Recent research out of India has indicated that as the country has become more developed, rates of coronary artery disease and heart disease in general have increased.
Some have erroneously applied the cause to vegetarianism. As the theory goes, vegetarians do not get enough B12, and this has caused the increase in heart disease in India.
The study (Kumar et al. 2009) that is being quoted tested 386 coronary artery disease patients and 448 control subjects for vitamin B12 deficiency, homocysteine and cysteine levels. In this test, the heart disease patients had lower levels of vitamin B12 and higher levels of cysteine. The researchers were puzzled by this, because they expected higher levels of homocysteine, not cysteine.
The researchers assumed that vegetarianism caused the B12 deficiency because most of the B12 deficient people were vegetarian (but so are a lot of people in India), so vegetarianism must be at the root of the coronary artery disease. Right?
Numerous studies over the past four decades have illustrated that vegetarians have lower rates of heart disease worldwide, and meat-eating increases the rate of heart disease. Furthermore, countries with the highest meat diets have the highest rates of heart disease (Jolliffe and Archer 1959).
Just to name a few recent studies, researchers from Harvard’s Department of Nutrition (Bernstein et al. 2010) followed 84,136 women between 30-55 years old for 26 years. Those who ate the most red meat had the highest heart attack rates.
In a study by Spain’s University of Madrid School of Medicine researchers (Guallar-Castillón et al. 2010), 40,757 people between the age of 29 and 69 years old were followed for eleven years. They found that lower-meat consumption (Mediterranean diet) was associated with significantly lower risks of coronary heart disease.
The Physicians Health Study by researchers at Boston University’s School of Public Health (Ashaya et al. 2010) followed 21,120 men with an average age of 55 years old from 1982 to 2008. They found that red meat consumption was associated with higher risks of heart failure. Furthermore, they found that the more red meat consumed, the higher the risk.
The assumption that vegetarian diets lead to B12 deficiencies is also a false one. Among developing countries vitamin B12 deficiency is increasing across the board, especially so amongst countries known for their meat diets.
In a review of B12 deficiency around the world by University of Colorado researchers (Stabler and Allen 2004), Europeans have one of the highest levels of B12 deficiency in the world, along with South Americans, Central Americans, Africans and Mexicans. These are not countries known for being vegetarian. In fact, these countries have some of the highest meat-eating rates.
Furthermore, most of the vegetarians of India consume cow’s milk, a rich source of vitamin B12 (however, many in the poor regions may not have adequate dairy availability).
The fact is, B12 deficiency, or pernicious anemia – an inability to absorb vitamin B12 – is a complex disorder that may involve the loss of intrinsic factor, a lack of intestinal receptor sites, sprue, gluten allergy, ileitis, or even parasites. A lack of probiotics, or other intestinal problems may also be at issue (another topic altogether). Helicobacter pylori infections in the stomach and upper intestines have also been shown to block B12 absorption.
Curiously, some of the same regions mentioned above by Stabler and Allen are also areas known for higher levels of H. pylori infections. In a study from researchers from Turkey’s Gülhane Military Medical Academy (Kaptan et al. 2000), 77 of 138 patients suffering from vitamin B12 deficiency were infected by H. pylori. Eradication of H. pylori led to healthy levels of B12 absorption and a reversal of B12 deficiency symptoms in 40% of the patients. Others likely had some of the other absorption problems mentioned above.
In a study from Sweden’s University of Gothenburg (Lewerin et al. 2008), elderly subjects with B12 deficiencies also had higher levels of gastritis and H. pylori antibodies.
Both of these above studies came from regions known for high meat consumption.
Furthermore, among Americans, where a meat diet is widespread, 10-15% of people over the age of 60 has B12 deficiency according to research from the USDA’s Human Nutrition Research Center on Aging at Tufts University (Baik and Russell 1999).
In other words, it is no surprise that coronary artery disease patients in an Indian Hospital are low in vitamin B12, because B12 is associated with coronary artery disease, and most people in India are vegetarian.
Like many other developing countries, India is experiencing more heart disease because of its increase in refined, foods, processed foods and fried foods. These foods damage intestinal health, promote free radicals, and are nutrient-poor. They also burden intestinal probiotics. Frying foods also produces acrylamide (Ehling et al. 2005). Acrylamide (another topic to discuss later in more depth) can lower the body’s levels of glutathione, which may well be why the Indian patients in the Kumar study mysteriously had high levels of cysteine (a component of metabolized glutathione.) And it is also interesting that countries with higher levels of B12 deficiency also happen to be developing countries known for diets high in fried foods.
Furthermore, why would heart disease be growing in India only recently? Indians have been primarily vegetarian for thousands of years. Only over the past few years have they had an increasing diet of refined and processed foods. Their former diets maintained more whole food diets than today.
Assuming healthy B12 digestive absorption, vegetarians can get plenty of B12 from milk, yogurt, whey, butter, cheese, nutritional yeast, malted foods and probiotic (cultured) foods. Vegans may have to look to nutritional yeast, cultured foods, fortified foods and supplements for their B12.
One of the messages here is that just being vegan or vegetarian doesn’t necessarily mean a healthy diet. Vegans and vegetarians can eat junk food too.
Primarily plant-based, whole food diets, together with B12 sources mentioned above, have been scientifically shown to reduce the risk of heart disease.
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