top | item 26453808

Can a Vegan Diet Be Healthy? A Literature Review

54 points| erwald | 5 years ago |erichgrunewald.com

143 comments

order
[+] sleavey|5 years ago|reply
Ctrl+F "B12". Here's a quoted reference from the article:

> [V]egans exhibited a higher estimated prevalence of inadequacies for some nutrients, in particular vitamin B12 (69.9% in men and 83.4% in women <55 years of age), compared to meat-eaters. […] Our study highlighted that, overall, self-reported vegetarians and vegans may meet nutritional recommendations.

Those numbers are crazy high. I am not an expert in any of this, so take this with a healthy dose of skepticism, but I wonder if a vegan diet can be considered healthy without supplements given the current range of available non-animal B12 sources. I think there are some algae sources but I'm not sure you can get enough B12 without getting too much of something else. There's also the question of how efficiently you absorb the nutrients in the food; I heard it's harder to absorb B12 from algae than from cheese for example. Happy to be shown evidence for or against...

[+] dignick|5 years ago|reply
I think it’s important to note that due to soil deficiencies (because of intensive farming) and factory farming, 90% [1] of B12 supplements are given to livestock. Regardless of your diet it’s good to make sure you are getting everything you need and are not deficient in anything. I think veganism raises awareness of that fact. [1] https://baltimorepostexaminer.com/carnivores-need-vitamin-b1...
[+] meowface|5 years ago|reply
As a life-long vegetarian, I noticed significant and permanent health, mood, and cognition benefits once I started supplementing vitamin B, vitamin D3, and omega-3 fatty acids (from algae) daily.
[+] yesenadam|5 years ago|reply
Vegan for 30 years here. I've never really worried about diet at all, except I guess reading about it a bit in the very beginning. Last medical checkup I got, levels of everything were fine.

B12 is added as a supplement to soy milk and some other vegetarian stuff (here in Australia, at least, and I assume elsewhere), so I've never needed to worry about that.

[+] Bancakes|5 years ago|reply
It's not just veganism. I have incredibly low vitamin D because I've been sitting at home in closed curtains for the past year. My doctor warned me I'd get impaired vision like this since sunlight releases valuable hormones in the eyes (or something).

What I'm trying to say is that I believe it be important to calculate your diet and not count on accidental vitamin intake from meats.

[+] samblr|5 years ago|reply
>> B12.. So take this with a healthy dose of skepticism

Absolutely this.

Meat is so highly nutritionally dense - vegans you have no clue.

I was a vegan for 20 years of my life. I thought it was env friendly, ethical, bla-bla-bla and had my mum as a company at home while growing up in this seriously flawed cult.

And then I figured that I was not only b12 border line deficient but also in other b-vitamins. And the list continued to Iron, zinc etc. As a vegan you can still get most vitamins other than the most important b12. Even if you can get other vitamins from vegan, you will have to eat a lot to get the same nutrients as in a simple steak!

Since turning into meat, my life has gotten 10 times better probably. Although I prefer to prepare it at home only and have it just once/twice a month.

[+] kristopolous|5 years ago|reply
That number doesn't have a comparison with non vegans so I went to the source. Open access

https://www.mdpi.com/2072-6643/9/9/1023/htm

Page 11.

The B12 delta is the most dramatic but some nutrients fall in the vegans favor (eg Vitamin E and Magnesium). It's kind of a mixed bag.

So the takeaway is quite boring: monitor your consumption regardless of dietary identity

[+] chmod600|5 years ago|reply
As far as I can tell (non-expert), B12 supplements are basically required for healthy veganism. Humans don't have the hardware that, e.g. cows have.

Does anyone say differently?

[+] moby_click|5 years ago|reply
https://veganhealth.org/vitamin-b12/ has pretty much everything one needs to know about B12. It's worth a read in general, but especially important for vegans. Teasing the crucial part: Relying on 100% RDA of B12 from a daily multivatimin will get you in trouble because that likely exceeds the capacity of your transport proteins in a single dose. For the less efficient "unassisted" absorption, you need to dose a lot higher.
[+] henearkr|5 years ago|reply
As I said in another comment, shiitake mushrooms are an excellent source of B12.

Moreover it's the same form of B12 as found in beef, liver, fish, etc, so you have no worries of bioavailability.

[+] sdoering|5 years ago|reply
You are right. A lot of plant based sources are not going to provide enough B12.

I am not a vegan nor vegetarian, though in the summer I mostly love plant based.

From personal interest some time ago I was looking for plant based alternative sources and stumbled (next to others) onto [1].

[1]: https://pubmed.ncbi.nlm.nih.gov/10794633/

[+] doomrobo|5 years ago|reply
There's B12 in nutritional yeast. One serving of Bragg's is something like 600% DV of B12
[+] helsinkiandrew|5 years ago|reply
I’ve been a vegan for 35 years and although I think it’s more healthy. It’s likely the biggest health benefit that someone would get going vegan in the past would be that most processed ‘crap’ food is not vegan and you are forced to make healthier choices.

I find it annoying that the rise in veganism means there are far more bad choices I can make: big chain burgers, ready meals, cakes, cheesy pizzas are all now available to me.

[+] sdoering|5 years ago|reply
From the first glance at the title I expected a worse article.

But actually it was unexpectedly non partisan. It read like a good and readable literary review. My SO studied nutritional science (actually Ecotrophology) and I gained quite some insights by reading lots of the studies directly. A lot of them I recognized in this article.

[+] o0|5 years ago|reply
I have been vegan for 6 months now and have seen remarkable health improvements, all verified by lab testing.

It has been very amusing having long discussions with my cardiologist trying to explain to him the changes I did as he could not believe the data he was getting.

[+] hirundo|5 years ago|reply
Yesterday marked six months that I have been > 99% carnivore. My labs also are greatly improved including putting my diabetes into remission, with blood glucose beneath prediabetic levels.

Perhaps our common benefits are as much from the foods that we no longer eat as from those we do eat.

I was raw vegan for six months a decade ago. I bounced off of that with health problems including brain fog at that point. At the moment carnivory feels more sustainable to me. Possibly the "raw" part is a difference between our experiences.

[+] isitdopamine|5 years ago|reply
That’s very good, I am glad your health improved.

However 1) correlation does not mean causation, less so with one data point 2) people who radically change their diet often do some other lifestyle change out of the same concerns.

For instance is not uncommon to switch diet and start exercising at the same time, or switching to a more regalar sleep schedule. Did you?

[+] david-gpu|5 years ago|reply
Are you consuming largely unprocessed foods with adequate fiber now? Were you in the past?
[+] dgellow|5 years ago|reply
Maybe a good place to ask vegetarians and vegans: how do you know if your diet is healthy?

I'm myself eating vegetarian since 2016 with no issues. But I never check if my food is balanced and wouldn't know if I would be missing some proteins or nutriments.

Do you check your blood regularly, or do you have other approaches to ensure that you have an adequate diet?

[+] yakkomajuri|5 years ago|reply
A few noticeable (and non-scientific!) points from someone who's dabbled with both sides over the last year (spent ~1/3 of the year as a vegetarian/vegan):

- I eat a lot more fruits, salad, and vegetables as a vegan (duh!)

- The diversity of the food I eat _increases_ as a vegan (even though there are less options to eat)

- I do feel the need to supplement protein (which I hate to do and stay away from when non-vegan)

- I also supplement B12 as a vegan

[+] rewq4321|5 years ago|reply
+1 to the food diversity point. I've never felt the need to supplement protein, but I've always been a big peanut butter eater, that probably helps. I've also really started enjoying tofu and tempeh recently.
[+] AussieWog93|5 years ago|reply
Pleasantly surprised to see a health-related article written by a vegan where a genuine, honest effort is made to explain scientifically what the actual benefits and risks are, and what the actual flaws are in various vegan/non-vegan diets.
[+] henearkr|5 years ago|reply
Many many comments here overlook that there are very good natural and vegan sources of B12:

Shiitake mushrooms are an excellent source of B12 (and it's in the same form as the B12 from beef, liver, or fish, so it has a very good bioavailability). It's not widely known even by vegans.

For both vegans and omnivores, the easiest way to keep an adequate level of B12 is with supplements. Omnivores have them fed to their steaks/cheese/milk during intensive farming.

The best of best B12 supplement is hydroxycobalamin, if you can find it in sublingual tablets (it's not readily available in every countries, but you can import it).

[+] ggm|5 years ago|reply
Osteopenea and osteoporosis are huge concerns for young women. Bone demineralisation post menopause comes off the strong bones laid down in youth. If you come off a low base it's higher risk.

Twenty or more years hence problem

[+] disgruntled101|5 years ago|reply
Any diet can be healthy as long as you hit your micronutrient targets for your age and sex and keep calories at your tdee if you want to maintain or slightly lower if you want to lose weight.
[+] qudchewer|5 years ago|reply
I've seen my mother and father dwindle in health while following a 'Whole Food Plant Based Diet' over the last five years. They followed it to a T, going to see Campbell more than once. They have both suffered G.I. issues, connective tissue problems. My mother's osteoporosis is now bordering life threatening. Once fish and dairy were re-introduced, they got better. The level of zealotry made it difficult to talk to them about their condition.
[+] franciscop|5 years ago|reply
The author notes it well:

> In Western studies, vegans had lower body mass index, lesser waist circumference, reduced blood sugar levels, lower low-density lipoprotein (protein that transfer lipids around the body; fats are a kind of lipid) cholesterol (a type of lipid), less body fat & lower blood pressure than omnivores.

My question is, do the studies shown account for body weight? Sure if you are comparing your average USA citizen (40.0% of which are obese) to a group that happens to be fit, you are definitely going to have much better outcome of the later.

First part of the question would be, does veganism help with obesity? Or is it just correlated to it for other reasons? Conjecture: it seems no surprise that people who spend a significant amount of time worrying about their diet have on average much better BMI, but maybe the diet itself also helps.

Second part would be, when adjusting for BMI, does veganism also show these benefits? Or are they benefits related only to BMI? There seem to be no separation of the benefits of being vegan vs the benefits of being fit when the health outcome is being discussed.

[+] noth1|5 years ago|reply
Can someone disapprove me, as i think we have some bacteria in our bowels that consume carbs and produce majority of amino acids, so in the end our basic requirement for proteins are satisfied.

As someone who grow up in rural russia in 90s, meet was a rare usually on holidays/birthday, and i believe i grow up perfectly healthy, ofc it's a fallacy to look at personal experience, but even tho.

[+] moby_click|5 years ago|reply
As their name implies, carbohydrates consist of carbon and water (hydrogen and oxygen), hydrated carbon. Amino acids need at least nitrogen in addition, which in our digestive tract is probably already most abundantly found in amino acids. The microbiome does consume carbohydrates though, mostly those that are inaccessible to our digestive system.

I'm not an expert on this, but my guess is that by mass their most important products for us are short chain fatty acids. They might assist in breaking down some proteins that we lack enzymes for or modifying amino acids, but the absorption of amino acids happens mostly in earlier sections of our intestines, whereas the microbial biomass and activity increases towards the later stages of the gut.

[+] im3w1l|5 years ago|reply
Can it be healthy? Yes. Is it healthy by default, is it typically healthy? Not really.
[+] 317070|5 years ago|reply
My rule of thumb: when there are whole civilizations that exist on a diet, you will be okay.

In this case the Jain are a prime example.

[+] isitdopamine|5 years ago|reply
Jain can drink milk and eat dairies, which are a good source of B12.

One of the major criticisms of a vegan diet is the a almost complete lack of B12.

[+] beforeolives|5 years ago|reply
> when there are whole civilizations that exist on a diet, you will be okay.

If okay = "survive long enough to leave offspring", then yes. However, health and quality of life are a lot more complicated than survival, that's why we look deeper into the science instead of using these rules of thumb.

[+] incrudible|5 years ago|reply
To my knowledge, there is not a single tribe known to survive on a truly vegan diet for any extended period of time (several generations).

Jains are generally vegetarians, not vegans. There may be some anecdotes that some Jains did live off truly vegan diets, but then again there are anecdotes of people living off sunshine. Neither are plausible.

[+] belgian_guy|5 years ago|reply
Counterpoint: there's a whole civilization on the western/USA diet, which has been shown to not be that great for your health (see e.g. obesity rates).
[+] leadingthenet|5 years ago|reply
Jainism is completely different to veganism, so unsure what point you’re trying to make here.
[+] nsomaru|5 years ago|reply
Jainas are not necessarily vegans.

Although the nation of India checks out for vegetarianism. One wonders what that collective moment of culture was that a whole group of people decided that meat eating was not going to be a part of their lifestyle.

[+] Hitton|5 years ago|reply
Using such rule of thumb would let one believe that cannibalism is ok as part of diet because Fore people practised it for generations. We of course know now that it caused spread of Creutzfeldt-Jakob disease among them with incubation period on average longer than 10 years. There even appeared mutation among them which granted immunity to it.
[+] denhaus|5 years ago|reply
quite the opposite diet can be claimed by the inuit. more, the most powerful civilization in the world, the US, has objectively one of the worst diets in history.
[+] sleepysysadmin|5 years ago|reply
Im not a vegan, but it absolutely can be healthy. They say 84% of vegans return to meat. https://www.psychologytoday.com/us/blog/animals-and-us/20141...

But this is because they aren't following a healthy approach. Moreover, unfortunately there we found out that there are basically no non-meat sources of B12. Except for the original bacteria. There were some almost-b12 options people were trying but failed. So even if you supplement b12, it's likely to be sourced via a meat source.

Worse yet, B12 isnt the only problem. There are 3 others that vegans often dont get in their diet because to get enough would require ungodly amounts of rather unusual foods like flaxseed or seaweed. Like how much can you really eat of those?

That said, there is a valid path of veganism. You can find the proper nutrition. You have to thoroughly investigate how to do it but you can.

[+] indy|5 years ago|reply
Fingers crossed that Betteridge's law doesn't apply in this case.
[+] throw8932894|5 years ago|reply
Fasting (AKA not eating anything for 40 days) can be healthy. The real question is: Is it sustainable, even in edge cases like childhood or pregnancy?

Even rural chinese sustained on rice and salt, need a chicken once a week.