Years ago I wrote a two part series called – is a vegan diet the healthiest way to eat? Due to website issues, those articles are gone and so I wanted to revisit the topic because I think it continues to be a relevant question.
I grew up vegetarian until I was about 12 and then animal sourced foods were limited for another few years after that. In my early 30s I began a 6 month on, 6 month off vegan/omnivore experiment that lasted about 5 years. I was looking to prove that I could thrive on a vegan diet despite my very high activity level as well as hit various goals of gaining muscle mass and managing certain blood markers. I did this with months of research prior to beginning and then continued this research throughout the process. So I am not coming at this from a one sided perspective.
I think plant foods should be the base of your diet, there are plenty of bioavailable micronutrients, macronutrients, phytochemicals, prebiotics, probiotics and fibre to be had from them. I also think we should consume clean, humanely raised animal foods. That might look like a lot less for each person than what we consume now and that is fine by me. You can both sacrifice and honour the life of the animals you choose to eat. It is the system we have evolved in and to separate ourselves from it seems to me both psychologically unsound and physically unhealthy.
A vegan diet, without supplementation and close adherence to amino acid ratios is doomed to fail you, it may even kill you. There is a disease called pernicious anemia where the body can not absorb B12. Up until the mid 1920s – when b12 injections were invented – this disease was 100% fatal. Veganism without supplementation will eventually mimic the progression of pernicious anemia. B12 supplementation was only achieved in 1972 and so strict veganism without this advancement would have inevitably lead to a massive extinction event. If the diet itself will inevitably kill you without supplementation then it can not be the healthiest way to eat. Yes, we can now cheaply and safely supplement b12 and lower the risk of health issues so a vegan diet is technically possible. Yet up to 86% of vegetarian children are still deficient in b12, so we are not doing a great job despite our ability to prevent it. Amongst the many consequences of b12 deficiency are brain changes, depression and dementia.
The human race developed (brain growth), survived and thrived because of its use of animal products as food. B12 is the low hanging fruit in this “debate” and I know plenty of vegans who will fight back against this point but there is no basis in their argument that if you eat the dirt from unwashed, freshly picked vegetables that you will amass enough b12. It simply isn’t true, especially with the poor grade, mono culture soils of modern agriculture.
The Belgian government has a 2 year prison sentence for parents who feed their babies a vegan diet without supplementation and close medical supervision. This came about after multiple cases of infant mortality due to nutritional deficiency from vegan diets. Nutrient deficiency can lead to other health issues for infants and babies, including permanent brain impairment and brittle bones. B12 is the most well recognized nutrient issue with vegans but there are other nutrients that are only (or predominantly) found in animal sources, like vitamin D3, vitamin A, creatine heme iron and DHA/EPA.
DHA is an essential fatty acid and it makes up about 20% of the fat in the brain, It is very important in the development and maintenance of the brain. EPA is converted to DHA in the body and has its own function in brain health, including regulating inflammation. There is significant evidence showing that EPA/DHA supplementation during pregnancy increases brain and retina development and cognition for babies (1) (2). The benefit seems to last for up to the first 4 years of life. You can get more than adequate DHA levels from eating 2 servings of fatty fish each week. Studies show that the benefits from eating fresh fish outweigh supplementation but it is still a good option, especially if you have a hard time finding mercury free, sustainably caught fish .
ALA, the plant based fatty acid that is often touted as the vegan substitution for fish oil is no substitute at all. Only about 2-5% of it is converted to DHA in the body and only a fraction of that is used. The only vegan option is an algae oil supplement. This is a perfectly fine option and I do recommend it to clients for some of the other nutrients it contains. You can not however get adequate DHA from eating seaweed. You would have to eat massive amounts of it to come close and so again, a strict vegan diet will not encourage brain and eye development as well as regulate brain inflammation – not without supplementation.
Just to be clear I am not advocating for a carnivore diet, or even a diet that is heavy in animal products. I am simply trying to de-influence people towards a strict vegan diet. The vast majority of us can see the logic in finding a diet that entails the least amount of friction with the natural world. We all recognize that processed foods are bad for us, that overabundance in micro or macronutrients tends to be harmful and the use of chemically formulated foods would be against best advice. Yet when it comes to being vegan, we can scrap that entire mentality and fight against nature and the way of eating that helped us evolve just so we maintain “moral superiority.” Which is also insulting to the generations of humans, all over the planet that found harmony and honour in the sacrifice of animals for food.
Iron is another nutrient that is often deficient in vegans and vegetarians. A review of the literature (3) showed that both vegans and vegetarians tend to have serum ferritin levels below safe threshold markers much more often than non vegetarians. Low iron stores and iron deficiency anemia was especially prevalent amongst premenopausal women. Several studies have also shown that Iron deficiency has been seen to impair normal cognitive development in infants (4) (5). Iron plays a role in cognition in older children and young adults as well. Iron is partially responsible for the production of two neurotransmitters in adult brains – dopamine and serotonin. Without enough of these neurotransmitters you see a severe reduction in cognition and sense of well being. This is on top of all the other symptoms of anemia, including fatigue, shortness of breath, generalized weakness, rapid heart rate and craving of clay, amongst others.
The reason the claim that iron deficiency is equal among vegans, vegetarians and omnivores lays in the misinformation found all across the internet about foods that are high in iron. Take a minute and google the phrase “foods high in iron.” You will most likely come across what i did when I searched it (pictured left). Not a single mention of animal sources, just legumes, leafy greens, nuts, seeds and tofu. In order to understand how bad this is we need to know the difference between heme iron and non heme iron. Heme iron is much more bio-available and is solely found in meat and seafood. Non heme iron is found in plant based foods and its average bioavailability is roughly 5%. Often claimed from the vegan community is that partnering non heme sources with vitamin C will increase absorption but a recent randomized control study showed no difference between the group using vitamin C to boost absorption and the group that did not (6). If you did not know this, it is not your fault. Finding truthful information is harder and harder these days.
I don’t use the word misinformation lightly. I know the kinds of triggers it has for people but when google openly announces its collaboration with The World Health Organization to curate the “right” information, we need to take note. You can see it for yourself here (7). I am not going to assume that the people involved are purposely trying to pull one over on the public, I just think that the WHO isn’t always carrying the best information, the bigger the organization the slower it is in making changes and search engines should let specialists and its users decide what is the right information. This is why I always suggest going directly to a practiced nutritionist or internal medicine practitioner – the good ones are sifting through the misinformation for you and Individuals can make changes to their practices at the fastest rate. This topic is one that I got wrong for many years, I fought hard to prove that anyone could thrive on a vegan diet and in so doing I got hurt and created bad or incomplete information. It’s not impossible to be healthy on a vegan diet but its definitely not something I recommend for most people. I continue to adapt eating strategies for those of my clients that prefer to eat plant based. These decisions are individual ones and I don’t believe in forcing my personal opinions on people. We try things, we test, we adapt and we move forward. Sometimes that means shifting away from plant based sometimes it means shifting towards it.
That aside, it is clear that iron deficiency is a real threat to brain development and cognition and a strictly vegan diet will carry a much higher risk in developing such a deficiency.
32% of Canadians and 35% of Americans have vitamin D deficiency but this is a worldwide issue – levels are low across the globe. In nordic countries, the lack of sunlight makes insufficiency and deficiency highly probable but it is clear that even sunny countries have problems. with something close to 450 million people in India having vitamin D deficiency. Supplementation is one way to curb this but we can also get enough of it by eating the right foods. Animal sources are 2-3 times more effective than plant foods at raising vitamin D stores in the body. But regardless of efficiency, the volume of plant foods needed to acquire enough vitamin D is outrageous. For comparison, 100g of mackerel has about 1000 IU while 100g of white mushrooms has about 7 IU. Just for reference; in order to thrive as an active male adult I take at least 3000 IU daily on top of my diet that is relatively high in eggs, fish and red meat as well as about 90 minutes per day being outside with my dog. This amount helps build and maintain bone mass, fight infection and stop cancerous cell growth on top of the hundreds of other mechanisms it s responsible for. One of the ways vitamin D helps build bones is by increasing Calcium absorption, another nutrient that is tough to acquire solely by plant foods. Our bone stores are set pretty early on in life, so if you grow up with insufficient vitamin D and Calcium levels, then you are at a much higher risk of bone fractures, joint problems and osteoporosis as you grow older. Children and young adults should be building their bone stores without any unnecessary hindrance.
As you can see a strict vegan diet is inadequate for proper health. Without proper care it can be detrimental to your health, even lethal. The only way to adhere to one and reap any reward is to supplement. I am not arguing against supplementation as a general practice I am simply trying to outline the fallacy that anyone at any given moment can (and should) switch to a vegan diet because it is the best way for humans to eat. That makes no sense, it is pure dogma.
I haven’t even broached the subject of protein intake – not because I am avoiding it but only because it has been covered ad nauseam. I will say this; you can get all essential amino acids through a varied intake of legumes and vegetables but it is very taxing on your digestive system. If you are trying to hit a moderate level of protein per day, which most people should be, then you will find it very difficult. I have done it myself. On one of my 6 month vegan runs I tried to reach about 3500 calories per day, including 1.2g of protein per kg of body weight. This was in order to gain muscle mass and fuel my 90 minute workouts, 4 -5 days per week. I was literally eating on the toilet. My girlfriend at the time caught me leaving the bathroom with a banana peel, asked if I had eaten that in there and proceeded to laugh at me and tell me how gross I was. She wasn’t wrong. I was constantly bloated and gassy and felt like garbage. Even when I cut it down to 2500 calories, the protein intake was still killing me. So while it is possible to survive on the amount of protein you get from plant foods, for the sake of longevity, I would highly recommend adding animal sources. Your immune system is interconnected with amino acid stores in the body. As we age, we lose muscle mass at a fairly quick rate and as this happens our ability to fight infection waivers. Building muscle gets harder and harder and this will only be exacerbated on a plant based diet. If you are over the age of 40 and trying to build muscle, I once again highly recommend supplementation if you are vegan or vegetarian.
The other big issue with the dogma of the vegan movement is that it has propped itself up on the back of very poor research. Nutrition research is very hard to do well, some even say it is impossible. I think it is a worthwhile source of information that you then need to take and do your own experiment with – your N of 1 study. The only worthwhile nutrition research out there for you is the one you do on yourself. But we need to know where to start and if we are going to take the lead from scientific study it should be of the highest quality.
Up until very recently every study comparing vegetarians to omnivores has fallen short due to what is called the healthy-user bias. Most people who engage in one behaviour that is seen as healthy tend to take part in other behaviours seen as healthy. With research having mistakenly deemed red meat as unhealthy for the last fifty years, those choosing to avoid it would also tend to choose other healthy activities and thus vegans and vegetarians tend to be more health conscious in general – this is the healthy user bias. They exercise more, smoke less, sleep better, drink less alcohol and so on. On the other hand, omnivores have been placed in the Standard American Diet (SAD) category. Those who tend to eat processed meats, with a side of oily french fries and a soda. They eat more in general, exercise less, smoke more and tend to have higher levels of stress. You can already see the issue here – we have not been comparing proper cohorts, it’s been apples to oranges.
In order to properly compare, we need to find health conscious omnivores, or what Dr. Sarah Ballantyne has coined as nutrivores (8). Comparing vegans or vegetarians to nutrivoes, you begin to eliminate confounding factors, which all good research does.
There are 4 studies that have approached this method in one way or another. By no means did they seek out true nutrivores but they have attempted to limit related confounding factors. The Health Food Store study is one of these studies (9) and it was looking at lifespan. 11,000 people participated in this study and the results after a 17 year follow-up showed that while health conscious omnivores and vegetarians fared better than the average population, they showed no differences in lifespan between them.
A similar study, The Oxford Vegetarians Study (10), comparing health conscious omnivores with vegetarians over a 4 year span had the same conclusion – lower risk of early death compared to the general population but no differences between them.
In 2002, a massive European study began looking into the proponents of cancer and nutrition, called the Epic-Oxford Cohort (11). It included over 44,000 participants including vegans, vegetarians and health conscious omnivores and spanned about 7 years. The results showed that both cohorts shared a 52% reduction in death due to cancer compared to the general population. Once again, no differences between them though.
243,096 people participated in the 45 and up Australian Study; (12) a six year study located in New South Whales comparing vegetarians and omnivores. While they did not seek out health conscious omnivores, the researchers did mention their awareness of the healthy user bias in previous studies and attempted to control for as many confounding factors as possible. While this did not eliminate the bias, it did add to the growing acknowledgement of previous shortcomings in nutritional research and it also eliminated any differences found between the two cohorts with regards to mortality rates.
All nutritional studies are flawed, even the best of them but there is a hierarchy of methodology and observational studies are at the bottom of the pile. Observational studies are just what they sound like – observing populations and interpreting any relationships seen between them. In doing so we need to understand that associations do not necessarily infer causation. So this is a little trick you can take with you when coming across headlines in the media or amongst the trash heap of “information” on social media. If you see the words “linked to” or “associated with” then you can be sure they are talking about observational studies. I have done this myself and I have tried to include the caveat that more research is needed to prove causation. What you see when there are headlines related to health and red meat consumption is observational data interpreted as “links” and “associations” to cancer, heart disease, etc. These are meaningless conclusions that have powerful effects on peoples life choices.
The use of self reported food questionnaires is common practice in a lot of these older studies demonizing red meat. I can tell you first hand that when I ask my clients to submit a food journal of what they ate just a few days ago they are consistently bad at recalling. I can’t use it for reference to determine their tendencies, never mind use it to find correlations for the health of the general public, that would be absurd. The other problem with these kinds of studies is that researchers have often grouped in foods like Hamburgers, pizza, hotdogs and sausages as “red meat.” This is part of the healthy user bias I mentioned above. These foods are highly processed, contain high amounts of sugar, salt, sulfites and other preservatives. It is scientifically unsound to categorize them as meat.
When trying to figure out the value of a scientific study you want to look for ones that are categorized as randomized control studies. In these, participants along with all of their confounding variables are randomly placed into one of two cohorts. When the group sizes are big enough, this randomization will evenly distribute the confounding variables and basically cancel them out. Statistically speaking, conclusions can be made with much greater confidence with regards to the factors you are looking at. This is the gold standard for nutritional studies and should be the only kind we pay serious attention to.
Animal studies are also often referenced in books, articles and social media. While an important part of the process of discovering how we might react to certain nutrients, compounds, lifestyles and so on they do not reflect human data. They need to be taken for what they are – preliminary research that suggest avenues to explore in randomized control studies. Nutritional research using animal studies needs to be taken with a hefty dose of salt, so to speak.
Another flaw commonly found in research linking disease to animal product consumption is the use of surrogate or proxy markers. You see this in much of the research using LDL (low dense lipoprotein) as a marker for cardiovascular disease. I wrote an in depth article outlining this particular issue a couple months back called – Cardiovascular Disease: Testing, Prevention and Reversal. A systematic review of nineteen studies concluded that the higher the LDL level the lower your chance of dying was. This is in stark opposition to what you will see all over the internet if you google LDL levels and heart disease. This is because, for the last 50 years it has been used as a proxy marker in cardiovascular disease research. Many of these studies also point to lowering consumption of animal products such as dairy and red meat as a way to lower LDL and therefore reduce mortality risk. Which is absolutely false and has been proven so repeatedly but does not fall in with the prevailing narrative. This information does not fall in line with the dogma of the vegan movement either and there has been unbelievably strong push back using no new evidence. This has led to countries like Denmark , ignoring good research and pushing for plant based food policies in schools, farming initiatives, restaurants and retailers. Can some good come of this? Absolutely, but we need to make sure that whatever policies come into play are built on the foundation of strong research, not the rickety foundation of vegan propaganda.
I am all for more vegetables and less meat as a general rule, If in doing this we can support regenerative agricultural styles that include animal grazing and eliminate factory farming methods. It would also be nice if we supported education or cultural norms that brought us closer to our foods. Not just the process of humanely raising and sacrificing animals but also the ways we can grow fruits and vegetables without obliterating wildlife and destroying soil quality. If we are honest with ourselves, we are not doing either very well – we are not growing plant foods or raising animal foods sustainably. Not only can we marry the two but we can also teach our children how and why this is important for our health and the ecosystems of our towns, provinces and countries. I don’t have the time to go over the problems concerning studies eschewing animal sourced foods for environmental reasons, but there are many. I just want to plant the proverbial seed that there are many ways we can get our nutrients to survive and thrive. The way we have done this for millennia is using animal sources along side plant sources. The tried and true method has been to only eliminate foods that proved to make us sick. Animal sources do not do this, not unless processed or treated poorly and fed grain and antibiotics. We should all at least know this before we make any decisions about eliminating them from our diet.
Animal sourced foods are a powerhouse of nutrition that continue to keep people alive who can not grow enough plant based foods that cover the loss in nutrition if meat is eliminated. And even for those who are lucky enough to have access to fruits and vegetables that are out of season and shipped from thousands of miles away, they tend to be pretty poor at ensuring that they get all the required nutrients. We are moving deeper into a dependency market and way from our ability to self sustain. The new dependency will be supplementation. I have some knowledge of gardening and I know a bit about cleaning a fish and am confident I can learn more about these skills. But I have no idea where to start when designing supplements. do you? And what happens when governments finally make the move to mandatory approval and accreditation. We will probably (?) have higher quality supplements, but we will also have less options in developing and acquiring them and it will come at a much higher cost. Don’t think this will happen? The Canadian government is already having hearings over the possibility (13) .
I’m off to eat my high fat, low sugar greek yogurt topped with berries, seeds, nuts, cacao powder and a splash of granola. Delicious and nutritious and Hal and Joanne approved! I am just joking, I have no idea if that meal would be featured on BodyBreak and I don’t want to get sued. For any help with your nutrition plans, even if it is on how to adapt a plant based diet (I promise not to berate you) please contact us here, we would be happy to help.
Have a Goudah day
Joey
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