Change my mind: Veganism entails trade-offs, and health is one of the axes

post by Elizabeth (pktechgirl) · 2023-06-01T17:10:02.075Z · LW · GW · 81 comments


  My cruxes
  My evidence
  Evidence I’m looking for
   Preemptive responses to counter-arguments
    “You’re singling out veganism”
    “The costs of misinformation are small relative to the benefits of animals”
    “The human health gains are small relative to the harms to animals” 
    “The health costs don’t matter, no benefit justifies the horror of farming animals”
    “This is a strawman, vegans already address nutrition” 
  Why is this so hard to talk about?
    The stakes are so high
    Vegans are sick of concern trolls
    Typical minding/failure of imagination
    Lies we tell omnivores
    Failure to hear distinctions, on both sides


To me, it is obvious that veganism introduces challenges to most people. Solving the challenges is possible for most but not all people, and often requires trade-offs that may or may not be worth it.  I’ve seen effective altruist vegan advocates deny outright that trade-offs exist, or more often imply it while making technically true statements. This got to the point that a generation of EAs went vegan without health research, some of whom are already paying health costs for it, and I tentatively believe it’s harming animals as well. 

Discussions about the challenges of veganism and ensuing trade-offs tend to go poorly, but I think it’s too important to ignore. I’ve created this post so I can lay out my views as legibly as possible, and invite people to present evidence I’m wrong. 

One reason discussions about this tend to go so poorly is that the topic is so deeply emotionally and morally charged. Actually, it’s worse than that: it’s deeply emotionally and morally charged for one side in a conversation, and often a vague irritant to the other. Having your deepest moral convictions treated as an annoyance to others is an awful feeling, maybe worse than them having opposing but strong feelings. So I want to be clear that I respect both the belief that animals can suffer and the work advocates put into reducing that suffering. I don’t prioritize it as highly as you do, but I am glad you are doing (parts of) it.

But it’s entirely possible for it to be simultaneously true that animal suffering is morally relevant, and veganism has trade-offs for most people. You can argue that the trade-offs don’t matter, that no cost would justify the consumption of animals, and I have a section discussing that, but even that wouldn’t mean the trade-offs don’t exist. 

This post covers a lot of ground, and is targeted at a fairly small audience. If you already agree with me I expect you can skip most of this, maybe check out the comments if you want the counter-evidence. I have a section addressing potential counter-arguments, and probably most people don’t need to read my response to arguments they didn’t plan on making. Because I expect modular reading, some pieces of information show up in more than one section. Anyone reading the piece end to end has my apologies for that. 

However, I expect the best arguments to come from people who have read the entire thing, and at a minimum the “my cruxes” and “evidence I’m looking for” sections. I also ask you to check the preemptive response section for your argument, and engage with my response if it relates to your point. I realize that’s a long read, but I’ve spent hundreds of hours on this, including providing nutritional services to veg*ns directly, so I feel like this is a reasonable request. 

My cruxes

Below are all of the cruxes I could identify for my conclusion that veganism has trade-offs, and they include health:

Those are my premises. Below are a few conclusions I draw from them.  I originally didn’t plan on including a conclusion, but an early reader suggested my conclusions were milder than they expected and it might be good to share them. So: 

My evidence

One is first principles. Animal products are incredibly nutrient dense. You can get a bit of all known nutrients from plants and fortified products, and you can find a vegan food that’s at least pretty good for every nutrient, but getting enough of all of them is a serious logic puzzle unless you have good genes. Short of medical issues it can be done, but for most people it will take some combination of more money, more planning, more work, and less joy from food. 

“Short of medical issues” is burying the lede. Food allergies and digestion issues mean lots of people struggle to feed themselves even with animal products; giving up a valuable chunk of their remaining options comes at a huge cost.

[Of course some people have issues such that animal products are bad for them and giving them up is an improvement. Those raise veganism’s average health score but don’t cancel out the people who would suffer]

More empirically, there is this study from Faunalytics, which found 29% of ex-vegans and ex-vegetarians in their sample had nutritional issues, and 80% got better within three months of quitting. Their recorded attrition rate was 84%, so if you assume no current veg*ns have issues that implies a 24% of all current and former veg*ns develop health issues from the diet (19% if you only include issues meat products cured quickly). I’m really sad to only be giving you this one study, but most of the literature is terrible (see below).

The Faunalytics study has a fair number of limitations, which I went into more detail on here. My guess is that their number is a moderate underestimate of the real rate, and a severe underestimate of the value for naive vegans in particular, but 24% is high enough that I don’t think the difference matters so I’ll use that for the rest of the post.

Evidence I’m looking for

The ideal study is a longitudinal RCT where diet is randomly assigned, cost (across all dimensions, not just money) is held constant, and participants are studied over multiple years to track cumulative effects. I assume that doesn’t exist, but the closer we can get the better. 

I’ve spent several hours looking for good studies on vegan nutrition, of which the only one that was even passable was the Faunalytics study. My search was by no means complete, but enough to spot some persistent flaws among multiple studies. I’ve also spent a fair amount of time checking citations made in support of vegan claims, only to find the study is either atrocious or doesn’t support the claim made (examples in the “This is a strawman…” section). There is also some history [EA(p) · GW(p)] of goalpost moving, where an advocate cites a study, I criticize it, and they say it doesn’t matter and cite a new study. This is exhausting. 

I ask that you only cite evidence you, personally, find compelling and are willing to stand by, and note its flaws in your initial citation. That doesn’t mean the study has to be perfect, that’s impossible, but you should know the flaws and be ready to explain why you still believe the study. If your belief rests on many studies instead of just one (a perfectly reasonable, nee admirable, state), please cite all of them. I am going to be pretty hard on people who link to seriously flawed studies without disclosing the flaws, or who retract citations without updating their own beliefs.

A non-exhaustive list of common flaws:

A non-exhaustive list of evidence I hope for:

 Preemptive responses to counter-arguments

There are a few counter-arguments I’ve already gotten or expect to get shortly, so let me address them ahead of time. 

“You’re singling out veganism”

Multiple people have suggested it’s wrong for me to focus on veganism. If I build enough trust and rapport with them they will often admit that veganism obviously involves some trade-offs, if only because any dietary change has trade-offs, but they think I’m unfairly singling veganism out.

First off, I’ve been writing about nutrition under this name since 2014. Earlier, if you count the pseudonymous livejournal. I talk about non-vegan nutrition all the time. I wrote a short unrelated nutrition post while this one was in editing. I understand the mistake if you’re unfamiliar with my work, but I assure you this is not a hobby I picked up to annoy you.

It’s true that I am paying more attention to veganism than I am to, say, the trad carnivore idiots, even though I think that diet is worse. But veganism is where the people are, both near me and in the US as a whole. Dietary change is so synonymous with animal protection within Effective Altruism that the EAForum tag [? · GW] is a wholly-owned subsidiary of the animal suffering tag. At a young-EA-organizer conference I mentored at last year, something like half of attendees were vegan, and only a handful had no animal-protecting diet considerations. If keto gets anywhere near this kind of numbers I assure you I will say something.

“The costs of misinformation are small relative to the benefits of animals”

One possible argument for downplaying or dismissing the costs of veganism is that factory farming is so bad anything is justified in stopping it. I’m open to that argument in the abstract, but empirically I think this isn’t working and animals would be better off if people were given proper information. 

First, it’s not clear to me the costs of acknowledging vegan nutrition issues are that high. I’ve gotten a few dozen comments/emails/etc on my vegan nutrition project of the form “This inspired me to get tested, here are my supplements, here are my results”. No one has told me they’ve restarted consuming meat or even milk. It is possible people are less likely to volunteer diet changes, although I do note I’m not vegan.

But even if education causes many people to bounce off, the alternative may be worse. 

That Faunalytics study says 24% of people leave veg*nism due to health reasons. If you use really naive math, that suggests that ignoring nutrition issues would need to increase recruitment by 33%, just to break even.  But people who quit veganism due to health issues tend to do so with a vitriol not seen in people leaving for other reasons. I don’t have numbers for this, but r/exvegans is mostly people who left for health reasons (with a smattering of people compelled by parents), as are the ex-vegans angry enough to start blogs. Even if they don’t make a lifestyle out of it, people who feel harmed are less likely to retry veganism, and more likely to discourage their friends.

I made a toy model comparing the trade off of education (which may lead people to bounce off) vs. lack of education (which leads people to quit and discourage others). The result is very sensitive to assumptions, especially “how many counterfactual vegans do angry ex-vegans prevent?”. If you put the attrition rate as low as I do, education is clearly the best decision from an animal suffering perspective. If you put it higher it becomes very sensitive to other assumptions. It is fairly hard to make a slam-dunk case against nutritional awareness, but then, (points at years of nutrition blogging) I would say that.

“The human health gains are small relative to the harms to animals” 

I think this is a fair argument to make, and the answer comes down to complicated math. To their credit, vegan EAs have done an enormous amount of math on the exact numeric suffering of farmed animals. But honest accounting requires looking at the costs as well.

“The health costs don’t matter, no benefit justifies the horror of farming animals”

This is a fair argument for veganism. But it’s not grounds to declare the health costs to be zero.

It’s also not grounds to ignore nutrition within a plant-based diet. Even if veganism is healthy for everyone and no harder a switch than other diets, it is very normal for dietary changes to entail trade-offs and have some upfront costs.  The push to deny trade-offs and punish those who investigate them (see below) is hurting your own people. 

“This is a strawman, vegans already address nutrition” 

I fully acknowledge that there are a lot of resources on vegan nutrition, and that a lot of the outreach literature at least name-checks dietary planning. But I talk to a lot of people (primarily young EAs focused on non-animal projects) with stories like this one [LW(p) · GW(p)], of people going vegan as a group without remembering a single mention of B12 or iron. I would consider that a serious problem even if I couldn’t point to anything the movement was doing to cause it.

But I absolutely can point to things within the movement that create the problem. There are some outright lies, and a lot more well-crafted sentences that are technically correct but in aggregate leave people with deeply misleading impressions. 

While reading, please keep in mind that these are formal statements by respected vegans and animal protection organizations (to the best of my ability to determine). All movements have idiots saying horrible things on reddit, and it’s not fair to judge the whole movement by them. But please keep that context in mind while reading: these were not off-the-cuff statements or quick tweets, but things a movement leader thought about and wrote down. 

Why is this so hard to talk about?

This is probably the least important section. I’m including it mostly in the hope it lowers friction in the object-level conversation. 

The stakes are so high

Hardcore vegan advocates believe we are surrounded by mass torture and slaughter facilities killing thousands of beings every day. That’s the kind of crisis that makes it hard to do really nuanced math people may use to justify ignoring you. 

Vegans are sick of concern trolls

Vegans frequently have to deal with bad-faith interrogation of their choices (“wHxt ABuoT proTEIn?!?!”). I imagine this is infuriating, and I’ve worked really hard to set myself apart by things like investing hundreds of hours of my time, much of which was unpaid, and working to get vegans the nutrition they needed to stay healthy and vegan.

Typical minding/failure of imagination

People who find veganism easier are disproportionately likely to become and stay vegan. That’s what the word “easy” means. Then some of them assume their experiences are more representative than they are, and that people who report more difficulty are lying. 

E.g. this comment [LW(p) · GW(p)] on an earlier post (not even by a vegan- he was a vegan’s partner) said “there is nothing special one needs to do to stay healthy [while eating vegan]” because “most processed products like oat milk, soy milk, impossible meat, beyond meat, daiya cheese are enriched with whatever supplements are needed”. Which I would describe as “all you need to do to stay healthy while vegan is eat fortified products”. That’s indeed pretty easy, and some people will do it without thinking. But it’s not nothing, especially when “no processed foods” is such a common restriction. Sure enough, Faunalytics found that veg*ns who quit were less likely (relative to current veg*ns) to eat fortified foods. 

That same person later left another comment, conceding this point and also that there were people the fortified foods didn’t work for. Which is great, but it belonged in the first comment.

Or this commenter [LW(p) · GW(p)], who couldn’t imagine a naive vegan until an ex-vegan described the total ignorance they and their entire college EA group operated under. 

Lies we tell omnivores

Ozy Brennan has a post “Lies to cis people”. They posit that trans advocates, faced with a hostile public, give a story of gender that is simplified (because most people won’t hear the nuance anyway), and prioritizes being treated well over conveying the most possible truth. The intention is that an actual trans person or deeply invested ally will go deeper into the culture and get a more nuanced view. This can lead to some conflict when a person tries to explore gender with only the official literature as their guide.

Similarly, “veganism requires no sacrifice on any front, for anyone” is a lie vegans tell current omnivores. I suspect the expectation, perhaps subconscious, is that once they convert to veganism they’ll hang around other vegans and pick up some recipes, know what tests to get, and hear recommendations for vegan vitamins without doing anything deliberately. The longer sentence would be “for most people veganism requires no sacrifice beyond occasional tests and vitamins, which is really not much work at all”. 

But this screws over new vegans who don’t end up in those subcultures. It’s especially bad if they’re surrounded by enough other vegans that it feels like they should get the knowledge, but the transmission was somehow cut off. I think this has happened with x-risk focused EA vegans, and two friends described a similar phenomenon in the straight-edge punk scene

Failure to hear distinctions, on both sides

I imagine many people do overestimate the sacrifice involved in becoming vegan. The tradeoff is often less than they think, especially once they get over the initial hump. If omnivores are literally unable to hear “well yes, but for most people only a bit”, it’s very tempting to tell them “not at all”. But this can lead even the average person to do less work than they should, and leaves vegans unable to recognize people for whom plant based diets are genuinely very difficult, if not impossible.


I think veganism comes with trade-offs, health is one of the axes, and that the health issues are often but not always solvable. This is orthogonal to the moral issue of animal suffering. If I’m right, animal EAs need to change their messaging around vegan diets, and start self-policing misinformation. If I’m wrong, I need to write some retractions and/or shut the hell up.

Discussions like this are really hard, and have gone poorly in the past. But I’m still hopeful, because animal EAs have exemplified some of the best parts of effective altruism, like taking weird ideas seriously [EA · GW], moral math [EA · GW], and checking to see if a program actually worked [EA · GW]. I want that same epistemic rigor applied to nutrition, and I’m hopeful about what will happen if it is. 






Thanks to Patrick La Victoire and Raymond Arnold for long discussions and beta-reading, and Sam Cottrell for research assistance.


Comments sorted by top scores.

comment by wilkox · 2023-06-03T02:52:45.188Z · LW(p) · GW(p)

I’ve been trying to figure out why I feel like I disagree with this post, despite broadly agreeing with your cruxes. I think it’s because it in the act of writing and posting this there is an implicit claim along the lines of:

Subtle nutritional issues that are specific to veganism can cause significant health harms, to a degree that it is worth spending time and energy thinking about this as ‘a problem’.

For context, I am both vegan and a doctor. Nutrient deficiencies are common and can cause anything ranging from no symptoms to vague symptoms to life-threatening diseases. (For simplicity, I’m going to focus on deficiencies only, although of course there are other ways diet can affect health.) They are generally well-understood, can be detected with cheap laboratory tests, and have cheap and effective treatments.

Veganism is a known risk factor for some nutrient deficiencies, particularly B12 and iron. Many vegans, including myself, will routinely get blood tests to monitor for these deficiencies. If detected, they can be treated with diet changes, fortified foods, oral supplementation, or intramuscular/intravenous supplementation.

Some vegans don't know about this, and they might end up with a nutrient deficiency. They might be asymptomatic, or they might develop symptoms, and if they go to a doctor with those symptoms the doctor will (hopefully) figure out the problem and recommend a solution. If they don't go to a doctor, it could be either because the problem is minor enough that they can't be bothered, or because they generally don't seek medical help when they are seriously unwell, in which case the risk from something like B12 deficiency is negligible compared to e.g. the risk of an untreated heart attack. Many people don’t have good access to medical care, but this is a problem orthogonal to veganism, and for these people veganism is unlikely to be their most important health concern.

Beyond these well-known issues, is there any reason to expect veganism in particular to cause any health harms worth spending time worrying about? People have vague symptoms all the time, and perhaps some of these are related to veganism. They might also be related to microplastics, or pathogens, or antibiotics in the meat supply, or who knows what. As far as I’m aware, there is no mysterious syndrome or increased mortality rate among vegans that is currently going unexplained.

Let’s suppose that people do the exact opposite of what you recommend: proselytise for veganism without mentioning the risk of nutrient deficiencies; fail to suggest dietary issues when discussing health problems; make false claims about vegan nutrition. If you take out the references to veganism, this is just the current state of the world. People advertise their fast food restaurants and feed their children sugary breakfast cereals without caveats about the risk of heart disease or diabetes. People give each other folk medical advice and swap half-baked ideas about supplements and fad diets. Much of the work of public health and medicine is preventing, screening for, and fixing the problems caused by this. ‘People should have better health knowledge’ is broadly laudable and agreeable, but it’s not a claim about veganism.

In summary:

  • The potential health harms associated with veganism are well understood, easily detected, and easily treated
  • To the extent that vegans don't know about them, this is not a problem specific to veganism nor is it one where veganism in particular is likely to be causing significant health harms
  • There is no reason to suspect veganism in particular is causing as yet undiscovered harms
Replies from: pktechgirl, Lanrian
comment by Elizabeth (pktechgirl) · 2023-06-03T19:16:06.031Z · LW(p) · GW(p)

Beyond these well-known issues, is there any reason to expect veganism in particular to cause any health harms worth spending time worrying about?

I'm confused- the issues you mention seem both important and, in most cases, extremely easy to fix. If there's a large population that is going vegan without the steps you mention (and my informal survey says there is), it seems high value to alert them to the necessity.

Perhaps you expect this to be caught at regular physicals, but many people don't have those, or their doctors don't think to run the right tests for any number of reasons. 

I mentioned my history of nutrition blogging [LW · GW] above, but one thing I didn't get into was that I focus my efforts on things that are easy or have extremely good feedback loops, ideally both. People know Oreos are bad for them, but they taste good and the payoff for ceasing is ambiguous and years away. If I found a quick fix for that I would absolutely share it- like I did when I found an easy (if incomplete) way to eat more vegetables. Hell I've talked about reducing sugar cravings, but even if it works the method takes noticeable effort so I don't expect anyone to act on it. 

Replies from: wilkox
comment by wilkox · 2023-06-04T00:41:03.701Z · LW(p) · GW(p)

I'm confused- the issues you mention seem both important and, in most cases, extremely easy to fix. If there's a large population that is going vegan without the steps you mention (and my informal survey says there is), it seems high value to alert them to the necessity.

I suspect we have different intuitions as a matter of degree for ‘important’, ‘high value’, and ‘necessity’ here. Despite that, I think we would probably agree on a statement like ‘vegans who are not aware that their diet increases the risk of nutrient deficiencies would benefit from learning about this’.

If you had posted something like ‘PSA: if you are vegan, you might not know you are at increased risk of certain nutrient deficiencies; read (this link) to find out more and see your doctor if you have (list of symptoms) or want to get tested’, I would have thought this was a good idea. What confuses me is why you wrote the post you did instead, which seems to be gesturing at a larger problem. As a specific example, in ‘Evidence I’m looking for’, you wrote:

The ideal study is a longitudinal RCT […] I’ve spent several hours looking for good studies on vegan nutrition.

While more high-quality evidence on veganism would be valuable in general, I’m confused by what you expect to learn from such an RCT or study. Do you think there is reason to believe there are significant health harms of veganism that we don’t know about yet? If so, why?

Replies from: pktechgirl
comment by Elizabeth (pktechgirl) · 2023-06-04T18:39:22.946Z · LW(p) · GW(p)

The Faunalytics data says, at a minimum, 20% of vegans develop a health issue that's cured when they quit. Do you disagree with their data (please elaborate) or not consider that important (in which case, what is your threshold for importance)?

Replies from: wilkox
comment by wilkox · 2023-06-05T23:35:25.660Z · LW(p) · GW(p)

I don’t doubt the Faunalytics data. If anything the number seems surprisingly low, considering it comes from self-reporting among people who went on to quit veganism.

I’m not sure how to weigh ‘importance’ other than subjectively, but I’ll attempt to at least put bounds on it. As a floor, some number of people experience health issues that are important enough to them that they are motivated to quit veganism. As a ceiling, the health risks of veganism are less important than those of other harms related to diet – for example, dyslipidaemia or diabetes – that increase mortality, given that veganism doesn't seem to increase mortality and may reduce it.

My stance at the moment is still more ‘generally confused about what you’re trying to communicate/achieve’ than ‘disagreeing with a particular claim you’re making’. I'd like to close the inferential distance if possible, but feel free to ignore this comment if you don’t think it’s leading anywhere useful.

I still don’t understand which of the following (if any) you would endorse:

  • Many vegans don’t know about the risk of nutrient deficiencies and would benefit from this knowledge (in which case I’m still confused why you wrote this post instead of just presenting this information)
  • The health harms of nutrient deficiencies in veganism are more serious than is widely recognised
  • There are serious health harms of veganism other than the risk of nutrient deficiencies that are known but this knowledge is not widespread, or that we don’t know about yet but have good reason to suspect exist
Replies from: pktechgirl, olli-savolainen
comment by Elizabeth (pktechgirl) · 2023-06-07T02:01:48.110Z · LW(p) · GW(p)

This feels very epistemically cooperative, thank you.

The answer is primarily point 1,  although whether that's distinct from point 2 depends on the definition of "widely recognized" .  Which brings me to your question:

in which case I’m still confused why you wrote this post instead of just presenting this information

The answer is that I did present the information, and proactively provided help, and I got pushback that only made sense if people disagreed with "veganism is a constraint on a multidimensional problem". But they would never defend that position.  Announcing my own view and asking for counter-evidence was my Plan C after "offering help" and "asking why certain people thought that help was harmful" failed. 

Replies from: wilkox, Natália Mendonça
comment by wilkox · 2023-06-09T11:20:21.335Z · LW(p) · GW(p)

Thanks, this and your comment here [LW(p) · GW(p)] helped a lot to clarify your position and intentions. My initial impression was similar to Natália's [LW(p) · GW(p)], i.e. that you believed something more like point 3.

Re. point 2, by "widely recognised" (and similarly for "widespread" in point 3) I meant something like "widely recognised in relevant academic literature/textbooks/among experts" rather than "among people who have ever tried a vegan diet". My impression is that on this definition you wouldn't endorse point 2 either.

We may still disagree on the "importance" of point 1, although to be clear I completely support any effort to inform vegans or potential vegans about the risk of nutrient deficiencies. It's probably not possible or worth the effort to resolve this disagreement, but it does make me wonder about:

I’ve seen effective altruist vegan advocates deny outright that trade-offs exist, or more often imply it while making technically true statements. [LW(p) · GW(p)]


People did not necessarily outright say "everyone can switch to veganism naively and suffer no trade-offs", but the things they did say only made sense if that were true [...] anything less blunt or less focused got rebuffed in obfuscated ways [LW(p) · GW(p)]

Could at least some of these encounters be explained by a similar "disagreement about importance", as opposed to disagreement about the basic facts? That might explain why these exchanges seemed obfuscated or un-cooperative; you thought they were evading obvious facts, while they thought you were making mountains out of (what they saw as) molehills.

Replies from: pktechgirl
comment by Elizabeth (pktechgirl) · 2023-06-11T03:23:42.035Z · LW(p) · GW(p)

I feel like I'm in a bit of a trap here.

I don't think anyone thought "oh, Elizabeth's statement is obviously true but I will argue with her and make obviously false claims" while twirling a mustache. That's not how people work. But I also think my words were extremely clear, and if they're being misread this often there's a systemic problem in the readers. 

I realize this is a big claim; frequent misunderstandings are by default the fault of the author. But a lot of people got it, and I don't know what I could have done to get a different outcome. You can argue the framing of the post was suspicious [EA(p) · GW(p)], and I can see why that would be true for this post and why it would make people overly aggressive in rebuttals. But what about when I was offering [LW(p) · GW(p)] nutritional tests and vegan supplements? And that one was at least pretty overt, some private ones were mental jui-jitsu to which my only defense was stating my own opinions very plainly.

Relatedly: this is not my first time asking for this evidence. Every [EA(p) · GW(p)] time I posted installments of my nutrition testing program, someone would say "this sample size is too small" and I'd say "you are correct, do you know of anything better?", and nothing would come of it. It took this post for someone to send me the 7th Day Adventist data. 

So if I focus on productively treating the object level problem, people push back in ways that can't be argued with because they're not epistemically cooperative. If I try to engage in a way that feels epistemically tractable, people get even angrier and impugn my motives more. 

Given the context I laid out, is there anything I could have done to create a more productive discussion with you, personally?

Replies from: wilkox
comment by wilkox · 2023-06-11T06:02:02.197Z · LW(p) · GW(p)

That is a frustrating situation. As you note in the introduction this is a charged topic that tends to lead to poor discussions, so you deserve credit for wading in anyway.

Given the context I laid out, is there anything I could have done to create a more productive discussion with you, personally?

I'm not sure. The discussion in this comment thread (and [LW(p) · GW(p)] others [EA(p) · GW(p)]) has been productive in the sense that I now have a much better understanding of your position and the context. In terms of the original post, I don't know if a one-sentence summary [EA(p) · GW(p)] would have changed much; given my impression of the post it might have looked like an attempt to motte-and-bailey. I could try to break down why the post gave me the impression it did, if you think that would be useful.

Replies from: pktechgirl
comment by Elizabeth (pktechgirl) · 2023-06-12T06:24:02.818Z · LW(p) · GW(p)

Thank you for the empathy, this has been extremely challenging.

I think something similar to "why the post gave you the impression it did" could be helpful, and I'm even more interested in what you think could be done to convey the important, true points with as little animosity-due-to-misreading as possible

Replies from: wilkox
comment by wilkox · 2023-06-13T11:17:46.719Z · LW(p) · GW(p)

Thoughts on why the post gave (me) the impression it did, in no particular order:

  • 'Trade-offs' is broad and vague, and the post didn't make a lot of detailed claims about vegan nutrition. This makes sense in the context of you trying to communicate the detailed facts previously, but coming to the post without that context made it hard to tell if you were just making an unobjectionable claim [EA(p) · GW(p)] or trying to imply something broader.
  • Some statements struck me as technically true but hyperbolic. Examples:

You can get a bit of all known nutrients from plants and fortified products, and you can find a vegan food that’s at least pretty good for every nutrient, but getting enough of all of them is a serious logic puzzle unless you have good genes.


Some people are already struggling to feed themselves on an omnivore diet, and have nothing to replace meat if you take it away.


If vegans are equally healthy but are spending twice as much time and money on food, that’s important to know.


If there are three vegan sources and you’re allergic to all of them, you need animal products.

  • I was very confused by what you were hoping to learn from an RCT or 'good study', and my impression of your in-office nutritional testing was that you were trying to gather new primary data about vegan nutrition. Because the basic facts about the risk of nutrient deficiencies in veganism seemed uncontroversial, my interpretation of that was that you thought there were other and potentially more significant 'trade-offs' that might exist at the level-of-evidence gap between an RCT or in-office testing and e.g. the introduction to the Wikipedia article on veganism.
  • The implied model for the relationship between diet and health, or at least different from my own. I tend to think of diet as an input to a set of homeostatic processes, which are generally robust but can be slowly pushed off-balance by sustained problems and usually fixed with gentle correction. This post seemed to model diet as an all-or-nothing 'logic puzzle' to be either solved or, more likely, failed.

...what you think could be done to convey the important, true points with as little animosity-due-to-misreading as possible

Beyond the points above, I genuinely don't know. I'm probably not the intended audience anyway, since that seems to be vegans or potential vegans who don't already know about the risks of nutrient deficiencies. The only thing I can think to contribute here is: if you've tried presenting the basic facts of the matter, and experienced pushback for it, does that necessarily mean that just presenting the facts is the wrong strategy? It's a charged topic with a polluted local memespace, so some level of malicious or confused pushback is guaranteed; it's what you would expect to see even when you are communicating well.

Replies from: pktechgirl
comment by Elizabeth (pktechgirl) · 2023-06-23T01:47:29.638Z · LW(p) · GW(p)

if you've tried presenting the basic facts of the matter, and experienced pushback for it, does that necessarily mean that just presenting the facts is the wrong strategy? 

If people are very convinced I'm wrong then asking them why seems like a great strategy to me. They might be right and that might have implications for my plans. The point of this post wasn't to convince anyone, it was to ask for evidence on a specific question. 

I'm really glad we got to a more cooperative space and I hate to puncture that, but two weeks later I'm still kind of aghast you said "If you take out the references to veganism, this is just the current state of the world. People advertise their fast food restaurants and feed their children sugary breakfast cereals without caveats about the risk of heart disease or diabetes." Surely you don't think that's the right moral category for ethical veganism? 

Replies from: wilkox
comment by wilkox · 2023-06-24T06:53:48.628Z · LW(p) · GW(p)

Surely you don't think that's the right moral category for ethical veganism?

I don't really understand what you're asking here. How would you describe the moral category you're referring to, and why do you think it doesn't or shouldn't apply to veganism?

Replies from: pktechgirl
comment by Elizabeth (pktechgirl) · 2023-09-15T02:08:06.559Z · LW(p) · GW(p)

McDonalds and sugary cereal advertisers are widely viewed as harmful if not evil for the way they confuse the epistemic environment in order to make money and others' expense. Calling something "no worse than fast food and sugary cereal advertisers" is an enormous moral and epistemic insult to it. 

Replies from: wilkox
comment by wilkox · 2023-09-15T07:25:39.175Z · LW(p) · GW(p)

I absolutely agree. McDonalds and the other demons of the Western Diet cause much more harm, both in absolute terms and per capita. That was really my point; within the class of 'health misinformation and disinformation that causes harm', furphies about vegan nutrition are a comparatively minor problem.

Replies from: pktechgirl
comment by Elizabeth (pktechgirl) · 2023-09-15T18:35:30.141Z · LW(p) · GW(p)

This sounds like you're saying "I won't prescribe B12 until my patient gives up oreos" or even "I won't prescribe B12 until everyone gives up oreos", which would be an awful way to treat people. Even if you're right that oreos represent a larger problem, taking B12 pills is useful in its own right, and easier than giving up oreos[1].

I assume you don't mean that. You probably mean "I don't think Elizabeth/anyone should spend time on veganism's problems, when metabolic issues are doing so much more aggregate harm." But tractability applies even more on a population level.  People aren't eating oreos out of ignorance: they know they're bad. They eat them because taste is winning out over health. 

It's impossible for a blog post to fix "oreos taste good" or "people care more about taste than health". But it's pretty easy theoretically possible for a blog post to fix ignorance of the benefits of some tests and supplements. When I see similarly tractable opportunities to help omnivores, I take them.

Hell, I found a (vegan) cure for oreos tasting good (n=1). Finding it took years of self-experimentation (where the iron post took a few days, for more certainly).   AFAIK no one else has tried it, because it takes consistent effort over several months to see an effect on weight[2]

So no, I am not going to let McDonalds shitty advertising hold up alerting people to problems with simple diagnoses with simple solutions

  1. ^

    Especially by the time someone is in the doctor's office for oreo-related problems. The people who find oreos easy to give up have already done so. 

  2. ^

    It also costs $5-$10/day, but I know people jumping through a lot of hoops to get semaglutide, so I'm pretty sure the issue here is the delay and uncertainty. 

Replies from: wilkox
comment by wilkox · 2023-09-17T03:13:50.136Z · LW(p) · GW(p)

This sounds like you're saying "I won't prescribe B12 until my patient gives up oreos" or even "I won't prescribe B12 until everyone gives up oreos", which would be an awful way to treat people.[1]


You probably mean "I don't think Elizabeth/anyone should spend time on veganism's problems, when metabolic issues are doing so much more aggregate harm."


I wouldn’t say either of these things. A quick and easy treatment like B12 replacement is not mutually exclusive with a long-term and difficult treatment like diet modification. (This is not an abstract question for me; prescribing a statin and counselling on lifestyle changes are both things I do several times a week, and of the two, the script is orders of magnitude easier for both me and the patient, but we’ll usually do both in parallel when treating dyslipidaemia.)

As I said earlier in the thread [LW(p) · GW(p)], I’m all in favour of you or anybody else spending time on making people aware of the risk of nutrient deficiencies associated with veganism and what to do about them. (Again, this is not an abstract issue to me; I routinely discuss, screen for, and treat nutrient deficiencies with vegan and vegetarian patients.) I do recognise that you’ve had some bad experiences doing this, which is unfair.

  1. ^

    I’m not sure if you chose this example intentionally, but for what it’s worth: Oreos are vegan.

comment by Olli Savolainen (olli-savolainen) · 2023-06-07T13:39:39.168Z · LW(p) · GW(p)

I would like to endorse that last item, that there is a potential harm that is not widely known. It's not specific to veganism, but the risk is elevated for them.

Oxalic acid is ubiquitous in plant-based foods. Absorbed oxalic acid can precipitate in the body as calcium oxalate. This most often damages the kidneys, but it can also cause joint pains and degeneration. The crystals are not as inflammatory as the crystals that cause gout, but they are much more persistent.

People who have trouble with fat absorption are at an increased risk for getting too much oxalic acid from their diet, a condition called enteric hyperoxaluria / oxalosis. These include persons treated for obesity with baryatric surgery or old fashioned weight loss drugs, and sufferers of IBD. This is a growing demographic. Their problems with kidneys and joints can very easily be imputed to pre-existing conditions like diabetes, overweight or autoimmune disorders.

The studies on oxalate content of foods are somewhat conflicting as to the precise amounts in each plant or foodstuff. It is not always clear what part is bound to e.g. calcium and how much is in a more readily absorbed form.

Legumes seem to contain significant amounts. Rhubarb is a well known source, but how many people know that a larger serving of carrots, sweet potatoes or almonds can be just as dangerous? Processing methods have a big effect: instant coffee has manyfold higher levels than ground and percolated coffee.

Oxalic acid also has some endogenous sources in the body, such as protein metabolism. It is a metabolite of both xylitol and ascorbic acid. Gut flora can both generate and consume oxalic acid, depending on the species.

I haven't found any oxalate data on novel highly processed plant based foods like meat and dairy substitutes. Fermentation might push it either way. Many of the ingredients, like mushrooms, almonds, spinach, beetroot and coconut seem to have very high levels of oxalate to begin with. 

Perhaps you can now see why I'm worried. Add some supplement (or eating liver as suggested in other comments) that has too much vitamin A or D to the mix and you might also get a high blood calcium level and more crystallization in the body.

Oxalic acid is more famously the most common constituent of stones in the urinary tract. Kidney stones are often described as a "ten" on the pain scale from 1 to 10. It is not given that large stones will be the first symptom of too much oxalic acid, their formation might require low hydration or abnormalities in the pH of the urine. Smaller stones or crystals might imitate a urinary tract infection or a STD with painful discharge. There might be no urinary symptoms other than those resulting from kidney damage. Animal protein intake is a risk factor for renal and urinary tract calculi, so if vegans don't have a higher risk of stones it does not necessarily mean they are safe from other oxalate pathologies. But stones are definitely something to look for.

The standard way to prevent problems with dietary oxalic acid is to consume a small amount of calcium carbonate after meals to bind it in a non-soluble form. I would also recommend that people avoid xylitol and big doses of vitamins A, C and D.

If you are now concerned about it (you're welcome!), oxalate absorption and production can be assessed with a 24-hour urine collection sample. Note that the upper reference range might not be all that far from what is observed in primary (i.e. hereditary) hyperoxaluria, a very serious condition.

Most likely oxalic acid does not and will not have a big impact on the health of the vegan population. But is has some potential of being a major under-the-radar (persistent and low-grade inflammatory, crystal deposits perhaps hard to image) threat for serious and long-term problems like chronic kidney disease and osteoarthritis. Why do some people get these conditions early in life?

I hope this helps.

PS. I'm not a vegan, but I believe meat and dairy has had an immense negative impact on everyone's health, including vegans. There is of course the historic zoonotic origin of many high impact infectious diseases in domesticated animals. But I'm talking about a more modern development.

It used to be the case that the distribution and prevalence of gut microbiota was largely dependent on the fitness and mobility of the host. Nowadays the vast majority of mammal biomass is either livestock or humans. Their mobility and that of their manure is mainly supported by technology.

This independence of the host's fitness frees the microbiome to increase its own fitness in new, potentially pathogenic ways. One obvious modification could be to make the host eat more. Because the manure is spread by mechanized means, any increase in eaten and excreted volume results in a roughly proportionate advantage to the microbe. Animal breeding and market forces aren't strictly working against this development, perhaps the opposite.

This model of the etiology of obesity fits with the geographical prevalence: lower at high altitudes, i.e. upstream of agriculture. It would also explain why wild animals are getting fatter, if that is the case. It suggests the quick health fix of getting a fecal transplant from a healthy hunter-gatherer. The more remote and isolated the donor, the better. But we would have to be careful not to corrupt them as they get wealthy off their product.

comment by Lukas Finnveden (Lanrian) · 2023-06-03T16:51:26.292Z · LW(p) · GW(p)

If they don't go to a doctor, it could be either because the problem is minor enough that they can't be bothered, or because they generally don't seek medical help when they are seriously unwell, in which case the risk from something like B12 deficiency is negligible compared to e.g. the risk of an untreated heart attack.

I'm personally quite bad at noticing and tracking (non-sudden) changes in my energy, mood, or cognitive ability. I think there are issues that I wouldn't notice (or would think minor) that I would still care a lot about fixing.

Also, some people have problems with executive function. Even if they notice issues, the issues might have to be pretty bad before they'll ask a doctor about them. Bad enough that it could be pretty valuable to prevent less bad issues (that would go untreated).

(This could be exacerbated if people are generally unexcited about seeking medical help — I think there are plenty of points on this axis where people will seek help for heart-attacks but will be pessimistic about getting help with "vaguely feeling tired lately". Or maybe not even pessimistic. Just... not having "ask a dr" be generated as an obvious thing to try.)

Replies from: wilkox
comment by wilkox · 2023-06-04T00:48:08.320Z · LW(p) · GW(p)

I agree with this, though I would expand

there are plenty of points on this axis where people will seek help for heart-attacks but will be pessimistic about getting help with "vaguely feeling tired lately"

to note that heart attacks are on average a much more serious problem then vague fatigue, so the fact that people are more likely to see a doctor about the former is a good thing. People will generally self-select whether to seek medical help by the severity of the problem, and to the extent that they don't veganism is probably the least of their worries.

comment by Natália Coelho Mendonça (Natália Mendonça) · 2023-06-05T23:48:42.774Z · LW(p) · GW(p)

Someone on the EA Forum brought up some useful context [EA(p) · GW(p)] that I think is missing from this post. 

AHS-2 [the Adventist Health Study 2] does have some comparisons between omnivores to vegans. From the abstract: "the adjusted hazard ratio (HR) for all-cause mortality in all vegetarians combined vs non-vegetarians was 0.88 (95% CI, 0.80–0.97). The adjusted HR for all-cause mortality in vegans was 0.85 (95% CI, 0.73–1.01)". So depending on how strict you are being with statistical significance there's somewhere between a small signal and no signal that veganism is better with respect to all-cause mortality than omnivorism.


I think I would be confident enough in the AHS data to say that it shows that veg*nism does not entail a tradeoff on the 'years of life lived' axis. The most conservative reading of the data possible would be that a veg*n diet has no effect on years of life lived, and I think it is probably more reasonable to read the AHS study as likely underestimating the benefits a veg*n diet would give the average person. Obviously 'years of life lived' is not the same thing as 'health' so I'm not saying this is a knock-down argument against your main point - just wanted to contextualise how we were using the data in the linked piece.

AHS-2 is not a longitudinal RCT where diet is randomly assigned, but neither is the Faunalytics ex-veg*an survey. I think AHS-2 is instructive because it looks at an objective clinical outcome (all-cause mortality).

I also think that, in addition to the Adventist observational study, there are vegan diet RCTs that have useful context for this discussion. This systematic review of RCTs concludes that

In comparison with control diets, vegan diets reduced body weight (-4.1 kg, 95% confidence interval (CI) -5.9 to -2.4, p < 0.001), body mass index (BMI) (-1.38 kg/m2 , 95% CI -1.96 to -0.80, p < 0.001), glycated hemoglobin (HbA1c ) (-0.18% points, 95% CI -0.29 to -0.07, p = 0.002), total cholesterol (-0.30 mmol/L, 95% CI -0.52 to -0.08, p = 0.007), and low-density lipoprotein cholesterol (-0.24 mmol/L, 95% CI -0.40 to -0.07, p = 0.005).

Putting those things together, I would say it's not at all obvious that a vegan diet has health tradeoffs ex-ante. There is a substantial probability that it would make you healthier, all things considered. 

Of course, taking B12 is important, and like wilkox [LW(p) · GW(p)], I would not disagree with this post if it just said “PSA: if you are vegan, you might not know you are at increased risk of certain nutrient deficiencies; read (this link) to find out more and see your doctor if you have (list of symptoms) or want to get tested.” However, this post took a different approach, which makes it look like you might think there's a deeper ex-ante problem with being vegan, and I think it's very unclear that there is. 

Replies from: pktechgirl, pktechgirl, Vaniver
comment by Elizabeth (pktechgirl) · 2023-06-08T03:07:45.961Z · LW(p) · GW(p)

It feels weird to me that you describe this as "missing context", when the whole point of the post is "I might be missing evidence, please show it to me". The 7DA data is easily the best answer I've gotten so far and it makes me very glad I asked. 

comment by Elizabeth (pktechgirl) · 2023-06-06T00:41:43.423Z · LW(p) · GW(p)

PSA: if you are vegan, you might not know you are at increased risk of certain nutrient deficiencies; read (this link) to find out more and see your doctor if you have (list of symptoms) or want to get tested


I did. I also provided [LW · GW] tests and supplement suggestions (none of which, AFAIK, led to anyone resuming animal consumption), and tried to get the ball rolling [LW · GW] on vegans helping vegans. I kept getting pushback, public [LW(p) · GW(p)] and private, that felt extremely epistemically uncooperative. People did not necessarily outright say "everyone can switch to veganism naively and suffer no trade-offs", but the things they did say only made sense if that were true. This post is an attempt to get clarity on a fairly narrow question. I get why it feels loaded, but anything less blunt or less focused got rebuffed in obfuscated ways.

I love the Adventist study and hope to get to a deep dive soon. However since it focuses on vegetarians, not vegans, and I think [LW · GW] those are very different, I don't expect it to update me much about veganism. I also don't think it will be informative about uninformed diets or transitions, since these are people growing up a culture that holds their dietary choices rather than switching. 

The cardiac RCT looks very interesting, I will need some time to dig into that. Before I do, are there any flaws [LW · GW] you want to declare ahead of time? Is this a paper you personally put high confidence in?

Replies from: Natália Mendonça
comment by Natália Coelho Mendonça (Natália Mendonça) · 2023-06-06T00:46:02.874Z · LW(p) · GW(p)

I love the Adventist study and hope to get to a deep dive soon. However since it focuses on vegetarians, not vegans

That's not true. The Adventist study I cited explicitly calculated the mortality hazard ratio for vegans, separately from non-vegan vegetarians. 

(I’ll reply to the questions in your last paragraph soon). 

Replies from: pktechgirl, pktechgirl
comment by Elizabeth (pktechgirl) · 2023-06-12T06:48:26.468Z · LW(p) · GW(p)

I see it did cite a specific vegan hazard ratio, however that ratio is tied with pescetarianism in men, and well above both pescetarianism and 1/week meat consumption in women. If you take this at face value it suggests small-but-present meat consumption, in addition to millk and eggs, are good for women, and fish at least is good for men. 

[Note that the pescevegetarian and semivegetarian categories include unlimited milk and egg consumption]


Replies from: pktechgirl, Natália Mendonça
comment by Elizabeth (pktechgirl) · 2023-09-12T01:11:34.764Z · LW(p) · GW(p)

@Natália Coelho Mendonça [LW · GW] I would really appreciate a reply or at least acknowledgement of my comment here. I took your initial comment to be a very strong endorsement of the paper in ways I think make a reply a fair request. 

comment by Natália Coelho Mendonça (Natália Mendonça) · 2023-09-29T23:30:04.340Z · LW(p) · GW(p)

Given the wide and greatly overlapping confidence intervals for all diets among women, it might be more fitting to interpret these tables as suggesting that “animal product consumption pattern doesn’t seem associated with mortality among women in this sample” than that “small-but-present meat consumption, in addition to millk and eggs, are good for women.” Based on the data presented, a variety of diets could potentially be optimal, and there isn’t a big difference between them. I think this fits my initial conclusion that veganism isn't obviously bad for your health ex-ante if you supplement e.g. B12.

comment by Elizabeth (pktechgirl) · 2023-06-06T02:44:03.073Z · LW(p) · GW(p)

Oh cool, I misread a comment from the author.

comment by Vaniver · 2023-06-06T00:18:54.271Z · LW(p) · GW(p)

But that is not what this post said, which makes it look like you might think there's a deeper ex-ante problem with being vegan, and I think it's very unclear that there is. 

I read the post not as claiming that veganism has deeper ex ante problems, but that responsible vegan advocacy should include the PSA you mention (or people should convince Elizabeth that the PSA is not actually necessary).

comment by dr_s · 2023-06-01T18:31:45.747Z · LW(p) · GW(p)

The longer sentence would be “for most people veganism requires no sacrifice beyond occasional tests and vitamins, which is really not much work at all”.

I think you could add "and the more vegans there are, the easier it is". A huge part of it is adoption. Things like which foods are easily found, what restaurants offer, whether you have to bring vegan options from home if you're eating at a conference or other event, etc. will change a lot between cultures and times depending on how common the need is.

I'm pescatarian, trending towards vegetarian, live in the UK, and feel like being vegetarian here would be fairly effortless - almost everywhere always has at least a few options. Veganism already would be a lot harder. Not impossible (if only thanks to all the Indian and Pakistani food around!), but noticeably harder.

Replies from: Making_Philosophy_Better
comment by Portia (Making_Philosophy_Better) · 2023-06-02T15:57:15.943Z · LW(p) · GW(p)

Seriously. I've been vegan in hip modern Western cities now, and in 2009, and I have travelled as a vegan through Eastern Europe and the Middle East. The difference is insane. The former feels effortless. The latter was absolutely awful (the number of times I had to explain that no, chicken are in fact not plants, alone... in Iran, they put lamb into fucking desserts, I kid you not), and if I had to live there longer, I think I would have changed my diet to facilitate social inclusion, variety and health. By the end of that trip, I could not tolerate eating any dates or any rice for a long time, and felt like taking bites out of my fellow travellers just to get any damn protein. Vegan food in these places is regular food, minus the majority components that were giving nearly all the nutrients and taste, you live off sides and fillers.

comment by Elizabeth (pktechgirl) · 2023-06-03T00:30:09.300Z · LW(p) · GW(p)

Note for posterity: I've asked Portia to make her responses fewer, slower, and more concise. I'm very happy about her best comments on this post, but the volume, length, and muddledness of the lowest end was untenable. 

While we're here: orthonomal has been doing some defense so I feel like I should note he's a personal friend and not an objective stranger, although I assure you he's not bending his epistemics out of friendship

comment by lincolnquirk · 2023-06-02T15:10:12.106Z · LW(p) · GW(p)

Thanks for writing this. I think it's all correct and appropriately nuanced, and as always I like your writing style. (To me this shouldn't be hard to talk about, although I guess I'm a fairly recent vegan convert and haven't been sucked into whatever bubble you're responding to!)

comment by df fd (df-fd) · 2023-06-02T08:09:02.608Z · LW(p) · GW(p)

Would a replication of your study of "in-office nutritional testing [LW · GW]" in a different EA population [say EA Sydney, Australia] be helpful?

In the sense of knowing how many self-identified vegetarians/vegans are clinically deficient in iron, Vit B12, Vit D,... [maybe even compared to omnivores]. We can then advise people on supplementation. With maybe follow-up surveys in 3,6,12 months to see if the number actually improved and if they actually feel improvement.


I am a nurse and I can take blood so that may help. I am willing to sink 40 hours into this if there is interest. 

However, I have never done anything like this before and I am pessimistic [<30%] about whether this would actually happen.

Replies from: pktechgirl, lincolnquirk, Making_Philosophy_Better
comment by Elizabeth (pktechgirl) · 2023-06-02T19:29:00.734Z · LW(p) · GW(p)

As a tool of data collection to inform expectations around EA vegans as a whole: probably not, the format doesn't deliver that kind of data.

As a tool to get more people tested and well supplemented: I expect that or something like it could be quite helpful. Even though my follow-up rate was bad, the buzz around it motivated many non-participants to get tested and treated. The fewer people currently testing themselves, the more useful I think it is.

I'm happy to provide advising to get this off the ground. 

Replies from: df-fd
comment by df fd (df-fd) · 2023-06-03T02:57:29.044Z · LW(p) · GW(p)

I'll look into the actual feasibility of this.

May I get back to you in one week?

I mean if say 20 EA vegans in Sydney got blood tests and for some reason, none of them has any iron, Vit B12, Vit D deficiency [by some metric] it would be significant evidence contradicting your belief isn't it?

It would help me if you can outline a short sketch [don't spend much time on it] on what you think I am going to do [both to prevent the double illusion of transparency and a type of pre-registration].

Replies from: pktechgirl
comment by Elizabeth (pktechgirl) · 2023-06-03T03:41:18.227Z · LW(p) · GW(p)

I want to say "take all the time you need", but then I remembered I go almost off the grid for July and August, so there's a discontinuity there. I may be able to connect you with funders, although I don't know what the situation is in Australia, and EA money is harder to come by than it was when I started. 

I mean if say 20 EA vegans in Sydney got blood tests and for some reason, none of them has any iron, Vit B12, Vit D deficiency [by some metric] it would be significant evidence contradicting your belief isn't it?

I feel like this skips over the part where I said my protocol isn't good for establishing base rates, so I'm confused about your plan.

What sample size I'd consider convincing depends a lot on the protocol. 20 people randomly selected from a pool of completely naive, no-effort vegans? yes, definitely. 20 people recruited by saying "let's prove her wrong" on a vegan athlete forum? of course not. That would demonstrate veganism can be done healthily by some people, but I already believe that. 

Simultaneously I think you're making things too hard on yourself, vitamin deficiencies aren't that rare in omnivores so it doesn't seem fair to expect 0 in vegans.

I would love to do a real study to establish base rates in both groups of EAs, with proper quantification of effort, supplementation, etc, but it's a lot of money and effort. I only felt able to tackle that with a co-founder, but after being rebuffed on some direct inquiries I lost a lot of hope for that. 

Replies from: df-fd
comment by df fd (df-fd) · 2023-06-03T10:02:10.342Z · LW(p) · GW(p)

RE timeline: no problem, I am happy to wait until September or after, giving me even more time to look into it.

I am going to put a feeler out to see if there is any interest in the Lesswrong/EA community in Sydney, I would not go ahead unless 30 people plan to participate.

RE base rate: I can run blood tests on [say 10+] omnivores in the community, assuming Lesswrong/EA community to be homogenous in other aspects aside from the tested diet, [we do have 10-20x the autism/neurodivergent rate compared to general population]. That should establish Lesswrong/EA community-specific base rate [hopefully].

RE protocol: the pool should be anyone from Sydney Lesswrong/EA community I can talk into participating, divided by diet.

The result of [how many self-described vegans in the Lesswrong/EA community in Sydney are deficient in iron, Vit B12, Vit D as found in blood tests [according to so and so metric]? and would supplementation help?] should speak for itself.

RE "Real study": yeah, it's nice for me to talk a big game but personally, I am very pessimistic [<30%] that any test is going to be done at all. If nothing else, at least it should raise the problem to the local community consciousness.

Personally, I am a big fan [did I say big? I mean huge, humongous] of your past works and found them to be enlightening.  I believe your numbers and my only complaint of your in-office test adventure was that you did not manage to establish the benefit of supplements. Which, if the stars aligned, I hope to remedy this round.

I am an omnivore, although I greatly admire those who go on vegan diets for animal suffering. I am only in this to find out what is true and if there's anything we can do about it. My stake is that I care deeply about the community, many of them vegans. If doing vegan causes easily fixable deficiency I would really want to know.

Replies from: pktechgirl
comment by Elizabeth (pktechgirl) · 2023-06-03T19:33:10.575Z · LW(p) · GW(p)

I don't think there's a way to get a representative sample of healthy people (vegan or omnivore) without paying them. People just don't care about the information enough. 

One thing I have toyed with is comparing [% of omnivores with fatigue who have nutritional issues] with [% of vegans with fatigue who have nutritional issues]. My theory is if all other sources of fatigue strike each group equally often, and vegans are more prone to nutrition-caused fatigue, vegans with fatigue should have a higher % of nutritional issues than omnivores with fatigue. And both groups are more motivated to get tested than unfatigued people.

And then you try to control for effort and supplements, but I found getting that information from people to be a real uphill struggle and am probably not willing to run another project myself unless I have enough money to pay participants. I worry I'm being too discouraging, I want you to run this, I think it would be valuable even in a limited form and if you can get the data I couldn't that's fantastic. But I also don't want to set you up for failure by being unrealistic about the amount of effort required. 

Replies from: df-fd
comment by df fd (df-fd) · 2023-06-04T08:19:26.340Z · LW(p) · GW(p)

Let's not jump the gun, I'll look deeper into it once I am certain there is huge interest.

tbh the main thing I care about is whether those who self-designated as vegans are significantly more likely to be deficient compared to baseline and whether supplement help. Everything else is extra.

Replies from: pktechgirl
comment by Elizabeth (pktechgirl) · 2023-06-13T22:05:57.581Z · LW(p) · GW(p)

Lightspeed grants [LW · GW] were just announced, with a July 6th deadline. They are unusually promising as a source of funding, so it might be worth your while to meet that deadline. 

Replies from: df-fd, df-fd
comment by df fd (df-fd) · 2023-06-14T00:55:40.392Z · LW(p) · GW(p)

jinx, I have applied already, not sure if I did a good job selling it though. Thanks for reminding me though.

still waiting on whether my hospital would be interested in the study. 

 so far community members I have spoken to said "others" should be interested, but few actually gave me a commitment, I am not pushing very hard though.

Replies from: alex-k-chen
comment by Alex K. Chen (parrot) (alex-k-chen) · 2023-06-14T04:17:27.719Z · LW(p) · GW(p)

Try iollo blood tests too, they're new and can test hidden deficiencies

Replies from: pktechgirl
comment by Elizabeth (pktechgirl) · 2023-06-14T07:21:57.093Z · LW(p) · GW(p)

Looking at the list, I don't see any vitamins or minerals listed. It tests a variety of markers, but not raw micronutrients.

comment by df fd (df-fd) · 2023-06-16T09:16:58.415Z · LW(p) · GW(p)

so update, after consultation with a research doctor turn out I am not qualified to do it.
I need to be either a doctor, a higher ranking nurse or a nurse on research track at least.
since I am a nurse on the clinical track so I am not qualified to do the research, bummer.

people could still go to their doctor, get their blood check and give the result to me to tabulate, but it does not require me in particular.

comment by lincolnquirk · 2023-06-02T15:10:47.255Z · LW(p) · GW(p)

If you have energy for this, I think it would be insanely helpful!

comment by Portia (Making_Philosophy_Better) · 2023-06-02T16:08:28.794Z · LW(p) · GW(p)

Ironically, for me this sort of thing was the final step to going vegan, so I would be very curious about implementing this. I'd also test the values vegans often reference as positive markers (cholesterol, other b vitamins, etc.)

I was a teenager, and had several vegan friends, while I ate meat. I had wanted to go vegan as a young child, but my conservative doctor father had told me it would make me ill, and had driven that point home with rather ghastly methods, until I believed him. (He fed me nothing by carrots for half a week, while showing me pictures of severely disfigured babies who some twerp had tried to raise on apple juice, and as the week got on, the belief that I was turning into them became increasingly plausible.) So I told my vegan friends that as much as I cared for their ethics, I would never go vegan, for health reasons.

We were all broke as fuck, and went to donate blood. All the vegans did. Lady at the desk told me that unfortunately, I could not, because my blood values were such a mess, especially my iron. I was utterly stunned. Staring at my blood values. Staring at theirs. In utter disbelief. Saying over and over "but I practically live off red meat, how the heck is this possible". Went vegan shortly afterwards. I've regularly tested and kept an eye on things, and my blood values got better, not worse. Still confused by it.

comment by maia · 2023-06-03T03:21:38.756Z · LW(p) · GW(p)

I feel more EAs (or anyone who wants to eat ethically) should consider ameliatarianism if they find that veganism is too difficult, nutritionally or otherwise. It removes the vast majority of animal suffering from your diet, with very few nutritional concerns.

I'm also curious what you think about lacto-vegetarianism. It's a step between vegan and ameliatarian suffering-wise, but I'm not sure where it falls between the two in terms of nutritional difficulty. There's the example of the large and ancient lacto-vegetarian culture in India, but if you don't eat the specific foods of that culture, how hard is it to stay nutritionally balanced as a lacto-vegetarian?

Replies from: pktechgirl
comment by Elizabeth (pktechgirl) · 2023-06-03T04:21:13.498Z · LW(p) · GW(p)

I'd want to spend more time with the numbers before committing to specifics, but tentatively I'm delighted my request [LW · GW]got fulfilled a month ago without my knowledge.  As a compromise diet I think it's great, I'd be really happy if this became the new EAGlobal standard.

My guess is poultry is easy to give up, nutritionally speaking, unless someone has a serious issue like a red meat allergy. People are weird and variable but there's nothing obvious poultry has that something else doesn't. 

Giving up eggs and farmed fish is harder. My guess is that for many omnivores that would take some thought to work around, eggs are so goddamn convenient, but by no means insurmountable except for actual medical issues. Fish have special nutritional benefits and wildcaught are more expensive, although that may be fixable by switching to a cheaper species. 

If I could make a few additions:  I would love to see organ meats get more airtime. They require different cooking skills and are less popular so no savings on that front, but relative to muscle meat they're more nutritious, have less fat, and contribute less to the marginal profit on livestock.  I'd also add mussels, which are neurologically plants, but I've never met anyone who could tolerate the taste.

My guess is lacto-vegetarian cultures are healthy, but an American dropping down to lacto-vegetarianism has a high risk of implementing it poorly. For some it won't matter, and more people can do it with less effort than veganism, but many will require some thought. Probably most people can fix that with mussels, but then I also think most could fix veganism with mussels (and by fix I mean get back to the same level of health they had on an omnivorous diet, not necessarily optimal).

Normally I'll admit to medical issues being a tail risk, lactose intolerance is incredibly common. The first sources on google say 68% of the population has lactose malabsorption. That's too high- it includes people with some limited ability to digest dairy, not all forms of dairy have lactose, lactose free milk is pretty available in the US, lactaid works for some people- but there are enough people it can't work for that there need to be other options. 

Replies from: TAG
comment by TAG · 2023-06-03T12:27:13.729Z · LW(p) · GW(p)

The Wikipedia page says 65% of the global population -- bearing in mind that LI is normal in East Asia -- and 42% in N.America.

comment by green_leaf · 2023-06-02T18:48:24.094Z · LW(p) · GW(p)

A well-planned, balanced vegan diet is suitable to meet all recommendations for nutrients in every stage of human life.

Replies from: pktechgirl, orthonormal
comment by Elizabeth (pktechgirl) · 2023-06-02T20:21:26.952Z · LW(p) · GW(p)

to be clear- you agree with the stipulation that the diet needs to be well-planned and balanced?

Replies from: Making_Philosophy_Better
comment by Portia (Making_Philosophy_Better) · 2023-06-02T22:17:36.932Z · LW(p) · GW(p)


But would you say an omnivorous diet does not need to be?

comment by orthonormal · 2023-06-02T19:33:01.692Z · LW(p) · GW(p)

The citation on that sentence is the same as the first paragraph in this post about the website; Elizabeth is aware of that study and did not find it convincing.

comment by Cathar · 2023-06-02T13:47:21.712Z · LW(p) · GW(p)

Thanks for writing this - it's exactly what I needed to be able to point people to. AnthonyC's comment that nutrition is multidimensional, and optimizing along any axis requires compromises in others sums up my feelings perfectly. I know the plural of anecdote isn't data, but here's my experience. Take with a pinch of salt:

For most of my adult life, I steadily reduced my consumption of animal products for ethical, health, and environmental reasons. I wasn't eating a lot of animal products when I went vegan for mostly ethical reasons 5.5 years ago. After a surprisingly steep learning curve I settled into it.

A major depressive episode prompted me to reintroduce (some) seafood, which helped, but I still spend more money and effort in return for a less healthy (physically and mentally), less varied diet than before. Overall I consider it worth some of my health and happiness to do what I consider morally right, but that's my decision to make for me. 


I am baffled by the short-sightedness of people who think it's helpful to lie about this stuff and recruit people by trickery. 

comment by Kamil Pabis (kamil-pabis) · 2023-06-04T08:11:24.161Z · LW(p) · GW(p)

I think the consensus among nutritionists is that a well-planned vegan diet is among the healthiest possible diets. Almost everyone in the US would benefit from "going a bit more vegan". Nevertheless, it is probably not optimal on certain axes.

It would seem that the best diet to improve long-term health is a flexible pescolacto-vegetarian diet supplementing certain carninutrients, e.g. creatine. So not vegan.

Tradeoffs are real and you have to optimize for one thing over another. For example, a standard (unsupplemented) vegan diet may not be optimal for mental and physical performance due to the higher risk of iron deficiency, low protein intake and lack of dietary creatine intake, among other things. A lot of those issues can be alleviated through careful planning. However, it may very well be that low-moderate intakes of protein and iron are one of the reasons why a vegan diet is healthy and you will have to weigh this against the potential performance aspect.

We have two types of evidence in favour of veganism:

We can extrapolate that veganism is healthy from first principles by studying individual foods and nutrients. For example, we know that saturated fat often found in animal foods increases LDL which is a validated marker of cardiovascular disease. Saturated fat intake will be low on a vegan diet. Another example is iron, we know that even unprocessed red meat is problematic because it is a rich source of iron and we know that many men consume too much iron (whereas some women consume too little). We know that iron intake and availability will be lower on a vegan diet and we have relatively strong evidence that elevated iron levels are harmful to health.

Or we can be lazy and just take a bird's eye view and look at mortality data in observational studies. These studies clearly show that both vegetarian and vegan diets are associated with reduced mortality and superior health outcomes. Unfortunately this kind of study design is subject to different biases like residual confounding, e.g. it may be that vegans are healthier than average even after we controlled for obvious variables associated with health like income, cholesterol, body weight, etc. While this does not prove that veganism is healthy, it definitely shows that veganism is consistent with above-average health outcomes.

comment by WilliamKiely · 2023-06-02T04:00:23.837Z · LW(p) · GW(p)

I only read the title, not the post, but just wanted to leave a quick comment to say I agree that veganism entails trade-offs, and that health is one of the axes. Also note that I've been vegan since May 2019 and lacto-vegetarian since October 2017, for ethical reasons, not environmental or health or other preferences reasons.

It's long (since before I changed my diet) been obvious to me that your title statement is true since a prior it seems very unlikely that the optimal diet for health is one that contains exactly zero animal products, given that humans are omnivores. One doesn't need to be informed about nutrition to make that inference.

Replies from: orthonormal, WilliamKiely, WilliamKiely, Making_Philosophy_Better
comment by orthonormal · 2023-06-02T19:25:32.578Z · LW(p) · GW(p)

In this and your comments below, you recapitulate points Elizabeth made pretty exactly- so it looks like you didn't need to read it after all!

comment by WilliamKiely · 2023-06-02T04:06:17.383Z · LW(p) · GW(p)

IMO the largest trade-offs of being vegan for most people aren't health trade-offs, but they're other things like the increased time/attention cost of identifying non-vegan foods. Living in a place where there's a ton of non-vegan food available at grocery stores and restaurants makes it more of a pain to get food at stores and restaurants than it is if you're not paying that close attention to what's in your food. (I'm someone without any food allergies, and I imagine being vegan is about as annoying as having certain food allergies).

comment by WilliamKiely · 2023-06-02T04:03:39.032Z · LW(p) · GW(p)

That being said, it also seems to me that the vast majority of people's diets are not well optimized for health. Most people care about convenience, cost, taste, and other factors as well. My intuition is that if we took a random person and said "hey, you have to go vegan, lets try to find a vegan diet that's healthier than your current diet" that we'd succeed the vast majority of the time simply because most people don't eat very healthily. That said, the random person would probably prefer a vegan diet optimized for things other than just health more than a vegan diet optimized for just health.

comment by Portia (Making_Philosophy_Better) · 2023-06-02T15:49:08.262Z · LW(p) · GW(p)

Mh, I think we need to distinguish two different things here.

Is veganism healthier than all other diets? - Doubt it. While reducing meat consumption has demonstrable benefits, I don't think you get any particular advantage from removing all animal products entirely to the last tiniest piece, despite the known harms many of them entail. I doubt a little bit of animal products now and then does much harm, plus there are some nutrient forms you get more easily that way to outweigh that. I would not universally recommend going vegan for health reasons.

But can you live a very healthy, long life while vegan, just like an omni? - With rare exceptions (severe food intolerances or food access issues), it seems like the answer is yes; people have been raised vegan from birth, been vegan for decades, and they do perfectly fine. So I do not think I will die earlier, or later, because I am vegan. And that is good enough for me. I care a lot about animal rights, but I would not make myself sick over them. (E.g. I take non-vegan medications, because I actually need those to be healthy. I wish they existed in vegan, and push for it, but until they do, I will take them as is.) But the mere inconvenience of reading food labels or not being able to eat the cake in a traditional restaurant, that I am fine with.

Ironically, I think being vegan was healthier 1,5 decades ago. At the time, there were no fancy fake replacement products, so going vegan effectively entailed quitting practically all chocolate, candy, cake, takeout, etc. and having to cook most everything oneself from whole foods from scratch. Nowadays, I can buy the exact same crap in vegan, and the sugar content is just as bad, and I doubt the vegan options are healthier at all.

Replies from: pktechgirl
comment by Elizabeth (pktechgirl) · 2023-06-02T19:12:06.862Z · LW(p) · GW(p)

But can you live a very healthy, long life while vegan, just like an omni?


I worry the following will sound defensive, but it's an important question and I couldn't figure out a better way to ask it.

I agree with what you said here, with some minor quibbles on the margin. I tried very hard to signpost my belief that veganism was not necessarily a big hit to health for most people, and few people eat optimally anyway. Reading your comment and a few others, it sounds like that did not come across in the original post. What could I have done to better convey that belief to you? 

Replies from: Making_Philosophy_Better, Making_Philosophy_Better, Making_Philosophy_Better
comment by Portia (Making_Philosophy_Better) · 2023-06-02T22:48:40.499Z · LW(p) · GW(p)

To follow up after more pondering: I think it is the title. Veganism having "trade-offs, and one of the axes is health" sounds to me like "veganism will necessarily make most people sick in a significant way they should carefully consider before going vegan to see if this is a sacrifice they are willing to make", and that, I would not have agreed with at all. I think for near everyone, the problems are fixable, and that I have not sacrificed my health for veganism in any relevant way.

But the specific statements in the text - that a vegan diet can be harmful, if badly done, like any diet; that it isn't necessarily suited for everyone, if that person has a lot of allergies or severe digestive issues; that being careless about your diet, vegan or not, is not a good idea; that while veganism avoids some health issues from excessive meat consumptions, it comes with risks of deficiencies in turn that need to be countered - I would all agree with. I'm in the camp "For the vast majority of people, veganism can be done without relevant harm to their health, while achieving a lot of ethical good. For most people, this is not as hard as they think. Some may even feel better and get healthier, but I wouldn't rely on that, and you should put some thought into changing your diet so profoundly, and do regular blood tests to make sure you haven't dropped something you needed."

But collectively, I wouldn't title these statement the way your text was titled. But more as "please get blood tests, folks, nutrition is easy to fuck up and impactful" or "can we please not guilt sick people into going vegan, they have enough shit on their plate without complicating their diet further via restrictions" or "can we please not promote veganism as a panacea, the data does not support this, going vegan doesn't make french fries suddenly healthy" or "B12 and D3, supplement it, people, seriously, how many times do we need to tell you".

comment by Portia (Making_Philosophy_Better) · 2023-06-02T23:41:14.903Z · LW(p) · GW(p)

Edit: I currently have debilitating pain levels due to a spinal injury, and have been distracting myself with this content, resulting in writing comments increasingly stream-of-consciousness style. I fear my comments have long become increasingly incoherent. Apologies.


Third: I also think the responses to your text are a bit all over the text, because the overall pragmatic goal/motivation behind the research question remained unclear.

Like, when it comes to veganism, having concluded that eating vegan would be much better for animal rights and the planet, in order to make my own diet choices and advocacy, these were things I needed to settle and needed data for:

  1. Is it possible for me to live vegan, without compromising my health or happiness significantly? (The data I saw made it plausible enough for me to decide to try in 2009. Actually going vegan and checking my values across 14 years confirmed it, and I found it much easier than expected.)
  2. Is it possible for specific person x (say, a friend of mine) to live vegan, without compromising their health or happiness? (Very probably, but depends on the person. Need to listen to them to understand their individual needs and issues to assist them in making a transition to a point they pick for themselves, to e.g. see if we can still find a particular nutrient if they can't digest a particular class of food. But for the most part, again, I found people overestimated how tricky it would be.)
  3. Is is sensible for humanity on average to significantly reduce meat consumption? (Definitely yes. Whatever positive role meat may play for some people, the quantities currently consumed are definitely unnecessary and harmful for the planet and health, so advocacy in this direction is likely to promote average health. So getting vegan food into my university cafeteria, or reducing tax breaks for meat producers, is a good idea.)

But none of these questions seem to require the kind of data you are looking for, although I'd be very interested in reading the data regardless if it exists. Like, it is possible that if I take an entire city filled with unhealthy omnivores, and force them to become a 100 % vegan without giving them any information or taking any account of existing health issues, their health would worsen slightly on average, because some of the garbage they ate beforehand happened to contain a key nutrient as well and they no longer eat it now. (No idea if this would happen, but I could imagine it.) But... noone is doing that. (Nor should we. I think there are some people who would not do well on such a diet, I object to coercion, and any major campaign would definitely need education and support.) And if we found huge number of clueless omnivores going 100 % vegan without doing any research, and having their health worsen, my conclusion from that would be "understand what is going wrong, and then advocate for the right supplements or educational policies". Not "accept that veganism is bad for health in general", because we have so many examples of vegans who are perfectly fine, so I'd want to understand what sets these individuals apart - and I think, often it will be bad implementation.

I once met a dude who told me he used to be vegan, but he got critically clinically protein deprived despite everything he tried, so he no longer is. I said that surprised me, did he have special issues? Well, no. How curious, what had his diet been like, then? He said, well, seeing as mushrooms are the main vegan source of high quality protein (?!?), he tried to eat mushrooms at least twice a week. I waited for him to continue. That was it. Turns out that this man discovered that two handfuls of mushrooms per week do not, in fact, meet human protein needs. Maybe because 100 g of champignons contain a whooping 2,7 g of protein. My conclusion that day was that that man was an idiot, and that our communities need proper nutritional knowledge in schools. Not that vegan diets cannot provide protein. I assume the same man now runs around and says he and his pregnant wife make sure they get all their folate by making sure they eat chicken nuggets twice a week.

comment by Portia (Making_Philosophy_Better) · 2023-06-02T22:12:18.770Z · LW(p) · GW(p)

I think the impression I got from your text is that it is motivated and overshadowed by a profoundly traumatic personal experience (namely, your body consistently rejecting food, and hence ruining your well-being) and the immense frustration when some vegan people witnessing this degree of suffering went "hey, have you considered, on top of all the existing problems, also introducing an additional complication into your diet by cutting out a huge part of the little that somewhat works for you? It is easy, I did it, it is great for everyone!" This was tone deaf of them. With all the shit you are dealing with, whether it is in theory possible for you to be healthy as a vegan or not, I think it is utterly unreasonable for you to make a situation that is already very, very hard on you even harder. Originally, the definition of "vegan" was "to avoid consuming in a way that harms animals, wherever reasonable." I like this definition to this day. For you, a reduction in animal product consumption is currently likely not reasonable at all. If you are doing better, and you have the mental and other capacities for it, and want to, I'd be happy to support you in doing so, but getting your health working is clearly more important, and going vegan would entail a significant sacrifice for you that is totally disproportional to the gains.

I think you are aware that your experience is not common, which is why you said so - but the big factor it plays in the text gives a different impression to the reader, because presumably, all the cases you have encountered resonated with you, a lot. Hence all the readers who are stressing that for most people, going vegan does not have to entail any meaningful sacrifice in their health, because most people can be perfectly healthy while vegan. But exceptions like you are valid, and important.

It also sounds like you have heard from a lot of vegans with what I would consider fringe opinions. When this movement started, people kept saying that all the vegans would die within a year. It was incredibly wonderful and satisfying to see that we not only did not die, but were perfectly fine, and even beating some omnis on some health values. For me, the point of this was that we had shown that it could be done. But some people - I think frustrated at having been told over and over that they would starve to death, when they really didn't, and in fact felt better than prior to going vegan, and had some health values even improve - basically countered by assuming that because veganism helped them, it would help everyone, that it wasn't just healthy, but somehow massively superior. They clearly wanted to spread something that had helped them, and with good intentions, but I think they are wrong to assume it is superior health wise, or doable for everyone, or safe without any worries (insofar as good nutrition is something everyone should worry about, the more so if they take an existing diet and cut away a chunk of it rather than restarting from the ground up). I angrily correct them when they start spouting that going vegan will fix cancer, or that it is the duty of some disabled kid with massive food issues to go vegan because it is easy for everyone, because that strikes me as actively harmful, and I do remind people of B12 - but then, so does every doctor and vegan advice site. But for the most part, I see them in the context of what is still a majority opinion - all the regular people who go, I couldn't go vegan, I'd be missing all the things, humans have to eat meat, or they die. That opinion does a lot of harm, and I think it still does more harm than the people who are very excited about veganism.

I mentioned elsewhere in this post that I do not think all animal products are unethical in principle; I don't have a problem with someone drinking goat milk from a goat that happily hops along some cliffs where we can't grow shit anyway, or someone eating the eggs from runner ducks they keep in their food forest for slug control. The products most potentially relevant for health are the ones often currently thrown away, not the fancy muscle meat. My major issue is with our current large scale industrial farming ruining animal welfare and the planet, the animals kept in tiny cages, the immense waste of land and water and destruction of rainforests, and production of climate gasses. With people consuming vast quantities of meat that they do not need in any way, that actually make them sick, and that this planet cannot produce. Not with people fulfilling genuine needs in ethically reflected ways. I'm happy for all the ethical products to go to folks like you, because I don't need them, and I am happy to accept that you do.

comment by isabelhasse · 2023-06-30T21:04:35.005Z · LW(p) · GW(p)

I am primarily a consequentialist, but when it comes to animal rights, my reasoning is not consequentialist first and foremost, which is why I am a vegan and not simply avoiding eggs and chicken (which might be better from a consequentialist perspective given the trade-offs explained here---my effort might be better spent on changing my lifestyle to donate more, etc.). I think "do not pay people to abuse and kill others on your behalf for the sake of convenience and pleasure" should be a strict rule. The ambiguity comes in once the justification changes from "gaining convenience and pleasure" to "avoiding misery" (from either physical health problems or having to manage your diet so strictly as to cause significant suffering). I don't know where to draw the line, but for the majority of people I think their justification for not going vegan falls more into the first category than the second, so the majority of people should still go vegan.

That being said, I agree we should be honest and up-front about the tradeoffs, and this is something I am frustrated with other vegans about---when we say "going vegan is easy", we alienate people who struggle to go and stay vegan, which I do (mainly due to cravings for animal products, difficulty cooking for myself consistently, and a tendency toward impulsive behavior). 

comment by Rodrigo Heck (rodrigo-heck-1) · 2023-06-02T22:33:38.439Z · LW(p) · GW(p)

How is health a trade-off when the longest living populations are the ones eating mostly plant based diets?

Replies from: pktechgirl, orthonormal
comment by Elizabeth (pktechgirl) · 2023-06-02T23:28:43.705Z · LW(p) · GW(p)

could you quantify "mostly", and connect this to "omnivores who grew up in an omnivorous culture"?

comment by orthonormal · 2023-06-02T23:12:44.265Z · LW(p) · GW(p)

Elizabeth has invested a lot of work already, and has explicitly requested that people put in some amount of work when trying to argue against her cruxes (including actually reading her cruxes, and supporting one's points with studies whose methodology one has critically checked).

comment by Portia (Making_Philosophy_Better) · 2023-06-02T15:37:16.276Z · LW(p) · GW(p)

Sure, going vegan involved some things that were annoying for me in 2009, thought it has gotten a lot easier, and nowadays, no longer bothers me at all. And there are definitely people for whom the situation is much harder. (I have a friend who is severely allergic to soy, gluten, and a large number of vegetables, fruits, nuts and pulses. She is no longer vegan, despite being vegan before I was. The amount of grief I give her over it is exactly zero, the effort and danger for her were in no proportion to the gains.)

But compared to other changes I make to reduce animal suffering and my CO2 footprint and stop climate change, I feel the impact to drawback ratio was very good, which is why it is among the things I recommend. E.g. I find it much easier and more attainable than, say, quitting plastic, or acquiring a carbon neutral home, or ceasing to use any planes or cars whatsoever, or making my local politicians stop subsidising oil, all of which are things I also aim for but struggle more with.

I didn't reach the same conclusion with my cat. I am sceptical that I can guarantee her health on a vegan diet, the vegan feeding trial studies went better than expected (frankly, I had thought the poor cats would get severely sick very quickly, I am surprised how very well they did on a diet so utterly unlike the one they evolved to it, as a healthy diet isn't just nutrients, but very much also their whole food context, and the macros seem totally off; e.g. to my surprise, they showed no evidence of protein deprivation or digestive issues), but left a lot of open questions for me (long term urinary health due to weird ph values, and what is going on with the B vitamins that none of us thought would be an issue do to the high numbers in plant sources, aren't they taking them up?, and do cats really do well on this many carbs in the long run, and doesn't the increase in hunting indicate that they are missing something?), and the potential research, checks, cost, risk and time seem significant, so my cat currently lives quite happily of organic slaughterhouse scraps that would otherwise be tossed, organic eggs, and a proven organic food with an okay ethical track record and only limited plant content (Yarrah) until there is more solid evidence that partial (most conventional cat foods contain insane amounts of wheat and other plant products, often as the primary ingredients, which many of the angry people attacking vegans seem unaware of) or even complete vegan feeding is genuinely safe and healthy. (I wouldn't worry about her happiness in eating it - I regularly angrily inform this cat that she is an obligate carnivore because she is constantly stealing my vegan food.)

But back to humans; you also already get a huge amount of these benefits by simply being a flexitarian reducing animal consumption where feasible for you, it is not an all or nothing thing. If it is hard for you, I'd focus on how it can be made easier, and on finding an option that is genuinely doable and good for you, even if it is a compromise. The majority of meat substitutes aren't eaten by vegans, they are eaten by flexitarians, and yet, they avoid a lot of animal suffering.

If you have specific challenges for yourself you would like to debug, I am also happy to advise, as someone who is both a vegan, and a nutrition nerd.

Replies from: pktechgirl
comment by Elizabeth (pktechgirl) · 2023-06-02T19:36:19.972Z · LW(p) · GW(p)

Not to dump a bunch of homework on you, but... could I encourage you to write up vegan nutrition tips and tricks on the EAForum? I think imparting the same nutrition culture hardcore vegans get into the wider community of EA vegans would be extremely useful. 

And while I'm making a wishlist, I think "optimizing your health per unit animal suffering" would be a good blog series. Organ meats (lots of health benefits, few health costs, lower marginal cow production) certainly seem more justifiable to me than chicken nuggets or egg custard.

Replies from: lincolnquirk, Making_Philosophy_Better
comment by lincolnquirk · 2023-06-05T14:14:21.286Z · LW(p) · GW(p)

Not who you're responding to, but I've just written up my vegan nutrition tips and tricks:

Replies from: pktechgirl
comment by Elizabeth (pktechgirl) · 2023-06-05T20:54:30.885Z · LW(p) · GW(p)

It's an open request.

comment by Portia (Making_Philosophy_Better) · 2023-06-02T21:41:13.788Z · LW(p) · GW(p)

(Long nerd rant ahead, I find nutrition genuinely interesting.)

I find it difficult to give general nutrition advice, because good nutrition is such a very individual topic. Eating lots of vegetables is one of the few things with really good support, but depending on the person, they might have huge difficulties digesting them, at which point the benefits become completely outweighed by their constantly digestive issues. I have very bad opinions on high sugar high calorie diets, and know people who do great on low carb, but also people who get absolutely fucked on keto, especially women, and see lower carb lower glycemic index as a good alternative, too. I generally consider fibre and fermentables and wild ferments healthy and very important, but depending on your gut problems, some types can completely screw you. Protein is extremely important, but frankly, the type of people who worry about nutrition often overconsume. Eating a great variety of differently naturally coloured foods is generally a good rule, but if you have serious disease states, you will likely need an elimination diet to get to the bottom of it. The whole idea of particular substances being "easily digestible" or even more so "healthy" very much depends on the individual, and on the quantities - too much of even the healthiest things will kill you. On the other hand, there are a lot of substances that humans do not strictly need, because they can in theory synthesise them, but de facto, you in particular may not be able to. (E.g. I recommend that all vegans supplement algae oil, because humans utterly suck at producing the omega 3 from the precursors you encounter in things like flaxseed, and find it ludicrous for any person in the global North to believe they can synthesise their own D3; but in a lot of people with depression or chronic fatigue, it also makes sense to try to up products that your body ought to be able to synthesise, but may be failing to) But it all depends on where you are, your genes, your microbiome, your allergies, your hormonal cycle. But telling people that it really depends on them individually is often read as "Well, I should just follow my intuition, and live off dessert", which is a really bad idea. Nutrition has such an incredible impact on health and well-being, I think so many people do not realise how much it holds them back.

Pretty much the only approach I universally recommend to people who do badly (!) is to spend a month tracking everything they eat, weighed (because if you aren't weighing it, your estimate is worthless) in an online tracker that resolves the core things you are interested in (like protein), incl., if you have any suspicions in that direction from less detailed food diaries previously failing, how it was prepared (for FODMAPs and ferments) and how long it was stored (for histamine content), while tracking well-being parameters, while weighing themselves daily under the same conditions, and comparing very comprehensive blood work before and after. And if their issues are really bad, to start this period with an elimination diet. But the point afterwards where they debug this data to find a solution for them depends on what they are experiencing, how they are feeling and responding. And the solutions themselves also depend crucially on what they want. They need to find the diet tasty, affordable, easy to make, available, it has to make them feel happy and good, otherwise it won't work, and what people consider doable and pleasant differs a lot. I like my diet, but I think a lot of other people would not.

And the only thing I universally recommend preventably to any vegan, whether they do badly or not, is yearly comprehensive blood work, and reasonable vitamin B12, D3 and algae oil supplementation unless the blood work actively contradicts it - and an awareness that nutrition has the power to make you feel really, really good,  and massively impact longevity, in ways that you will really regret taking lightly and fucking up.

Ironically, I see two major forces of potential severe damage among vegans. 

The one is the people who literally do not worry about nutrition at all while eating what they must know is garbage. I had a friend I once co-organised a workshop with, which ended with me eating what he did for a day. It was vile. I felt awful. No protein, no fibre, no vitamins, and the amount of sugar I ingested essentially purely,  and Jesus Christ, I had no idea vegan fats could be this bad. (Palm fat, if anyone is interested, is one of the few vegan ways to really fuck yourself up with fat, as well as margerine optimised for trans fats. Shortly followed by isolated, super heated plant oils with bad omega 6 ratios, like sunflower oil, that have been heated to deep frying, which my friend was also a fan of. I have literally felt better overeating on goose.) And I thought it was a one-off, and then realised, no, this is what he eats literally all the time. I told him, in detail, that he was setting himself up to be seriously sick in so, so many ways. With concrete studies, and advice, recipes, links, the works. He ignored me. He is now morbidly obese and has nerve damage from lack of B12, as well as severe fatigue and depression, and beyond accepting B12 injections, did not change a thing. I would be very surprised if this man lived to be 70. I had another vegan friend who literally lived of marzipan, French fries, and peanut butter. For what it is worth, I have omni friends like this as well, and they don't do better for living off bacon and cake; the fact that the theoretical range of foods is much broader is amply made up by the fact that the range of fast food is also much, much greater, allowing you to set yourself up in a complete mess. My mum works with pregnant women, and I have always been confused how any of them manage to get insufficient folate, when it is so abundant in diet. Until I started realising how many people consider five portions of vegetables a day utterly unrealistic. So just being omni is no protection there.

But there is another group that tries to really, really optimise, and those are honestly often just as bad. Had a friend who tried to make her own better huel from scratch. Except she never got a fine scale for the micros, or lab analysis. Caused herself long term damage. (Though come to think of it, I think she was still consuming whey at the time. Did not save her.) Others who drown themselves in so many supplements they actually manage to get nerve damage effects from water-soluble vitamins. (You'd think that is impossible, because the body would flush out the excess. Turns out that reasoning presumes that the quantities consumed are not literally insane.) Or who ingest so much green tea concentrate they give themselves liver damage. Young people who actually enter kidney failure in a bizarre attempt to be healthy. Often out of the strange idea that healthy things are universally healthy for everyone, and that more is always better. This is also the terrifying group that looks at the soy based baby formula they can get in stores, that is perfectly vegan except for the D3, has passed all tests and is perfectly safe, and say... but wait, the D3 isn't vegan, you know what, fuck this so nearly perfect option, let's make our own in our dirty kitchen and without any knowledge of pediatric nutrition! And then proceeds to needlessly starve their child to death in the middle of a rich nation, by feeding a growing organism a diet that was developed to help adult humans with a fully developed digestive tract lose weight.

And yet, there is the group I would perceive as the sane ones with reasonable caution, which is in the middle, and the majority. Within the vegan range, they eat a large variety of foods, to cover all their bases, while not hugely overdosing on any one thing. They usually cook from scratch and eat whole foods, but also sometimes eat what I would consider crap. They eat a normal amount of calories, so even if their individual food items aren't super nutrient dense, they end up getting enough. (If your vegan diet is temporarily only like 800 kcal, then you absolutely need to fucking plan each little bit; but if you are eating full caloric range, that compensates a lot of silliness.) They get a blood test with their regular physical. If they don't feel well, they take it seriously, and investigate, and then make careful changes based on empirical data, and verify that it helped. I think a lot of them could do better, and get peak health - but I am not worried any of them are about to do themselves any serious harm, and I am definitely not more worried about them than about their omni counterparts. Where I am in Europe at least, this is where most vegans I know seem at, and I don't worry that badly, or more about them than the omnis.


Also, I would be very interested in the whole optimising your health per animal suffering thing. I'm not vegan because I think this is 100 % aligned (not everything non-vegan is unethical, not everything vegan is ethical), but because I think the alignment is close enough that anything running a more subtle division is a bitch to implement socially and practically for me personally, with none of the exceptions crucially relevant for me personally. Like, there are conditions under which I would find eating animal products ethically acceptable, but the cognitive load of telling them apart each time with their unclear sources and arguing for the exceptions just didn't seem worth it or necessary for me in the end, mostly cause none of them were things I genuinely enjoyed eating, and because "I'm okay eating these waste organs but I do not want them fried in your industrially produced butter" is a path to madness for me. The things I used to really like definitely weren't in the health necessity camp. The things I have been considering consuming for health reasons certainly aren't attractive as delicious to me. (Lots of animal connective tissues, for one.) But I know people who do not find this stressful, and live accordingly, e.g. a dude who is mostly vegan, but eats mussels, because he finds them tasty and healthy, is convinced they aren't sentient, and has a climate friendly harvesting process, and I found his take convincing, a lot of seafood arguably falls in the healthy camp. (I just hate seafood, tastewise.) - I do also think optimising for ethics and health should not stop at being vegan. See palm oil - that stuff isn't just an atrocity health wise, it is also an atrocity ethically, vegan or not. Growing plants is generally more climate friendly by a significant margin than raising animals, but there are cases where this is inverted.

Also for pet food. I'd really like an optimally healthy and ethical pet food. For some reason, the commercial options are generally either "feed your cat this meat flavoured grain deprived of all moisture and covered in sugar for no reason who knows why she has kidney and dental issues" or "feed your cat this extremely expensive human grade beef steak that she neither needs health wise nor enjoys and that is extremely harmful for the planet and animal welfare and also lacking in key micronutrients, we also threw in a bunch of human superfoods which cats have never historically eaten that have not been tested on cats and might poison them for no bloody reason at all, oh, and we don't test our food for whether it is complete despite wanting you to feed your cat nothing else, we think this will just be fine because it is all natural and made with love". I'd fucking love a reasonable option, that optimises not for what sounds good, but for what would actually make sense. But somehow, other vegan animal rights activists do not share my enthusiasm for obtaining animal waste products to feed their carnivore pets. (E.g. you know about this horrifying process where people raise mono chickens just good for eggs and not meat, and hence at birth, sort the chicks and kill all the male ones? Super common, at large scale. Horrid, I hate it, have protested it forever. But I also think... wait, you are saying there are huge quantities of whole small prey animals that are currently being killed and wasted, anyway? This is literally an ideal cat diet. Can I have them? Can we redirect this so the harm is at least a little bit less wasteful and pointless? And yet, I think people wouldn't want to buy this ethical food consisting of whole chicks and eggshells and so much other stuff that we toss that cats find delicious and good for them.)

comment by thesdr · 2023-06-02T09:42:05.520Z · LW(p) · GW(p)

"it’s deeply emotionally and morally charged for one side in a conversation, and often a vague irritant to the other."

Very true, as a vegan I find non-vegans can become highly emotionally volatile when they want to talk about why I want to do what I'm doing, and it gets pretty irritating.

Replies from: pktechgirl, lelapin
comment by Elizabeth (pktechgirl) · 2023-06-02T19:25:13.650Z · LW(p) · GW(p)

When I was vegetarian (for complicated digestive reasons) I met omnivores who were deeply invested in my choice and demanded a bunch of justification and emotional management around it, and it was super irritating. I just wanted to eat my peas in peace. To the extent that's what's happening to you: I'm sorry, yeah, that sucks. People feeling entitled to have your diet meet their standards is bad in all forms. 

comment by Jonathan Claybrough (lelapin) · 2023-06-02T18:44:12.140Z · LW(p) · GW(p)

It's standard that the morally charged side in a veganism conversation is from people who argue for veganism. 
Your response reads as snarky, since you pretend to have understood the contrary. You're illustrating op's point, that certain vegans are emotionally attached to their cause and jump to the occasion to defend their tribe. If you disagree to being pictured a certain way, at least act so it isn't accurate to depict you that way.

Replies from: Making_Philosophy_Better
comment by Portia (Making_Philosophy_Better) · 2023-06-02T22:30:49.533Z · LW(p) · GW(p)

Honestly, I have seen intense emotional responses on both sides. While yes, nearly all vegans are emotionally invested (because we made a conscious choice based on sincere beliefs to change daily habits, so we clearly cared), I've been surprised at the intensity of emotional reactions I have seen in omni people when they realise someone is vegan, even if the vegan does literally nothing beyond personally refraining from eating animal products. I've had people get genuinely angry at me and give unprompted and ludicrous lectures about plant sentience when they realised I wasn't eating the meat, or give long and comprehensive histories of why they can't go vegan, when I never asked. Similar to turning down cake at a party, and realising the person next to me suddenly feels a strong need to justify their cake consumption to me, when I really do not give a shit whether she eats cake or whether she had breakfast and how long she worked out today, but apparently, she really needs me to know now. Food is just a really emotional topic. I remember being a teenager, and being asked to sign some bizarre petition at my vets to get our government to put pressure on China to stop people from eating dogs. And I said why, I eat pigs, they are equally sentient, seems hypocritical to me, I'm not signing that. The next ten min, I thought I was going to get literally quartered by the (equally pig eating) dog owners in the waiting room. Because I refused to condemn other people for the animals they were eating. It was surreal.

Replies from: lelapin
comment by Jonathan Claybrough (lelapin) · 2023-06-04T23:19:32.836Z · LW(p) · GW(p)

I focused my answer on the morally charged side, not emotional. The quoted statement said A and B so as long as B is mostly true for vegans, A and B is mostly true for (a sub-group) of vegans. 

I'd agree with the characterization "it’s deeply emotionally and morally charged for one side in a conversation, and often emotional to the other." because most people don't have small identities and do feel attacked by others behaving differently indeed. 

comment by AnthonyC · 2023-06-01T19:58:47.465Z · LW(p) · GW(p)

I think, in full generality, "Nutrition is complicated and multidimensional, and the more you restrict along any axis for any reason the more tradeoffs you need to make and considerations you need to take to ensure you're getting what you need."

I'm also not sure if relying on traditional vegan dishes and cuisines is sufficient, if your metabolic context is very different otherwise? E.g. I suspect a farm worker who needs to eat 4000 kcal/day to do all his physical labor has to worry a lot less about specific food choices to ensure he gets enough of key micronutrients, and just eating a reasonable amount of variety is usually going to be good enough. Getting everything you need from, say, 1500 kcal/day is a lot harder, and if you cut out a whole subset of the most nutrient dense foods on top of that you will likely miss something. Maybe majorly, and it shows up in bloodwork at your next physical. Maybe only slightly, in a way that takes months to years to notice and then is similarly hard to pinpoint and that no one else around you thinks is a thing.

comment by Roko · 2023-06-04T14:12:18.210Z · LW(p) · GW(p)
comment by Roko · 2023-06-02T13:20:15.176Z · LW(p) · GW(p)Replies from: pktechgirl, lelapin, Making_Philosophy_Better
comment by Elizabeth (pktechgirl) · 2023-06-02T18:31:47.809Z · LW(p) · GW(p)

I have attempted to delete this comment for being off topic. I asked veganism's advocates to stick to health and nutritional issues in their responses and while it didn't occur to me to explicitly ask the same of critics, I think that's only fair. However the UI is failing and I'm about to enter some meetings. Please don't respond, I intended to delete it as soon as the option is available. 

comment by [deleted] · 2023-06-04T08:59:48.528Z · LW(p) · GW(p)