Vegetarians, vegans, and raw foodists often eat an unhealthy diet — for years or even decades. With basic information, you can avoid making the same mistakes.
© Bought from Jenko Ataman, fotolia
Numerous scientific studies have shown just how much of an effect food has on our health.1 The wrong diet, smoking, drinking alcohol,2 and a lack of exercise cause many people — often only after age 60 — to get lifestyle diseases that could have easily been prevented.3 We are drawn to cheap convenience products, but these are harmful and unnecessary. These factors and excess are also causes.
Our book review of Salt Sugar Fat explains why the government has chosen not to get involved.
Most people today eat what we would call a “normal” western diet. Only a minority follows an alternative diet, with individuals who have either healthy or unhealthy habits.
When it comes to vegetarians, vegans, and raw foodists, the main problem is that many of them eat an unbalanced diet because they don’t know the facts. They often blindly follow a certain diet trend without questioning. Problem areas include vitamin B12, Vitamin D, iodine, the ratio of omega-6 to omega-3 fatty acids, and calcium.
If you don’t eat a balanced omnivorous diet, it is important to get regular check-ups at the doctor’s office in order to identify any areas of poor nutrition. Unfortunately, most physicians have little or no knowledge about nutrition because they have been given the task of healing, not of prevention.
Informed vegans can indeed eat a very healthy diet. However, pregnant and nursing women should take careful note of certain points so that their babies can grow up healthy and strong. Problems are rare.4 Physicians should neither be blind followers of a vegan diet nor absolute critics, but instead have obtained the necessary knowledge about nutrition.
In the spring of 1978, the author (at the time 41) was given an average statistical life expectancy of only 2.6 years.5 He then faced with a number of fundamental questions that showed him a way out of his dilemma. Otherwise, he would never been able to walk from the Lucerne Train Station to the Zurich Main Train Station on his 80th birthday - 55 km and two "heights". Main "points" on the route: Reuss to the Eisenbahnbrücke (Railway bridge), Cham, Alte Lorze, Neue Lorze, and Sihl Valley.
Too many vegetarians and vegans fall into “diet traps” that don’t become apparent for some time. They follow a trend, a guru, or a book. And they will tell you that they are doing it for at least one of the following three reasons: for animals, for nature, or to stay or get healthy.
Usually, people who switch to a vegan or even raw food diet focus on the enjoyment factor rather than on the value the food has for their body. This fact is reflected in the focus of vegan (cookbooks). The Foundation G+E, Diet and Health (diet-health.info) can attest to this fact as it has reviewed more than 30 such cookbooks since 2015. You may know that a person can be a hard-core smoker or alcoholic for many years without noticing much change in their body. A person often feels just fine for a long time and then when they realize that something is wrong, it’s too late — the body can no longer heal itself.
It’s just the same with diet. Many people blindly follow a trend and don’t consider whether or not it is causing them more harm or benefit. They might feel drawn to information that promotes a certain type of diet.
Jean-Jacques Rousseaus’ novel Émile, for example, was the reason why Gustav Karl Johann Christian von Struve (1805–1870) became a vegetarian in 1832. At the time, no distinction was made between a vegetarian and vegan diet. A large number of followers of Jainism have lived vegan for more than 2500 years, generation after generation, and even without “killing” plants.
Raw foodism has been around since the time of our ancestors, but throughout our history it has been rediscovered by many including Richard Nagel with his book “Der Weg zur Gesundheit, zum Wohlstande und Glück, zum Paradies” (The path to health, prosperity and happiness, and paradise) in 1929 and Gustav Schickeysen in 1877.
Incidentally, the term “fruitarian” was entered into Merriam-Webster’s Collegiate Dictionary (English) in 1893 and is not a new movement.
Well, for example, it would be potentially dangerous to follow the 80/10/10 diet developed by Dr. Douglas N. Graham (chiropractor) as people have died as a result of following his fasting advice.6,7 However, with the right understanding of fats and proteins, you will be able to eat a healthy diet. One good habit (with about 81/10/09) to start with would be to eat Erb Muesli, a breakfast that covers the daily requirement for the essential fatty acid alpha-linolenic acid (ALA).
There are also other poor variations, for example 90/5/5, which is one variation of a low-fat raw vegan diet (LFRV). Wikipedia discusses this diet in the entry Raw veganism, which is not entirely correct.
It can also be risky, for example, to be a fruitarian for too long. Young people may enthusiastically follow a fruitarian diet for a longer period of time and combine this with a high level of physical exercise. However, this can be dangerous. See the Wikipedia article on fruitarianism.
The raw food movement has other hidden dangers, but it also holds the possibility of more success than any other type of diet. Raw foodism is highly controversial as even this type of diet can cause people to eat in an unhealthy way. An unbalanced diet and intake of nutrients is often the problem.8
Other mistakes that people make include consuming oils and certain nuts that have a poor omega-6 to omega-3 ratio. The importance of this ratio was first discovered and widely discussed in the US.
A healthy diet in the long term includes a variety of vegetables, fruits, seeds, nuts, and algae and takes into account certain factors for specific foods (recipe ingredients) that are discussed on the website diet-health.info. It would be simpler to achieve a healthy diet by eating insects or fish, at least in cases where the conversion of ALA to EPA and DHA (EPA and DHA links in German only) is not functioning properly. Just as with all types of diets, there are several points to be aware of here that we will explain below.
The Süddeutsche Zeitung (Largest newspaper in Germany) publishes many interesting articles on the topic of nutrition. One especially interesting example is an article titled “Das grosse Messen nach dem Essen” (The great measurement after eating) that includes a list of images showing a number of diet forms that originated very early or are strange in some way.
The Inuit population had a short life span. Even if you don’t take the high death rate of 0–4 year olds in account, they could only hunt until they were about 30 and after that they were “too old.” Special genes? Now even worse? What does Dr. Thomas M. Campbell have to say on this topic (son of T. Colin Campbell of The China Study)?
He debunks a study from 1964 that George Mann conducted on the Massai people, in which he showed that about 60 % of the men were younger than 44 years old and less than 1 % were over 55 years old. In addition, the study did not directly measure the subject’s dietary intake; instead the researchers used other measurements to infer that the subjects consumed high levels of animal protein (blood and milk). The result of this diet was that 35-year-olds were already considered senior citizens ...
In spite of studies that point to the contrary, many people still believe that the Inuit population has fewer cardiovascular problems than we do. However, these claims from the 1960s have been disproved by multiple scientific studies. See 2003 and 2010.10,11 In addition, this type of diet is associated with a low bone mineral content, a problem which has been known since 1974.12
Nevertheless, there are still many people who eat a paleo diet (also called caveman or stone-age diet), a diet form that was introduced by Walter L. Voegtlin in 1975. This type of diet is related to the low-carb principle and the Atkins diet from 1972. The criticism of both diets is not always justified, and the various phases of the Atkins diet are difficult to recognize. However, in general it is clear that eating these diets over the long term can be harmful. The German magazine Der Spiegel writes about the risks of a low-carb diet: “Five grams more of protein per day can increase the risk of cardiovascular diseases by 5 %.”13 In 1991–92, a total of 96'000 women in Sweden were asked to complete a questionnaire with questions about their dietary habits. Of the total number, 49'000 returned the questionnaire and 43'396 of these women were then followed until 2007. The results gave a clear picture of the dangers of a low carbohydrate-high protein diet and drew attention to the potential for considerable adverse effects on cardiovascular health of these diets when they are used on a regular basis.14
Going beyond the norms (social norms) is more difficult as there is usually a lack of set guidelines. Young people are often swept along by trends that don’t receive any criticism. Such trends can cause us to eat unbalanced diets and have deficiencies that don’t necessarily have to be apparent. We can also end up consuming too much of certain essential substances. What are the critical nutrients? How can we determine if we have a deficiency or a dangerous excess of certain nutrients? Is it easier to eat a healthy diet as a vegan or as an omnivore? The critical nutrients are listed below in order of importance.
There are many good reasons to cut out animal products, but we shouldn’t take too narrow of a view.
In general, we should focus on eating a variety of unprocessed, natural foods that are rich in nutrients (whole foods diet). We might think that as long as we consume vegetables, fruits, lentils, some grains and rice, nuts, seeds, and water that we will be healthy. That is true, but only if we make sure that we are eating a balanced diet. No matter if you eat meat or not, if you don’t pay attention to the points below it is very easy to end up having a deficiency that while you don’t notice it, it can shorten your life span.
Whether or not you eat meat or not, it is best to get certain parameters checked by having regular blood tests and urine analyses done. You should do this when you begin to change your diet and again a year later to provide a base comparison — the results will determine how often you should get certain values checked thereafter.
Most people pay more attention to the enjoyment factor and not to how the foods they eat can promote their health. It is said, for example, that it takes about three months to get used to less salt and to develop a preference for foods with a lower salt content.
Not everyone is aware of the fact that meat eaters can also develop a vitamin-B12 (in German only) or cobalamin deficiency. The risk of this happening is especially high for older people. There is a good reason why our body has an amazingly well-organized storage system. We can get by even if we only consume very small amounts of B12 at each meal. Our body can only absorb about 1 to 2 µg from the food we eat at a meal, but we only need 2 to 3 µg per day. In addition, our bodies store a supply that will last for three to five years.
Nevertheless, vitamin B12 or cobalamin deficiencies in the body are frequent and often go undetected. Vegans consume a lot of vitamin B6, and this can cover up a vitamin-B12 deficiency. “Vitamin B12” is actually a coenzyme (cofactor) and not the vitamin. A study conducted in 2010 showed that 52 % of vegans with less than 118 pmol/l have a deficiency in vitamin B12.15
If you have even a moderate deficiency, your body will suffer. A deficiency can cause weakness and even shorten our lives, without us even noticing. It usually takes several years until problems begin to manifest. But in the case of pregnancy and breastfeeding, having irregular levels can be tragic. Cobalamin is responsible for cell division, blood formation, and a functioning nervous system. Over the long term, a deficiency can cause dementia and neuropathies.
Certain bacteria produce vitamin B12, a vitamin that contains cobalt as a central atom. This also occurs in our large intestine. But unfortunately we can’t absorb vitamin B12 here even if we eat meat regularly. We need an intact production of the glycoprotein “intrinsic factor,” which acts as a transporter, as well as a properly functioning small intestine. In the small intestine, it is the terminal ileum (final section) that can absorb vitamin B12.
Plant-eating mammals solve this problem in an entirely different way. For example, rabbits have bacteria in their cecum that produce the essential vitamin B12. They then eat the caecal pellets directly from the anus (see cecotropia).16 Coprophagia is a similar behavior exhibited by rodents, dogs, and other animals. Gorillas and bonobos also eat some feces and soil.17 Cows consume these bacteria via grass that naturally sometimes also contains fertilizer.
In earlier times, we didn’t have the same type of hygiene that we do today when it came to the drinking water and soil on vegetables — and in this way we got enough B12. A number of followers of Jainism have lived vegan from generation to generation for over 2500 years and they even do so without “killing” plants. They are one of the most economically successful groups in India because they were never able to be farmers and therefore had to follow other career paths.18
Vegans, vegetarians, and all older individuals need to take special measures to make sure that they are getting enough vitamin B12 (in German only). Vitamin B12 is available as a number of different types of cobalamin. For some time, it was thought that certain plants and the bacterium spirulina contained vitamin B12, but it was then discovered that these were only analogs. Spirulina maxima contains the pseudovitamin B12, which contains the same receptors but doesn’t have the same effect as vitamin B12. In fact, the pseudovitamin can even be harmful.
Fermented vegetables; some types of algae; legumes such as peas, beans, and lupine; and Zingiberales such as ginger contain a very small amount of vitamin B12.19
About 1 to 3 % of the dietary cobalamin enters the bloodstream without first binding to IF via an unspecified mechanism via the gastrointestinal tract or the oral mucous membranes. If large quantities are consumed orally, this passive cobalamin absorption becomes increasingly important.20
We can prevent a deficiency by taking cobalamin daily, for example, in the form of a lozenge, tablet, or spray. One milligram per day is sufficient. Alternatively, you can get an injection of 1 ml of cobalamin every four to six months, if possible, it should contain the biologically active form adenosylcobalamin (AdoCbl or extrinisic factor) or methylcobalamin and not cyanocobalamin. The latter type of cobalamin has a lower half-life period in the body and has to be converted to other forms, which causes the body to excrete very small amounts of hydrocyanic acid. Instead of taking cobalamin daily, I give myself an injection in the stomach area using a dental needle with a diameter of 0.4 mm, instead of 0.8, 0.9, or even 1.2 mm needle, which I only use to draw fluid into the syringe.
The best way to determine a deficiency is to have the homocysteine concentration in the blood checked. Elevated levels indicate a B12 deficiency and/or a folic acid deficiency. Checking the vitamin B12 levels in the blood is more inexpensive, but the results are not as accurate. If you suspect a deficiency, you can also have the levels of methylmalonic acid (MMA) in your urine checked. The methylmalonic acid urine test is a reliable indicator of a B12 deficiency. The concentration of MMA is measured in comparison with the concentration of creatine so as to account for any variation in the excretion capacity of the kidneys. In addition, the concentration of holo-transcobalamin in the blood serum is also a reliable marker. The Schilling Test or deoxyuridine suppression test (DUST) is only used to determine the cause of a B12 deficiency when the cause is not diet.
In the temperate climate zones, everyone needs to give special attention to this problem. We can only absorb a portion of the vitamin D (in German only) we need from the foods we eat, and we therefore need to spend time in the sun. However, after about 20 minutes of exposure to UVB radiation without wearing sunscreen, the production of vitamin D stops.
We can also get enough vitamin D in winter if we spend time in the sun at elevations of 1500 meters or higher. Below this elevation, the angle of incidence is such that there is too much air mass between the sun and ourselves and the body can’t produce vitamin D. The half-life period of our reserves is about three weeks.
The dermatologist Dr. Richard Weller explains in this TED Talk why it is important to have exposure to a certain amount of sunlight. UVA lowers blood pressure and therefore helps ward off cardiovascular diseases while UVB provides us with the vitamin D we need. The study shows that people die a hundred times more often from cardiovascular diseases than from skin cancer.
It is important to have a good balance of UV radiation — and to know that neither tablets nor diet can truly solve the problem of a vitamin D deficiency. See also the original study in the Oxford Academic European Heart Journal.21
This link contains ingredients and recipes that contain high levels of vitamin D. Mushrooms and avocados (DEBInet 3.43 µg/100 g), in particular, can provide significant levels of this vitamin. We consume 10 to 20 % of the daily requirement of vitamin D via diet. The WHO (2004) recommends that children and adults up to 50 years old consume 5 µg/day, adults between 51 and 65 then 10 µg/day, and over 65 then 15 µg/day.
The amount of vitamin D is labeled in a variety of ways: one unit of vitamin D (IU) is equal to 0.025 micrograms (µg) or rather 1 µg corresponds to 40 IE. In addition, a number of official and important organizations recommend different amounts of vitamin D per day — for example, the German nutrition society (Deutsche Gesellschaft für Ernährung e. V., DGE) recommends between 800 and 2000 IE, which is between 20 and 50 µg. You cannot get an overdose of vitamin D from sunlight or diet but if you take supplements of 100 µg/day or more (i.e., more than 4000 IE/day), you are at risk. A good treatment approach is to take 4000 IE (IU) of cholecalciferol (vitamin D3) in oil form for a limited period of time.
Blood tests measure the concentration of calcifediol (25-OH-Vitamin D3) in the blood, a prehormone which is produced by hydroxylation of cholecalciferol (Vitamin D3). Where necessary, the body (kidneys and cells) transforms calcifediol into the hormone calcitriol (1,25-Dihydroxy-Vitamin-D3). Vitamin D regulation can be disrupted by a thyroid disorder or severe magnesium deficiency. In these cases, the calcifediol levels are too low and the calcitriol levels too high.
The German Wikipedia entry on vitamin D delves deeper into the issue and refers to additional scientific literature. In recent years, knowledge about the topic has increased, but the average person has not yet heard about the following:
Calcitriol is found in much lower concentrations in the body than calcifediol and is generally bound to VDBP. The concentration of free calcitriol, in particular, is highly regulated and largely correlates with its activity. The levels are mostly independent of the concentration of it precursor calcifediol or of VDBP. ... Our diet usually only covers 5 to 20 % of the daily requirement of vitamin D. It is therefore essential to have direct exposure to the sun so that vitamin D3 can be produced.
The following study shows that the average vitamin D levels in Germany are only 16 ng/mL: Kipshoven, Christoph. Querschnittsstudie zur Abschätzung des Vitamin-D-Status in der Bevölkerung in Deutschland (Cross-sectional study to estimate vitamin D levels in the German population, DEVID-Studie). Diss. Cologne, Univ., Diss., 2010, 2010. Nevertheless, there is still much controversy in the field because supplements are a big business.
Calcifediol levels can be checked by a simple blood test — a drop of blood from the finger can be used as a blood sample or a nurse or physician can draw blood intravenously. There are tests that you can do at home by taking a few drops of blood from the finger and then sending the sample into a laboratory. In Switzerland, we get the results back within two days. Vitamin B producers recommend that you have a value between 35 and 60 ng/mL, which corresponds to 87 to 150 nmol/L. If the value is less than 20 ng/ml (50 nmol/l), this indicates a deficiency.
Iodine is necessary for the synthesis of thyroxine (T4) and triiodthyronine (T3). Most countries have taken specific measures in order to make sure that the population can get enough iodine by eating a standard diet. Iodine is usually added to table salt and as such is present in many processed foods. The US RDS has set the recommended daily allowance for iodine at 150 µg (200 µg for pregnant women). The recommended maximum daily amount is 500 µg, but iodine is only toxic at levels twice this amount.
Individuals who eat a natural foods diet do need to pay particular attention to iodine.
See this text on the brown alga bladder wrack. One gram of bladder wrack contains 3000 µg, which is equal to 3 mg or ten times the daily requirement for iodine. The iodine content can be reduced by over 95% if the algae are soaked (and water changed out) and/or cooked for several hours. In contrast, the brown alga wakame supplies acceptable amounts ranging from 4200 to 10'000 µg/100 g. This number might seem high, but most people eat wakame only occasionally and then in smaller amounts. In contrast, red algae such as nori sheets contain only about 300 µg/100 g.
Since our body stores between 10'000 and 20'000 µg (enough for a year), you can easily maintain the required levels of iodine by eating some wakame every month. Wakame looks like it is raw, but it isn’t. Once you understand the basics about iodine, it really isn’t a problem because the body can store large amounts and the tolerance levels are much wider than with other nutrients.
In the collapsible text, you can see how much iodine the most common sources of this nutrient contain. These include brown algae, spirulina, and rot algae seaweed. Based on these values, you can make a plan that works for you to make sure you are occasionally eating foods that contain enough iodine. There are also other foods that contain at least traces of iodine. However, regulatory authorities don’t require food companies to label this, and the information is therefore usually not included.
It is important to make sure that your total monthly iodine consumption does not exceed 20'000 µg (20 mg). Stiftung Warentest (German consumer organization) warns that this can happen if you eat Assi Brand Drier Seaweed (not dried), Eaglobe Seaweed Sheets, or Eaglobe Dried Seaweed.22 The organization advises against consuming these products. However, this warning doesn’t apply to Japanese who genetically have a much higher tolerance limit.
With sufficient supply, excretion via urine should be more than 75 µg iodine per gram of creatinine.23,24
|Kelp (Laminaria)||Brown algae||300'000|
|Bladder wrack||Brown algae||300'000|
|Kombu algae||Brown algae||200'000|
|Arame algae||Brown algae||70'000|
|Nori sheet **||Red algae||317|
|Irish moss||Red algae||50|
|Dried porcini mushrooms||Comparison||27|
* Spirulina was categorized as a blue-green algae until it was discovered that it is actually cyanobacteria.
** Nori sheets usually weigh only 2.5 to 3 grams per sheet and are usually lightly roasted and then have a greenish color instead of a dark brown. Sources on the Internet also list nori as containing up to 8000 µg/100 g.
Federal Institute for Risk Assessment (Das Bundesinstitut für Risikobewertung, BfR) do not permit algae products with an iodine content of 2000 µg/100 g or higher as they could be harmful to our health (2004).
The Swiss authorities have distributed potassium iodide tablets (65 AApt) to all of the households and businesses that lie within 50 kilometers of a nuclear power plant. In the event of a nuclear disaster, everyone would be instructed to take two tablets per day (100'000 µg iodine/day). The iodine tablets work against radioactive iodine isotopes such as Iodine-131 and protect against thyroid cancer. In Germany, similar tablets would be distributed to the population in a radius up to 100 km away from a disaster site. Iodine-31 has a half-life of eight days. This iodine excess can cause hyperthyroidism, Graves’s disease, and Hashimoto’s thyroiditis and also cause a severe blockage of iodine absorption (Wolff-Chaikoff effect). The latter is definitely the lesser evil.
It wasn’t until around the year 2000 that scientists discovered that vegetarians, vegans, and raw foodists generally have a poorer ratio of these two essential fatty acids as compared to omnivores. Linoleic acid (LA), an essential omega-6 fatty acid, and alpha-linolenic acid (ALA), an essential omega-3 fatty acid, should ideally be in a ratio of 1:1. Simply put, after the body converts the two essential acids, LA tends to promote inflammation and ALA to prevent inflammation. In the mid-twentieth century in Japan, there was still an average ratio of 2:1. But in the industrial countries, we are happy to have a ratio of 4:1 or 5:1 instead of around 10:1 or higher.25,26
Information about this topic is found primarily in the US because the level of suffering and poor health is higher there than in Europe. Dr. Michael Klaper, a prominent physician from the US, explains the problem in a YouTube video. He debunks the myth that a Mediterranean Diet is a healthy choice.
Dr. Michael Greger, another leading physician, gets to the heart of the issue and describes the situation in a very transparent manner. Although he is advocating that we eat an oil-free diet, his high voice and unusual gestures unfortunately distract from the issue at hand. His talk was recorded in 2003 — since then, not much has changed!
As necessary, our body transforms ALA, the only essential omega-3 fatty acid, into eicosapentaenoic acid (EPA) and then when needed further into docosahexaenoic acid (DHA) (in German only). Both of these nonessential long-chain omega-3 fatty acids are found in fatty fish.
Vegans, vegetarians, and plant-based raw foodists can get the daily recommended allowance for the essential omega-3 fatty acid ALA and work toward achieving the ratio of 1:1 by starting their day with Erb Muesli. This special muesli also has other positive effects — see the nutritional information in the tables below the recipe.
I have eaten this muesli every day for breakfast for many years now — even when I am on holiday as I take the seed mix and an electric coffee grinder with me. Although I have an above-average level of fitness, I wanted to know whether or not the effects of Erb Muesli could be detected in my blood, and I therefore had the fatty acid levels analyzed on July 14, 2017 (Cost: 250 SFr).
The results were as I had hoped. The report showed the following: A very unusual constellation can be seen in the polyunsaturated omega-3 fatty acids. First, there is a significantly elevated concentration of alpha-linolenic acid (ALA). This essential omega-3 fatty acid is at 41 mg/l and as such well above the average value of 15–33 mg/l. And the “harmful” linoleic acid (LA) is at the lower end of the normal range.
Other values such as low cholesterol were also identified. The saturated fatty acids myristic acid, palmitic acid, and stearic acid were all under the normal values. This also showed a positive difference from the normal Western diet. The same was true for the simple unsaturated palmitoleic acid and oleic acid. And I also had lower levels of the inflammation-promoting arachidonic acid (AA), which the body produces from LA (120 mg/l instead of the normal 185–340 mg/l). This result was most likely because I have cut out oil from my diet for many years now.
However, the test showed lower values for EPA and DHA, which points to a possible insufficient desaturase. I want to determine whether this is caused by a large loss of blood that I had for over a year due to a bladder papilloma or if the body only produces what it needs. I had the papilloma removed via TURBT (Trans urethral removal of bladder tumor) on July 17, 2017, more than 12 years after it was detected.
The following books written by physicians in the US recommend completely cutting out oil from your diet:
Dr. John A. McDougall: The Starch Solution: Eat the Foods You Love, Regain Your Health, and Lose the Weight for Good!
Dr. Michael Klaper: Pregnancy, Children, and the Vegan Diet
Dr. Caldwell B. Esselstyn: Prevent and Reverse Heart Disease: The Revolutionary, Scientifically Proven, Nutrition-Based Cure
Dr. Michael Greger: How Not to Die: Discover the Foods Scientifically Proven to Prevent and Reverse Disease
Dr. Joel Fuhrman: The End of Dieting: How to Live for Life
There are certainly other physicians who recommend cutting out oil, but I felt that this list was representative and did not include additional sources. Another interesting book that covers the subject of oil is Dr. Neal D. Barnard’s Power Foods for the Brain: An Effective 3-Step Plan to Protect Your Mind and Strengthen Your Memory.
From Wikipedia Vegan nutrition:
1 Basic information
Basically, if you are well-informed about areas to pay special attention to, you will be able to thrive on a vegan diet, but eating vegan without this knowledge may cause you to experience health problems. In addition to the nutrients discussed above, vegan diets may also be deficient in iron, zinc, and riboflavin (vitamin B2) (links in German only).
With the nutritional information for the three recipes from the more than 30 new vegan cookbooks that we provide, we can’t confirm these common problems. However, extremists, fruitarians, and others may experience these.
The risks of an EPA or DHA deficiency are unclear as these are not essential fatty acids; they are fatty acids that our body can produce from ALA (alpha-linolenic acid) — most likely it produces only the amount that it needs at any given time.
A quote from this Wikipedia entry:
While a well-planned, balanced vegan diet is suitable to meet all recommendations for nutrients in every stage of life, improperly-planned vegan diets may be deficient in vitamin B12, vitamin D, calcium, iodine, iron, zinc, riboflavin (vitamin B2), long-chain fatty acids EPA and DHA, and omega-3 fatty acids.
Includes the following sources:
High-risk groups such as vegetarians, adolescent girls and women athletes need to eat iron-rich foods each day (combined with foods that are high in vitamin C). … Vegetarians who exclude all animal products from their diet may need almost twice as much dietary iron each day as non-vegetarians. Sources include dark green leafy vegetables — such as spinach — and raisins, nuts, seeds, beans, peas, and iron-fortified cereals, breads and pastas.[unreliable medical source?]
2 What do prominent physicians write?
The eight physicians listed before are the most well-known American advocates of a healthy diet. All eight strongly recommend avoiding oil. Only when it comes to nuts is there disagreement between Joel Fuhrmann and Michael Greger.
We would emphasize that it is important to choose nuts that have a good ratio of LA:ALA — and we provide this ratio for our ingredients and recipes — and in the table that lists essential nutrients (found below each recipe and ingredient).
Doctors Dean Ornish, T. Colin Campbell, John A. McDougall, Michael Klaper, Caldwell Esselstyn, Michael Greger, Joel Fuhrman, and Neal D. Barnard claim that high animal fat and protein diets, such as the standard American diet, are detrimental to health.[hier 1,2,3] They also state that a lifestyle change incorporating a vegan whole foods diet could not only prevent various degenerative diseases, such as coronary artery disease, but reverse them.[hier 4,5,6,7,8] A number of documentary films, such as Fat, Sick and Nearly Dead, Planeat and Forks over Knives, focus on the purported health benefits of plant-based diets. Although there is general consensus amongst doctors advocating plant-based diets, Joel Fuhrman and Michael Greger have disagreed with Campbell and Esselstyn on the use of nuts and seeds.[hier 9]
Includes the following sources:
Set aside animal products
Even raw foodists are misled when it comes to oils and without realizing it the oils they consume can shorten their life span and cause inflammations such as coronary artery disease (CAD). In this respect, many raw foodists, vegans, and vegetarians are eating an unhealthier diet than omnivores, and on average they have alarming ratios of omega-6 to omega-3 fatty acids (e.g., from 17:1 to 24:1).
Long-term effects include inflammations and pain, “thick” blood, higher blood pressure, less stability with blood glucose, more triglycerides and LDL cholesterol, more allergies, rheumatoid arthritis, dementia (incl. Alzheimer’s), digestive problems, depression, and others.27
Nothing has only advantages or disadvantages. And the food industry understands the power of presenting studies — although these are normally one-sided and naturally put oil in a good light.
Very few oils have a good ratio of omega-6 to omega-3 with the exception of flaxseed oil (1:3.7) and canola oil (approx. 2:1). Walnut oil (5:1) is on the border whereas olive oil (11.5:1) has a poorer ratio and is consumed in large quantities. According to studies (see link), the greatest successes for absolute risk reduction (ARR) can be achieved by making sure that 20 % or less of the total calories consumed are from fat.
In general, we know that for technical reasons processed foods have a poor ratio of omega-6 to omega-3 that can be detrimental to our health. A keyword here is trans fat.28
For each group of products, the table starts the product with the best ratio and ends with the worse.
|LA g/100 g||ALA g/100 g||LA:ALA||Monounsat.||Saturated||Fat g/100 g|
|Flaxseed oil (cold-pressed)||14.28||53.09||1:3.7||18.44||8.98||99.5|
|Canola oil (cold-pressed)||18.97||9.42||2:1||63.28||7.36||99.5|
|Olive oil (extra virgin)||8.24||0.78||10.6:1||72.96||13.81||98.11|
|Pumpkin seed oil||47.74||0.49||97:1||28.01||17.65||99.30|
|Sesame oil (cold-pressed)||42.05||0.35||120:1||39.7||14.2||99.5|
|Coconut oil, virgin *||1.34||0.01||127:1||6.33||82.48||99.60|
|Sunflower oil (cold-pressed) *||64.70||0.11||616:1||19.5||10.3||99.5|
|Hemp seed (shelled)||30.36||8.74||3.5:1||7.50||4.00||50.60|
|Sea buckthorn berries||2.60||1.80||1.4:1||7.10|
This information comes from the USDA (US Department of Agriculture) and Önwt (Österreichische Nährwerttabelle: Austrian nutrition table) as well as in a very few cases from Debinet (Deutsches Ernährungsberatungs & Informationsnetz: German nutrition advising and information network). In these cases, we have used the average value.
* Ingredients for which different source provide widely differing information.
The dairy industry makes sure that the daily recommended allowance for calcium (in German only) is generously calculated (e.g., reference values for German, Austria, and Switzerland range from 1000 mg to 1.2 g per day whereas the NHS in England lists 700 mg). There are very good reasons for this lower value.29
It is interesting to note that in non-milk-drinking countries the WHO recommends 400–500 mg/day of calcium and in milk-drinking countries 900–1500 mg/day. All recommendations take into account that we can only absorb 20 to 40 % of the calcium we consume. However, if enough vitamin D is present then we are able to absorb a higher percentage.
Consuming too much protein (phosphates) is the main reason for calcium loss. This is primarily the case with dairy products, meat, and eggs; these contain high levels of sulfur-containing amino acids (amino acid metabolism) and sodium, which cause large amounts of calcium to be loss. The Federal Supreme Court of Switzerland accordingly ruled in 2001 that the dairy industry may no longer use the slogans “Milch macht starke Knochen” or “Milch gibt starke Knochen” (Milk makes/gives us strong bones) and that the industry may no longer claim that the calcium contained in milk is effective in the fight against osteoporosis.30
The market for food additives is unfortunately very lucrative, which is why companies in the food industry produce scientific studies and invest huge amounts of money in marketing. The dangers then remain hidden as this unbiased study from May 2017 shows.31
Countries that consume only small amounts of milk and dairy products have a much lower incidence of osteoporosis — and the reverse also holds true.
Practically all natural spices contain high levels of calcium, usually more than 1 % of their weight (e.g., dried basil contains 2.2 g/100 g); however, we generally only consume spices in small amounts. In addition, poppy seeds contain 1438 mg, sesame seeds 780 mg to 1 g, chia seeds 630 mg, and mustard and nettles 500 g. Almonds and flaxseed contain 250 mg. Soy beans, a number of leafy greens, nutmeg, garlic, and beans come in at 200 g, amaranth contains 500 g, and kale, wakame, turmeric, and arugula provide 150 mg. Somewhat lower levels are found in cocoa beans, wasabi, water cress, spirulina, hazelnuts — and finally in milk.
Peanuts, pistachios, broccoli, pak choi, chicory, fennel, walnuts, borage, chives, and macadamia nuts contain 100 mg/100 g. And a number of vegetables, nuts, and seeds provide about half this amount. As a result of the oxalic acid contained in rhubarb, Swiss chard, and spinach, we can only absorb a little of the high amounts of calcium they contain.
The values above show that vegans who eat a balanced whole foods diet can easily get enough calcium by eating vegetables, spices, herbs, nuts, and seeds. In addition, these foods are mostly alkaline and the calcium can be easily stored instead of being pulled out of the bones, which is what happens in the case of dairy products.
You can also ensure that you get enough calcium by drinking mineral water that contains high levels of this important nutrient. The table below shows the amount of calcium contained in 100 ml. Theoretically, you could cover the daily recommended allowance for calcium by drinking 2 liters of mineral water. However, you would have to pay careful attention to the amount that different brands contain — this can range from 1 mg/100 ml to more than 60 mg/100 ml.
Tab drinking water (soft natural drinking water without addings) as an example: Meggen from mountain source has 41.3 mg/l (ie 4.1 mg/100ml) of calcium at pH 7.93. This is 12 times less than a selected mineral water. At least in Switzerland (see this map) the drinking water varies greatly, from about 0.2 mg/100ml to 15 mg/100ml depending on city. With a few exceptions like Schaan of 41 mg/100ml. Also pay attention to the magnesium content.
|D: Name (sparmedo)||mg/100 ml||A: Name (mokant)||mg/100 ml||CH: Name (profarma)||mg/100 ml|
|St. Anna Heilwasser||60||Long Life||27||Adello||53|
From the book Milch besser nicht! (Milk, better not!): We know that the calcium in milk and other dairy products isn’t absorbed into the bones because of the pH, but that it saturates the blood which inhibits the formation of Vitamin D. However, Vitamin D is important in the differentiation of healthy prostate cells and also helps to prevent cell proliferation. As a result, the fact that calcium from milk is somewhat more easily absorbed than calcium from plants is not particularly relevant. Milch, besser nicht! is probably the best of the numerous books published on this almost taboo topic of milk and dairy products.
Our body uses about 30 to 40 percent of the calcium we consume. Depending on the amount of phosphate and sulfur-containing amino acids, a large amount of calcium can be lost through our urine. Consuming too much protein is a major cause of calcium loss. Phosphate binds to calcium to form solid calcium apatite. The phosphate levels in the body are closely connected to the calcium levels.
Dairy products, meat, and eggs, in particular, contain high levels of sulfur-containing amino acids (amino acid metabolism) and sodium, which are responsible for the high level of calcium loss. ... Milk is low in magnesium, but magnesium is necessary for calcium transport and absorption. ... Vegetables are one of the best sources of magnesium — and in vegetables, it is found in the calcium-magnesium ratio we need. ... We also read that phosphates, oxalates, phytin, fiber, alcohol, and coffee act as calcium antagonists and calcium killers. In addition, the phosphates in other animal products and also in grains lead to a less than optimum calcium-phosphate balance (C-P-B), which causes additional calcium to be excreted in the urine.32
We can assume that individuals who do not consume milk and dairy products have a lower daily requirement and that the necessary amount in the bloodstream is lower for vegans than omnivores. In fact, bone brittleness only occurs if less than 600 mg/day of calcium is consumed over a longer period of time.33
It is, of course, important to make sure that small children are consuming good natural sources of calcium.
A 24-hour urine test can show you the current state of your calcium intake. Normally, there is between 100 and 300 mg/day of calcium in urine samples collected over a period of 24 hours. A blood test can provide the same information. Normal calcium levels range from between 8.5 and 10.2 mg/dL.
Vegans who eat a balanced whole foods diet have no problem getting enough zinc. This is also true for riboflavin (vitamin B2), niacin (vitamin B3), and pantothenic acid (vitamin B5). And it is strange to see texts that list folic acid (vitamins B9 and B11) as problematic because vegans who eat a healthy diet tend to get this nutrient in excess.
A healthy vegan diet also provides more than enough of the essential amino acids — with the exception of methionine, for which the necessary amount is usually just met. However, vegans get enough L-cysteine, which the body can then use to produce methionine. Sunflower seeds, walnuts, and lentils are good sources of essential amino acids.
It is interesting to note that you will have no problem meeting the recommended daily allowance for iron (links in this section in German only) if you eat the vegan recipes found on the website diet-health.info. This website is unique in that it provides nutritional information on the essential nutrients for almost every ingredient.
Thanks to major medical advances since the end of the Second World War, we have been able to steadily increase our life expectancy. This has occurred even though the modern diet and lifestyle habits most of us have are quite poor.34 The result is an ever increasing number of people with poor health and significant limitations instead of individuals who are enjoying good health in old age.
Eating excess protein in the form of meat and grains is one of the main causes of civilization diseases and obesity. We would rather hear the hopeful prognoses for increasing life expectancy than to reflect upon the causes that are leading our affluent society into a state of degeneration.
It would be much better to focus on recommendations as to how we can really eat a healthy diet — even as vegans. Or especially as vegans? There is probably no other subject that we hear more differing views on than health and diet. And this has good reasons. In brief salt, sugar, and fat can be used to create best-selling products that meet our “bliss point.” This is the point when palatability is at its highest and we crave more, which occurs in the amygdala in the core of our brain. Our brain connects results with emotions and then releases endorphins called opiode peptides, which work in the same way as opiates.
The agriculture and food industry have the money and power to tempt us day in and day out with such products. These industries also have great influence on politics. And for the media, the revenues from advertising are very important. Doctors are usually not well informed on the subject of nutrition as this subject is not included in their training. And our family and society also “determine” our health and lifestyle habits.35
I’m not sure whether or not what top athletes do is really healthy, but it does show what a vegan lifestyle can accomplish.
Athletes such as Brendan Brazier, Scott Jurek, and Patrik Baboumian have eaten vegan for many years and naturally take a vitamin B12 supplement.
A vegan diet tends to contain more fiber, magnesium, folic acid, vitamin C, vitamin E, iron, phytonutrients, and other healthy substances. And it has fewer calories. However, a vegan diet is low in saturated fats, cholesterol, long-chain omega-3 fatty acids, vitamin D, calcium, zinc, and vitamin B12, as we can read in the Wikipedia entry on vegan nutrition.
Brendan Brazier (born 1975) is a former Ironman athlete who has won many races including the 50K run at the national Harriers Elk/Beaver Ultras in 2003 as well as the 50K ultramarathon in Toronto in 2006. In his books, Brazier advocates eating a vegan diet with a high proportion of raw food and avoiding highly processed foods, sugar, and grain products containing gluten.*
The extreme athlete Scott Jurek (born 1973) has been vegetarian since 1997 and vegan since 1999. His greatest victory is inevitably the 2168 miles he ran on the Appalachian Trail thru-hike in 2015, where he set a new record of 46 days, 11 hours, and 20 minutes (3 hours faster than previously). Scott Jurek has set so many records, some of which have not yet been broken, that it would be too much to list them out here. Please see the Wikipedia entry.
The strength athlete Patrik Baboumian (born 1979) has been vegetarian since 2005 and vegan since 2011. In 2011 he won the title of Germany’s strongest man and in 2012 he set the world record in beer keg lifting (150.2 kg) and the front hold (20 kg for 1:26:14 minutes). In 2013 he set the world record of the yoke walk carrying 550.2 kg over 10 m in Toronto.
Some athletes, such as Brendan Brazier, follow a vegan diet, including raw veganism.[hier 2] Other examples of endurance and strength include ultramarathon runner Scott Jurek, who has set several records, and has won two dozen ultramarathons on a vegan diet, and strongman competitor Patrik Baboumian, who has set 4 strongman world records while vegan.
Vegan diets tend to be higher in dietary fibre, magnesium, folic acid, vitamin C, vitamin E, iron, and phytochemicals, and lower in calories, saturated fat, cholesterol, long-chain omega-3 fatty acids, vitamin D, calcium, zinc, and vitamin B12.[hier 3] Because uncontaminated plant foods do not provide vitamin B12 (which is produced by microorganisms such as bacteria), researchers agree that vegans should eat foods fortified with B12 or take a daily supplement.[hier 4]
With the sources
As described above, vegans who eat a balanced whole foods diet tend to get enough zinc, riboflavin (vitamin B2), niacin (vitamin B3), and pantothenic acid (vitamin B5). However, this means that vegans who don’t eat a balanced diet are in danger of having deficiencies in the long term. And this is even more true for omnivores. If we consider the foods that are rich in these nutrients, we can understand why omnivores are more likely to be deficient.
You can see here that eating legumes is a good way to get all five of these nutrients. Legumes include beans, peas, peanuts, chickpeas, lentils, sweet peas, soy beans, and lupine.
A folic acid deficiency can have very serious consequences. Such a deficiency caused by poor diet during pregnancy can sometimes result in neural tube defects. We need folic acid to make DNA. At the very least, women who could be pregnant must make sure that they are getting enough folic acid
A deficiency of vitamin B12, vitamin B6, or folic acid can cause there to be elevated homocysteine levels in the blood. This can cause damage to the blood vessels and lead to an increased risk of cardiovascular diseases and arteriosclerosis. In addition, a link has been found between low folic acid levels and depression, as well as dementia in old age.
The risk of cardiovascular diseases (CVD) increases as a result of elevated values of the amino acid homocysteine in the blood. These diseases include high blood pressure, coronary heart diseases, heart attacks, and problems with the arteries. Our body uses folic acid and vitamin B12 to convert homocysteine into methionine (in German only).36
Alternatively, homocysteine can be converted into methionine with the help of the coenzyme trimethylglycine. For this to occur, there must be sufficient levels of vitamin B6.
In 2015, the German nutrition society (Die Deutsche Gesellschaft für Ernährung e. V., DGE) recommended 300 µg of folic acid daily and 550 µg for women who are trying to get pregnant (during the period from before conception to early pregnancy). A deficiency of folic acid or the other nutrients listed above can be determined by measuring the levels of homocysteine in the urine. A histidine metabolic loading test can be used for the diagnosis of a folic acid deficiency. Unfortunately, elevated folic acid levels can cover up a vitamin B12 deficiency.
Vegans who eat a balanced diet get plenty of iron; in fact, they are much better off than omnivores who eat an unbalanced diet. Our body can absorb the iron found in foods such as leafy greens, red beets, cress, whole grain products, legumes, and nuts. When eaten together with vitamin C (in German only), for example, in bell peppers, cauliflower, broccoli, or a glass of orange juice, the iron in plant-based products can be better absorbed. Thanks to the high amounts of vitamin C that vegans consume, larger amounts of trivalent iron can be converted into divalent forms that are easier to absorb. Omnivores get iron from meat and eggs.
1. Metz M, Hoffmann I. “Effects of Vegetarian Nutrition–A Nutrition Ecological Perspective.” Nutrients. 2010;2(5):496–504. Available from: ncbi.nlm.nih.gov/pmc/articles/PMC3257660/.
2. Roerecke M, Rehm J. “Alcohol intake revisited: risks and benefits.” Curr Atheroscler Rep. 2012 Dec;14(6):556–62. Available from: ncbi.nlm.nih.gov/pubmed/22864603.
3. Metz M, Hoffmann I. “Effects of Vegetarian Nutrition — A Nutrition Ecological Perspective.” Nutrients. 2010;2(5):496–504. doi:10.3390/nu2050496. Available from: ncbi.nlm.nih.gov/pmc/articles/PMC3257660/.
4. Piccoli GB, Clari R, Vigotti FN, Leone F, Attini R, Cabiddu G et all. “Vegan-vegetarian diets in pregnancy: danger or panacea? A systematic narrative review.” BJOG. 2015 Apr;122(5):623–33. Available from: ncbi.nlm.nih.gov/pubmed/25600902.
5. Ernst E. “Tragedies, Fatal Disease, Health, and Life!” [Internet]. Switzerland; 2015 [cited 2017 Oct. 24]. Available from: https://www.diet-health.info/en/100001/papers/6156/personality/tragedies-fatal-disease-health-life.
6. Haeske R. “Breaking News: Dr. Douglas Graham Removed as Moderator at Vegsource Forum.” United States, Oregon; 2014 [cited 2017 Oct. 24]. Available from: rogerhaeske.com/?p=2122.
7. Florida Department of Health. License verification. Available from: appsmqa.doh.state.fl.us/MQASearchServices/HealthCareProviders.
8. Clarys P, Deliens T, Huybrechts I, Deriemaeker P, Vanaelst B, De Keyzer W, et al. “Comparison of Nutritional Quality of the Vegan, Vegetarian, Semi-Vegetarian, Pesco-Vegetarian and Omnivorous Diet.” Nutrients. 2014;6(3):1318–1332. Available from: ncbi.nlm.nih.gov/pmc/articles/PMC3967195/.
9. Singh PN, Sabaté J, Fraser GE. “Does low meat consumption increase life expectancy in humans?” Am J Clin Nutr. 2003 Sept; 78 (3): 526–532. Available from: ajcn.nutrition.org/content/78/3/526S.long.
10. Bjerregaard P, Young TK, Hegele RA. “Low incidence of cardiovascular disease among the Inuit — what is the evidence?” Atherosclerosis. 2003; 166:351–7.
11. Chateau-Degat ML, Dewailly E, Louchini R, Counil E, Noël M, Ferland A, et al. “Cardiovascular burden and related risk factors among Nunavik (Quebec) Inuit: Insights from baseline findings in the circumpolar Inuit Health in Transition cohort study.” The Canadian Journal of Cardiology. 2010;26(6):e190–e196.
12 Mazess RB, Mather W. “Bone mineral content of North Alaskan Eskimos.” The American journal of clinical nutrition 1974;27:916–25.
13. Ballwieser D. “Low-Carb erhöht Risiko für Herz-Kreislauf-Krankheiten.” [Internet]. Germany; 2012 [cited 2017 Oct.24]. Available from: spiegel.de/gesundheit/ernaehrung/diaeten-low-carb-erhoeht-risiko-fuer-herzinfarkt-und-schlaganfall-a-841072.html.
14. Lagiou P, Sandin S, Lof M, Trichopoulos D, Adami HO, Weiderpass E. “Low carbohydrate-high protein diet and incidence of cardiovascular diseases in Swedish women: prospective cohort study.” BMJ 2012;344:e4026. Available from: bmj.com/content/344/bmj.e4026.
15. Gilsing AM, Crowe FL, Lloyd-Wright Z, Sanders TA, Appleby PN, Allen NE, et all. “Serum concentrations of vitamin B12 and folate in British male omnivores, vegetarians and vegans: results from a cross-sectional analysis of the EPIC-Oxford cohort study.” Eur J Clin Nutr. 2010 Sep;64(9):933–9. Available from: ncbi.nlm.nih.gov/pmc/articles/PMC2933506/.
16. Rühle, A. “Das Kaninchen - Nahrung und Gesundheit.” Norderstedt: BoD - Books on Demand; 2017. 312 p.
17. Fritz J. “Allometrie der Kotpartikelgröße von pflanzenfressenden Säugern, Reptilien und Vögeln.” Inaugural-Dissertation zur Erlangung der tiermedizinischen Doktorwürde der Tierärztlichen Fakultät der Ludwig-Maximilians-Universität München. München; 2007. Available from: edoc.ub.uni-muenchen.de/7554/1/Fritz_Julia.pdf.
18. Jain World. “Jain Nahrungsmittel.” [Internet]. USA Alpharetta; 2016 [cited 2017 Oct. 24]. Available from: jainworld.com/JWGerman/jainworld/educationg/level1/lesson07.asp.
19. Busch-Stockfisch M. “Lebensmittel-Lexikon.” 4. Auflage. Deutschland: Behr’s Verlag; 2005.
20. Biesalski HK, Grimm, P: “Taschenatlas der Ernährung.” 6. Auflage. Stuttgart und New York: Georg Thieme Verlag. 2015.
21. Feelisch M, Kolb-Bachofen V, Liu D, Lundberg JO, Revelo LP, Suschek CV, et all. “Is sunlight good for our heart?” European Heart Journal 2010; 31 (9); 1041–1045. Available from: doi.org/10.1093/eurheartj/ehq069.
22. Stiftung Warentest. Jod in Gemüsealgen: Schock aus dem Meer. [Internet]. Deutschland; 2002 [cited 2017 Oct. 24]. Available from: test.de/Jod-in-Gemuesealgen-Schock-aus-dem-Meer-1051651-1051653/.
23. Elmadfa I, Leitzmann C. “Ernährung des Menschen.” 5. Auflage. Stuttgart: Verlag Eugen Ulmer. 2015.
24. De Groot H, Farhadi J. “Ernährungswissenschaft.” 6. Auflage. Haan-Gruiten: Verlag Europa-Lehrmittel. 2015.
25. Jump DB, Depner CM, Tripathy S. “Omega-3 fatty acid supplementation and cardiovascular disease: Thematic Review Series: New Lipid and Lipoprotein Targets for the Treatment of Cardiometabolic Diseases.” Journal of Lipid Research. 2012;53(12):2525–2545. Available from: ncbi.nlm.nih.gov/pmc/articles/PMC3494243/.
26. Abedi E, Sahari MA. “Long-chain polyunsaturated fatty acid sources and evaluation of their nutritional and functional properties.” Food Science & Nutrition. 2014;2(5):443–463. Available from: ncbi.nlm.nih.gov/pmc/articles/PMC4237475/#!po=21.8750.
27. Ehrlich SD. “Omega-3 fatty acids.” [Internet] USA Baltimore; 2015 [cited 2017 Oct. 24]. Available from: umm.edu/health/medical/altmed/supplement/omega3-fatty-acids.
28. Vieira SA, McClements DJ, Decker EA. “Challenges of Utilizing Healthy Fats in Foods.” Advances in Nutrition. 2015;6(3):309S–317S. Available from: ncbi.nlm.nih.gov/pmc/articles/PMC4424769/.
29. NHS Choices. “Are calcium pills any good at preventing bone fractures?” [Internet] England; 2015 [cited 2017 Oct. 24]. Available from nhs.uk/news/2015/09September/Pages/are-calcium-pills-any-good-at-preventing-bone-fractures.aspx.
30. Bundesgerichtsurteil Art. 10 EMRK und Art. 27 BV; Art. 18 LMG; Art 19 Abs. 1 lit. c und d LMV.
31 Tankeu AT, Ndip Agbor V, Noubiap JJ. “Calcium supplementation and cardiovascular risk: A rising concern.” J Clin Hypertens (Greenwich). 2017 Jun;19(6):640–646. Available from: ncbi.nlm.nih.gov/pubmed/28466573.
32. Rollinger M. “Milch besser nicht!” Deutschland: JOU-Verlag e.K; 2007. 350 p.
33. Appleby P, Roddam A, Allen N, Key T. “Comparative fracture risk in vegetarians and nonvegetarians in EPIC-Oxford.” Eur J Clin Nutr. 2007 Dec;61(12):1400–6. Epub 2007 Feb 7. Available from: ncbi.nlm.nih.gov/pubmed/17299475.
34. Willems W. “Zwei Faktoren lassen Männer früher sterben.” [Internet] Deutschland: 2015 [cited 2017 Oct. 24]. Available from: welt.de/gesundheit/article143639836.
35. Moss M. “Salt Sugar Fat, How the Food Giants Hooked Us.” United States: Random House; 2013. 446 p. (Abstract)
36. Zimmer L. “Zusammenhang von Ernährungsfaktoren und Alzheimer-Demenz.” Deutschland: GRIN Publishing; 2011. 60 p.