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.

Vegan Omega 3's and more

A Brief Overview of Fats
(If you know your fats well, skip to the end for the bit on Omega-3s)

Fat, also called lipid (and sometimes referred to by its liquid name "oil"), really describes a large and diverse group of substances that share a similar chemical structure of carbons linked together. Because of this similar structure, fats all are packed with energy, making them excellent storehouses for energy in the body. Fats are also a critical part of every single cell in our body and serve innumerable functions beyond that of simply providing energy.

There are groups of specialized fat storage cells called "adipose tissue" (when people talk about someone's fat, or love handles, or junk in the trunk, etc. they are talking about adipose!). A recent explosion in scientific research has begun to uncover Adipose tissue's hundreds of novel functions -- scientists are so impressed that they are calling for Adipose to be classified as a separate organ system.

Did I say I was going to be brief? Ok, so let's talk about fats from a vegan perspective according to the way we classify and organize fats:

Saturated Fats - saturated refers to the fact that all the carbons in these fats are full (i.e. saturated) with hydrogens. That's why I'll include partially hydrogenated and hydrogenated vegetable oils in this category. These fats are still a grouping of many types of fats, some of which are worse than others, but in general, these are the guys that raise blood cholesterol and contribute to heart disease and a very large host of atherosclerotic diseases. Yes, most saturated fat in the American diet comes from dairy and other animal foods.

But hefty amounts of saturated fat can creep their way into the vegan diet in the form of margarines, baked and processed foods (which contain hydrogenated vegetable oils, or palm oil, cocoa butter and coconut oil) and a few whole foods like avocado, chocolate, Brazil nuts or coconut.

Are all of these foods bad for us? No. For example, dark chocolate contains ample saturated oils but many studies point to the net benefit of daily intake of a small amount of dark chocolate. Similarly avocados are not enemy number one in health circuits and contain beneficial fat soluble vitamins and nutrients.

The biggest question of debate is palm oil (now gaining infamy for its role in rain forest destruction). Palm oil is ~50% saturated fat and Palm Kernal oil is ~88% saturated fat. Palm oil can be further hydrogenated or fractionated to get a more saturated fat rich product. It seems clear that hydrogenated palm, partially-hydrogenated palm and palm kernal oil are plain terrible for you and your heart. Avoid these in any quantity. So the question is about raw or unrefined palm oil, which is touted to have lots of beta-carotene, vitamin E and other antioxidants. Here studies show mixed results - some reporting a beneficial effect on blood lipids (cholesterol, etc.) and other showing detrimental effect. The differences may have to do with who was selected for the study (e.g. it may have a worse effect on men and people predisposed to bad lipids), on the type of palm oil (red palm may be better than regular palm), how "crude" or unrefined the oil is (in the same way that unfiltered extra-virgin olive oil is far superior to "light" olive oil), or on other factors that are not clear to me. Part of the argument for palm oil not being bad is that the saturated fat is mostly in the 2nd position of the 3 fatty acids on the glycerin backbone - and that this is much less bioavailable (i.e. digested/absorbed) and that palm also contains beneficial mono and polyunsaturated fats.

So in sum, my sense is the verdict is still out on unrefined palm oil. I'll chose to keep my intake small until more is known.

Trans Fats - Most often these are the news-savvy by-product of hydrogenating and modifying oils and contain a chemical structure not often found in things we eat. Until recently, about 80% of trans-fat in the US diet came from hydrogenated soy oil. There is now plenty of science revealing how toxic these critters are... thus the ban on trans-fats now in place in several cities. Do not buy anything with trans fat and be aware of products that say "now trans-fat free" - check to see if they've replaced their trans fat with palm kernal oil or other not-so-good oils.

Unsaturated Fats - we typically divide these into mono-unsaturated oils (think: olive oil, mmm) and poly-unsaturated oils (think: most vegetable-based oils). I won't talk much about mono-unsaturates, except to say they seem to be good for us.

Polyunsaturates can be further divided into categories based on their chemical structure (for you chemistry lovers: the position of the first double bond in the carbon chain), the main groups being Omega 3, Omega 6 and Omega 9.

Omega 3 and Omega 6 are the "essential fatty acids" because if you don't eat any you'll die! You'd be guessing right if you thought that both have beneficial properties. But omega-6s are in so many foods you eat that you don't have to worry about getting enough. Omega-3s are much harder to find and there is growing recognition of the theory that the balance of Omega 3's to Omega 6's in the diet is important. And that our ratio is wayyyy out of whack - we eat way way more omega 6's than 3's (roughly 10x more, rather than the 2-4x more that may be 'ideal').

Where are the Omega-3's hiding?

Well there are modest amounts in some common vegan foods, most notably tofu and other regular fat soy products (excluding soy-oil). So all of us do eat some omega 3's. But given the abundance of Omega 6's in our diet, a strong argument can be made for getting more of the 3's.

Papa Omega 3 and the important fine print of omega 3s:

The parent of the omega 3 family is a fat called alpha-linolenic acid (LNA). The main vegan sources of omega 3 (such as flax oil, canola oil, tofu, walnuts) are mostly alpha-linolenic acid. From LNA our bodies can make some other omega-3s special kiddies called EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). EPA and DHA are the omega 3's most well studied that lower the risk of dying from heart disease. It's thought that large amounts of omega 6 can suppress our ability to convert LNA to DHA and EPA, which may be a particular disadvantage to the common vegan diet at present. So the major question still unanswered is can we make enough EPA and DHA by eating predominantly LNA? And if not, how much does this matter?

I'll skirt these questions by saying this: My hunch is that the modern vegan will get meaningful benefits from improving fat intake - through the combination of reducing harmful fats, increasing omega 3s (especially by replacing omega 6 dominant oils with omega 3s) and likely added benefit from supplementing with DHA (vegan EPA can be extracted from some plant seeds but is still hard to come by right now, and our bodies likely find it easy to convert DHA to EPA...so the main issue is getting or making enough DHA).

Who should pay particular attention to omega 3's?

Those at risk for heart disease and stroke (ok that's most of us); those with depression and women during their childbearing-potential years, especially if you are pregnant or breast-feeding (omega-3s are critical for normal development of the brain).

How to get your omega 3s & improve your balance of 3 to 6:

1. have a daily source of concentrated omega 3s, e.g. 1-3 tablespoons of Flax oil. Flax meal (ground flax seeds) is also an excellent choice because you get the other benefits of the seed, but obviously you need to eat more to get the same amount of omega-3s in the oil. NOTE: whole flax seeds will pass straight through you so are not a viable source (watch out for this in products that claim to have omega-3s from flax).

2. for cooking and baking - switch from generic vegetable oils to canola or extra-virgin olive oil. Do not use shortening or margarine at all. Experiment with flax meal+water as an egg replacer in baking. Pay close attention to the ingredients in those vegan baked goods we love so much.

3. for spreads - again throw out the typical margarine. Use an oil like olive, canola or flax. Or look for specialty margarine-like spreads that boast omega 3s, or at least no hydrogenated, partially hydrogenated oils or palm kernal oils (and thus don't have trans fat or excess saturated fat).

4. Consider a daily source of vegan DHA. These are typically made from algae (precisely where the fishees get theirs) and come in supplement form (e.g. Omega Zen, Health from the Sea and Neuromins (if you don't mind gelatin)) and are now being added to some soymilks (e.g. Silk special formula).

5. Read your labels. Most of us eat an extraordinary amount of packaged and processed foods - try to minimize the junk - stuff with refined grains, hefty sugar helpings and bad oils...

6. Look for fun foods - e.g. refrigerated dark chocolate truffles made with omega-3 rich oil.

7. Focus on the minor sources too. There are plenty of vegan foods that have small amounts of omega-3 (like leafy greens) and or decent amounts but we don't eat them often (like walnuts, hemp and pumpkin seeds). Of course, there are lots of other good reasons to eat these foods too. A recent study on walnuts suggest that daily intake of ~2 ounces offers the same cardiovascular protection as fish.

8. Keep your eye open for more plant based EPA and DHA. These compounds are being discovered in a decent handful of plants (often in the seeds of plants we don't commonly eat) and are sure to make their way to us in functional foods or supplements in the near future...

The fears of a suspecting vegan. Answered.

Maybe you're a touch freaked out about becoming vegan...about abandoning the dietary staples that billions of dollars in marketing have told you are essential to a happy successful productive and fertile life?

You're asking yourself: "But, where will I get my protein?!!!"

Now, I do believe that you're genuinely concerned about your amino acid pool, though I think what you're really asking is: how easy is it for me to screw this vegan business up and end up a crippled wreck? What do I really need to worry about? And what can I chill out about?

Important questions. Here is my answer:

If you're vegan, there are 5 major concerns you should address:

Pssst. don't tell anyone, but you should concern yourself with these things even if you're not vegan. Oh, and I have a much longer list for non-vegans, but I'll spare you that for now.

From easiest to tackle to hardest:
1. Vitamin B12
2. Vitamin D
3. Omega 3 Fatty Acids
4. Befriending refined Carbs
5. Getting cozy with isolation
 

Notice that protein isn't on this list. But it does get an honorable mention in my rant on carbs...so read on! If I had to list a number 6, it would probably be Iron (mostly for women) and 7 might be getting enough calories (though this would only apply to maybe 10-20% of us at most)...

Update: This blog will provide a BRIEF overview of the above worry list and I will wax philo-medical on each topic in more detail in separate blogs. If you're interested in topics 6 or 7 let me know and I'll happily offer a spiel!

1. Vitamin B12 - the vitamin that makes doctors and scientists alike wave their big wobbly index finger at us crazy vegans. And they are right (but they conveniently forgot to wave it at themselves as well) - you need to hunt out little bits of this vital substance and get your B12 level checked periodically. Read why and how by clicking here.

2. Vitamin D - the sunshine vitamin. Understanding this master vitamin will give you a new found respect for that golden globe that warms our spirits. Vitamin D deficiency runs surprisingly rampant in us northerners and it's so easy to prevent. In the least, take a supplement in the fall and winter. Read why and how by clicking here.

3. Omega-3 - the rarest of the "essential fatty acids". It's the fat you need in your diet for your heart, brain and maybe more. But omega-3s are a little tricky to find in good quantities unless you're a regular fish eater (which I'm guessing you're not). Read why and how to get vegan sources by clicking here.

4. Refined carbs - unlike D, B12, and omega-3s the problem here is that these little devils are just too easy to find and they are awfully tasty. We all (vegan or not) need to crack the whip and get these foods off the everyday menu. But they are everywhere. Like mosquitoes ruining a good sunset picnic. Take a hard look at what you eat and you'll be surprised. Read about your options for switching to whole grains, and why that's important, here.

5. Avoiding isolation - say what?! I don't eat isolation. Thank goodness you don't, because being vegan can be a good recipe for adding isolation into your life.

Let me rewind for a second. I've often asked myself: if eating animal foods is so damn harmful and eating plant foods so protective, why doesn't the medical literature abound with data that blows the efforts of our friendly meat and dairy lobby groups to smithereens? (Don't get me wrong - it does support the benefits of a whole food vegan diet).

Well, one answer (of many) may be that people who choose to buck society and become vegan are different. Maybe (and for good reason) they are more often depressed about the world they see around them. Maybe (and for good reason) they feel different and more isolated from the average Joe or Jane. Maybe there is an unspoken psychological toll that befalls those of use who care deeply about what we eat and what we don't. No, I'm not advocating ignorance - just that as a community we need to start thinking and talking about this. I'll muse on this more, tell you why I think it deserves a place on the top 5 list and offer a few suggestions on the topic if you click here 

The unofficial 6th worry: keeping it in context.

I want to be clear - eating a whole-foods vegan diet is a great way to help maximize your health and make the earth a better place. It's a great way to bring purpose and meaning into your life, to minimize cruelty to animals, to lessen your environmental foot-print and hey, it may even help you stay lean in America.

But let's face it, eating vegan doesn't cure malaria or prevent SUVs from running you over. Being Vegan = one important piece of the puzzle, but it rarely stands alone. There are many other important determinants of health and well-being. But we can muse more on that later.

Oh, and worrying IS bad for you. So take action on these concerns, but don't let them cause undue stress!
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Note: take everything you read on The Internet with a grain of salt. My writings do not constitute individual medical advice - for there is no advice that applies to everyone. These are just my informed opinions and I hope they can provide some guidance in your quest for wellness. In short: Please don't sue me. I'm Canadian.

One final disclaimer: my views do not represent the views of my employers or the academic centers I have been fortunate to attend.

Thanks for reading this. Feel free to comment, or offer suggestions on further blogs...