What nutrients are your vegan patients missing?

Keep patients healthy with nutrition awareness.

It may seem that the vegan diet is healthy—by cutting out all meat and animal products, which can be high in fat. Instead of these, there are mounds of fresh vegetables and fruit.

Shouldn’t that be enough for a healthy diet?

This is precisely the question that DCs should come to expect from their patients who have decided to follow a vegan diet. The truth is, there are a number of vital nutrients and vitamins that patients may not know are missing from their vegan diet.

Is the vegan diet popular?

A recent Harris Poll study commissioned by the consumer publication Vegetarian Times found that more than 7 million Americans follow some form of a vegetarian diet. Furthermore, 1 million of these people follow a vegan diet, meaning that not only will they not consume any meat, they will also not eat any meat products, such as eggs or dairy.¹

What’s missing?

There are a wide variety of vegetarian-based diets, ranging from those who will occasionally eat meat or fish, to those who will not eat meat or fish but will consume dairy or egg products, all the way up to those who will not consume any meat or animal product.²
With a vegan diet lacking in these foods, patients are missing access to key nutrients such as:

• calcium (generally found in dairy products, but also in dark leafy vegetables such as kale and broccoli)
• iron (most commonly found in red meat, as well as in peas and lentils)
• omega-3 fatty acids (most often found in fatty fish, such as cod or mackerel, but also in walnuts, ground flaxseed, and soy)
• vitamin D (also found in fortified dairy products, cereals, and margarine. Check ingredient labels).³

Important vitamin D

Perhaps the most vital of these is vitamin D, which helps build and maintain healthy bones. Vitamin D is found only in a small number of natural food sources, most of which are meat or meat-based. It is usually found naturally only in trace amounts in plants. However, there is recent evidence that mushrooms exposed to ultraviolet light may be a potent source of Vitamin D.^4,5

Most Vitamin D intake of the average American diet is via fortified food products. Fortified non-dairy products will help those with vegan diets get enough Vitamin D, and a little sun helps too. A vitamin D supplement is an alternative to fortified products or where a severe deficiency is discovered.

Awesome omega-3

Omega-3 is another important nutrient that vegan patients may be missing out on. It is most often associated with lower cholesterol and better heart health.³ There are some fortified foods, as well as plant-based supplements that patients can take.

That said, plant-based omega-3 must be converted into the type of omega-3 necessary for the human body to use.^3,4 Because this conversion is inefficient, vegan patients may need an extra boost from supplements.

Beneficial vitamin B12

Vitamin B12 is essential for producing red blood cells and preventing anemia.³ Again, this vitamin is also almost exclusively found in meat or meat products. There’s actually a twist here, as a vegan diet is generally high in folate, which can actually mask Vitamin B12 deficiency. The answer to this is to consume fortified cereals, soy products, and supplements.³

Watch for these complications

Despite the positive health effects of a vegan diet, including lower blood pressure, cholesterol and weight—all of which can improve cardiovascular health—it is important for vegan patients to be aware of the adverse effects of not paying attention to their nutrition.⁶

Some nutrients that are lacking in the vegan diet helps regulate cardiovascular health and vision. To overcome this, patients can take DHA supplements. However, these supplements may be associated with prolonged bleeding time or reduced immune system response.⁶

Patients with vegan diets may also have reduced levels of Vitamin B12, compared to those who have a diet with meat and eggs. Vitamin B-12 deficiency can produce a number of problems, including psychoses, disorientation, dementia, mood and motor dysfunction, and difficulty concentrating.⁶

A recipe for good health

The bottom line for DCs is to discuss their patient’s current diet so that appropriate recommendations can be made. They should remind patients to be diligent monitoring what they eat, read food ingredient labels for key nutrients, and to report any unusual symptoms. In areas where there are more of these kinds of patient needs, there is good incentive for DCs to add vegan-friendly vitamins and supplements to their offerings.

References

¹ Vegetarian Times. “Vegetarianism in America.” www.vegetariantimes.com/article/vegetarianism-in-america/. Accessed September 2015.

² Vegetarian Nation. “Types of vegetarian diets.” http://www.vegetarian-nation.com/resources/common-questions/types-levels-vegetarian/. Published August 2010. Accessed September 2015.

³ Mayo Clinic. “Nutrition and healthy eating.” http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/vegetarian-diet/art-20046446?pg=2. Mayo Clinic. Published July 2012. Accessed September 2015.

⁴ Office of Dietary Supplements. “Vitamin D.” https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/#h3. National Institutes of Health. Accessed September 2015.

⁵ Norris J. “Calcium and Vitamin D.” http://www.veganhealth.org/articles/bones#recs. VeganHealth. Accessed September 2015.

⁶ Craig WJ. Health effects of vegan diets. Am J Clin Nutr May 2009, 89(5):1627S-1633S.