Vegan diet, a regimen that encourages whole, plant-based foods and discourages meats, dairy products, and eggs as well as all refined and processed foods, is gaining popularity.

 

 

Patients often choose diet rules for themselves for various reasons. Opinions regarding the risks and benefits of dietary choice—omnivore, vegetarian, and vegan—can at times be polarized, with contradictory evidence.But when patients present with such choices, it is prudent to have an unbiased dietary information to share with the patients.

 

Here is an overview that may help

Many advantages of plant-based diets have been well documented. Empirical evidence from health care practitioners of varied specialties have indicated tremendous results in patients with respect to association of plant-based diets with lowered ischemic heart disease mortality; sustainable weight management; reduced medication needs for certain lifestyle diseases; lowered risk for most chronic diseases; decreased incidence and severity of high-risk conditions like obesity, hypertension, hyperlipidemia, and hyperglycemia and type 2 diabetes.

 

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Addressing Limitations

 

• Well-balanced, plant-based diet can provide adequate amounts of essential amino acids and prevent protein deficiency. Soybeans and foods made from soybeans are good sources of protein and may help lower levels of low-density lipoprotein in the blood. Generally, patients on a plant-based diet are not at risk for protein deficiency. Essential amino acids can also be obtained by eating certain combinations of plant-based foods. Examples include brown rice with beans, dals, and lentils with whole wheat bread and rotis.

 

• Iron stores may be lower in individuals who follow a plant-based diet and consume little or no animal products. However, the American Dietetic Association states that iron-deficiency anemia is rare even in individuals who follow a plant-based diet.

 

• Patients following vegan diets are vulnerable to B12 deficiency and need to supplement their diet with vitamin B12 or foods fortified with vitamin B12.

 

• Calcium intake can be adequate in a well-balanced, carefully planned, plant-based diet.

 

• The fatty acids that vegans are most likely to be deficient in are the omega-3 fats (n-3 fats). Consumptions of the plant version of omega-3 fats, alpha-linolenic acid, are also low in vegans. Foods that are good sources of n-3 fats should be emphasized. They include ground flax seeds, flax oil, walnuts, and canola oil.

 

• A vegan should regularly consume plant foods naturally rich in the n–3 fatty acid ALA, such as ground flaxseed, walnuts, canola oil, soy products, and hemp seed–based beverages. In addition, it is recommended that vegans consume foods that are fortified with the long-chain n–3 fatty acid DHA, such as some soy milk and cereal bars. Those with increased requirements of long-chain n–3 fatty acids, such as pregnant and lactating women, would benefit from using DHA-rich microalgae supplements.

 

• Vegan diets naturally have high phytate content. Adequate consumption of foods that are rich in zinc, such as whole grains, legumes, and soy products, to provide a sufficient zinc intake is important.

 

• Periodic monitoring of serum nutrient levels by physicians is recommended; vitamin B12, calcium, vitamin D, and iron are of concern.

 

To sum it all, what seems to be a fair modus operandi is that without getting into terminologies such as “vegan” or lacto-vegans” it would be in best interest of both, the patient and the physician to  focus on health-promoting, whole, plant-based foods (primarily fruits and vegetables) and minimizing consumption of meat, eggs, and dairy products.

 

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References

• Appleby PN, Key TJ. The long-term health of vegetarians and vegans. Proc Nutr Soc. 2016 Aug;75(3):287-93
• Hever J. Plant-Based Diets: A Physician’s Guide. The Permanente Journal. 2016;20(3):93-101.
• Tuso PJ, Ismail MH, Ha BP, Bartolotto C. Nutritional Update for Physicians: Plant-Based Diets. The Permanente Journal. 2013;17(2):61-66. 
• Craig WJ1. Health effects of vegan diets. Am J Clin Nutr. 2009 May;89(5):1627S-1633S