Fat in Vegan Diets: How Low Should You Go?

Fat in Vegan Diets: How Low Should You Go?

By | 2010-03-18T14:22:00+00:00 March 18th, 2010|Tags: , , |106 Comments

I’ve been living among stacks of nutrition research papers over the past six months while working on an update to The Dietitian’s Guide to Vegetarian Diets, a textbook for health professionals and dietetics students. The last edition was published in 2004 so my co-authors and I have looked at all of the studies on vegetarian and vegan diets that have been published since then, along with hundreds of other nutrition papers that are pertinent to vegetarianism.

I’ve learned a lot in the process. It’s reinforced my opinions about some aspects of nutrition and forced me to change my mind about others. I finished my last chapter, which focused on fat and carbohydrates and how they affect heart disease, diabetes, and obesity, yesterday.

Twenty years ago, when I first started working in the area of vegan nutrition I was a big proponent of very low-fat diets. At that time, when diets like the Ornish plan were especially popular, it really did look like this was the best approach for lowering cholesterol and controlling weight. Since then, our understanding about the role of fat in the diet has changed a lot and the situation is far more complex than we originally thought. Anyone who is taking a serious and honest look at the research on diet and heart disease has to question the low-fat approach.

One thing we know (more or less for certain) is that replacing saturated fat in the diet with poly- or monounsaturated fat lowers blood cholesterol just as much as removing all fats from the diet. And there is evidence that eating more unsaturated fat is better as far as heart disease is concerned. Low fat diets are associated with a drop in HDL cholesterol, which is the “good” cholesterol. If HDL drops as much as LDL (the bad) cholesterol, there is actually no net gain as far as heart disease is concerned. There are still a lot of questions about how much HDL really matters, but most research suggests that it matters a lot, especially for women.

Reducing all fats in the diet and replacing them with carbohydrates can also boost triglyceride levels. Some studies show that if most of the carbohydrate comes from whole fiber-rich plant foods (as opposed to refined carbs), this doesn’t happen. Other studies show it happens no matter what kind of carbohydrates people eat. 

Very low-fat diets also produce a type of LDL-cholesterol that is very small and dense and more easily incorporated into artery-blocking plaque. Because of these effects on HDL levels, triglycerides, and LDL size, many researchers question whether very low-fat diets are a wise choice for people at risk for heart disease.

Finally, heart disease is not all about cholesterol. There are other diet factors that have nothing to do with blood cholesterol levels but affect the health of the arteries. Some high fat foods—nuts in particular, but also soyfoods—appear to have benefits for heart disease that aren’t related to cholesterol levels. Unfortunately some low-fat vegan diet plans severely limit these foods or even eliminate them altogether.

And while low-fat eating plans have been promoted for weight loss, they tend not to be effective over the long term. Some research shows that including higher fat foods—like nuts or avocado—in meals helps to make reduced-calorie diets more satisfying and actually promotes better long-term weight control.

This isn’t to suggest that vegans should have a free-for-all with fats. In fact, there is good evidence that eating large amounts of fat all at once can raise risk for heart disease. Because of that, some experts recommend consuming no more than 30 grams of fat at one sitting. That could be a problem for the average omnivore or for those who regularly eat at places like fast food restaurants. But for a vegan who is not indulging in tons of baked goods or fatty snacks, it’s not at all. Here is an example of a healthful vegan breakfast that includes some high fat foods and comes in well under the 30 gram limit:

1/2 cup tofu with mushroom and onions scrambled in ½ tbsp soft margarine
1 slice whole wheat toast with 1 tbsp peanut butter
Fresh fruit

Total fat: 20 grams

Or consider this lunch which doesn’t skimp on healthful fats:

1 cup black bean soup topped with ¼ cup cubed avocado
Tossed green salad sprinkled with 1 tbsp sunflower seeds and dressed with vinaigrette containing 2 tsp olive oil
6 ounces raspberry-flavored soy yogurt

Total fat: 22 grams

Some low-fat vegan diets strive for fat intakes that are as low as 10% of calories. But the World Health Organization says that no one should go below a 15% fat diet and that women of childbearing age should consume diets that are at least 20% fat. They suggest that intakes up to 30 or even 35% of calories can be healthful.

The idea that we need to avoid all dietary fats, including healthful plant ones, is outdated and perhaps even harmful. But even if eating a very low-fat diet is perfectly safe, there is no evidence that it has any advantages over a diet that includes some fat-rich plant foods. Foods like avocado, nuts and nut butters, olives, tofu, dressings and sauces add interest and variety to vegan diets. As always with diets that take veganism a step beyond what is necessary, very low-fat diets add a layer of restriction that can make vegan diets look limiting and unappealing. 

(Here is some updated information about fat in heart healthy diets)


  1. WolfKenobi March 19, 2010 at 9:36 am - Reply

    Thanks for this post, Ginny. It has long seemed to me that veganism attracts people with "absolutist" personalities*, who grab onto some "fact" and will loudly assert it as "true" and shout down anyone who dares question their dogma. It is nice to have people like you and Jack Norris doing an honest and open-minded assessment of reality.

    *This is not to say all vegans are like this — just that there are plenty, and they tend to be the loudest.

    • Richard May 11, 2016 at 4:17 am - Reply

      Personally, I see a lot more misinformation produced by non-vegans but the sad fact is we are likely a hundred or more years away from really knowing the best way to live a healthy life relatively disease free.
      Meanwhile, I follow the five Blue Zones that consume very little animal products and lots of whole plant-based products like fruits and vegetables. It appears that many avocado, nuts and seeds are the best sources of fat but as I stated in the beginning we are not so knowledgeable on nutrition as we should be primarily because there is little money in honest research. The government and industry are not reliable sources of good information.

      • Valerie Cipolla February 11, 2017 at 10:55 am - Reply

        Thank you RIchard. I am just seeing this post. Would you happen to have any favorite vegetarian recipes you would be willing to share. Thank you.

    • michael June 15, 2016 at 8:23 am - Reply

      Your comment sounds very absolutist. Veganism does not attract the absolutist personality of someone who “grabs” on to an idea. In fact it appears the inflexible people are those who are somehow annoyed by veganism. What you have stated is totally absurd, not to mention too “certain” a commentary, creating well.. irony in its true form.

  2. beforewisdom March 19, 2010 at 1:53 pm - Reply

    The proponents of very low fat diets seem to refer to people with severe cardiovascular issues, diabetes and high weights.

    Maybe very low fat diets have their place as therapeutic diets and that diets for healthier people would be different?

    • Robert January 10, 2011 at 12:04 pm - Reply

      Would you be referring to reversal diets that eliminate all added fats and foods high in fat such as nuts, avocados, etc? Dr. Caldwell Esselstyn is a proponent of such a diet. Mr. Clinton is basically following such a diet but not 100% as Dr. Esselstyn would like. ;o)
      I've never been a fan of low-fat. Low saturated fat, yes. I follow a vegetarian Mediterranean style diet so it is anything but low fat. I do still eat cheese but generally it is in the form of grated parmesan sprinkled on my vegetables, legumes and pasta.

    • Richard May 11, 2016 at 4:20 am - Reply

      I think you are right on track on that comment. Let us also remember that most adults already have heart disease.
      Studies have found that yellow streaks in the arteries are common on children as young as ten and males reaching 20 generally have clogged arteries.
      That leads me to believe that most adults in the US need to be on the extreme diet for some time before thinking moderation is in order.

  3. Anna Down Under March 19, 2010 at 2:20 pm - Reply

    What about the 20+ year studies by Dr Caldwell B Esselstyn (www.heartattackproof.com) that show he can prevent and even reverse heart disease by following a very low fat vegan diet?

    I tend to stay at about 71% carb/16% protein/13% fat in my diet. Admittedly I lose weight easier if I lower the carbs and raise the protein and fat just a bit, but am I setting myself up for heart disease by doing so? It's hard to know what do do anymore, as there's so much conflicting information out there. By the way, those are good, healthy carbs, not processed carbs.

    • Richard September 28, 2016 at 5:16 am - Reply

      Dr Esselstyn’s study indicates one way of reversing heart disease but it does not prove that it is the only way.
      As I stated in one of my earlier comments we are at least 100 years from truly knowing what is best to eat.
      It would seem reasonable that a healthy person does not have to have as strict a diet as someone with CHD and/or diabetes while trying to reverse it.
      The science does not exist yet and given the demand for money may never exist to a satisfactory level.

      • Todd October 11, 2016 at 12:36 pm - Reply

        However, one of Esselstyn’s main points is that heart attacks are not primarily caused by clogged arteries. the vast majority are caused by arteries with plaque that becomes dislodged. Heart attacks are prevented by having no plaques, not by just reducing them. His research indicates a no added fat diet is the only way to avoid buildup of plaque.

        Anectotally, I had a 44 year old friend who died this way. Avid golfer, sailor, in great shape in appearance. His arteries were not blocked. They did have plaque deposits and they ruptured. He died.

  4. Georgie Fear, RD, CPT March 20, 2010 at 6:12 am - Reply

    One fabulous article – I have some people to send this way! 🙂
    I have seen several clients adopt a vegetarian/vegan diet but make the mistake of over-doing the carbohydrates and restricting fats. And often it comes back to bite them as high triglycerides and weight gain.

    Thanks for a factual and balanced article on an oft-misunderstood topic!

    Georgie Fear RD

  5. Ginny Messina March 20, 2010 at 11:09 am - Reply

    Thanks all for these comments. To the best of my knowledge, Dr. Esselstyn has reported on what he has seen in his clinical practice. His findings still provide important evidence but, because they aren't based on randomized and controlled studies, they can't be viewed as conclusive (not that any single study is conclusive; it's just that some are stronger than others).

    The issue I have with these very low-fat approaches is that they give the impression that all fat raises cholesteol levels and contributes to heart disease and that is simply not true. Again, the evidence suggests that replacing saturated fat with plant protein or unsaturated fats can reap the same benefits–and perhaps counter some of the potential negative effects of very high-carb diets. Certainly approaches promoted by Dr. Esselstyn and others are better than those endorsed by the American Heart Association but that doesn't mean that they are the ideal approach. And, Beforewisdom, those who are at high risk for heart disease might also be the ones who are most at risk for some of the problems associated with very high carbohydrate diets (raised triglycerides, low HDL, small dense LDL)–so no, I don't think that very low-fat eating is the best approach for them. It think including some healthful higher-fat foods in diets is probably best for everyone.

    The issue for me as an ethical vegan always comes back to how we can best promote vegan diet while being responsible about nutrition issues. If I thought there were advantages to very low-fat eating, I would have to promote that type of diet even though I know it is hard for most people to follow. Because I have not seen anything to convince me that this is the best way to eat AND because it makes a vegan diet look more difficult and less appealing, I think we do a disservice when we promote very low-fat vegan diets.

    And to be honest, because there are so many legitimate questions about this in the scientific literature, an insistence that low-fat vegan diet is the best way to eat can make us look pretty outdated and out of touch with the current science on this issue. For example, the evidence for coronary protective effects of nuts is very strong–and yet, many of these low-fat diets don't include any nuts!

    • Veronica March 29, 2012 at 11:10 pm - Reply

      I have your book by the way. What I am curious about is why you have not said anything about specific types of fats being better than others in this post.

      I promote a lower fat diet and make oil free vegan recipes that I share on my website. But they still contain some nuts, seeds, avocado, nut milks etc, just no oils. I think this is a better approach than suggesting people cook everything in hydrogenated margarine and refined oil. Oil is a refined food, you don’t get anything from it that you wouldn’t get from the whole version of the plant. I know nutritionists don’t recommend people eat sugar or flour, but then why do you recommend people eat margarine and olive oil?

      Wouldn’t eating some raw nuts, seeds, olives, coconuts, and nut butters be the better choice?

      The vegan diet is so confusing when there are so many versions. I think it’s hard for people to draw the line between a healthy vegan diet and a junk food vegan diet covered in olive oil and fatty foods. It’s very confusing to people.

      • Amanda October 31, 2012 at 6:43 pm - Reply

        She does. If you read it again you will see that the difference between saturated fat and poly and monounsaturated fats is mentioned and that very low fat is not the way to go but those good fats specifically have their place in one’s diet.

        • Richard May 12, 2016 at 12:00 am - Reply

          No matter how many times one reads an article does not make it ring more true!

          I have not found one valid study that proves a person with heart disease is better off adding fat to what naturally is contained in whole plant-based foods.
          It is relatively easy to make a case for nuts, seeds and avocado but even those have not been proven benefits to a person trying to reverse heart disease so they are better consumed in moderation only by healthy people.

      • vethrive June 8, 2014 at 12:43 pm - Reply

        Well said. Thank you!

    • sara January 29, 2016 at 5:23 am - Reply

      I have high cholesterol. In an effort to reduce it I stumbled upon Dr. Esselsteins low fat diet. I was already a vegetarian for over 40 years so it wasn’t too hard to do the low fat thing. I did it “religiously” for 6 months. Cholesterol came down but not enough and my Triglycerides soared. Not Good. So I have gone back to including walnuts, avocado and very small amounts of oil in cooking. Other than cholesterol my blood pressure is excellent, I have an active lifestyle and I have lost a lot of weight with lowering the fats (that will happen) so now, I’ll wait to see with my next blood work. But my feeling is…remove all processed food from diet, soda pop and packaged juices…it will remove a lot of the harmful stuff from a diet. I still eat very little dairy (none really) and discovered that a very important vitamin K2 with D3 needed to be added. K2 i only available in animal products.

      • Richard June 7, 2016 at 8:16 pm - Reply

        The source of K2 is not animal products. Natto has about 1000 times the amount of K2 as the second place food and all those do not have enough K2 to be sufficient so it is Natto or supplements…

      • Monica Benyk June 19, 2016 at 3:00 am - Reply

        I highly recommend the Portfolio Diet. Simple, easy, inexpensive, flexible and effective! I had high cholesterol for 10 years before starting it and have reduced my total cholesterol and triglycerides, raised my HDL and reduced my LDL – simply eat 3 serves of soy, 1 serve of nuts, 1-2 serves of oatmeal or barley, 1 serve of flaxseed, 1-2 tsp of margarine with plant sterol like “pro Activ” margarine and an apple or pear every day, as well as a serve of okra or aubergibe etc. If you eat all this stuff, you won’t have a huge amount of room for anything else. Oh they also encourage you to have fatty fish or fish oil tablets every week.

        I was amazed when my cholesterol dropped from 6.8 to 4.8 in only three weeks (and I’m a very active, thin, fit vegetarian and have always followed a low fat diet- but my cholesterol was high for 10 years and never budged from say 5.5 and above).

        Happy days!

    • Richard June 7, 2016 at 8:06 pm - Reply

      You ignore the obvious Ginny. It is just possible that people having serious artery and heart problems require a low-fat whole plant-based diet to reverse their situation quickly before they die.
      On the other hand, the studies on the Seventh Day Adventists that are on good diets and include nuts, seeds and avocado who live longer than their peers not including such could very well be that those plant fats are beneficial to people without serious heart/artery problems.
      The world is likely at least a hundred years away from knowing the individual’s best diet. To knock low-fat diets for everyone is premature and irresponsible till more evidence is collected.

  6. Johan March 20, 2010 at 12:26 pm - Reply

    I'm kind of on the fence on low-fat diets so I'm not really in favor for anything but your article does bring out some questions. The so called "healthy fat" sources you are using as examples are either rich in polyunsaturated fatty acids or omega-6. PUFAs raises plasma concentrations of cholesteryl oleate. Older animal studies and studies on humans shows that cholesteryl oleate predicts arteriosclerotic vascular disease. So I'm seriously wondering why that's considered healthy?
    Omega 6 and inflammation is def intresting but it's far from conclusive if vegetable omega-6 cause it. However, if you have a high omega-6 intake you will most likely not get adequate DHA (and possibly EPA)unless you supplement. Some comments regarding these issues would be great.

  7. healthyhealthyhabits March 20, 2010 at 2:29 pm - Reply

    I would think that both Ornish and Esselstyn independently reversing heart disease through a no-added fat vegan (or in Ornish's case, vegetarian) diet says a lot more than randomized trials.

    Furthermore, adding olive oil is adding pure fat with minimal nutritional value. It's not even a real food.

    I suggest you read Esselstyn's book before suggesting that his research isn't valid.

    It's the added fat that fuels development of plaque.

    We just don't need the added oil and believing that it contributes nuritionally is silly. You can get Omega 3 from healthier (and less artificial) sources.

    • Veronica April 2, 2012 at 11:54 pm - Reply

      I agree 100%. I don’t like that people think randomized studies are everything. These are tested on average people, average people cheat on their “diets”, don’t listen to instructions, are more overweight and sicker than they think and it’s not really a good baseline.

      I prefer to teach people to NOT add 100% refined oil all over their food at home. They get enough fat from restaurants, packaged food, and treats. I highly doubt there are large portions of vegan living on a zero overt fat diet. No one is advocating that the general public of vegans be terrified of nuts, nut butters and seeds.

      We just don’t want people snacking on roasted salted nut trail mixes every day on top of eating fried foods and a salad with olive oil. It’s too much.

      And it repulses me that a dietician would recommend that people cook in margarine. I don’t even understand that. Ethical veganism aside, you do know how bad hydrogenated oil is for the body. Why even suggest it? You could have said Earth Balance if you wanted to stipulate a margarine like substance that wasn’t hydrogenated. But then palm and coconut oil are mostly saturated fat anyway, just like butter. So I see little difference health wise.

      • Richard June 7, 2016 at 8:09 pm - Reply

        NO Oils ring a bell? I like the studies done so far supporting whole plant-based fats like nuts, seeds and avocado but it may be that very sick people with heart disease can only reverse their situation with low-fat….

    • IndianaJones February 10, 2014 at 1:28 pm - Reply

      Very well put and right on the money!

  8. Elaine Vigneault March 21, 2010 at 8:35 pm - Reply

    I'm sticking with Dr. McDougall, Barnard, Esselstyn, and Ornish. I think they're right on the money with their methods and they are effective at reaching the population they speak to: those who need to radically change their diets in order to reverse heart disease, diabetes, or obesity.

    I think it's rather silly to suggest to average American eaters that they should seek out fatty food sources.

    If we're going to give any nutritional advice along with promoting veganism, then we should aim for advice that reaches the average person. Most Americans need to be told to cut back on all fats. And to cut back on calories. And to eat more fruits and veggies. They do not need to be told to go out of their way to try to include "good fats."

    Most people, unless they live under a rock or are crazy, will get enough "good fat" simply by virtue of eating a wide variety of vegan foods.

    • Robert January 10, 2011 at 12:24 pm - Reply

      I don't think she's talking about adding fat but rather replacing saturated fat with unsaturated fats thereby changing one's lipid profile. The population that Esselstyn "speaks to" is comprised of people with advanced CHD or people that have already had a heart attack. The diet is not that palatable. Mr. Clinton is not following the diet to the letter. The reversal diet of Dr. Esselstyn will be followed by people in dire straits because they really don't have many options. Face it, fat makes a diet more palatable and humans, as a species, crave fat. 

      • Lucas March 2, 2011 at 3:21 pm - Reply

        How can you say that Esselstyn''s diet is not palatable?  Have you tried some of the recipes?  What is not palatable to me is adding refined oils for "health" benifits.  Refined oils should be listed as the number one junk food, since it contributes 100% of its calories from fat providing no other nutrition.

        • Ginny Messina March 2, 2011 at 3:34 pm - Reply

          Extra virgin olive oil is not "refined." And it's contains a number of phytochemicals that are linked to reduced risk for heart disease and cancer. It doesn't mean you should drink it by the gallon, but it's pretty silly to try to make it out to be a poison.

          • Eva May 21, 2012 at 12:57 am

            How come all the oils are refined, but olive oil is not, while the producing process is more or less the same: it’s extracted from the plant, just like any other oils; it doesn’t have any dietary fibre or the nutrients the original plant had, it’s just plain fat: http://nutritiondata.self.com/facts/fats-and-oils/7727/2 (OK, there is some vitamin E and vitamin K in it, but the %DV is so low, that if you want to get these vitamins by eating olive oil, you should eat a pound per day.)
            Olives or nuts are not refined but the oils pressed out of them definitely are. Or do I misunderstand the meaning of refining?

          • Richard April 17, 2016 at 5:27 am

            EVO and all oils are refined….end of story!

          • Rick May 30, 2016 at 11:08 am

            If cold pressed extra virgin olive oil is “refined,” I guess lemon juice is also “refined?”

          • Richard September 28, 2016 at 5:22 am

            You seem to be having a problem with the word “refined”….of course lemon juice is refined, as is apple juice or any other juice squeezed out of the fruit.
            Whole plant-based means exactly that, the whole thing that nature produced.

          • Richard April 17, 2016 at 5:26 am

            Of course EVO is refined….it is not in the natural original form which is an olive. Besides fiber being removed there are other nutrients also removed…
            Olive oil is 100% fat and no study has ever proven it is beneficial to health, on the contrary it has been shown to decrease blood flow.
            There are many foods detrimental to health that are not poison, what is your point?

      • Barb Z May 15, 2012 at 5:08 pm - Reply

        I thoroughly enjoy the recipes from Esselstyn and McDougall. It takes a few weeks to adjust to no added oil if you are used to having it. After your palate has adjusted, oil-less food tastes cleaner and fresh. What is difficult about eating this way is finding it when you eat out.

      • Monica June 13, 2014 at 8:16 pm - Reply

        My husband and I have been following Dr. Essilstyn’s diet. It is very palatable. I am no longer pre-diabetic and I have lost 42 lbs. we’re feeling healthier than we have in years!

    • Richard May 11, 2016 at 5:02 am - Reply

      I like your comment Elaine more than the article and will only add that children of age 10 already have yellow streaks in their arteries and most men of age 20 have clogged arteries.
      Therefore most adults in the US should be following a program to reverse heart disease and so far the studies that have accomplished that have used low-fat whole plant-based diets.
      The studies that have tried to micro-manage components like saturated fat and others do not impress me till they are used to reverse heart disease and diabetes as Drs Ornish, Esselstyn and others did.

    • Richard June 7, 2016 at 8:13 pm - Reply

      Since most people over the age of ten already have at least the beginnings of heart disease I think the Drs. in your comment are relevant to a large portion of the population.

      One confusion often in publications is the mistake of mixing what is best for losing weight, lowering cholesterol and reversing heart disease. The next hundred years could prove me wrong but I doubt only one diet does all three and no other does one of them…

    • AlmostDEAD February 21, 2017 at 1:17 pm - Reply

      I think the low fat vegan diet proposed by Ornish, Esselstyn etc. is right on the money for people with severe vascular disease.

      BUT it is not SUSTAINABLE. I tried for many years to follow the No nuts/avacado/oil and low fat vegan and every single time I end up binging.

      I suffer from heart disease and am about 5 years away from death supposedly.

      What has worked for me with 95% of the benefits of the low fat vegan diet to reverse my heart disease is to eat 1-2 walnuts + a 5g fat fruit/nut bar 3X per week.

      The vegan diet is already so damn limiting but using this method I dont feel deprived and can actually live with it.

      Sticking to a pure Esselstyn diet this is what happens to me, 28 days I stick to it and then 2 days I go crazy and eat disgusting food like mcdonalds or expensive steak house steaks with mashed potatoes and gravy.

      This ends up doing way more damage and suggest people just incorporate a very small amount of fat int he from of nuts/avacado a few times a week.

      Your body CRAVES fat and if you dont have enough millions of years of evolution will make you find it and when you do BINGE city!

      Good luck!

    • Richard May 4, 2017 at 1:29 am - Reply

      I am familiar with the doctors you listed but they are not consistent. There are small differences and if you read the comments above you will see the differences.
      Is fish or fish oil supplements really a health food? I do not think so because the oceans are polluted resulting in one of four wild fish having microplastics which might contain various toxins, after all plastic was not designed to be consumed.
      Dr Esselstyn recommends no added fats, oil, nuts/seeds or avocados.
      McDougall is very focused on starch which often is not as nutritious as berries or other vegetables.

  9. Ginny Messina March 22, 2010 at 7:00 am - Reply

    Elaine, this is not about telling Americans to seek out fatty foods. My point is that there is absolutely no reason to eliminate all fatty foods from a vegan diet. The scientific evidence does not support the need for doing so and, as noted, it may actually have some real health disadvantages. And as vegan advocates, we want to promote a healthy diet that is actually attractive to people. Including some higher-fat foods in meals does that–without any negative effects on health. So why would anyone be opposed to that?

    • Richard May 11, 2016 at 5:04 am - Reply

      What scientific evidence are you looking at that has reversed heart disease given moderate amounts of fat????

  10. Yoga March 22, 2010 at 9:54 am - Reply

    I wish I'd had a copy of this back when I was vegan! People tend to assume all vegans are on a mission, rather than just trying to eat better.

  11. Mike March 22, 2010 at 12:33 pm - Reply

    I am a vegan, but I have come to believe that there's a lot of important research that has been compiled by advocates for a more 'paleo-style' diet. I know saying so may get me bumped to the bottom decks of the good ship Vegan, but there are a number of potential insights into the link between diet and health that can be comfortably integrated into a animal-free diet.

    I strongly recommend Whole Health Source because the researcher who posts there is fairly reasonable and appreciates the cruelty and environmental destructiveness of our factory farming system.

    He has well documented that traditional human populations can thrive on a wide variety of diets, from the extraordinarily high-fat diets of the Inuit and Massai to the 70% carbohydrate diet of the Kitavans. Despite the remarkably wide-range of diets we can handle, in all documented transitions from traditional foodstuffs to a more modern/western diet that includes sweeteners and other refined carbohydrates (primarily white flour) the investigated population has had their health markedly decline.

    I don't wish to post a feature-length article documenting all the important evidence, but I'd like to list what I believe to be the most relevant implications for vegans from evidence supporting a more 'paleo-oriented' diet. Much of the relevant science is still unsettled, but here are the hypotheses I believe we should pay attention to:

    Refined carbohydrates, especially sweeteners and white flour, are particularly harmful to health in large quantities.

    Fat from industrial seed oils (polyunsaturated omega-6) is uniquely harmful in high quantity in the human diet, in part because it disrupts our usage of omega-3. We should reduce the usage of these oils and/or replace them with saturated (e.g. coconut/palm kernal oil) or monounsaturated ( e.g. extra-virgin olive/avocado oil) fats.

    [This is absolutely controversial, but there's some pretty significant evidence within the Whole Health Source's posts on dietary fats.]

    Omega-3 polyunsaturated fats have been significant in all traditional diets, and almost certainly lacking in most modern diets. Flax oil's short-chain ALA may not convert well to long-chain DHA and EPA in humans. Vegans may want to consider algae-sourced DHA and EPA supplements.

    Traditional societies relying on grains and legumes for a large portion of their diet soak, sprout and/or ferment them before consumption. These processes all serve to improve the bio-availability of the nutrients and may be important for vegans eating a large portion of their calories from these sources.

    Vitamin K2 has been been under-appreciated for its role in human health and is chronically low in western(ized) populations. It's found in greatest concentration in the parts of animals we rarely eat (organs and bone marrow) and dairy from pasture-raised ruminants (displaced by factory dairies). The research isn't definitive, but I believe this nutrient is worth paying attention to. As with B12, fully vegan sources of K2 supplementation are available.

    Again, these are hypotheses, but I think it's worth evaluating the evidence in support of them to best determine how to adopt a healthy vegan lifestyle.

    • Richard May 4, 2017 at 1:33 am - Reply

      ‘paleo-style’ diet is today impossible to follow. Meat, vegetables and fruits are not what they were 100,000 years ago besides the fact that even at that time the diet varied by locations and seasons.
      Chicken today has 9X the amount of fat as in 1970. Try as you will to find grass-fed, toxin free foods but there are studies clearly indicating the harms done by high levels of animal protein.

  12. Crystal March 22, 2010 at 7:44 pm - Reply

    I get most of my fats from tofu and peanut butter and rarely add oil to anything during cooking (I use non-stick cooking spray). I feel better with only the occasional addition of fat foods, a few servings a day of avacodo or peanut butter, but not much more. I think different things work for different people.

  13. Ava Odoemena March 23, 2010 at 2:05 pm - Reply

    It's great to hear there's a shift in the perception relating to good fats. Not only because I've always enjoyed a high fat vegan diet, around 20-30% calories from fat myself. I have excellent blood-lipid values.

    It's also nice to now have some more reasoning weight against those who masochistically enslave themselves to very restrictive eating patterns, and defend them against the science which tells otherwise.

    Good fats are good for you, what's so complicated about that?

    • Richard April 17, 2016 at 5:35 am - Reply

      There is no evidence clearly proving that your “good fats” are good for you. You use the word science but have none to cite.
      You say you have excellent lipids but do not include any facts that the reader can agree or disagree…
      I do not know how long you have followed your current diet and whether you have heart disease or not. Avoiding getting heart disease as we age requires a different diet than reversing heart disease.

  14. thedalyn March 23, 2010 at 5:58 pm - Reply

    Wow. I had no idea that this was such a can of worms. Like Ava, I take the approach that good fats are good for you (even though the specifics of that tend to change…coconut, anyone?) and, when I had gestational diabetes last year, the importance of fat was made clearer to me. In fact, the dietitian that I saw, who unfortunately wasn't overly familiar with vegans diets, was more concerned that I eat enough fat than the fact that I was vegan, which was contrary to what people told me I was in for. She was right, too. When I was careful about a good mix of healthy fat and protein with the prescribed number of carbs, I felt MUCH better than when I left out the fat. I think, therefore, that I learned a valuable lesson from the GD.

    Since I'm no expert, despite having read a variety of books about diet and nutrition, I appreciate that fact that you've taken the time to discuss the findings of your diligent research, Ginny. I know personally how time consuming research is and how vexing it can be. It's refreshing to have access to sane, grounded, well-researched information.

  15. Marty March 24, 2010 at 1:50 am - Reply

    Crystal – I would suggest you use other nuts aside from peanuts – pecans, almonds, cashews and seeds: sunflower, chia, hemp, sesame.

    Like any diet – a well-rounded food source supplied more the daily nutrients we need as vegans. I use grapeseed and olive oil for sauteeing for soups, using mainly nuts and avocado for fats. Plenty of veggies and fruits and not even daily grains. I don't find many vegans where I live and if I have, I've not found them to be absolutists. Moderation!

  16. CamelMan March 24, 2010 at 8:37 am - Reply

    I applaud your promotion of vegan diets, which are laudable for their own sake regardless of the macronutrient ratio one chooses to adopt. However, Dean Ornish does have a published controlled study showing that his very low fat diet reverses heart disease.

    Furthermore, the argument that there may be disadvantages to a high-carbohydrate diet makes use of a straw-man tactic. Just as all fats are not equal, neither are all sources of carbohydrate. The Ornish and Esselstyn type diet makes use of unrefined plant foods, not cookies.

    Finally, regardless of any studies about fat metabolism conducted after Ornish published, his diet will not suddenly stop working. No other diet than a very-low fat diet has ever been shown to reverse heart disease.

  17. debplus4 March 24, 2010 at 1:05 pm - Reply

    I also will go with McDougall, Essyltein, Campbell, Jeff Novick and the like. Where is your scientific studies, notes to back up your claims? They have decades of knowlege, training and scienic behind them.

  18. Tarah March 24, 2010 at 1:24 pm - Reply

    I'd just like to say that I am a low fat raw vegan, following Dr. Douglas Graham's plan. His book is "The 80/10/10 Diet". I, along with many others thrive on this lifestyle. I average around 3000 calories daily, ensuring I am eating enough for my athletic endeavours. We promote large amounts of fresh fruits and vegetables, along with small amount of avocado, nuts, and seeds, usually averaging 30 grams of fat daily.
    This is not to say that our way of eating is the only way, but it certainly is optimal for a great number of individuals.
    Our network is http://www.30bananasaday.com, if anyone is interested in this way of life. Dr. Douglas Graham also has a website, http://www.foodnsport.com.
    Eating large amount of fresh produce has helped me eliminate toxins from my body, and keeps me fit and healthy!

  19. G-dsgirl March 24, 2010 at 5:30 pm - Reply

    First read Prevent and Reverse Heart Disease by Esselstyn. You can't argue with 25 years of hard data.

  20. Ginny Messina March 24, 2010 at 6:02 pm - Reply

    Thanks all for these comments. I'm traveling right now so can't respond quite as extensively as I would like this week. But I will say once again that all fats do not raise blood cholesterol levels and promote plaque formation. Only certain fats do that. So to make a blanket requirement for eliminating all fats from the diet to promote heart health is not in line with the current scientific findings. As good as the very low fat diets might be, they would probably be improved with the addition of some foods with proven heart health benefits like nuts. And by promoting heart healthy diets that include some of these foods, which make meals more appealing and tasty, we could attract more people to veganism, thereby providing health benefits for more people and saving more animals.

    Health professionals don't make recommendations based on a handful of studies. The research on these issues is vast and it is important to look at all of it and see what the majority of the best studies say. It's a mistake to think that a few popular books based on a few studies–some of which were not randomized clinical trials–should form the basis for our recommendations regarding vegan diets. If we're going to be successful in promoting vegan diets, we need to evaluate the research much more critically than that.

  21. Heidi March 28, 2010 at 7:13 am - Reply

    I am wondering if you know how many fat grams per day is healthy to shoot for? Based upon a 1,500 calorie diet.

  22. Ginny Messina March 30, 2010 at 1:25 pm - Reply

    Hi all,
    A few quick responses to the comments that have come up over the past week.

    Regarding monounsaturated fats and diabetes, there is a lot of good research on this and eating more of these fats appears to be beneficial for some people with diabetes, so I appreciate having this pointed out.

    And yes, oil is a food! Granted, partitioned foods lose a lot of their good components, and it’s best to eat primarily whole plant foods. But oils have been a part of cultural diets for hundreds of years. They improve the flavor of other more healthful foods and can enhance some nutrient absorption. Obviously, most of us could stand to consume less oil, not more—but that doesn’t mean that there is anything wrong with having a little bit of oil in your vegan diet. I would agree though, that it is much better to get healthful fats from whole foods like nuts, seeds, olives, and avocado.

    As far as the effects of unsaturated fats on cholesteryl oleate, these are animal studies using very high fat intakes and the results are actually conflicting with some research showing low levels of cholesteryl oleate when unsaturated fat is fed.

    I agree that the relationship of fat intake to DHA levels in vegans is an interesting topic. It is very, very complex, though, with a lot of conflicting recommendations—I’ll try to write more about that in the next few weeks.

    Heidi, no one really knows exactly how much fat is appropriate in a diet, and again, type of fat seems to be more important than amount of fat (up to a point, of course) I’m inclined to suggest something between 20 and 25%. If your calorie intake is low, as yours is, it’s probably wise to aim for the lower end of that range so that there is plenty of room in your meals for other healthful foods. At 1500 calories, you might want to aim for 30 grams of fat per day. It’s not an exact science, though, so a little more or little less on some days is okay.

    Peter, I did point out in my post that the type of carbohydrate consumed is important. However, some of the problems associated with very low-fat diets—which include lowered HDL levels and higher triglycerides—have also been seen in diets that used complex carbohydrates. I’ve responded to some of your comments about the Ornish Program (and no, I don’t think that it has stopped working because of newer data!) in a new post today.

    • john chiaravalle April 28, 2012 at 11:49 pm - Reply


    • Doug Spoonwod May 24, 2012 at 8:06 pm - Reply

      “And yes, oil is a food! Granted, partitioned foods lose a lot of their good components, and it’s best to eat primarily whole plant foods. But oils have been a part of cultural diets for hundreds of years. They improve the flavor of other more healthful foods and can enhance some nutrient absorption. Obviously, most of us could stand to consume less oil, not more—but that doesn’t mean that there is anything wrong with having a little bit of oil in your vegan diet.”

      Yes, but that also doesn’t mean that there exists anything right with having oils in your vegan diet. Enhanced nutrient absorption can pose a problem in certain situations at least (e. g. absorption of sodium leading to a calcium deficit). Oils are not the only way to improve flavor. A simple one which requires very little effort comes to use herbs and spices liberally… even in salads. Curiously, I found no mention of herbs and spices in _Vegan for Life_ (did I miss something?).

      The drawbacks to oils lie in drawbacks which arise from overconsumption of fat, including saturated fat. The drawbacks to herbs and spices lie in what again? Which have more phytochemicals on average herbs and spices or oils (honestly, I don’t know)?

    • Amanda October 31, 2012 at 6:52 pm - Reply

      Thank you for your kind, thorough and informative responses. Diet can be such a polarizing topic! Who knew?

  23. Johan April 3, 2010 at 8:17 am - Reply

    No you're wrong regarding cholesteryl oleate. It's been shown in both animal and human studies. The Uppsala longitudinal showed this most recently but also clinical trials with humans have shown increased levels of cholesteryl oleate.

  24. Mahesh April 4, 2010 at 2:55 pm - Reply

    Hi Ginny,

    One thing I like about you is that you are available to post replies in response to various comments.

    Somewhere you had mentioned that Dr Ornish and Dr Esselstyn did different things and hence we can attribute reversal of heart disease to low fat diet alone. While I agree that they did different things, low fat plant based diet was the common denominator. Esselstyn didn't ask his patients to exercise. He simply went by cholesterol below 150 and low fat plant based diet. Ornish program required exercise, yoga, meditation etc etc. Since low fat diet was common, logic tells me that low fat diet had significant effect compared to other components. If Dr O did A, B and C and Dr E did X,Y and C and both of their patients saw reversal then one can conclude that C had significant effect and may the only component responsible for the reversal. Conversely, even in the worst case one can not say that C was not responsible for the reversal.

    Secondly, you say by adding good fats to low fat diet, one can expect even better results? now what is "better result" than the reversal itself? So If I'm a high risk patient or already had heart disease, why would I fiddle with anything other than what is pr oven to be true?

    Would love to hear your comments.

  25. Ginny Messina April 6, 2010 at 1:20 pm - Reply

    Mahesh, no it doesn’t exactly follow that every single common element in the different diets is responsible for the benefits. It’s perfectly realistic to think that both A and X are beneficial so that subjects got good results from either of those things. More importantly, though, the programs had a number of factors in common, some of which are known to be protective and some of which aren’t. Both were low in saturated fat and both caused weight loss. Those are two well-known powerful factors for reducing heart disease risk. Low unsaturated fat intake was also common to both programs but is most likely just an innocent bystander—taking all that credit for something that is really just the result of other dietary changes.

    If someone has reversed their heart disease on the Ornish Program, I wouldn’t expect them to try something else. But a lot of people are never going to try a low-fat vegan diet because the low-fat part of it is too difficult. And since it is unnecessary, why promote it? Especially given that many vegans promote this way of eating for everyone not just those with heart disease!

    • Darlene October 14, 2012 at 9:00 am - Reply

      Hi Ginny. Have been enjoying all these posts and as a diabetic vegan, had to respond. not everyone is the same. Maybe if you are reversing heart disease, a low fat diet would work better, but as a diabetic I can tell you through experience that it doesn’t work for me.

      My triglycerides went up to 300 and my good cholesterol dropped to 38. I almost gave up the vegan diet, but after some reserch, decided to keep the vegan diet and add some healthy fat and it worked like a charm.

      Today, I love what I eat and have healthy levels on all my blood work.

  26. Mahesh April 8, 2010 at 5:50 am - Reply

    Ginny, there is lot of contradictions in your posts. It seems you did believe that Ornish diet reversed CVD. Then you say it is unnecessary that means you have to prove first that adding little more fat to low fat diet, you can still reverse CVD. If yes then yes people can add little more fat and still reverse CVD. For those who do not have CVD, may be they will be OK with 20-25% fat.

    You believe most of the benefits came from reduced sat fat and weight loss. Now, low fat plant based diet should give you the lowest sat fat and weight loss as fat is calorie dense.

    What people can or can not do is different animal altogether.

  27. Ginny Messina April 8, 2010 at 11:46 am - Reply

    Mahesh, first of all, no—there is no evidence that the Ornish diet reversed heart disease. We know that the Ornish Lifestyle Program—which included a low-fat vegan diet—reversed it. No doubt, diet is a powerful part of the reason for the reversal but this study alone does not prove that and I really don’t think that Dr. Ornish has ever said it does.

    Second, you can’t draw conclusions about the best way to eat based on one or two studies. Nutrition research and knowledge are far more complex than that. (I’m going to blog about that topic in another few days.) So based on an overview of the body of research on diet and heart disease, here is what we know:

    • Polyunsaturated and monounsaturated fats do not raise blood cholesterol. This is pretty much rock solid fact.

    • Saturated fat raises blood cholesterol levels. There is not total consensus about this, but for the most part, we can still recommend with some confidence that people who want to reduce their risk for heart disease or reverse existing heart disease should drastically reduce their saturated fat intake.

    • In overweight people with elevated cholesterol, weight loss will reduce cholesterol levels. Again, this is pretty close to being rock solid fact.

    • Nuts have some rather amazing heart-protective effects. This is a growing area of research but the findings are impressive. There is a very consistent relationship between nut consumption and reduced heart disease.

    Looking at these facts, it doesn’t make any sense to think that avoiding all high-fat foods—including nuts—is necessary to reduce heart disease risk. And it’s really not very likely at all that improved heart health would be due to a lower intake of heart healthy foods like nuts. While we don’t have studies that lasted long enough to show reversal, we do have studies showing that diets including heart-healthy higher-fat foods have advantages over low-fat diets in terms of blood cholesterol levels and type. It’s very hard to imagine that adding moderate amounts of these foods would make things worse and it is very likely that they might make them better.

    Finally, most people do lose weight when they severely restrict fats in their diets, but keeping the weight off is another matter altogether. There are, in fact, plenty of studies showing that including some higher fat foods in the diet is more effective for long-term weight control.

    Again, my intent was not to dissuade people from going on the Ornish diet if they have severe heart disease. It was to point out that some of the widely-held beliefs among vegans about nutrition are simply wrong. And the idea that all high-fat foods are bad for you is one of them.

  28. Mahesh April 15, 2010 at 7:20 pm - Reply

    There you go


    All these studies have further underlined the importance of diet by showing that high fat food raises their risk of developing coronary heart disease separately from blood cholesterol levels. For example, in one study, a group of people following the American Heart Association dietary guidelines — eating 20% of overall calories as fat — showed no change over time in the progression of their coronary artery disease or in their risk of having a heart attack. When their fat intake was lowered to 10%, their heart disease either stopped or began to regress. Their risk of having a heart attack also went down

  29. Ginny Messina April 16, 2010 at 9:05 am - Reply

    Mahesh, I'm not really sure what you're saying here. The article you posted suggested that heart disease reversal could be achieved in response to a comprehensive program that included low-fat diet along with cholesterol-lowering drugs, smoking cessation, and weight loss. It doesn't actually make the case for very low-fat diets at all.

    Also, I'm not recommending a high-fat diet or an American Heart Association diet. I'm recommending a vegan diet (which is extremely different from the AHA diet) that includes some healthful higher-fat foods like nuts. I don't disagree with anything in the article you posted. It just doesn't refute anything I've said here.

  30. Mahesh April 16, 2010 at 10:06 am - Reply

    Ginny, the link that I posted, author doesn't talk about Ornish Program but specifically talks about diet, fat and cholesterol. So we are not talking about other variables here.

    " ***All these studies*** have further underlined the importance of ***diet**** by showing that high fat food raises their risk of developing coronary heart disease separately from blood cholesterol levels"
    Also when you recommend to add nuts and seeds to low fat diet which may be 10-12%, you can easily increase that percentage to 20 -25% which is a problem.

    I would like to see evidence where in adding nuts and seeds to low fat diet will get atleast the same results as low fat diet if not better.

    Otherwise it is like everyone is trying to tinker with the % CFF. We don't like 10% and we don't like 30%, so let's make it 12%, 15% 17% or 20% should not be the basis for dietary recommendations.

  31. Ginny Messina April 16, 2010 at 10:59 am - Reply

    Mahesh, the quote you included actually references studies that did not show benefits of very low fat diets or dangers of moderate fat intake. In fact, most of those studies cited actually used drug therapy. And later in the article, the references to high fat intake are specifically in response to the effects of very high fat meals. I addressed that issue in my post, pointing out that eating a lot of fat at one sitting can raise risk for a coronary event.

    Again, I am not promoting high fat diets! But the fact is that the evidence showing protective effects of nuts and seeds is very impressive. I wrote a little bit about that on the examiner site here.

    And again, if people with severe heart disease want to follow a very low fat vegan diet, I don't have a problem with it. There is nothing in the scientific literature to suggest that having a few nuts and seeds every day would reduce the benefit of that diet, but I won't quibble about that. However, there is a trend among some vegans toward promoting a very low fat diet for everyone as a way to lower disease risk. They suggest that if a lot of fat is bad then so is a little. The evidence suggests otherwise.

  32. Ryan June 10, 2010 at 1:05 am - Reply

    Diabetes symptoms can be seen in early & older age. But can be cured. Proper diet has to be maintained to control diabetes.

  33. soulveggie July 3, 2010 at 11:30 am - Reply

    That a fatty meal or olive oil affects the elasticity of your cardiovascular system is not a theory, it's a measured fact. Occurs for sometimes up to six hours after ingesting.

    You don't need "randomized trials" to prove that measurement. Added oil fuels plaque development which can lead to strokes, and that's probably more significant than a small drop in cholesterol.

    Which snowflake causes the avalanche?

    How can one seriously consider oil a food. How do you grow olive oil?

    Oil is a highly processed non-food.

    Sure, some nuts and seeds are fine, even avocados, if you don't have heart disease symptoms.

    But to claim that oil, or olive oil, is healthy, is a micro-view of a particular result (cholesterol lowered in some cases).

    Heart disease, Altzheimer's, Type II Diabetes, etc., are the macro-view.

    Then there's the issue of what does added oil actually contribute to one's diet nutritionally?

    Essentially nadda… little of anything.

    Just fat. You're ingesting fat. It's not needed. You can get enough from REAL food sources.

    Here's a summary I did awhile back that might be useful as it provides cits and links:


    This constant rationalization for added oil is not helping people get rid of their taste addictions to fat.

    Having been "no added fat vegan" now for two and a half years, I can tell you, in all honestly, I lost my taste for added fat about 14 or so weeks into the experiment.

    As Esselstyn put it, I've "recalibrated" my taste buds.

    As to Esselstyn's studies, he reversed heart disease. Tell me of a dietician or modern nutritionist or doctor who's done the same thing, and that it's been tracked over 20 years. Where are the cries for more studies validating his research?

    Simple. You can make more money with heart surgery, satins, and stents, than urging people to eat healthier.

    Bottom line: oil is not a "natural" or "real" food any more than high fructose syrup is. You don't need it, and the evidence is not there that you do.

    Regards, Mark

  34. Ginny Messina July 3, 2010 at 11:54 am - Reply

    Mark, thanks for commenting. But your list does exactly what I talked about in this post. You've picked out a few studies that make your case–along with some questionable resources–and ignored the large body of data on this subject. So your list doesn't prove anything and actually does not reflect current understanding of nutrition and heart disease.

  35. Jerryd December 12, 2010 at 11:40 am - Reply

    You said, “Finally, heart disease is not all about cholesterol.” This is a direct contradiction to the cardiologist W.C. Robert’s 2008 editorial on this topic. I wonder if you’ve read it, and what you think?

    The article is at: http://api.ning.com/files/f4nlaCT2ISE8lWOiDrm4CxFbfQBS41idHW2YHJavJ9V5KK-4jqklM7CC42CkWNkTBKvVZ-6EjOZsGQ22vQnYtA3vXhbjubQ4/Roberts.pdf



    • Ginny Messina December 15, 2010 at 12:02 pm - Reply

      I think there is a lot of evidence that heart disease risk is affected by a number of factors, including, for example the health of the endothelium. In some cases, differences in heart disease risk are not explained completely by differences in cholesterol levels. This isn’t to say that cholesterol levels aren’t important, just that they aren’t the entire explanation.

    • Robert January 10, 2011 at 2:41 pm - Reply

      Well you don't have to read too far into this document to see that Dr. Roberts has an agenda. He drags out that same tired old example that when you feed a natural herbivore, in this case a rabbit, a diet with saturated fat it causes elevated cholesterol levels. This explanation only works if you actually believe that humans are herbivores. Let's see what the good doctor has to say about that:
      "Because humans get atherosclerosis, and atherosclerosis is a disease only of herbivores, humans also must be herbivores. Most humans, of course, eat flesh, but that act does not make us carnivores.”
      Well, he does get one thing right. We aren’t carnivores. Guess what? We aren’t herbivores either. And you can preach about taxonomy all you want but the fact is we are different physiologically from herbivores as well. A better comparison would be between two natural omnivores – a pig and a human. Humans have spent the last 2.5-3.0 million years as omnivores. I guess the good doctor doesn’t want to let facts get in the way of a good theory though. He doesn’t mention the fact that humans have relied on flesh to provide their B12 and taurine during our entire existance. You see, pharmacies didn’t exist back in the Palaeolithic era and neither did vitamin supplements. ;o)
      He goes on to try and show through the taxonomy argument how we have the same physiological makeup of a herbivore, except I’ve heard this argument before and have seen it debunked by experts in the field. Who are you going to believe? I know where I’ll put my money.
      The good doctor also talks about the Seven Countries Study as well as the Framingham Study. Let’s start with the Seven Countries. Ancel Keys hand picked only those countries that supported his theory that populations that consumed a lot of saturated fat and cholesterol had the highest rates of heart disease. The results certainly seemed to indicate he was correct. Japan had a low intake of fat and cholesterol and had a low rate of heart disease while a country like Finland consumed a fatty diet and likewise had a high rate of heart disease. I wonder if he included the fact that the Finns also smoked like chimneys, but I digress. Keys had other countries he could have included in his study (there were 22 countries) but he chose to ignore most of them. Why? Because these countries, Sweden, Spain, Switzerland to name a few examples, indicated the population had a high intake of fats but a low incidence of heart disease. Shame on you Ancel Keys and shame on you Dr. Roberts for leading people on by quoting flawed (read dishonest) studies.
      Framingham couldn’t conclusively prove the link between cholesterol and heart disease either. It could not explain why people with a total cholesterol of 150mg/dl still get heart disease. Perhaps he could have mentioned the Kitava Study. Coconut is a significant part of the Kitavan diet, along with tubers, fruit and fish. But isn’t coconut oil very high in saturated fat? Yes it is and the Kitavans also have a very low incidence of heart disease. I suppose the good doctor wouldn’t want to mention this inconvenient fact. Neither would Keys for that matter. ;o)
      Here’s a quote that might explain the good doctor’s stance on this topic:
      "When we kill the animals to eat them, they end up killing us because their flesh, which contains cholesterol and saturated fat, was never intended for human beings."
      Ah, it all becomes so clear now!

  36. jim January 20, 2011 at 4:13 pm - Reply

    U seem to go through this whole article without refrences one study.
    U talk about weight loss and how nuts and seeds can play a key role in weight loss, however it has been shown over and over again  throughout the literature that weight loss is merely energy balance(calories in – calories out) . Energy Density plays a key role in this because it allows one to fill up before they exceed there daily caloric needs.And the National Wieght Control Registry Shows that most obese people in there registry were able to lose there weight following a low fat diet an keep it off for over 7 years.
    You talk about how low fat diets have no advantage over a diet with healthy fats however it doesnt seem like u have any clincal evidence of that, when there is clear evidence supporting a low fat plant based diet from Caldwell Esselstyn showing widening of the Arteries and prevention cardiac events in i think 17 of his patients for 20 years when before his study they had 49 between them, Neal Barnard Showing the Reversle of diabetes(, Robert Fleming showing improvement of blood Flow and the biomarkers involved in heart Desease, Shintani, Mcdougall, Pritikan, Ornish.
    So my question to you is there is a mountain of Clinical evidence showing reversel of severel deseases and weight loss with a low fat diet what clincal evidence can provide showing the same amount of success on a diet with a higher amount of fat.

    • Robert January 22, 2011 at 3:35 pm - Reply

      The downfall to a very low fat diet (<15% total fat) is the palatability issue and the rate of people quitting. I suppose if a person is in dire straights then they will do whatever brings them positive results.
      Open question: How exactly does a VLF diet remove existing plaque deposits?

  37. Amy March 10, 2011 at 8:53 pm - Reply

    Thanks, your blog is always one of the most interesting when it comes to vegan health issues. I just read this post so I'm sorry if I'm a bit late to the party. 🙂

    One of my big struggles trying to get myself from vegetarianism to veganism was I would start feeling tired a lot. Then I read Brendan Brazier's book Thrive and decided to up my intake of raw food, nuts and seeds, and a bit of coconut here and there. At the same time I have been trying to ditch a lot of refined carbohydrates, especially white flour and sugar. I was terrified I was going to gain a lot of weight but did not. And, I feel that being a vegan is much easier this way and I feel better. I don't crave things like eggs anymore so I think I was going too low on the fats in my previous attempts. Like you, I remember the fat free diets and I was on one for about a year. I did lose weight but I was not able to stay on it in the long run.

  38. Jackie August 27, 2011 at 4:31 pm - Reply

    One of the problems I have with diet and the concentration of minds on Fats, Carbs and proteins is that we overlook the issue of minerals both macro and micro.
    Calcium build up occurs when insufficient magnesium is present within the diet. Monitoring blood levels for calcium and magnesium does not give an accurate picture of levels within the body as the blood likes to be balanced. Calcium will build up when insufficient magnesium is consumed.

    There is some fascinating research on calcium and magnesium and most diets are high calcium and low magnesium in fact in has been estimated that 80% of Americans are deficient in magnesium. In reducing a diet or eliminating the dairy products which are high calcium could well be the reason the plaque deposits reverse. However this method does not address the underlying issue of low magnesium which is the real problem.

    Calcium rushes to an injured site causing pain and signals for magnesium to come and help with repair. Repair cannot be undertaken without magnesium’s presence.

    Soy should possibly be consumed with warning. If it is not fermented it should not be consumed at all!!! There is no progesterone to balance out all that estrogen that soy contains. And for men do they really need a diet high in estrogen? I think not.

    Food should be natural and preferably grown in a balanced manner from the soil up. Otherwise your eating rubbish food with little to know nutrient levels. In fact I would be highly concerned with most fruits, vegetables, nut and seeds etc as they predominately grown using a plethora of pesticides, herbicides etc of which can cause enormous harm to human health. In fact many are known to disrupt just about every important system within the body. This is how these chemicals destroy insects, weeds etc.

  39. Steve fisher February 5, 2012 at 12:47 pm - Reply

    Great advice – ive been a lacto vefetarian for 45 years but was shocked to discover from your website that the so called ‘good foods’ like eggs and milk that ive been consuming over the years (at the advice of parents and the authorities) are most likely the cause of my high cholestorol – who would’ve thought a single egg woud contain 222mg of cholestorol and cheese similar amounts?
    So much for those healthy cheese omelettes i was brought up on and all those lattes at starbucks – my god i might as well have been drinking drain cleaner!
    Well done guys for a grwat web site and putting us straight. Prob too late for me but hope others read it b4 they get to my age.

  40. JD Mumma May 28, 2012 at 2:53 am - Reply

    Bravo for focusing on and requesting we all focus on at good science/studies rather than just consciously or unconsciously focusing on studies that match our ignorance and/or biases!

    Question: Have you ever come across a study that eliminated DAMAGED (trans-, oxidized, heated, chemically extracted…) fats from both comparative study groups – low fat and higher fat diet?

    My decades of research has yet to find ONE study that compares people on very low fat diet (usually an automatic reduction in UNDAMAGED fats) vs. people consuming 20-30% of UNDAMAGED fats.

    What we can find plenty of studies on is people eating very low fat diets that are actually simply reducing and/or eliminating the DAMAGED fats, which of course will reduce the damaged and allow the body to heal itself… BUT and until we can actually make a fair comparison of removing DAMAGED fats from both study groups we are just repeating poor protocol studies!

    Seems to me that we would reduce the assumptions and argument fallacies if we stopped solely focusing the conversation on:
    QUANTITY of Fat Macro Nutrient Percentages and included
    QUALITY of Fat Macro and Micro Nutrients!

  41. Wendy Nusche July 28, 2012 at 4:44 pm - Reply

    My first point is that many of us in North America have silent heart disease . Over the years there have been autopsy studies on Americans who died accidently and these studies show that the majority of people over 15 years of age have atherosclerosis and a surprisingly large proportion have coronary artery disease.
    There is evidence that a diet of 10% fat is superior to a diet of 20% fat in decreasing risk of having a heart attack and in stopping and reversing heart disease. {reference on the doctor will see you now site)
    Adding nuts and avocado to Dr. Esselstyn’s prescribed diet is almost 100% going to get you to the 20% mark. If you don’t believe me try it and see.
    I have not seen one study that showed that a healthy vegan diet with nuts and avocado reverses heart disease , not even a nonrandomized small study. It means nothing to associate more nuts to a lower cholesterol. You have to show that adding nuts to a healthy low fat vegan diet decreases the risk of heart attacks and death and results in better reversal of atherosclerosis to say it is a heart healthy food. The present nut studies show that replacing saturated fat from ?meat with fat from nuts is healthier for the heart . This information is not helpful to low fat vegans .

  42. Jon Wheeler August 3, 2012 at 1:09 pm - Reply

    Didn’t the Okinawan centenarians have a diet of 6% fat ?

  43. sharp May 2, 2013 at 7:16 am - Reply

    1) The reason HDL lowers significantly is the direct result of having low blood cholesterol. There is no need for high HDL levels if there is no “bad” cholesterol for HDL to take care of. Many people on a low fat plant based diet have experienced this when their total levels go under 150. High HDL levels are only necessary when LDLs/total cholesterol is high.

    2) The reason for oil-free and lower fat plant based diets is for the recovery of heart disease and dangerously high cholesterol levels. It has been clinically proven to work, and what noted nutritional doctors have successfully used with their patients. Note these aren’t “zero” fat diets, they are low in overt amounts of fats. Many do well on lower fat diets and continue on with them, others may choose to add higher fat plants foods.

    3) Dietary fat intake does indeed cause cholesterol to rise in many people. While some people are able to eat plant fats and not have their cholesterol rise, others do. You can see this evidence on the Dr. McDougall discussion forum, where one star McDougaller was eating a higher fat vegan diet, reduced her fat intake and thus reduced her cholesterol by about 50 points.

  44. […] nutrition chart for everything I ate during my week of eating all low fat raw vegan. This post on fat in vegan diets by Ginny Messina, the Vegan R.D., also provides a good perspective on dietary […]

  45. Robert October 1, 2013 at 3:51 pm - Reply

    First, worrying that people won’t become vegans because the diet is too strict is like Burger King not wanting to reduce the fat in their fries because they might lose customers.

    If people don’t want to eat well they simply won’t, sorry, I’m not in the enticing business, I’m a vegan because it’s the healthiest diet around in this century in my view. It’s nice when people ask me why I look so good at 68 and I can talk about vegetarianism and being a vegan for the major portion of my life.

    Olive oil is NOT food and NOT good for you. Read the studies, the Mediterranean diet was originally a study of the Greeks when they worked in the fields 10 hours a day. The study said, olive oil MIGHT contribute to their health. Today the Greeks are overweight and having the same health problems as any society eating their diet.

    The brachial artery tourniquet test clinches it:


    However, if I sold Olive oil in pint bottles for 20+ bucks a pop like Rachael Ray than I would probably be telling everyone how great it is. Rachael is looking a little frumpy to me lately (Oct. 2013). Follow the money, olive oil is big money, I’m always leery about how good expensive things are when someone is making a pile of bucks selling them.

    Personally, I’ll stick with Esselstyn and Campell. They look pretty darn good for their ages and they had the courage to stand up to billion dollar industries with FACTS and data. Who else reversed heart disease? And while I’m at it, Esselstyn’s book is “PREVENT and Reverse Heart Disease”, it’s not just for the Bill Clinton’s of the world, it’s for everyone.

    Vegan diet too strict? OK, why aren’t I eating things that are bad for my health, like olive oil? For the same reason I’m not smoking, IT”S BAD FOR ME. Am I healthy? Very, med free when my friends get up every morning to a container full of meds. To skinny? No, I can work 12 hours a day, I’m just right. Why because I’m too strict in my vegan diet. Don’t want to be strict? Then don’t, join my overweight, sick friends with the pill bottles swearing by the Paleo diet while it kills them. Hey maybe their too strict!


    • Stephen B October 7, 2016 at 5:23 am - Reply

      Rob, I find your comments particularly helpful and intelligent. As a newcomer here, I would be particularly keen to hear your (and others too, of course) view on the following two points:

      1. It seems (but I could well be wrong) that Bill Clinton has moved a little away from pure Ornish towards a kind of hybrid Ornish / Hyman / Gregor approach. As such, I believe he has added a little more (good) fat back into his diet albeit unrefined, presumably because he believes this will be better for him.

      2. Perhaps less contentiously, are you in favour of adding a few walnuts, for example, and perhaps a small amount of avocado, to a very low fat vegan diet?

      I ask this as a reasonably healthy 61 year old who could nonetheless lower his cholesterol some more, and drop his weight some more.

  46. Fidel Castrati June 2, 2014 at 4:35 pm - Reply

    The oldest verified human lifespan is a French woman who lived to over 122, crediting olive oil, wine and cocoa: http://en.m.wikipedia.org/wiki/Jeanne_Calment She even smoked which might make a case for the protective qualities of those foods. Haven’t eaten much olive oil for quite a while but am presently eating grape seed oil vegenaise daily.

  47. Elizabeth July 30, 2014 at 2:45 pm - Reply

    Interesting article. Thanks. You lost me when you suggested margarine. How, as an expert on nutrition can you do that?

  48. Sunny September 21, 2014 at 6:28 am - Reply

    For me there is a direct correlation between fats and satiety. Tho I have been loosely following the low fat approach where the mantra is ‘eat more starch’, I find that starch alone does not satisfy as much as a combination of starch and perhaps higher levels of fat. The day after ‘indulging’ and going off plan with a creamy coconut curry – my appetite was markedly diminished. I dont know what that means for me as could simply be a quirk, but the feeling of rampant appetite that characterises my mood most days has gone and that is a relief!!

  49. Breanna Verlinda February 13, 2015 at 4:13 am - Reply

    those same organizations tell us to eat dairy and meat as part of our daily diet…. No thanks. I dont trust their “recommendation”. In fact, lets see a picture of how fit and healthy they are!

  50. Fidel May 30, 2015 at 6:51 pm - Reply

    There is evidence that genes determine the ideal amount of fat any given individual should eat. At http://gg.gg/apoE-macro-guide , people who are apoE-4 are listed as doing best with 20% of their calories from fat, while apoE-2 people do better with 35%. MOST people do best with 25-35% of their calories from fat. Perhaps this helps explain why people like the Ikaria Greeks can live so long while eating quite a bit of olive oil.

    Based on genetics, there are very real differences from person to person on how a body processes fats, and what effect given amounts of fat consumption have on one’s lipoprotein particles.

  51. […] Fat in Vegan Diets: How Low Should You … – The proponents of very low fat diets seem to refer to people with severe cardiovascular issues, diabetes and high weights. Maybe very low fat diets have their place … […]

  52. Lucky December 10, 2015 at 3:57 pm - Reply

    Disappointing comment. While added fats may not be the entire problem, they are a problem. If you really scour the evidence the ‘eat more fat/ and that olive oil is healthful is deeply flawed and unhelpful. Of course, eating olive oil instead of another oil may be less damaging, but less damaging is not healthful. It’s like electing to be shot with two bullets instead of six. There is absolutely no need or point to take on board added oils from bottles. A couple of brazil nuts a week, a spoonful of flaxmeal a day, oily fish once a week will give everyone more than enough oil/fat. Reducing levels of Omega 6 from grains will reduce they need for excessive counterbalancing of Omega 3.

    There is a lot of evidence now that simple carbohydrates that cause a harsh insulin response are also harmful. Of course my meat loving friends love to hear that because they want to hear anything that allows them to keep eating meat and oil. In my view both bottled oils and simple carbs are a no go area.

    • Patrick February 8, 2016 at 8:38 pm - Reply

      Explain to me how people on a ketogenic diet with 65-70% of calories coming from fat, 20-25% coming from protein, and the rest coming from carbs causes small dense LDL to disappear? That is what causes heart disease. Obviously you are against meat but are you against coconut oil? One of the healthiest oils on this planet!
      You can live without consuming carbs, but you need protein and fat to function or you will die.
      Also explain to me how diabetics become non diabetic, depression and suicidal thoughts go away, arthritis and many other auto immune diseases go away! I have seen no other diet this powerful. Most of the research in support of a Vegan diet is skewed anyways, got to keep people from killing the poor animals. Even though humans have been doing it for over a million years and only recently have incorporated grains in our diet, the rise and downfall of humanity.

  53. […] can get away with a little higher fat in my diet. My current intake is just over 10%. This post on fat in vegan diets by Ginny Messina, the Vegan R.D., also provides a good perspective on dietary […]

  54. Richard April 26, 2016 at 9:40 pm - Reply

    Sorry to say that all the evidence is not in yet and there are still many questions remaining on nutrition.

    Maybe it is necessary for a low-fat whole plant-based diet to reverse disease like CHD and diabetes. Which leaves the advice that nuts, seeds and avocado are good for the heart as an unanswered question for most US adults over 10 years old that already have signs of heart disease.

    The low-carb studies are not specific enough for me. I only consume unrefined carbs and want to know what the impact of those are. I am certainly not about to follow a low carb diet and avoid all those good carbs without proof.

  55. Ro May 3, 2016 at 8:20 pm - Reply

    Hello, I’ve been following a low fat plant based diet for the weekdays and in weekends I eat an omnivore diet, I’ve been doing this for a couple of months and I lost 5 kg but then gained 2 kg… I wonder if I add more fats, I will gain weight? I started with a BMI of 21 but I want to achieve a BMI of 18, I don’t know if it is possible doing it the healthy way… I also see on youtube nina and randa that have a BMI of 17, is that healthy?

    • Ginny Messina May 10, 2016 at 7:34 am - Reply

      Including higher fat foods in your diet isn’t associated with weight gain. At any rate, if you have a BMI of 21, I think you should be concentrating on eating a healthy diet without worrying about losing weight. A BMI of 18 is considered underweight and is not a good goal. I don’t know who Nina and Randa are, but no, a BMI of 17 is not healthy. I’m glad that you’re experimenting with a vegan diet, but I hope you’ll add some more healthy high-fat foods to your diet like nuts.

  56. Hannah May 25, 2016 at 2:17 pm - Reply

    How does this sound for 21 year old/ based of info from the net I chose to do 60% carbs , 15% proteins, and 25% fats. I’m introducing veganism into my lifestyle and also wanted to make sure I was introducing the right needs as well.

  57. Jen June 9, 2016 at 9:59 am - Reply

    I found this article to be a huge relief to me. As someone who has familial high cholesterol I have strived to follow the no oil PBWF life for almost 20 years but was constantly failing. I have been vegetarian for 8 years and a wanna-be vegan for just as long and will continue to make efforts to go completely vegan because it’s the right thing to do for humans and animals. The no oil/very low-fat lifestyle just doesn’t work for me, so I decided to try cutting out sugar and allowing the healthy fats (EVOO, nuts, avocados) and was truly amazed to find my cravings diminish, my blood sugar staying steady, more energy, and for once, enjoying and feeling satiated by the food! The bonus of including fat and cutting out sugar (desserts and processed food and simple carbs) is that I also lost weight and felt less puffy. I believe sugar causes inflammation, and for me, headaches and water retention. I haven’t had my cholesterol checked but will give an update when I do. Thanks for all the research you do and for staying up-to-date on new information.

  58. […] want to read about hitting the right balance of dietary fat on a healthy vegan diet, I recommend this article from registered dietician, Ginny Messina. Oil free vegan food gets fat from healthy, whole food, […]

  59. […] want to read about hitting the right balance of dietary fat on a healthy vegan diet, I recommend this article from registered dietician, Ginny Messina. Oil free vegan food gets fat from healthy, whole food, […]

  60. […] Fat in vegan diets: How low should you go?, by Ginny Messina, The Vegan RD […]

  61. Matthew September 13, 2017 at 10:23 am - Reply

    While low-carb diet advocates are correct about avoiding simple carbohydrates like table sugar, low-fat diet advocates are correct about avoiding saturated fat and cholesterol as well. Saturated fat, cholesterol, and simple carbs are bad for our health, for various reasons.

    Instead of going for an “extreme” diet, whether it be low-carb or low-fat, why not eat a diet that is based on the right kinds of fats and the right kinds of carbs? What matters more to our overall health is the sources of fats and carbs we are eating, not avoiding carbs and fats entirely.

    At the end of the day, a calorie is a calorie:

    “We conclude that a calorie is a calorie. From a purely thermodynamic point of view, this is clear because the human body or, indeed, any living organism cannot create or destroy energy but can only convert energy from one form to another. In comparing energy balance between dietary treatments, however, it must be remembered that the units of dietary energy are metabolizable energy and not gross energy. This is perhaps unfortunate because metabolizable energy is much more difficult to determine than is gross energy, because the Atwater factors used in calculating metabolizable energy are not exact. As such, our food tables are not perfect, and small errors are associated with their use.

    In addition, we concede that the substitution of one macronutrient for another has been shown in some studies to have a statistically significant effect on the expenditure half of the energy balance equation. This has been observed most often for high-protein diets. Evidence indicates, however, that the difference in energy expenditure is small and can potentially account for less than one-third of the differences in weight loss that have been reported between high-protein or low-carbohydrate diets and high-carbohydrate or low-fat diets. As such, a calorie is a calorie.”

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