*NOTE: My definition of vegan is a plant based diet that includes fruits, vegetables, nuts, legumes and grains. I am not referring to a raw diet or a low-fat-high-carb (LFHC) diet or any other extreme forms of veganism that restrict how you can consume your plant based food. I am also not a doctor or registered nutritionist and this paper is based on my personal research. Please consult with your doctor or dietitian before making any changes to your diet.
I have gotten this question so many times. We vegans already have an almost instinctual response for when we tell people we are vegan. There is always a protein or iron comment. How many times have we heard ” oh I can’t be vegan because we need more protein” or ” oh no I have low iron”!
The goal of this post is to present the very well researched studies that have lead me to the conclusion that a plant based diet is not only adequate but can be just as nutritionally complete as a healthy omnivores diet. Although many studies suggest that a plant-based diet can address many types of chronic diseases (I have included some of those studies below), that is not my goal here. I will not try and argue that a vegan diet is superior or a ‘cure-all’ diet. Mostly because I believe that many chronic diseases are not more complicated then something that can be cured by diet alone.
The main thing I want to address here is the argument that is made about veganism being a deficient diet. First off, to be clear any diet can become a deficient one. There is no strong evidence to suggest that a healthy vegan diet is a deficient one, no more so then what can be said for a healthy omnivores diet (references below).
A comment I hear a lot is that if a vegan diet was adequate then we shouldn’t need to supplement. Now while I agree that the ideal diet should require no supplementation, we live in a modern world, we work, we eat out, we don’t own farm land or get enough sunlight. That is why cereal is fortified, dairy is fortified (preventing many deficiencies in the standard diet) and why supplementation is sometimes needed regardless of whether you are vegan, pescavegatarian, lactovovegatiarian or a meat-eater (references below, just to many to add here). As an example breast fed infants need vitamin D, that does not mean breast milk is inadequate and we should all switch to formula.
During my ongoing research these past 2 years (I find nutrition very interesting and read about it often) I have come across some articles that talk about certain risks associated with plant-based diets. The risks are always in deficiencies if the proper steps are not taken to ensure a complete diet ( but this is also concluded in non-vegatarian diets as well). Just like omnivores, vegans must take care to make sure they get enough of the vitamins and minerals they are at risk of not consuming (mostly B12, calcium, zinc, iodine). My research is not one sided and I actually started reading up on veganism almost as an anti-vegan, if you can believe that. After watching plant pure nation I had many questions because I did not feel like the researchers in the documentary, and of the China study, explored all aspects of a plant based diet or asked enough questions about why they see the benefits they do. As a phD we are taught that causation does not equal causality (for example are the benefits they reported a result of the elimination of processed foods or was it truly related to cutting out animal products).
I was a very strong meat-aterian, following the paleo diet never the less, so I set out to prove that veganism was not ideal and that we are in fact meant to eat meat… But as a good scientist I accepted that my research lead me to conclude that my ideas about veganism were essentially wrong and based on fear and personal opinions not on actual data!
What I have learned in my graduate studies is that research is not simple. You can not read 1 paper or even 10 and make strong arguments for something. It takes many scientists to publish many unbiased papers so one can review the overall literature to get an idea. This is why I make sure to read many papers and look at many different sources. Recently, plant based diets have received a lot of attention so it will be interesting to see all the studies that will come thru in the next 10 years. No to answer the question, did my research lead me to believe that we are not meant to consume animal protein…NO! Did my research lead me to believe that only vegan diets are healthy…A BIG FAT NO!!! But it did lead me to conclude that a vegan diet is healthy and in some cases preferred based on the circumstances of that individual. For me it eradicated my lingering GI issues, bloating, skin problems, and extremely low iron levels. Now again going plant based required me to really clean up my diet so despite my health improvements correlations are not causations.
OK SO WHAT DID I FIND…
A great place to start when trying to understand vegan diets and how it may influence overall health and longevity is to look at the below section on the Adventist Health Studies. These are some of the largest longest set of studies conducted. Countless studies over almost 100 years (see section below)
Three great papers:
- A great review summarizing the findings from the Adventists studies. They specifically look at the vegan population and the effects of this diet on health. Additional more comprehensive studies are below in the Adventists health study section
- Another great review of current published literature regarding the effects of a vegan diet :
- An opinion paper with some references but gives an idea. The other references in this document add and help support this paper.
The Physician’s Committee:
A group of almost 1200 physicians, scientist and nutritionist that treat and do research on nutrition and health. They support and actually promote a plant-based diet.
- http://www.pcrm.org/nbBlog/four-ways-vegan-diets-can-benefit-kids
- http://www.pcrm.org/health
- http://www.pcrm.org/sites/default/files/pdfs/health/info_children.pdf
List of references:
1. A well-planned plant-based diet has proven to be adequate and sustainable
The seventh day Adventists participated in some of the biggest health studies conducted which are longitudinal and have over tens of thousands of participants. Not to quote Wikipedia but it’s a quick review to the study. Importantly they have a wide range of diets (omnivores, pesco- vegetarian, lacto-ovo-vegetarian, and vegan) with some studies looking at over 90,000 subjects (link).
Here are some more (pubmed ‘Adventists health study, so many studies)
- Orlich, Michael J., and Gary E. Fraser. “Vegetarian diets in the Adventist Health Study 2: a review of initial published findings.” The American journal of clinical nutritionSupplement 1 (2014): 353S-358S.
- Rizzo, Nico S., et al. “Nutrient profiles of vegetarian and nonvegetarian dietary patterns.” Journal of the Academy of Nutrition and Dietetics12 (2013): 1610-1619.
- Tonstad, S., et al. “Vegetarian diets and incidence of diabetes in the Adventist Health Study-2.” Nutrition, Metabolism and Cardiovascular Diseases4 (2013): 292-299.
- Orlich, Michael J., et al. “Vegetarian dietary patterns and mortality in Adventist Health Study 2.” JAMA internal medicine13 (2013): 1230-1238.
- Pettersen, Betty J., et al. “Vegetarian diets and blood pressure among white subjects: results from the Adventist Health Study-2 (AHS-2).” Public health nutrition10 (2012): 1909-1916.
B. Vegaisms is not only adequate but a healthy diet:
- Messina, Virginia, and Ann Reed Mangels. “Considerations in planning vegan diets: Children.” Journal of the American Dietetic Association6 (2001): 661-669.
- Mangels, Ann Reed, and Virginia Messina. “Considerations in planning vegan diets: infants.” Journal of the American dietetic Association6 (2001): 670-677.
- Varner, Gary E. “In defense of the vegan ideal: Rhetoric and bias in the nutrition literature.” Journal of Agricultural and Environmental Ethics1 (1994): 29-40.
- Dwyer, Johanna, and Franklin M. Loew. “Nutritional risks of vegan diets to women and children: Are they preventable?.” Journal of Agricultural and Environmental Ethics1 (1994): 87-109.
- Fuhrman, Joel, and Deana M. Ferreri. “Fueling the vegetarian (vegan) athlete.” Current sports medicine reports4 (2010): 233-241.
- Ellis FR. Mumford P. The nutritional status of vegans and vegetarians. Proc Nutr Soc1967;26:209–16.
- McEvoy, Claire, and Jayne V. Woodside. “Vegetarian and vegan diets: weighing the claims.” Nutrition Guide for Physicians. Humana Press, 2010. 81-93.
- Clarys, Peter, et al. “Comparison of nutritional quality of the vegan, vegetarian, semi-vegetarian, pesco-vegetarian and omnivorous diet.” Nutrients3 (2014): 1318-1332.
- Mangels, Ann Reed, and Virginia Messina. “Considerations in planning vegan diets: infants.” Journal of the American dietetic Association6 (2001): 670-677.
- Mangels, Ann Reed, and Suzanne Havala. “Vegan diets for women, infants, and children.” Journal of Agricultural and Environmental Ethics1 (1994): 111-122.
- Dwyer, Johanna T. “Nutritional consequences of vegetarianism.” Annual review of nutrition1 (1991): 61-91.
- Ströhle, Alexander, et al. “Diet-dependent net endogenous acid load of vegan diets in relation to food groups and bone health-related nutrients: results from the German Vegan Study.” Annals of Nutrition and Metabolism2-4 (2011): 117-126.
- Schüpbach, R., et al. “Micronutrient status and intake in omnivores, vegetarians and vegans in Switzerland.” European journal of nutrition1 (2017): 283-293.
- MÄ…dry, Edyta, Aleksandra Lisowska, and Philip Grebowiec. “The impact of vegan diet on B-12 status in healthy omnivores: five-year prospective study.” Acta scientiarum polonorum Technologia alimentaria2 (2012): 209-212.
- Peregrin, Tony. “A Successful Diet for Vegan Children Nourishes the Child.” Journal of the American Dietetic Association6 (2001): 669.
- Abdulla M, Andersson, I, Asp N-G, et al. Nutrient intake and health status of vegans. Chemical analyses of diets using the duplicate portion sampling technique. Am J Clin Nutr1981;34:2464–77
- Resnicow, Ken, et al. “Diet and serum lipids in vegan vegetarians: a model for risk reduction.” Journal of the American Dietetic Association4 (1991): 447-453.
- New, Susan A. “Intake of fruit and vegetables: implications for bone health.” Proceedings of the Nutrition Society4 (2003): 889-899.
- Sanders, T. A. “Growth and development of British vegan children.” The American journal of clinical nutrition3 (1988): 822-825.
- Sanders, T. A., and R. Purves. “An anthropometric and dietary assessment of the nutritional status of vegan preschool children.” Journal of human nutrition5 (1981): 349-357.
- Guggenheim K, Weiss Y, Fostick M. Composition and nutritive value of diets consumed by strict vegetarians. Br J Nutr1962;16:467–71
- Larsson, Christel L., and Gunnar K. Johansson. “Young Swedish vegans have different sources of nutrients than young omnivores.” Journal of the American Dietetic Association9 (2005): 1438-1441.
- Ball, Madeleine J., and Melinda A. Bartlett. “Dietary intake and iron status of Australian vegetarian women.” The American journal of clinical nutrition3 (1999): 353-358.
- Foster M, Chu A, Petocz P, Samman S. Effect of vegetarian diets on zinc status: a systematic review and meta-analysis of studies in humans. J Sci Food Agric. 2013 Apr 17
- Fraser, Gary E., and David J. Shavlik. “Ten years of life: is it a matter of choice?.” Archives of Internal Medicine13 (2001): 1645-1652.
- Appleby, Paul N., et al. “Mortality in vegetarians and comparable nonvegetarians in the United Kingdom.” The American journal of clinical nutrition(2015)
- Sanders, T. A. B., F. R. Ellis, and J. W. T. Dickerson. “Haematological studies on vegans.” British Journal of Nutrition1 (1978): 9-15.
2. A vegan diet can help address many cronic diseases:
(again there are so many studies so just pubmed or look on google scholar)
- Esselstyn Jr, Caldwell B., et al. “A way to reverse CAD?.” Journal of Family Practice7 (2014): 356-364.
- “>Nordqvist, Christian. “Plant-Based Diets May Prevent Chronic Diseases.” Medical News Today. MediLexicon, Intl., 20 Oct. 2012. Web.
“> 19 Jul. 2017. - “>Gomez, Maria. “Vegan diet and exercise may stop or reverse prostate cancer progression.” Medical News Today. MediLexicon, Intl., 11 Aug. 2005. Web.
“> 19 Jul. 2017. - Hu, Frank B. “Plant-based foods and prevention of cardiovascular disease: an overview.” The American journal of clinical nutrition3 (2003): 544S-551S.
- Ferdowsian, Hope R., and Neal D. Barnard. “Effects of plant-based diets on plasma lipids.” The American journal of cardiology7 (2009): 947-956.
- Hafström, I., et al. “A vegan diet free of gluten improves the signs and symptoms of rheumatoid arthritis: the effects on arthritis correlate with a reduction in antibodies to food antigens.” Rheumatology10 (2001): 1175-1179.
- Barnard, Neal D., et al. “A low-fat vegan diet improves glycemic control and cardiovascular risk factors in a randomized clinical trial in individuals with type 2 diabetes.” Diabetes care8 (2006): 1777-1783.
- Kaartinen, K., et al. “Vegan diet alleviates fibromyalgia symptoms.” Scandinavian journal of rheumatology5 (2000): 308-313.
- Pettersen, Betty J., et al. “Vegetarian diets and blood pressure among white subjects: results from the Adventist Health Study-2 (AHS-2).” Public health nutrition10 (2012): 1909-1916.
3. NOT just vegans have a deficiencies:
- NIH states that most of the cases of B12 deficiency are unknown
- Varner, Gary E. “In defense of the vegan ideal: Rhetoric and bias in the nutrition literature.” Journal of Agricultural and Environmental Ethics1 (1994): 29-40.
- Rizzo, Nico S., et al. “Nutrient profiles of vegetarian and nonvegetarian dietary patterns.” Journal of the Academy of Nutrition and Dietetics12 (2013): 1610-1619.
- Monteagudo C, Scander H, Nilsen B, Yngve A (2017) Folate intake in a Swedish adult population: Food sources and predictive factors. Food Nutr Res. Jun 7;61(1)
- Mangels, Ann Reed, and Suzanne Havala. “Vegan diets for women, infants, and children.” Journal of Agricultural and Environmental Ethics1 (1994): 111-122.
(No difference in iron etc.. between vegans and omnivores)
- Rizzo, Nico S., et al. “Nutrient profiles of vegetarian and nonvegetarian dietary patterns.” Journal of the Academy of Nutrition and Dietetics12 (2013): 1610-1619.
- Ball, Madeleine J., and Melinda A. Bartlett. “Dietary intake and iron status of Australian vegetarian women.” The American journal of clinical nutrition3 (1999): 353-358.
- Ball, Madeleine J., and Melinda A. Bartlett. “Dietary intake and iron status of Australian vegetarian women.” The American journal of clinical nutrition3 (1999): 353-358.
- Craig, Winston J. “Iron status of vegetarians.” The American journal of clinical nutrition5 (1994): 1233S-1237S.
- Sanders, T. A. B., F. R. Ellis, and J. W. T. Dickerson. “Haematological studies on vegans.” British Journal of Nutrition1 (1978): 9-15.
- Chan, Jacqueline, Karen Jaceldo-Siegl, and Gary E. Fraser. “Serum 25-hydroxyvitamin D status of vegetarians, partial vegetarians, and nonvegetarians: the Adventist Health Study-2.” The American journal of clinical nutrition5 (2009): 1686S-1692S.
4.Calcium on a Vegan diet:
- New, Susan A. “Intake of fruit and vegetables: implications for bone health.” Proceedings of the Nutrition Society4 (2003): 889-899.
- Kohlenberg-Mueller, Kathrin, and Ladislav Raschka. “Calcium balance in young adults on a vegan and lactovegetarian diet.” Journal of bone and mineral metabolism1 (2003): 28-33.
- Fuhrman, Joel, and Deana M. Ferreri. “Fueling the vegetarian (vegan) athlete.” Current sports medicine reports4 (2010): 233-241.
- Appleby, P., et al. “Comparative fracture risk in vegetarians and nonvegetarians in EPIC-Oxford.” European journal of clinical nutrition12 (2007): 1400.
5. B12 on a vegan diet:
- General discussion articles
- https://www.drmcdougall.com/misc/2007nl/nov/b12.htm
- http://veganhealth.org/b12/dig
- Supplementing with B12 is common knowledge in the vegan community
- https://www.ncbi.nlm.nih.gov/pubmed/15570032
- https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional/ (go to the at risk section, there are references there)
- https://www.ncbi.nlm.nih.gov/pubmed/20648045
- Fuhrman, Joel, and Deana M. Ferreri. “Fueling the vegetarian (vegan) athlete.” Current sports medicine reports4 (2010): 233-241.
- Natural sources of B12 so you don’t have to supplement, just plan
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5188422/#B141-nutrients-08-00767 (lots of references in section 8)
- Seaweed:
- Suzuki HJ Serum vitamin B12 levels in young vegans who eat brown rice. Nutr Sci Vitaminol (Tokyo). 1995 Dec; 41(6):587-94.
- Watanabe F, Takenaka S, Katsura H, Hussain Masumder SAMZ, Abe K, Tamura Y, Nakano Y. Dried green and purple lavers (nori) contain substantial amounts of biologically active vitamin B12but less of dietary iodine relative to other edible seaweeds. J Agric Food Chem. 1999;47:2341–2343. doi: 10.1021/jf981065c.
- Fermented foods:
- Babuchowski A., Laniewska-Moroz L., Warminska-Radyko I. Propionibacteria in fermented vegetables. 1999;79:113–124. doi: 10.1051/lait:199919
- Nout M.J.R., Rombouts F.M. Recent developments in tempe research. Appl. Bacteriol. 1990;69:609–633. doi: 10.1111/j.1365-2672.1990.tb01555.
- Formation of B-vitamins by bacteria during the soaking process of soybeans for tempe fermentation.
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