The Vegan Dietitian is at it again, stirring up controversy with two articles on olive oil:

Olive oil is a healthy addition to vegan diets [article has been removed]

Olive Oil, Health and Advocacy

In July, a meta-analysis of the effect of calcium supplementation on heart attacks was published in the British Medical Journal (1). They found that people taking calcium supplements were more likely to have a heart attack. People have asked me if I think this means vegans should not supplement with calcium.

If you look at the study (the full paper is available for free at the link in the abstract below), they found that the increased risk of heart attack was limited to people who started out with a dietary calcium intake of 700 mg/day or more. Most vegans do not get that much calcium through foods. In most of the studies they examined, the level of calcium supplementation was substantially higher than 500 mg.

This study indicates that if you are an adult who gets 700 mg of calcium from your diet (including fortified foods), you probably shouldn’t take more than about a 300 mg supplement of calcium per day.

The DRI for calcium for ages 9 to 18 is 1,300 mg. This meta-analysis was conducted on older people trying to prevent osteoporosis and is probably not applicable for teenagers, whose bones are still building.

The DRI for calcium for people over 50 is 1,200. My recommendation for people in this age group who want to meet the DRI is to get at least 700 mg per day through foods and only supplement enough to make up the difference.

It’s worth noting that some observational studies of calcium intake (from foods, not supplements) have shown higher intakes to be protective against heart disease.

1. Bolland MJ, Avenell A, Baron JA, Grey A, MacLennan GS, Gamble GD, Reid IR.
Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis. BMJ. 2010 Jul 29;341:c3691.

Two people have recently asked me for B12 recommendations for children, so I created a table in which I extrapolated the adult recommendations to children.

Link

You’ll notice a range in the table for both one and two doses per day; anywhere within that range will be a good amount to take to maximize B12 status. Note that the RDA is to prevent overt B12 deficiency, not to minimize homocysteine levels. My recommendations are intended to be enough B12 to minimize homocysteine.

Video has just been posted of a talk I gave last June at the Their Lives, Our Voices conference in Minneapolis.

Link

2007 was the last time I updated the VeganHealth.org article, Mild B12 Deficiency: Elevated Homocysteine. Since then, a whole lot of research has been published on the topic, and a number of people have written me about some of those studies.

Today I finished rewriting the article. Despite the large amount of research, the article is now much shorter than it used to be, with the new stuff starting here.

A Quick Summary

Vegetarians and vegans who do not regularly supplement with vitamin B12 normally have elevated homocysteine levels which are linked to cardiovascular disease and dementia.

Research has shown that people with previously diagnosed cardiovascular disease who embark on treatment to lower homocysteine levels have a reduced risk of stroke (in some but not all studies), but there has been very little benefit for other cardiovascular diseases. It appears that except for stroke, once the damage has been done, lowering homocysteine will not do much to improve cardiovascular disease.

More importantly for vegans without cardiovascular disease, a marked decrease in the rate of stroke in the USA and Canada has paralleled the fortification of foods with folate indicating that damage from homocysteine can be prevented.

The Take-Home Message

If you are vegetarian or vegan, make sure you follow the recommendations for taking vitamin B12.

Link

WebMd has an interesting article, Sleep Loss Hampers Weight Loss Efforts.

The study found that when people trying to lose weight slept 7.5 hours per night, they lost 3.1 pounds of fat and 3.3 pounds of fat-free body mass (mostly muscle tissue). When they slept for 5.5 hours a night, they only lost 1.3 pounds of fat and 5.3 pounds of fat-free mass.

This is ultimately a sad book. Lierre Keith has suffered from multiple health problems all of her life and was desperate to find an answer. She landed on vegetarianism and then spun a tale to support her theory. Her intent seems heartfelt; she sees herself very much as a savior of vegetarians and wants us to learn from her mistakes. And the book has been widely embraced by those who want to believe that meat-eating is healthy and just. The problem is that there is truly nothing in this book that accurately supports that conclusion.

Link

Opti3omega Complete Omega-3 is a new vegan omega-3 supplement. It contains 20 mg EPA and 100 mg of DHA per capsule.

Other vegan EPA and DHA sources are listed here.

I have added some more study summaries to the section on vitamin D2 vs. D3 in the article Bones, Vitamin D, and Calcium on the VeganHealth.org site. My conclusion has remained the same – in amounts of around 1,000 to 2,000 IU per day, vitamin D2 is as effective as vitamin D3.

Here are the new paragraphs:

Glendenning et al. (39) (2009) compared 1,000 IU of D2 vs. D3 in people with vitamin D insufficiency who had hip fractures. After three months, those who supplemented with D3 had a 31% or 52% (depending on how they were measured) greater increase in 25(OH)D levels than those supplementing with D2. However, parathyroid hormone levels did not differ between groups, leading the researchers to question whether the difference in 25(OH)D levels were of biological importance.

Gordon et al. (40) (2008), treated 40 infants and toddlers with vitamin D deficiency. Each were assigned to one of three 6-week regimens: 2,000 IU oral vitamin D2 daily, 50,000 IU vitamin D2 weekly, or 2,000 IU vitamin D3 daily. At the end of the trial, participants’ 25(OH)D levels went from an average of 42.5 to 90 nmol/l (17 to 36 ng/ml), and there were no significant differences between treatment groups.

Thatcher et al. (41) (2009) gave children with rickets one oral dose of 50,000 IU of vitamin D2 or D3. After three days, 25(OH)D levels rose from approximately 50 to 72 nmol/l (20 to 29 ng/ml) for both groups. Calcitriol levels also increased similarly in both groups (by about 70%), however, calcium absorption did not increase, leading the researchers to conclude the rickets were not caused by low vitamin D deficiency. This should not be a surprise since the baseline average level of 50 nmol/l (20 ng/ml) of 25(OH)D should be adequate to prevent rickets.

References at Bones, Vitamin D, and Calcium.

Another interesting post at the PaleoVeganology blog.

“In short, if the evolutionary pattern of hominid brain size is steady rather than punctuated, and if butchery and meat-eating have been part of hominid behavior since the days of the australopithecines, then the likelihood that meat-eating and hunting sparked sudden increases in cranial capacity goes down considerably.

“This is not to dismiss the ETH out-of-hand. It’s a serious and legitimate hypothesis, with experimental support in the literature… It may turn out to be true; many other respected theories began this way. But the appeal of its simplicity is also its danger.”

Link