Game Changers: A Review

Stories are powerful. They help us imagine, feel and go so far as to give us meaning and purpose. In his masterpiece, Sapiens, Yuval Noah Harari credits humans’ survival on this planet to our ability to collectively believe in stories. And often, it’s only through the grandest of myths that we find meaning and collaboration. Religion, nation states and now maybe diets… Each aims to bring people together, often under the firm belief of collective myths.

And so we have the newest diet drama, The Game Changes.  A film that not only advocates the value, but the advantage of eating a plant based diet over one with animal products. As well as being an example of incredibly effective story telling, it’s a brilliant display of carefully constructed persuasion – with the end goal not to make us healthier and more informed (I’ll get to why), but to scare us into eating a vegan diet.

Before I go any further, I think it’s important to outline the films merits. They do well to expose our broken food system, outline the unsustainable and unethical nature of industrial agriculture… junk food is bad, veggies are good, and we should generally be more aware of what we put into our bodies. I’m also onboard with them illustrating that people CAN live a perfectly healthy life eating a vegan diet, and be world class athletes by doing so.

Where I’m not onboard is the cherry picking of data, fear tactics and blatant lies to promote their agenda. This agenda COULD be about educating vegans to make more informed decisions to lead a healthy life – particularly the lengths that plant based athletes go to to get the right amount of nutrients in. Instead, they opt for fear and emotion, clouded by dodgy interpretation of science.  I therefore believe that this film will continue to divide dietary tribes under binary perspectives with the layman caught in the middle, forever confused about what the hell to eat.

As a disclaimer, I have nothing against anyone following a plant based diet, and I admire someone who doesn’t want to contribute to the suffering of animals. I’ve been vegan myself and have worked with many people following a plant based diet. Though I do think it’s important to be a well informed plant eater, as there are many gaps in adopting this way of eating. Sadly, the film fails to communicate this so that is why I’m here.

Before we go through the film, I think it’s important to cover two important factors that aren’t talked about in the film… Money and data.

1. Follow the money

Before watching any documentary, or reading any research, we should consider where the funding is coming from – movies are expensive, and this one was not some arthouse flick. In this case, Game Changes has the backing of the irrepressible James Cameron. Not only is he one Hollywood’s most prominent directors, he’s also an advocate for sustainable farming (Go James), promotes a plant based diet AND is the founder of Verdiant Foods – an organic pea protein company. And Verdiant isn’t just a side hustle…. In 2017 they stated in a press release that “Cameron has the goal to become the largest organic pea protein fractionation facility in North America.” On top of this, Cameron has attracted investment from plant based giant Ingredion, to the tune of $140 million. So this film is not just a charity gig for him, it’s a clear conflict of interest.

Now, this doesn’t mean the information is obsolete, it just means that we should be aware of the bias from the outset.

2. Epidemiology based studies and the Healthy user bias.

As well as any conflict of interest, we should be aware of how Game Changers goes about collecting information. In this case, they predominantly use anecdote, expert opinion and epidemiological based studies – all at the very bottom of an evidence hierarchy in science.

Epidemiology is a term worth knowing about. It refers to a population based study that aims to find CORRELATIONS between the behaviours of participants and health outcomes. With these CORRELATIONS they can build a hypotheses and go on to find CAUSATIONS through randomised controlled trials. The problem is that often conclusions are made from the epidemiology alone – this is why we’re bombarded with ridiculous headlines like this:

Source: The Guardian (seriously, do better guys)

I googled some funny correlations and there’s a whole bunch of them:

Source: http://tylervigen.com/spurious-correlations

Obviously this is a far fetched example, but the film is full of conclusions based on these sorts of epidemiological based findings, without consideration of all of the other factors that may have contributed to correlations.

I’ll show you what I mean:

“People who get their protein from plant sources reduce their risk of cardiovascular disease by 55% !” 

Now, this isn’t untrue, they just don’t go into specifics, like how the study was actually a lifestyle intervention study where participants exercised, stopped smoking, and underwent stress management techniques (1).

This is a phenomenon known as the “healthy user bias” where a person who engages in something that’s deemed healthy is likely to engage in other healthy behaviours. Ie. your vegan friend is probably more likely to engage in other healthy conscious behaviours like exercise and stress reduction. Whereas your meat eating mate might be more likely to smoke, drink alcohol and eat junk food (5). You can read more about this in my last post on “why vegans are healthier.”

The same study even makes special mention of the healthy user bias as they state:

“Another study reported no difference in total mortality between British vegetarians compared with other health-conscious participants” (1)

Takeaway from this is that whenever you see a headline from a media outlet, it’s probably based on epidemiology and you should probably ignore any sort of causative conclusions they’ve built from it.

Now, the film in chronological order (you can follow at home).

What? The Gladiators were vegan?!

Very early on we set the scene of the macho vegan warrior, with Wilks pointing out that the fierce and ferocious Roman Gladiators ate a plant based diet, and this does seem to have some truth to it. The source of this information is an article (not study) by the magazine Archaeology America, which states:

“Consuming a lot of simple carbohydrates, such as barley, and legumes, like beans, was designed for survival in the arena, as they “needed subcutaneous fat, as a fat cushion protects you from cut wounds and shields nerves and blood vessels in a fight….” (2)

So yes, all signs point to the Gladiators being fat, and not the 2000s Russell Crowe that we’d hoped for. This theme of truth bending and story telling is rampant throughout the film and this is the first example.

Sorry, The Gladiators probably didn’t look like this

We only need to think logically to work out how flawed the vegan Gladiator idea is. Do you really think Gladiators, who mainly consisted of slaves, offenders and prisoners of war (3), would be picky about what they were eating? Do you think they were in the know about supposed magical powers of plants? It’s more likely that they ate whatever was available them – like most of our ancestors. Not surprisingly, the research supports this too, as another Gladiator burial site in Thebes, found that their bones were rich in nitrogen, which suggests a diet with animal products. (3)

Plant Based vs Animal Based Proteins

In one instance where Wilks does cite peer-reviewed research, he states: “when it comes to gaining strength and muscle mass, research comparing plant and animal protein has shown that as long as the proper amount of aminos acids are consumed the source is irrelevant.” (4)

Now, this isn’t untrue, it’s just bending the results (like we saw with the Gladiators) towards team plant – based.

What Wilks misses is in the same study it states:

“As a group, vegetarians have lower mean muscle creatine concentrations than do omnivores, and this may affect supra-maximal exercise performance.” And, “vegetarians are likely to experience greater performance increments after creatine loading in activities that rely on the adenosine triphosphate/phosphocreatine system.” (4)

Yeah, I wouldn’t include that in the movie either.

One reason for a vegetarian diet being inferior for strength and muscle mass is due to the nature of plant proteins being considered “incomplete” versus animal proteins being “complete.” This is due to the amount and ratio of amino acids that are in the protein – it’s not that plant based foods are “depleted” of amino acids, it’s just that they have lower levels than animal products, and you have to eat A LOT more food, and know what you’re doing to reach optimal amounts. Have a read of what vegan strongman Patrik Baboumian eats in a day.

Digestibility of Protein – The Rosetta Stone

It’s widely accepted that animal based protein is better digested than plant varieties, though digestion and assimilation is given no air time in the film… This is why you’ll see those silly memes espousing all of the protein in plant foods, but with no mention of how well we digest them.

Animal based protein is digested at a 90% or higher rate, while plant protein ranges anywhere from 55% to 80% (5).

The reason for this is due to the “anti – nutrients” like phytates and trypsin inhibitors. This is why vegans should always be soaking, sprouting, fermenting, and boiling those beans as it reduces the content of these anti nutrients (5)(6). This would have been valuable information to include in the film to promote a healthy plant based diet.

This is a screenshot from Game Changers – I did NOT say this. 

The Middleman Paradox

This is where the film gets lazy, as they imply that animals are just the middle men in our quest for protein. The truth is that they play a vital role in the conversion of inactive nutrients into active ones for us to digest.

Though the film depicts animals as being “just the middle men,” these middle men are CRUCIAL for you getting a host of vital nutrients.

How our animal friends convert nutrients for us:

1. Short – chain fatty acids into long chain fatty acids EPA, DHA, and arachidonic acid. Yeah, those anti inflammatory omega 3’s that we’ve heard are so important for brain, heart, and skin health?! You can thank our animal friends for that.

2. Pyridoxin B6 – Pyridoxal B6 active form. This B  Vitamin is crucial for energy production and hormonal health, so much so that many people supplement with it as they don’t get enough with diet.

3. Vitamin K1 – Vitamin K2. This is a big rock, as K2 helps keep calcium out of the arteries and into bones… Another one that many of us supplement with, but you can get all of the K2 you need through organ meats.

Plant based and Athletic Performance

The crux of the film is that being plant based isn’t just good for you, it’s a performance enhancer and will help you get next level alpha athleticism. To illustrate this point they pick out some highly trained athletes who are at the top of their game and all are plant based. The main athletes are: Kendrick Farris (weightlifter), Scott Jurek (endurance runner), and Patrik Baboumian (strongman).

Let’s look at these athletes a little more closely:

Kendrick Farris is someone I’ve followed for some time. I’m a fan. He started lifting at 12 years old, won the American titles in 2006 and 2007, then went on to place a career best eighth in the 2008 Olympics and tenth at the 2012 Games – this was the peak of his career, and he did this eating meat. He then transferred to a plant based diet in 2014 and placed eleventh in the 2016 Olympics. Now, we shouldn’t look into these standings as much as we should look at his developmental stages in strength and conditioning NOT following a plant based diet. So team plant based can take credit for a few pages in the book of Kendrick Farris, not the whole book.

(Side note: the greatest weightlifter of the modern era, Ilya Ilyin, IS vegan! Though he doesn’t quite fit the narrative of the film as he was stripped of his two olympic titles after testing positive for anabolic steroids… you won’t be seeing him in the film)

Jurek became vegan in 1999, after 26 years of eating meat. He spent much of his upbringing hunting, fishing and was already an accomplished endurance runner before transitioning to a plant based diet.

This is critical information when it comes to training age, which is my main point here. This refers to amount of time athletes have spent developing their bodies to withstand stressors – ie. how many reps have you done in a given sport. Often this is quite different to biological age where we look at cellular health. Clearly Jurek and Farris are genetically predisposed to their sports and have extremely high training ages. Despite what the film conveys, eating veggies wasn’t the catalyst for their success… Their success is due to a combination of genetic predisposition and years of hard training and all the behaviours that come from being an athlete.

This selection bias seems to be a common theme when we look at someone successful as we cherry pick their current habits and ignore the years spent slaving away at their craft.  We don’t see Mark Zuckerberg slaving away in College before Facebook existed, nor do we see the bodybuilding reps and years of farm work that 4 times Fittest man on Earth, Rich Froning went through. What we do see is an inspirational meme from Zuckerberg and a training video from Rich that suggests you just need to do what they do.

We’re also bombarded with other plant based athletes who’ve enjoyed success in their sport while following a plant based diet. While it seems like a magical potion that’s given to them to express superhuman levels of strength and endurance, I believe that their newfound performance is due to them simply cleaning up their diet and eating more fruits and veggies – that and the verrryy powerful placebo effect that comes with eating “well.”

Vegan Gainz – Plant Power and Muscle Gain

Just the plants?

There’s a theme throughout the film of plants being carbs and carbs being plants, and with that information they display some plant based bodybuilders and use a study that compared a “normal carbohydrate” group to a “low carb” group, with both groups eating 2g of protein per kilo of bodyweight, and both groups were eating meat! Something the filmmakers decided to leave out. So really, we have one group eating more carbs and one group ketogenic… Of course the “normal” group is going to gain more muscle, as carbs do play a part in anabolism. So really the takeaway here is that a diet with high protein and some carbs will put on more muscle than high protein and little carbs. The takeaway is not plants make you jacked.

Plant based diet and “energy”

The film does very well to create a magical link between vegan diets and vital energy. They do this with horrible explanations of physiology masked by beautiful and athletic bodies.

They set the scene by saying that many athletes believe that protein gives them energy… I don’t buy this. Most athletes are well attuned to the fact that carbohydrates are their main source of energy, and most athletes will know that protein aids in recovery from the work they’re doing.

They then go on about muscle glycogen depletion as a result of adding more protein to the diet.
To further illustrate this point, they use this graphic:

While it’s true that low muscle glycogen levels can be seen with low carbohydrate diets, it’s only seen on a VERY low carb diet (<20% of total calories), and this is only in the acute phase. After 6 weeks muscle of adaptation, glycogen returns to 69% of its original levels (8). As for depletion, the body has a crafty mechanism called gluconeogenesis to ensure that this doesn’t happen,  though this isn’t mentioned in the film.

It should also be noted that protein plays a critical role in an athletes recovery as it aides in glycogen resynthesis, and a combination of carbs + protein has been shown to be more effective than just carbs for glycogen replenishment. (8)

Gorillas and Humans are Different

You are not him

“I was surprised to learn that all the meat we eat originally comes from plants.”

This is where Wilks peaks in ridiculousness as the film makes the age old comparison between gorillas and humans’ diets and physiques.

All too often our plant based friends are quick to point out the impressive amounts of  muscle mass on vegetarian animals – cows, chimps, gorillas are all pretty jacked, and they mostly eat plants…. Or to quote strongman Patrik Baboumian (who is a BEAST) in the film:

“People ask, how could you get as strong as an ox without eating meat? My answer was; Have you ever seen an ox eating meat?”

What Patrik may not know is that cows and humans are vastly different creatures (shocker), and have completely different digestive systems.

You may have heard the crazy fact that cows have 4 stomach’s, which are used to store the triumphant amount of grass they take in. They’re then able to ferment the vegetation, turn it into volatile fatty acids (VFA’s), then create protein from the digested bacteria. This makes an efficient grass burning machine. The same cannot be said for Patrik or any other human.

This argument really needs to be put to bed. In what other situation would we look to the behaviours of other animals to base ours on?!

Blue whales look pretty strong… I’m gonna go get me some plankton.

Antioxidants in Iceberg lettuce vs Eggs/Salmon

I nearly turned it off after this point as the narrators backed their iceberg lettuce against the nutritional powerhouses eggs and salmon. Their method of measurement? Antioxidant content. Not choline, iron, carotenoids, protein or fatty acid content… Antioxidants.

Now, not only are the benefits of antioxidants vastly overrated (10), they’re choosing some of the most nutrient dense foods available to us to get their point across. If we have to score, we should do so with a “nutrient density” scale, which takes into account all of the different vitamins and minerals in foods and ranks them. I wrote about nutrient density back in 2015 – have a look at what foods are stacked at the top!

A healthy message would be to eat your nutrient dense salmon for your protein, omega 3’s etc and have you iceberg lettuce on the side for antioxidants. Though Game Changers are not interested in creating health, they’re interested in promoting an ideology.

Endothelial dysfunction and “that” experiment

Here they compared the plasma content of 3 participants eating a meat burrito vs a bean burrito. The argument was then that the cloudier the plasma, the more endothelial dysfunction, constriction of blood vessels, chance of CVD etc etc etc.

An uninteresting experiment of postprandial lipemia

This bit was as powerful as it was flawed. While the meaty burrito created cloudy serum each time, this is a perfectly normal process that occurs when we eat a fatty meal… it’s known as postprandial lipemia. This is why you always fast before you draw blood! It would have been interesting to see the results when the 3 participants were fasted (like any serious experiment), but this wouldn’t fit their agenda.

To the films credit, they did disclose that the omnivores ate a junk food diet rich in fried chicken…. This is a far cry from a diet rich in grass fed meat and organic vegetables. So really the comparison is junk food diet vs plant based. So a diet rich in fruits and vegetables is healthier than a diet rich in refined carbohydrates and nutrient depleted food – that’s something we can all agree on.

The point that I did like is when they stated that this vasoconstriction would inhibit performance. Sure, it would.  Digestion takes up A LOT of energy and eating a meal high in fat and protein will divert resources away from the peripheral muscles and into the gut, thereby inhibiting performance. That’s why you wouldn’t find a coach in the world who would recommend a high fat meal prior to training as it’s seriously inhibiting (11).

Plant based and testosterone levels  

The appeal to manliness continued with a compelling piece of information regarding testosterone levels and plant based diets. The piece of information they came up with was that plant based eaters had higher amounts of T than meat eaters – again, the research seems to support this claim, sort of. What they don’t tell you is that there’s an important difference between free and bound testosterone, and when you look at the testosterone that’s actually usable, there’s no difference between the groups (12). In fact, in the study that they cited, vegans had significantly higher sex hormone binding globulin, which binds to testosterone, so they would have had LESS available T than the meat eaters (12).

Though a case for a protein deload?

I do think this is an interesting point, as increased T levels have been linked to gut function, and intermittently de-loading the gut from a protein rich diet. This gives the gallbladder, lymph nodes and the gut a break – maybe this is why folk feel so good when they first go on a vegan diet? On top of this, many athletes eat a diet that’s high in protein for extended periods of time, and going through a phase of a plant based diet might be a good idea in taking pressure off these organs. I happen to adopt a plant based diet several times throughout the year and always feel better for it.

Could the short term benefits of a vegan diet be from deloading the gut?

Inflammation, Cholesterol, Oxidative Stress, and Other Perils of Evil

I feel that at this point in the movie they were just throwing grenades and hoping they would stick. Audience is tired, emotions are heightened…. it’s a good chance to lob some buzz words out there that we know are bad but we don’t know why.

Truth is that inflammation and cholesterol are both vital in the human body and their benefit or cost is all dependent on context.

With inflammation we signal to the body to repair and grow. This is critical in performance as athletes deliberately inflict inflammation throughout the body while training (this is different to when they’re competing).

The way they used inflammation to demonise meat was to cite a study that compared inflammatory markers after consuming a beef patty vs a beef patty with Hass avocado. (worth mentioning that this study was funded by Big Avocado, which has to be my favourite lobby group).

Big avocado at it again

This study found ONE inflammatory marker, IL-6, was elevated after eating the burger, but this inflammatory response was diminished when avocado was added (13). This is pretty cool to know: Adding avocado to a burger decreases the inflammatory marker IL-6 in the short term. Go avocado.  Though there are many questions to ask before we come up with conclusions: is this an acute (beneficial) or chronic (harmful) inflammatory response, does this depend on genetics, gut function etc? Or is this is a perfectly normal physiological response (like postprandial lipemia) which will self regulate over time?

An interesting cohort study also found an association with meat eaters and inflammation. Though when they corrected for differences in BMI, there was no significant association (14). This is because inflammation is highly associated with obesity, and as mentioned at the start of the article, vegans are typically healthier and eat less calories than meat eaters (5). The healthy user bias is at it again!

Cholesterol is a vital molecule in the body that is at the forefront of hormone production. The evidence that has linked it to cardiovascular disease has largely been debunked. In a 2005 systematic review, researchers chose 28 studies to analyse on the issue…. Twelve found no link between LDL (so called bad) cholesterol and mortality, and the remaining studies showed that lower LDL was linked with HIGHER risk in mortality! (15) This information is so well known that even Governments have retracted warnings about dietary cholesterol.

Cholesterol is so 80’s, get with the time guys

Oxidative stress can indeed be a nasty one, but most of the evidence around it associates it with the easily oxidised polyunsaturated fatty acids (mostly plant based foods!) (16). The way they link meat to oxidative stress levels is through a small study (17) that used the following high fat meal:  “110g rice, 100g Korean barbecue, 20g egg, 200ml milk, 8 g oil, 25g mayonnaise, 50g vegetables.” Right there we need to question the quality of the ingredients used… What “oil” was used? What did the Korean BBQ consist of? What was in the mayonnaise?

It’s likely that this meal is full of PUFA, which is likely the cause of oxidative stress. If we look at studies that measure molecules of meat and oxidative stress, we find that there’s no association between the two (18).

Concluding

I think there’s some real benefits to eating a plant based diet, and I hope that people who have watched this film can see the value in eating plants, and see what athletic pursuits are possible while adopting this approach. I also hope those who are following a plant based diet can understand the gaps in this method, and do their research to find the best strategies to be as healthy as possible.

What worries me is that this film is so steeped in biases, cherry picking and in some cases straight out lies, that it’ll cause a precedent to disregard the science and make decisions based on misinformation. This leads to further confusion, division, and dietary tribes, where we forget about how we actually feel.

I do hope that we can go move past this form of information in the form of nutrition infotainment, and do as Bruce Lee says:

References

(1) Beyond Meatless, the Health Effects of Vegan Diets: Findings from the Adventist Cohorts. May 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4073139/

(2) The Gladiator Diet. Archeology America. November, 2008.  https://archive.archaeology.org/0811/abstracts/gladiator.html

(3) Stable Isotope and Trace Element Studies on Gladiators and Contemporary Romans from Ephesus. Oct 2014. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0110489

(4) Nutrition considerations for vegetarian athletes. July 2004. https://www.ncbi.nlm.nih.gov/pubmed/15212753

(5) Nutrient Profiles of Vegetarian and Non Vegetarian Dietary Patterns. December 2013. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4081456/pdf/nihms497174.pdf

(6) Reduction of phytic acid and enhancement of bioavailable micronutrients in food grains. April 2013. https://www.ncbi.nlm.nih.gov/pubmed/25694676

(7) Capacity for moderate exercise in obese subjects after adaptation to a hypocaloric, ketogenic diet. Nov 1980. https://www.ncbi.nlm.nih.gov/pubmed/7000826

(8) Regulation of Muscle Glycogen Repletion, Muscle Protein Synthesis and Repair Following Exercise. Sept 2004. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3905295/

(9) Efficacy of ketogenic diet on body composition during resistance training in trained men: a randomized controlled trial. July 2018.  https://www.ncbi.nlm.nih.gov/pubmed/29986720

(10) Antioxidants: Beyond the Hype. https://www.hsph.harvard.edu/nutritionsource/antioxidants/

(11) Exercise and postprandial lipemia: effects on vascular health in inactive adults.  April 2018. https://lipidworld.biomedcentral.com/articles/10.1186/s12944-018-0719-3

(12) Testosterone, sex hormone-binding globulin, calculated free testosterone, and oestradiol in male vegans and omnivores. July 1980. https://www.ncbi.nlm.nih.gov/pubmed/2400756

(13) Hass avocado modulates postprandial vascular reactivity and postprandial inflammatory responses to a hamburger meal in healthy volunteers. Feb 2013 https://www.ncbi.nlm.nih.gov/pubmed/23196671

(14) Effects of Total Red Meat Consumption on Glycemic Control and Inflammation: A Systematically Searched Meta-analysis and Meta-regression of Randomized Controlled Trials (OR22-08-19) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6574076/

(15) Lack of an association or an inverse association between low-density-lipoprotein cholesterol and mortality in the elderly: a systematic review. https://bmjopen.bmj.com/content/6/6/e010401.full

(16) Health Implications of High Dietary Omega-6 Polyunsaturated Fatty Acids. April 2012.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3335257/

(17) Postprandial hypertriglyceridemia impairs endothelial function by enhanced oxidant stress. April 2001.  https://www.sciencedirect.com/science/article/abs/pii/S0021915000006018

(18) Increased lean red meat intake does not elevate markers of oxidative stress and inflammation in humans. Feb 2007. https://www.ncbi.nlm.nih.gov/pubmed/17237312

Thank you for reading. This took a lot of energy and I appreciate you getting to the end!

Steve Hennessy is a Functional Diagnostic Nutrition Practitioner. He consults with clients from around the world, using fitness, nutrition and lifestyle coaching to create healthier humans.

*Disclaimer: This post is for information purposes only, and is not designed to diagnose or treat any disease. Always seek help from a medical professional whenever you undergo any dietary change.