A Vegan Diet Can Be Unhealthy. Nutrition Mistakes

© Bought from Jenko Ataman, fotolia

Summary

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.

Introduction

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 Diet and Health Switzerland (diet-health.info) can attest to this fact as it has reviewed (up to 2020) more than 70 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.

What are the potential risks?

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.

© CC-by 2.0, Albert CM, 2002, Foundation Diet Health Switzerland

What is a healthy diet?

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.

Nutrition mistakes vegans make

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.

1. Vitamin B₁₂ — the classic problem
2. Vitamin D — a problem for “everyone”
3. Iodine — vegan sources
4. Omega-6 fatty acids in relationship to omega-3
5. Calcium

What aspects of our diet should we all be aware of?

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 lower salt content.

1. Vitamin B₁₂ — the classic problem

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 a 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 cecotrophy)_.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 contain 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 extrinsic 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 a 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 a diet.

2. Vitamin D — a problem for everyone?

In 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.

Blood tests measure the concentration of 25-OH-Vitamin D₃ in the blood — a drop of blood from the finger can be used as a blood sample or a nurse or physician can draw blood intravenously. Measuring the levels of 1,25-Dihydroxy-Vitamin-D is not a good way to get an accurate reading of vitamin D present in the body. There are test kits that you can use at home for this and then send back to a laboratory. In Switzerland, we get the results back within two days. But these tests are controversial.

Vitamin D producers recommend that you have a value between 35 and 60 ng/mL, which corresponds to 87 to 150 nmol/L. But levels of 88 ng/mL and higher lead to an increased risk of mortality. In observational studies, 25(OH)D levels between 60 and 100 nmol/L (24–40 ng/mL) are associated with the lowest risk of mortality.

3. Iodine — vegan sources

Iodine is necessary for the synthesis of “thyrox...” (T₄) and “triiodthyron...” (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 bladderwrack. One gram of bladderwrack 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

4. Omega-6 in relationship to omega-3

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.

The way I achieved an excellent level of omega-3 fatty acid

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 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 (Transurethral 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.

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.