The Big Idea: Dr. Neal Barnard


I love cheeseburgers. How they smell and how they taste. With fried onions and lettuce and tomatoes and lots of ketchup. I love the memory of eating them in the bar in Baltimore where my husband and I went all the time early in our marriage–the place that served them big as saucers in red plastic paper-lined baskets, with cold National Premium on tap and ’80s hits by Donna Summer and Joe Jackson on the jukebox.

I don’t eat too many cheeseburgers these days. Middle age, caring for my once-vibrant mother after her heart attack and stroke, and decades spent counseling my patients about the dangers of saturated fat have sobered me into moderation.

But lately I’ve been wondering if moderation is enough.

Reports of the cruel treatment of animals raised for food, such as a recent undercover video leading to shutdown of a California slaughterhouse, force me to face the fact that eating animals always involves, well, killing animals. Information, presented in the popular documentary Forks Over Knives, about the health problems caused by even “healthier” versions of animal products, such as lean meat, fish, and low-fat dairy products, makes me wonder about avoiding all animal products—going vegan.

Change is hard—especially when it involves food, so deeply tied to identity. Who would I be if I never had another pastrami on rye, hunk of cheddar, or Thanksgiving turkey? But who would I be, as a person and as a doctor, if kept eating these things?

I discussed my quandary with author, medical researcher, and activist Dr. Neal Barnard. Dr. Barnard has advocated for animal protection and veganism for the past thirty years. Physicians Committee For Responsible Medicine (PCRM), the nonprofit he founded in 1985, works to educate clinicians and the public about the benefits of veganism, and to end animal experimentation. Dr. Barnard also conducts research on the effects of vegan diets on diabetes, chronic pain, and other conditions, and lobbies the U.S. government for changes in agricultural subsidies and healthier school lunches.

I met with Dr. Barnard in the Washington office of PCRM. He’s 58 but looks…I was going to say “younger” but I really mean healthier. He’s lean and energetic and makes you realize how flabby and lethargic most Americans of all ages look these days.

He’s an excellent advertisement for a vegan diet.

Dr. Barnard had much to say about what motivates people to adopt veganism, about the idea that humans are natural carnivores, about what’s really involved in producing animal-derived food, and about Michelle Obama’s “Let’s Move” campaign.

Though he was open to discussing any aspect of his work, I was most interested in how people decide not to eat animals and then stick with that decision. I told him that—like the average Rumpus reader, I imagine—I’m not blind to animal cruelty, not blind to the health effects of eating animal products, or to the relation of meat eating to global warming. And yet I’ve found it hard, over the years, not to slip back into denial about these things and start eating meat again.

I began by asking Dr. Barnard about the moment when he, born into a family of cattle ranchers, decided to become a lifelong vegan.


The Rumpus: I read that you stopped eating meat one day when you were in medical school. You assisted in an autopsy on someone who’d had a heart attack, saw the fat in the arteries and the severed ribs. And then you went to the hospital cafeteria for lunch and they were serving…ribs. That moment seems to encapsulate the complementary missions in your career: promoting health and preventing cruelty to animals. At the time, which felt more important to you?

Dr. Neal Barnard: You know there’s another piece of it, which is the element of disgust. The way you’d feel if someone handed you a glass of blood. In some cultures that would be a totally normal thing to do. But in our culture, that would be absolutely disgusting. I’ve heard it said that of all of the motivators, that is the strongest one. The health messages and morality messages pale compared with that.

But to answer your question more directly, both were important. I grew up in North Dakota, and I was aware of what animals go through because I had driven animals to slaughter and I’d killed animals. And I was aware that there were certain ethical issues, but they weren’t preying on my mind very heavily. And I was aware of the health issues—sort of.

Rumpus: But isn’t there an evolutionary basis for meat eating—for us not to be disgusted by it? We have canine teeth, our forebears speared animals and ate them. Aren’t we hardwired for meat eating? Is the fact that cooking meat smells good to us really just a cultural thing?

Barnard: Meat smells good, bleu cheese smells good—to some people. But it’s acquired. If you ask a guy who’s thirty-five if a cold beer on a hot summer day would taste good, he’d say, “Yeah, that would taste wonderful.” But if you could go back in time to his first taste behind the garage when he was fifteen, it probably tasted disgusting. We acquire certain tastes for things.

And if you took a baby and put a bunny in front of him, and if you had a cat and a bunny, the cat at any age would want to attack and kill the bunny and the child would say, “Oh, look at the bunny!” So the idea that we have some innate aggression towards animals…we don’t.

About the teeth: if you open the mouth of a cat, a carnivore, you see that they have long canines, way beyond the other teeth. If you open the mouth of a dog, you see the same. If you open your mouth, you don’t. You have canines that are the same length as your incisors. If you have long canine teeth, it allows you to do two things: one, it allows you to snatch your prey. The other thing it allows you to do is to pull away the hide. If a dog happens to catch a rabbit or another animal, it can very easily remove the hide. If a cat catches a squirrel, they have no trouble with that. But if a person does that, they will work all day and all night to get the skin off of an animal, because they don’t have long canine teeth anymore.

We also don’t have claws. Plus we’re not fast. Plus we don’t have very good vision, or good sense of smell. An owl is a predator and can detect a mouse at a tremendous distance. Dogs have a sense of smell much greater than ours and they’re much faster than we are. We have fairly dull senses, fairly slow locomotion. In our Olympic trials, we celebrate speeds that would be an embarrassment to a bird or a dog or another animal.

We have nothing to kill prey with and nothing to remove the hide with. So the question is when did that change come? It’s something like 3.5 million years ago that we lost our long canine teeth. And most of the great apes did, too—and they’re almost entirely vegetarian. Chimpanzees will eat a little bit of meat. But, they never eat dairy products, and no other animal would do that.

Rumpus: What do you think that’s all about, humans eating dairy? Is that an evolutionary thing or purely cultural?

Barnard: It isn’t evolution. It’s creativity. It’s the same as eating meat. Meat eating wasn’t really practical until the Stone Age. The Stone Age gave us arrow heads and eventually knives, and that allowed us to kill animals in ways you couldn’t before, and once you had them you were able to remove the skin and bones.

We’re not carnivores. We’ve never been carnivores, ever. And even today, the most you can say is that people have become honorary omnivores. And that’s only because a) we are creative and find ways to do things that are not natural for us; and b) the dangers of eating animal products occur after the age of reproduction. If people developed cardiovascular disease that was fatal by the age of twelve or thirteen, eating animals would have died out long ago. You get it after you’ve already reproduced.

Dairy is a northern European invention and nothing that nature ever had in mind. It’s all because we figured out how to make cows stand still.

Rumpus: So suppose someone wants to pull back on this 3.5 million years of meat and dairy eating. How do you feel about the incremental approach? Giving up just red meat, say. Or becoming a pescatarian, or a lacto-ovo vegetarian rather than a vegan?

Barnard: It doesn’t do a lot of good for your health to move from red meat to white meat, but it gets you further down the road towards making more substantial changes later. So any move is a good move. And while it’s certainly true that many people think that dairy doesn’t have a cost to the animal, it’s because they never went to a dairy farm.

Rumpus: How about this trend I’ve noticed: super-aggressive meat eating—usually locavore or “farm to table.” In the TV show Portlandia, they make fun of these restaurants where the waiter tells you what a nice life the chicken led before it arrived on your plate. I went to a place in Boston that serves locally sourced pork with the jaw and teeth on the side as a garnish. Among modern, urban, liberal people, this seems to be a thing—among the same people who you’d think would be exploring vegetarianism. Have you noticed this?

Barnard: Yeah, that’s the same person who reads Cigar Afficionado. It’s someone who’s thumbing their nose at science and hoping they’re an exception to the rule.

Rumpus: But it’s a whole movement, it seems, in culinary culture. You think “locavore,” etc. is a smokescreen?

Barnard: It’s a rationalization—and this too shall pass.

Rumpus: It’ll pass because we can’t sustain it environmentally and we can’t sustain it health-wise? Because ultimately you get just as sick from a free-range chicken as from Chick Fil-A?

Barnard: Apologizing to the animals or having them come from a local farm doesn’t change the ethics of it nor does it change the health aspects of it.

Rumpus: How about seafood? I know someone who doesn’t eat meat or poultry but she does eat shellfish because she feels that while she couldn’t kill a cow or a chicken, she could net a shrimp herself. She can’t imagine that a shrimp suffers. Is shrimp really part of the same spectrum of suffering that you talk about?

Barnard: She’s just feeling what she can picture—and she can’t picture the shrimp suffering very much. On the other hand, if she saw her six-year-old son pulling the wings off a butterfly, or pulling the legs off a bug one by one, would she send him to a psychiatrist or not?

Rumpus: So it’s a narrative that works for us—that animals don’t suffer as we do—and we go with that?

Barnard: I think that’s right. Another thing to think about is why people make the decisions that they do. The evidence that someone who eats animal remains is much more likely to have heart attacks, certain cancers, weight problems, hypertension, dementia of the Alzheimer’s type—that evidence is quite conclusive. So why do they do it? Well, first, they might not have the information. There’s a lot of noise, a lot of conflicting information out there. That’s the first thing.

Rumpus: You mean like about milk being the “perfect food”…?

Barnard: Yes: “you need red meat for iron,” “you need ‘complete’ protein,” whatever… The second thing is: where is your herd going? I think herd mentality is a good thing overall. Because if every sheep had to figure out the velocity of the wolf and their personal risk, that would take forever. It’s much better to say, “If the herd is running, I’m running with those guys.” And humans have herd mentality, too.

Rumpus: I read somewhere that you said there are no non-vegetarians, only “pre-vegetarians.” Do you see our “herd” running in the right direction?

Barnard: Well, we’re kind of running in two different directions. Overall, our population is in the worst shape it’s ever been. Children are in terrible shape. We have absolutely unprecedented numbers of obese and overweight children—one in three now. A generation ago it was something like one in ten. However, meat intake is starting to fall. It peaked in 2004. We’re down about 5% from 2004. We were at 201.5 lbs per person per year. I’m talking about all meat together—red meat, chicken, poultry, fish. And we’re now at 188.9 lbs per person per year in the U.S. That’s good. So we’ve been in bad shape, and the effects of our previous meat eating are still very evident, but at the same time, conflicting with that in a good way is that the number of people who are changing is bigger than it’s ever been.

Rumpus: I’ve noticed that your work recently has emphasized the public health aspects of veganism, perhaps more than animal protection. Is that because the public health issues are so overwhelming?

Barnard: I think both are really intertwined. Take diabetes: it’s the worst it’s ever been in the U.S. and in almost every other country. And it’s getting worse year by year. The federal government’s response is to fund research that is headed towards making new drugs. To do that, the government spends approximately half a billion dollars a year on animal research, consuming about 70,000 animals per year. I am going to assert that the use of those animals in developing drugs would have made sense decades ago before it was really clear that diabetes is a lifestyle-related disease for the most part. So instead, if we studied human beings which can include human genes, human blood samples, and human behavior, then you can leave the animals out of the labs and you can leave them off your plate.

Rumpus: In terms of your work, do you feel that the upcoming election matters a lot? In other words, do you see President Obama as being a positive leader in terms of your work?

Barnard: As a nonprofit we are absolutely not allowed to make any comment about a political candidate, however I will say this: we have pushed the current administration to be more vigorous, and whoever is in the next administration, we’ll push them, too. I feel that [Michelle Obama’s] “Let’s Move” campaign is mostly window dressing. I’d hoped it wouldn’t be that way and it doesn’t have to be that way. Does she really want to stop childhood obesity? I don’t know the answer to that. I can’t tell.

Rumpus: But of course she’s operating in such a hostile environment…

Barnard: But it has become a very feeble effort. And whether it was ever intended to be more than that, I don’t know. But my feeling is, if it’s literacy [Laura Bush’s cause] or billboards [referring to Lady Bird Johnson’s attempt to get ugly signs off highways], you can fool around, because nobody is going to die as a result. But if you’re talking about something like childhood obesity, which kills those children when they grow up, you can’t say “Do more hula hoops,” as if that will solve it. And so we have encouraged the first lady to show some leadership and to try to get this government to stop subsidizing unhealthy food, to stop promoting exercise as a substitute for good eating habits.

Rumpus: And has the administration been receptive?

Barnard: Completely unreceptive.

Rumpus: Just because it’s too big to…

Barnard: I can’t speak for them. All I know is that they have shown no interest in going in the direction that we have suggested.

Rumpus: What about the medical profession? I can tell you that the colleagues in my primary care group are not promoting vegetarianism, or even talking much about nutrition at all. Some of that has to do with time. Some of it has to do with the fact that we’re so poorly educated in nutrition. And yet, why are we not making the connection?

Barnard: I think it starts with doctors knowing what nutrition can do. Up until now, it’s been pretty disappointing. You bring a person in with diabetes and start them on “medical nutrition therapy” [a standard, non-vegetarian diabetic diet] and nothing happens. You start them on insulin and you can bring their glucose down as much a you want. When we use vegan diets, the results are much better and you have a much more grateful patient.

Rumpus: And haven’t you compared them head to head in a study? Was vegan better?

Barnard: In our NIH trial the vegan diet is way, way better.

Rumpus: What about Atkins, low-carb, or “paleo” diets? Some argue that it’s carbohydrates, not saturated animal fats that cause obesity, diabetes, and other chronic conditions.

Barnard: The thinnest people on the planet are those who eat the most carbohydrates. I’m thinking of people in rural Japan and China, where McDonald’s hasn’t yet arrived. These are the thinnest, healthiest, longest-lived people with the least risk of cardiovascular disease and diabetes. As soon as you put a McDonald’s in their neighborhood, rice intake and intake of carbohydrates in general fall dramatically, waistlines get wider, diabetes goes up. In Japan, from 1980 to 1990, diabetes went up from less than 5% to about 11-12% of the population. Just like that. So the idea that carbohydrates are responsible for that is complete nonsense. People do lose weight on an Atkins diet. The reason they lose weight is because of calorie reduction. If a person’s caloric intake has not fallen, if they are really shoveling in the steak, they don’t lose weight. And a third of low carb dieters will have a substantial elevation in their cholesterol. And there was a paper on cognition, that said that objectively, though they may not be aware of it, people on [an] Atkins diet are slower, their reaction time is not as good.

Rumpus: We have made progress, though. We’ve gone from those dusty health food stores of the 1970s, to veggie burgers everywhere…

Barnard: Including at the Republican National Convention! They had veggie burgers on the menu!

Rumpus: Do you feel like the environment in which you’re working is less hostile and less lonely than back in the early days of your career?

Barnard: Dramatically so. Bill Clinton went vegan, and Rosie O’Donnell, Ellen Degeneres, and the Williams sisters… In the past couple of years there have been all these athletes, including super runners and football players… If you look at what’s happened to those dusty health food stores, they’re gone. They’ve been replaced by Whole Foods and similar places that are enormous, that have every possible vegan product that you could ever want.

Rumpus: But Whole Foods is expensive. Have you gone to developing countries? Have you gotten the reaction that veganism is somehow a luxury of rich, Western people?

Barnard: No, it’s the reverse. In China, because China is gaining wealth, rice consumption is way down. Rice is a poor person’s food, and they’re eating less of it. To wait in line at a fast food chain is cool. And they haven’t historically had weight problems. So they don’t have this culture of, “I need to lose weight.” Whereas Americans do have that culture.

Rumpus: But it sounds like they’re not far behind us…

Barnard: Oh, they’re leap-frogging us! But I don’t think China or Japan or India, for that matter—where there’s a lot of diabetes now—I don’t think they’re putting two and two together: that it’s the Western diet that’s causing it. Since I first went to India twenty some years ago, there’s been a palpable change. There’s now pizza everywhere, meat is much more popular than it’s ever been. Vegetarianism is “that quaint thing our parents did.”

Rumpus: So, I just want to circle back to the very beginning of our conversation, to disgust. That’s a hard sell if that’s the most potent motivator. To encourage veganism do we have to disgust people and make them feel guilty and force them to look at what they don’t want to look at?

Barnard: I think we have to do everything that’s useful. We’re doctors. Our job is to tell the truth. And it doesn’t have to be embellished in any way. People have to know that if they’ve wanted to lose weight, if they’ve wanted to get their diabetes better and get their cholesterol down, here is how it works. Beyond that point, you can’t force people into changes, you have to guide them. I think it’s also fair game to play all the emotional cards, which can mean talking about celebrities and how they’ve changed—which helps us to realize that part of our “herd” are moving in a different direction.

I am always struck by how difficult it is for people to see how much cruelty they are bringing not only upon animals but upon themselves and their loved ones and other people, how much we are screwing up the planet, how much we are hurting our own health, how hard it is to change all that, how eager people are to make a buck at everybody else’s expense—all those things are discouraging.

But I think it’s fair, if something really is disgusting, to make people aware of it. For example, I just sampled about 120 chicken samples in Buffalo, New York. And we sent them to the lab and tested for fecal contaminaton. We’ll find it in about half of the samples. If you take a chicken thigh and wring it out, there’s fecal soup that comes out of it because there’s chicken feces everywhere in these places, and as they go through the chill bath, that spreads it around and the meat soaks it up and that measurably increases the weight of the chicken product they’re selling. How many people know that? They see the little preparation label that tells you to make sure you cook it, as if somehow a little peppering of bacteria has come from the atmosphere. They don’t realize that it’s chicken dung that’s not just on the surface but soaked into the meat. So people are serving their kids cooked poop. I think it’s fair game for people to know that. They may decide they’re going to do it anyway. But if some people think, “Why am I eating a dead bird soaked in poop?” I think if some people get disgusted by that, it’s all to the good. Their coronary arteries will be healthier.


“The Big Idea” features interviews with writers, artists, scientists, activists, and others who take a long and broad view of an issue, problem, or concept, and pursue it over many years. Visit the archives here.

Suzanne Koven MD, MFA is a primary care physician and writer-in-residence at Massachusetts General Hospital in Boston. Her writing has appeared in the New England Journal of Medicine, the Boston Globe, VQR, and elsewhere. Her interview column “The Big Idea” appeared at The Rumpus. Her memoir-in-essays, Letter to a Young Female Physician, will be published by W. W. Norton & Co. on May 4, 2021. More from this author →