The response offered to our "Without Dairy" chapter overlooked
one significant part of the document -- the acknowledgments. The
experts to which the Dairy Bureau nutritionists refer in an effort
to prove that our work was inaccurate and unscientific were, on
more than one occasion, the same experts who reviewed our manuscript
and provided the information and guidance for our book. We saw no
reference to their input on the Dairy Bureau document.
People reading the Dairy Bureau critique without Becoming Vegetarian
on hand for verification, might incorrectly assume that our critics
were accurately reflecting our position. The Dairy Bureau response
lacked both logic and accuracy, with consistent use of materials
taken out of context, serious distortions of our words and blatant
disregard for the moral and ethical view points of vegetarians.
Our position on dairy foods is very clear:
"Many North Americans and Europeans rely on milk and its products
as major sources of calcium, vitamin D and riboflavin. With the
North American style of eating, it can be a challenge to get these
nutrients without milk. But this doesn't make cow's milk an essential
food" (from "Without Dairy", pages 71-72 in Becoming Vegetarian).
In Becoming Vegetarian, we choose to write a chapter which addresses
the nutritional concerns of people who use little or not dairy.
Our decision to do this was based on our interaction with other
vegetarians and vegetarian organizations. The need for practical
information for those who choose to minimize their intake of dairy
products was expressed time and time again -- we felt that it would
be a serious oversight to ignore this issue in a book on vegetarian
The remainder of this rebuttal focuses on key criticisms made in
the Dairy Farmers of Canada Response to Becoming Vegetarian (page
number and quote from the response appear in bold), followed by
and our rebuttal to these criticisms.
1. "...the book's claims lack a firm scientific basis"
The resources used in writing Becoming Vegetarian included hundreds
of scientific articles from peer reviewed medical and dietetic journals,
the World Health Organization's (WHO) technical report #797, Diet,
Nutrition and the Prevention of Chronic Disease (1990), Health Canada's
Nutrition Recommendations for Canadians (1990), the U.S. Surgeon
General's Report (1989) and the National Research Council's Diet
and Health, Implications for Reducing Chronic Disease (1989). Each
chapter was peer reviewed, and the technical chapters were also
reviewed by leading experts in the field -- university professors
and associate professors from across the U.S. and Canada. The chapter
in question -- Without Dairy -- was reviewed by Dr. Susan Barr,
an associate professor of nutrition at the University of British
Columbia and portions of the chapter were also reviewed by Dr. Connie
Weaver of Purdue University. The section on vitamin D was reviewed
by Dr. T.C. Chen, a researcher from Dr. Michael Holick's lab. Numerous
professional colleagues also reviewed this chapter.
2. "It also contains a number of errors and false assumptions and
the practical aspects of its implementation have not been thought
through sufficiently to warrant the recommendations it makes for
the general public."
While the nutritionists at the Dairy Bureau of Canada charge us
with making errors and false assumptions, leading nutrition experts
and scientific researchers, professional colleagues from numerous
hospitals, public health nutritionists, private practice dietitians
and dietitians representing Dial-a-Dietitian in B.C. not only reviewed
the book, but provided resources and assistance to ensure accuracy
of the information provided. Every professional organization that
has reviewed Becoming Vegetarian to date has given it most favorable
recommendations. The following are quotes from these reviews:
|"Few books on vegetarian nutrition are as comprehensive
and accurate as Becoming Vegetarian...It would be a valuable
addition to the bookshelf of all dietetics professionals and
other health care providers who work with vegetarian or near-vegetarian
| Journal of the American Dietetic Association
"In the forward to this book Louise Lambert-Lagace gives
Becoming Vegetarian a glowing recommendation. After reading
it I understand why! The book's sub-title tells it all: 'The
complete guide to adopting a healthy vegetarian diet"...This
book is well-written, flowing logically from one topic to
| Journal of the Canadian Dietetic Association
"A good read for anyone and a must-read for those considering
conversion to lacto-ovo vegetarianism or vegetarianism...The
three authors have a scientific yet sensible approach to the
topic. One cannot read this without learning some useful facts
about one more of the Things Medical School Never Taught Us."
| BC Medical Journal
"While vegetarian means different things to different
people, this book shows that meatless meals don't have to
jeopardize growth and health...A vegetarian food guide, along
with dozens of charts, tables and lists illustrates how to
switch from a meat-based to a grain-based way of eating. You'll
learn the new thinking about protein, fat, omega-3 fatty acids,
fibre and vitamin B12."
| BC Medical Association News
"Becoming Vegetarian is a timely book that fills a large
gap in the resources available to would-be vegetarians...Readers
can use this book at a variety of different levels and be
assured that they will find practical, accurate information
to help them follow a balanced vegetarian diet".
| British Columbia Dietitians and Nutritionists
"Dietitians with an interest in vegetarian nutrition will
welcome this reliable, comprehensive and very readable resource.
It offers invaluable support for people shifting to a plant-based
diet, for those who are fine-tuning a vegan diet and for everyone
| Issues in Vegetarian Dietetics
(newsletter of the ADA vegetarian practice group)
With reference to the recommendations made in Becoming Vegetarian,
they were directed towards the near-vegetarian, vegetarian and vegan
population, rather than to the general public as our critics charge.
Our goal in writing this resource was to provide these people with
the information necessary to achieve excellent health.
3. "To play a central role in PREVENTION (a theme central to the
book's premise), dietary factors must be PROVEN to PREVENT. No study
published to date has demonstrated that changing diet prevents coronary
artery disease or cancer".
This argument could also be used against Health Canada's Nutrition
Recommendations, The Surgeon General's Report on Nutrition and Health
(U.S. Department of Health and Human Services), the National Research
Council's Diet and Health: Implications for Reducing Chronic Disease
and the World Health Organization's Diet, Nutrition and the Prevention
of Chronic Diseases. All of these documents are based on a thorough
review of the scientific literature, and all agree that we can reduce
the incidence of chronic disease by dietary changes, namely eating
more grains, vegetables and other plant foods and less fat, particularly
saturated fat. The whole concept of disease risk reduction is also
referred to consistently as "prevention" throughout the literature.
The WHO states in Diet, Nutrition and the Prevention of Chronic
"Medical and scientific research has established clear links between
dietary factors and the risk of developing coronary artery disease,
hypertension, stroke, several cancers, osteoporosis, diabetes and
other chronic diseases. This knowledge is now sufficiently strong
to enable governments to assess national eating patterns, identify
risks, and then protect their populations through policies that
make healthy choices the easy choices."
Health Canada, in Nutrition Recommendations for Canadians, states:
" The Nutrition Recommendations for Canadians are a product of
a review of the literature on nutrient requirements and on the various
relationships linking nutrition and disease. They are intended to
provide guidance in the selection of a dietary pattern that will
supply recommended amounts of all essential nutrients, while reducing
the risk of chronic diseases."
The U.S. National Research Council in Diet and Health, Implications
for Reducing Chronic Disease Risk, states:
"A large and convincing body of evidence from studies in humans
and laboratory animals shows that diets low in saturated fatty acids
and cholesterol are associated with low risks and rates of atherosclerotic
cardiovascular disease. High-fat diets are also linked to a high
incidence of some types of cancer and, probably obesity. Thus reducing
total fat and saturated fatty acid intake is likely to lower the
rates of these chronic diseases."
It is important to note the central theme of the book is achieving
adequate nutrition on a vegetarian or vegan diet, not disease prevention.
While Chapter two addresses the issues of disease prevention and
the nutritional adequacy of vegetarian and vegan diets, this is
not the central theme of the book.
4. "If we focus on the SFA-blood cholesterol-CVD links, the analysis
of Ramsay et al. clearly reveals that lowering blood cholesterol
by current dietary recommendations is rarely as effective as claimed."
We agree that current dietary recommendations are relatively ineffective
at lowering blood cholesterol, and we make several statements to
that affect in Becoming Vegetarian. Indeed, current recommendations
(<30% of calories from fat) result in a cholesterol reduction
of about 5-10% at most (recall that reducing plasma cholesterol
by 1% results in a decrease in coronary artery disease of at least
2%).1 However, more aggressive diet therapy can result in reversal
of coronary artery disease and significant reductions in total and
30% or more. 2,3
1. Health and Welfare Canada. Nutrition Recommendations: The Report
of the Scientific Review Committee. Ottawa: Supply and Services
2. Ornish et al. Can Lifestyle changes reverse coronary heat disease?:
The Lifestyle Heart Trial. Lancet. Vol. 336, No. 8708, pages 129-133;
3. Gould et al. Changes in myocardial perfusion abnormalities by
positron emission tomography after long-term, intense risk factor
modification. JAMA. Vol. 274, No. 11, pages 894-901; 1995.
5. "Looking at cancer, we see evidence in the research literature
that diets rich in polyunsaturates enhance tumor growth and that
the fat of ruminant animals contains a substance (conjugated linoleic
acid) that is anticarcinogenic. Vegan philosophy would have people
consuming more of the former and none or less of the later."
It would appear from this statement that our critics are suggesting
that people should consume fewer plant foods and more ruminant fat
so that they might increase their intake of conjugated linoleic
acid (CLA) and reduce their intake of other polyunsaturated fats.
The advice to consume fewer plant foods and more ruminant fat is
contrary to the recommendations of every government nutrition body
of which we are aware, in addition to every legitimate organization
aimed at reducing the risk of chronic disease (i.e. Canadian Cancer
Society, Heart and Stroke Foundation, etc.)
Here's what the World Health Organization has to say about the
link between diet and cancer:
"Diets high in plant foods, especially green and yellow vegetables
and citrus fruits, are associated with a lower occurrence of cancers
of the lung, colon, oesophagus, and stomach. Although the mechanisms
underlying these effects are not fully understood, such diets are
usually low in saturated fat and high in starches and fibre and
several vitamins and minerals, including beta-carotene and vitamin
A....The experimental data, however, also point to an adverse effect
of very high intakes of polyunsaturated fats, at levels that are
considerably above current intakes in human populations."1
Dr. Walter Willet and his colleagues in the Department of Nutrition
at Harvard Medical School have done extensive, long term research
on the links between diet and cancer. In September of 1996 they
summarized their findings as follows:
"...we have a good idea of what people should eat if they want
to improve their odds of avoiding cancer. Their diet should be high
in vegetables, fruits and legumes (such as peas and beans) and low
in red meat, saturated fat, salt and sugar. Carbohydrates should
be consumed as whole grains -- whole-wheat bread and brown rice
as opposed to white bread and rice, for example. Added fats should
come mainly from plants and should be unhydrogenated; olive oil,
especially, appears potentially beneficial."2
The potential danger from excessive amounts of polyunsaturated
fats is thought to be due to the oxidation of these unstable molecules
- particularly when antioxidants are in low supply. Fortunately,
vegetables and fruits come packaged with antioxidants which can
reduce lipid peroxidation. Research suggests that the level of polyunsaturated
fat must be considerably higher than is seen in human populations,
thus the overall impact of these fats is likely to be very low.
On the other hand, the WHO points out that diets high in saturated
fat and low in plant foods and fibre are most highly associated
with diet-related cancers.
It is interesting to note that the anticarcinogenic substances
referred to in the Dairy response are actually a group of positional
and geometric isomers of linoleic acid (an omega-6 fatty acid).
While the two double bonds on linoleic acid are in the 9 and 12
positions, in CLA, the double bonds are at the 9 and 11, and 10
and 12 positions. While there may be some evidence to suggest that
this group of polyunsaturated fatty acids may have some anticarcinogenic
potential, it does not make foods which contain this fat anticarcinogenic
foods, nor does it negate all of the potentially damaging effects
of the excessive saturated fat they might contain.
If we compare the anticarcinogenic substances in the fat of ruminant
animals vs the anticarcinogenic substances found in plant foods,
there would be no contest. Plant foods are not only generally low
in fat and high in fibre but they are loaded with phytochemicals
that are potent anticarcinogens. Many commonly consumed plant foods
contain literally hundreds of potent phytochemicals. By contrast,
the fat of ruminant animals is over 50% saturated, is fibre-free
and totally void of the protective phytochemicals found in plant
foods. To suggest that people should consume more ruminant animal
fat and less plant foods to reduce cancer risk shows a complete
disregard for the research conducted on this vitally important disease
over the past 2-3 decades.
Finally, if their logic was correct, vegans and lacto-ovo vegetarians
would experience a greater incidence of cancer than omnivores. There
are many studies to show that vegetarians and vegan experience significantly
less cancer as compared to omnivores. 3-5
1. WHO Study Group on diet, Nutrition and the Prevention of Non-Communicable
Diseases. Diet, Nutrition and the Prevention of Chronic Disease.
Geneva, Switzerland: Technical Report Series No. 797. World Health
2. Willet, W., Colditz, G. and Mueller, N. Strategies for minimizing
cancer risk. Scientific American. September, 1996.
3. Thorogood, M., Mann, J., Appleby, P. and Mcpherson, K. Risk
of death from cancer and ischaemic heart disease in meat and non-meat
eaters. Br Med.J. Vol. 308:1667-1671, 1994.
4. Mills, P. Cancer among Seventh-day Adventists. Am.J.Clin.Nutr.
5. Phillips, R. and Snowden, D.A. Association of meat and coffee
use with cancers of the large bowel, breast, and prostate among
Seventh-day Adventists. Preliminary results. Cancer Research. 43(suppl):2403s-2408s,