I went vegan in 1992 at age 15. At that time, most of us in the vegan community believed and promoted that eating only plants was the most natural and complete diet for humans. We pointed to our flat molars and long intestines as proof that humans are natural herbivores. We rejected supplements because we thought our diet was naturally perfect. We thought we’d get our B12 from mushrooms, sea vegetables, or microscopic bits of soil clinging to our farmer’s market produce. We thought we’d get enough vitamin D naturally from the sun. We had never heard of DHA and EPA.
After seven years of being an unsupplemented vegan, I had a health crisis when I was 22 and in graduate school. I wasn’t a junk food vegan–I cooked my own meals and ate my share of fresh produce. I’d always been an ace student, but I was finding it harder and harder to read my textbooks. I couldn’t concentrate. My short-term memory was shot. I felt tired and weak all the time and I was diagnosed with depression. I learned that these are all symptoms of B12 deficiency and I started to take vegan supplements: B12 and a multi-vitamin for extra insurance.
I have now proudly celebrated my 25th year as a vegan, and I take supplements regularly. In addition to the B12 and multi-vitamin, I now take vegan vitamin D3 supplements (I was diagnosed as vitamin D deficient a couple of years ago), algae-based DHA/EPA, and the occasional calcium pill.
I am healthier than any of my family members who are all omnivores. They suffer from a variety of illnesses (including diabetes and heart disease). In contrast, I can walk into a doctor’s office at 40 years old and check exactly zero disease boxes. I’m an active rock climber and hiker and still weigh what I did in high school, which is uncommon in my genetic family.
One other very powerful experience I had with my diet was using a nutrition-tracking food diary website for about a year. I logged every single food I ate, including home-cooked recipes, and the website broke down my daily, weekly, and monthly nutrition stats. It taught me a few important things:
I am not going to eat enough variety of food every single day to get all the nutrients I need, so a multi-vitamin really is a good idea for me.
I feel better when I eat a balance of good fats, protein, and healthy carbs at every meal.
I need a significant amount of vegan protein to feel my best.
I think many of us vegans get so fed up with being questioned about, “Where do you get your protein?” and we spend so much time debunking the protein combining myth, that we overcorrected in the other direction and began to believe that we’ll get enough protein no matter what plants we eat. It just isn’t true for me, at least based on how I feel after eating a low-protein meal. This is one of the reasons why I love and embrace the vegan meats (seitan, veggie burgers, veggie dogs and sausages, Field Roast, Beyond Beef, etc.) and soy products (tofu, tempeh, soyrizo). They may not be “natural”, but they help keep me healthy and feeling good as an active vegan, and that’s my most important dietary value.
The underlying motivation for my nutrition work is to prevent vegetarian/vegan recidivism. I have focused on nutrition and put myself out there as someone who will help people who are having health issues with becoming vegetarian/vegan. Because of this, I regularly hear from people who are struggling and it can sometimes seem like a lot of people, but I know my view is likely skewed and I have always wanted to know just how many people quit due to health difficulties.
On December 2, the Humane Research Council (HRC) released a report, How Many Former Vegetarians Are There? which sheds some light on this question. I helped out a bit in designing some of the nutrition-related questions and have been anxiously anticipating the results. I would like to thank HRC and all the people who funded this important research.
A quick overview of the report is that it was a cross-sectional survey of 11,000 people in the USA aged 17 and older. They found that 2% are currently vegetarian/vegan, 10% are ex-vegetarian/vegan, and 84% of people who go vegetarian/vegan quit.
The researchers used a high bar for determining who was vegetarian/vegan and ex-vegetarian/vegan – the participants had to answer a food list questionnaire indicating that they were vegetarian/vegan and then also say that they considered themselves “vegetarian” or “vegan”. I have not seen such a high bar used in any previous research.
Their report covers many of the difficulties former vegetarians/vegans had on the diet, but I’m only going to focus on the health aspects in this post. I have more to say about the rest in my post Humane Research Council Survey on Vegetarian Recidivism on Vegan Outreach’s blog.
The HRC blog post linked above does not include much information about health issues, but their complete report (which you can access by signing up for a free account on their site) has more. Below are excerpts followed by my comments.
“Former vegetarians/vegans were asked if they began to experience any of the following when they were eating a vegetarian/vegan diet: depression/anxiety, digestive problems, food allergies, low cholesterol, an eating disorder, thyroid problems, protein deficiency, B12 deficiency, calcium deficiency, iron deficiency, iodine deficiency, vitamin A deficiency, vitamin D deficiency, zinc deficiency. The findings show that 71% of former vegetarians/vegans experienced none of the above. It is quite noteworthy that such a small proportion of individuals experienced ill health.”
HRC sounds pleased that only 29% experienced ill health – but that’s almost one-third of people who tried the diet. I was actually hoping to find out that, say, only 1% of former vegetarians experienced poor health because it would allow me to retire from my nutrition work that, while being a labor of love, is indeed a labor, and takes away from my other efforts. At almost 1 out of 3 people, I’m not so sure it’s time to cross the finish line and declare victory.
“All of the conditions [listed above] were experienced by some participants, though only rarely. In each case, less than 10% of lapsed vegetarians/vegans experienced one of these issues, except iron deficiency (experienced by 11%).”
Fatigue is the most common complaint I hear. I have not found any one explanation for most cases of fatigue though vitamin D deficiency and iron deficiency in female endurance runners are common.
The fact that B12 deficiency was not a big complaint is not surprising given that overt vitamin B12 deficiency symptoms normally take years to develop whereas most of the former vegetarians/vegans were only on the diet for a few months, and any lacto-ovo-vegetarians would be getting B12 from dairy and eggs.
“Respondents who indicated they began to experience at least one of the conditions were asked if it improved after they started eating meat. 82% of these respondents indicated that some or all of the conditions improved when they reintroduced meat. The most typical timeframes for improvement were: within 2–6 days (20%), within 1–3 weeks (33%), and within 1–3 months (22%).”
Interesting. For some people who come to me with severe problems that we cannot seem to solve, I have often wondered if I should suggest they try going back to eating animal products, reset their health (if it does in fact reset), and then try becoming vegetarian/vegan again more slowly.
HRC emphasized the rates at which vegetarians/vegans had gotten their vitamin B12 levels checked. I would find this somewhat irrelevant other than as a marker for knowing that vitamin B12 is important for vegans. I generally discourage vegans from getting their B12 levels checked as a way to prevent B12 deficiency in most cases because of the unreliability for people who regularly eat seaweed (including sushi) and the fact that no matter what your B12 levels turn out to be, all vegans should be getting a regular, reliable source of B12 (see Should I Get My B12 Status Tested?).
In their section on Taste, they found that about one-third of former vegetarians/vegans craved meat compared to about 8% of current. It’s a mistake to consider “cravings” and “taste” to be equivalent. You can’t simply add the taste of meat to a low-fat, low-protein vegetable and expect that to take away someone’s meat cravings. Meat cravings are about the nutrients, most notably fat and protein. Craving the “taste” of meat is a Pavlovian response for craving those nutrients. (Note: I don’t know if this has been scientifically tested in a rigorous way.)
There were two positive findings from the HRC report:
More than one-third of former vegetarians/vegans said they are interested in resuming the diet, and vegans were less likely to abandon the diet (at rate of 70% compared to 86% for vegetarians).
Nutrition-wise, I have been working on a resource on zinc for the Vegetarian Nutrition Dietetic Practice Group.
The only new info from that research that I had not been considering before is that people who eat a lot of soy and who take calcium supplements might have higher zinc needs. Since I fall into both those categories, I’m wondering if that’s why I seem to benefit so much from zinc. I’m happy to report that I still have not gotten more than the mildest and shortest of colds since starting zinc supplements a number of years ago.
Many links I’ve wanted to share with readers have been building up and so I’m going to knock them all out in one post right here.
Examine.com is a website with a panel of health writers who research a wide array of nutrition supplements and other topics. They appear to do an excellent job of assessing the research. Along with the Linus Pauling Institute at Oregon State University and the Office of Dietary Supplements, I can see Examine.com as being one of my go-to sites for seeing what research is out there.
On March 10, the Washington Post ran an article (originally appearing in NewScientist) suggesting that many species of invertebrates feel pain: Do lobsters and other invertebrates feel pain? To summarize the article: octopi, squid, lobsters, crabs, and shrimp: yes. Insects: no.
Speaking of invertebrates and pain, there is a movement among some animal protectionists to promote bivalveganism. See The Ethical Case for Eating Oysters and Mussels – Part 2 at Sentientist. The author, Diana Fleischman, argues that bivalveganism can solve many of the nutrition dilemmas posed by vegan diets such as B12, iron, omega-3s, and zinc. It does seem like a decent solution for people who find it hard to thrive on vegan diets.
I seem to run about an average of 6 months behind on these ex-vegan stories.
A reader sent me a blog post from Heather of “Run, Hike, Live, Love” and (had a blog?) “Vegans on the Run.” Her post is titled, 10/1/10–4/17/13, and it is about how she gave up a vegan diet to eat fish again due to iron deficiency.
It starts off with Heather running a race, struggling to run 8 minute miles, going to the doctor and finding out she has iron deficiency anemia. That’s no fun. 🙁
After a year of supplementing with iron, Heather was still struggling with her running. She got tested and her serum ferritin was “24 out of a possible 200.” Well, 24 is low, but it’s not really out of a possible 200 – 24 isn’t even considered iron deficient, though it’s close. 50 would be well out of the danger zone. It would be more important to find out what her hemoglobin was.
She then tells a story about how when she was a kid she caught a fish and was horrified at its suffering and went vegetarian. I sympathize because I also started towards vegetarianism after a day of fishing.
Moving along, Heather decides to buy some fish. At this point, she still has my sympathy.
She takes it home with great anxiety but sees her 8 bottles of supplements on her shelf and realizes that “Real nourishment comes from whole foods, not from bottles.” Now she’s losing me.
Heather cooks the fish and in her words, “The first bite was not what I anticipated. It was delicious. I whispered thankful prayers for the life that I was about to consume to maintain my own and let the tears flow….My stomach was raging for over an hour at the unexpected substance….Eventually the nausea subsided and was replaced within a few hours by a strange sensation: Energy. The fog of fatigue I’d been stumbling around in all day subsided as though I’d been hooked up to a caffeine IV. I was soon bustling around the house doing 10 things at once like I used to.”
And in her final paragraph, Heather says, “The one thing I know is that my body and blood do not lie.”
Hmm. Could Heather have absorbed the iron from one serving of fish and within hours produced enough hemoglobin to have a profound increase in energy?
This sort of thing could happen from blood doping. It happens from cocaine. But a serving of fish?
Apparently, taking the hormone erythropoietin, also known as EPO, takes a full week to increase hemoglobin one point.
Either her body does lie or she had something else going on besides iron deficiency as her story is not physiologically plausible if due to iron deficiency.
I wonder if oysters would provide the same amazing burst of energy?
I realize it’s currently summer. But someone forwarded to me the post of yet another ex-vegan food blogger who divulged to the world this past winter that she was giving up the vegan diet. This time it was Kristen of KristenRaw.com in her post of March 17, 2013, My Vegan Diet Caused Health Problems. Would Primal, Paleo, Or “Real Food” Be Better?
A few paragraphs in, Kristen lists a couple of common threads that she has noticed among the meat-curious vegans:
“We were vegan, some quite smugly, thinking it was the human ideal of a smart-n-healthy diet, but then, only after several years, started to experience health problems, and then switched back to omnivore, and the health problems disappeared….What we also have in common — made somewhat easy no doubt due to having adapted to a strict (vegan) diet for many years — are the strict kinds of omnivore foods we eat now vs what we were eating pre-vegan….Even more so for former raw fooders, whose restrictions (such as avoiding grains) make some vegans’ diets look like junk food.”
Kristen’s story is the typical one – she became vegan for animal rights reasons and at first she did great on the vegan diet and got into raw foodism, etc. After a few years she started to not feel so well, she tried everything to make it better, she went back to eating animal products and within hours she started to have a miraculous turn around in her health.
She originally tried to counter her health problems with, “superfoods, fancy juicers, superherbs, tonic herbs, prepping foods various ways to optimize nutrients, following rules for combining or not combining certain foods like having vitamin c with iron rich plants – just to name a few….”
Although there isn’t much to indicate that Kristen was suffering from iron deficiency, I’m impressed with her attempt to add vitamin C to meals with iron rich plants which is scientifically based. In terms of the rest of her attempts to reclaim her health, if only she knew about all the vegans who are not failing, who she might describe as “junk food vegans.”
At one point, Kristen’s cholesterol was measured at 95 mg/dl. Her animal food cravings started out with “dreams of eggs.” Craving eggs seems to be a common theme, and I take the egg cravings as a possible sign of nutrient deficiency for a few reasons. One, eggs are fairly disgusting, especially if you haven’t eaten them in a long time and don’t happen to be craving them. If someone said they were craving Häagen-Dazs, I’d be skeptical of a nutritional basis. KFC? Might be the 11 herbs and spices. But eggs? Something must going on here.
To sum up the situation, we have someone with very low cholesterol at 95 mg/dl craving one of the main sources of cholesterol, eggs. And after eating animal products, she quickly started to feel better. Following Occam’s razor, it seems to me a safe bet that she was craving eggs because her body needed cholesterol and she improved so quickly because she got an immediate boost from it.
Admittedly, I don’t know for certain if this is what is going on. Eggs are also high in choline and sulfur. And perhaps people just cannot crave what they need and these cravings are the brain misfiring. But, in my humble opinion, the evidence is mounting to implicate low cholesterol in many of these cases of failed raw foods/whole foods vegans.
Here are links to the previous posts on ex-vegans:
A reader (thanks, Dan!) pointed out a follow-up study to one I had included in VeganHealth’s article Iron, about iron supplementation in women with unexplained fatigue who have low iron stores but do not technically have anemia. I updated the article:
“Two studies from Switzerland have shown that iron supplementation can reduce fatigue in premenopausal women (1, 2) whose hemoglobin levels are above 120 g/l (and thus not diagnosed with anemia). The most recent, from 2012 (2), was a double-blinded, randomized controlled trial in which 80 mg of ferrous sulfate (an iron supplement) per day for 12 weeks increased hemoglobin in women who had average serum ferritin levels of 22.5 µg/l. This increase in hemoglobin was matched with a 50% reduction in symptoms of fatigue (compared to only 19% for placebo). Improvements in hemoglobin were seen after 6 weeks.”
This study got me thinking… I remember back around 2001 when I was doing my dietetic internship at Georgia State. I was able to spend some time working at a couple of alternative health clinics that specialized in helping people with chronic fatigue. At that time, they were putting pretty much everyone on a low carb diet, which translated to more meat. I actually don’t know if many people made any sort of recovery from the fatigue – my memory is that one person I counseled had made a significant recovery while another hadn’t made any improvement, but I have no idea what the success rates were for the clinics. To the extent that a low carb diet helped, I wonder if it was merely due to the women getting more heme iron and curing an undetected deficiency.
Improving iron status is worth considering for anyone with fatigue whose hemoglobin is on the lower end of normal and who has a serum ferritin less than 50 µg/l.
Iron does seem to be a possible culprit in three of higher profile cases of young women becoming ex-vegan that come to mind, and perhaps it’s something to which our movement needs to be paying more attention.
While the studies above used iron supplements to increase iron status, don’t forget that adding a significant amount of vitamin C to meals has been shown to be better for increasing iron absorption than increasing iron (more info).
References
1. Verdon F, Burnand B, Stubi CL, Bonard C, Graff M, Michaud A, Bischoff T, de Vevey M, Studer JP, Herzig L, Chapuis C, Tissot J, Pécoud A, Favrat B. Iron supplementation for unexplained fatigue in non-anaemic women: double blind randomised placebo controlled trial. BMJ. 2003 May 24;326(7399):1124. | link
2. Vaucher P, Druais PL, Waldvogel S, Favrat B. Effect of iron supplementation on fatigue in nonanemic menstruating women with low ferritin: a randomized controlled trial. CMAJ. 2012 Aug 7;184(11):1247-54. | link
In February, my post To Quit or Not to Quit Veganism briefly mentioned ex-vegan blogger and holistic health counselor Alex Jamieson. Jamieson had just written an article about how she was no longer vegan.
Then a couple of weeks ago, I was contacted by the producer of The Current, a radio show in Toronto. They were doing a story on Jamieson’s choice to no longer be vegan and the backlash it entailed, and wanted to interview me.
The Current’s story aired on May 15 (link). None of my comments were included, which is probably just as well because I wasn’t very eloquent.
After listening to the show, I have further thoughts on Jamieson’s experience with veganism and since she continues to publicly talk about it, I feel okay about doing so, too. In fact, in her interview, she says that she might some day return to a vegan diet so this is in the spirit of helping her or people like her.
I definitely have sympathy for Jamieson – it must have been very stressful to feel like you could no longer eat a diet that you have been promoting. If I started to believe that I could no longer be vegan because my health was failing it would be quite disconcerting.
Here is Jamieson’s story from what I can piece together:
She ate a lot of junk food most of her life, and she also had iron deficiency issues. She went vegan and felt great for about 10 years after which she started having cravings for animal products. At a certain point, she started menstruating too frequently. She tried adding “mineral rich” foods and iron supplements and it didn’t help. She tried eating foods higher in protein (as I pointed out in my previous post, none of the foods she mentions eating for protein are terribly high in protein). She started eating eggs which made her feel a lot better, and then added back meat. She now eats 75%+ plant foods and her menstrual cycles have normalized and she feels good. When speaking about it in the interview, she attributes her improvements to “animal protein.”
Let’s go through the usual suspects:
Vitamin B12 – Jamieson doesn’t mention B12 anywhere. But her symptoms are not indicative of B12 deficiency.
Choline – Jamieson starts out craving, eating, and feeling better from eggs. Eggs are high in choline. But once again, her symptoms don’t seem to be typical of choline deficiency. I did some searching and found an article, which I do not consider reliable, suggesting that choline deficiency can cause liver problems, “resulting in excessive estrogen produced during menstrual cycle leading to hormone imbalance and endometrial cramps (link).” Severe choline deficiency can cause liver problems, but I don’t know where they got the part in quotes and if there is any direct evidence for it. Still, choline deficiency is a potential culprit.
Iron – Except for the fact that she never says she got her iron levels tested, there’s little question that she likely had iron deficiency given her history of it and the fact that she was having frequent menstruation. The question is whether she could have improved her iron deficiency by way of adding vitamin C to her meals and doing the other typical things that are recommended such as avoiding tea and coffee at meals.
Cholesterol – In watching some of her videos Jamieson appears to be on the thin side and her diet sounds very low in fat. A low-fat diet with low body weight could theoretically lead to low steroid hormones (made from cholesterol) leading to menstrual disruption (though admittedly less frequent menstruation, not more, in most cases). And eggs are probably the easiest way to get cholesterol, so a craving for eggs could make some sense.
Cravings
Can you crave foods because they have cholesterol, choline, or iron and you are deficient? Can you crave fat? It’s hard to know – there is very little research on craving nutrients during deficiency. And if a low fat intake (leading to low cholesterol) was a problem, why didn’t she just crave higher fat, higher saturated fat, or higher choline plant foods?
When I haven’t eaten in a while, I crave the versions of foods that contain more of those nutrients and with less fiber, presumably so that my body can get the nutrients faster. While an apple will provide carbohydrates, when real hungry I prefer cookies or juice. It doesn’t mean that’s the best or only way to get those nutrients on an ongoing basis.
If someone has gone for years on an exceptionally low-fat diet and has depleted their fat stores to the point that they are having low-cholesterol and hormone irregularities, combined with iron deficiency, it seems plausible that they might crave the food that is most quickly going to replenish those nutrients such as eggs (cholesterol) and meat (iron).
In searching around, I have found that there are other low-fat vegans who have egg cravings (link), so apparently it’s not unusual.
Probably the most obvious thing about eggs, when it comes to what separates them from other foods sensually, is the sulfur smell, which I find rather disgusting and it’s hard for me to imagine craving them unless you really have a serious deficiency! The sulfur smell is probably due to a high level of sulfur-containing amino acids (cysteine and methionine). Could it be those amino acids that people are craving in eggs? It seems possible, but unlikely since those amino acids are also in tofu in decent amounts, yet these people don’t crave tofu. Not a lot is known about sulfur and nutrition, but it’s something to consider.
Animal Protein
Jamieson repeatedly refers to what she needed as “animal protein.”
What we know about physiology and nutrition would indicate that there is nothing important about animal protein that separates it from plant protein except in cases of extremely low intakes. On the other hand, we shouldn’t rule out that she had extremely low intakes.
In her video on food cravings (link) Jamieson tells people that if they are craving protein, to add hemp seeds to their diet. I cannot find reliable info on how much protein hemp seeds have, but it looks like the highest amount being tossed around is 5 grams per tablespoon. Unless you are blending a whole lot of hemp seeds, you aren’t going to get large amounts of protein from that ratio. How about a Tofurky Italian sausage instead, with a whopping 29 grams of protein?!
Jamieson mentions that she was flirting with orthorexia, and people with orthorexia are unlikely to even consider processed foods like Tofurky.
I don’t think protein was likely her problem (or her main problem), but if you think you’re low on protein, eat something with some serious protein. Most of the vegans I know who are not failing to thrive do eat processed foods, and I’d venture that a good 1/3 of my food intake is processed. It is disappointing to hear about people who quit veganism to take up eating higher-fat, higher-protein animal foods when they could have tried the higher-protein, higher-fat plant foods but didn’t because they are processed.
Edited: 2013-05-26T17:36:46 Don’t Forget the Shellfish!
Oysters and clams are high in cholesterol and they are not capable of suffering. If processed vegan foods don’t help, then ex-vegans might consider trying oysters and clams to see if that would solve their problems before eating products from conscious animals.
Don’t Forget Bivalves: Clams, Oysters, Scallops, and Mussels
Oysters, clams, scallops, and mussels have significant amounts of cholesterol and they are not capable of suffering. If processed vegan foods don’t help, then ex-vegans might consider eating these animals to see if that would solve their problems before eating products from conscious animals.
Privilege
At minute 19:00 of Jamieson’s interview on The Current, the interviewer talks about how having the luxury to debate our food choices comes from a “very privileged place” and suggests that this whole conversation is “navel gazing”.
I object. Calling veganism “privileged” is a common dart thrown at it, usually by people who are, themselves, living relatively privileged lives. We should keep in mind that the farmed animals are the least privileged of anyone in discussions about whether to be vegan or not. Eating gourmet cheeses and steak, or being any sort of “foodie” is a privilege. Buying fair trade bananas and chocolate is privileged. The forty-hour work week and child labor laws only can happen in privileged societies.
So, while I agree that many people in the world do not have the option to eat a vegan diet (for one thing, some people don’t have access to vitamin B12 supplements or fortified foods), just because everyone cannot do something doesn’t mean it’s not the right thing for the rest of us to do. It’s not a good excuse for middle-class (or wealthier) Americans and Canadians to embrace farmed animal exploitation just because some other people are too poor to buy vegan packaged products at Whole Foods.
Conclusion
I do not want to blame the victim – Jamieson had failing health as a vegan and there might not have been any way to help her that we know of. And I think it’s commendable that instead of going from vegan to all-out paleo, she went from vegan to 75% vegan.
In her interview on The Current she says, “I may go back to a completely 100% plant-based diet. If and when that’s appropriate for me. I’m not ruling that out. The only problem is that I’m no longer welcomed back into that vegan community. I’ve been shut out of that conversation to help people be healthier in that way, to even promote plant-based living because I’m somehow a heretic.”
I would welcome her back.
Alex, you could be the first high-profile ex-ex-vegan – think about it!
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.
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
Sayward Rebhal, of Bonzai Aphrodite, has an excellent post about her struggles to stay healthy as a vegan. When I got done reading it, I thought “This is EXACTLY what I’ve been saying!” It sounds like she had not been aware that there is a group of vegan health professionals who do not promote very low-fat diets or dismiss any concerns about protein.
In contrast, another (now ex-) vegan blogger, Alex Jamieson, posted yesterday that, “I’m not vegan anymore.”
Jamieson became vegan for health reasons, but it appears that she later came to be a vegan for more than just health, in which case it is disappointing that she didn’t try to do more to figure out why the diet might not have been working for her. Taking a vitamin B12 supplement or getting tested for iron are two things that are easy to do and that could be the culprits in many of these cases of ex-vegans.
While I do not dismiss all cravings for meat as being simply in people’s heads, and I think Jamiesons’s cravings for meat might really have indicated a nutritional deficiency, it is very frustrating to see people talk about getting in tune with their bodies as though it’s some legitimate stand-in for nutrition science.
Jamieson says, “At first, I thought: ‘I must be mineral deficient. Or maybe I need more concentrated protein. I’ll eat more sea vegetables. I’ll just add more nuts and hemp seeds and drink more green juice. Then the cravings will stop.'”
Those are not terribly concentrated sources of protein. It sounds like she was on a very low-fat diet, too, something that might have caused cravings.
In any case, it is not the leftover remnants of the spirit of the animal that is making her feel better. Her body might require some molecules, or mixtures of molecules, that she was only able to find in animal flesh. But if that same mixture of molecules could be reproduced outside of an animal, it would satisfy her body’s needs.
Dr. Ben Kim is a chiropractor who has a blog on personal and environmental wellness. In March of 2007, he wrote a piece called More Thoughts on Earthlings Documentary, Including Potential Problems with a Strict Vegan Diet. His article was just recently brought to my attention and I’d like to comment on it publicly because I think there are other ex-vegans out there who have had a similar experience to Dr. Kim.
In his article, Dr. Kim talks about the film Earthlings, which many of you will know is a film that documents the horrible ways that we humans treat animals. He talks about the importance of minimizing animal cruelty and was even vegan for four years. The first two of those years he felt well and the second two he failed to thrive.
Dr. Kim stuck with the diet through his two years of poor health because he trusted the books and “prominent physicians” who were advising him that a strict vegan diet was the best choice. He then found out that many of these people were not actually strictly vegan. He does know of some strict vegans who don’t cheat but they have health problems.
After eating what appears to be relatively small amounts of animal products for three months, Dr. Kim says, “My energy came back, my cravings disappeared, I stopped having skin breakouts, and most notably, I felt physically strong again. I vividly remember going from being able to do about 3 sets of 10 pull-ups before getting exhausted to being able to do 100 full body weight pull-ups within 20-30 minutes….”
Dr. Kim lists his strict vegan diet: “…plenty of fresh leafy greens, tomatoes, bell peppers, cucumbers, celery, sprouts, many varieties of steamed greens, steamed root vegetables like potatoes, sweet potatoes, hard squashes, carrots, and red beets, whole grains like brown rice and quinoa, a wide variety of fruits (including avocados), legumes like chickpeas and red beans, and small amounts of raw nuts and seeds.”
He gives a quick review of some of the typical concerns with the vegan diet, including B12, but he doesn’t mention supplements or fortified foods as a source, suggesting that he probably wasn’t getting any B12.
Okay. So, I really dislike it when someone tries a certain diet for years, and then when it doesn’t work, the proponents of the diet say, “You just did it wrong.” However, there are some glaring reasons why Dr. Kim might have failed to thrive.
Obviously, if a vegan is not taking B12 supplements or eating fortified foods, for more than two years, chances are excellent they are going to get fatigued and have mental issues.
Secondly, if you read Dr. Kim’s description of his diet you have to get well into his list before you come across a plentiful source of protein (quinoa), and the most reliable sources that most vegans rely on, even raw foodists, are listed second to last and last!
When someone asks me what I eat as a vegan, the first thing I tell them are legume products – refried beans, soy foods, peanut butter, chili, bean burritos, lentil soup, etc. If these foods are only an afterthought, then there should be no surprise that someone trying to do 100 chin-ups in 30 minutes is going to have trouble retaining muscle mass.
Reading a few posts on Dr. Kim’s site, it is clear that he places a high value on eating unprocessed foods. So I’m guessing he is not going to be real open to eating a Tofurky or seitan sandwich for more protein. But what about tempeh, peanut butter, lentils, and peas?
Dr. Kim says, “Truly, if I could thrive on a 100 percent vegan diet, I would go back to it this instant. How could I not after having watched Earthlings?”
Indeed. I hope Dr. Kim will give it another try with plenty of high protein foods which are staples of most vegans I know who do not cheat on the diet and are thriving. And a vitamin B12 supplement would help quite a bit also. Is this such a high price to pay in order to end your support of animal agriculture?
