Members of The South African Vegan Society rapped Health24 over the knuckles recently: they say we’ve run misleading stories that suggest vegan diets are unhealthy. Whether one agrees with that or not, we thought they deserved a chance to state their views.
Health24's Olivia Rose-Innes put a few key questions to them and found that they make some convincing arguments. If "vegan" conjures up for you a pale wimpy person piously nibbling on wilted spinach, you’re in for a surprise. Vegans are feisty, and they know a lot about nutrition science.
Olivia Rose-Innes: Meat-eaters, and many ovo-lacto vegetarians, often say they don't want to cut out animal foods entirely, because they're worried about nutrient deficiencies. Above all, people worry about not getting enough protein. Isn’t it true that plant foods are lower in certain essential nutrients?
Vegan Society: Dietary studies show that plant foods can easily provide enough protein. Good plant protein sources include nuts, lentils, beans, peas, grains and seeds.
Virtually all foods, however, contain some protein. The only medically documented cases of protein deficiency have been those caused by severe undernourishment and malnutrition.
Olivia: What about Vitamin B12? That doesn’t occur in plants at all.
Vegan Society: Vitamin B12 occurs only where certain bacteria exist. In an increasingly sterile food environment, B12 deficiency is increasing in the general population, including omnivores. A USA study found 9% of the general population were deficient; 39% were near-deficient.
The last comprehensive study of B12 levels in vegans did find high deficiency levels, but that was in 1982 among vegans who took no supplements, when foods were not commonly fortified with B12 or other nutrients. More recent research is needed to know true levels of deficiency in modern vegans who have increased access to fortified foods, supplements, and nutritional information.
B12 is first made by yeasts and micro-organisms; animal products are not the only reliable source. Vegan sources include fortified foods (some cereals, vegan custards, mieliepap etc.), non-dairy milks and supplements.
Many authors claim B12 is found in algae, sea vegetables and spirulina. However, as many studies indicate that these food items do not have B12 biological activity for humans, the Vegan Society B12 guidelines recommend vegans ensure adequate intake via fortified foods and/or supplementation.
These recommendations shouldn’t be seen as “evidence against a vegan diet”. Many studies support a vegan diet, and major health organisations across the world officially endorse it – not only as being capable of meeting nutritional requirements, but for its value in terms of disease prevention.
Everyone, whether carnist or vegan, should follow a well-planned diet. Many meat-eaters consume the same fortified foods vegans do, and take supplements – often unknowingly, e.g. Vitamin D (margarine), iodine (table salt) and other nutrients (fortified cereals).
Worrying trends in people following traditional carnist diets, such as increases in obesity and diabetes, are correlated with increased deficiencies of vitamins and minerals such as Vitamin D, potassium and magnesium.
See these guidelines for a healthy vegan diet.
Olivia: Concerns about dietary deficiencies are particularly acute when it comes to a vegan diet being imposed on children, and babies in the womb. Actress Natalie Portman, a self-proclaimed “vegan activist”, admitted she went back to eggs and dairy while pregnant. Surely this is only sensible?
Vegan Society: As the British Medical Council states, “It is possible for vegetarians and vegans to be adequately nourished for successful pregnancy and lactation, but they need to be knowledgeable about nutrition and plan their diet carefully.”
The American Dietetic Association and the British Dietary Association both agree that a vegan diet is suitable for pregnancy and lactation, with care around vitamin B12 and folic acid. These associations have extensive guidelines for omnivorous, vegetarian and vegan diets; for omnivores, there are many warnings about health risks associated with animal products during pregnancy and the early months of life (as well as later in life). Vegans avoid these risks, and can avoid risks associated with B12 and folic acid deficiencies by following dietary guidelines.
Guidelines for vegan parents: pregnancy and childhood.
Olivia: Over the past decade, a handful of children’s deaths have been linked to vegan diets. Such cases elicit condemnation of veganism from the public and some experts. Most recently, an 11-month-old French baby, fed only on her vegan mother's milk, died from vitamin A and B12 deficiency. Health24 published a related article, Do vegan diets endanger child health?, which the SA Vegan Society criticised. What were the main objections to the article?
Vegan Society: These deaths were attributed to neglect and, in the case of the French couple, to their refusal to take their child to a standard Western hospital. The Health24 article claimed the vegan diet was to blame, despite expert statements and final judgements in these cases concluding that a vegan diet can be suitable for pregnant women and infants. Read the full response.
Health24’s DietDoc responded with cherry-picked citations of warnings about vegan diets, without noting similar warnings to meat-eaters or that the citations she provided actually conclude that a vegan diet is safe, especially if properly planned. Our response cites scientific references that dispute DietDoc’s claims, which included an insinuation that people are too lazy to follow a properly-planned diet.
Olivia: The Vegan Society was also unhappy about Vegans' elevated heart risk requires omega-3s and B12s, which refers to a literature review concluding that, although vegans and vegetarians generally have lower risk for heart disease than omnivores, this may be undermined by deficiencies that raise risk.
Vegan Society: The article title is misleading: it implies vegans are at higher risk of heart disease than omnivores, when in fact the original study found that vegans were at significantly lower risk. Within the vegan group, those who have Omega-3 and B12 deficiencies are at a higher risk than those who don't, but still have a lower overall risk than omnivores. Read the full study.
Omega-3 and B12 deficiencies are common among meat-eaters too. Less than 0.5% of the population is vegan, yet studies show that much higher proportions of the general population have below optimum levels of essential nutrients, including omegas and B vitamins. Plant-based sources of omegas include seeds and seed oils e.g. flaxseed, sunflower seed, linseed, or supplements.
Olivia: My understanding of the literature is that a well-planned vegan diet is, overall, likely better for you than a typical Western diet. But to ensure you get the essential nutrients as a vegan, you need to supplement and be well-informed about diet. Doesn't this mean that veganism is impractical for people who can't afford supplements, specialist health foods and nutritionists?
Vegan Society: Living vegan healthily does require informing oneself about nutrition (as does any healthy diet). This can't be seen as a bad thing – many report drastic improvements in health after adopting a vegan diet, partially due to greater awareness of nutritional requirements. Many people adopt veganism to reverse a disease such as diabetes or hypertension, and even to assist alongside Western treatments for e.g. cancer.
Not all vegans take supplements, although the Vegan Society recommends at least B12 supplementation. These are no more expensive than numerous supplements available for omnivores, and are certainly cheaper than treatment for numerous ailments such as cancer, heart disease, erectile dysfunction, osteoporosis, arthritis, acne, asthma, Alzheimer's, and clinical depression which are positively associated with an omnivorous diet and negatively associated with veganism (i.e. vegans are at reduced risk).
The conception that a vegan diet is inherently more expensive is false. Meats and cheeses are notoriously expensive. A healthy vegan diet can comprise very affordable products such as:
- Legumes: dried pulses and beans
- Fresh fruit and vegetables
- Fortified cereals or non-dairy milks
The above are available in mainstream stores and affordable. Affordable vegan meal ideas include:
- Rice, lentils and green leaves (spinach/kale etc.)
- Pasta with vegetables, beans or legumes
- Oats with fruit and/or non-dairy milk
Data on South African household consumption patterns show that vegan foods are increasingly popular across income groups, including low-income households (Stats SA Income and Expenditure Survey, 2005/6). Vegetarianism and veganism are growing in popularity across income groups, and omnivores are including vegetarian products in their diets for various budgetary, taste and health reasons.
A plant-based diet is also more easily supported on a subsistence basis: vegan food items can be produced with lower land, water, energy and other input requirements. In urban areas, a plant-based subsistence diet can be achieved without violating health and safety regulations pertaining to livestock. In this way veganism can assist with food security locally, and globally: the UN’s FAO and Human Equality call for a move to a plant-based diet to ensure environmentally sustainable food security.
There are certainly expensive vegan products available, but these are luxury products that would depend on individual budget and taste, and aren't essential for a healthy, satisfying vegan diet.
When considered alongside cost to the environment and to the animals themselves, a little extra work on the part of vegans is well worth it. Most vegans report an adjustment period of six to eight weeks, when one learns about products available and food preparation. After that, veganism requires no more effort than any other diet.