Is game changers game changing or is it sensationalism?

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Game Changers

The last few weeks I have been bombarded with questions about the documentary Game Changers. In this documentary the benefits of eating plant-based foods are highlighted as well as the dangers of eating meat. Viewers, many of them athletes, are alarmed by some of the messages, scientists are telling us how dangerous eating meat is and how great eating vegetables is for your health and performance. Have they missed something? Should they now switch to a plant only diet? The documentary that pretends to search for the truth… but does it?

Before we look into the evidence a bit more, let me first start with saying that I have no problem with vegetarian eating, with vegetarians or vegans, and I think everyone should make their own decisions when it comes to food intake. If you want to eat paleo that is your choice, if you want to eat ketogenic, that is your choice, if you want to be a vegetarian or vegan this is absolutely fine. My daughter is a vegetarian, even though she doesn’t like vegetables… It is her choice. But although I don’t have a problem with people’s individual food choices, I do have a serious problem with people who want everyone else to eat their way, or people that claim that their way is the only way. I have a problem with information that is confusing, misinforming or even misleading. I also have a problem with bad science and when claims are made that scientific methods are used when they clearly are not. I also have a problem with scare mongering: if you eat meat you will die!

The game changers documentary

Well, Game Changers seems to do all of these things that I have a problem with. Game Changers ticks almost all the boxes of pseudoscience, and none of the boxes of science (Below we will go through some examples and discuss what pseudoscience is and what science is).

Game Changers ticks almost all the boxes of pseudoscience, and none of the boxes of science

Are you confused by all these diets we have been bombarded with in the media? We had paleo a little while ago. We had to eat like our ancestors otherwise we would develop diseases and die. Then we had keto, we need to go keto otherwise you will get diabetes and die. Avoid carbohydrate! Now we can’t be keto and definitely not paleo, we need to avoid meat! We have seen three massive trends in the space of a few years. Believe me, scientific insights haven’t changed in this short period of time! Science doesn’t move that fast…. However, different interpretations and especially opinions do change fast… Unfortunately, these are not always based on science or evidence, even thought they may pretend that they do.

There are some conclusions and statements in the documentary I personally agree with and the scientific community in general agrees with as well. The main point of agreement being that we should eat more fruit and vegetables. I think there is a lot of evidence that this can help our health. But this is also a general recommendation we are given, anyway! Haven’t we been bombarded with this message? Haven’t we bombarded with the 5 a day message? This doesn’t mean you have to become vegetarian or vegan, you just need to eat more fruit and vegetables. If this is the takeaway from the documentary or the effect of it than that is great.

A closer look

I watched the documentary 3 times. The second and third time I specifically paid attention to how the arguments were built, what evidence was used and also what evidence was NOT used. It is actually the latter that is the bigger problem and the first sign that we are dealing with pseudoscience… nowhere in the entire documentary is there a discussion or even a mention of different views. In fact, the body of evidence against some of the arguments, is far greater than the few very small studies that are cherry picked to support some of the points in the documentary. Most of the studies that are picked are also published in lower quality journals where there is generally less scrutiny. Some of the large scale studies are not mentioned because the results do not align with the messages of the documentary. This is what pseudoscience does. If you are engaged in pseudoscience you have an opinion and search for evidence that supports your view. You present all of this information and say: see this proves my theory is right. This is completely different from what science is, and does. Science does not prove anything. Science will bring us closer to the truth. Science will formulate a hypothesis and design a study to test this hypothesis. The results are critically discussed: arguments and counterarguments are carefully analysed. One study will not give the answer. Science is evaluated in the totality of evidence, not just the cherry picked studies that support your hypothesis. Science is scrutinised by experts whom may have different views, but objectively look at the data collected.

Science is evaluated in the totality of evidence, not just the cherry picked studies that support your hypothesis.

The documentary is the personal journey of James Wilks, a former MMA fighter who describes how he got injured, started to read and stumbled across what he calls “a study on the Roman Gladiators” that “blew his mind” - A scientific looking article gets flashed in front of us on the screen… - I checked this reference and was disappointed that it was not a study but a narrative, a magazine article. The narrative describes how roman Gladiators needed to be fat to be well protected and to do this they ate very large amounts of barley, and legumes, like beans. I looked for the underlying study by Dr Fabian Kanz and this study shows evidence from isotopic data that suggest that gladiators had a mixed diet with a high share of vegetables. So, they were NOT vegetarians or vegans. They just ate a lot of vegetables. Kanz explains how they found that gladiators had very strong bones (high bone mineral density) which can be explained by training in combination with a good diet. In the documentary it is not mentioned that the reason gladiators did this was to get fat (not to get strong bones).

The red flame makes great TV, but is not reality.

A study in PLOSone 1 uses different isotopic methods to deduce what the diet of gladiators might have been. Different amounts of foods in the diet will results in different amounts of strontium in bones. In general, low strontium levels are found in carnivores and high levels in vegetarians. Strontium levels can be visualised as a flame. If the flame turns red there is a lot of strontium.. and a huge red flame flashes in front of us: Conclusion the gladiator was vegetarian…. Well no. Although our mind likes black and white, or in this case red and blue, the reality is that most real life situations are shades of grey. So what we see, a red flame, would only occur in an extreme case. Usually the distinction between diets is not that clear. There is considerable overlap in the light spectra between carnivorans and vegetarians. The red flame makes great TV, but is not reality.

There are some similarities to an example I often use when discussing a really obvious example of pseudoscience: oxygenated water. In one of the adverts of this magic “water” that is promoted as the cure for virtually everything, two thermal images of a person are presented. One image with a subtitle BEFORE is red, the other image with the subtitle AFTER is mostly green.

Before drinking oxygenated water, the person is red. The text on the web site explains that this means inflammation. After drinking the oxygenated water, the person turns green. The inflammation is gone. Thus, oxygenated water removes inflammation! There is the evidence! Well no, this is not evidence: the amount of oxygen you can get into water is incredibly small and we do not absorb oxygen in our intestine: we have lungs for that. So, you might as well breath in a couple more times, and that is free! Drinking this expensive water does not affect inflammation. These sorts of before after comparisons are meaningless, unless we are told exactly how the results were obtained but the answer to this can never be found in pseudoscience. But the flames, the lab coats the flashing of research papers on the screen quickly gives the impression that we are dealing with real science here!

It is also not surprising that the diet of a gladiator was predominantly plant-based. Roman legionnaires had daily expenditure of energy that can be estimated at around 5000 kcal for the legionnaire performing engineer work and at 6000 kcal in training or war action. This is comparable to Tour de France cyclists, who have a high protein intake, but the vast majority of their intake is carbohydrate (pasta, rice, bread, cereals, potatoes)! For legionnaires this came mainly from wheat or barley. There is no practical way to get this many calories from meat and it couldn’t provide the carbohydrates you need to perform the training.

Misleading graph in game changers

Graphs pop up on the screen.. looking highly scientific but these graphs are misleading and really make no sense at all. Early on there is a pie chart that shows that protein becomes about 60% and carbohydrate only 40% when meat is consumed. This does not make any sense at all…. 60% of what??? 40% of what? Protein intake is typically 10-15% of someone’s energy expenditure. A high protein intake can result in 20% of energy intake coming from protein. I don’t think 60% would even be possible to achieve with normal foods. The graphs, look scientific, but do no represent reality and are misleading.

Carbohydrate is plant and plant is carbohydrate?

It also seems that throughout the documentary the words carbohydrate and plant foods are used interchangeably. A plant food is not a carbohydrate and a carbohydrate is not a plant food. Plant foods can of course be high in carbohydrate but many of them are not. So, it is nonsense and misleading to use the terms as synonyms. All of this happens already in the first few minutes of the documentary, setting the tone for what is to come… but the lay viewer is terribly impressed by the huge shifts (whatever they are), the big numbers and the take home message is clearly that eating meat affects your performance.

Banner to lecture Luc van Loon plant based proteins

They say...

An approach that is often and successfully used by pseudoscience is making a statement as if this is consensus (everyone believes….) and then this statement is attacked. The statement here is “Athletes believe protein is for energy”…. I have worked with many athletes in the last 25 years and I don’t think I have met one athlete who thinks protein is for energy. I think that almost all athletes would say that it is for recovery, for muscle building and maybe some smart ones would say it is for adaptation. But the documentary starts to build on this “athlete’s belief that protein is for energy…”. It is traced back to a paper by von Liebig in the late 1800s and indeed this paper claims that protein is an energy source. But this theory got refuted and in 1912 it was shown that carbohydrate and fat were the main fuels. More studies followed in the 1920s. The statement that athletes 100 years later think protein is for energy is absurd. But it helps the makers of the documentary to then say, can you believe it, we have been wrong all this time? But now we have found the solution! Now we know better!.... the reality is that nothing has changed. We didn’t believe protein was a fuel before, and we still don’t.

Enough protein from plants?

Wilks acts surprised that you can get enough protein from plants. Even he as an athlete with increased needs, can still meet his needs using plant based foods. But is this really so surprising? Athletes have slightly highe