I’ve been a vegan for 17 years now, and in that time, I’ve seen the movement grow and change significantly. The great news is that vegan “cheese” no longer tastes like rubber, and most meat analogs aren’t like munching salty plastic anymore (huzzah!) Most restaurants, particularly in large cities, easily accommodate a vegan lifestyle these days, and most stores carry at least some vegan-friendly items outside of the produce aisle. Best of all, no one looks at me like I have three heads anymore when I order the vegan option. (Well, not most of the time, anyway.)
That being said, as the vegan (or part-time vegan) population grows, I find that it becomes increasingly important for people to be educated on how to approach veganism properly, and to know which rumors we find zipping around the interwebs are true or untrue. The following is a quick exercise in busting myths, bringing on the science, and finally answering the age-old question: OK, I’m vegan. Now what?
Studies on the health effects of a vegan diet generally demonstrate that vegans as a whole tend to have lower risks of heart disease and obesity, and have much higher intakes of vitamin C, vitamin E, vitamin B9 (folic acid), fiber, magnesium, potassium, a number of beneficial plant compounds, and unsaturated fats [1][2][3]. Vegans and vegetarians also appear to have a lower risk of diverticulitis, kidney stones, arthritis, hyperthyroidism, and cataracts [1].
As far as cancer is concerned, as a whole, vegans and omnivores do not appear to have much difference in overall cancer mortality risk [1][2]. While plants do have a number of cancer-fighting qualities, there are unfortunately not many studies that demonstrate a definite link between a vegan diet and lower overall risk of cancer in humans. There is some evidence that vegetarians and vegans may have a slightly smaller risk of certain types of cancer than omnivores, but more research is needed in this area [1][2].
There is conflicting evidence about whether or not bone density is affected negatively by a vegetarian or vegan diet. In one study, the higher fracture risk in vegans was eliminated in those who consumed a daily minimum of 525 milligrams of calcium [1]. A study on wrist fractures in vegetarians vs. omnivores demonstrated that those who ate the least amount of protein had the highest risk of wrist fracture [4]. In this study, when plant-based proteins were significantly increased, risk of wrist fracture decreased by almost 70 percent. Vitamin K is also important in bone health — in fact, hip fracture risk was lowered by 65 percent in those who ate one or more servings of green leafy vegetables per day [2].
A large, 5-year study demonstrated that vegetarians, vegans, and pescatarians seem to have lower all-cause mortality than omnivores, and that men appear to have more benefits from these lifestyles than women do [5]. While this is really interesting news, it’s also important to remember that one study is not the end-all-be-all of evidence, and that there are a lot of factors that may come into play that may have nothing to do with long term vegetarianism. More research is definitely needed.
Bottom line, however, is that a well-planned vegan diet can have a number of health benefits, and, done properly, can contribute to a long and healthy life [1][3].
Simply put, an optimal vegan diet needs supplementation as there are certain nutrient gaps in a vegan diet that cannot be filled solely by food. Take your supplements, and take them with pride!
One caveat: if you are on any medications or have any health conditions, make sure you check with your doctor before taking any supplements — even vitamins — to ensure that they will not cause complications.
Here are the supplements that I highly recommend:
Creatine is one of the most widely researched supplements out there, and it is absolutely safe to take for healthy individuals [6]. Creatine is an important supplement, particularly as we age: in addition to aiding in recovery and adaptation to training, creatine has huge cognitive benefits, fighting against brain aging and degeneration [6]. I could go on and on about the benefits of creatine — it has been shown to help type 2 diabetics control glucose, prevent bone loss and increase muscle mass in older individuals, improve fetal health in pregnant women, and much more [6].
Because dietary creatine is generally found in meat and fish, vegans and vegetarians generally do not have as much creatine in their muscles as omnivores [7][8]. With creatine supplementation, however, vegans and vegetarians have a greater ability to absorb creatine into the muscles than omnivores, and creatine utilization is not changed by diet [8]. A daily dose of 3 grams of creatine is recommended [6].
B12 is generally found in animal products such as meat, eggs, and milk. It is therefore not easily accessed in a vegan diet. B12 deficiency can lead to a lot of serious health effects such as weakness, digestive disorders, nerve conduction problems, loss of vision, depression, cognitive dysfunction, changes in the skin, fetal development problems in pregnancy, and more [9].
Vegans will need to either take a B12 supplement or eat foods fortified with B12 (check labels). Nutritional yeast (not to be confused with brewer’s yeast) is generally an excellent vegan source of B12. The current RDA for B12 is 2.4 micrograms for ages 14 and older and 2.6 micrograms for pregnant women [10]. You may need to speak to your health professional to determine the amount you personally need, particularly if you are anemic, elderly, severely deficient, or have other health conditions.
Both omega-6 and omega-3 fatty acids are essential fatty acids, meaning the body cannot produce them on its own, so it has to get them through food. Both types of fatty acids are important for brain function and for human development, hair growth, skin growth, metabolism, bone health, and more [11].
Omega-3 fatty acids help reduce inflammation in the body [12]. This is extremely important for the prevention of disease marked by inflammation, such as cardiovascular disease, arthritis, skin damage caused by the sun, asthma, ulcerative colitis, and more [12]. While omega-6 fatty acids can cause inflammation, this is not necessarily a bad thing in the correct amount — for instance, if you injure yourself and don’t get an inflammatory response, you body will not heal [11]! A balance between the two fatty acids is key for optimal health.
The average Western diet, however, does not tend to provide a good ratio of omega-3 to omega-6 fatty acids [12]. It is commonly thought that humans originally ate a diet based on a 1:1 ratio of omega 6 to omega 3; however, that ratio in modern times is more like 10:1 to 25:1 [13]. This is understandable — omega-6 fatty acids seem to be prevalent in everything! Some major food sources of omega-6 fatty acids include nuts, potato chips, salad dressings, grain-based desserts such as cakes, eggs, mayonnaise, pizza, French fries, many snack foods, and more [14]. It is recommended that a ratio of 1:1 or 2:1 be consumed for obesity prevention and optimal health [15].
DHA and EPA are formed during the metabolism of omega-3 fatty acids. They are extremely important for brain function. While more research is needed and current evidence can be contradictory, some studies on supplementation with DHA and EPA demonstrated potentially beneficial effects for reducing the risk of dementia, as well as improving symptoms of cognitive decline, aggression, dyslexia, depression, ADHD, autism, schizophrenia, bipolar disorder, premenstrual syndrome, and more [16]. DHA and EPA are important for cell membrane function, lowering inflammation, and may be important in pregnancy for fetal development [16].
While you can get omega-3s in the form of ALA (alpha-linoleic acid) from sources like flax, chia, rapeseed, and hempseed as well as monounsaturated fats such as macadamia nuts, hazelnuts, olive oil, and high-monounsaturated sunflower oil, the body cannot break those down very well into DHA and EPA [15][16]. Therefore, we have to get them from food sources. The most well-known food sources of DHA/EPA are fish oil and krill oil. However, fish and krill do not naturally contain DHA/EPA — they get them from eating algae. Fortunately for vegans, we can get it that way, too! Algae oil has been found to be an effective supplement for vegetarians [17]. However, there is no current consensus on proper dosage, as studies to date have been very small. That being said, for the moment, just discuss options with your health professional, and, if there are no suggestions, follow the manufacturer’s recommendations on your algae oil product.
Because vitamin D tends to come from fatty fish and eggs, vegans tend to have very low vitamin D intakes based on food alone [2][18]. Supplementation and fortification have increased vitamin D levels in vegans significantly, but many continue to have lower than recommended levels even despite this [18]. Vitamin D levels can be increased by spending time in the sun without sunscreen, eating fortified foods (mushrooms treated with UV rays can be a good food source of vegan vitamin D!), and through supplementation [2][18]. However, it is important to realize that the traditional vegan form of vitamin D (vitamin D2) is not as easily utilized by the body as is vitamin D3 and may therefore not raise levels as well as D3 would [2]. A few products containing a vegan version of D3 grown from lichen have recently come on the market. If you have had trouble increasing your levels using D2, this may be a good option for you.
Vegetarians and vegans, and particularly postmenopausal vegetarian and vegan women, have much higher rates of iron deficiency than do omnivores [2][19]. Interestingly, intake of iron has been found to be higher in vegans than in omnivores despite this insufficiency [20][21]. This is because although vegans tend to eat many iron-rich foods, the iron in vegan diets (non-heme iron) is not as easily absorbed by the body as the iron in animal sources (heme iron) [2][20][21]. Furthermore, when a vegan diet contains a lot of phytate-rich foods like beans and grains, the phytates can block the absorption of iron [21].
The good news is, the vegan diet also tends to be extremely high in vitamin C, which greatly increases the absorption nonheme iron [2]. The Institute of Medicine has recommended that the reference intake of vegans and vegetarians be increased to 1.8 times that of omnivores in order to satisfy the requirements for a vegan diet.
A few good sources of iron in a vegan diet include beans, dark green leafy veggies like spinach and broccoli, some types of dried fruit including raisins and apricots, canned tomatoes, peas, chocolate, tofu, pumpkin or squash seeds, whole wheat products (bread, pasta, etc), potatoes with skin, brown rice, wheat germ, and fortified foods [22]. Make sure to eat foods high in vitamin C (citrus, and most green, orange, and red fruits and vegetables) in order to help absorb more iron. Sprouting, soaking, and fermenting foods may help increase iron’s availability in foods, as can cooking in iron cookware [23].
Good news for those of us who love to experiment in the kitchen: garlic and onions have been shown to significantly increase iron absorption in foods [23]. Adding lime or amchur — an Indian spice made from dried unripe mango — to foods can also increase bioavailability of iron [23]. You can use amchur in any recipe that needs a sour/tangy kick such as that from lemon juice or vinegar. Speak with a health professional before adding any kind of iron supplement to your diet.
Zinc is crucial to immune system function, proper growth and development, wound healing, optimal functioning of taste and smell, and more [24]. While the quality of the studies has varied, as a general rule it appears that vegans tend to be a higher risk for zinc deficiency than omnivores due to the fact that the foods richest in zinc tend to be animal sources [2][24][25][26]. It appears, though, that vegans may adapt somehow to lower zinc levels and manage maintain the same immune function as omnivores [2].
With that said, zinc and iron are very similar in the things that block their absorption as well as the things that increase their absorption — sprouting, fermenting, and the addition of amchur, lime, as well as garlic and onion can greatly increase zinc absorption [23]. Foods that are rich in zinc include hyacinth beans, wheat germ, sesame seeds, amaranth (grain and leaves), vegetarian baked beans, chickpeas, oatmeal, almonds, kidney beans, wild rice, pumpkin and squash seeds, peanuts, soybeans, adzuki beans, peas, and fortified foods [26].
While it’s true that there is protein in most foods, protein varies in quality from food to food. Protein quality is based on whether or not all the needed amino acids are present as well as how well it is digested and utilized in the body [27]. The Protein Digestability-Corrected Amino Acid Score (PDCAAS) is the current standard for determining the quality of a protein.
Soy protein scores a 1 on the PDCAAS, which is the absolute highest score that can be had on this scale [28]. However, depending on the preparation and type of soy protein used, this score can go as low as .95 (which is still pretty darn high quality) [28].
I’d like to note at this point that soy is not the evil devil that it has been made out to be, and should be perfectly fine for normal, healthy people to include in their diets. This is fodder for a whole ‘nother article, though.
Mycoprotein, a protein made from fungus, is the stuff Quorn products are made of [29]. It is a close second in protein quality with an impressive score of 99 on the PDCAAS [29].
Most beans score between a .50 and a .70 on the PDCAAS, and the preparation of the beans will affect their protein scores [30]. Corn scores between a .37 and a .57, depending on the type of corn. Oats are around a .66, and quinoa is around a .78. Brown rice scores around a .53, while wheat scores around a .40 (again, depending on the type of wheat and its preparation). However, sprouting all these foods increases their protein digestibility, and combining beans with wheat, rice, or corn increases their PDCAAS score [30].
The bottom line is, as long as you are eating a wide variety of foods, particularly those higher on the PDCAAS scale (some of which are listed here), you’re likely getting enough protein. Personally, I like to have a plant-based protein shake every day just to give myself an extra 25 grams. If you go this route, try to choose a formula that has several different types of protein sources in it.
If you’re planning on going vegan, or even if you’re just curious or trying to win an internet debate, I’ve hopefully cleared up a few misconceptions about the vegan diet for you. Of course, there is a lot more to discuss, but think of this as a good jumping-off point. Yes, you can absolutely be a strong, healthy vegan. You just need to know a little bit about nutrition in order to do it right. Now finish your tofu, get out there, and lift something heavy!
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