Should Vegans Take A Multivitamin?

I Love Macro from Flickr via Wylio — © 2006 Matt Reinbold, Flickr | CC-BY-SA | via Wylio

It’s tempting to automatically take a multivitamin when we go vegan.

We’ve made big changes to our diet; changes that most people don’t understand – changes that most doctors don’t understand.

We get asked questions about what our new protein, calcium and iron sources are going to be; where our vitamin B12 is going to come from; and what about vitamins D and K?

It can be enough to scare the bejesus out of you!

Isn’t it ironic that the omnivores that ask us these questions often aren’t the pictures of health themselves? And how are they so sure that they have all the correct levels of vitamins and minerals?

One thing you need to know as a vegan is that vitamin and mineral deficiencies are not just a potential problem for vegans. Nope, not even a vitamin B12 deficiency is this.

But it’s still vegans that most people believe are more susceptible to malnutrition, and no-one would blame you for feeling fearful after hearing these beliefs vocalised ad nauseum.

I’ve personally been told that it’s impossible to live without eggs; and that not eating protein from meat will make me weak.

Well, here I am all strong and living and s**t.

But after so much fear-mongering it seems logical, doesn’t it, to invest in a multivitamin to cover all bases?

So what SHOULD you do?

I very much lean towards the advice of the doctors that have been teaching (and living) a plant-based diet for decades. They base their decisions on independent, non-reductionist, peer-reviewed scientific evidence.

These guys – Dr John McDougall, Dr Tom Campbell (son of Dr T Colin Campbell), Dr Michael Greger, Dr Caldwell Esselstyn and Dr Neal Barnard all say taking a multivitamin is unnecessary (in every single link you’ll find each doctor saying this somewhere). They advise that taking a multivitamin can distract from us trying to eat a healthy whole food, plant-based diet; and that it’s best to get all our nutrients in dietary form – excluding vitamin B12 of course, for which we need to supplement.

Dr Greger in particular points out all the studies that have been done on multivitamins; some show that they’re beneficial; some show that they are harmful. Ultimately, the most comprehensive studies show that they don’t make any difference, and that they’re a huge waste of money.

All this said….

Dr Barnard says in one article that a multivitamin can play a role if you know you are not eating enough whole plant food. And both he and Dr Esselstyn say that you MAY need to supplement with vitamin D, for example if you live somewhere that doesn’t have much sunshine – as sunshine is the best source of vitamin D for vegans.

What do I do?

I do not take a multivitamin, but as I’ve said before, I DO supplement with vitamin D, and sometimes with zinc and iodine, because through one thing and another (long-ass story), I’ve learned that my body needs help with these nutrients, seemingly regardless of my healthy diet.

The best advice, if you feel you may be short on any nutrients, is to go to your doctor and have a comprehensive blood test for all vitamins and minerals. These tests can tell you if you are low or deficient in any particular nutrient.

It’s important to identify this exactly. If, for example, you are feeling fatigued – there could be any one of several reasons for this. So it would not be prudent to assume you have an iron deficiency and take iron supplements, as iron can be harmful in excess. Thus, I urge you to get your blood tested and not self-diagnose.

Once you’ve been tested; should you be found to be low in any nutrient, firstly try and improve your levels with diet. This will always be the best way to regain optimal nutrient levels.

Should this not work sufficiently – and I know that for me, I need help with vitamin D (not much sun here), and zinc in the winter (immune system compromised over the years), THEN it may be worth supplementing with small doses of whatever it is you need.

Conclusion

It seems from everything I’ve learned with my studies; from my experience; and from researching the advice of the plant-based doctors, that the best advice is this:

You do NOT automatically need a multivitamin just because you are vegan. This could lead to overload of certain nutrients that are harmful in excess; or just be a plain waste of money
If you feel you may have a deficiency, or if you know you are not eating a varied plant-based diet, have your blood levels checked at the doctors
If you ARE low in anything, try and eat foods that contain this nutrient, and the ones that help absorption of it. I can help with this!
If this still doesn’t work, supplement with low levels of just the SPECIFIC nutrient(s) you are lacking

How Do You Get Enough Zinc As A Vegan?

Zinc from Flickr via Wylio — © 2011 fdecomite, Flickr | CC-BY | via Wylio

A reader emailed me in the week asking how vegans get enough zinc.

It’s a great question. We tend to focus on nutrients that uninformed journalists have scared us into thinking we won’t get enough of on a plant-based diet; like protein, calcium and iron.

Zinc doesn’t often figure in this list.

So let’s do zinc; right here, right now!

Zinc is a highly important nutrient; vital for healthy growth during childhood, adolescence and pregnancy; for a healthy immune system; for nerve development and for wound healing.

Symptoms of zinc deficiency include frequent infections, skin sores, loss of hair and problems with sense of taste and smell.

White spots on fingernails are also thought by many to be a sign of mild zinc deficiency, but though I can find this information on several MD websites, I can’t find science to back this up and there are differing opinions on this.

In any case, you don’t want a zinc deficiency, no sir.

The good news is there is no science that suggests that vegans do not get enough zinc.

According to the Vegan Society, vegans of all ages generally have a dietary intake of zinc which is similar to or greater than that of non-vegans.

If a vegan IS deficient in zinc this is more likely to be because they are restricting their caloric intake (i.e. as with an eating disorder) rather than because a plant-based diet is naturally deficient in zinc.

The recommended daily amount is 8 – 11mg. The higher end of this scale is for sexually active males, as zinc is lost through semen expulsion.

It has been suggested by the Institute of Medicine that vegans who have high intakes of whole grains might need more zinc than recommended. It’s true that the phytic acid found in whole grains can bind to minerals like zinc and make them less bioavailable to the body, but there is no solid science to show that this is a problem that causes zinc deficiency in vegans.

In fact, Dr Michael Greger says that even though whole grains ARE high in phytates, phytates have other health benefits, so we don’t want to avoid them. He says there are two simple solutions to combat any negative effect they may have on zinc absorption. Either 1) Eat bigger portions of whole grains (brown rice for example), to ensure more zinc intake, or 2) make sure you eat alliums (onion or garlic – or both!) with the brown rice, as these aid mineral absorption. This is easily done if you’re making a curry or chili for example, as onion and garlic would both be default ingredients, and you can serve it over brown rice. We certainly do NOT want to avoid whole grains bcause of the phytates and to miss out on the other great nutrients in whole grains.

Even though plant foods are not high in zinc, there are lots that contain zinc. Whole grains, legumes, nuts, seeds, tofu and tempeh are all great sources.

If you want to pro-actively increase your intake of zinc then add toasted nuts and seeds to salads, or grab a small handful as a snack; and make sure to eat leavened (risen) bread over flatbreads.

Should you take a zinc supplement?

Probably, no.

However –

Disclaimer:

I do take a zinc supplement (30mg per day) in the winter, or at times when I feel like I might be coming down with a cold.

This is because my immune system was decimated as a young’n’! (I had lots of antibiotics as an infant, and took them for years as a teen to combat acne, which pretty much destroyed my health and immune responses).

Taking a supplement when I need to works for me. I live in London and am often on cramped public transport in the winter, standing underneath people that are sneezing on my head.

Yes, my head.

In order to avoid catching infections I take supplementary zinc but you very probably don’t have to because your medical history and your lifestyle may be different.

I’ve also found, in the past that if I have white flecks on my nails, a daily zinc supplement takes care of these (but as I’ve already mentioned, I cannot find the science to support this).

If you feel you may have a zinc deficiency, please consult your doctor and have your blood tested for zinc levels before deciding to supplement.

Iron and A Vegan Diet. What Is The Truth?

A few days ago I saw an ‘article’ in Harpers Bazaar entitled ‘5 Reasons Not To Go Vegan’ in which a ‘nutritionist’ explained how hard it was to get enough iron on a vegan diet, and that meat is a much better source of iron.

She went on to explain how, as a vegan, it can also be hard to get enough protein and other nutrients that, in fact, AREN’T AT ALL hard to obtain from plant food.

I was surprised this article was allowed to be published – and why didn’t they ask ME to be the resident nutritionist? I tell the truth that I learned from peer-reviewed science, rather than regurgitate old information that I haven’t once questioned. GRRRR!!

Funnily enough, that article has since been deleted – I’m guessing people must have complained. I’d have complained myself if I wasn’t jaded from seeing too many of these types of ‘articles’ with their dodgy ‘nutritionists.’

Just to prove it WAS there – here it was! Just check out that dumb old URL…

Here’s what’s what on iron:

We need iron. It’s well known that iron deficiency can lead to anaemia. Symptoms of iron deficiency and anaemia include fatigue, dizziness, weakness, and palpitations (though if you suffer from any of these symptoms, don’t automatically assume you have an iron deficiency. These symptoms are compatible with lots of conditions, so go see your doctor and find out what’s up).

Many people who go back to meat-eating from being vegan say they felt tired and weak and feel it’s because they weren’t getting enough iron, believing that ALL the iron is in the red meat.

The sad truth is that many doctors still recommend upping red meat intake to those that are low in iron – I’ve even heard this within the last year.

Unfortunately, most have so little nutritional education, they advise their patients to eat food that is carcinogenic and full of saturated fat, cholesterol and antibiotics rather than study modern science on how BEST to acquire sufficient iron levels from food safely.

So what IS the truth?

The confusion arises because iron from meat (haem iron) IS more quickly absorbed in the human body than iron from plants (non-haem iron). THIS is why the medical profession will often prescribe red meat or liver to patients low in iron, thinking that this will be a quick cure.

Because haem iron is known to be more quickly absorbed, people think that haem iron is better for us, period.

BUT…

…This is NOWHERE NEAR the full picture.

That haem iron is more quickly absorbed is not a good thing. It is absorbed by the body quickly WHETHER WE NEED IT OR NOT. It is not a balanced way for the body to receive iron and can result in iron overload. This increases risk of cancer, stroke and heart disease.

Non-haem iron from plant food is slower to be absorbed by the body but is absorbed as our bodies need it (isn’t this clever?)

All the main health advisory bodies – ADA, BMA, WHO, PCRM – concur that iron deficiency anaemia is no more common in vegetarians than it is amongst meat eaters.

And in the UK in 2002; a study of 33,883 meat-eaters, 18,840 vegetarians and 2,956 vegans found that vegans were found to have the highest daily intake of iron.

As we’ve seen, iron overload is just as dangerous as iron deficiency – but we stand far less chance of over-dosing on iron on a plant-based diet.

Great plant-food sources of iron are whole grains, green leafy veg, beans, lentils, nuts and seeds; and vitamin C-rich fruit and veg help us absorb the iron, but really, if you’re eating a varied whole food, plant-based diet, you don’t need to stress over it.

It’s actually hard to NOT get enough iron on a whole food, plant-based diet.

Just in case you come across an article with information on veganism or plant-based health and you are not sure of it’s credibility; or it seems to contradict information you believed to be true, here is a handy guide to help you navigate conflicting information.

How Do Vegans Get Calcium?

020 Calcium - Periodic Table of Elements from Flickr via Wylio — © 2015 Science Activism, Flickr | CC-BY | via Wylio

The other day a potential client told me they’d be concerned about how they’d meet their calcium needs if they went vegan.

This made me realise I haven’t yet written a ‘calcium’ post. Yipes!

Since I live in a bit of a ‘vegan bubble’ – my partner is vegan, and I am now chatting to other vegans daily on Periscope (Oooh talking of which – why don’t you come join me there on www.periscope.tv/karencottenden), I often assume that people KNOW there are plenty of plant sources of calcium, but clearly I am being presumptuous in this assumption!

If you have the ‘where would I get my calcium from as a vegan?’ question, this post is for you.

Similar to the protein issue, you cannot be blamed for asking yourself this question and not immediately knowing the answer. We’ve all been led to believe a HYYUUUUGE load of crapola, and it’s hard to comprehend just how entrenched and pervasive those beliefs have become.

I had yet another wake-up call to this when I heard the question being asked of me the other day.

So, here’s the deal with calcium.

Firstly, you need to know that it’s hugely probable that we don’t need as much calcium as we’re told we do. There are major interests invested in keeping us all drinking cow’s milk. They’d have us believe that we need a ton of calcium and that this must come from milk – but this is not true.

Secondly, the calcium we DO need is obtainable elsewhere.

Where?

From exactly the same source lots of other animals get it – plants.

Getting calcium from plants instead of milk also ensures that we not getting the horrid saturated fat, cholesterol, hormones and antibiotics that are in cow’s milk.

Where do cows get their calcium? Hmmm, let’s think about that for a second…

Calcium is a mineral.

Minerals come from the ground.

Cows get the calcium (that is in their milk) from the grass that grows in the ground (except, these days they mostly eat feed crops that are supplemented with calcium!).

Where do you think the huge animals (elephants, giraffes etc) are getting their calcium from?

Not from cow’s milk that’s for damn sure!

If you eat a whole food, plant-based diet, then calcium – just like protein – is not something you need worry about.

We’re led to believe we should worry about it far more than we actually should.

I highly doubt you know someone who has suffered from calcium deficiency.

Dr John McDougall writes:

The relationship between people and plants works so well that there has never been a case of dietary calcium deficiency ever reported.

Yet I can bet you know someone who has suffered a disease of excess related to the other properties in cow’s milk (cholesterol, saturated fat, hormones); like diabetes, heart disease and prostate or breast cancer.

There is also a widespread belief STILL, that if you don’t drink milk for calcium you’ll risk getting osteoporosis when you’re older.

A study involving 77,761 women, monitored over 12 years, found that drinking three or more glasses of milk per day DID NOT protect them against hip or arm fractures. It actually showed that there were significantly higher fracture rates in the milk-drinking group than in those who drank little to no milk.

Then there is this study, from 1992, that shows that populations with the lowest calcium intakes had far fewer fractures than those with much higher intakes.

There is lots of evidence suggesting that dairy is harmful and actually contributes to osteoporosis rather than helping to prevent it.

The best osteoporosis-preventing foods are, in fact, whole grains, beans and legumes.

Worried that the calcium from plants might not be as well absorbed as the calcium in milk?

Don’t waste ya time a’ worryin’!

PCRM (Physician’s Committee for Responsible Medicine) says:

The calcium absorption from vegetables is as good or better than that of milk. Calcium absorption from milk is approximately 32 percent. Figures for broccoli, Brussels sprouts, mustard greens, turnip greens, and kale range between 40-64 percent.

Thinking about taking calcium supplements to be sure? Don’t waste your $$$.

Honestly? If you’re eating a varied, whole food plant-based diet, you really don’t need to be worrying about calcium.

If you WANT to worry about it ‘cos that’s just who you are, then just ensure you’re getting enough leafy greens, beans and whole grains, and as an extra calcium bonus – have a couple of teaspoons of ground sesame seeds (high in calcium) on your oatmeal a couple of times a week, or enjoy tahini sauce over falafel or salad from time to time.

How Do You Get Enough Protein As A Vegan? (Yes, I know! But It’s Still An Issue!)

Protein® from Flickr via Wylio — © 2011 Ilias Bartolini, Flickr | CC-BY-SA | via Wylio

I’ve been blogging for almost two years on all things vegan and I’ve never yet written a post on protein.

Why?

Because SO many excellent vegan educators have written on it before me, and I genuinely thought we were past that. I thought there was enough info out there with the truth on how much and what sort of protein we actually need and how we’ve all been led to believe a shedload of garbage concerning this.

I was wrong. The protein issue is still coming up frequently.

I’m still seeing comments under vegan articles like ‘we need animal protein or we get weak and tired,’ or ‘I’ve never seen a vegan that didn’t look pale and sickly.’ Never mind the fact that there are plenty of healthy and strong vegans out there (including these ultra-strong guys); the oft-spouted ‘pale and sickly vegan’ shizzle comes from the belief, as erroneous as it is deeply entrenched, that we need a certain amount and certain sort of protein (i.e. meat) for strength.

Admittedly, I DO live in a bit of a vegan bubble, and I reckon I underestimated just how profoundly ingrained the whole ‘YOU NEED PROTEIN FROM MEAT OR YOU WILL DIE’ thing was.

My bad.

If you are a new vegan and wondering where you’ll get your protein, or more likely, if you are coming up against this question from concerned friends and family, this is for you.

What’s the deal with ‘complete’ and incomplete protein?

Protein is an essential macronutrient and we need it, this much is true.

It is composed of amino acids that are essentially building blocks for every function in our bodies

There are 20 amino acids, 8 of which are essential to our bodies – i.e., they cannot be synthesised.

Some people may tell you that meat is a ‘complete’ protein (i.e. contains all the necessary amino acids), and that plant protein isn’t, and think they’ve won the protein argument.

It is true that plant food doesn’t always contain all the amino acids, but it’s also a fact that we don’t need to eat complete proteins.

We can eat foods that contain the amino acids separately, and our bodies are clever enough to put the pieces together themselves. Rice and beans combined, for example, are an excellent way to get the full complement of amino acids, (lots of world cultures have known this forever, think of chana masala and rice in India, or rice and beans in Cuba); beans and wholewheat works great too – think beans on toast, or wholewheat pasta dishes that contain beans. See? It’s as simple as that. And the steamed broccoli you have on the side? Well that actually contains more protein per calorie than beef!

However, please don’t think you need to pay lots of attention to food combining in order to get enough protein, you really don’t. Eat whole, plant-based foods and you’ll easily be getting enough – without the health risks associated with animal protein!

How much protein do we need?

Just remember, it serves the meat and dairy industries well to have us believe that we need as much protein as possible.

We actually need about 10% of our daily calories to come from protein, a little more if you are pregnant, breastfeeding, or an athlete.

Considering that around 11% of the calories in brown rice come from protein, 40% of the calories in leafy greens come from protein, and 5% of the calories in a banana come from protein, it’s not difficult to reach your daily protein needs.

It’s actually harder to NOT reach them than it is to reach them!

How best to get that protein?

It also serves the meat and dairy industries to have us believe that there is only protein in animal products.

Some people even know there is protein in plant foods (food scientists and dieticians for example) yet they still believe (thanks to meat and dairy industry advertising) that animal products are the BEST source of protein.

Just look at the food plate the United States Department of Agriculture and the US government (who subsidise the meat industry) use for dietary recommendations to the public.

This plate graphic does not represent the fact that there is plenteous and sufficient protein for us in vegetables, grains and fruit without needing the meat. To be fair, in the text on the USDA website they do include nuts and seeds as protein, but many people don’t read the information on the website. They just focus on this graphic and think that ‘protein’ means meat – which was very possibly the intention.

This graphic does little but perpetuate the idea that protein = meat and meat only.

Those with interests in livestock agriculture have, quite frighteningly, well and truly achieved making this belief mainstream.

As we’ve seen above, protein is in all whole foods.

Getting enough protein on a vegan diet is NO PROBLEM AT ALL!!!!

As well as the brown rice, bananas and greens mentioned above, other protein superstars are beans, lentils, legumes, nuts, seeds, tofu, tempeh.

Just eat a variety of whole foods and you’ll be good.

**Look, I really need convincing – is there any chance at all of becoming protein deficient on a vegan diet?**

Anyone heard of kwashiorkor?

Kwashi-WHAA..?

Exactly.

Yet you’ve surely heard of cancer, heart disease and diabetes. This is because these are diseases of excess – which are the majority of diseases we suffer from in the western world.

Kwashiorkor is the medical term for protein deficiency. You haven’t heard of it ‘cos it doesn’t happen where you are. It is a disease of ‘lack’ as opposed to ‘excess.’ It can happen to emaciated children in parts of Africa, or in singular cases of seriously neglected children here, but that’s it.

I can bet you don’t know anyone who’s had it.

Yet there are millions of vegetarians and vegans NOT suffering from kwashiorkor. There are all the HUGE herbivores – cows, gorillas, elephants, horses etc – all NOT suffering from kwashiorkor.

To the people who say ‘well, I was vegetarian but I felt weak and tired all the time so I had to go back to eating meat and the first time I bit into a steak I burst into tears of joy as I could feel the strength returning to my body’ – if you were feeling weak as a vegetarian or vegan, this was NOT a protein issue, but something else; very likely an iron issue. Possibly not enough energy-giving complex-carbohydrates were consumed; or maybe it was the fact that they just weren’t eating enough nutrient-dense food. If you just take the meat out of your diet and don’t replace it with nutrient-dense whole foods, you may have energy or strength problems, but this won’t be because of lack of protein.

Are there any dangers in consuming too much protein?

Li’l bit!

Too much protein is highly detrimental to us. Excess protein (specifically animal protein) is linked to osteoporosis, heart disease, cancers, and kidney disease.