deserved. Numerous studies have shown that diets higher in fiber, fruits, and vegetables and lower in saturated fats (such as vegetarianism, though it is not the only such diet, of course) are considerably healthier than the SAD when looking at certain degenerative diseases.
"Failure to thrive" is usually mild and unrecognized as such at first. However, there is another side to the vegetarian story that rarely gets talked about, which is the phenomenon known as "failure to thrive" (FTT). Normally this term is used to describe infants who fail to do well or to meet minimum standards for growth and development, due to some shortfall in the standard of care received. However, the term can also be applied to anyone not doing well health-wise when they might otherwise be expected to.
Where vegetarianism is concerned, it means that despite following prudent recommendations for the diet, some people simply do not experience the best health, or, put differently perhaps, "well-being." This can range anywhere from mild symptoms such as:
Prudent vegetarian diets are sufficient "on paper." Usually, since well-planned vegetarian diets are sufficient on paper, overt deficiencies are rare (other than of vitamin B-12 occasionally in pure vegans not taking a supplement). However, there is much that is still being discovered about nutrition, and--as is discussed elsewhere on the site--given that vegetarian diets are not the kind of diet that the human species evolved on, it may be there are dietary factors, particularly micronutrients, that don't measure up on diets that significantly deviate from our natural one. Or some elements in the diet may not be extracted as efficiently from plant foods, whether in general, or by certain individuals. (See Timeline of Dietary Shifts in the Human Line of Evolution for a footnoted discussion of dietary developments indicating the diet the human species is naturally adapted to. Also see Key Nutrients vis-a-vis Omnivorous Adaptation and Vegetarianism for a discussion of differences between plant and animal foods in absorption efficiency of certain dietary nutrients.)
- Lassitude or "being hungry all day" and "not feeling satisfied," as described above; to
- Poor sex drive or poor-quality sleep; to
- Behavioral effects such as not being able to get one's mind off food (not uncommon if one is not feeling physically satiated or otherwise satisfied on the diet), or
- The yo-yo syndrome of not being able to stay on the diet consistently due to cravings; to
- Emotional effects such as a vague, nonspecific loss of zest for life (which is usually more apparent to other people than to the person themselves); to
- Actual deficiencies in some cases.
But even allowing for the somewhat "covert" or subliminal nature of the above kinds of early or mild symptoms that might predispose people to believe FTT is not really real in the first place, what are the other reasons why FTT doesn't get talked about much? There are a few separate ones:
- The self-selection effect among long-term (successful) vegans screens out awareness of failure to thrive. This first reason generally underlies the other additional reasons FTT is seldom acknowledged or discussed. Most people who try vegetarian diets usually do not stick with them for a long period of time, and go on to something else. At any point in time, therefore, the pool of currently practicing vegetarians is composed mostly of long-term vegetarians. This sets up a "self-selection" effect that filters awareness, whereby most of the vegetarians you talk to are inevitably either the most motivated or the most "successful" ones who do the best on the diet long-term.
Yet ironically, many more people are ex-vegetarian than currently vegetarian. But since practicing vegetarians tend to be far more vocal, those are the voices most people hear about vegetarianism from. Thus, the ex-vegetarian population is something of a "silent majority" that doesn't get heard from much compared to current vegetarians, because most often, they simply go on to something else that becomes their focus instead, and the subject is dropped before it has much of a chance to make an impact on others.
- The large number of "social dropouts" diverts attention and is a scapegoat for the actual cases. Why do people "drop out"? Oftentimes, of course, it is strictly for social reasons having to do with peer pressure from family, friends, or workmates, or just the social inconveniences of not being able to find good vegetarian meals outside the home. Or people may simply like animal foods, and eventually find they don't want, or have trouble trying, to give them up despite the proposed benefits of doing so (not surprising given the evolutionary heritage of Homo sapiens, with meat being a natural food that most of us enjoy). And vegetarianism often is an enthusiasm of younger, more idealistic people that doesn't last or doesn't "stick" as they get out into the world, and start dealing with the everyday vicissitudes of life that make idealism of any sort difficult.
However, the foregoing primarily tends to describe people who haven't practiced vegetarianism for a very long time before dropping out--often before there would be much likelihood of developing FTT anyway. And since most people who embrace vegetarianism do at least passably well on the diet at first, and FTT--if/when it occurs--may take anywhere from a few months to a few years to several years (sometimes longer) to develop, dropouts of this particular variety don't really tell us very much about failure to thrive. I.e., despite the way in which "social dropouts" are brought up as a refutation of FTT, they are a "red herring" and mostly irrelevant to the question.
- Moral ostracism marginalizes willingness of FTT dropouts to speak out. But it would be erroneous to conclude that the FTT population will automatically be insignificant just because there are a lot of "social dropouts" or because there is no publicity about the phenomenon. In addition to the "self-selection" effect discussed above about why FTT is not heard about much, there is also a strong tendency toward moral ostracism toward ex-vegetarians by current vegetarians. (Anyone who doesn't believe this should listen in on a conversation among "ethical" vegetarians about some failed ex-vegetarian sometime. So much for "compassion" as one of the underlying values of vegetarianism, if it doesn't apply to fellow human beings.) This quite commonly results in either blackout of contrary information (within the vegetarian community), or failure to take it seriously when it does surface.
- Pat answers. But of course, not all cases of FTT completely escape attention. Instead they may be rationalized. Usually this happens by explaining away all examples of FTT as failures to "intelligently plan," or adhere to, the diet instead. While in some cases this might well be true, most often what occurs is that the people making such comments don't really know if it is or not, because rarely do people explaining away FTT bother with finding out all the particulars of the cases that come up. (For more on how morally based ostracism operates to screen out awareness of FTT in the vegetarian community, see both Drawbacks to Relying Exclusively on Clinical Studies of Diet [go about halfway down the page] and Failure to Thrive: Your Health is More Important than Dietary Dogma.)
Failure to thrive is real, but its extent unknown.
After adopting the diet, cases of FTT are small in the beginning, but increase over the long-term. Now that the vegetarian and alternative diet movement has had almost three decades to mature since it began mushrooming in the U.S. with the contingent of baby-boomers who began adopting it starting in the late 1960s and early 1970s, results contrary to the standard healthy script of what is supposed to happen have had time to surface and undergo more close re-examination. Based on anecdotal reports, the number of people who experience FTT is small in the beginning after the diet is adopted, but will increase over time. Some begin not doing well within just a few months. For others it may be a decade or longer before they realize their state of health is not what it once was. Sometimes people find they have very slowly adjusted to a lowered sense of well-being without realizing it until some years later. It would be nice if one could put a percentage figure on the rate of FTT among those who try vegetarian diets, but unfortunately this number is unknown at present.
(Note: Vegan advocate Michael Klaper, M.D. has been attempting, since about 1997/1998, to put together what appears to be the first-ever study on failure to thrive in vegans, and also appears to be one of the very few vegan advocates to acknowledge it publicly as a worthwhile issue. It is a prospective study and not longitudinal, and thus will not be able to determine rates of incidence; but it is a start, and those who are interested in this topic may want to check out the web page for the study at http://www.vegsource.com/klaper/study.htm.)
Most individuals with FTT make changes quietly, and go on to other diets. Some of these individuals who have had extensive firsthand experience from which they can speak have been forced to seriously question their diets--or at the least, the claim that they will work for everyone. And in some cases these individuals have even gone so far as to re-introduce animal foods back into their diets (some including carefully chosen portions of flesh) and are experiencing improved health. Others who haven't seen fit to make that kind of change may nevertheless have made compromises in the area of adding supplements or other auxiliary items to their diets formerly eschewed. (You can read stories of a few such individuals here on the website: see Dietary Problems in the Real World.)
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