Is Vegan the ‘Game Changer’ we all need? - Part 1
Over the past decade, we have witnessed an undeniably increasing interest in “plant-based” diets, from the ever-expanding demand for oat milk and almond lattes at our local cafes, to vegan-burger patties that ‘bleed’. More often we’re seeing positive plant-based headlines, most recently with the all-vegan menu served at the 2020 Golden Globes*, plus the documentary The Game Changers - which became the best-selling documentary of all time on iTunes, within just a week from its release.
Considering this undeniable momentum, I felt it important to dispel some of the stigma often associated with a vegan diet and to speak to the benefits and challenges associated with going 100% plant-based from a clinical perspective.
The outpouring of vegan-promoting documentaries over the past ten years - such as Forks over Knives, Cowspiracy, and the 2019 The Game Changers are worth a mention, as these documentaries advocate for Veganism from a personal health and wider global-wellness perspective. Their message is often amplified with the shock value of exposing gory scenes from slaughterhouses and factory farms – leaving viewers horrified by industrialised animal farming and deeply saddened.
The subsequent “knock-on” effect of these documentaries is for viewers to feel motivated and curious to explore how a vegan way of living might be workable for them. In Part 1 of this blog series, I’ll cover the nutritional arguments raised through these documentaries and dispel some common vegan health myths. In Part 2, I will expand into the environmental and ethical questions associated with our food choices.
After watching The Game Changers in the holidays with my own family, and having been asked innumerable times for my thoughts on it, I am motivated to address some ideas specific to this documentary. Despite the documentary being presented with an obvious and overt bias towards the vegan-favourable data, it did present some salient points. It did highlight the additional photochemical protection offered when one’s diet is predominantly plant-based, as well as outlining the inflammatory nature of both trans fats and animal fats (which increase the amount of Inflammatory cytokines in the body, increasing pain, slowing recovery, and accelerating the ageing process). The documentary argued that a plant-based diet is protective against cardiovascular disease, with some simple and uncontrolled (but engaging) experiments comparing the impact of animal-based meals to plant-based meals in endothelial function and blood flow just hours after eating (remember the erection experiment?!). The main argument was – due to its immediate benefits on endothelial function and improved blood flow - that a plant-based diet is specific for faster recovery in athletes, and is, in fact, the ‘secret weapon’ of many world-class athletes.
Of the many topics that The Game Changers didn’t cover comprehensively, it omitted to discuss thoroughly some of the realistic and common challenges faced when one’s diet is limited to the plant kingdom. Research and self-education on how to achieve a balance of nutrients are critical to its success, and unfortunately, it’s not uncommon for me to meet with clients who need ‘rescuing’ with emergency B12, Iron and Zinc repletion after they are through to the other side of their ‘vegan honeymoon’**.
It is also common for clinicians such as myself to see considerably sub-optimal intakes of minerals such as calcium on 100% plant-based diets, which must be carefully managed long term to prevent osteopenia and osteoporosis. Similarly, insufficient intakes of PUFA’s (polyunsaturated fatty acids like EPA & DHA) and fat-soluble vitamins such as Vitamin A & E often fly under the radar for many months before being picked up - unless the diet is very well managed with ‘active surveillance’ for these nutrients.
“Either way, the hype The Game Changers created speaks to how confused most of the general population are on what style of ‘eating’ constitutes ‘healthy’. ”
Either way, the hype The Game Changers created speaks to how confused most of the general population are on what style of ‘eating’ constitutes ‘healthy’. It reflects the exasperation many clients express to me as they wade through the jungle of information ‘out there’, trying to make some sense of everything for their own unique circumstances.
While certainly inspiring, the documentary The Game Changers neglected to speak adequately to the variability of nutrient requirements that different people have - based on age, stage of development, gender, activity, and other considerations such as convalescence, pregnancy and breastfeeding. A critical component of Naturopathic philosophy is to acknowledge that we all have unique requirements and a uniquely personal interaction our foods and environment. No one size fits all. And it must be said that a vegan diet is not necessarily going to provide the health benefits that these popular documentaries purport. Many transition to a plant-based diet by simply removing meat without looking at their dietary needs or gaining personalised guidance, or even worse – by falling into the vegan packaged “junk food” trap.
In clinic, I work hard to maintain a compassionate approach towards each and every client that sits with me. My observation - well into my second decade of private clinical practice - is that people generally try different diets because they want results and are frustrated with their current experience. Specifically, with the vegan diet, I find that people are generally driven to embrace this plant-based diet and lifestyle, motivated either by their own personal health, legitimate environmental concerns, or animal welfare & compassion – all admirable motivations. In fact, for many people, Veganism is much more than a diet – it’s a lifestyle, a community, and a culture of mindful, compassionate and conscious living. It infiltrates into people’s sense of identity and becomes an integral part of who they are, offering a wider sense of community and connection – something of enormous value to many.
It’s no doubt that plant-based diets have been around since the beginning of time, offering a plethora of vital nutrients and phytochemicals for all living creatures. Archeological research has shown that Paleolithic diet was a vegetable feast. Yet in modern times and with the industrialisation of food systems, many societies globally have evolved to include a large amount of animal product in their plates, something that has probable and plausible negative consequences for individual health. It’s difficult to argue against the fact that - compared to a Western industrialised, meat-centric diet – an eating pattern low in animal products and generous in whole plant foods is correlated with a healthier heart and vessels, healthier brain function, reduced inflammatory markers, longevity and a higher quality of life. Plus, although there are a limited number of studies examining the impact of a vegan diet on cancer risk, a 2017 meta-analysis found that a vegan diet significantly lowered the risk of total cancer by 15% compared with non-vegetarians – an outcome not to be overlooked.^
A vegan diet takes considerable effort to get right. For those that have the winning formula of unwavering intrinsic motivation PLUS the skill for nutrient-rich and balanced meal planning PLUS the time, a well-balanced vegan diet has enormous potential to be therapeutic. Likewise, for those who are working towards a specific health goal (like reversing the progression of cardiovascular disease or maintaining remission from cancer), and whom can acquire the skill through some professional guidance, I genuinely see the significant beneficial health benefits and outcomes.
“it is not critical to exclusively and forevermore eliminate ALL animal products to gain significant health benefits… but rather to chase and commit to a plant-food-PREDOMINANT diet.”
Acknowledging the variability between individuals (age, stage of life, gender, religion and unique circumstances), it’s my balanced clinical view that it is not critical to exclusively and forevermore eliminate ALL animal products to gain significant health benefits… but rather to chase and commit to a plant-food-PREDOMINANT diet.
What is a plant-food-predominant diet? It’s a way of eating where plant foods - such as vegetables, fruits, whole grains, nuts, seeds, beans and legumes are the main focus of the diet, but where there may be occasional consumption of carefully sourced seafood, dairy products, and even meat. Rather than placing this predominance on ‘energy/kilojoule’ intake, I prefer the concept of basing it on what’s covering the plate or bowl – where vegetables and plants are the main part of the meal, rather than the accompaniment.
I have been a long-term advocate for fitting as many colourful plants on your plate (and throughout your day) as you possibly can, and my Phytochemicals & Eating the Rainbow Checklist Handout that many of you would have seen is testament to this. Eating more vegetables, herbs and spices each day is completely aligned with my view and overall messaging, and is the cornerstone of what I advocate every day in the clinic. Not just for the abundant phytochemicals it provides, offering protection to our DNA and our cells, and enhancement of our cellular detoxification processes, but also as effective in promoting a diverse and robust ecosystem of beneficial bacteria to support both the human microbiome and overall health.^^ And, brilliantly, this principle of eating more vegetables each day can be applied to every style of eating, at virtually every stage of life!
Unfortunately the reality is - according to Australia’s Health Report 2018*** - that more than 99% of Australian children and 96% of adults do not eat the recommended daily amounts of vegetables. We are clearly not eating the vegetable feast we are designed to eat, and we can’t overlook this as a potent yet reversible driver for the chronic lifestyle conditions that pose a significant burden in terms of morbidity, mortality and health care costs in Australia.
Having said this, I am yet to be convinced that maximising plant intake has to be done at the expense of consuming any ethically sourced, pasture-raised, humanely treated animal produce. Is there anything wrong with a few slices of organic grilled haloumi over a large bowl of sautéed greens? Or a couple of eggs each week to bind together the rainbow chard into a frittata? What about a weekend treat of some sustainably sourced sardines or oysters?
I am genuinely curious as to what may be the most positive eating-path-forward - that takes some pressure off the planet. Can we find a ‘win-win’ for humans, animals, soil, our personal nutrition and our planet - without being so strict and exclusive? Despite it occasionally feeling a bit like a battle-ground between ‘the meat-eaters’ and ‘the vegans’ - I feel it’s important to highlight that there is actually enormous common ground between those of us that chose to eat with ethics and sustainability front of mind (seasonally, locally produced, organic, whole-food) - eating well is eating simply. We may have more similarities than differences – as we highlight in our book One Bite at a Time.
If you are looking to transition to a vegan or primarily plant-based diet (or if your nutrient intake is sub-optimal despite eating a varied diet), here is a quick summary of some nutrients that may need a little extra attention:
Vitamin D3 supplementation is something to consider for many modern people, more based on lifestyle than diet – whether vegan or not. Ultimately Vitamin D is the ‘sunshine vitamin’ – as well as being present in small amounts in egg yolk, sardines, cod liver and dairy products. Based on the season, and how much sunshine you may get in any given week, it may be worth having a blood test annually to ensure optimal levels are maintained.
Vitamin B12 is a worthy supplementation consideration for people on a limited/restricted diet, and also those with stomach inflammation, or on particular medications. In fact, many people (vegan or not!) present in clinic with low B12 levels due to a combination of factors including genetic metabolic ‘handicaps’, poor diet quality, high alcohol intake, prolonged intermittent fasting, and stage of life. It’s an important consideration – perhaps to request an annual blood test from your trusted and good ‘detectively minded’ GP or Naturopath – as moderate-to-long-term B12 deficiency outcomes include irreversible neurological effects (which are otherwise preventable). Vitamin B12 is also necessary for the synthesis of red blood cells, and healthy growth and development in children, plus fatigue plus poor recall can also be symptoms of B12 deficiency. B12 is available in almost all animal products, but very few plant foods, with the exceptions of nutritional yeast, spirulina, some sea vegetables, and fermented products like miso and tempeh, and mushrooms.
Omega 3 fatty acids (PUFA’s) are also often limited in a Western diet – vegan or not. Vegan sources of PUFAS EPA & DHA are more difficult to come by, but algal sources at reasonable concentration are available and protected from the concerns of ocean contaminants such as dioxins and PCB’s.
Zinc is another common deficiency on a vegan diet. The mineral zinc is present in every part of the body and has a wide range of functions. It helps with the healing of wounds and is a vital component of many enzyme reactions. It is particularly vital for healthy skin and is essential for a healthy immune system and resistance to infection. Meeting zinc needs on a plant-based diet can be a challenge, so zinc-rich foods must be emphasised: chickpeas, pumpkin seeds, cashews, baked beans, tahini, dried figs, brazil nuts, oranges, almonds.
It’s important to highlight that various factors impact zinc bioavailability (amount body can readily absorb) and absorption, in particular, phytates / phytic acid. Phytate, a phosphorus-containing compound found in grains, nuts, and legumes, reduces zinc bioavailability from these foods, which are common in vegetarian diets. Vegetarian diets often contain two to three times more phytate than non- vegetarian diets so phytate can markedly affect zinc absorption in vegetarians. Luckily, several dietary factors and practices can improve zinc absorption from plant foods. Fermentation partly destroys phytates, so fermented soy foods such as tempeh or miso are good sources of zinc. Similarly, yeast-raised or lactic acid fermented sourdough bread is a better zinc source than whole-grain cereals or muffins. My suggestion is to consider a supplement for at least three months of the year on a purely vegan diet.
Iron deficiency is one of the most common found on a vegetarian or vegan diet, particularly (but not limited to) menstruating females. Iron is essential for the transport of oxygen around the body- thus the extreme fatigue that can result from insufficient available iron and iron stores. While iron can be found in plant foods, the bioavailability of iron in these sources is lower compared to the heam-iron found in animal foods. Many grains, nuts and seeds also contain phytates, which can bind to iron and inhibit absorption. Soaking and/or sprouting grains or nuts significantly reduces the phytate content. The best plant-based food sources of iron are spirulina, edamame, black beans, lentils, kale, dried figs and apricots, parsley, spinach, pumpkin seeds, and molasses.
Calcium is another essential mineral for humans. Our bones contain large amounts of calcium, which helps to make them firm and dense, plus our bodies require abundant calcium for other tasks, including nerve and muscle function and blood clotting. These tasks are so crucial for survival, that, when dietary calcium is too low, calcium will be lost from bone and used for other critical functions. Many green vegetables contain oxalates, which inhibit the absorption of calcium. Oxalates are largely destructed at high temperatures (ie, it’s generally best to blanch or steam your greens). The best plant-based food sources of calcium are molasses, collard greens, firm tofu (processed with calcium), tempeh, kale, bok choy, un-hulled tahini, broccoli, almonds, and fortified almond, soy or oat milks.
I have always felt that the potential of the human body is incredible, and I truly believe that the more we lean into the plant kingdom, the better for our bodies and the planet. Ethically and sustainably sourced animal products should be considered condiments to the meals, rather than the focus.
To become more proficient at including more plant-based meals into your week, and for some inspiration, please check out our Vegan Meal Planner, which offers a practical plant-based weekly plan plus recipes and nutritional information specific for vegans and vegetarians.
Finally, if you would like to learn more or are considering a transition to a plant-based diet, please do book in for a consultation so we can discuss your unique needs and ensure the most successful outcome. To book in your consultation, feel free to use the online system or contact us for more information.
* the winner for best performance by Joaquin Phoenix (who played The Joker) used his speech to recognise and acknowledge the link between animal agriculture and climate change, and the impact of our choices on the future of our planet – yes please!
** the elation and lightness one often feels when embarking on a purely vegan diet can sometimes be self-limiting when mineral and vitamin needs are not being met.
*** Published AIWH July 2019, PDF available here: https://www.aihw.gov.au/getmedia/7c42913d-295f-4bc9-9c24-4e44eff4a04a/aihw-aus-221.pdf