Naturopathic Guide to Healthy Veganism
By Bee Osborne, Naturopath
As a clinical naturopath and a long-term plant-based eater, I am an advocate that veganism can be a healthy choice. The evidence suggesting eating a vegan diet has positive health outcomes is not hard to come across, even in the contentious field of nutritional science. Studies show that whole food plant based vegan diets are preventative against 8 out of the top 10 leading causes of death (the others being non-diet related death i.e. accidents). The American Dietetic Associations has affirmed, “Appropriately planned vegetarian or vegan diets, are healthful, nutritionally adequate and may provide health benefits in the prevention and treatment of certain diseases.”
“Appropriately planned” being an important insight. As a plant-based naturopath, I have supported many vegan patients. Eating right is so difficult with our current food culture. There are also a variety of vegan diets (processed, refined, macronutrient controlled, high carb, low fat etc.) not all of which are healthy. We can’t assume that because something is ‘vegan’ (soft drinks and chips) that it is a healthy regular option. It’s hard to be nutritionally balanced all the time. Unless you follow recommended guidelines on vegan nutrition and supplement sufficiently, where diet is lacking, becoming vegan won’t necessarily be healthy for you. It is also important to state, a radical shift in diet is significant. If and how you decided to change your diet is up to you, as only you can decide what type of diet is right for you.
Here are some of the most common pitfalls I have seen and some suggestions for how to overcome them:
Weight gain or weight loss
During a complete diet change weight loss or gain is common. Particularly when making such a radical change. Depending on your diet beforehand, veganism can eliminate a lot of “go to” foods that make up a large part of your diet. This can often lead to not knowing what to eat, causing weight loss or not knowing what to eat and then eating all the calorie dense vegan yums, causing weight gain. If you eat too many calories, even if they are nutritious, plant-based, low-fat calories, you will gain weight. As an added affect you’re introducing new foods, which is great, but our bodies need time to adjust. Depending on what your diet was beforehand, where you’re at, and how good your gut microbiome is at digesting these foods, it is often indicated to transition into this diet slowly (weeks or months) instead of overnight, this will reduce fluctuations in weight.
Often patients tell me “I tried to go vegan, but I was just so tired.” This is a fair concern, maintaining adequate energy level has its complexities but for most patients this is easily surmountable. Iron is most often the major culprit. Studies show that in westernised countries, vegans tend to get the same amount of iron as omnivores. However, iron in meat (heme iron) is more readily absorbed comparatively to plant-based non-heme iron. A good trick is eating high vitamin C foods with iron foods as vitamin C enhances absorption. Avoiding black tea with meals is also a vegan trick as the tannins found in tea binds to iron, decreasing absorption. There are a lot of bio-hacks, but importantly iron levels need to be checked in individuals who are vegan, particularly in menstruating women. And a strategy to ensure sufficient iron should be implemented whether dietary or supplementary.
Now, when some people remove animal foods from the diet, their acne can resolve and their skin is glowing. This is normally due to removal of dairy protein known to contribute to insulin/IGF-1 signaling, increasing cell proliferation, increasing cell debris and thickening of the skin making pores more likely to clog. Removing dairy protein often has a positive effect on skin, so initially when vegan patients presented with acne there was confusion. However, upon investigation there are some routine mistakes new vegans make in their nutrition that has impacts on skin barrier function and health. Firstly, some vegan diets have very high glycaemic loads, this is all the white bread, pasta and other carbs some new vegans eat to feel full, when we take a large part of the diet away (all animal products), it makes sense that many will just eat the foods that are left in higher amounts. This can be easily addressed, switch white for brown (bread, pasta, rice) get adventurous with your plate! Try new foods, try foods you don’t think you like, try vegetables and fruits, and reduce that glycaemic index!
Another common cause is the shifting zinc sources. Studies found vegans are considered to be at risk for zinc deficiency. Interestingly, although vegans have lower zinc intake than omnivores, research shows that vegans do not differ from the non-vegetarians in functional immunocompetence as assessed by natural killer cell cytotoxic activity indicating there may be compensatory mechanisms to help vegans adapt to lower zinc intake, our bodies are smart, however it takes time to adjust. Phytates, a common component of legumes, seeds and grains binds zinc and thereby decreases its bioavailability. There are ways around this, like soaking legumes and sprouting seeds. Eating more zinc rich foods, soybeans, whole grains, sunflower seeds, a handful of raw nuts daily will help maintain healthy skin. The other common dietary cause is essential fatty acids. Plant-based n-3 fatty acid a-linolenic acid (ALA) can be converted into EPA and DHA, however with a fairly low efficiency. Compared with nonvegetarians, vegetarians, particularly vegans, tend to have lower blood concentrations of omega-3. With omega-3 being vital for several important body systems, the best solution is supplementation from a microalgae containing DHA, as well as fortified foods. Treating acne does depend on several factors, only some being dietary driven, if your new vegan diet contains the same amount of nutrients essential for skin health, then considering hormonal drivers for acne is appropriate.
Stomach upset, pain, gas
Patients presenting with gut issues or stomach pain after a vegan dietary transition can be due to a few factors. One being vegan diets are high in fibre. This is a good thing, with most Australians consuming less than the recommended minimum daily fibre intake. It’s not that vegan diets contain too much fibre it’s just that our microbiome may not be equipped. This can be solved by slowly implementing higher fibre foods. Research shows that the gut bacteria of a vegan looks very different to a meat-eater, you’re microbiome will begin to change. However, for some patients, such as those with irritable bowel syndrome or severe gastrointestinal symptoms working with a health practitioner is indicated and for others such as patients with an ileostomy or lap-band, high fibre diets are contraindicated.
Dietary intake studies have shown that vegans, on average, are not getting the recommended daily intake of three nutrients: calcium, iodine and vitamin B12. However using the same criteria omnivores are deficient in seven nutrients: calcium, iodine, fibre, folate, magnesium, vitamin C & E. It is eating a diet that is micronutrient sufficient that is healthy, not the label ‘vegan’ or ‘carnivore’.
If you need further support in creating and implementing a strategy to ensure wellness living a vegan lifestyle consider getting appropriate practitioner support. You can visit your doctor or naturopath and have your blood work checked before you commence and have a follow-up check 6-12 months into your journey, this will increase your confidence and lessen any concerns from loved ones. Often the pathology work shows improvements, which is great, and in other cases it may indicate areas that can be optimised, that’s okay too. Don’t forget that there is a learning stage with anything new, particularly in the beginning, it’s important to be kind to yourself as well as the animals.
Bee Osborne is a Naturopath at The Health Lodge with a passion for working collaboratively with patients and their health teams to facilitate cohesive planning, resulting in high quality, personalised medicine, to achieve optimal health outcomes. As a long time vegan, Bee is certified in Plant Based Nutrition and enjoys supporting her patients by using food as medicine, implementing gradual and sustainable changes with the aim of achieving long-term health and wellbeing.
Book an appointment with Bee online or call us on 02 6685 6445 for more information.
*This blog features the views of the writer and is for educational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always consult your doctor or other qualified health practitioners before acting on information on this article, particularly if you have a medical condition, taking medication or if you are pregnant.