Forks Over Scalpels

[Correction: As I learned from a comment on today's post, from the creator and executive producer of "Forks Over Knives," there was no product placement in the movie by the Whole Foods Markets grocery store chain. My comments in the third-to-last paragraph below -- especially my use of the harsh term "sell out" -- were thus based on an incorrect assumption on my part. My apologies.]

-- Posted by Neil H. Buchanan

A new documentary film, "Forks Over Knives," discusses the connection between public health and the consumption of animal products. It is a brisk, lively movie experience, full of fascinating information, combining a clear-eyed description of depressing reality with an equally honest assessment of how much good people could do themselves by removing animal products from their diet. The film's title is a play on words, with the "knives" referring to surgeons' scalpels, which would be used much less often if people would pick up a fork and eat a healthy meal.

As I wrote in a Dorf on Law post last December, the case for veganism is over-determined, with four independent, individually sufficient reasons to become a vegan. It is possible to care only about the environment, or the economy, or animal rights, or human health, and conclude that our current practice of exploiting animals is a disaster. "Forks Over Knives" makes the case from the latter perspective.

The film is devoted mostly to describing the work of Drs. T. Colin Campbell and Caldwell Esselstyn, a nutritional researcher at Cornell and a surgeon at the Cleveland Clinic, respectively. Working independently, each of these men discovered through their research (starting in the 1970's) that people who eat animal products suffer much worse health outcomes than those who do not.

Their research cannot, of course, be described fully in a feature-length documentary, but the audience is given some very convincing results of their careful (and peer-reviewed) research. Among the more memorable statistics: in one year in Japan, there were 18 deaths from a particular kind of cancer, while in the US there were about 18,000. Even adjusting for population size, this is a 500-1 ratio, with the US on the losing end. Campbell and Esselstyn have spent decades demonstrating that such dramatic differences in health outcomes are the result of dietary differences, with consumption of animal products leading to much, more worse health outcomes (cancer, diabetes, heart disease, and so on).

These differences appear both at the individual and the societal level. For individuals, Dr. Esselstyn points out that the "radical" idea of changing what one eats is hardly as radical as splitting open a person's chest and inserting a blood vessel from that person's leg into his heart. Yet people opt for surgery (at great expense, and exposing themselves to risks of death during surgery and from hospital-based infections) rather than consider not eating animals. Esselstyn's patients who opt against surgery are able not only to arrest, but in many cases reverse, their surgery-eligible conditions by simply eating plant-based foods.

At the societal level, the Japan/US difference noted above is merely one small example (if 18,000 deaths per year can be considered small) of health differences among countries that are correlated with dietary differences. Most notably, Dr. Campbell's work has shown that the non-animal diet that has been common in China for millennia is associated with much better health outcomes than in countries that consume animals and their secretions. These "much better health outcomes" are not mere percentage reductions in various types of diseases, but their literal absence among the population. Moreover, while the movie cannot be expected to show how the research has controlled for other explanations (much less grapple with the causation/correlation problem), it does note that all of these "Western diseases" are showing up in the areas of China that are becoming more Western in their eating habits. Within a generation, a population that virtually never experienced obesity, heart disease, and all of the scourges of the Western world has become "just like us."

The movie thus makes a compelling case for action at both the individual and policy-making level to change what we eat, literally to save our lives. As a person who chose to become a vegan entirely for ethical reasons, this was good (but unnecessary) news. For the remainder of this post (and perhaps in one or more future posts), I will offer a few reactions to the movie that go beyond how the film presented Campbell's and Esselstyn's research.

-- Unsurprisingly, Campbell and Esselstyn report that they are often ridiculed by their colleagues for being anti-meat. Esslestyn reports that his colleagues took to mocking him as "Dr. Sprout." The general hostility of the American medical and scientific establishment to veganism is really quite shocking. For example, I recently saw a cardiologist about a potential problem (described in a DoL post in March). The prognosis was good. During our first meeting, however, as I was going through my medical history, I said, "Oh, and I'm a vegan." Did the cardiologist respond by noting the positive health effects of my refusal to eat animal products? Of course not. Instead, he immediately became grim and said, "Well, that's going to be a problem." When I asked why, he said that it is hard for vegans to lose weight because they eat too many starchy foods! I assured him that I am capable of losing weight on a vegan diet (which I am, in fact, currently doing), but he was unmoved. I changed the subject.

-- Indeed, one of the strengths of "Forks Over Knives" is its depiction of just how ill-informed the American public health community is about dietary issues. The filmmaker does a great job of debunking the widely-held myths about diet, such as the idea that we need meat for protein (wrong, because humans can easily get enough protein from plant-based food) and milk for calcium (ditto). Even so, the public believes these things, encouraged by supposed experts. The film includes two clips from an interview with the nutritionist at Washington University, who parrots the discredited nonsense about protein and calcium as if she were a character from the movie "Pleasantville."

-- One of my pet peeves about modern movies is product placement. I thus found "Forks Over Knives" a bit difficult to watch, because it was so obviously promoting the grocery-store chain Whole Foods. Characters are shown walking through Whole Foods, carrying Whole Foods bags, and so on. Nearly everyone uses the term "whole food, plant-based diet" to describe a vegan diet. At one point, Dr. Campbell said "plant-based diet," but immediately corrected himself, saying, "I mean, whole food, plant-based diet." In the same cineplex the previous week, I had seen Morgan Spurlock's new film, "Pom Wonderful Presents The Greatest Movie Ever Sold," which presents a subversive take on product placement. Given that Whole Foods makes its money by selling all manner of animal products, moreover, it was more than merely annoying to see the makers of "Forks Over Knives" sell out in this way.

-- Only one person in the entire film uses the word "vegan." That person happens to be an extreme fighting champion, who is deeply committed to veganism. Given the syllable-laden alternative favored by everyone else in the film, the filmmakers must have made a conscious decision to avoid the word vegan. Given the outright contempt for veganism even among some of the more enlightened elements of American society, this might well have been a sensible choice. Allowing a macho man -- a guy who beats people up for a living -- to use the V-word must, therefore, have seemed strategically sensible. I cannot help but think, however, that vegans do themselves little good by refusing to use the simple word that describes us. After all, Michael Dukakis's refusal to admit that he was a liberal (in response to George H. W. Bush's sneering reference to "the L-word") hardly made it easier to be a "progressive."

Notwithstanding these concerns, this is an important film. It presents facts that should be the basis for changing society. I hope that the world will change because of it.