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On June 20, 2023, Dr. Tedros Adhanom Ghebreyesus, director general of World Health Organization (WHO), congratulated the Nordic Council of Ministers for what he called “this impressive product and for the inclusive process of public consultations that produced it”.
Link to source.
In his address to the Nordic Council of Ministers he said the following:
“– This new edition of the Nordic Nutrition Recommendations makes a powerful link between healthy people and a healthy planet. We must work to promote and to protect both. Focusing only on one ... diet or large environmental impact. I congratulate the Nordic Council of Ministers for this impressive product and for the inclusive process of public consultations that produced it. The overarching recommendations align with current scientific literature is to shift to plant base diets. Animal sources such as fish should come from sustainable managed stocks with moderate amount of low fat dairy and eggs while limiting sugary and processed foods. This year, WHO will launch a new healthy diet guideline in line with the Nordic Nutrition Recommendations. And we'll introduce a concept of a healthy diet that considers sustainability and environmental impact. We're also working to make health central to climate negotiations. COP28 in the United Arab emirates this year will feature the first dedicated health day and the first health and climate ... to take place at the cop. Congratulations once again for the important contribution and thank you all for you commitment to healthy people and a healthy planet”.The impressive product Dr. Ghebreyesus refers to is the Nordic Nutrition Recommendations (NNR) 2023.
Link to source.
According to the people who wrote NNR, it's the sixth edition of the Nordic Nutrition Recommendations in the report’s 40 – year history, and “It is now also the most comprehensive scientific basis in the world for how we should eat well for the benefit of the planet and our health”.
Do the new Nordic dietary guidelines converge with studies conducted using credible methods?
In order to understand what's going on, it makes sense to look at the history of dietary guidelines, especially in the Nordic region.
In the 1700s, Emanuel Swedenborg (1688 – 1772), one of the most renowned scientists in the Swedish kingdom with his Opera philosophica et mineralis (1734), including Principia Rerum Naturalium, became interested in mysticism. In 1758 he published Heaven and Hell, and he claimed that he had experienced revelations – a deeper understanding about how people should prepare for the second coming of Jesus:
“Drawing on the passage in Genesis (1:29-31) in which God Institute a vegan diet, Swedenborg said that meat-eating corresponds to the fall from grace in the Garden of Eden and was, therefore, the point of entry of sin and suffering into the world” (Phelps, p. 149).In 1817 the Swedenborgian Church of North America was established,
“and 1845, when the movement toward Swedenborg was in full tide, George Bush, professor of Hebrew and Oriental Literature in the University of the City of New York and long a favorite oracle of the orthodox church, was converted and took the lead of it” (John Humphrey Noyes (1811 – 1886), Letters: 1867).In parallel to that, the Temperance societies emerged inspired by John Edgar, professor of theology and a presbyterian Church of Ireland minister. Sylvester Graham (Graham Crackers; 1794 – 1851) joined the Temperance movement in 1830 for a few months but then left to focus on promoting a plant-based 'Garden-of-Eden' diet. In 1850 Graham, together with Alcott, William Metcalfe (1788 – 1862), and Russell Trall, founded the American Vegetarian Society
“The meeting was called by William Metcalfe who had led a migration of 40 members of the Bible Christian Church from England to Philadelphia in 1817, all abstainers from flesh foods. By 1830 Sylvester Graham (picture right) and William Alcott MD were also following the meatless diet. Metcalfe soon heard about the formation of the Vegetarian Society in Britain in 1847, and about the new word 'Vegetarian' now being used. He contacted Graham and Alcott and arranged the New York gathering (IVU).”In 1830, William Millet (1782 – 1849) is said to have started an Adventist movement with a similar ambition, that is, also projecting the second coming of Jesus. And Millet had a date: October 22, 1844. The failure of the prophecy led to the Great Disappointment and the formation of the Seventh-Day Adventist Church (SDAC). Millet's goal-statement was reframed to a starting point.
Seventh Day Adventist Church (SDAC) was formally established in 1863, following the religious zeitgeist to promote a Garden-Eden, plant-based, diet in preparation for the second coming of Jesus.
One of the prominent members of SDAC was a young teenage girl named Ellen G. White (1827 – 1915). She claimed that meat, milk, and butter were responsible for 'carnal urges' – impure thoughts in men. Another early member, John Harvey Kellogg (1852 – 1943), developed breakfast cereals as a 'healthy food' (Figure 3). We know the brand because his brother William founded Kellogg's (Wikipedia).
In the 1940s, Haqvin Malmros (1895 – 1995), a professor of medicine at Lund University, conducted an epidemiological study, where he concluded that saturated fats raise serum cholesterol, which was claimed to increase the risk of contracting arteriosclerosis (Malmros, 1950).
Malmros' result was noticed by Ancel Keys (1904 – 2004), an epidemiologist (Noakes, 2019).
1954, Dr. Keys reiterate Dr. Malmros claims:
“a major factor in this difference lies in the relationship among dietary fats, serum cholesterol and atherosclerosis” (Elliott, 2014).In 1958, Dr. Keys launched an international project to further test the diet-heart hypothesis, the Seven Countries Study. One of the countries was Finland. They took data from two places: Åbo in the south-west, and North Karelia. 300/10 000 people in Åbo died of Cardiovascular disease (CVD). 995/10 000 people in North Karelia died of CVD (Teicholz, 2014).
In 1961, American Heart Association (AHA) warned people from eating saturated fats (Teicholz, 2023).
In 1969, Seventh Day Adventist Church's own University, Loma Linda, promoted a balanced diet.
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In 1975, a questionnaire-based study which claimed that meat causes colon cancer was published (Armstrong och Doll, 1975).
31 years later, the most expensive RCT-based study on women's health was published. The researchers set out to test Malmros/Keys diet-heart hypothesis, but found nothing among the people in the general sample. But, on page 661, a special table appears. It shows that women with a history of health issues, who reduce their consumption of saturated fats by 10%, increase the risk of contracting CVD by 28% (Howard et al. 2006).
10 years later, another paper, this time with forgotten data from the Seven countries study, also rejected the diet-heart hypothesis (Ramsden et al. 2016).
The PURE-project published studies which showed that carbs, but not fat, was bad for health (Dehghan et al 2017, 2018).
In 2018, the J-curve showed how the risk of developing cardiovascular disease increases almost exponentially as a function of abstaining from eating salt (Mente, 2018).
studies which tested the correlation between diet and mental health were conducted. They show that people who abstain from animal source food typically report mental health issues (Forestell and Nezlek, 2018; Nezlek, Forestell, and Newman, 2018).
In the spring of 2019, Georgia Ede, a clinical psychiatrist who successfully applied Ketogenic diet in her practice, claimed that animal fats are crucial for mental health (Ede (2019).
In parallel to Dr. Ede's article, a group of people from something called the EAT commission, published a hypothetical paper where they proposed that people should abstain from eating animal source food (Teicholz, 2019; Willet et al. 2019).
In August, I had lunch with Finnish nutritionist Mikael Fogelholm at a restaurant close to our work places at Vik Campus at University of Helsingfors. They had told me that nutrition was Dr. Fogelholm's territory, so I suggested a meeting. And it all started well. But when I asked him about his thoughts on Ramsden et al. (2016) and the PURE-project, all hell broke loose; Dr Fogelholm dismissed both Ramsden et al and PURE-project (using strong language and waving his arms) and then started to lecture me, the social psychologist, about questionnaire-based studies!?
Soon after, a number of papers were published, which showed that it was safe to consume meat (Han et al. 2019; Johnston et al. 2019; Zeraatkar et al. 2019), but also crucial for children to develop, and for adults to sustain, physical and mental health (Adesogan et al. 2019; Balehegn et al. 2019; Itkonen et al. 2020; Tong et al. 2020; Ylilauri et al. 2019).
This caused Dr. Fogelholm to react again. And even though he is fluent in English and the trade language around the Gulf of Bothnia and the Baltic sea, he used one of the most remote languages on planet Earth – Uralic-Finnish to write this on Twitter:
Link to source.
The only way to understand Dr Fogelhom's message, is to use Google translate:
“Here's a really good, longer comment about that beef meat research (see Prof. Katz's article in the link below). So the result was the same as before, only the interpretation was different. It is, for example, on the evaluation of research types. The best evidence here against meat was completely ignored.”The person Dr Fogelholm refers to is Michael Greger, a physician who believes that abstaining from eating animal source food, in his case, veganism, favors health. Greger in his turn refers to an article written by David Katz, another physician/vegan who also believes that abstaining from eating animal source food, favors health. The article was published on Linkedin.
In late 2019, I got an invitation from the head of the department where Dr Fogelholm works. She invited me to open their seminar series for experts on food and health.
On January 23, 2020 I made my case – What’s the Prospect of sustainable Food? The Case for mental health. Here's the abstract:
“The human mind has unique mental abilities. Why? Some 3.6 million years ago, our ancestors change their diet to include bone marrow which contains a number of important micronutrients, e.g. heme-iron, zinc, vitamin A, and some B vitamins, and docosahexaenoic fatty acids, to mention a few. 800 000 later, when the climate changed [again], from Pliocene to Pleistocene, meat was added to ‘the plate’. The consequence of this dietary change was an expansion of the brain, from 405 cc to today's 1300 cc, which opened the door for the ability to experience the future rationally by applying functions such as explorative and disjunctive reasoning as well as metacognitive sensitivity. This includes the ability to combine/blend non-related abstractions into new concepts, like the lion-man (40 000 years ago), the first bread (14400 years ago), beer (13000 years ago), Göpekli Tepe, agriculture, and religion (11 700 years ago). The Swedish Emanuel Swedenborg (1688-1772) suggested meat to be a sin, calling for an all plant-based Garden-of-Eden, or vegan, diet. The idea was picked up by the Seventh-Day Adventist Church. The 1950s saw the birth of the diet-heart hypothesis, connecting cardiovascular disease with the consumption of saturated fats, cholesterol, and red meat. Diet-heart hypothesis was never validated in experimental trials, but are still the ‘holy grail’ for some believers who continue to promote a Garden-of-Eden diet. The decision to abort animal-sourced food attracts some 1-2 % of a normal population and is explained by a combination of temperament: openness to change and neuroticism - worrying for the future. The consequence of a plant-based diet is lower self-esteem and psychological adjustment, less meaning in life and more negative moods and social experiences compared to people on an omnivore diet. In order to sustain mental health, it seems we need need to consume a plethora of micronutrients. Next time you go shopping for food, put the following on your shopping list: 13 vitamins (e.g. A, several B:s, C, some D, E, K2-Mk4 and Mk7), 15-16 minerals (Heme-Iron, Magnesium, Zinc and so forth). Choline, as well as Docosahexaenoic, Arachidonic fatty acid”.Dr Fogelholm chose to be absent.
In 2020, another paper was published showing a correlation between the decision to abstain from animal source food and the Similarity-Attraction Effect (SAE) – the tendency to like and be attracted to others who are similar, rather than dissimilar, to themselves (Nezlek, Cypryanska, and Forestell, 2020). SAE is very similar to phenomenas like conformity and groupthink.
Fogelholm and I started a communication on Twitter about an upcoming conference on dietary guidelines:
Someone running the conference Twitter account responded with the following:
I responded to that:
Someone from the conference admin responded:
I persevered:
That triggered Dr Fogelholm to write a reply in his own name:
I persevered:
So did Dr Fogelholm:
Me:
Dr Fogelholm then used som ad hominem:
In 2021, a systematic review and a meta-analysis was published, supporting previous findings that the decision to abstain from animal source food correlates with mental health issues (Dobersket et al. 2021 a; Dobersek et al. 2021 b).
Finnish state media – YLE – reiterated an interview that Dr. Fogelholm had done in another, Uralic-Finnish, tabloid. The headline reads: Allt fler finländare vill att vi äter mindre kött – bland de unga tycker sju av tio så.
In English via Google translate: More and more Finns want us to eat less meat – among the young, seven out of ten think so.
In the interview Dr Fogelholm made the following claim:
“Kopplingen mellan tjocktarmscancer och rött kött är tydlig. Men då det kommer till de andra sjukdomarna kan det också handla om att man överlag har ohälsosamma levnadsvanor”.In English via Google translate:
“The link between colon cancer and red meat is clear. But when it comes to the other diseases, it can also be about having unhealthy lifestyle habits in general”.
Link to source.
It's important to eat at least 1.5 teaspoons of salt per day, but not more than 2.5 teaspoons (Mente et al. 2021).
In March, 2022, Finland's institute for Welfare and Health (THL) bragged about having convinced Finns to lower their consumption of butter and salt.
Link to source
3 month later, Dr. Fogelholm together with Dr. Erkkola (main author) and a number of their colleagues set out to check if their expectation about lowering consumption of meat had been fulfilled. But to their despair, it had not happened:
As their prophecy failed, again, the group of researchers didn't pay attention to scientific ethics (see my short video on the topic). Instead, they expressed their disappointment in the label for the paper – A slow road from meat dominance to more sustainable diets: An analysis of purchase preferences among Finnish loyalty-card holders (Erkkola et al. 2022).
After meeting many people in Finland whose relatives had died of Alzheimer's/dementia, I took a look at the stats. Between 1971 to 2019, the number of deaths had risen by a factor of five (5), from ~25 men and ~25 women per 100 000 to 175 per 100 000 (Österberg, 2022 a).
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| Diagram from Statistics Finland. |
(link to source.)
In 2023, Willet et al.'s proposal for a planetary diet was scrutinized, showing it is deficient of important nutrients (Beal, 2023):
“However, concerns have been raised about the extent to which the diet provides adequate essential micronutrients, particularly those generally found in higher quantities and in more bioavailable forms in animal source foods”.And soon after, another paper pointed out the health benefits of eating meat (Johnston et al. 2023).
To fill the dietary gaps that were estimated for vitamin B12, calcium, iron, and zinc, we suggest modifications to the original planetary health diet to achieve micronutrient adequacy (without fortification or supplementation) for adults, which included increasing the proportion of animal source foods and reducing foods high in phytate”.
The criticism against the dietary guidelines has been thorough; the recommendations were introduced in 1983, in the absence of supporting evidence from RCTs (Harcombe et al. 2015).
Why is animal source food important for our species?
That backstory actually has a lot to do with the changes in the climate.
Earth's history, including climate, is described in the Chronostratigraphic chart (Cohen et al. 2023), and is divided into four eons, many more eras, periods, and epochs. We know the first three eons as Hadean, Archean, Proterozoic, or Precambrian. They make up 88% of Earth's existence, during which there were no visible life.
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| The International Chronostratigraphic chart (Cohen et al. 2023). |
The fourth and current eon – Phanerozoic – dates 538 million years before the present, and marks the starting point for visible life. This starting point is also known as the Cambrian explosion.
Then, levels of carbon dioxide (CO2), Oxygen (O), and temperature was different compared to the present: 5000 – 7000 ppm CO2, 4 – 10 % O, and 50 % higher temperature compared to today (see figure 1).
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| Figure 1. Variation in temperature and CO2-levels. (see numerous references in the subtext to the figure). |
Since the start of the Phanerozoic, 95 % of the carbon dioxide (CO2) has moved from the atmosphere to the bedrock, forests, and the oceans, the oxygen levels have doubled, and temperature has only decreased.
How does changes in the climate relate to humans and nutrition?
Here are some notable changes in the climate that opened the door for mammals to thrive, and which coincided with the emergence of our lineage, our species, and extra-ordinary brain power.
225 million years before the present, mammals walked the Earth. Humans are mammals. But due to predators dominating the Earth, they remained small.
66 million years before the present, the Cretaceous–Paleogene extinction event occurred when an asteroid, the Chicxulub impactor, struck Earth, and created the Chicxulub crater. This event is generally known as the fifth extinction, which wiped out 75 % of Earth flora and fauna, including some, but not all, dinosaurs. However, the extinction also provided evolutionary opportunities; when the big predators were gone, mammals could thrive (Coolidge and Wynn, 2018). Hence, the era which started after the Chicxulub event is called Cenozoic – the age of the mammals.
10 million years later, the Paleocene-Eocene Thermal Maximum occurred, The interval was characterized by the highest global temperatures during the Cenozoic Era (Brittanica).
9 – 8.5 million years before the present, two super volcanic eruptions occurred in what is now Wyoming (Knott et al. 2020). Earth went through another significant climate change.
7 – 6 million years before the present, when our ancestors separated from the chimpanzees, our so-called lineage existed in the Tugen hills. Their brain size: ~350 cc (Pickford, 2006; Pobiner, 2016).
6 – 5.33 million years before the present, the Messinian salinity crisis occurred, seeing the Mediterranean Sea partly or nearly completely drying out.
5.33 million years before the present, another change in the climate occurred, marked by the Zanlcean flood and a change from Mioscene to Pliocene (5.33 – 2.58 Mya).
During the Pliocene, our ancestor – Australopithecus Afarensis, or Lucy (3.9 – 2.9 Mya) – lived.
Lucy's kind had an estimated brain volume of 365 – 417 cc.
~300 000 years into their existence, Lucy's kind made a remarkable change in their behavior; findings suggest they ate bone marrow which contained nutrients that were hard to find in a plant based diet. The result was an acceleration of the human evolution, causing the shape of their hands and change, their guts to reduce, and their brains to expand, from the occipetal lobe and forward (Aiello and Wheeler, 1995; Kimbel and Willmoare, 2016; Mann, 2018; Ponzter et al. 2016; Thompson et al. 2019).
2.8 mya, close to the ending of Pliocene, our genus existed. Their brains volume: ~650 cc (Kimbel och Villmoare, 2016; Villmoare, 2018; Villmoare et al. 2015):
“This specimen combines primitive traits seen in early Australopithecus with derived morphology observed in later Homo, confirming that dentognathic departures from the australopith pattern occurred early in the Homo lineage”.2.58 Mya, another change in the climate occurred when the Pliocene was replaced by Pleistocene. Common knowledge in nutrition anthropology is that our ancestors at that time ate meat, which further reduced their guts and expanded their brains, from the occipetal lobe and forward (Pobiner, 2013, Sahnouni et al. 2018). With a bigger brain, there was room for more mental faculties – the executive functions (Ardila, 2008; Ardila et al. 2018).
1.8 Mya, Homo Ergaster, or Erectus, had emerged. Their brain size had doubled compared to Lucy's kind, especially their prefrontal cortex. New mental capacities emerged: social cognition, which may facilitate rhythmic synchronization of behavior, symbolic thinking, and a cultural language (Adornetti, 2016; Coolidge and Wynn, 2018; Everett, 2017). With a language, it was possible to send information from one mind to other minds (Pinker, 2010).
320 000 years before the present, our species had emerged (Hublin et al. 2017).
200 000 years before the present marks a Fork in the road; they had theory of mind, and a rudiment to a grammatical language (Pagel, 2019).
Findings show that around 100 000 – 35 000 years before present, our ancestors brains were rewired (Neubauer et al. 2018).
~70 000 years before the present, it is proposed that constructive memory emerged (Ambrose (2010); Schacter and Addis, 2007).
~35 000 years before the present, the Lion-man, a figurine which demands constructive memory, is dated (Wynn, Coolidge and Bright, 2009).
They now had the ability to elaborate scenarios forward in time (Barkley, 2001; Gallistel, 2017; Gilbert and Wilson, 2007; Kaku, 2014; Liu et al. 2017; Spzunar et al 2014).
25 000 – 20 000 years ago, the Epipaleolithic emerged; the weather became warmer and therefore more stable. Archeological findings have discovered remains of settlements. That indicates that the warming again influenced some of them to change their lifestyle – to settle (Hodder, 2018). During the Epipaleolithic, the first bread was baked and the first beer was brewed. Putting bread and beer on “the table” wasn't a staple diet, but rather something that was served for special occasions. One reason was the effort-to-nutrition--ratio; the energy and time used to bake bread and to brew beer gave less nutrients and energy compared to hunting for marrow and meat. Still they prioritized this diet (Arranz-Otaegui, et al. 2018; Liu et al 2018).
From a nutritional- and neuro-anthropological perspective, we can conclude that changes in the climate caused changes in the human lifestyle, including diet, which in turn caused changes in their biological set-up (Österberg, 2022 b).
When the climate changed again, from the Pleistocene to the Holocene, the current epoch, more people changed their lifestyle from hunting and gathering to agriculture.
Agriculture was a game-changer. When our ancestors, who for millions of years lived as meat-eating hunters and gatherers, settled to develop this new lifestyle, it wasn't an immediate success story. It took its toll on health, it transformed societies from egalitarian to hierarchical and divided humans into a number of societal roles still present in modern societies: guards, priests, administrators and so forth (Kohler et al. 2017; Mummert et al. 2011).
Why don't Dr. Ghebreyesus include information about nutrition anthropology, and RCTs which reject the previous papers that laid the ground for the dietary guidelines?
Members of our species are prone to mental fallacies. For example:
- Confirmation bias, the tendency to apply the same theory on all situations, or search for information which fits the conviction (Nickerson, 1998; Wason, 1960, 1966; 1968; Wason och Shapiro, 1971).
- Natural stupidity – our species propensity to rely on information which are either prototypical (Kahneman och Tversky, 1972), available (Tversky och Kahneman, 1973), or just easy to access (Kahneman and Tversky, 1977).
- Dysrationlia – the inability to think and behave [epistemic and instrumental] rationally despite adequate intelligence (Stanovich, 1993, 2011, 2016).
- Myside bias – a psychological disinclination to abandon a favored hypothesis (Stanovich, West och Toplak, 2013).
- Continued Influence Effect – Misinformation continues to influence memory and reasoning about an event, despite the misinformation having been corrected (Cacciatore, 2021).
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