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Considerations for the healthfulness of plant-based eating!

I’ve noticed quite a shift lately towards more desire to engage in plant-based eating (PBE). Personally I think this is great! If there’s one thing that is sorely lacking from people’s diets on a population level its intake of healthy plant foods like fruits, vegetables, nuts/seeds and pulses/legumes.
And I like the term ‘plant-based’ eating because it effectively describes a healthy diet I think whereas ‘vegetarian’ or ‘vegan’ have their definitions in what they don’t consume rather than what they do. i.e. you can still have a shitty vegetarian or vegan diet that is going to be as bad for your health as any other diet containing lots of processed or low-nutrient foods.
With PBE though it sounds very much like it encourages more consumption of plants foods rather than just the exclusion of all or certain animal products. Of course people will have their own definitions of what PBE means to them but I’m writing this from the standpoint of a nutritionist and coach who’s primary focus is on eating for health and wellbeing.

Vegetarian vs Vegan vs Plant Based Eating:

In this post I’m going to steer well clear of:

i) the environmental considerations for different types of eating because I simply don’t know enough about it to have an opinion (if only that attitude popped up in more places on the internet)

ii) eating considerations from an ethical or religious standpoint because as a nutritionist focused on health this isn’t really any of my business.

That said I want to briefly define vegetarianism vs veganism vs PBE in this context.

Vegans tend to eat the most exclusively by not including any animal or animal-derived products at all in their diets. This includes things like dairy and honey and even certain supplements like vitamin D3 derived from lanolin (sheep’s wool).
Next up vegetarians have several different categories but again there is some emphasis on excluding animal products. Lacto-ovo vegetarians for example only consume dairy and eggs in terms of animal produce because it does not involve any animal slaughter which is the key point.
Then with PBE as far as I’m concerned this means to eat mostly whole plant foods and not as much animal products yet that isn’t to say they’re to be excluded entirely.

Issues with exclusive diets:

As I have eluded to already there are many benefits to a PBE approach. However as a nutritionist I will always have potential concerns when a large food group, like animal products, carbohydrates, dairy etc. is excluded unless it is for good reason. Simply by reducing your availability of food choices you could limit yourself on the nutrients available to yourself to keep yourself in top health unless you engage in a lot of supplementation to fill in any gaps. I think with a well-constructed vegetarian diet you can achieve maximum health and wellness.
With a PBE diet there’s no question because as I’ve said it may not necessarily exclude animal products – it just encourages more plants so it doesn’t have to be necessarily exclusive. Vegan diets on the other hand require a lot of supplementation and micro-management to ensure all your nutrient needs are met. Therefore as a nutritionist I would not recommend a vegan diet from a health standpoint. Remember I’m leaving aside the environmental, ethical and religious connotations of a vegan diet. Now if you are currently eating a pretty poor, low-nutrient diet would I think a well-managed vegan diet is better? Of course, but that’s a bit of a silly question. If you’re starting from a poor diet then making it better in any way will of course..make it better.

Nutrition considerations for vegans:

It is certainly possible to achieve extremely good health on a vegan diet so long as it is well-managed. These are some key nutrients to think about.

1. Vitamin B12 – vegans and vegetarians are at the highest risk of B12 deficiency as it cannot be reliably obtained from plant foods unless they are fortified (B12 added to them). So consuming fortified foods is definitely a good option to maintain good B12 intake. For example fortified cereals, plant milks and nutritional yeast. I would certainly suggest though that for anyone not consuming animal products that they use a B12 supplement in the form of methyl B12/methylcobalamin. B12 deficiency can manifest as anaemia, low energy and damage to the nervous system (this includes the brain).

2. Vitamin D3 – this goes for anyone who doesn’t live on the equator really and isn’t actually dependent much on diet but rather, sun exposure. So vitamin D3 is always worth mentioning as unless you get regular sunshine you may have low levels which can result in poor bone health, poor immune function, poor recovery and lowered mood. For vegans you will have to source a vegan vitamin D3 as the naturally vegan vitamin D2 is not as effective as D3 for vitamin D levels.

3. Marine omega 3’s – you’ll have likely heard the advice to consume omega 3 fats and oily fish for good health? These are important for brain & mental health, heart health and helping to regulate inflammation. While there are some plant sources of omega 3 like flaxseeds, chia seeds and walnuts they don’t provide the ones we’re looking for that come from marine sources and while we can convert a little bit of the plant ones into the ones we really want in the body, this process is very inefficient so supplementation for anyone not consuming oily fish on a regular basis (2-3x meals per week) is advised. For vegans this will require a high quality algae oil since fish oil and krill oil are excluded.

4. Calcium – contrary to popular belief there are ways to achieve good calcium intake without using dairy products. Leafy green vegetables, soy products, almonds, pulses and fortified plant milks, yogurts and cereals. It still does take some vigilance though to get enough so you would want to be consuming plenty of these foods to get in at least 500mg but ideally 1000mg per day. If you can still consume fish then canned sardines or salmon are actually fantastic sources of calcium when you consume the edible bones – which are pretty much pure calcium. So that’s an awesome hack if available to you to hit your calcium and omega 3 fat requirements. You need adequate calcium for bone and teeth health as well as nerve signalling and muscle function (the heart is a muscle too remember).

5. Zinc – zinc is a key mineral for things like immune function, hormonal health, growth and development and repair. Oats, nuts, seeds, wholegrains, pulses and tofu are all decent plant sources of zinc so make sure to eat plenty of them. There are compounds in plant foods called phytates that could limit zinc absorption by binding to it in digestion so for people not eating much animal products you may need to consume slightly more zinc. If you opt to supplement, zinc gluconate is a good source.

6. Creatine – gone are the days where creatine was just for people playing sports or training in the gym (though it still is fantastic for increasing performance and muscle gain). Theres plenty of research now to show that creatine is also very important for brain and cognitive health. And unless you’re eating fish and meat you probably won’t be getting enough creatine unless you choose to supplement. For the performance benefits either way supplementation is advised.

7. Protein – As standard I would say that the majority of people don’t consume enough protein whether or not they have specific training or performance goals. This is especially true for older people who do not digest protein as well and therefore need more than usual. It can be hard to get enough protein from just plant sources alone but consuming plenty of pulses, soy, nuts, seeds, mycoprotein and wholegrains will get you off to a good start. However it’s rare I find a person eating no animal protein that is having an easy time getting in enough protein especially when in theory they need more since the amino acid quality of plant based protein isn’t as good as in animal proteins. Fortunately there are many tasty and nutritious plant based protein powders on the market now which can offer a convenient way to boost your daily protein content if you avoid animal products.

While this is not an exhaustive list it does cover some of what I think are the key gaps in a diet containing no animal products. Additionally we could also look at nutrients like iodine, iron, choline and saturated fat but those ones I mentioned above are the main ones.

The ‘Best’ diet:

While I’m not too keen to throw around a generalist ‘best’ diet for people that doesn’t factor in things like the sustainability and ability to adhere to it I might go so far as to say that a plant-based diet that does include some animal products might be on to a winner.
How much animal products depends on your own needs and preferences but the fact is that animal products like meats, poultry, fish, seafood and dairy are an extremely abundant source of key nutrients that when added to plant-based diet really round it out and make it the best that it can be in my opinion. The most nutrient dense foods we have available to us are animal products particularly meats and seafood and specifically the organ meats of different animals. And for that reason I think it would be unwise from a health standpoint to exclude these foods.
The reality is you could get away with very little. Say you did want to minimise your intake of animal products but also keep your health a priority and not have to micro-manage and supplement your diet to a large extent. You could then eat the vast majority of your foods from whole-food plant sources like fruits, vegetables, nuts, seeds, pulses and wholegrains and then tactically complement it with small amounts of organ meats and seafood several times a week or a fortnight. Now unfortunately not many people – even avid meat eaters are willing to eat organ meats so this may devolve to consuming quality fish and meats on a semi-regular basis. For me this is a prescription for an awesome diet and awesome health. This is personally the approach I adopt with myself, maximising health being the main target outcome.
I eat tonnes of plant foods, 15-20 servings per day and I also eat a lot of quality meat, fish, poultry and eggs – more than is maybe ‘needed’ but I also have training and performance goals to take into account here too.

So by all means (I’m begging you here) eat more plant foods.
Most of us don’t get enough and therefore miss out on key nutrients, phytochemicals and fibre which are crucial for health but don’t be lead to believe (by certain shite..cough..documentaries) that a diet devoid of all animal products is going to be the best one for your health and vitality.

If you can, have the best of both worlds.

By Brian Ó hÁonghusa, BSc (Hons) Human Nutrition, ANutr, PN1, PN2

Copyright @2017 bodyfirst nutrition.