The headline-grabbing documentary What the Health makes a strong case that going vegan will improve your health on just about every level. If you cut all animal products out of your diet—meaning no more meat, poultry, dairy, or fish—you’ll also decrease your risk of obesity, type 2 diabetes, cancer, and other chronic health conditions. Those who have read a What the Health review prior to this one may have noticed that many experts aren’t convinced that the science used to make that case holds up under scrutiny.
Directed by Kip Andersen and Keegan Kuhn, What the Health aims to make clear how our diets affect our health so that viewers can make informed, healthy food choices. It’s a commendable goal, but Andersen and Kuhn cherry-pick data to back their claims that a plant-based diet is always the best choice for everyone. They dramatize findings about the connections between specific foods and disease, and rely on expert opinions from health professionals known to be vehement backers of veganism. Plus, they use misleading tactics to suggest organizations like the American Diabetes Association are intentionally attempting to obscure the truth about how animal products affect human health.
Like many other food documentaries and guide books, What the Health falls into the trap of highlighting only the nutritional research that validates a plant-based diet, and overlooking how diverse human bodies can have very different nutritional needs. In this What the Health documentary review, we’ll give you the full story behind seven of the most significant claims made in the documentary.
Claim #1: Excess Sugar Doesn’t Cause Diabetes
When fact-checking What the Health, one of the first claims to tackle comes early in the film: dietary sugar doesn’t cause diabetes. Experts including Dr. Neal Barnard, who founded the Physicians Committee for Responsibility, a nonprofit that advocates a vegan diet, put forward the idea that primary dietary causes of type 2 diabetes are not carbs and sugar, but rather, animal products.
“Diabetes is not and was never caused by eating a high-carbohydrate diet and it’s not caused by eating sugar. The cause of diabetes is a diet that builds up the amount of fat in the blood,” Dr. Barnard said in the film. “I’m talking about a typical meat-based, animal-based diet,” he continued. “You can look into the muscle cells of the human body and you find they’re building up tiny particles of fat that’s building insulin resistance. What that means is the sugar that is naturally from the foods that you’re eating can’t get into the cells where it belongs. It builds up in the blood.”
To support this claim, the film cites a Harvard study that found one serving a day of processed meats raised a person’s risk of diabetes by 51%, which does sound dire but hardly captures the full truth. First of all, the 51% refers to relative risk, not absolute risk. So if your absolute risk of developing diabetes was, say, 4 in 1,000, then eating a serving of processed meats would raise it to about 6 in 1,000. The change to absolute risk just isn’t that big.
And according to a systematic review, the impact of processed meats on your diabetes risk may be even smaller. The authors found that daily consumption of processed meat only led to a 19% increase, and again, that’s to relative not absolute risk. Data from the National Health Interview Survey puts the lifetime risk of developing diabetes at 32% for the average American man and 38% for the average women. If you ate bacon (or prosciutto, or pepperoni, or…) each and every day, you’d raise your absolute risk by a minimal 6 or 7 percentage points. Now, we aren’t advocating the consumption of processed meats by any means, as premium sourced meat products from pasture-raised animals are always preferable, but we also want to dispel claims that have been blown out of proportion to actual truth.
But what about sugar and carbohydrates? Does Barnard have a point that they’re not as strongly linked to diabetes as we’ve been told? Probably not. A literature review published in the Mayo Clinic Proceedings found that sugar, and specifically added sugars, are the “principal driver” behind type 2 diabetes.
The research showing that excess consumption of sugar and refined carbohydrates undermines your health is quite compelling. For example, researchers from the Department of Preventive Medicine at the University of Southern California conducted a global investigation of what drives the progression of type 2 diabetes, and found that the prevalence of the disease is 20% higher in countries where high-fructose corn syrup, a highly concentrated, highly processed kind of sugar, is readily available.
It seems quite clear that high sugar and carbohydrate consumption can, in fact, make you more likely to develop type 2 diabetes. It also seems clear that not only meat—specifically, processed meat—has a much more minimal effect, but also that dietary fats, from animal products or otherwise, can actually decrease your diabetes risk. The Swedish government has gone so far as to recognize a high-fat, low-carbohydrate diet as being an effective health intervention for people with type 2 diabetes as well as those looking to lose weight or maintain a healthy weight. A low-carbohydrate diet is, by necessity, low in sugar too.
Given the documentary’s harsh take on food industry lobbyists (which we’ll get into more later), it’s notable that it fails to mention how the sugar industry has poured money into research meant to obscure their product’s link to adverse health outcomes. This tactic has been quite effective, even influencing governmental recommendations.
Claim #2: Eggs Can Be as Harmful as Cigarettes
One of the other claims made by What the Health that grabbed the attention of all who came across it is that eating a single egg a day hurts your health as much as smoking five cigarettes a day. The evidence behind that statement just doesn’t add up. The logic used to equate eating eggs with one of the most provable dangerous behaviors out there stems from an outdated view of how cholesterol impacts human health.
It’s true that health professionals used to believe eating more cholesterol could raise your blood cholesterol levels and risk of heart disease, an idea that received widespread media coverage. But scientists now know that high-cholesterol foods, like eggs, don’t necessarily lead to artery plaque buildup. Research shows that the link between the kind of cholesterol you eat and the kind in your blood is nowhere near as definitive as was once believed.
In fact, a national nutrition committee declassified cholesterol as a “nutrient of concern,” meaning there’s no need to worry about overconsumption.
Andy Bellatti, a dietician who has followed a vegan diet for six years, absolutely believes in the health benefits of plant-based food. And yes, he said an an interview: “The idea that if you're going to eat an egg, you might as well smoke a Marlboro, I don’t find accurate.” And for good reason. Two out of every three long-term smokers die because of the cigarettes they consume. Egg eaters just don’t meet that same fate.
Claim #3: Processed Meats Can Be as Dangerous as Asbestos
The claim that eating processed meats, like bacon, can increase your risk of cancer as significantly as asbestos can comes from a massive distortion of a 2015 World Health Organization (WHO) review.
Andersen states that WHO considers processed meats to be as dangerous as asbestos, plutonium, and cigarettes. He also claims that eating a single daily serving of processed meat raises your risk of developing colon cancer by 18%. Let’s break those down.
First, it’s true that the International Agency for Research on Cancer (IARC), a World Health Organization group, classified processed meat as a Group 1 carcinogen. It’s also true that IARC classifies cigarettes, asbestos, and plutonium as Group 1 carcinogens. What’s completely untrue is that the classification has to do with how dangerous those substances are. The information page makes it unmistakably clear that the Group 1 classification for processed meat reflects the strength of the evidence showing it can raise your risk of cancer, and not that it’s as dangerous as the other substances with the same classification. Based on existing research, they feel there’s compelling evidence that processed meat can increase your risk of a specific kind of cancer. It definitely doesn’t mean eating processed meat can be as harmful as being exposed to asbestos or smoking cigarettes.
In an explanation of their findings, the IARC actually spelled this point out: “Processed meat has been classified in the same category as causes of cancer such as tobacco smoking and asbestos, but this does not mean that they are all equally dangerous.” WHO puts the annual number of cancer deaths due to diets high in processed meat at around 34,000 globally. The number due to tobacco smoking? One million.
When Andersen asks, “If processed meats are labeled the same as cigarettes, how is it even legal for kids to be eating this way?” he either didn’t understand the reasoning behind the IARC classification, or he was indulging in scare tactics to further his agenda.
Second, Andersen puts the increased colon cancer risk associated with eating processed meat at 18%. It’s worth noting the data he uses to get that number comes from epidemiologic studies, which can only show correlation and not causation. There are many factors that can influence your actual risk of developing cancer, and it’s possible that lifestyle factors like smoking, higher overall salt consumption, and even genetics might correspond with eating more processed meats.
And, as with the claim made in What the Health about processed meat and diabetes, the percentage refers to an increase in relative, not absolute, risk. According to the American Cancer Society, your lifetime risk of developing colon cancer is approximately 5%. Eating processed meat every day raises that risk by 1 percentage point—18% of your 5% lifetime risk—to give you a 6% lifetime risk. So, even if you eat a full serving of processed meat daily, you’re only increasing your risk of developing one type of cancer by a single percentage point.
Claim #4: Milk Can Increase Your Risk of Cancer
What the Health features studies linking milk consumption and an increased risk of cancer. While there are studies out there that suggest a link between milk and cancer, there’s just as much evidence contradicting that.
A systematic review of the highest quality findings on the topic to date concluded that there’s no consistent link between drinking milk and an elevated risk of cancer. Furthermore, research from the Shanghai Municipal Bureau of Health found that women who ate more dairy had a lowered risk of cancer.
The documentary also conveniently excludes high-quality data on the health benefits of dairy products, especially in connection to cardiovascular disease, the leading cause of death in Western countries.
Claim #5: Protein Deficiency Isn’t a Real Problem
One of the physicians interviewed for What the Health observes that they have “never seen a patient with a protein deficiency.” What they neglect to specify is that they’re referring to an acute protein deficiency, such as kwashiorkor. This detracts from the very real fact that it’s highly possible to eat too little protein for optimal health.
As you get older, your protein needs may increase. And if you choose to adhere to a plant-based diet, you will almost certainly need to eat more protein than meat-eaters do in order to meet your body’s amino acid needs.
There are 20 amino acids total, 11 of which we can synthesize as long as we get sufficient nitrogen in our diets, and 9 of which we can’t. Those nine are called essential amino acids and we have to get them from food. Plant-based proteins do contain all nine essential amino acids, but they’re often low in one or two, whereas animal proteins more closely match the human body’s amino acid needs.
The same doctor who claimed protein deficiencies aren’t something to worry about went on to say you can meet your body’s amino acid needs with 2000 calories of rice. Aside from being a very boring and very imbalanced way to do that, you’d also come up short for your requirement for an amino acid called lysine. Ginny Messina, a dietician who runs a website called The Vegan RD, described this statement as “a distraction and an irresponsible one….This kind of casual disregard for real issues in nutrition can set vegans up to fail.”
If you’re worried your typical diet may not be providing your body with properly balanced amino acid ratios, you may want to consider amino acid supplements. These supplements typically come either in beverage or capsule form and can help you fill any amino acid gaps you might have in your diet. Because supplements contain only active amino acids, your body can rapidly absorb them and put them to use right away.
You’ll want to be discerning about the supplement you choose, however. Some of the most widely touted kinds, like branched-chain amino acids (BCAA) supplements, don’t contain all nine essential amino acids. To avoid deficiencies that can interfere with the production of neurotransmitters, blood flow regulation, immune function, and more, be sure the amino acid supplement you pick is formulated to include scientifically optimized ratios of all the essential amino acids. This is an assurance you can count on with all Amino Company supplements.
Claim #6: Meat and Dairy Lobbyists Influence Dietary Recommendations
If you’ve begun to suspect that none of the claims presented in What the Health hold up, get ready for a plot twist. Andersen points out that there are verifiable financial relationships between giant food industry corporations and public health groups. For instance, Kraft, Dannon, and Oscar Meyer, to name a few, sponsor the American Diabetes Association. Given that these companies also sell products high in fat, sodium, and/or sugar, they have a clear financial stake in any diet recommendations the American Diabetes Association might make. Given these conflicting interests, it’s hardly surprising, then, that these mainstream public health groups seem to focus more on the treatment, not the prevention, of disease.
And a broad coalition of health experts feel that food industry lobbying, including efforts by meat and dairy lobbyists, influence nutrition guidelines. In the same interview cited previously, dietician Bellati said, “It’s important for Americans to know that many health organizations receive funding from companies and trade groups that are not in line with health,” Bellatti says, “and how that affects recommendations.” For instance, the long-standing recommendations to fill up on grains, which we now know should be consumed in moderation.
Claim #7: Factory Farming Hurts Human Health and the Environment
What the Health also makes a number of valid points about the harmful impact of factory farming, and not only on the animals. The film focuses on North Carolina pork production, revealing how factory farming adversely impacts the communities, primarily low-income and populated by people of color, that surround these concentrated animal feeding operations, as the farms are known.
One of the issues these hog farms must deal with is disposing of the massive quantities of waste generated by the pigs they raise and slaughter. Unfortunately, the way they solve it—spraying raw feces onto fields—causes ongoing health problems for nearby residents.
The film also touches on a nationwide problem faced by all large-scale animal feeding operations, and which now affects us all: increased antibiotic resistance. Researchers have found that farm animals are now showing resistance to carbapenem, an antibiotic of last resort used to treat severe infections.
If serious changes on a large scale aren’t implemented soon, the impact of factory farming on human health and the environment will only grow starker.
What the Health Review: Takeaway Points
Of the seven major claims we looked at, five were either overhyped or flat-out falsified, and two hit on genuine areas of concern.
Claim #1: Excess sugar doesn’t cause diabetes.
High-quality evidence shows sugar intake is strongly linked to type 2 diabetes. While Dr. Barnard suggested animal products can lead to a buildup of fat in the blood, which then results in diabetes, research actually shows high-fat, low-carbohydrate diets lower your risk of type 2 diabetes.
Claim #2: Eggs can be as harmful as cigarettes.
High-cholesterol foods, like eggs, don’t necessarily lead to artery plaque buildup. Research shows that the link between the kind of cholesterol you eat and the kind in your blood is nowhere near as definitive as was once believed.
Claim #3: Processed meats can be as dangerous as asbestos.
Studies have linked processed meats to an increased risk of colon cancer, and the strength of those findings did lead the World Health Organization to classify them as a Group 1 Carcinogen, a designation asbestos has also received. What the Health uses this to suggest the two are equally dangerous, but what the classification actually indicates is that the evidence about their respective—and very different—levels of danger is equivalent. If you eat a full serving of processed meat daily, you’ll only be increasing your risk of developing one type of cancer (colon cancer) by a single percentage point.
Claim #4: Milk can increase your risk of cancer.
Research on the connection between milk and cancer has been inconclusive so far. There’s at least as much evidence to suggest it has a neutral to beneficial effect as there is to suggest it has a harmful one.
Claim #5: Protein deficiency isn’t a real problem.
It’s entirely possible to get a less-than-optimal amount of protein from your diet, especially if you’re older or adhering to a plant-based diet. It’s also important to consider the percentages of amino acids found in the proteins you eat. Supplements can help ensure you’re getting an optimized ratio of the nine essential amino acids.
Claim #6: Meat and dairy lobbyists influence dietary recommendations.
This is a long-standing and very real problem. A wide variety of health experts have expressed frustration with the impact lobbying has on dietary recommendations made by mainstream public health organizations and by the government.
Claim #7: Factory farming hurts human health and the environment.
If you eat meat and dairy, it’s best to avoid factory-farmed products. Not only are they less nutritious than free-range, grass-fed animal products, but factory farming methods also contribute to widespread antibiotic resistance and serious health problems in communities near the farming operations.