How would you respond to someone with severe dietary restrictions?

[aroneous]

I got started thinking about something after watching this video:
https://www.youtube.com/watch?v=DdQvp9LnyOI

When we encounter someone with severe dietary restrictions resulting from medical conditions like MCAS, IBS, or severe allergies, is it even feasible to try to convince them to cut out animal products from their diet?

In my opinion, actually, I do believe that there is no medical condition that requires you to eat animal products in much the same way that there is no medical condition that requires you to consume toothpaste -- our bodies may have evolved to accept some nutrition from animal products in times of desparation, but fundamentally we are herbivores, and it's extremely unlikely that someone who claims to require meat in their diet has a genetic mutation that has caused them to "evolve" away from other humans to acquire the dietary needs of a carnivore. Okay, if you have a "fiber allergy" then almost all vegan foods are off the table and you're restricted to a carnivore diet, but with a carnivore diet your chances of surviving past 10 years are pretty bleak anyways. And googling it, fiber allergies don't actually exist. Perhaps there's another component common to most plant foods that isn't found in animal products and which people can realistically develop an allergy to, but I haven't heard of one.

So, I think we can't be quick to accept someone's consumption a minimal amount animal products for "medical reasons" as falling under the "possible and practicable" part of the definition of veganism. If they have entirely convinced themselves that it is necessary, then I'm sure we can consider them vegan (at least, unto themselves), but we should also recognize that they have probably been misled to some extent. When people are in a difficult medical situation, they may be very scared and quick to accept the advice of their doctors and not realize or care about the fact that doctors have an extremely inadequate understanding of human nutrition (very little is known about this scientifically, in general), so the options that they present to you may not in fact be the only ones.

I think that there's a bit of a bias to present animal products to patients with dietary restrictions and ignore other possible plant-based options, simply because animal products are so ubiquitous in food stores and easily available, and they "crowd out" other plant foods that would naturally have more variety and may contain something equally, or even more suitable for them. And most of our research on what kind of foods people with these medical conditions need is also biased because most people are already eating an animal-product heavy diet with not a lot of diversity in plants, so it's hard to discover what these possible options are. It's really quite unfortunate, especially considering all of the other health problems that can arise from regularly consuming animal products -- of course, it's not like doctors are actually really thinking about this, but it's like they're imposing another serious potential future health problem on their patients, just to make things a little bit more convenient for them in the present, and framing this as a "necessity".

You could say that someone with these restrictions needs to eat meat because they're living in a "perpetual food desert" where adequate vegan options are simply not available, but I think we should be very hesitant to just accept that, and, even if it is true, it's important to not conflate that with an exact need to eat meat itself -- rather, I would say it's probably more of an unfortunate result of the way that food cultures currently tend to be centered around animal products. For one thing, I think it would indeed be quite odd if someone who was raised vegan from birth came down with a condition like MCAS and was suddenly recommended to start eating meat. I think in that case, doctors would make more of an effort to try to find suitable vegan options for them.

So, anyways, getting back to the original question, how do you think you might talk to someone like the person in the video above about, say, cutting out turkey from their diet? Would you even try? I don't think I would, the first impression they would get would probably be that I am being incredibly tone-deaf and insensitive to their condition -- after all, they are the ones suffering from it, not me. Outside of turkey, their 14 safe foods do not contain anything that really has a lot of protein or calories, but I think there simply must be some other reasonably satiating plant food out there that they can eat. But who am I to tell them anything, especially against the advice of a medical professional? It sort of seems like a non-starter for me. How would you approach this?

[Red]

When we encounter someone with severe dietary restrictions resulting from medical conditions like MCAS, IBS, or severe allergies, is it even feasible to try to convince them to cut out animal products from their diet?

It probably would be a bit harder (and I would focus more on the people without such dietary restrictions) but a lot of dietary medical conditions could actually be alleviated from a healthful vegan diet, especially Crohn's disease and IBS. I would like to talk to an RD on the matter though.

In my opinion, actually, I do believe that there is no medical condition that requires you to eat animal products in much the same way that there is no medical condition that requires you to consume toothpaste -- our bodies may have evolved to accept some nutrition from animal products in times of desparation, but fundamentally we are herbivores, and it's extremely unlikely that someone who claims to require meat in their diet has a genetic mutation that has caused them to "evolve" away from other humans to acquire the dietary needs of a carnivore.

I'm not sure if such conditions exist, but even if they do they're so incredibly rare that it's unlikely that most people complaining about not being able to adopt vegan diets have them.

Okay, if you have a "fiber allergy" then almost all vegan foods are off the table and you're restricted to a carnivore diet, but with a carnivore diet your chances of surviving past 10 years are pretty bleak anyways. And googling it, fiber allergies don't actually exist. Perhaps there's another component common to most plant foods that isn't found in animal products and which people can realistically develop an allergy to, but I haven't heard of one.

Haha, you're right on that one, but apparently they're coming pretty close to "curing" allergies.
https://pubmed.ncbi.nlm.nih.gov/31733120/

Now they'll lose their best excuse.

So, I think we can't be quick to accept someone's consumption a minimal amount animal products for "medical reasons" as falling under the "possible and practicable" part of the definition of veganism. If they have entirely convinced themselves that it is necessary, then I'm sure we can consider them vegan (at least, unto themselves), but we should also recognize that they have probably been misled to some extent. When people are in a difficult medical situation, they may be very scared and quick to accept the advice of their doctors and not realize or care about the fact that doctors have an extremely inadequate understanding of human nutrition (very little is known about this scientifically, in general), so the options that they present to you may not in fact be the only ones.

Hey, if they can get to 99% Vegan, that's a massive win. Hell, let's grant that a lot of people have dietary conditions that make it impossible for them to embrace a fully vegan diet. What exactly is stopping them from integrating more plants into their diets? They can still go 40% vegan at least, can't they? Unless they have that "fiber allergy" which as you said if they do have they're gonna be dead soon anyway.

I think that there's a bit of a bias to present animal products to patients with dietary restrictions and ignore other possible plant-based options, simply because animal products are so ubiquitous in food stores and easily available, and they "crowd out" other plant foods that would naturally have more variety and may contain something equally, or even more suitable for them.

It probably has more to do with the fact that doctors know next to nothing about nutrition but think they're authorities on the matter and thus recommend what they believe is good.

The solution to this is to make nutrition a core part of medical education. Right now all that's required of medical students is just one semester on the topic, which is absurd given how many diseases and ailments can be alleviated or even outright cured/prevented with even a moderately healthful diet.
https://www.sciencedaily.com/releases/2 ... t%20habits

And most of our research on what kind of foods people with these medical conditions need is also biased because most people are already eating an animal-product heavy diet with not a lot of diversity in plants, so it's hard to discover what these possible options are.

And that's why you see things like that New York Times article about eggs not increasing health risks from a study that involved people eating one egg a day ignoring the fact that if you're already eating a diet high in cholesterol and saturated fat, one extra egg a day isn't going to make much of a difference. I would LOVE to see a study where they do it with people eating WFPB diets instead of people eating normal garbage diets.

It's really quite unfortunate, especially considering all of the other health problems that can arise from regularly consuming animal products -- of course, it's not like doctors are actually really thinking about this, but it's like they're imposing another serious potential future health problem on their patients, just to make things a little bit more convenient for them in the present, and framing this as a "necessity".

A lot of it probably is "here, now stop wasting my time" but as I said earlier, many of them believe themselves to be real authorities on the matter.

You could say that someone with these restrictions needs to eat meat because they're living in a "perpetual food desert" where adequate vegan options are simply not available, but I think we should be very hesitant to just accept that, and, even if it is true, it's important to not conflate that with an exact need to eat meat itself -- rather, I would say it's probably more of an unfortunate result of the way that food cultures currently tend to be centered around animal products.

I'm not even sure if food deserts are as much of a problem as they're made out to be. You probably won't have access to a variety of fruits, vegetables, spices, and teas, and almost certainly won't have access to many mock meats, but you don't need those for adequate nutrition. Whole grains, beans, root vegetables (potatoes, sweet potatoes, carrots) and nuts are widely available, along with other vegan foods like peanut butter. But I wouldn't expect a doctor from some undeveloped area to be sympathetic at all to vegan diets.

So, anyways, getting back to the original question, how do you think you might talk to someone like the person in the video above about, say, cutting out turkey from their diet? Would you even try? I don't think I would, the first impression they would get would probably be that I am being incredibly tone-deaf and insensitive to their condition -- after all, they are the ones suffering from it, not me. Outside of turkey, their 14 safe foods do not contain anything that really has a lot of protein or calories, but I think there simply must be some other reasonably satiating plant food out there that they can eat. But who am I to tell them anything, especially against the advice of a medical professional? It sort of seems like a non-starter for me. How would you approach this?

Yeah, even if you do have evidence on your side, it's hard not to come across as a total asshole. Kind of like criticizing shit like the Make a Wish Foundation, despite being a total waste of charity money that could go towards saving lives instead of emotional moments, would make you seem like a heartless bastard, which is kind of ironic considering that you're arguing in favor of maximizing good (How dare you say this kid shouldn't be paid for to go to Disneyworld?? Sure some kid in Africa who that money could've saved is going to die of Vitamin A deficiency, but are you REALLY going to deny a child a chance to GO TO DISNEYWORLD????)

I generally avoid making the health arguments a big part of the Vegan message since it can be a bit dubious, and mainly focus on how Veganism is nutritionally adequate and can help reduce the chances of diseases:
https://www.theveganrd.com/2010/11/how- ... -veganism/

But if I were to talk to someone with a condition, regardless of whether or not they can actually go vegan, I would probably advise them to consider integrating more plants into their diet and wouldn't even mention veganism. I would probably do things like recommend Vegan breakfast ideas (smoothies, oatmeal) or tell them to add in some beans and sweet potatoes for dinner, which can displace some meat. I don't think people would react hostilely to that, and since they actually might benefit from it, they might increase their consumption of plants even more.

[aroneous]

It probably would be a bit harder (and I would focus more on the people without such dietary restrictions) but a lot of dietary medical conditions could actually be alleviated from a healthful vegan diet, especially Crohn's disease and IBS. I would like to talk to an RD on the matter though.

Yeah, personally I would never take nutrition advice from a doctor and always try to get a second opinion from someone actually trained in nutrition, like a dietician. They may be a bit less knowledgable in the specifics of what triggers your condition, but provided you have all the info you need regarding that from your doctor which you can pass on to them, they should be able to help you expand your range of safe foods thanks to their much broader knowledge of what possibly compatible foods are out there to begin with.

Haha, you're right on that one, but apparently they're coming pretty close to "curing" allergies.
https://pubmed.ncbi.nlm.nih.gov/31733120/

O_o I didn't hear about that one, that's pretty wild.

Hey, if they can get to 99% Vegan, that's a massive win. Hell, let's grant that a lot of people have dietary conditions that make it impossible for them to embrace a fully vegan diet. What exactly is stopping them from integrating more plants into their diets? They can still go 40% vegan at least, can't they? Unless they have that "fiber allergy" which as you said if they do have they're gonna be dead soon anyway.

Agreed, and I didn't want to sound too attached to the vegan label here -- as long as they're consciously putting in the maximum effort to minimize animal products, and truly the only thing that is stopping them from going fully vegan is the constant fear of going into anaphylactic shock, then there's probably nothing more we need to tell them other than to maybe talk to a dietician to see if there are some other suitable plant foods for them to try out.

It probably has more to do with the fact that doctors know next to nothing about nutrition but think they're authorities on the matter and thus recommend what they believe is good.

Hmm yep, now that you mention it I realize that's probably a major factor here as well.

The solution to this is to make nutrition a core part of medical education. Right now all that's required of medical students is just one semester on the topic, which is absurd given how many diseases and ailments can be alleviated or even outright cured/prevented with even a moderately healthful diet.

It's a shame, and the lack of education around nutrition probably has to do with the fact that it's more associated with preventative medicine, which is not really where the money is in the healthcare business.

Yeah, even if you do have evidence on your side, it's hard not to come across as a total asshole. Kind of like criticizing shit like the Make a Wish Foundation, despite being a total waste of charity money that could go towards saving lives instead of emotional moments, would make you seem like a heartless bastard, which is kind of ironic considering that you're arguing in favor of maximizing good (How dare you say this kid shouldn't be paid for to go to Disneyworld?? Sure some kid in Africa who that money could've saved is going to die of Vitamin A deficiency, but are you REALLY going to deny a child a chance to GO TO DISNEYWORLD????)

I generally avoid making the health arguments a big part of the Vegan message since it can be a bit dubious, and mainly focus on how Veganism is nutritionally adequate and can help reduce the chances of diseases:
https://www.theveganrd.com/2010/11/how- ... -veganism/

But if I were to talk to someone with a condition, regardless of whether or not they can actually go vegan, I would probably advise them to consider integrating more plants into their diet and wouldn't even mention veganism. I would probably do things like recommend Vegan breakfast ideas (smoothies, oatmeal) or tell them to add in some beans and sweet potatoes for dinner, which can displace some meat. I don't think people would react hostilely to that, and since they actually might benefit from it, they might increase their consumption of plants even more.

Yes, I think it's best to accept that this is just about all we can do in this situation. I would be happy to leave it there, if it weren't for the fact that this sort of thing is often brought up by non-vegans who don't have any such restrictions themselves. If they say that "not everyone can be healthy on a vegan diet" and you try to make a point against this, you'll still come off as a presumptuous asshole and they probably will take you less seriously afterwards. Though you can probably soften things a bit by saying something like "I'm not 100% convinced that any such health conditions exist, at least there is no scientific literature supporting that claim". Hopefully this way you can avoid having to qualify everything you just said as "you should go vegan, granted that your health conditions permit you to do so", which shouldn't be necessary especially since (I believe, at least) it's certainly the case that anyone, regardless of health conditions, can thrive a vegan diet.

Another problematic aspect is that people who believe that veganism is not possible (or reasonably convenient) for everyone may use this as a way to silently downplay your motivations for being vegan. They might think that "you're only vegan because it just so happens to be convenient enough for you", and assume that if you had a sufficient number of dietary restrictions, you'd start eating animal products again. For example, I eat a lot of food containing gluten, so someone may assume that if I ended up with Celiac disease, I would start eating dairy products to "make up" for the lost convenience/pleasure that I get from eating bread. So my motivations for being vegan can't be that strong, and veganism can't be as important of a moral obligation as I'm putting on. But of course that is completely wrong, I know that no matter what kind of restrictions I had I would find a way to make it work as a vegan, and even eventually become convenient once I find a "new normal" for myself. But since I don't have any such restrictions, there is literally no reason for me to self-impose them (other than to prove this point).

[brimstoneSalad]

I try to choose my battles, and those are usually uphill even if the actual reality is that a vegan diet is superior for that condition. Drop some links to mainstream sources and suggest they talk to their doctors about it if they're curious, this is probably about the best you can do. Most people don't see dietitians. Of course doctors can be pretty ignorant about nutrition, but you might get lucky and find they see reasonable and competent ones. Luck is about the best you can hope for without immense time expense -- not only in the discussion itself and gaining trust, but in just researching and understanding all of these conditions which can be complicated, and you might open yourself up to liability if you go too far beyond peer folk advice into specific medical advice. The line there any how far free speech protections go is not always overly clear.