“What the Health,” a recent Netflix documentary showcasing the perils of consuming animal protein and animal products, has created a firestorm of controversy. The film targets a grand number of industries in an attempt to argue they are not only in cahoots with each other, but are even actively making people sick for their profit. These grandiose claims are supported by either clever utilization of writing and video editing, interviews with well-known skeptics, or arguably faulty or unsubstantiated research. Perhaps this article can allow me to draw on my English-Major-Turned-Personal-Trainer skills to shed some light on concepts found within the film, ranging from the stylistic composition of it, and of course, the research and arguments proposed within.
What We Should Understand First:
Kip Andersen, along with Keegan Kuhn, the writers, producers, and directors of “What the Health,” have previously published a work known as “Cowspiracy: The Sustainability Secret,” a documentary trying to reveal the environmental footprints that animal agriculture practices are leaving. Both “What the Health” and “Cowspiracy: The Sustainability Secret” were heavily crowd-funded and drew famous supporters, science-community controversy, and responses have been fairly moderate in both praise and criticism.
Amongst the professionals interviewed in the film, the most noticeable trend between them is their own almost-lifelong advocacy for plant-based eating and avoidance of animal protein and products. These physicians, cardiologists, and researchers, have extensively written about plant-based diets with avoidance of animal products. Some have made the New York Times Best-Seller list, while others have run their own clinics, speak around the world, or sell their own health-products.
Watching the Film:
We open with a compelling start; an interview with Dr. Robert Ratner, accomplished researcher and professor, specializing in endocrinology and metabolic science, and currently the Chief Scientific and Medical Officer of the American Diabetes Association. He explains that Diabetes is taking a huge toll on the people worldwide, both as an epidemic and American economic issue. Our director, Kip, asks a seemingly simple question: “What in particular is the correlation between diet and diabetes?”
Dr. Ratner: “I’m not gonna get into that.”
Kip: “Into diet?”
Dr. Ratner: “No.”
The opening credits begin, and we’re ready for our ride. Having seen this, we’ve begun with a precedent: that a medical practitioner and head of a large health organization is avoidant answering a seemingly “simple” question. The viewer is both suspicious, and intrigued.
The film’s segments include:
The Analysis
If we as an audience can disregard:
We can see there’s a glaring misuse of research. In the research setting, there are very, very few things that can be considered “causal”- as in, we can attribute this thing as the exact reason a result happened. We can use causal arguments regarding cigarette smoking; it will cause cancer, given the overwhelming results of research across the globe. However, the majority of research finds correlations; eating less processed, fatty meat is likely to reduce your risk of Coronary Heart Disease, or Cardiovascular related instances.
In the film, Kip (and by proxy, Keegan) scrolls over snapshots of studies he paraphrased from. Luckily, with the advanced pause/play technology of Netflix and our T.V. remotes, we can find the names of those studies and see them for ourselves. Two examples:
Kip’s claim for the former was, “… when a Harvard university study showed that men with prostate cancer who eat large amounts of chicken, increase their risk of the disease progression 4x”. When this is written out, it seems straightforward when taken literally. However, the film’s framework implies that the study concluded eating more chicken makes your cancer worse. However, we’ll see the conclusions drawn are:
We can concede to Kip that his claim did corroborate the study, in the event his paraphrased words did pinpoint the men already had prostate cancer. The issue here isn’t that his words were literally correct—the issue is his argument attempted to frame chicken as a means of advancing cancer, and what the study actually concluded was:
“Our results suggest that the post-diagnostic consumption of processed or unprocessed red meat, fish, or skinless poultry is not associated with prostate cancer recurrence or progression, whereas consumption of eggs and poultry with skin may increase the risk.”
When the term “may” is used, it’s a defense of the outstanding potentialities existing outside of the study, or rather, factors which aren’t controlled within the study. So while the research can look at an individual’s consumption of processed meats, chicken, or eggs, and correlate it to the fact the participant’s cancer is progressing, they can’t causally indicate the chicken is what’s making the cancer progress. Which leads to the latter study:
Kip implies through his argument that “Big Dairy” is sponsoring research studies on dairy products and their health outcomes, and implies that the Dairy industry in America is fabricating favorable research so they can keep promoting their products. This is a very valuable point the audience should be aware of. Big companies do sponsor research, the ramifications of which we don’t know. However, we should knit-pick this claim, too.
In the second study highlighted above, we shouldn’t forget it’s a meta-analysis. What this means is it’s not standalone research; it’s a review of a compilation of studies with similar concepts.
The research overseen within this meta-analysis ranged from places such as Japan, to Great Britain, to Israel. Meaning, the findings on Cardiovascular Disease or Coronary Heart Disease weren’t all conducted in America with American diets. Lastly, the meta-analysis concluded that there is “no significant evidence for concluding that dietary saturated fat is associated with an increased risk of CHD {Coronary Heart Disease] or CVD [cardiovascular disease].”
Even if we can follow the claim that the results were “fishy” and showed no negatives and was sponsored by “Big Dairy,” and even if we can say it’s even more fishy that results were determined from Non-American Diets, it still holds less bearing on the research of dairy fat in the American Diet, making Kip’s claims about dairy in the American diet causing CHD and CVD as weak at best.
American Health Organization’s Guidelines:
American Heart Association Guidelines: Summary
Eating for general health, one must eat a variety of fruits and vegetables, whole grains, low-fat dairy products, skinless poultry and fish, nuts and legumes, non-tropical vegetable oils, and to limit saturated fat, trans fat, sodium, red meat, sweets and sugar-sweetened beverages. If red meat is chosen, eat the leanest cuts available.
American Cancer Society Guidelines: Summary
For most Americans who do not use tobacco, body weight, diet, and physical activity are the most important risk factors that are manageable. About 20% of all cancers diagnosed in the U.S. are related to “body fatness, physical inactivity, excess alcohol consumption, and or poor nutrition, and thus, can be prevented.” Genetics influence risk of cancer, but most factors between groups are not associated with genetics—previously stated behaviors are also linked with a higher risk of developing heart disease and diabetes. Environment plays a key role in success or failure to live healthier lifestyles.
American Diabetes Association Guidelines: Summary
Eat frequently, limit trans and saturated fats to proposed limits, limit dietary cholesterol and sodium, and gives stringent guidelines on the number of carbohydrates per meal, their sources, and adequate fiber intake. These instructions go hand-in-hand with proposed dietary options and meals.
Conclusions and Opinions:
One of the main points I’d like to get across is that in research, or in writing, or in healthcare, or in documentaries, is that the audience, patient, or clients, need to trust the one bringing the information to us. Kip (and Keegan) are what we consider an unreliable source; these arguments should be much better organized, succinct, and shouldn’t require obscene metaphors, video splicing, scripted interview scenes, biased speakers, or general false tomfoolery. Examples:
With this said, we can look to the following as barometers to help guide us in our viewing and conclusions:
“There is a growing movement to create a more honest and evidence-based approach to vegan nutrition, though. And those of us who value this effort need to be a more visible presence in the animal rights community. We can’t allow our voices to be drowned out by the pseudoscientific noise. We need the non-vegan world to know that it is possible to stand in support of animal rights while embracing scientific integrity.”
“There are undisputed health advantages to a plant-based diet, but the evidence is insufficient to recommend that everyone adopt a vegan diet. The What the Health movie is not a balanced documentary, but an alarmist, biased polemic. It cherry-picks scientific studies, exaggerates, makes claims that are untrue, relies on testimonials and interviews with questionable “experts,” and fails to put the evidence into perspective. It presents no evidence to support the claim that a vegan diet can prevent and cure all the major diseases. It is simply not a reliable source of health information.”
Closing Arguments
This documentary, much like Morgan Spurlock’s “Supersize Me”, is flawed in its research and fear-mongering in its conclusions, with fabrication used to expound on arguments. Yet, due to Spurlock’s efforts, we now have calorie totals and macronutrient breakdowns on fast-food menus in the U.S. The discussion of “how bad is fast-food, really?” became a national headline. And now, thanks to “What The Health,” we have new concepts being thrown back into the forefront of national consideration:
This documentary is correct in touting the health benefits of whole-foods; more specifically, the things that grow in trees or out of the ground. While it demonized animal protein, it should have taken a more mild approach and explained the difference between high-quality protein sources, and low-quality (bacon, sausage, certain cuts of meat and ground beef, etc).
Finally, this documentary also overlooked providing valuable information to the viewer; that established nutrition practices understand limiting red-meat consumption, increasing fiber intake, having a variety of complex carbohydrates, and staying within a healthy activity range, are optimally better than not. Pair this with a protocol that touts moderation in all things and being smart about what goes into one’s body.
If I were to provide any information that makes sense to me, and one wants to improve their quality of life, psychologically, emotionally, and physically, it’s well established following the below:
Thanks to everyone’s suggestions, recommended reading, and of course, Kip Andersen for sparking such a national conversation. Without people like Kip, perhaps we wouldn’t even be talking about this so fervently.
Please feel free to contribute in the comments; this conversation is valuable, and I'm very open to discussion and also to editing suggestions if necessary!
What We Should Understand First:
Kip Andersen, along with Keegan Kuhn, the writers, producers, and directors of “What the Health,” have previously published a work known as “Cowspiracy: The Sustainability Secret,” a documentary trying to reveal the environmental footprints that animal agriculture practices are leaving. Both “What the Health” and “Cowspiracy: The Sustainability Secret” were heavily crowd-funded and drew famous supporters, science-community controversy, and responses have been fairly moderate in both praise and criticism.
Amongst the professionals interviewed in the film, the most noticeable trend between them is their own almost-lifelong advocacy for plant-based eating and avoidance of animal protein and products. These physicians, cardiologists, and researchers, have extensively written about plant-based diets with avoidance of animal products. Some have made the New York Times Best-Seller list, while others have run their own clinics, speak around the world, or sell their own health-products.
Watching the Film:
We open with a compelling start; an interview with Dr. Robert Ratner, accomplished researcher and professor, specializing in endocrinology and metabolic science, and currently the Chief Scientific and Medical Officer of the American Diabetes Association. He explains that Diabetes is taking a huge toll on the people worldwide, both as an epidemic and American economic issue. Our director, Kip, asks a seemingly simple question: “What in particular is the correlation between diet and diabetes?”
Dr. Ratner: “I’m not gonna get into that.”
Kip: “Into diet?”
Dr. Ratner: “No.”
The opening credits begin, and we’re ready for our ride. Having seen this, we’ve begun with a precedent: that a medical practitioner and head of a large health organization is avoidant answering a seemingly “simple” question. The viewer is both suspicious, and intrigued.
The film’s segments include:
- 1. A combative phone call with Sam, the Cancer Information Specialist, who answered the phone for the American Cancer Society (amongst other uninitiated representatives),
- 2. Soundbites from the aforementioned doctors, cardiologists, clinical nutrition specialists with arguably skeptic claims,
- 3. Interviews with decrepit citizens taking prescription drugs,
- 4. Footage of a visit with a woman in the outskirts of a North Carolina agriculture center,
- 5. Verbiage from unlisted studies that the viewers haven’t been party to, and which a large portion of the audience wouldn’t be able to find, peer review, and form an opinion,
The Analysis
If we as an audience can disregard:
- 1. The animation splices (including a fictional mother cooking sausage and cigarettes for her children’s breakfast, image of a pregnant woman eating red, glowing dairy products during the discussion on Dioxins, making her glow red), or
- 2. The use of leading questions (phone calls), apocalyptic metaphors (percentage of the population dying from anti-biotic resistance is “equivalent to 4 jumbo airliners crashing every hour, every day”), or
- 3. The proposition of systematic civil-rights issues in the agriculture and food industries, and
- 4. The confirmation bias of the professionals within,
We can see there’s a glaring misuse of research. In the research setting, there are very, very few things that can be considered “causal”- as in, we can attribute this thing as the exact reason a result happened. We can use causal arguments regarding cigarette smoking; it will cause cancer, given the overwhelming results of research across the globe. However, the majority of research finds correlations; eating less processed, fatty meat is likely to reduce your risk of Coronary Heart Disease, or Cardiovascular related instances.
In the film, Kip (and by proxy, Keegan) scrolls over snapshots of studies he paraphrased from. Luckily, with the advanced pause/play technology of Netflix and our T.V. remotes, we can find the names of those studies and see them for ourselves. Two examples:
- 1. Intakes of meat, fish, poultry, and eggs and risk of prostate cancer progression
- 2. Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease
Kip’s claim for the former was, “… when a Harvard university study showed that men with prostate cancer who eat large amounts of chicken, increase their risk of the disease progression 4x”. When this is written out, it seems straightforward when taken literally. However, the film’s framework implies that the study concluded eating more chicken makes your cancer worse. However, we’ll see the conclusions drawn are:
- 1) post-diagnostic consumption of processed and unprocessed red meat, fish, poultry, and eggs and the risk of prostate cancer recurrence or progression, and
- 2) the observation of 127 events (prostate cancer death or metastases [cancer moving elsewhere in the body], elevated prostate-specific antigen concentration [a marker for advancing cancer], or secondary treatment).
We can concede to Kip that his claim did corroborate the study, in the event his paraphrased words did pinpoint the men already had prostate cancer. The issue here isn’t that his words were literally correct—the issue is his argument attempted to frame chicken as a means of advancing cancer, and what the study actually concluded was:
“Our results suggest that the post-diagnostic consumption of processed or unprocessed red meat, fish, or skinless poultry is not associated with prostate cancer recurrence or progression, whereas consumption of eggs and poultry with skin may increase the risk.”
When the term “may” is used, it’s a defense of the outstanding potentialities existing outside of the study, or rather, factors which aren’t controlled within the study. So while the research can look at an individual’s consumption of processed meats, chicken, or eggs, and correlate it to the fact the participant’s cancer is progressing, they can’t causally indicate the chicken is what’s making the cancer progress. Which leads to the latter study:
Kip implies through his argument that “Big Dairy” is sponsoring research studies on dairy products and their health outcomes, and implies that the Dairy industry in America is fabricating favorable research so they can keep promoting their products. This is a very valuable point the audience should be aware of. Big companies do sponsor research, the ramifications of which we don’t know. However, we should knit-pick this claim, too.
In the second study highlighted above, we shouldn’t forget it’s a meta-analysis. What this means is it’s not standalone research; it’s a review of a compilation of studies with similar concepts.
The research overseen within this meta-analysis ranged from places such as Japan, to Great Britain, to Israel. Meaning, the findings on Cardiovascular Disease or Coronary Heart Disease weren’t all conducted in America with American diets. Lastly, the meta-analysis concluded that there is “no significant evidence for concluding that dietary saturated fat is associated with an increased risk of CHD {Coronary Heart Disease] or CVD [cardiovascular disease].”
Even if we can follow the claim that the results were “fishy” and showed no negatives and was sponsored by “Big Dairy,” and even if we can say it’s even more fishy that results were determined from Non-American Diets, it still holds less bearing on the research of dairy fat in the American Diet, making Kip’s claims about dairy in the American diet causing CHD and CVD as weak at best.
American Health Organization’s Guidelines:
American Heart Association Guidelines: Summary
Eating for general health, one must eat a variety of fruits and vegetables, whole grains, low-fat dairy products, skinless poultry and fish, nuts and legumes, non-tropical vegetable oils, and to limit saturated fat, trans fat, sodium, red meat, sweets and sugar-sweetened beverages. If red meat is chosen, eat the leanest cuts available.
American Cancer Society Guidelines: Summary
For most Americans who do not use tobacco, body weight, diet, and physical activity are the most important risk factors that are manageable. About 20% of all cancers diagnosed in the U.S. are related to “body fatness, physical inactivity, excess alcohol consumption, and or poor nutrition, and thus, can be prevented.” Genetics influence risk of cancer, but most factors between groups are not associated with genetics—previously stated behaviors are also linked with a higher risk of developing heart disease and diabetes. Environment plays a key role in success or failure to live healthier lifestyles.
American Diabetes Association Guidelines: Summary
Eat frequently, limit trans and saturated fats to proposed limits, limit dietary cholesterol and sodium, and gives stringent guidelines on the number of carbohydrates per meal, their sources, and adequate fiber intake. These instructions go hand-in-hand with proposed dietary options and meals.
Conclusions and Opinions:
One of the main points I’d like to get across is that in research, or in writing, or in healthcare, or in documentaries, is that the audience, patient, or clients, need to trust the one bringing the information to us. Kip (and Keegan) are what we consider an unreliable source; these arguments should be much better organized, succinct, and shouldn’t require obscene metaphors, video splicing, scripted interview scenes, biased speakers, or general false tomfoolery. Examples:
- Kip’s use of fabrication is insulting to the viewer: such as portraying Michael, Amy, and Jane as decrepit, all in dark clothing, in dark spaces, and then showing them “after 2 weeks” on a plant-based diet as totally healed, in flourishing colors, and bright, outdoorsy spaces.
- Kip’s use of a handful of speakers who, when reading their bios, are all within the same networks (board members together, funding each other's research, starting websites together, and appearing in multiple plant-based eating documentaries together), publishing similar material, living similar lifestyles, is disingenuous to the research that doesn’t wholly agree with what’s been highlighted. A stronger film criticizing medical industries, pharmaceutical industries, the agriculture and food industries, and civil rights in disease prevention, would have used less inflammatory pseudo-propaganda, and could have entertained some cynicism.
- Kip’s use of vegan athletes to finish the documentary only stands to imply “vegan lifestyles can make you strong, too” as one of the major arguments of vegan eating is a lack of performance or vital nutrients.
With this said, we can look to the following as barometers to help guide us in our viewing and conclusions:
- Virginia Messina, RD, and Vegan author of A Vegan Dietician Reviews ‘What The Health’:
“There is a growing movement to create a more honest and evidence-based approach to vegan nutrition, though. And those of us who value this effort need to be a more visible presence in the animal rights community. We can’t allow our voices to be drowned out by the pseudoscientific noise. We need the non-vegan world to know that it is possible to stand in support of animal rights while embracing scientific integrity.”
- Dr. Harriet Hall writes in her article “What the Health- A Movie With An Agenda”:
“There are undisputed health advantages to a plant-based diet, but the evidence is insufficient to recommend that everyone adopt a vegan diet. The What the Health movie is not a balanced documentary, but an alarmist, biased polemic. It cherry-picks scientific studies, exaggerates, makes claims that are untrue, relies on testimonials and interviews with questionable “experts,” and fails to put the evidence into perspective. It presents no evidence to support the claim that a vegan diet can prevent and cure all the major diseases. It is simply not a reliable source of health information.”
- A slew of other established nutrition and exercise science specialists have also voiced their concerns.
Closing Arguments
This documentary, much like Morgan Spurlock’s “Supersize Me”, is flawed in its research and fear-mongering in its conclusions, with fabrication used to expound on arguments. Yet, due to Spurlock’s efforts, we now have calorie totals and macronutrient breakdowns on fast-food menus in the U.S. The discussion of “how bad is fast-food, really?” became a national headline. And now, thanks to “What The Health,” we have new concepts being thrown back into the forefront of national consideration:
- a. Our current animal-product production and agricultural practices, raising animals, and standards of quality, are being analyzed heavily,
- b. An open discussion on how money influences science and medicine,
- c. An open discussion on how much animal protein is really needed for human health,
- d. An open discussion on how valuable dairy is in human health,
- e. Revitalizing the concepts that vegetables, fruits, and complex foods not found in bags and boxes is necessary for average optimal health,
- f. An open discussion on the ethics of research, both in the lab, and with a camera,
- g. The value of propaganda and its powers,
- h. Despite our respect for research, doctors, and medicine, we can openly discuss lifestyle changes that keep you out of the doctor’s office, and
- i. Not all experts and specialists agree, as not all engineers, architects, or businesspeople agree, despite all of their myriad successes.
This documentary is correct in touting the health benefits of whole-foods; more specifically, the things that grow in trees or out of the ground. While it demonized animal protein, it should have taken a more mild approach and explained the difference between high-quality protein sources, and low-quality (bacon, sausage, certain cuts of meat and ground beef, etc).
Finally, this documentary also overlooked providing valuable information to the viewer; that established nutrition practices understand limiting red-meat consumption, increasing fiber intake, having a variety of complex carbohydrates, and staying within a healthy activity range, are optimally better than not. Pair this with a protocol that touts moderation in all things and being smart about what goes into one’s body.
If I were to provide any information that makes sense to me, and one wants to improve their quality of life, psychologically, emotionally, and physically, it’s well established following the below:
- Take time out of your day to disconnect from stress; better sleep, meditation, mindfulness.
- Eat high-quality animal protein in constructive amounts. The Academy of Nutrition and Dietetics recommends that the average individual should consume 0.8 grams of protein per kilogram or 0.35 grams per pound of body weight per day for general health, or roughly 70g of protein for a 200 lbs individual. And if you’re an athlete, eat a little bit more protein. And if you fall into a plethora of other spectrums of protein requirements, consult a professional.
- Eat fibrous foods, leafy greens, vegetables of all shapes and sizes, and drink water until you’re not thirsty, often.
- Eat complex carbohydrates more often than simpler ones, and,
- Eat simpler carbohydrates closer to activity time (before and after).
- Eat slowly enough to feel when you’re full and stop there.
- Lastly, as a human adult, perhaps consider limiting dairy intake, as the majority of us are lactose intolerant in some form or fashion, due to enzymatic changes in our small intestine after infancy.
Thanks to everyone’s suggestions, recommended reading, and of course, Kip Andersen for sparking such a national conversation. Without people like Kip, perhaps we wouldn’t even be talking about this so fervently.
Please feel free to contribute in the comments; this conversation is valuable, and I'm very open to discussion and also to editing suggestions if necessary!
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