Everything You Need to Know about Vegan Nutrition (Plus a Few Words about Vitamin B12)

My friend Erik Marcus recently invited me to write an introduction to vegan nutrition for his website vegan.com. In his weekly newsletter, Erik wrote about why he feels so strongly about providing solid nutrition information for vegans.

One of the most important and most neglected topics in all of veganism is our high recidivism rate—the percentage of vegans who go back to eating meat. I suspect in many cases, it’s because these people did not read accurate information about how to sensibly plan a vegan diet. There’s just so much misleading information about vegan nutrition out there, much of it passed along by people who have only the best intentions. […]  Remember, animal lives aren’t just saved by people going vegan. They’re also saved by people staying vegan. Doing things that will cut the recidivism rate is one of the most important forms of activism.

Needless to say, I agree, and it’s the main reason why I do what I do. On the same day my article was published, I was sent a newsletter article about vitamin B12 (yes, the B12 thing again) written just last month by a prominent vegan health professional. The article shared less-than-optimal recommendations. Vegans who follow those recommendations run the risk of deficiency which is bad in and of itself, obviously. But it also has the unfortunate consequence of aiding those who want to disparage a vegan diet as “dangerous.”

It seems like it never ends — this harmful information in the vegan community. And misinformation regarding vitamin B12 is especially annoying. While a deficiency of this nutrient can be extremely serious, it is also incredibly easy to get enough — but only if you have good information.    Which is why I’m especially grateful that a website like vegan.com, which has a large readership, is advocating for safe, evidence-based nutrition information. (For more in depth information about vitamin B12, please see my primer, and of course, the incomparable VeganHealth site.

I hope you’ll read and share my comprehensive introduction to vegan nutrition on vegan.com. But if you don’t feel like plowing through the whole article, please at least skip to the end where I summarize the most important guidelines for planning healthy vegan diets. Let me know what you think and if you have any questions.

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17 Responses to Everything You Need to Know about Vegan Nutrition (Plus a Few Words about Vitamin B12)

  1. Michael Parish May 20, 2017 at 10:12 am #

    I read the guide and was concerned about your comment relative to low fat vegan diets.

    “Don’t hesitate to include other fat-rich foods in your diet, too, if you like them. Low-fat diets are based on an outdated understanding of nutrition that’s been largely discredited. Current recommendations support a wide range of fat intakes for good health, anywhere from 20 to 35 percent of daily calories.”

    My question is, “discredited” by whom? The only real systematic research done on vegan diets reversing heart disease are those done by Doctors Dean Ornish and Caldwell Esselstyn. And those are low fat (under 10% and no oils) primarily vegan diets that have been proven to reverse heart disease. Have these somehow been discredited and if so, by whom?

    • Ginny Messina May 22, 2017 at 7:29 am #

      Michael, this is a common misconception among vegans. There are no studies showing that a low-fat diet reverses atherosclerosis. The Ornish study used a comprehensive plan with many components including diet, and there is no way to know which of those components was responsible for the outcome. The study doesn’t allow us to say anything about diet and doesn’t show that a low-fat vegan diet has any advantage over a higher-fat vegan diet. And the findings from Dr. Esselstyn’s work come from observations of his own patients. It was not an actual study with a control group and therefore it’s not possible to know what other kinds of factors were involved. Based on the extensive research on the health benefits of different unsaturated fats, it’s very difficult to conclude that low-fat diets would have any particular advantage. In fact, both Drs Ornish and Esselstyn are listed as authors of a new paper that highlights benefits of nuts and oils for heart health. http://www.onlinejacc.org/content/69/9/1172 Most of us who used to promote benefits of low-fat eating are headed in a new direction as we follow the science.

  2. Michael Parish May 22, 2017 at 10:37 am #

    Ginny,

    Are you aware of anyone else that has shown reversal of heart disease regardless of how they did it? The only studies I’m aware of that showed any reversal are those that were low fat, no oils and yes, maybe statins, some exercise, and some stress control.

  3. Michael Parish May 26, 2017 at 10:03 am #

    It was interesting that the study conclusion was that it was the reduction in blood pressure from the weight loss that caused the regression, not just the weight loss in and of itself.

    Thanks for taking the time to respond.

    Very interesting.

    By the way, I agree with your assessment that he health benefits from a vegan diet are often very overstated.

    • Ginny Messina May 26, 2017 at 11:33 am #

      Thanks, Michael. And yes, it’s interesting about the blood pressure because I’m pretty sure that I saw some research about benefits of yoga for regression of atherosclerosis. I can’t remember anything about the quality of the study or whether it was even statistically significant, but since yoga may also reduce blood pressure, there is at least a plausible explanation. The more options available to help people, the better!

      • Michael Parish May 26, 2017 at 4:53 pm #

        Unfortunately, if it was simply a drop in blood pressure doing the reversal most of us who were given blood pressure medication years before our heart attacks wouldn’t have had them.

        By the way, if the day comes when you don’t have much to do why not read my 3 star review of The Starch Solution on Amazon. You’ll have to click on “All reviews” since they moved my review from Certified Purchase to other. I guess a sneaky way of hiding the review. It in fact was the top negative review since 2012 when I posted my first review of Dr. John McDougall’s book. Amazon moved the review to the trash bin of those who couldn’t be confirmed to have bought the book this year. I guess there must be a McDougall fan who didn’t care for my latest update. I did updates to the review each year with the difficulties I had with the program including the McDougall website and my opinion of what was happening there. Just to make a point about over promising on health benefits I joked about the claims to heal a broken heart. And of could not all that long ago I had a major heart attack and posted that I had perfect weight, blood pressure, cholesterol, Trigs, LDL, and HDL. I pointed out that there was no such thing as being heart attack proof. I believe what got my review relegated to the trash bin was when I posted that Dr. McDougall ended up collapsing in his bedroom where he fractured two vertebrae, his hip and a spiral fracture of his femur. I pointed out that no one with healthy bone should have suffered that much damage from collapsing in his own bedroom. Dr. McDougall refused to go to the emergency room claiming he was afraid he’d be stented. My guess is his real fear was that he’d be required to submit to ex-rays which would have confirmed very poor bone health which would have leaked as did Atkin’s hospital records. His followers would have dropped out of the program if that had been known.

        Thanks again for the information and response. Stay healthy!

        • Ginny Messina May 26, 2017 at 5:48 pm #

          Even if reduced blood pressure was solely responsible for the benefits, it doesn’t mean that everyone who lowered their bp would experience regression. It’s never quite that straightforward with diet and health. But I agree that it’s likely that other factors are at play.

          And that’s an interesting comment about the bone fractures. I’m working right now on a blog post about bone health. I hear from many vegans (mostly women) who have osteoporosis or who have had bone fractures. Some of the dietary advice on this issue that continues to be popular in certain plant-based groups is pretty outdated and potentially harmful. It’s had me thinking a lot about bone health of aging vegans (of which I am one). More on that to come. And I will track down and read your review!

          • Michael Parish May 29, 2017 at 9:26 am #

            Yes, I agree. Somehow folks just never seem to figure out that bone is made from a protein matrix. Remove the matrix and there isn’t anything for the calcium to hang on to. That’s why I believe limiting beans to a absolute maximum of one cup a day and eliminating soy to keep protein right at some minimum in order to minimize IGF-1 as some vegan doctors do is foolish. As I remember the Adventist two study showed that older women who maintained a protein intake of better than .8 gram per kilogram has better bone health and fewer fractures. I also remember a hospital study where they upped the protein intake to 1.2 grams per kilogram in elderly women who already had hip fractures and they healed faster and mortality dropped dramatically. I believe Vitamins C, D, and E plus adequate protein is required for bone health. It’s sort of tough keeping you E up if you aren’t eating nuts and seeds in an effort to keep fat as low as possible.

            • Ginny Messina May 30, 2017 at 12:41 pm #

              I wasn’t aware that any vegan docs are limiting beans to 1 cup per day. I do know that some are still suggesting that protein contributes to bone loss — despite all evidence to the contrary. You’re right that the evidence now suggests a protective role for protein — both in preventing fractures and in healing them.

              • Michael Parish May 30, 2017 at 6:03 pm #

                Dr. McDougall limits beans to one cup per day and he has soured on all soy and therefore recommends against them.

                Here is his newsletter where he puts the fear of god into anybody who even thinks about going to the emergency room with a serious problem. If he refused to have his bones taken care of after serious fractures it scares the heck out of me what his program followers are thinking when something happens to them. Will they be foolish enough to follow his example?

                https://www.drmcdougall.com/misc/2016nl/may/heartsurgeons.htm

        • Karen June 1, 2017 at 3:53 pm #

          Wow,I’m no expert but that seems like a lot of fractures from one fall. Especially for someone who is supposed to be a picture of health

          • Michael Parish June 4, 2017 at 12:27 pm #

            I agree. If he had fallen down a flight of stairs I would have understood, but to faint in your own bedroom and end up with that much damage is very telling about his bone health. His recommendation against too many beans, and soy is really telling. And the fact that he’s against vit D regardless of how far north you live is also a bit short sighted.

            But what really scared me was his write up after the fainting incident and his refusal to go the emergency room. He railed against his followers going as well. His scare tactic was to tell them they’d be stented no matter what emergency they came into the hospital with. He gave an example of his friend who did go, agreed to the stent and they almost killed him. The newsletter article I mentioned to Ginny with the url has a photo shopped picture of him bare chested with a tattoo that says, “Do not Cath or I’ll sue.”

  4. Karen June 1, 2017 at 5:18 pm #

    They are talking about you on the McDougall forums Ginny https://www.drmcdougall.com/forums/viewtopic.php?f=1&t=55618&start=45

    • Ginny Messina June 1, 2017 at 6:28 pm #

      Ha — thanks, Karen. I think I have to give that discussion a pass! I’m not especially popular among the McDougallers. :)

      • Karen June 3, 2017 at 2:35 pm #

        Yeah,they are not very nice when discussing people who disagree with him!

  5. Michael Thompson June 10, 2017 at 5:30 am #

    Hello! Thanks for being a voice of reason and science in the plant based community that is so loaded with woo woo! I just found your blog a few weeks ago, look forward to learning more. I followed McDougall for a while, but my suspicions have been confirmed that his claims are too good to be true. Another red flag for me is he is against cancer screenings on some of his videos, because he claims his diet would stop the growth of any cancers.

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