Advice Column, Health, Parenting

Vegan – Is it healthier?

  • Paarl Dietitians
  • Category Advice Column, Health, Parenting

As popular campaigns like ‘Veganuary’ fuel New Year’s pledges to cut back on meat, MANY people has been asking my opinion on vegan diets and on documentaries such as ‘The Game Changers’. If you are intrigued – keep reading.

Why go Vegan?

People choose a vegetarian or vegan diet for a number of reasons. Sometimes it’s out of concern for the way animals are treated or for the environment. According to the Worldwatch Institute, the rate at which the world currently consumes animal meat and other animal products is not sustainable. Currently, 51 percent or more of annual worldwide greenhouse gas emissions are caused by animal agriculture.  And the numbers continue to climb. Thousands of tons of grain and water are used to feed livestock each year. And raising animals requires a lot of workforce and transport. By not eating animal products, and eating locally grown produce, vegans are helping to reduce the environmental toll caused by the food industry.

But it’s also common to choose a plant-based diet because it’s considered healthier.And that’s for good reason. Research over many years has linked plant-based diets to lower rates of heart disease, type 2 diabetes, and some cancers (as compared with diets high in processed meat and other animal products). Since vegan diets are rich in plant-based foods—and therefore in antioxidants—vegans can enjoy the benefit of having a lower risk of developing cancer.

Previous studies have consistently shown that diet plays a crucial role in the prevention of chronic disease. Researchers in the UK analyzed the risk of stroke and other health problems over two decades among nearly 50,000 people based on the diets they followed. The rates of heart disease (such as angina or heart attack) were 13% lower in pescatarians and the rates of heart disease were 22% lower in vegetarians. Therefore, there is new awareness of plant food in particular, based on the huge array of phytochemicals provided by plants.

A vegan diet is the optimal diet?

So … could a vegan diet be even better for you than a healthy omnivorous one? It’s not as simple as that! 

Yes, there is the risk of nutritional deficiencies but some recent studies also raises the possibility that despite the health benefits demonstrated by past-research, plant based diets could come with other previously unrecognized health risks. The same UK based study (mentioned in paragraph above) found that vegetarians and vegans may have an increased risk of stroke – rates of stroke were 20% higher among vegetarians. 

These findings will complicate the way we look at plant-based diets. Are there serious and underappreciated downsides to these diets that should make us think twice about choosing them? Or is the increased risk of stroke heavily outweighed by cardiac and other health benefits? 

Nutritional Considerations

Some experts are concerned about the nutritional adequacy of a vegan diet. Such a diet may place individuals at risk of deficiencies in key nutrients like protein, iron, zinc, calcium, vitamin B12, omega-3 fatty acids, vitamin D and choline. Also, if a vegan diet is not well planned, the diet could be high in carbohydrates which is of significant concern — especially in light of the extremely high rates of overweight and obesity. This in itself is a risk factor for chronic disease. 

Protein

There is the concern that reducing meat and dairy intake will lead to reduced protein intake and therefore one would need to consider alternative sources to conventional animal protein sources such as soya, nuts, seeds, pulses, legumes. 

The issue with plant based protein, is QUALITY. Protein quality is characterised by the amino acid profile and digestibility.

Protein is made up of amino acids, 9 of which are essential. Amino acids can’t be produced by body and therefore is it essential to obtain it through diet. There are claims that plants are missing essential amino acids…. However a more accurate statement would be that on average, plants contain less essential amino acids than animal products. Interesting is that plants are low in the essential amino acid called Leucine (compared to animal protein) and Leucine is needed for muscle growth in particular. Soya is the closest to being a complete protein and is one of the reason why many people choose soya as a meat alternative. 

Vegans may need extra protein because on average plant protein is less digestible than animal protein. Plant proteins are much less digestible because of ‘anti-nutritional compounds’ that inhibit protein absorption such as phytates, trypsin inhibitors etc. Cooking techniques such as soaking, boiling, steaming and fermentation have been shown to reduce the content of these anti-nutrients and assist in proper digestion as well as absorption of protein.

Iron

We are all well aware that iron is essential to ensure good health. Interestingly, individuals following a plant-based diet often tend to have normal iron levels. Research shows that some individuals can adapt to inefficient iron absorption over a period of time in order to maintain iron status. 

To improve iron absorption eat plant based sources of iron such as seeds, nuts, legumes, dark green leafy vegetables together with a source of vitamin C for better absorption. Consuming 25-100mg of vitamin C increases the absorption on non-haem iron (plant sources) by four times. Try to have ½ cup of orange juice or ¼ cup red peppers or ½ cup broccoli with the above mentioned plant sources of iron. 

Some foods e.g. coffee, tea, red wine contain what we call ‘iron-blockers’. Tea contain tannins and some plant foods phytates that can block your body from absorbing iron.  For improved absorption of iron avoid drinking tea 1 hour before or after a meal. 

Calcium

A reduction in milk and dairy consumption make an important contribution to a reduction in environmental footprint. Some concern exist about the impact of reduced dairy intake for certain population groups. 

Dairy is often touted as being an important source of calcium, but it’s by no means the only source. Plenty of plant-based foods contain it, including tofu and some nuts, legumes and seeds. Vegans often need even more calcium than omnivores, because some plant foods have chemicals that make it harder for your body to access it. For example, spinach and beans contain oxalates and some grains, nuts and legumes contain phytic acid, which both interfere with calcium absorption.

Studies looking at dietary patterns in East Asia where diets are typically high in fruit and vegetables but low in dairy were actually associated with good bone health. High intake of dairy products (at least 3 servings/day = 1200mg/day) has been widely promoted in western countries for bone health and reduced fracture prevention. New research however show that 500-700mg calcium per day is adequate.

You can bolster your calcium intake with almonds, sesame seeds, fortified plant milks and fortified breakfast cereals —check the label to make sure the product you are choosing is actually fortified, because not all are.

Choline

Although a vegan diet is considered to be eco-friendly, avoiding meat and dairy can have some nutritional consequences. One such nutrient that has recently come to attention is choline. Choline is a recently discovered nutrient. It was only acknowledged as a required nutrient by the Institute of Medicine in 1998.  Choline is an essential nutrient – this means it’s required for normal bodily function and human health. Though your liver can make small amounts, you must obtain the majority through your diet. In fact, this nutrient affects a number of vital bodily functions. It impacts liver function, healthy brain development, muscle movement, your nervous system and metabolism. Therefore, adequate amounts are needed for optimal health. 

Vegans can have a hard time sourcing foods containing choline as the majority fall into the meat or dairy category. However, that doesn’t mean it’s impossible for vegans to have a choline-rich diet. Cruciferous vegetables including cauliflower, kale, broccoli, and Brussels sprouts can be a good source. So can peanuts, baked beans, quinoa, mushrooms, peas, and sunflower seeds. Soy lecithin is a widely used food additive that contains choline.

Vitamin B12

Vitamin B12 is something we humans can really only get via animal foods — such as meat, fish, dairy and eggs — or in the form of supplements. It’s an important vitamin too, essential for making DNA, fatty acids, red blood cells and chemicals called neurotransmitters which help to pass signals around the brain. 

Because B12 is not generally found in plant-based foods, vegetarians are at risk for B12 deficiencies. This explains why studies consistently demonstrate that up to 50% of long-term vegetarians and 80% of vegans are deficient in B12. It’s a good idea to have your B12 level checked if you follow a vegan way of eating. Early detection and treatment of a vitamin B12 deficiency is important. If left untreated, the deficiency can cause severe neurologic problems and blood diseases.

The Flexitarian Diet

Vegan diet sounds scary to you …. Then consider the movement called flexitarian, which is like being a part-time vegetarian or even a part-time vegan. So a few days a week, you are consciously trying to boost your intake of vegetable sources of nutrients. Swapping out a few meals a week with whole-food vegan protein sources is not going to do you harm and will probably do you good. A good starting point is to implement ‘meat-free Mondays‘.

Take home message

There are definitely things that most of us could learn from veganism!

  1. A vegan diet is high in plant-based ‘whole foods’ – and it primarily works because it promotes a frequent intake of fruits, vegetables and wholegrains. More veggies, less junk would benefit us all! Many vegan protein sources (e.g. pulses and nuts) are also rich sources of fibre and healthy fats that promotes satiety and lower disease risk.
  2. Since vegan diets are rich in plant-based foods—and therefore in antioxidants—vegans can enjoy the benefit of having a lower risk of developing cancer. Studies show that a diet rich in legumes, fruits, and vegetables is beneficial for overall health and that those who consume more of these things have a lower risk of developing cancer.
  3. The risk of inadequate protein, vitamin and mineral intake are readily overcome by choosing the right vegetarian foods and, when necessary, supplements.
  4. Yes, I agree we are eating TOO much meat; however this is not the primary issue. The issue is the excess of meat that is replacing plant foods in our diet.
  5. In my opinion: You do not have to be a vegan to eat healthy and prevent disease. Many recommended diets from nutrition experts such as such as the Mediterranean diet and the DASH diet are also heavy on fruits and vegetables and restrict the consumption of red meat. 
  6. It’s really about stepping back and asking yourself: Hey, what are the things I’m eating? Am I eating nutrient rich foods? Am I not going overboard on ultra-processed junk food?

Important considerations

It is important to avoid a poor version of a plant based diet. There are plenty of animal-free products that are highly processed, high in salt, hydrogenated fat and low in other essential nutrients – and people buy these products without thinking through what it has really taken to manufacture some alternative-meat products.  The lazy way to be a vegan is to just leave the meat out and leave the dairy products out and make no effort to bring back in the foods that you need to replace the nutrients that you’re missing out on.

Poorly implemented vegan diets are high in sugar and other refined carbohydrates, preservatives, hydrogenated fats which can actually increase the risk of disease e.g. cancer, heart disease, diabetes. I often see individuals whose health suffered from long-term vegan diets that weren’t properly implemented. The effects of nutritional deficiencies often don’t appear for several months. 

For those wanting to eat vegan, it could be of great help to see a certified nutrition specialist such as a dietitian, to help plan a balanced plant based diet to address and prevent common nutritional deficiencies. Frequent blood testing would also be good to monitor nutrient levels. 

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