The purely plant-based diet is approaching the middle of society with great strides. More and more people are participating in the annual “Veganuary” and are switching to a plant-based diet partially or even forever. What this means for their health is the subject of controversial debate. In this confusion, it is difficult to keep track. A professional outlook helps.
What distinguishes vegan diets?
Those who follow a vegan diet do not consume foods of animal origin. This excludes not only meat, dairy products and eggs from the menu, but also gummy bears with gelatin, various flavors, animal additives such as carmine and juices, as well as wines clarified using egg white or gelatin. At first glance, this diet seems very restrictive, which is why many people express concerns about its practicality. However, according to a meta-analysis, the positive side effects on health of a vegan diet may include, for example, reduced risks of
- Obesity,
- Diabetes,
- Individual cancers
- And cardiovascular diseases
count. However, it should be said that this is only true if the vegan diet is designed healthy as well as balanced. Due to the growing popularity of plant-based products, there is also a growing supply of highly processed foods, which can be bad for health regardless of the dietary form.
What are the potential risks of the vegan diet?
A frequently cited argument against vegan diets is the position of the German Nutrition Society (DGE), which considers various nutrients critical and potentially critical. It should be noted: the only truly critical nutrient is vitamin B12. In addition, there are the potentially critical nutrients
- Protein or essential amino acids
- Vitamin D
- Vitamin B2
- Calcium
- Iron
- Iodine
- Zinc
- Selenium
- And omega-3 fatty acids.
By potentially critical is meant that these nutrients may be present in the vegan diet in too small quantities. The DGE is absolutely right about this, which is why its position in this regard should be taken seriously. However, this does not mean that a vegan diet is impossible. One of the world-wide largest nourishing societies, the US-American Academy OF Nutrition and Dietetics, describes the well planned vegan nutrition as appropriate for all life phases of the pregnancy over the Stillzeit up to child, youth, adult and senior age. The addition of “well-planned” is important here, because without nutritional knowledge, it can actually be difficult to eat a diet that meets purely plant-based needs.
Excursus: the National Consumption Study II – nutrient deficiencies even in mixed-food eaters.
Often, vegan diets in particular appear to be particularly risky, as people have difficulty meeting their nutrient requirements with them, according to the DGE. Here, however, it is necessary to look at the situation in a more differentiated way, and the National Nutrition Survey II (NVS II) helps [3]. It was conducted a few years ago to find out how the nutrient supply of the German population stands. The NVSII mainly involved people with a mixed diet. The scientists found that an undersupply of nutrients is not uncommon even in these groups of people. An often unmet need was found in:
- Vitamin D: 91 percent of women and 82 percent of men.
- Vitamin B2: 20 percent of women and 26 percent of men
- Vitamin B12: 26 percent of women and 8 percent of men
- Calcium: 55 percent of women and 46 percent of men
- Iron: 58 percent of women and 14 percent of men
- Iodine (excluding iodized salt): 97 percent of women and 96 percent of men.
- Zinc: 21 percent of women and 32 percent of men
Consequently, it may be true that there is a risk of nutrient deficiencies in the context of vegan diets and that this requires a thoughtful menu plan. However, this does not mean that people on a mixed diet are per se free from the risk of deficiency. They, too, benefit from a well-planned diet.
Eating whole foods is essential for vegans
A well-planned vegan diet includes regular utilization of all relevant food groups. These include:
- Whole grains: Contains appreciable amounts of protein, fiber, B vitamins and valuable minerals such as zinc and iron.
- Legumes: Are rich in protein, fiber, phytochemicals, B vitamins and valuable minerals.
- Soy products: Are excellent suppliers of essential amino acids and therefore contribute to a vegan diet that meets the needs. Myths regarding the intolerance of soy due to contained phytoestrogens have now been disproved.
- Nuts, seeds and kernels: Are good sources of B vitamins, depending on the variety also high quality fatty acids, fiber and minerals.
Since the bioavailability of various nutrients such as iron, protein, zinc and vitamin B2 from plant sources is not always as good as those from animal sources, it is necessary to adjust the diet accordingly. For example, the bioavailability of non-heme plant iron can be increased by serving a source of vitamin C with food and consuming coffee only about an hour and a half apart from a meal. It is also a good idea to break down phytic acid in whole grains by soaking, sprouting, or roasting, as this can otherwise inhibit the absorption of minerals such as iron and zinc.
| Extra tip: Vegans cover the daily calcium requirement more easily if they reach for a calcium-rich mineral water. There are varieties with more than 500 milligrams of calcium per liter, where just by meeting personal fluid needs, the calcium requirement is also met. |
Blood values for vegans
Whether a deficiency symptom is present or not due to a vegan diet, usually only a blood test can provide clarification. To find out whether their own supply of nutrients is ensured, vegans should regularly have a blood test. A small blood picture is not sufficient here, because this does not cover micro nutrient values. Values that should be checked once a year for vegan adults and twice a year for plant-based children are:
- Holo-transcobalamin: Is a meaningful marker for vitamin B12 deficiency.
- Ferritin: Describes the status of iron storage.
- Zinc in serum
- Selenium in serum
- EGRAC: reveals whether sufficient vitamin B2 is absorbed.
Who wants to have his iodine supply tested, should not choose the blood value, but an excretion test via the urine.
| Important: Many of these parameters must be paid for by the patient, as they are services that are not covered by health insurance. A preliminary consultation can provide information about the expected costs. |
Supplements in the vegan diet
The supply of micronutrients is not always possible in the plant-based diet without supplements. However, this in turn is not an exclusion criterion.
| Attention. About the necessary supplements, women and men should always inform themselves individually and not carelessly reach for nutrient preparations. Many minerals and vitamins could otherwise be overdosed, which is detrimental to health. In the case of underlying diseases and absorption disorders, special precautions are also important, which is why supplementation should be discussed with specialists. This information is never a substitute for a doctor’s visit or sound nutritional advice and is provided for guidance only. |
Supplements that vegans should think about after an initial blood test are:
- Vitamin B12
Supplementation of vitamin B12 is essential in the vegan diet. Cyanocobalamin is the best researched and most stable, but should not be taken by smokers and people with kidney disease.Instead, they should choose methylcobalamin or a so-called MHA formula, which consists of the three forms methyl-, hydroxo- and adenosylcobalamin. As for the dosage of vitamin B12, vegans need to know that the amount once ingested does not correspond to the dose contained in the supplement. The so-called intrinsic factor, which is formed in the stomach mucosa, limits the intake of vitamin B12 per meal to about 1.5µg. However, the daily requirement of an adult, for example, is around 4µg, which is why additional passive absorption via the oral and intestinal mucosa is necessary. This amounts to about one percent of the total dose. Consequently, the recommended daily dose for a healthy adult person without absorption disorders would be 250µg. Here, 1.5µg comes from intrinsic factor and 2.5µg from passive absorption. This applies only to cyanocobalamin; higher doses may be needed for other forms.
- Iodine
To meet the iodine requirement with iodized salt alone is difficult, given the content of just under 20µg per gram. After all, an adult person needs about 200µg of iodine daily. For this reason, people living vegan can either turn to a supplement or to suitable algae such as nori. Algae should definitely have analysis values and not be too rich in iodine. Patients with thyroid disease are best to discuss iodine intake in advance with their endocrinologist.
- Selenium
Soils in Germany are poor in selenium, which is why plant foods hardly contain this nutrient. It is often said that the need can be covered by Brazil nuts. However, the ranges of variation are often very large, so it is not sure how much selenium is actually in a nut. If you want to be on the safe side, reach for a supplement with selenomethionine or sodium selenite in the appropriate (!) dosage for your personal needs.
- Vitamin D
Vitamin D can be synthesized by the human body through the skin. However, this does not apply to people who spend most of their time indoors in the summer, nor during the months of October to April. For this reason, a deficiency is very common and can bring symptoms such as depressive moods or susceptibility to infections. The correct dose cannot be calculated until a blood value is available. Here, a doctor should be consulted again.
- Omega-3 fatty acids
The essential fatty acids omega 3 (alpha-linolenic acid, or ALA) and omega 6 (linoleic acid, or LA) are absorbed through the diet. From omega 3, the body then forms the fatty acids docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). However, it can only do this if sufficient ALA is available and not too much LA is consumed. This is due to the fact that ALA and LA use the same system within the metabolism. The more LA is available, the more difficult it is for the body to create DHA and EPA, because alpha-linolenic acid can hardly be used. For this reason, it may be useful to supplement DHA and EPA via fortified microalgae oil.
