Considering a Plant-Based (Vegan or Vegetarian) Lifestyle? Start Here.
There are few topics in nutrition that foster heated debate than "going Vegan." My job as I see it is to make sure your body gets healthy and stays healthy with the dietary program you would like to follow. What I choose for me works for me based on my daily performance (especially considering how hard I train) and the all important blood metrics and other health metrics I monitor. What you choose must work for you.
"For the uninformed consumer, caution should be exercised when making wholesale transitions from diets containing food of animal origin to plant-based diets, particularly those moving to a vegan diet."
"...it is easy for the uninformed consumer to unintentionally increase public health-sensitive nutrients such as fat, sodium and sugar while also decreasing the nutrient density of the diet. Recent innovation in the plant-based product space has focused more on organoleptic properties (texture, taste and appearance) and formats (nuggets and burgers), rather than developing innovative ways to enhance the nutrient density of plant-derived foods, and ensuring a balanced nutrient profile similar to products of animal origin. Many newer plant-based products are similar to animal products in calories, but lower in protein, calcium, potassium, magnesium, zinc and Vitamin B12 while being higher in sodium and fat after being prepared. If habitually consumed, this could create nutrient shortfalls for consumers motivated to follow healthier, more sustainable diet" From Unintended Consequences: Nutritional Impact and Potential Pitfalls of Switching from Animal- to Plant-Based Foods
So if you decide to go on this journey, do it right from the outset.
Dr. Kahn recommends the following supplements:
The Position paper on vegetarian diets from the working group of the Italian Society of Human Nutrition recommendations state:
Since the digestibility of plant proteins is lower than that of animal proteins, it may be appropriate for vegetarians to consume more proteins than recommended for the general population
Vegetarians should be encouraged to supplement their diets with a reliable source of vitamin B12 (vitamin-fortified foods or supplements)
Vegetarians should be encouraged to regularly consume foods that are good sources of calcium
Vegetarians should be encouraged to increase their iron intake above the population reference intake suggested for omnivores, by eating a variety of iron-rich plant foods that are low in phytate and oxalate
Vegetarians should be encouraged to consume more dietary zinc than the population reference intake suggested for omnivores, especially when the dietary phytate/zinc ratio is high
Vegetarians can improve their n-3 nutritional status by regularly consuming good sources of alpha-linolenic acid and limiting intake of sources of linoleic acid
"I monitored three key biomarkers – iron, calcium, and vitamin B12 – micronutrients difficult to obtain from a plant-based diet, and three measures of metabolism and weight control – glucose, cholesterol and triglycerides."
Iron: "When I started this "experiment," my iron levels were "low" at 17ng/mL, and fell closer to deficient levels (14ng/mL) at the end of the two months. If I were a lifelong vegan, I would strongly consider taking an iron supplement; alternatively, I would abstain from supplements and more actively monitor my plant-based iron intake." Note: heme Iron is what is missing from a Vegan's diet.
Vitamin B12: "Although still in the optimized zone, my levels decreased after two months.... Had I continued the experiment, I would have either increased my almond milk consumption, or considered taking a B12 supplement."
Calcium: " the result at the end of the diet indicated a deterioration in bone health. Similar to B12, if I remained a vegan, I would begin a calcium supplementation routine or increase my almond milk consumption to reach my daily needs."
Glucose: "With an initial, borderline-high, glucose level of 97mg/dL, InsideTracker recommended that I increase my consumption of avocados, chia seeds, and old-fashioned oats. I took their advice, ate almost an avocado a day, and happily saw my glucose level drop sharply"
Cholesterol: "my total cholesterol and LDL or ‘bad’ cholesterol remained unchanged while my HDL or ‘good’ cholesterol improved significantly."
Trigycerides: "My results agreed with current research findings as my levels declined into my optimized zone."
My comments: I do not agree with this author's comments about saturated fats.
I also do not agree with the "eat whole grains" commentary. Try removing them for a month and let the results determine what you do.
The issue about ethics: "plant-based diets cause less harm to the environment" is something you must decide for yourself. Do some research on this topic for yourself.
Finally, there are several other nutrient deficiencies that are probable in a vegan/vegetarian diet that were not tested by this author: zinc, Vitamin D3, Iodine, Vitamin B2, Omega 3 fatty acids, and creatine.
Outside of that, this is a great n=1 study. Blood work does not lie .... you don't know what you don't know .... do not ignore .... test and make a plan.
DIETARY RECOMMENDATIONS FOR OPTIMAL VEGAN DIETS from Health affects of Vegan Diets
"1) To avoid B-12 deficiency, vegans should regularly consume vitamin B-12–fortified foods, such as fortified soy and rice beverages, certain breakfast cereals and meat analogs, and B-12–fortified nutritional yeast, or take a daily vitamin B-12 supplement. Fermented soy products, leafy vegetables, and seaweed cannot be considered a reliable source of active vitamin B-12. No unfortified plant food contains any significant amount of active vitamin B-12.
2) To ensure adequate calcium in the diet, calcium-fortified plant foods should be regularly consumed in addition to consuming the traditional calcium sources for a vegan (green leafy vegetables, tofu, tahini). The calcium-fortified foods include ready-to-eat cereals, calcium-fortified soy and rice beverages, calcium-fortified orange and apple juices, and other beverages. The bioavailability of the calcium carbonate in the soy beverages and the calcium citrate malate in apple or orange juice is similar to that of the calcium in milk (78, 79). Tricalcium phosphate–fortified soy milk was shown to have a slightly lower calcium bioavailability than the calcium in cow milk (78).
3) To ensure an adequate vitamin D status, especially during the winter, vegans must regularly consume vitamin D–fortified foods such as soy milk, rice milk, orange juice, breakfast cereals, and margarines that are fortified with vitamin D. Where fortified foods are unavailable, a daily supplement of 5–10 μg vitamin D would be necessary. The supplement would be highly desirable for elderly vegans.
4) A vegan should regularly consume plant foods naturally rich in the n–3 fatty acid ALA, such as ground flaxseed, walnuts, canola oil, soy products, and hemp seed–based beverages. In addition, it is recommended that vegans consume foods that are fortified with the long-chain n–3 fatty acid DHA, such as some soy milks and cereal bars. Those with increased requirements of long-chain n–3 fatty acids, such as pregnant and lactating women, would benefit from using DHA-rich microalgae supplements.
5) Because of the high phytate content of a typical vegan diet, it is important that a vegan consume foods that are rich in zinc, such as whole grains, legumes, and soy products, to provide a sufficient zinc intake. Benefit could also be obtained by vegans consuming fortified ready-to-eat cereals and other zinc-fortified foods."
This paper states, "Nutrients of potential concern are protein quantity and quality, iron, zinc, selenium, calcium, riboflavin, vitamins A, D, B12 and essential fatty acids."
Another paper states that for children who eat a vegan diet, "Deficiencies in cobalamin, calcium, and vitamin D seem to be the biggest risks associated with a poorly planned vegan diet. For a more definitive assessment, data on the intake and nutrient status of omega-3 fatty acids, zinc, iodine, and selenium in vegan children are needed."
This paper states, "Following a vegan diet may result in deficiencies in micronutrients (vitamin B12, zinc, calcium and selenium) which should not be disregarded."
"The vegan dietary intake of vitamin A, vitamin D, riboflavin, niacin and vitamin B12 were lower compared with the general population (P < 0.001). Vegans had a higher intake of beta carotene, vitamin E, thiamine, B6, folic acid and vitamin C compared with the general population (P < 0.001). The dietary intake of calcium, phosphorus, zinc, iodine and selenium were lower in vegans compared with the general population (P < 0.001) while intake of magnesium, potassium and iron was higher in vegans compared with the general population (P < 0.001) (Table 3)."
"In general, vegan diets tend to be lower in Calories, protein, fat, vitamin B12, n-3 fats, calcium and iodine than omnivorous diets, whilst concurrently being higher in carbohydrates, fibre, micronutrients, phytochemicals and antioxidants. Achieving a high energy intake is difficult in some instances, owing to plant-based foods promoting satiety. Issues with the digestibility and absorption of nutrients such as protein, calcium, iron and zinc might be an issue too, meaning that athletes might need to consume higher amounts of these foods compared to omnivores and other vegetarians. However, through the strategic selection and management of food choices, and with special attention being paid to the achievement of energy, macro and micronutrient recommendations, along with appropriate supplementation, a vegan diet can achieve the needs of most athletes satisfactorily. Supplementation with creatine and β-alanine might offer augmented performance-enhancing effects in vegans, who experience low pre-existing levels of these substances, and further research is needed to investigate the performance-enhancing effects of these substances in vegan populations."
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