02 Dec 2022 Veganism and the quest for optimum nutrition
Going 100% ‘Plant-based’ doesn’t always mean ‘healthy’. Learn how to maximize your nutrient intake while taking steps towards a kinder and more sustainable existence
Is adopting a vegan diet as nutritionally beneficial as claimed? Most of the global population follow an omnivorous diet, eating both plants and meat, however the balance between consumption of these foods has shifted to such an extreme, some say irrevocably, with devastating impact on health and planet. More and more individuals are now choosing a plant-rich or fully-vegan diet in response to climate, environmental, ethical and health concerns. In our latest article, BANT Nutritionist ®, Vandana Chatlani, explores the benefits of veganism, the ultra-processed vegan food trap, and highlights how to overcome potential nutrition pitfalls to ensure adequate nutrient intakes to support health and wellbeing.
“Our relationship with nature is broken, but relationships can change,” says climate activist Greta Thunberg in a powerful speech about veganism. “The climate crisis, ecological crisis and health crisis, they are interlinked. If we don’t change, we are f*****. We can change the way we farm, we can change what we eat, we can change how we treat nature (1)”.
Ethical and environmental factors relating to meat consumption and intensive livestock production have driven millions to adopt a vegan diet and lifestyle. Concerns about the dangers that modern farming have on the earth’s resources, the use of antibiotics and growth hormones in animal rearing and fears about animal-borne diseases have fueled the popularity of veganism further (see Climate concerns).
Thunberg and other activists aren’t alone in recommending a reduction, if not total elimination, of meat consumption. The government’s Climate Change Committee says that in order to meet net zero goals by 2050, we must reduce how much meat we eat by 20-35% (2).
Others have switched to veganism for health reasons, cutting out meat and dairy to combat inflammation, intolerances and allergies, or simply because they have been inspired by the benefits of a plant-based diet endorsed by celebrities such as Natalie Portman, Romesh Ranganathan and Billie Eilish.
A rich and varied, plant-based diet can be extremely beneficial for overall health. Vegan diets often contain high levels of fibre, polyphenols, antioxidants, folic acid, potassium and magnesium. Studies have shown that vegans overall appear to be slimmer, have lower blood pressure and lower cholesterol and a lower incidence of cardiovascular disease, obesity and type 2 diabetes (3,4).
Despite these advantages, those adopting a vegan diet may be at risk of reduced macro and micronutrient status, specifically a deficiency in proteins, calcium, vitamins B-12 and D and omega-3 fatty acids (5). Vegans should also pay close attention to their zinc and iron status (6,7) (see table on Vegan food sources).
The protein debate
Experts continue to debate whether vegans can obtain enough protein from non-animal food sources, particularly because all 20 amino acids – the building blocks of protein – are easier to find in meat and other animal products and are thus referred to as “complete proteins” (see Amino acids table for more details). Of course, amino acids are present in plant foods. In fact, complete vegan proteins do exist and include foods such as quinoa, tofu, edamame, amaranth, spirulina, buckwheat and nutritional yeast. But these complete sources are limited in number and variety, and so vegans require a wide diversity of foods in order to consume sufficient amounts of all amino acids (8,9).
Often protein deficiency among vegans results from a low consumption of foods such as beans, lentils, peas, millet, nuts, seeds, oats, tofu, tempeh and other protein-rich foods. To a large extent, this is about meal planning and combining foods such as rice and beans, or hummus and pita to create complete proteins. It is also about absorption and bioavailability. Protein intake is crucial for growth, muscle maintenance, hormone and enzyme production, satiety and more.
Despite the availability of amino acids in plant foods, several factors indicate that vegans may still be at risk of protein insufficiency. Research has shown that protein from animal sources is digested far better than plant-based protein, which are often missing essential amino acids. As a result, vegans may need to consume higher levels of protein in order to compensate for poorer digestibility, or consider alternative sources such as plant protein powders (10). This may change in the future as clinical trials are exploring how to create plant blends that could mimic animal proteins such as egg white, chicken and cow’s milk (11).
Amino Acids
Maximising micronutrient status
Addressing micronutrient status is vital for vegans. Plant sources of iron for example, are less bioavailable than meat sources and so may impact iron stores among vegans, particularly women. Another consideration for vegans is that certain substances and compounds can inhibit the absorption of iron-rich foods. Tannins, which are present in tea, coffee and cocoa, and phytates which occur in whole grains and legumes, reduce the amount of iron that is absorbed from the diet (12,13). Consuming iron-rich foods alongside foods rich in vitamin C can help improve absorption. In some cases, iron supplementation may be advisable, however it is important to carry out blood tests and check iron and ferritin stores first to prevent iron toxicity.
Vitamin B12 deficiency is also a risk for vegans since animal products are the primary source of this micronutrient. Plant-based B12 is difficult to find, aside from seaweed, so vegans should consider consuming foods such as cereals fortified with B12, or supplementing to ensure adequate levels. B12 is essential for the production of energy, haemoglobin, red blood cells, methionine and folate. It is also necessary for the nervous system to function, for homocysteine metabolism and DNA synthesis (14).
Both zinc and vitamin D are important micronutrients for immune function and appear in low concentrations in a typical vegan diet. Plant foods rich in zinc include nuts, whole grains and seeds, although the level of zinc absorption from these can be compromised by the presence of phytates. Zinc deficiency may be linked to poor overall health, alopecia, skin conditions such as dermatitis and mental health disorders, so vegans may consider cooking methods such as soaking and sprouting nuts, seeds & legumes to improve zinc bioavailability, while also considering a well-rounded multivitamin to cover nutrients which may be more difficult to obtain through the diet (15).
In the case of vitamin D, deficiency can be avoided with the consumption of mushrooms and sun exposure. In cases where sunlight may be less prevalent such as during the winter months (and sometimes the summer months) in the UK, a supplement could be beneficial. Vegans can also rely on fortified cereals and grains to boost their vitamin D intake (16).
Along with vitamin D, calcium is integral to bone health. Studies have shown that low calcium status in vegans may make them more prone to fractures (17). To protect bone health, vegans may consider including greater amounts of tofu, broccoli, pak choi, dark green leafy vegetables, chickpeas, fortified plant milks and juices in their diet. The good news is that a balanced vegan diet rich in fruit, vegetables and wholegrains is naturally high in magnesium, potassium and vitamin K, all of which also contribute hugely to bone health (18).
Potential vitamin/mineral deficiencies in a vegan diet
In some cases, supplementation may be a better option than consumption of alternative sources of food alone. Consult a nutritionist for advice tailored to your specific needs.
The processed food trap
Veganism is often thought to be synonymous with a greener, cleaner, healthier lifestyle. But the reality is not always this rosy. Many vegan food products are highly processed and add to the nutritional challenges already present as a result of removing certain food groups such as meat and dairy from the diet. Vegan junk food is as much at risk of containing high levels of sugar, salt, fat, and additives as junk food consumed in other diets. Vegan nuggets, instant noodles, vegan butter, desserts and crisps are just a few examples of foods that offer very little nutritional value.
Vegans can look for inspiration globally when it comes to healthy, colourful, plant-based diets. The Mediterranean diet is perhaps the most well-known for relying heavily on vegetables, fruits, cereals, legumes, nuts, pulses and olive oil with moderate servings of meat, fish and dairy (19). Plants also form an important component of diets in the Blue Zones of the world – areas where centenarians consistently thrive. In Sardinia for example, residents regularly consume whole-grain bread, beans, garden vegetables, and fruits, while meat is eaten mainly on Sundays or special occasions. In Loma Linda, California, the Adventist community relies on a vegan diet of leafy greens, nuts and legumes, and in Costa Rica, tropical fruits are widely consumed (20).
Key Takeaways
- Choose nutrient dense, colourful and varied plant foods, and consider menu planning to ensure your diet is as diverse as possible
- Cook from scratch where possible using fresh ingredients
- Opt for local and seasonal produce to maximize nutrient intake as plants transported from other parts of the world may lose some of their nutritional value by the time they make it to your home
- Consider soaking, germinating and fermenting grains and legumes to increase bioavailability and absorption of micronutrients
- Read food labels and steer clear of overly processed foods such as gluten-rich vegan burgers, ready meals and desserts
- Consider supplementation where necessary (under the guidance of a Nutrition Practitioner)
- Consult a nutritionist to ensure you are addressing any potential macro and micronutrient deficiencies
Climate Concerns
Author: Vandana Chatlani, Registered Nutritional Therapy Practitioner, NT Dip, mBANT, CNHC
References:
- Nature Now video with Greta Thunberg https://www.conservation.org/video/nature-now-video-with-greta-thunberg
- Government’s Food Strategy ‘a missed opportunity’ for the climate https://www.theccc.org.uk/2022/06/13/governments-food-strategy-a-missed-opportunity-for-the-climate/.
- Nutritional Status and the Influence of the Vegan Diet on the Gut Microbiota and Human Health https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7073751/
- Health effects of vegan diets https://academic.oup.com/ajcn/article/
- Intake and adequacy of the vegan diet. A systematic review of the evidence https://www.clinicalnutritionjournal.com/article/S0261-5614(20)30656-7/
- Health effects of vegan diets https://academic.oup.com/ajcn/article/
- Vegan diets: practical advice for athletes and exercisers https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5598028/
- Dietary Protein and Amino Acids in Vegetarian Diets – A Review https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6893534/
- Staying Healthy with Nutrition (2006), Elson M Haas and Buck Levin
- Vegan diets: practical advice for athletes and exercisers https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5598028/
- Combining Plant Proteins to Achieve Amino Acid Profiles Adapted to Various Nutritional Objectives—An Exploratory Analysis Using Linear Programming https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8850771/
- Vegan diets: practical advice for athletes and exercisers https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5598028/
- Foods for Plant-Based Diets: Challenges and Innovations https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7912826/
- Vitamin B12 https://onlinelibrary.wiley.com/doi/10.1111/j.1747-0080.2007.00198.x
- Intake and adequacy of the vegan diet. A systematic review of the evidence https://www.clinicalnutritionjournal.com/article/S0261-5614(20)30656-7/
- Intake and adequacy of the vegan diet. A systematic review of the evidence https://www.clinicalnutritionjournal.com/article/S0261-5614(20)30656-7/
- Comparative fracture risk in vegetarians and non-vegetarians in EPIC-Oxford https://www.nature.com/articles/1602659
- Health effects of vegan diets https://academic.oup.com/ajcn/article/89/5/1627S/4596952
- Definition of the Mediterranean Diet: A Literature Review https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4663587/
- Blue Zones https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6125071/
- Ask: Is veganism best for soil and farmers? https://wickedleeks.riverford.co.uk/features/ask-is-veganism-best-for-soil-and-farmers/
- Ask: Is veganism best for soil and farmers? https://wickedleeks.riverford.co.uk/features/ask-is-veganism-best-for-soil-and-farmers/
- The rise and fall of monoculture farming https://ec.europa.eu/research-and-innovation/en/horizon-magazine/rise-and-fall-monoculture-farming
NOTES TO EDITORS:
The British Association for Nutrition and Lifestyle Medicine (BANT) acts as a professional body for Registered Nutritional Therapy Practitioners in one-to-one clinical practice and as a self-regulator for BANT Registered Nutritionists®. BANT oversees the activities, training, and Continuing Professional Development (CPD) of its practitioners and has a governing council, who may be non-members but whose professional experience lies in the medical, scientific or educational area of nutritional science.
Registered Nutritional Therapists are regulated by the Complementary and Natural Healthcare Council (CNHC) that holds an Accredited Voluntary Register (AVR) for the Professional Standards Authority for Health and Social Care (PSA). A report by the Royal Society for Public Health and the Professional Standards Agency made a key recommendation that AVR practitioners have the authority to make direct NHS referrals, in appropriate cases, to ease the administrative burden on GP surgeries. BANT Nutrition Practitioners are the key workforce asset to harness 21st century lifestyle medicine to tackle the rising tide of stress-related fatigue, obesity, Type 2 Diabetes, dementia and other chronic diseases.
To find a BANT Nutrition Practitioner, please click here
BANT WELLBEING GUIDELINES:
The BANT Wellbeing Guidelines are specifically designed to provide clear, easy to understand general information for healthy diet and lifestyle when personalised advice is not available.
BANT launched its “Food for your Health” Campaign in February 2021 to provide open-access resources to help guide the public towards healthier food choices in prevention for diet-induced disease. Download a wide range of food and lifestyle guides, recipes, infographics, planning tools and fact sheets and start making healthy choices today.
