the case that animal agriculture is the "most destructive industry facing the planet today."
What the Health takes the cause even further by stating that animal-derived products—including eggs and milk—cause an array of life-threatening diseases, even when consumed in moderation. It's challenging, eye-opening stuff.
It's also almost completely bogus.
Before we tell you why, we'd like to note that many dietitians recommend plant-based diets, and if you're not practicing moderation in your diet, red meat can certainly be a serious problem. Vegan and vegetarian diets can be extraordinarily healthy, and if you've got ethical issues with meat production or factory farming, we're right there with you. By all means, eat vegan.
The research has not proven that eating animal products (in all quantities) leads to health problems across the board.
But that's not what this controversy is about. When someone makes uses broad brushstrokes to make claims in support of a worthy cause, they often end up defeating their own arguments, and although What the Health raises some important points, Andersen might be causing real damage by trying to make a more forceful case.
Adina Pearson is a registered dietitian who's been certified in the state of Washington for nearly 15 years. She's been a hospital dietitian, dialysis dietitian, and general outpatient dietitian, and she frequently works with people with diabetes and eating disorders. In other words, she knows her stuff, and she some serious issues with What the Health.
"While there are certainly well-documented benefits of eating more plants, the research has not proven that eating animal products (in all quantities) leads to health problems across the board," Pearson tells HealthyWay.
When we ran some of What the Health's claims past her, Pearson didn't pull any punches.
1. "Meat causes inflammation and diabetes."
Andersen presents this claim in a pretty astounding way. Here are some film quotes taken from the What the Health website:
"One serving of processed meat per day increased risk of developing diabetes by 51 percent … Within minutes of eating dead meat bacteria toxins, the body gets a burst of inflammation, stiffening or paralyzing the arteries."
So much info is not included.
In response to this claim, Pearson notes that she'd need to review Andersen's original source to give a full analysis. However, she does call the claim that eating meat is a huge risk factor untrue.
"Is the risk cited an absolute risk or a relative risk?" Pearson asks. "What population was studied? Were these otherwise healthy people with a varied diet? Were they people who already had risk factors? So much info is not included."
Fortunately, What the Health's website provides some sources, so we decided to look into them.
The "dead meat bacteria toxins" line sources NutritionFacts.org, a site operated by Dr. Michael Greger. Greger is a vegan, which isn't surprising, given his strong views on the dangers of meats, but he's also controversial. Dr. Harriet Hall, who writes for the medical skeptic site Science Based Medicine, says that Greger's videos sometimes mischaracterize research to promote veganism.
In this case, Greger appears to reference research published by Dr. Clett Erridge of the University of Leicester. Erridge's study was performed in vitro, which means that human subjects weren't involved, and he recommends further studies at the end of his paper. Here's how Erridge sums up his findings in the conclusion:
"It is tempting to speculate that the occasional ingestion of meals high in LPS [lipopolysaccharide] and/or BLP [bacterial lipopeptide] could promote transient, mild, systemic inflammatory episodes that predispose subjects to the development of atherosclerosis and insulin resistance."
It's quite a jump to read that research and conclude that, "The body gets a burst of inflammation, stiffening or paralyzing the arteries," though.
Animal-derived products may actually create inflammation, but we certainly don't know enough about that reaction to make such a broad statement.
Likewise, red meat does appear to increase a person's predisposition toward type 2 diabetes, but science still isn't sure about the extent of the threat.
2. "Vegan diets work better than the American Diabetes Association diet for controlling diabetes."
Here's what What the Health has to say about the American Diabetes Association (ADA) diet:
"Low fat, plant-based diet [sic] is more than twice as powerful at controlling and/or reversing diabetes, than the American Diabetes Assn. diet recommending meat and dairy."
There's no 'you must eat meat' dogma within the ADA.
There's a big error in that statement, according to Pearson (who, remember, has actually worked with people who have diabetes).
"There is no ADA diet," Pearson says. "The ADA recommends that health practitioners individualize each patient's eating in a collaborative way with the patient. There's no 'you must eat meat' dogma within the ADA."
Setting aside the point that the What the Health claim is based on erroneous assumption, is there any truth in it? Sort of. To support his claim, Andersen references a randomized, controlled trial performed by Neal D. Barnard, et al. (Interestingly, Barnard also sells a book on reversing diabetes.)
Most dietitians who work with diabetes patients help those patients to incorporate more plant foods, as far as is reasonable for that individual.
The researchers compared a low-fat vegan diet and a "conventional" diabetes diet. Here's the conclusion of that paper:
"Both diets were associated with sustained reductions in weight and plasma lipid concentrations. In an analysis controlling for medication changes, a low-fat vegan diet appeared to improve glycemia and plasma lipids more than did conventional diabetes diet recommendations. Whether the observed differences provide clinical benefit for the macro- or microvascular complications of diabetes remains to be established."
Once again, Andersen seems to have used hyperbole to get his point across. But according to Pearson, he's not telling dietitians anything they don't already know—people with diabetes certainly should eat vegetable-rich diets, but they should work with their physicians and dietitians to make those decisions.
"Most dietitians who work with diabetes patients help those patients to incorporate more plant foods, as far as is reasonable for that individual," Pearson says.
3. "Most Americans get about twice the protein they need."
In defense of this claim, the What the Health website lists two online articles: one from Bloomberg and one from Huffington Post, neither of which is an expressly scientific publication.
Why should any organization dictate how much protein, carbs, fiber, or veggies any individual should eat?
"Aren't we lucky that we have an abundance of food most of the time in the USA?" Pearson asks. "But even so, there are populations and individuals who aren't getting enough protein or have needs that exceed the 'vegan' recommendations for protein."
The problem, Pearson says, is that this claim is extremely vague and not specific to individuals. It might mislead people into believing that they get plenty of protein simply because they live in the United States.
"Really, why should any organization dictate how much protein, carbs, fiber, or veggies any individual should eat?" Pearson says. "Are there people who possibly eat too much meat? Sure. Are there people who fail to meet their protein needs also? Yes."
It's also worth noting that not all proteins are the same. Proteins are made up of amino acids, and non-meat sources of protein tend to lack one or more of the amino acids essential to human health. Vegans and vegetarians can certainly construct safe diets rich in protein, but not everyone who observes a diet free from animal products does so healthfully.
"Any diet that thinks it will cure everything by telling people what's best for them in a blanket way has failed to meet the needs of most," Pearsons says.
4. "Humans are natural frugivores, built to eat fruit (not meat)."
What the Health makes the case that humans aren't really built to eat meat, since our closest relatives are chimpanzees, who get 97 percent of their calories from plants (itself a problematic claim, since some chimps eat more meat than others). Once again, there's a basic issue with this statement.
Our bodies are pretty amazing in their ability to get nutrients out of many foods.
"Humans the world over have been eating meat for centuries," Pearson says.
"[We] are remarkably adaptable. From blood and milk diets of certain tribes, to today's vast extremes of vegan diets or keto diets...our bodies are pretty amazing in their ability to get nutrients out of many foods. But in general, moderation and avoiding extremes works best for physical and mental health."
There's some controversy as to whether humans were "built" for meat, but that's also an enormous question from an anthropological perspective.
In a commonly shared article, for example, People for the Ethical Treatment of Animals (PETA) quotes anthropologist Dr. Richard Leakey in claiming that human canine teeth aren't capable of tearing into raw flesh. Therefore, PETA claims, humans are natural herbivores. Simple, right?
But the quote from Leakey appears to have been taken out of context from a book in which he also notes that humans ate meat 2.5 million years ago (credit to blogger Lori Miller for her research). Eventually, humans evolved to consume and digest meat, and we've been doing so for quite a while.
5. "Fat causes diabetes."
In What the Health, Andersen suggests that fat causes diabetes, not sugar, and he cites a study that indicates that consumption of pasteurized cow's milk may increase the chances of type 1 diabetes development in juveniles.
Fear mongering about food is also bad for our health, because it makes us unsure, anxious, and less trusting of our bodies.
Again, these broad statements weaken the effect of the documentary—and might even cause harm.
"The jury is still out on any singular 'cause' of diabetes," Pearson explains, "and of course one can overdo fat or sugar or carbs or protein. But you know what? Fear mongering about food is also bad for our health, because it makes us unsure, anxious, and less trusting of our bodies."
According to Pearson, that's the big problem with this type of shock-and-awe approach.
"People who have lost trust in their ability to eat are the very ones who over-restrict foods and then later end up binge eating those same foods," she says. "Eating disorders have a higher mortality rate than any other mental health issue—and movies like What the Health that fear monger about foods are a definite trigger for the vulnerable who are at risk of developing an eating disorder."
Should people eat more vegetables? Sure. But distorting the facts about our diets doesn't help anyone, and it might end up hurting people.