Vegan Blog Going On Holiday & 3 Most Popular Posts

While my posts have been sporadic at best over the past 7 years, my blogging efforts for the months to come will be found elsewhere.

For those of you who just stumbled upon this blog, here are the 3 most popular posts over time:

The #1 Favorite: How Can Vegans Be Overweight?

Eliminating animal foods is one step in a healthy direction, but for many it's not the only step that is needed. This post explores a few reasons why people eating a vegan diet can still struggle with their weight. So what to do if you're still struggling? Find a vegan-friendly dietitian to work with and consider slowly picking up serious weight training or running. If that fails, a lifestyle medicine doc might be a good ally.

Many people write looking for a vegan-friendly PCP or Lifestyle Medicine MD. Some potential leads are here:

http://www.lifestylemedicine.org/search
http://www.pcrm.org/
https://eu-lifestylemedicine.org/member-directory/

The #2 Runner Up: Why SOME People Struggle With A Vegan Diet

Each year, tens of thousands of people are inspired to go vegan out of deep concern for animals, the environment and their health. Sadly, the majority of those return to a regular diet of animal foods. Yes, it can be hard to not eat like everyone else and the effort of going out of your way to find vegan options can become hard to sustain for many. But some don't feel they are thriving on a vegan diet. Why is that? It's a topic that's almost never discussed, but one I encounter in clinic periodically and explore in this post. And no, the answer is not because we need to eat meat or combine proteins!

From my clinical experience, the first issue mentioned in this post - not eating enough calories - is the most common problem and is one that can be easily addressed if recognized. The common pattern is someone who switches to a vegan diet, loses a few pounds, feels fantastic at first but as the weeks and months go by they continue to lose too much weight or feel fatigued. Essentially, they need to learn how to eat more calories and monitor for weight periodically.

Dr. Furhman, one of the few docs with extensive clinical experience in this realm, also cites a need for some of his patients to supplement zinc, DHA/EPA and in rare cases possibly taurine, iodine, vitamin k2. Dr. Greger cites a rare Carnitine deficiency caused by a genetic disorder that might be unmasked by a vegan diet here. These are worth considering if other measures fail.

While cutting out a good 1/3 to 1/2 of your diet and replacing it with plants requires some learning for most people, it's definitely a doable (and highly worthwhile) challenge. But for those who struggle, don't revert back to the standard awful diet that is the norm. In the least, eat as many vegan meals as you can during the week and you'll be making a great difference in all realms. Sometimes, compromise is the answer. Adaptation takes a different time course for us all.

The #3 & Original Post: The Fears Of A Suspecting Vegan. Answered. 

Having been vegan for about 24 years, I have encountered innumerable health concerns borne of fear and propaganda along with every possible iteration of "You're vegan?!? Well, where do you get your protein/nutrients/vitamins/etc?". That inspired me to start a blog for some general responses. In this first post, I tried to spell out from my vantage point which things do actually warrant some attention. There's no reason to have fear on the menu, but there are a few important nutritional items those on a vegan diet should head. The list is much longer for those not on a vegan diet, and those can be found elsewhere.

Want More?

I highly recommend Dr. Greger's site - NutritionFacts.Org

Thanks Thanks Thanks!!!

Thanks to you for taking time to read my blog and share both feedback and your appreciation. Can't say how much that has given me over the years. Eventually, I'll get back to blogging more on these and other related topics.

But for now,
Much love to you all,
And thank you for all you do to make this a better world,

Mark

Why SOME people struggle with a vegan diet

Is a vegan diet for everyone?

If consciously crafted, a vegan diet has profound health advantages and allows us to best care for our environment and live in alignment with our innate compassion. So yes, a type of vegan dietary pattern could be ideal for the vast vast majority of humans. And yet, we can't deny that some people (read: the minority) struggle to make a vegan dietary pattern work for them.

Why do SOME people not thrive on a vegan diet? And what can you do about it.

Frankly, this question hasn't been well researched and is poorly understood. But here are a few hypotheses that are worth considering if you or someone you know is not doing well on a vegan diet.

1. Not Enough Calories

One great advantage of a vegan diet is lower calorie density.  People often lose weight when they go vegan. This is super awesome for the majority of people, but not necessarily for relatively-thin, highly-active young people who are also very health conscious. Chances are these people have less appetite-drive and don't absorb calories as well as others. They probably avoid food when they are anxious/stressed and avoid binging on calorie-rich foods. They tend to choose the least calorically dense foods possible because these are healthier - like raw veggies and brown rice.

For some of these folks, they simply will not always be meeting their caloric/energy needs and they might feel more fatigued then usual overtime. Perhaps this is the brain's way of saying "slow down, there just isn't that much food around to support all this extra activity". They might feel better when they return to eating animal products, simply because they begin eating more calories and have a less restricted diet.

Rather than adding back the animal products, a better solution is do some creative meal planning and figure out ways to add back the missing 500 or so calories. There are lots of ways to do this, from emphasizing fat rich foods (e.g avocado, nuts, seeds, coconut) to making food more dense (e.g. smoothies, dehydrated foods/food bars, nut butters, dried fruit) to even sometimes choosing more processed foods (e.g. white rice) and including more protein-concentrated foods (e.g. seiten).

2. Junk-Food Vegan

On the opposite side of the coin is the junk food vegan that lives off vegan pizza, tofutti, french fries, soda, vegan cupcakes, etc. This we know: just because it's vegan, doesn't mean it's healthy. Believe me, I <3 my vegan junk food on occasion. But the problem here is no different from the standard american diet: you are crowding out the nutritious life-sustaining food and stuffing yourself silly with crap.

3. Social Isolation Syndrome

It amazes me how poorly we appreciate the effects of social isolation. Watch this video to see how physiologically powerful physical and social isolation can be. Being vegan doesn't mean you have to be socially isolated, but for a few it can make them feel more isolated. This is not a recipe for optimum health.

Early adopters have to cope with a little isolation, but one idea how is to cultivate a greater sense of compassion for human-animals who eat other animals. They are just as flawed as you are and there's no reason they can't be your friend, share meals with you, be your lover, etc. In fact, if you really want to influence the world, the more you hang out with these creatures the better. (unless of course you're a miserable conspiracy-lover who refuses to shower and thus has the effect of decreasing the odds that other people will move to a vegan diet. Apologies for the rant.) 

4. It's Not The Food

Food makes a huge impact in health. Ok. But just because you're vegan doesn't mean that really bad stuff can't happen to you. And it doesn't mean that every health problem you have has something to do with your diet.

Genetics, horrific bad luck, mood/psychology, drugs, infections, and many other factors can trump diet. It's always wise to considering whether your diet caused the problem or can contribute to healing it, but you've got to be open to the idea that it might have nothing to do with what you eat.

Also remember that many people became vegan because their health was not optimal to begin with. Those same underlying issues might not go away on a vegan diet, and some might get worse over time.

5. Unmasking Effects & Rare Genetic Disorders

Changing your lifestyle can, in rare cases, unmask hidden problems. For example, fructose malabsorbtion - a not too uncommon issue whereby eating concentrated fruit sugar causes irritable-bowel like symptoms and is associated with depression. If you suddenly start eating fruit-juice sweetened desserts and more fruit and fruit juice, then these symptoms will get worse. The solution is a plant-based diet that favors vegetables over fruit and avoids concentrated fruit sugar and juice and minimizes refined sugars.

Another example is diabetes in a long-time Atkins-style eater. If you eat no carbohydrates but are very overweight and have insulin resistance, switching to a more carb rich plant-based diet may initially make blood sugar control worse.  The answer is weight loss, avoiding processed carb-rich foods, eating only healthy fats, exercise, minimizing/moderating fruit, along with a high-fiber vegan diet.

Finally, there is also at least one type of rare genetic disorder involving carnitine transport which can be mitigated by carnitine-rich foods (i.e. meat). However, this is better treated with high dose carnitine supplements then with meat. Dr. Greger has a great post on this. 

6. Under Supplemented

Yes, it would be ideal if we got all our nutrients from our diet. Frankly, there are just some cases where this is not possible (vitamin D, vitamin B12). And there are some individuals who need higher levels of some nutrients (iron, zinc, omega-3s) because they don't absorb them well for whatever reason. This is true for meat-eaters too.

Sometimes, you've just got to add some supplements to your diet. Some vegans have a ridiculous hang-up about taking an "unnatural" supplement. While I applaud their idealism, they are doing themselves and our movement a huge disservice.

People ask me what I take: Vitamin D 1000 IU to 2000IU with food (most days, but especially in the winter); B12 (I buy a bottle a few times a year to boost my body stores); occasionally I get paranoid and buy a bottle of algae-based DHA/EPA. And I regularly eat some nutritional supplements: flax oil, fortified soy milk, chia seeds, flax meal, hemp seeds, nutritional yeast, marmite (because I was born in South Africa and it's delicious ok!).

At the same time, I'm super skeptical of the functional/orthomolecular medicine folks who advocate massive supplement regiments to cure everything.

7. High-Fiber Exercise-Deficiency

We did not evolve to blog. Or read blogs or work at a desk. Sitting is one of the worst things for your health, and we do it all day. My sense is that our guts function way better when we are regularly active and that exercise becomes even more important when you increase your fiber intake.

A very high-fiber diet with a sedentary high-stress lifestyle can set you up for a lot of bloating and gas pain. The solution is daily movement/exercise and plenty of water.

8. Beat By Cravings

Our understanding of cravings is amateur. Just because your brain craves something doesn't mean you have a deficiency. Craving chocolate does not mean you are magnesium deficient. Craving meat does not mean you are iron deficient and need to go back to killing animals for sustenance.

It's not to say that cravings can't have true information embedded in them, it's just that it's complex. For example, we make psychological associations with food. When we are stressed, we seek comfort, and food is one way to get comfort. Thus when stressed I might crave my comfort food, not because I need the nutrients in the food but because I need to be comforted. Your comfort food is probably different from mine - not because we have different blood types (or other such nonsense) but because of the different exposure to comforting food we had as kids.

Another random psychological nuance: the more one tries to avoid thinking about something, the more likely one is to think about it. If you are obsessed with avoiding meat, you are more likely to think about it and to crave it. We are funny creatures that way.

One last example, dissection lab -- the formaldehyde has been known to illicit cravings for meat. You can imagine how disturbing that is to an unaware vegan med student, on many levels.

Point being -- cravings are complex and often misinterpreted. Take them with a grain of salt. Roll with them and focus your attention elsewhere when the craving defies common sense.

What Else? & What if My Problem isn't on this list?

This is not an exhaustive list, and admittedly it is a list of hypotheses, but chances are the reasons people don't thrive on a vegan diet are fairly small in number and have a feasible solution if there is a will, an understanding and a few good measures of creativity.

Sometimes it can be hard to figure out (or you lack a doctor who can help you figure it out), and sometimes adding back some animal-products seems to make the difference and provide a sense of well-being that was missing. In that case, think of the animal-products as supplements - not to be eaten at every meal, but in the smallest dose possible. You'll still be eating a predominantly plant-based diet and doing a lot for your health and the world.

Avoiding isolation... Influencing social norms

In this post we talk about the need to avoid social isolation and help change social norms.


Let's start with some basic questions:

In North America, why are so few people vegan?
And why are there many people who claim to be vegetarian, but actually eat meat?

The answer to both questions has a lot to do with social norms.
The dietary social norm in America is to eat and enjoy meat, milk and other animal-based products. The vast majority of people in wealthy nations follow this same social norm. And even those who identify with another dietary ideal (e.g. being vegetarian), often still follow this same social norm. Why?

Social norms are incredibly powerful.

Science is gradually waking up to this realization. Sure, we've known for ages that children learn by mimicking others. And we're quick to point out that most people follow trends and behaviors blindly "like sheep", victims of fashion and gadget fads. Strangely, we forgot to notice that even "free thinking and independent" adults cave-in to powerful social pressures, which have a measurable impact on our health and well-being.

Nicholas Christakis, a physician-scientist at Harvard Medical School, along with his colleagues has demonstrated this nicely with several recent studies. One study examined the evolution of a large social network over 30 years in the famous Framingham Heart Study - which revealed that obesity actually spreads through a social network the same way that an infectious disease might spread - i.e. through close contacts and friends. The take home here was that the health behaviors that lead to weight gain are in effect contagious. Ultimately, people do what their friends do because they want to be "normal."

((More recently Christakis and colleagues demonstrated that your happiness is actually influenced by the happiness of your friend's friends. (This by the way is one reason I left Boston and moved to San Francisco!) In other words, emotions are contagious.

More on Christakis's work: an Edge interview; NYT article on happiness study; NYT on spread of obesity))

If you really stop to think about it, you will be forced to agree that the way we think is profoundly influenced by others. The vast majority of what we "know" is knowledge told to us by others. Our language is a product of how those around us speak. And so to our actions. More often than not we do what other people do.

So, it's really not surprising that most Japanese eat Japanese food, that Americans eat very similarly to each other, and that Europeans typically gain weight when they move to America. Social norms exert influence on all humans to some degree.

On vegans and social norms:

Vegans are different. It takes a certain kind of person to be able to say "I don't care what most people think or do, I'm going to do what I think is right and best, even if that makes me different and weird in the eyes of society."

Many vegans, at least those who were not raised as such, share this characteristic. I'm not trying to say that all vegans are the same. Far from it. But by nature of the current dietary social norms, to be vegan is to choose to be different.

My concern is that for some (if not many) vegans, being different from the rest of society lends itself to a certain amount of social isolation. This social isolation may have some costs that we should understand and mitigate. Costs that are probably less than the benefits but which may need to be managed.

Even more importantly: learning to minimize social isolation may be the best tool for helping us change the current societal dietary norms.

On eating and social isolation:

Food is central to almost everything we do. Sharing food is incredibly important for social bonding and maintaining relationships (be they business, intimate or plutonic). This is why saying "no" to eating someone's food (say because it's steak and you're vegan) is often interpreted as a personal rejection even when it's rationalized.

Does this mean vegans can't have close non-vegan friends or are destined to be lonely? Of course not. Many of my closest and dearest friends eat meat, and they readily support my vegan-ness in any way they can.

Still, one can't help but feel a little isolated when you're eating with friends at a restaurant and everybody else is merrily sharing chunks of animal flesh, talking about this great steak they ate last week and you are in the corner eating something scrumptious but different, sharing only with yourself.

My point: as a vegan, a certain amount of social isolation is unavoidable if you are living among and with omnivores. We can pretend this isolation is minimal or doesn't exist, or we can explore it and learn how to mitigate it.

The cost of social isolation

Is it possible that the cost of social isolation, even if it's subtle, includes decreased health?

Perhaps. It has always seemed curious to me that studies among vegetarians and vegans who are not shunning the social norm - for instance, among large populations of Seventh Day Adventists (SDA) - demonstrate consistent and marked health benefits compared with SDA's who eat meat and other animal products. Whereas there is more variability in the results of studies that assess vegans or vegetarians who are living mostly among non-vegetarians (generally the results are positive, but not often as robust as we'd expect).

Of course, there are many other reasons why epidemiological studies may not show as large an effect (or even no effect) of a vegan diet compared to non-vegan diets. These reasons include methodological factors (e.g. poor sample size, study design, etc.) but they could also be from unknown confounders. (see definition at end*)

Some of these confounders include poor mental health, shunning of other normal health practices (like going to the doctor, or taking vitamins or medication when prescribed), the inability to self-deceive (this is a fascinating concept, perhaps a topic of a future post, but in short people who can pet their dog with one hand, eat a chicken with the other are good self-deceivers. good self-deceivers do better in business and probably in health as well; i.e. in part it's the ignorance is bliss phenomenon), or other genetic or behavioral factors that may be linked with the personality-type that allows people to shun social norms.

Furthermore, social isolation may have a significant impact on whether someone can maintain a vegan/vegetarian diet. I've met hundreds of people who "used to be" vegetarian/vegan. Why did they return to a meat centered diet? "It was too hard." "I felt better when I started eating meat again." "I missed cheese." etc. Some of these folks were experiencing the side-effects of social isolation and how difficult it is do shun the social norm. (As well as some of the addictive properties of animal-foods, but that's for another post!)

Please keep in mind that this is simply an emerging thesis I am describing; one that I think deserves attention and study, but to my knowledge lacks investigation.

Minimizing isolation, changing the social norms:

Think about the small but meaningful changes we have seen in the last 2 decades. Soymilk - once an obscure drink to North Americans - is now mainstream. When a good restaurant served salad it used to be iceburg lettuce, now it's mixed field greens. Tofu and veggie burgers used to be something to make fun of, now it's a question of preference. In a small crowd, foods like quinoa or tempeh will not be new to everyone. Even the word vegan is relatively mainstream and usually no longer denotes someone from an alien planet.

If you've been paying attention, you'll notice that knowledge of these words has spread throughout society and that enjoyment and preference of "new" vegan foods has spread alongside.

How did this happen? It happened because people like you and me decided that it's normal to eat these foods. We purchased them and essentially financed their existence. Other people did the same. Still other people paid attention (consciously or not) to what we were eating, and decided to take a chance on something new. Knowledge and behaviors spread.

The same phenomenon happens in reverse. Red meat, and especially veal, consumption has slowly but steadily declined over the past few decades in North America. Why? Again, because the idea that red meat is unhealthy, inhumane and environmentally disastrous has slowly spread. In short, because it is becoming less normal to consider red meat good or desirable.

The point is this: everything you do influences people around you, whether you like it or not. If you decide to lock yourself in your home, not patronize restaurants that serve meat and avoid delusional meat-eaters then you lose the opportunity to influence them. You also risk maximizing the downsides of social isolation.

Although I don't know this for sure, my guess is that the more normal, happy, successful and healthy you appear to others, the more they will look to mimic your behaviors, be they lifestyle, political or social behaviors. Yes "radical" people do influence others, but perhaps their main function is to stretch the boundaries of known behavior. If you have 100 body piercings, then suddenly someone with 2-4 piercings seems pretty normal.

As we grow older and evolve, we need to decide what role is the most meaningful and enjoyable for each of us to play. No one can tell you how radical or different from the norm you should be. My only hope is that you consciously weigh the pros and cons, and that the concept of social isolation is something you consider.

To be clear: I don't believe social isolation is a reason not to be vegan. I just think it's something to manage.

Along the way, remember that your actions can help "nudge" people to one day do the same thing. And this can happen without "preaching" or revealing your judgment on their behaviors. The more you understand other people, the more they will understand you.

Granted, there's always a time and place when you have to be vocal about your beliefs and convictions. But it's nice to know they are influencing other people even when you are not trying.
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* A confounder is something that could appear to be causing an effect/result/outcome, but is really only linked with the outcome for some other reason. For example, people who buy large size clothes tend to gain weight more than people who buy small size clothes; therefore, a misguided person could say "don't buy large clothes because it will cause you to gain weight". It's easy to see how in this case the shopping habit (buying large clothes) is not the cause of weight gain, but actually the result of it. Buying large clothes is a confounder in this analysis.