The recent pro-vegan Netflix documentary, What the Health, is under fire from nutrition experts. The film, which is co-directed by Kip Andersen and Keegan Kuhn—the creators of another Netflix documentary, Cowspiracy—and co-produced by actor Joaquin Phoenix, is being criticized by some health professionals for exaggerating weak data and misrepresenting science to promote a diet that avoids all animal foods.
TIME fact-checked the film. Here are four things that What the Health got wrong—and what it got right.
No, eggs are not as bad for you as cigarettes
The documentary claims that eating an egg a day is as bad for your life expectancy as smoking five cigarettes a day, due to artery plaque buildup from high cholesterol content in eggs. But that assertion is based on outdated information, and recent research suggests that the effects of eggs are nowhere near comparable to those of cigarettes. Recently, national nutrition experts declared that cholesterol, found in foods such as eggs, is not considered a nutrient of concern for overconsumption. Other research has shown that the kind of cholesterol you eat isn't solidly linked to cholesterol levels in the blood.
"Plant-based food can help decrease the risks for certain cancers," says dietitian Andy Bellatti, who has followed a vegan diet for six years. "The idea that if you're going to eat an egg you might as well smoke a Marlboro, I don't find accurate."
The link between meat and cancer comes with caveats
Andersen, co-director of the film, rightly points out that processed meat was declared a carcinogen by the International Agency for Research on Cancer (IARC), a World Health Organization group, in 2015. IARC did find a link between eating processed meat and a higher risk for colorectal cancer. However, in contrast to the film, IARC did not suggest that eating processed meat is on par with smoking cigarettes.
Instead, IARC maintains that eating processed meat and smoking bear different levels of risk. "Processed meat has been classified in the same category as causes of cancer such as tobacco smoking and asbestos, but this does NOT mean that they are all equally dangerous," the agency wrote in an explanation of its findings in 2015.
According to the World Health Organization, about 34,000 cancer deaths per year worldwide are attributable to diets high in processed meat, while about 1 million cancer deaths are due to tobacco smoking, 600,000 are due to alcohol consumption and more than 200,000 per year are due to air pollution.
Sugar is, in fact, linked to poor health
In the film, several nutrition experts downplay the role of sugar in health problems and instead shift the focus to animal protein, despite the fact that plenty of research has linked sugar to diabetes and heart disease. Several reports have also suggested that the sugar industry funded research that turned attention away from sugar’s link to heart disease, as well as research that has influenced national health recommendations related to sugar consumption and cavity prevention.
“I am of the belief that there are many issues with the American diet, and we can say that one of the issues is the high intake of added sugar,” says Bellatti. "I was dismayed that people were saying sugar is not the problem.”
Milk's link to cancer is weak
What the Health highlights studies that find links between people who drink milk and a higher risk of cancer, as Vox News points out, but there have also been plenty of studies in prominent journals that have not found a link between dairy and certain kinds of cancer . In moderation, dairy can be a part of a healthy diet because it’s high in nutrients like protein and calcium.
What the film gets right
What the Health underlines several aspects of the American food system that are often criticized, including the amount of antibiotics used in agriculture, which is linked to growing health issues like antibiotic resistance. The documentary also highlights the financial relationships between food industry companies and national public health groups. Andersen points out that companies like Kraft, Dannon, Oscar Mayer and more— which sell processed foods high in fat, sodium or sugar like mac and cheese, hot dogs and flavored yogurt—are sponsors of the American Diabetes Association, and may have a financial stake in diet recommendations by health groups.
Conflicts of interest between nutrition groups and food companies are nothing new. National nutrition guidelines are subject to lots of lobbying from the food industry—a common complaint among nutrition experts, including Bellatti, who argue that the government is giving too much weight to industry interests when forming dietary recommendations for Americans. "It's important for Americans to know that many health organizations receive funding from companies and trade groups that are not in line with health," Bellatti says, "and how that affects recommendations."