I received a question from a reader whose daughter has decided to follow a vegan diet. She is wondering whether her daughter is making a good choice and is worried that she might develop health problems in the future.
What is a vegan diet?
A vegan diet is one that does not include foods from any animal source, including foods produced by the animals themselves, like milk, eggs and even honey. Of course, there are different levels of vegan diets that are not as strict:
Pescatarian—no meat or poultry, but fish is included
Lacto-ovo vegetarian – a plant-based diet, plus dairy and eggs
Flexitarian – a plant-based diet that includes occasional animal products
Examples of foods that vegans can eat include fruits and vegetables, legumes (peas, beans and lentils), nuts and seeds, breads, rice, pasta, dairy alternatives (soy milk, coconut milk, almond milk) and vegetable oils. The full vegan diet does not include any meats (beef, pork, poultry, fish or shellfish, eggs, cheese, butter, milk and all dairy products, mayonnaise (includes egg yolks), and honey.
What might be her motivation?
A 2014 study asked 329 shoppers at vegan supermarkets in Germany about their motivation. Over 80% had more than one reason for their diet choice. About 90% gave reasons related to animals, 70% cited personal health and well-being and about 47% discussed environmental reasons. One-third of those who participated in the study indicated they would consider including animal products in their diet if the producers could guarantee the animals were raised to standards above current agricultural practices.
Health benefits
Studies show that vegans have better heart health and lower odds of developing high blood pressure, obesity, diabetes, and some kinds of cancer (breast, ovaries, uterus and digestive tract cancers). Better weight control may be one reason for these health benefits. Vegans, on average, have a lower body mass index (BMI), a measure of body weight in comparison to height. Going vegan, when done correctly, could help you live longer, especially if total daily calories are reduced.
But are there risks?
While a vegan diet, with its emphasis on fruits, vegetables, legumes and whole grains, is healthy overall, it is easy to miss some key ingredients if the diet is not well-designed. Protein, calcium, iron, omega-3 “good” fats, zinc and vitamin B12 are important nutrients that most of us easily get in the animal products we eat, but could be missed if foods containing them are not included in the vegan diet.
One key nutrient, vitamin B12, is extremely difficult to get from plant sources alone. This vitamin is essential for healthy nerves and making red blood cells. Without enough of it, a person will commonly develop symptoms such as paresthesia (“pins and needles”) in hands and feet, poor balance, anemia (“low” blood) or other symptoms. Taking a daily supplement of this vitamin is highly recommended when following a strict vegan diet. Note that all these nutrients are especially important for growing children and pregnant women.
Here are some examples of foods containing some of the key ingredients:
Protein – nuts, soy, beans, quinoa
Calcium – soy milk, fortified orange juice, tofu with calcium, broccoli, kale, almonds, dried fruit (raisins, prunes, figs, apricots)
Omega-3 fats – flaxseeds, vegetable oils, plant-based supplements
Iron – tofu, soy nuts, spinach, peanut butter, fortified cereals
Vitamin B12 – none, unless it has been added in processing (“fortified” foods)
It’s important to realize that a vegan diet, like all diets, is only as healthy as you make it. Just cutting out animal products from a regular omnivore (plant/animal) diet could easily result in malnutrition. It is important to add foods that will supply enough of the nutrients that most of us get from animal products. A consultation with a dietitian might be a good route to go, to ensure the diet change is done right.
Are vegan processed foods healthy?
Another part of my reader's question was about the many vegan processed foods, like veggie burgers, that are available now. I happened to catch a discussion of these on the radio a few months ago (sorry I don't have the reference to a recording of it, but I did find this similar discussion online) where a nutritionist evaluated some of the various meat-substitute products that are available in grocery stores and fast food restaurants. He explained that these are highly processed foods with many ingredients (some that are neither plant or animal based!). Many of the ingredients are not included for their nutritional value, but to make the food's appearance and texture more like the animal food it was designed to replace.
This expert's opinion was that because a great deal of energy was being expended to create this food, these meat substitutes are not better for the environment than the foods they replace. And many health experts recommend avoiding highly processed foods as much as possible, to avoid the many additives that could be harmful in the long run: added salt, sugar, fat and preservatives. Our new version of the Canada Food Guide emphasizes eating whole unprocessed foods to avoid these hidden additives. Although the occasional inclusion of prepared vegan foods, like the veggie burger, would have little impact on health and the environment, using these as a regular staple in place of real whole food is not advised. However, the expert I listened to suggested they might function as a bridge from a regular diet to a vegan one, as the person works through this complex diet change.
What could this mom talk about with her daughter?
So, to my reader who asked this question, I could suggest she talk to her daughter about her reasons for choosing a vegan diet. If, like most, her reasons are animal or environment-related, an alternative path (or a parallel one) could be to support local producers of animal products who respect the animals and the environment, and perhaps to become politically involved in requesting improvements in commercial agriculture practices.
She could also ask her daughter about the sources of information she is using to create a healthy diet. I would highly recommend a consultation with a dietitian to learn the important basics of the vegan diet and for help in tailoring it to her tastes while keeping enough of each food group and nutrient. She will need to thoroughly research the quality of any online or print resources used, and it would be beneficial to verify these with the dietitian as well. In a brief internet search, I found this article written for dietitians that describes the complexity of designing a well-balanced vegan diet. And, I would also suggest that she rely minimally on processed foods, opting for healthy whole foods as often as possible, as we all should be doing.
The bottom line...
One of the quoted benefits of any plant-based diet is the opportunity to reduce calorie intake when groups of high-calorie foods, like meats and some dairy, are eliminated. Calorie restriction is associated with a longer life! Of course, we all could achieve fewer calories by simply reducing portion sizes…just putting less food on our plates. Nutritionists recommend that we limit our intake of meat to ¼ of the plate, filling the other ¾ with lower-calorie plant-based foods, however, and recommend we consider having the occasional vegetarian meal. So, I think we could all learn something useful from a balanced vegan diet and the foods it includes.
References:
Motives of consumers following a vegan diet and their attitudes towards animal agriculture https://www.sciencedirect.com/science/article/abs/pii/S0195666316302677
What is a vegan diet? – WebMD https://www.webmd.com/diet/vegan-diet-overview#1
The vegan diet – NHS online https://www.nhs.uk/live-well/eat-well/the-vegan-diet/
Nine signs and symptoms of vitamin B12 deficiency – Healthline https://www.healthline.com/nutrition/vitamin-b12-deficiency-symptoms
Plan Healthful Vegan Diets – Today’s Dietician https://www.todaysdietitian.com/newarchives/021115p40.shtml
Dietitian, Dietician or Nutritionist? (on the spelling of dietitian/dietician) Journal of the Academy of Nutrition and Dietetics
Very good article and highlighted the important points . I have never tried a vegan diet but I do know people who have and with respect to food choices they seem to eat more carbohydrates and then the weight gain, so like you said, balanced nutrition, making good choices and researching the evidence and understand why you want to do it are of utmost importance.
Thanks so much for commenting, hdunnet and Erica. You both make great points! Having teens prepare their own food is great training for their future, especially if they are interested in a special diet such as the vegan one. I imagine there are many who don't realize what is involved in preparing a healthy meal from whole foods, and that it's much better for you than processed food. And a healthy body image is certainly an important topic, and could easily be an important underlying reason for food choices that a mom would want to discuss with her daughter... a subject worthy of a full blog. I appreciate your comments!
As a registered dietitian who works with patients struggling with eating disorders, I want to mention a few additional points to consider. While lacto-ovo vegetarian and vegan diets can absolutely be health-promoting, it is important to truly understand a teen's motivation for changing to this dietary pattern. Is it for ethical concerns or is it a diet for weight loss in disguise? These underlying beliefs, as you mentioned, are important to explore so a healthy body image can be maintained. All too often a weight loss diet can be the trigger for disordered eating and eating disorders. Thank you for bringing up this important topic!
Great article Jeannie. I’ve became vegan after a series of events that put me off meat and diary etc. So your advice is great, and along with getting a dietitian or doing some serious research, I would recommend that your reader gets her daughter to do her own daily cooking. A healthy vegan meal is pretty time consuming and takes real dedication... it might be an eye opener to someone who’s probably used to meals arriving ‘comme ça’ that good healthy non-processed vegan food (which is as bad as normal fast food cheats) is darn hard work. ;-)