“I was Vegan for A While, But…”

The recent controversy explained in my post To Quit or Not to Quit Veganism spurred me on to update the introduction to VeganHealth.org, “I was Vegan for A While, But…”.

Before getting to that, there is one more recent ex-vegan story, that of John Nicholson, as described in the article, From vegetarian to confirmed carnivore.

John Nicholson says that after having tried everything to cure his irritable bowel syndrome as a vegan, eating ox liver and rare steak cured it within 24 hours. Wow – maybe I was wrong and it is, indeed, the spirit of the dead animal that can perform such miracles.

I’d have more sympathy for these ex-vegans if their stories didn’t sound so strange, and if they didn’t swing from one extreme to the other. Nonetheless, there is no denying that Nicholson’s health improved when he went back to eating animal products.

Here is the article:

“I was vegan for a while, but…”

Let’s start with the good news: Vegans have a much lower risk of type-2 diabetes than do meat-eaters – in fact, it’s not even close. Research has also shown that vegans have a slightly lower risk of cancer by virtue of our diets.

Unfortunately, this isn’t the end of the story. While many people thrive on a vegan diet, others have a hard time. When someone is committed to reducing animal suffering, there are often solutions to these dilemmas, and finding answers has been a major focus of my nutrition writing. While bringing attention to these issues might not initially attract as many people as claiming that a vegan diet is a health panacea, getting people to stay vegan long-term is the more important task because every vegan who fails to thrive provides reasons for many people not to try veganism.

Macronutrients: The Bigger Picture

Something as simple as not eating enough calories might be a problem for an uninformed person who decides to eat vegan for a few days. They might only be aware of low-calorie vegan foods (e.g., salads, vegetables, fruits), and eating only these foods for a day might leave them feeling hungry and weak.

Of course, many advocacy groups are actively trying to educate people about the wide variety of satisfying vegan foods. In promoting the diet, each person could help prepare potential vegans for the real possibility that they won’t feel good if they don’t choose some calorie-dense foods.

In addition to calories, a lack of protein in the diet for a few days could lead to someone feeling less than optimal and wanting to eat animal products. While severe protein deficiency is certainly nothing to worry about on a vegan diet, if someone doesn’t know what high-protein vegan foods to choose, they could go from eating large amounts of protein (on an animal-based diet) to much smaller, less satisfying amounts on a vegan diet. Legumes (beans, peanuts, peas, lentils, soy), seitan, and quinoa are the best sources of protein for vegans. Include a few servings of these foods each day – maybe even each meal.

While a low-fat diet might improve someone’s health in the short-term, it might not be ideal over longer periods. If you are avoiding all added fats and you start to crave animal products, it might be time to add some fat back into your diet. People tend to think of animal products, and especially meat, as “protein,” but they are actually about 50% fat in many cases.

It’s theoretically possible that some vegans’ cholesterol levels might get too low on a low-fat, low-calorie, and/or low-saturated fat diet, leading to a low production of steroid hormones. In this case, adding plant saturated fat, such as coconut oil, to the diet, could improve their health. There is not much research into how low cholesterol levels must go, on average, to inhibit steroid hormone production and it may be very rare for this to happen. Two studies have shown vegans to have sex hormones on par with meat-eaters (1, 2), but one report showed vegan women to have lower levels of estrogen (3). A few anecdotal reports provide some evidence that low cholesterol problems might be an issue for some vegans (see Bonzai Aprodite’s story of regaining her health as a vegan, Facing Failing Health As A Vegan).

While the science is still in the early stages, it appears that some people genetically do not do well basing their diet on carbohydrates (see Dieting by DNA? Popular diets work best by genotype, research shows). For those people, the eco-Atkins type diet, high in plant proteins such as soy meats, legumes, and seitan, might be a better choice than a higher carbohydrate, low-fat diet.

Finally, if you find yourself craving animal products, it could be because you have a strong preference for the taste of glutamate, also known as umami. You can read more about foods high in umami in Ginny Messina, MPH, RD’s article, Is Umami a Secret Ingredient of Vegan Activism?

Micronutrient Deficiencies

Vitamin B12 in plant-based diets has long been a source of controversy and myths, so much so that a large portion of this site is dedicated to discussing B12. Although it rarely happens quickly, these myths have led to many vegans getting B12 deficiency. If you do not get a reliable source of vitamin B12, the chances are high that you will, at some point, find your health failing.

The need for calcium on vegan diets has also been surrounded by misleading ideas. Many vegan advocates have suggested that animal protein, including milk, is the main cause of osteoporosis in Western countries. Following this line of logic, it would make sense that vegans do not need to worry about osteoporosis since they are not eating animal protein. The research actually shows that vegans, like non-vegans, should try to meet the calcium recommendations for the greater population. Vegans are at a disadvantage in this area because our diets tend to contain much less calcium than your typical animal-based diet, so we must make an effort to ensure good sources of calcium on a daily basis.

More often than not, vegans who come to me with severe fatigue are suffering from vitamin D deficiency. This is not just a vegan problem, many people develop vitamin D deficiency in this era of sun avoidance. But vegans are at a slight disadvantage, on average, because we get less vitamin D in our diets. Make sure that you have a reliable source of vitamin D.

Although it appears to be a small percentage, some women develop iron-deficiency anemia after becoming vegetarian. If you think you are at risk, see the article on Iron for tips on increasing iron absorption from plants.

Iodine is a nutrient that most vegans rarely think about but a 2011 study showed that vegans do not get enough. Especially if you eat soy, you should make sure you are getting some iodine.

DHA is an omega-3 fatty acid that is important for cognition. A short time on a vegan diet is not likely to cause any sort of deficiency, but long-term vegans should take a supplement.

Finally, some vegans might not get enough vitamin A and zinc, depending on their dietary choices. Vitamin A is easy to get through orange vegetables, though eating them daily is critical to this strategy. Zinc is trickier and some vegans just opt for a modest supplement of 50-100% of the RDA.

For more information on all of these nutrients, please see the Daily Recommendations for people on plant-based diets.

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References

1. Thomas HV, Davey GK, Key TJ. Oestradiol and sex hormone-binding globulin in premenopausal and post-menopausal meat-eaters, vegetarians and vegans. Br J Cancer. 1999 Jul;80(9):1470-5. | link

2. Key TJ, Roe L, Thorogood M, Moore JW, Clark GM, Wang DY. Testosterone, sex hormone-binding globulin, calculated free testosterone, and oestradiol in male vegans and omnivores. Br J Nutr. 1990 Jul;64(1):111-9. | link

3. Goldin BR, Gorbach SL. Effect of diet on the plasma levels, metabolism, and excretion of estrogens. Am J Clin Nutr. 1988 Sep;48(3 Suppl):787-90. Review. | link

33 Responses to ““I was Vegan for A While, But…””

  1. Marek Says:

    It’s really a wonderful summary!

    Just one thing, in Vegan for Life, page 55, you say “it’s hard to know whether [DHA] supplements are useful for vegans. We are not convinced they are.” Has there been more evidence since then that they are needed? If not, I’m not sure if it’s good to say so decidedly that vegans SHOULD take them, especially since they are by far the most expensive supplements (from those that vegans might need) and also not easily available in some countries.

  2. Matt Says:

    One of the problems I had as a vegan initially is that I figured whatever worked for me is what everyone else should do. This seems to be pretty common among vegans — we think only our version of veganism is ethical, healthy, etc.

    PS — My impression is that it wasn’t necessarily Ox liver that cured John N’s IBS — that is just what he started with. Could have been something else, if he had chosen that.

  3. Jack Norris RD Says:

    Matt,

    I guess my point is that it is impressive to cure one’s IBS in 24 hours no matter what you’re eating.

  4. Jack Norris RD Says:

    Marek,

    On p. 89, we clearly recommend DHA supplements for vegans. There has not been any further evidence on the matter, but the evidence to date, in my opinion, comes in on the side that vegans (who do not have bleeding disorders) should take a DHA supplement. But there are still many questions and if someone would rather just increase their ALA intake, that seems reasonable to me. A DHA supplement would be ideal if they are available. I would say that taking a DHA supplement is “prudent” but that the evidence that it’s absolutely necessary for all vegans is lacking.

  5. John Says:

    Jack,

    Have you read Neal Barnard’s new book — Power Foods for the Brain? He comes down pretty hard against any zinc supplement saying that an excess of metals (i.e. copper, iron, and particularly zinc) could compromise cognition later in life. Do have any thoughts on this?

    thank you!

    Johnny

  6. Jack Norris RD Says:

    John,

    I have not read it. Did he cite any research for the zinc? I didn’t mean to suggest that people take large amounts of zinc – I definitely wouldn’t go above the Upper Limit which is 40 mg. I’d stay closer to a supplement of 5-10 mg which would ensure that you’re meeting the RDA.

  7. John Says:

    I don’t recall the specific research as I read it in Barnes and Noble and didn’t buy it.

    He did, however, say not to take a multivitamin supplement with any added minerals and most multivitamin/multimineral supplements have much less than 40mg of zinc.

  8. Jack Norris RD Says:

    John,

    The sources I use, Linus Pauling Institute, Institute of Medicine, and others don’t seem to think there is a problem with such small amounts and they monitor the research.

  9. dimqua Says:

    Jack,

    Unfortunately, vegan DHA supplements is not available in my city. So I think to try to increase my total intake of ALA to 4 g a day. But I am concerned about the link between ALA and age-related eye damage. In your opinion, the risks associated with low levels of DHA in vegans outweigh potential eye problems?

    Thanks

  10. Healthy Longevity Says:

    In my opinion the suggestion to increase the consumption of saturated fat and to raise serum cholesterol seems like a last resort measure that should carry a warning considering in most cases the dangers outweigh any minor benefits. Most free-ranging mammals including non-human primates have what is considered very low cholesterol levels, and obviously they are doing fine.

  11. coffeebrain Says:

    Dear Jack,

    This is totally unrelated to your blog post, but after reading parts of your book yesterday, I’ve decided to take a multi. I was sure to get one with zinc and iodine, but I notice it also has 18 mg. iron. Is it safe for a woman in menopause to take 18 mg. iron? I couldn’t find that in your book, although I did read I now half half the iron requirements. But I do drink a lot of coffee all day (they don’t call me coffeebrain for nothing), and I know coffee inhibits iron.

    18 mg safe? Thanks in advance for your answer, and I’m so grateful to own your book again.

    Sheryl

  12. Jack Norris RD Says:

    coffeebrain,

    I have reviewed the research on iron intake and chronic disease and the research indicates that less than 20 mg of iron per day in supplements is safe. Nonetheless, I would not risk it unless there was reason to do so. Unless you suspect you have iron deficiency, I would opt for a different multivitamin. That said, taking the one you just purchased until the bottle is gone and then getting one without iron should be safe given what I said in the first sentence. If you avoid coffee at meals, that should help reduce the problems caused by it. I drink a lot of coffee myself these days, but try not to close to meals.

  13. Jack Norris RD Says:

    dimqua,

    It’s a question I struggle with. Since you’re trying to pin me down, my opinion is that uncooked ALA probably does not cause problems for the eye. I’d probably limit it to 3 g rather than 4 g to be safe and because I think 3 g is probably enough for most vegans to convert enough to DHA. We need a lot more research on vegan conversion rates…

  14. Jack Norris RD Says:

    dimqua,

    I just reviewed the research again, which I should have done before answering, and it seems that 3 g should provide enough ALA to be converted to DHA over 10 months, but maybe 4 g is a better amount if you want the conversion to occur more quickly. Perhaps 4 g for the first 6 months and then back off to 3 g.

  15. John Says:

    Here’s Dr, Barnard on Dr. Oz discussing iron,copper, and zinc.

    http://www.vegsource.com/news/2013/03/dr-barnard-on-dr-oz-preventing-alzheimers-is-easy.html

  16. nepenthes59 Says:

    Met you & Matt at VegFest in 1996 & with your inspiration (& Pamela Rice’s too) I became vegan – Stayed vegan til 2006 when ulcer surgery complications had me spend the next 5 years in & our of the hospital for months at a time. Always vegetarian, but it was too challenging me for me o maintain veganism in the hospital. I’m a “flawed vegetarian” who eats mostly vegan & aspires to go back to that .. Thanks for all your work & inspiration

  17. Jack Norris RD Says:

    Good to hear from you, nepenthes59! I’m sorry to hear about your ulcer – wow that sounds like a long battle. I hope you’re fully recovered.

  18. dimqua Says:

    Jack,

    Thanks for the clarification. Before doing anything, I’m going to get tested for blood clotting time. If the result are normal, will I need to be tested for blood bleeding time or platelet count?

  19. Daisy Says:

    I find it interesting how he claims to immediately feel better after eating meat again. I remember Tasha (the voracious vegan) and Rhys Southan (letthemeatmeat) both had similar comments.

  20. Jack Norris RD Says:

    dimqua,

    I’m not aware of any difference between blood bleeding time and blood clotting time, so I’m not sure I understand the question. Unless you have reason to believe you have blood clotting problems, I don’t see a need to be tested (though it can’t hurt). If it is found to be abnormal, then you should probably talk to a physician about what to do further. If your blood clots too slowly, then I would not supplement with ALA more than a few walnuts or some canola oil every few days – but my opinion on this should not replace your doctor’s.

  21. dimqua Says:

    Jack,

    I read here that there are two different tests: http://www.medicine.mcgill.ca/physio/vlab/bloodlab/hemostasis_n.htm.

  22. Andrea Says:

    Jack, what do you think about this new study about meat consumption?

    http://www.ncbi.nlm.nih.gov/pubmed/23486512

    How is it possible? I’m curious to know who funded.
    And I’m sick of these controversial studies that confuse people.

    Anyway, I’m vegan and I’m sure it’s an healthier diet.

  23. Jack Norris RD Says:

    dimqua,

    Interesting.

  24. Andrea Says:

    Sorry Jack for the question not pertaining to the post, but i’m interested to know your opinion on that study. Thank you :-)

  25. Jack Norris RD Says:

    Hi Andrea,

    I will read the study as soon as I get a chance. Thanks for bringing it to my attention.

  26. Richard Says:

    Jack,

    in regards to low-cholesterol. There are actually people who have the opposite to FH. They are born and live their life with extremely low levels of cholesterol and in most cases do just fine, In fact people with familial hypobetalipoproteinemia tend to live about 9-12 longer and are basically immune to CHD. These people have often their LDL cholesterol <15mg/dl. So, no. Vegans cannot get loo low cholesterol eventhough they tried. The cholesterol what is needed for cell-functions are ridiculously low. There is some evidence that statins may induce some problems with testosterone. This is associated with cholesterol reduction, but it's a statin specific problem.

  27. Chris Says:

    Hi Jack,
    I’m interested in hearing how you recommend a pre-schooler should take a DHA liquid supplement. We’ve been providing our child, now 3 years old, with Deva DHA liquid drops in her soymilk at breakfast and dinner. This provides her with 100mg/day. Are you aware of any concerns taking the drops this way? The soymilk is cold and not cooked or heated in any way.
    Thanks!

  28. Jack Norris RD Says:

    Chris,

    That sounds like a good plan to me.

  29. Zeleni Says:

    I’m a vegan with familial hypobetalipoproteinemia (FHBL). A year and a half ago, I had undetectable LDL levels and low overall cholesterol. In the few months, I’ve been eating about a tablespoon of coconut oil a day. I just had another lipid test and my LDL is at 40 mg/dL. I had asked my doctor if I needed to start eating cholesterol, but she thought being vegan was the better route. FHBL causes malabsorption, so animal fats are harder for me to process. Coconut oil is easily digestible and boosts your LDL. Vitamin supplementation (A,E,D) is still important, but I can stay vegan and be healthy!

  30. Jack Norris RD Says:

    Zeleni,

    Do you know if you have (or have had) low levels of steroid hormones?

  31. jlo Says:

    Lol! NOTHING can cure IBS in a day! Talking from experience…Have struggled from IBS for more than 10years. The only thing that helped was vegan diet! Took longer than a day though :) Nevertheless, I’ve been flare-up free for years now. I don’t believe it’s a case for John Nicholson C4

  32. Jack Norris RD Says:

    Andrea,

    In case you missed by series Of Meat and Mortality, I give my analysis of that study: http://jacknorrisrd.com/of-meat-and-mortality-part-4-harvard-studies-conclusion/

  33. Jack Norris RD Says:

    John,

    Here is my answer about metals and Alzheimer’s Disease:

    http://jacknorrisrd.com/cadmium-levels-in-vegans-zinc-supplements-and-alzheimers-disease/

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