How do fresh food diets compare to their commercial cousins?

We should make decisions based on the best possible evidence, and we should limit our claims to what the evidence can support

While human convenience foods are deliberately designed to be appealing and not nutritious, pet foods, by comparison, are formulated with much more emphasis on nutritional value. Photo ID 41139991 © Katarzyna Bialasiewicz |
While human convenience foods are deliberately designed to be appealing and not nutritious, pet foods, by comparison, are formulated with much more emphasis on nutritional value.
Photo ID 41139991 © Katarzyna Bialasiewicz |

Nutrition is one of the most frequent subjects my clients want to discuss, and often one of the most controversial. Raw diets,1 vegetarian or vegan pet foods,1 ketogenic diets for pets,2 the significance of ‘artificial’ versus ‘natural’ pet food ingredients,3 and the fundamental question of whether veterinarians are trusted counsellors when it comes to nutrition4 are just some of the controversies in pet nutrition I have covered in Veterinary Practice News and Veterinary Practice News Canada.

These are all tough issues, both because of the passionate opinions they engender, and because of the inevitably limited and imperfect scientific evidence available to adjudicate them. A key tenet of evidence-based medicine, however, is we must make judgments based on the evidence we have, not the evidence we wish we had. Another core principle is our confidence in any judgment we make should only be as strong as the evidence allows.

This column’s topic is one where claims and passions far exceed the available evidence—fresh pet food. Various terms are used to describe such diets, including fresh, lightly cooked, whole food, etc., and there is no standardized terminology for these diets. In this article, I will mostly use ‘fresh food’ as a shorthand for the myriad diets marketed in this way.

What do we know?

In addition to homemade fresh diets prepared by individual dog owners, a number of companies are now selling cooked commercial diets designed and packaged like fresh, homemade foods rather than extruded kibble or traditional canned pet food. These companies market such diets with implicit (or often explicit) claims they are healthier than traditional commercial foods.

In an extreme example, the founders of Just Food for Dogs (JFFD) have written a polemical book, Big Kibble: The Hidden Dangers of the Pet Food Industry to promote their alternative to traditional commercial diets. They have not been restrained or respectful5 in their response to criticism of their claims and marketing methods. The company explicitly claims its product is healthier than traditional kibble, and the leaders are not impressed by calls for evidence to prove this.

“The mainstream veterinarian needs research and proof that real food is healthier, and that just boggles my mind,” says JFFD chief medical officer, Oscar Chavez, BVet.Med., MRCVS, MBA. “We’re the last healthcare profession that is recommending an ultra-processed daily sustenance. It’s just crazy.”5

So, is it crazy to wonder if fresh foods really are healthier than canned or kibble? Can we assume dogs eating traditional commercial diets will have shorter lives and more health problems than dogs eating fresh diets? Regular readers of this column will already know my answer—nope!

Equally ‘obvious’ claims about the complicated relationship between environmental factors and health outcomes have been stunningly wrong many times in the history of human and veterinary medicine. We should place very little confidence such beliefs without scientific evidence.

The ideal evidence for these claims, of course, would be long-term comparative feeding studies showing dogs eating fresh diets live longer and experience less disease than those eating kibble or canned foods. Such studies would be extremely complex and expensive to run, and I don’t see much chance companies on either side of the debate will step up to support them. This means, as usual, we need to rely on less robust evidence (and proportion our confidence accordingly).

Commercial diets are not junk food

There is certainly epidemiologic evidence consumption of whole foods (particularly fruits and vegetables) is associated with improved health outcomes in people compared with packaged and convenience foods. It must be emphasized, however, that commercial dog food is not the nutritional equivalent of potato chips simply because both come in bags.

Human snack and convenience foods are deliberately designed to be appealing; not nutritious. Pet foods, in comparison, are formulated with much more emphasis on nutritional value, and have been used and evaluated extensively for decades for their impact on health. They may well not be the optimal food we should be feeding, but they are hardly the egregious poison their detractors claim. As the analogy breaks down, too, so does the relevance of the epidemiologic evidence in humans to pet feeding practices.

There is little direct research on the potential health impact of fresh diets compared with other cooked pet foods. There is research showing homemade diets are often nutritionally unbalanced and incomplete, but little evidence pertaining to commercial cooked fresh diets.6-11

A small study12 was reported as a poster at the 2014 American Academy of Veterinary Nutrition Research Symposium, and this is often cited by fresh food advocates as positive evidence for their claims. Twenty-one dogs of various breeds were transitioned from kibble to a frozen cooked fresh-food diet, and basic bloodwork and exams were conducted at the beginning of feeding the diet and again at six months and 12 months later.

This was a pilot study, so there was no control group, no blinding, no pre-specified outcomes or hypotheses, no reported accounting for repeated measures or multiple comparisons in the statistical analysis, no discussion of any other aspects of the dogs’ health or environment, and, overall, no significant control for bias or random error. This limitation is especially relevant given the lead author is chief medical officer for JFFD, as well as an author of the book mentioned above.

A few differences were found in some clinical laboratory measures before and after the transition to the JFFD diet. Increases were seen in red blood cell count and globulins, for example, though all values remained within reference intervals for all dogs. This sort of data might suggest hypotheses for future testing, but it does not support any specific conclusions about the relative merits or health effects of different types of diet.

There is some laboratory research showing fresh diets have higher digestibility than extruded pet foods, and there may be effects on gut flora and other physiologic parameters.13-16 However, these are, once again, only useful bits of data that suggest testable hypotheses, not conclusive evidence, for real-world health effects.

Personally, I am sympathetic to the hypothesis pet diets containing less processed whole ingredients may be superior to conventional canned or extruded dry diets in terms of health outcomes. The epidemiologic evidence in humans, and pre-clinical research in laboratory animal models is suggestive, though by no means conclusive.

There are, of course, other issues besides health impacts that must be considered in comparing the merits of different types of pet food. The affordability and accessibility of different diets, storage and stability, safety, environmental sustainability, and many other factors are relevant, as well to the recommendations of veterinarians and the feeding choices of dog owners.

The bottom line is, as always, we should make decisions based on the best possible evidence, and we should limit our claims and confidence to what the evidence can support. Currently, the most optimistic assessment of diets identified by marketing materials as fresh, lightly cooked, whole food, human-grade, etc., is it is plausible they may have health benefits if properly formulated by veterinary nutritionists and properly handled and fed by owners.

Biologic plausibility and pre-clinical evidence are necessary starting points, but evidence from the real world on meaningful health outcomes will be needed before we can have any confidence in claims about the benefits of such diets.

Brennen McKenzie, MA, MSc., VMD, cVMA, discovered evidence-based veterinary medicine after attending the University of Pennsylvania School of Veterinary Medicine and working as a small animal general practice veterinarian. He has served as president of the Evidence-Based Veterinary Medicine Association and reaches out to the public through his SkeptVet blog, the Science-Based Medicine blog, and more. He is certified in medical acupuncture for veterinarians. Columnists’ opinions do not necessarily reflect those of Veterinary Practice News Canada.


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