Omnivores, Vegetarians and Big Babies

On Feb. 2, 2003, Dr. John McDougall posted a long response to the CDC’s reporting on a couple of cases of babies who suffered from B12 deficiencies due to their mother’s poor vegetarian diets. McDougall was outraged at the report characterizing it as “sensationalism” whose primary purpose was to reinforce people’s feelings about their “own bad habits” (i.e. including meat in their diets).

McDougall himself was not above sensationalism, however, in his criticism of “the Western diet.” For example, McDougall wrote,

For the unborn infant the consequences of mother following the Western diet are:

1) An abnormally large baby that is too big to fit through the mother’s birth canal, and therefore requiring a caesarean section — the medical description is “failure of progression of labor.”(1) Twenty-five percent of mothers deliver by this major surgery in the USA.

There are a couple of problems with this statement. First, the reader might assume that McDougall cites a study of caesarean sections and birth weights with his reference there, but instead the reference simply directs readers to one of McDougall’s books, The McDougall Program for Women.

The reality is that the percentage of cesareans in the United States has fluctuated wildly over the last 20 years, and has reached the 25 percent level for a variety of reasons which appear to be largely unrelated to birth weight.

First, many women appear to be opting for caesarean births rather than undergo vaginal births to avoid the pain and potential long term health effects of vaginal delivery. Second, both doctors and mothers appear to be using C-sections to better time births. Finally, legal and medical concerns are leading to Caesarean sections today where in the past a vaginal birth would have likely been attempted.

What role, if any, larger babies play in that mix is up in the air, but there is one thing we do know about babies — the bigger they are, up to a point, the lower the risk of infant mortality.

Here’s a breakdown from 1996 live births of the infant mortality rate by birth weight:

So, to keep infant mortality as low as possible, the ideal would be for infants to get as close to possible to the 4,000 g. level as possible. Infant mortality only starts increasing after infants pass the 4,500 g. level, but births that large constituted only 1.5 percent of all live births in 1996.

In contrast, the real weight-related health problem for babies is low birth weight, with births under 2,500 grams constituting a steady 7 percent of all births in the United States (though, to be fair, part of this increase in low birth weights is due to the dramatic changes in medical treatment for premature infants over the past 30 years).

If McDougall is right then — that “the Western diet” is leading to babies with higher birth rates — the appropriate response is: thank goodness for the Western diet!

Similarly McDougall makes inane comments about folic acid deficiency,

2) Thousands of birth defects annually, of which most are known to be due to too little folic acid in the expectant mother’s diet. Folic acid is from foliage, in other words, plants. . .. You will never see folic acid deficiency in a healthy vegan mother.

Of course, you won’t see folic acid deficiency in a healthy omnivore either. The main cause of folic acid deficiencies are poor diets.

Moreover, the reason folic acid is important is because it lowers levels of homocysteine. But research on vegetarians and vegans as found they tend to have homocysteine levels that are 20 to 30 percent higher than omnivores.

And since this all started with B12 deficiencies, that same research found that 78 percent of screened vegetarians and 26 percent of screened vegans had levels of B12 that were clinically deficient compared to none of the screened omnivores.

Since the science doesn’t support his position, McDougall falls back on unspecific generalities,

If you have any doubts about the wisdom of a healthy vegan diet then look around your neighborhood. Children on B-12-sufficient diets with lots of ice cream, milk, hot dogs, egg muffins, and chicken nuggets are fat and sick.

That’s a nice little rhetorical trick, to pretend that the only possible omnivorous diet must be an unhealthy fast food one. McDougall continues,

The obvious signs and symptoms are snotty noses, ear infections, stomach aches, and headaches. Get to know them better and you will find them constipated with bloody bowel movements. The pain and suffering inflicted on children by the American diet is so brutal that if it were administered with a stick, parents would put in jail. Because the instruments of injury are a fork and spoon, everyone ignores the agony as if nothing was out of the ordinary, and nothing could be done to remedy the problems — you know so well that is not true.

Translation: when all else fails, rant or go straight to irrational appeals,

First, have faith that a low-fat vegan diet, based around unrefined starches, vegetables and fruits, is the healthiest diet for men, women and children (after the age of 2 years).

Amen brother, preach that vegan gospel. Don’t worry though, McDougall has a nutty explanation and suggestion on why the vegan diet is deficient in B12 and how to get around it,

You might ask, “Why would a [vegan] diet so perfect in all other ways be deficient in a necessary vitamin?” Most likely the answer is that we live in an unnatural world these days. Remember, B-12 is made by bacteria. Our world is sterilized because of an irrational fear of germs. Once people consumed trillions of helpful B-12 producing bacteria daily — they lived with their chickens, goats, and horses. Today everything is sanitized by hand-washing, antiseptics, antibiotics, mouth washes, and cleaning agents. To compensate, we must add back B-12 or possibly, live more naturally, like I do, with my B-12 producing dog, cat, and birds.

Huh? People long ago received B-12 much like omnivores do today — they consumed meat laden with the bacteria that produce it. Plants might have some B-12 bacteria, but most of it is eliminated when the food is washed and otherwise prepared for eating.

If mouthwashes and antiseptics are responsible for killing off the B-12 bacteria, it’s odd that omnivores don’t suffer from this problem. The reality, of course, is that the vegan diet is not perfect and (like other diets, including the Western diet) has a number of nutritional challenges that must be properly accounted for in order to be healthy.

Sources:

Vegan diet damages baby’s brain — sensationalism! John McDougall, February 2003.

One-quarter of all births done by Caesarean section. Washington Post, December 16, 2002.

Caesarean births on the rise. Associated Press, June 6, 2002.

Big rise in Caesarean births. The BBC, August 9, 2000.

Study finds efforts to reduce rate unsuccessful. Associated Press, November 7, 2002.

Live Births, Infant Deaths, And Infant Mortality Rates By Birth Weight, Race Of Mother, And Age At Death: United States, 1996 Period Data. Centers for Disease Control.

Vegetarians and Vegans Have Elevated Homocysteine Levels. Annals of Nutrition and Metabolism 2000;44:135-138.