The Vegan Diet

By- Meena Ganagani,Practicing Clinical Nutritionist,Mumbai.

There are many types of plant-based diets, but they all emphasize certain foods associated with heart benefits, such as whole grains, fruits, vegetables, legumes, nuts, and healthy oils like olive oil. The diets that have been most studied for their impact on heart health include the Mediterranean diet, the DASH diet, and the MIND diet. These diets are rich in fiber, vitamins, and minerals that help lower blood pressure and LDL (bad) cholesterol, reduce the risk of diabetes, and help maintain a healthy weight, all of which can lower your risk of heart disease.(1)

A vegan diet contains only plants (such as vegetables, grains, nuts and fruits) and foods made from plants.

What is Vegan Diet?

Vegetarians don’t eat meat, fish and poultry, and neither do vegans. But vegans go further, excluding all animal products from their diets – even dairy and eggs. If you’re adhering to a vegan diet, that means no refried beans with lard, margarine made with whey and anything with gelatin, which comes from animal bones and hooves. Fruits, vegetables, leafy greens, whole grains, nuts, seeds and legumes will be your staples. (2)

Vegan vs. Vegetarians

The main difference between vegetarians and vegans is that although vegetarians do not eat meat (including cows, pigs, chicken, and fish), they consume dairy products, eggs, or both. The vegan diet excludes all products with animal-based ingredients.

The vegan diet is more restrictive, so people will need to think more about where their nutrients are coming from to ensure that they meet their daily dietary requirements.(3)

Getting the right nutrients from a Vegan diet

With good planning and an understanding of what makes up a healthy, balanced vegan diet, you can get all the nutrients your body needs.

If you do not plan your diet properly, you could miss out on essential nutrients, such as calcium, iron and vitamin B12.

Healthy eating as a Vegan

You can get most of the nutrients you need from eating a varied and balanced vegan diet. 

For a healthy vegan diet:

  • Eat at least 5 portions of a variety of fruit and vegetables every day
  • Base meals on potatoes, bread, rice, pasta or other starchy carbohydrates (choose wholegrain where possible)
  • Have some dairy alternatives, such as soya drinks and yoghurts (choose lower-fat and lower-sugar options)
  • Eat some beans, pulses and other proteins
  • Choose unsaturated oils and spreads, and eat in small amounts
  • Drink plenty of fluids(4)

Is being a Vegan good for weight loss?

Many people find that cutting out animal products translates to lower numbers on the scale, but adopting a vegan diet doesn’t automatically put you on the road to weight loss. It all depends on how and what you’re eating.

Plant-based foods tend to be less energy-dense than meat and dairy, but there are plenty of high calorie vegan foods out there that can not only contribute to weight gain but also skimp on nutrients.(5)

Health Benefits of a Vegan Diet

  • Metabolism benefits

Vegans benefit from increased consumption of vegetables but can miss out on essential nutrients due to the avoidance of meat and dairy. Vegan diets are usually high in fiber, magnesium, folic acid, phytochemicals, and vitamins C and E. Studies in the short and moderate-term have found that vegan diets can improve energy metabolism in healthy, obese, and type 2 diabetic individuals.

  • Cardiovascular benefits

Diets that are high in fruits and vegetables, nuts, vegetable oils, and whole grain are often associated with lower rates of cardiovascular disease development. These types of diets traditionally include Mediterranean and Asian diets, but recently the vegan diet has been postulated to have similar effects. While vegan diets are often seen as having lower fat content and vegans are usually thinner, the actual benefits of fat intake associated with veganism on cardiovascular diseases are disputed.

  • Effects on cancer prevalence

A lot of evidence indicates that vegans and vegetarians have a lower risk of various cancers, both due directly to nutrient intake and due to secondary effects. For example, obesity is a significant factor in cancer risk, and due to the lower BMI of vegans, they also enjoy lower cancer risk.

Fruits and vegetables have been described as lowering the risk of lung, mouth, esophagus, and stomach cancers, and they tend to be consumed at higher quantities in vegans. Phytochemicals, which are abundant in vegetables and occur at a higher volume in vegan diets, have antioxidant qualities and disrupt cells to stop the progression of cancer.

  • Cognitive benefits

Studies that have focused on this have found mild or moderate improvements when patients afflicted with migraine, multiple sclerosis, fibromyalgia, and rheumatoid arthritis consumed a vegan diet.

Studies looking at specific nutrients show some signs that vegan diets can be beneficial for cognition and mental health. Intake of phytochemicals, which appears to be higher in vegans, is associated with beneficial effects on mental health. (6)

Nutritional Disadvantages of Vegan Diets

  • Need for Protein

Meat, fish, eggs and dairy products are common sources of protein for most people. These foods typically get plenty of protein in their daily diets, but vegans need to turn to beans and nuts to get enough. Tofu, beans and nuts are rich sources of protein for vegans. 

  • Possible Iron Deficiency

Meat, particularly beef, and shellfish are rich sources of iron for omnivores, but it’s important for vegans to consume iron-rich foods as well. Iron deficiency can lead to fatigue and problems with brain function. Breakfast cereals fortified with iron, soybeans, white beans and spinach are good sources of iron for vegans. Some vegans who don’t care for iron-rich vegetables may need a daily iron supplement.

  • Getting Enough Calcium, Vitamin D and Vitamin B-12

Vegans need to eat plant sources of calcium; such as dark leafy greens or fortified soy products. Vitamin D helps the body absorb calcium. Vegans need to either take a vitamin D supplement or drink soy milk fortified with vitamin D. Most vegans need to take a vitamin B-12 supplement because the vitamin is mainly found in animal products. Some soy milk and breakfast cereals are fortified with B-12.

  • Difficulty Eating Away From Home

It’s often hard for vegans to eat out since many restaurants don’t offer many vegan choices. Parties and family events can also be difficult, though vegans can minimize this challenge by bringing their own meals if they know there won’t be any choices that conform to their dietary restrictions.(7)

Case Study

A 63-year-old man with a history of hypertension presented to his primary care physician with complaints of fatigue, nausea, and muscle cramps. The result of a random blood glucose test was 524 mg/dL, and HbA1C was 11.1%. Type 2 diabetes was diagnosed. His total cholesterol was 283 mg/dL, blood pressure was 132/66 mmHg, and body mass index (BMI) was 25 kg/m2. He was taking lisinopril, 40 mg daily; hydrochlorothiazide, 50 mg daily; amlodipine, 5 mg daily; and atorvastatin, 20 mg daily. He was prescribed metformin, 1000 mg twice daily; glipizide, 5 mg daily; and 10 units of neutral protamine Hagedom insulin at bedtime. His physician also prescribed a low-sodium, plant-based diet that excluded all animal products and refined sugars and limited bread, rice, potatoes, and tortillas to a single daily serving. He was advised to consume unlimited non-starchy vegetables, legumes, and beans, in addition to up to 2 ounces of nuts and seeds daily. He was also asked to begin exercising 15 minutes twice a day.

Over a 16-week period, significant improvement in biometric outcome measures was observed. He was completely weaned off of amlodipine, hydrochlorothiazide, glipizide, and neutral protamine Hagedorn insulin. Follow-up blood pressure remained below 125/60 mmHg, HbA1C improved to 6.3%, and total cholesterol improved to 138 mg/dL. Lisinopril was gradually decreased to 5 mg daily and his diabetes is controlled with metformin alone, 1000 mg twice daily. (8)

Conclusion

A healthy vegan diet requires planning, reading labels, and discipline. The recommendations for patients who want to follow a plant-based diet may include eating a variety of fruits and vegetables that may include beans, legumes, seeds, nuts, and whole grains and avoiding animal products, added fats, oils, and refined, processed carbohydrates.

References:

  1. https://www.health.harvard.edu/staying-healthy/the-right-plant-based-diet-for-you
  2. https://health.usnews.com/best-diet/vegan-diet
  3. https://www.medicalnewstoday.com/articles/149636#vegan-vs-vegetarian
  4. https://www.nhs.uk/live-well/eat-well/the-vegan-diet/
  5. https://greatist.com/eat/what-is-a-vegan-diet#why-do-it
  6. https://www.news-medical.net/health/What-are-the-Health-Benefits-of-a-Vegan-Diet.aspx
  7. https://www.livestrong.com/article/482780-disadvantages-of-being-vegan/
  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3662288/

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