This statement was made as part of the argument countering the
statement "we hear reports of ...diabetes" which, as we mentioned
was taken out of context. But since the Dairy Bureau nutritionists
mention it, vegetarians do have a lower risk for several major chronic
diseases. This fact has been recognized by researchers for some
time. The American Dietetic Association in their position paper
on vegetarian diets state:
"Studies of vegetarians indicate that they often have lower mortality
rates from several chronic degenerative diseases than do nonvegetarians.
These effects may be attributable to diet as well as to other lifestyle
characteristics such as maintaining desirable weight, regular physical
activity, and abstinence from smoking, alcohol, and illicit drugs."1
While there are a number of lifestyle factors that may favorably
influence the health of vegetarians, studies have been done that
control for other lifestyle factors to allow a more accurate assessment
of the affects of diet. Those which are most notable are studies
done within the Seventh Day Adventist community, where a definite
health advantage has been observed in those Adventists who consume
a vegetarian diet rather than an omnivorous diet.2,3
1. American Dietetic Association. Position of the American Dietetic
Association: Vegetarian diets. J.Am.Diet.Assoc. 93:1317-1319, 1993.
2. Snowden. D.A. Animal product consumption and mortality because
of all causes combined, coronary heart disease, stroke, diabetes,
and cancer in Seventh-day Adventists. Am J Clin Nutr. 48:739-748,
3. Mills, P. Cancer among Seventh-day Adventists. Am.J.Clin.Nutr.
59(suppl): 1136(s)-1142(s), 1994.
3. "In order for any one beverage derived from legumes to be considered
as an alternative to milk for those who do not drink milk, it should
provide (or be fortified to levels found in milk) the 15 vitamins
and minerals considered to be significant in milk".
This statement suggests that the only way one can meet their nutritional
needs is to include 2-4 servings of milk, dairy products or foods
that are fortified to provide the same amount of vitamins and minerals
as milk. This thinking ignores the many patterns of eating throughout
the world that provide adequate nutrition with little or no dairy
products. Following Canada's Food Guide is one way of ensuring nutritional
needs are met and indeed, this method works very well. But we cannot
assume that it is the only way.
In Health Canada's Nutrition Recommendations (calcium section),
we are told:
"Beyond weaning age, children and adults of various countries
and food cultures subsist on diet differing markedly in their calcium
content. These differences in calcium intake, which are due mainly
to the relative strengths of the dairy industry have not been demonstrated
to have any consequences for nutritional health."1
Food guides from many other cultures often include dairy foods
as "optional". This does not diminish the nutritional value of cows'
milk -- milk is an excellent source of calcium and people who consume
an Western style diet may have difficulty meeting their calcium
needs without milk. However, for those with different patterns of
eating, a nutritionally adequate diet can be planned using little
or no dairy products.
The criteria for being in the milk and milk products group of Canada's
Food Guide is that the food must be a dairy product and must contain
sufficient calcium -- nothing more.2 Thus, to meet Health Canada's
criteria, alternatives to dairy could also be selected on the basis
of calcium. When we look at the overall dietary pattern, other essential
nutrients (including those found in dairy products) are supplied
in adequate amounts by a variety of foods. Vegan diets generally
provide more whole foods such as legumes, nuts, seeds and vegetables
than do omnivorous diets, thus numerous vitamins and minerals are
already quite high.
1. Health and Welfare Canada. Nutrition Recommendations: The report
of the Scientific Review Committee. Ministry of Supply and Services
2. Health and Welfare Canada. Action Towards Healthy Eating. Report
of the Task Group and Technical Group on Canada's Food Guide and
the Task Group on Food consumption to the Communications/Implementation
Committee. Minister of Supply and Services Canada, 1990.
1. Table 6.1 (Contribution of Dairy Products to the Average Canadian
We are well aware of the contribution of dairy in the diet of the
average Canadian, and we recognize the value of dairy products for
the majority of the Canadians. Our intention in writing a chapter
for vegetarians who use little or no dairy products was to help
them plan a nutritionally adequate diet not to degrade milk as a
source of nutrients.
2. "Most people claiming to be lactose intolerant are self-diagnosed,
never having had an actual tolerance test. It's unfortunate than
dieticians would exploit a misunderstanding in order to promote
Our critics are once again incorrectly assuming they understand
our "agenda". Our "agenda", or the purpose of our book, is to assist
those people who choose a vegetarian or vegan diet to meet their
To downplay lactose intolerance as is done by the Dairy Bureau
nutritionists is unfair to the many individuals who suffer its consequences.
While they would have readers believe that lactose intolerance is
largely a "misunderstanding", it is a reality for the an estimated
75% of the world's population, including the majority of native
Indians, Orientals and African Americans.1 Even some Europeans populations
such as the Italians, Spanish and French experience relatively high
rates of lactose intolerance ( an estimated 32 to 72 % of their
populations)2. Indeed, an estimated 7-15% of Northern Europeans
are lactose intolerant, and it is this population who experiences
the lowest incidence. In United States, an approximately 20-25%
of the population is affected.1
1. Hertzler, S., Huynh, B. and Savalano, D. How much lactose is
low lactose? J.Am.Diet.Assoc. Vol.96, No.3:243-246, 1996.
2. Flatz,G. Genetics of lactose digestion in humans. In : Harris
H. and Hirschhorn, K. eds. Advances in Human Genetics. New York,
NY: Plenum: 1987: 1-77.
1. "It has been estimated that up to 70% of the world's population
(not Canada's) have genetically determined limited ability to digest
lactose, but 80% of lactose maldigesters can drink a glass of milk
(12 g of lactose)."
While it is true that some individuals with lactose intolerance
can tolerate up to a cup of milk per day, they can rarely tolerate
the 2-4 servings per day recommended in our food guide. This argument
only strengthens the case for including calcium-rich alternatives
to dairy products on food guides. If lactose-intolerant people can
only consume one cup of milk or less per day, it would certainly
be of benefit for them to have guidance regarding other reliable
sources of calcium.
2. "The bottom line is that to cite lactose intolerance as a valid
reason for mass rejection of milk is inappropriate".
At no point did we cite lactose intolerance as a valid reason for
"mass rejection of milk". What we did state is that some people
choose not to consume dairy or to consume less than the recommended
amounts because they are lactose intolerant.
1. "There are many well-known coping strategies that may help even
lactose-intolerant individuals enjoy dairy products. The authors
as dietitians, should have known this but here they are:
· Drink milk in servings of 250 ml (1 cup) or less.
· Drink milk with a meal or with another food.
· Use whole or chocolate milk.
· Have hard cheeses as most of the lactose has been removed.
· Eat yogourt with active cultures.
· Consume lactose-reduced milk or dairy foods that are
· Prepare lactose-reduced milk at home using an enzyme
· Use an oral lactase supplement before consuming dairy
An additional and very well recognized coping strategy, used successfully
for millennia is to use non-dairy sources of calcium. Providing
a lactose-intolerant vegan or near-vegan with a list of ways that
they can more comfortably consume dairy foods is of little value
to them. When we show such blatant disregard for the values of other
people, it merely serves to push them away. It would be of far greater
value to these individuals to provide them with ways of adding non-dairy
(lactose-free) sources of calcium to their diets.
As dietitians, we have counseled many lactose intolerant individuals
who prefer to use as much dairy as they can tolerate. For these
individuals we do not hesitate to provide the above mentioned coping
strategies, which are certainly of benefit, as are Lactaid tablets
2. "Vegans claim dairy products are notoriously high in fat and
should be avoided." [referring to: "Many milk products...are higher
in total fat, saturated fat and cholesterol than many consumers
Once again, our critics have chosen to re-write our words to suite
their own purposes. We did not make a statement of fact about the
fat content of dairy products, rather an observation about another
possible reason some consumers choose to reduce their consumption
of dairy foods.
Most vegans are well aware of the many fat-free and low fat dairy
products available, and if their goal was simply to avoid high fat
dairy foods, they would continue to consume skim milk and skim milk
products such as yogurt. Indeed, this is not the case. The reasons
why vegans choose not to consume dairy foods involves much more
than a concern about fat, as we outline in the section of the chapter
entitled "Reasons why people limit or eliminate dairy products".
1. "It's interesting to note that 250 ml (1 cup) of a soy beverage
contains 4.6 grams of fat, roughly the same as 2% milk. Yet soy
is touted by vegans as a near-perfect food, while milk is judged
unhealthy because of its fat content."
We describe neither soy nor dairy as a near perfect food. Vegans
choose not to consume milk for health reasons (only one of which
is the fat content of dairy foods), ethical reasons, concerns about
the environment and concerns about animal welfare. No one food is
"perfect", for to be perfect it would need to provide all the necessary
nutrients in the appropriate amounts to support human health, and
apart from breast milk for infants, no other food has the capacity
to fulfill such a role. Comparing the total fat in milk and soy
beverage leaves out many important details. While soy beverage and
2% milk may be similar in total fat content, that is where the similarity
ends. Soy provides 54% linoleic acid, 7% alpha-linolenic acid, 24%
monounsaturated fat and only 15% saturated fat. That compares to
cow's milk fat with only 2% linoleic acid, 2% alpha-linolenic acid,
30% monounsaturated fat and 66% saturated fat. Saturated fat is
the single most important dietary factor involved in raising blood
cholesterol levels. For every 1% increase in blood cholesterol levels
there is a 2% increase in risk of heart disease. There are many
other notable differences between cow's milk and soy. Soy milk is
free of cholesterol, provides a similar quality protein and is loaded
with beneficial phytochemicals (specifically the isoflavones genestein
and daidzein which are a potent class of phytoestrogens). While
most people are very much aware of the nutritional advantages of
cow's milk (calcium, riboflavin and added vitamin D), few are aware
of the nutritional advantages of soy milk.
2. "Also left out of the book are all the available lower-fat dairy
products which are perfectly suited to lower-fat diets."
Our critics obviously did not read the book in its entirety. We
suggest selecting lower-fat dairy products on pages 117 and 120.
We chose not to dedicate a large section of the book to the use
of dairy foods because this is an issue that has been covered in
great detail in many other resources.
3. "Let's also not forget that dairy fat is one of the sources
of conjugated linoleic acid, an antioxidant, which has been shown
in animal studies to be highly anticarcinogenic." "One should also
note that as the consumption of polyunsaturated fats has increased,
so has the rates of breast cancer and prostate cancer."
One of the articles cited by our critics helps to put the whole
CLA issue into perspective:
"Of the vast number of naturally occurring substances that have
been demonstrated to have anticarcinogenic activity in experimental
models, all but a handful of them are of plant origin.1 Conjugated
linoleic acid may turn out to be one of the few anticarcinogens
in animal foods, however plant foods are loaded with a wide variety
of potent antioxidants and other protective phytochemicals.
This is what the WHO has to say about diet and cancer:
"...A review of the evidence indicates that a high intake of total
fat -- and in some case-studies also saturated fat-- is associated
with an increased risk of cancers of the colon, prostate, and breast.
The evidence is strongest for cancer of the colon, and weakest for
breast cancer...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.
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
Using the presence of CLA in the fat of ruminant animals as a
reason to increase our consumption of these foods is highly irresponsible,
considering the information we have to date on the relationship
between diet and cancer. National programs aimed at cancer risk-reduction
feature brightly colored vegetables in their publication materials,
not chunks of ruminant fat.
1. Ip, C., Scimeca, J.A. and Thompson. Conjugated linoleic acid.
Cancer. 74: 1050, 1994.
2. 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
3. "Therefore it should be noted that the fat in butter is erroneously
classified as a saturated fat, when in fact as much as 40% of the
fatty acids are unsaturated. Of the 60% saturated fats, at least
one-third has no effect on blood cholesterol".
Foods are often referred to as being sources of one particular
class of fatty acids when that class of fatty acids is present in
larger amounts than the other classes of fatty acids. For example,
nutritionists often refer to olive oil as being monounsaturated.
In fact only 77% of the fat in olive oil is monounsaturated. About
9% is polyunsaturated and 14% is saturated. Likewise for corn oil.
It is often call it a polyunsaturated fat, but only 62% of its fat
is polyunsaturated -- 25% is monounsaturated and 13% is saturated.
Butter contains approximately 66% saturated fat. Thus classifying
it as a saturated-fat food does not seem so unreasonable. If a third
of this saturated fat does not raise cholesterol levels, that still
leaves 40% or more of the fat in butter that does raise cholesterol.
There are few foods that could compete with that!
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