Paleo Advocate Warns Against Veganism: A Vegan RD Response

Home|Paleo Advocate Warns Against Veganism: A Vegan RD Response

Paleo Advocate Warns Against Veganism: A Vegan RD Response

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As an ethical vegan, I don’t think we need to eat animals for many reasons. As a registered dietitian, I know we don’t need to eat animals in order to have an optimal diet; however, I also can say that you don’t need to eat a vegan diet to have an optimal diet. If I can admit that from a strictly research-based standpoint, why can’t those advocating other eating styles embrace the idea? Why must they espouse so many falsities related to a vegetarian/vegan diet? It is simply untrue that you can’t be healthy on a vegan diet, which essentially was the basis of the article “Why You Should Think Twice About Vegetarian & Vegan Diets,” written by a well-known advocate of the Paleo diet.

(Go ahead, roll your eyes. I did. I won’t dwell on my feelings about the Paleo diet – I am all for people making better food choices, but I could give a damn what our ancestors ate back in the day from the standpoint of how it should impact our current eating patterns. It’s apples to oranges, y’all.  Side note: the anthropologist wannabe in me does find ancestral eating patterns super interesting!)

I would like to dissect the assertions in this article, starting with:

Vegan diets, in particular, are almost completely devoid of certain nutrients that are crucial for physiological function. Several studies have shown that both vegetarians and vegans are prone to deficiencies in B12, calcium, iron, zinc, the long-chain fatty acids EPA & DHA, and fat-soluble vitamins like A & D.

First off, being “prone to” a deficiency is not equal to actually having one. And most studies looking at vegan & vegetarian nutrition intakes also note that there are increased intakes of fiber, vitamins C & E, potassium, magnesium, folate, and phytochemicals versus omnivores. Ergo, with such eating patterns, there are decreased risks of cardiovascular disease, some forms of cancer, Type 2 diabetes, and obesity. And the essential premise that vegan & vegetarian diets are inadequate completely forgoes the official position paper by the Academy of Nutrition & Dietetics (the professional organization of registered dietitians) which states, “Appropriately planned vegetarian diets, including total vegetarian or vegan diets, are healthful, nutritionally adequate, and may provide health benefits in the prevention and treatment of certain diseases.”

B12 deficiency is especially common in vegetarians and vegans…The takeaway is that the most recent studies using more sensitive techniques for detecting B12 deficiency have found that 68% of vegetarians and 83% of vegans are B12 deficient, compared to just 5% of omnivores.

Let the cherry picking of studies begin! This particular study looked at subjects who were not supplementing with vitamin B12, so it is really no surprise that vegans would have low levels.  I don’t know any respectable vegan health professional who isn’t screaming from the rooftop about the importance of vitamin B12 supplementation, myself included. The author goes on to discuss a study looking at cognitive performance in former “vegan” kids and how it was lower than omni children. This study was done on macrobiotic children and mentions no indication as to whether the children were given vitamin B12 supplements at any point in time. Typically, macrobiotics discourages the use of supplementation. So again, not a fair comparison.  And if we are going to mention vitamin B12 deficiency, we must mention that it is recommended everyone over the age of 50 consume vitamin B12 supplements because our physiological ability to absorb it when bound to animal foods decreases as we age. Vitamin B12 deficiency doesn’t discriminate.

…trying to meet your daily calcium needs from plant foods alone (rather than dairy products or bone-in fish) might not be a great strategy.

Again, the same research review cited in the author’s case against vegan diets being low in calcium goes on to discuss the fact that vegetarians “typically have lower BMI, serum total & LDL cholesterol & blood pressure; decreased rates of death from ischemic heart disease, decreased rates of hypertension, stroke, Type 2 diabetes, & certain cancers than non-vegetarians.” Why aren’t these findings being discussed? Admittedly, vegans tend to consume calcium in amounts below the recommended level, but when we look at bone health specifically, there are so many influential factors beyond calcium. Sodium, vitamin D, & protein intakes also matter, along with engaging in weight-bearing exercise.

And let’s reflect on the fact that milk consumption as a “main source” of calcium is a newer habit in the course of human history. Wild greens had been providing our ancestors with calcium until we started suckling the teat of animals. The author goes on to state how much spinach one has to eat to equal the amount of calcium in a cup of dairy milk. This is an absurd comparison given that spinach is one of the high oxalate foods that does interfere with calcium absorption. On the other hand, kale, greens and bok choy are all examples of vegetables that provide highly bioavailable calcium to the body (and it’s more bioavailable than cow’s milk). And is it really a burden to have to consume more than a 1/2 cup serving of these veggies as the author alludes? Calcium-fortified non-dairy beverages, calcium-set tofu, and other calcium-rich sources (like blackstrap molasses & beans) are possibilities to meet your daily requirement – and therefore you aren’t left to have to eat cups & cups of greens should you not choose. I know folks in the Paleo crowd tend to frown upon fortified foods (& supplements), but more on that in a bit.

Vegetarians eat a similar amount of iron to omnivores, but as with calcium, the bioavailability of the iron in plant foods is much lower than in animal foods…

It is true that animal sourced iron (heme) is more easily absorbed by the body, but that does not mean someone eating solely plants cannot obtain enough iron to meet his/her needs. And yes, there are compounds in plants which affect the bioavailability of iron; however, there are also ways to enhance iron absorption (like adding vitamin C rich foods to the meal). Iron deficiency affects omnivores as well – it is the most common worldwide nutrient deficiency. It was such an issue in our population that iron began to be added to flour in the 1940s, and today, grains are the main source of iron in the diets of American adults. And lower iron levels do not equate to an iron deficiency. In fact the same study that the author cites in his post also states, “Although it is clear that vegetarians have lower iron stores, adverse health effects from lower iron and zinc absorption have not been demonstrated with varied vegetarian diets in developed countries, and moderately lower iron stores have even been hypothesized to reduce the risk of chronic diseases.” Um, yeah…so there is that. And there is also the issue of adaptation, in which the body learns to reduce iron losses and increase absorption of the mineral in response to a diet high in nonheme iron.

Before I end this, I would like to briefly touch upon the issue of supplements. Many within the Paleo community essentially believe supplements shouldn’t be needed if you are eating properly (Paleo). As you have seen from the author thus far, it would appear he isn’t fond of supplementation (and perhaps fortification) based on his views that vegan diets are “devoid of certain nutrients” including vitamin B12. Obviously vitamin B12 is easily obtained via fortified foods & supplementation. It is a non-issue.

The author addresses the issue of supplements on his webpage stating, “However, I have also stated from the beginning that certain nutrients are difficult to obtain even in the context of a healthy diet (such as vitamin D and magnesium), and supplementing with them indefinitely may be necessary. I call this ‘maintenance supplementation’. Other nutrients that may fall into this category, depending on your diet and health needs, include vitamin A, vitamin K2, selenium, iodine and vitamin C.”

Now I am really confused. So, if you are eating Paleo, you may still run the risk of having multiple nutrient deficiencies? Additionally, you may need some other supplements to get you through the Paleo transition phase – and luckily, the author has his own line of supplements for sale. I am sorry – you cannot have it both ways. Chastise one method of eating for potentially lacking in nutrients and having to resort to supplementation while saying your method is The. Way. to eat – but oh yeah, you will probably need to  supplement at the same time. It just makes you look silly. If you don’t like veganism, that is your right. Just be damn honest about it because your dietary advice clearly isn’t coming from a place of science.

Photo credit: KD Traegner

March 4th, 2014|Vegan Health|

About the Author:

Anya Todd RD, LD is a registered, licensed dietitian specializing in vegan nutrition, receiving her BS in nutrition from Case Western Reserve University and completing her internship at the Cleveland Clinic. Anya holds additional training certificates in adult and pediatric weight management from the Academy of Nutrition and Dietetics, along with certification in plant-based nutrition from eCornell and the T. Colin Campbell Foundation. Currently, Anya teaches the Maternal & Pediatric Nutrition course as well as a Sports Nutrition course for the Wellness Forum Institute of Health Studies and also sits on their Health Advisory Board. Additionally, she serves as the State of Ohio's coordinator of the Vegetarian Nutrition Dietetic Practice Group of the Academy of Nutrition and Dietetics.

12 Comments

  1. Adam March 9, 2014 at 5:47 pm - Reply
  2. Don Matesz March 5, 2014 at 7:58 pm - Reply

    I discuss at length the faulty logic and assumptions of paleo and low-carb advocates in my recently released book, Powered By Plants: Natural Selection & Human Nutrition.

  3. Don Matesz March 5, 2014 at 7:57 pm - Reply

    Ben states: “But so are bone broths and fish bones, foods that were plentiful in the diet of dozens of modem hunter gartherers, all of whom were free or nearly free modern diseases like heart disease and cancer.”

    I am aware of no evidence that substantiates the claim that ALL hunter-gatherers were free or nearly free (of) modern diseases like heart disease and cancer. On the contrary, we have very good evidence that some ancient foragers suffered both cardiovascular disease and cancer. The HORUS study confirmed atherosclerosis in pre-contact foragers, and studies of pre-contact Inuit mummies have shown that these people suffered from cardiovascular disease and cancer (including breast cancer). Zimmerman MR. The Paleopathology of the Cardiovascular System. Texas Heart Institute Journal 1993;20:252-7.

    Further, I am unaware of any evidence supporting the implication that the health status of hunter-gatherers was exclusively determined by their diet. For example, several foraging or pastoral tribes exhibited low cholesterol levels despite eating fatty animal foods; however, these people also commonly suffered from parasite infections that influence cholesterol and lipid levels and the development of cardiovascular disease.

    Vasunilashorn S, Crimmins EM, Kim JK, et al.. Blood Lipids, Infection, and Inflammatory Markers in the Tsimane of Bolivia. Am J Hum Biol 2010 Nov-Dec;22(6):731-40.

    ianto L, Chame M, Silva CS, et al.. Animal helminths in human archaeological remains: a review of zoonoses in the past. Rev Inst Med Trop Sao Paulo. 2009 May-Jun;51(3):119-30. PMID: 19551285.

    Bansai D, Singh Bhatti H, Sehgal R. Role of cholesterol in parasitic infections. Lipids in Health and Disease 2005;4:10.

    Cancer is very poorly studied in the very small populations of foragers. It is a stretch to imagine that science has established their freedom from cancer.

  4. Anya Todd March 5, 2014 at 11:01 am - Reply

    Ben – The author states, “B12 deficiency is especially common in vegetarians and vegans.” I standby my ‘cherry picking’ comment because yes, it is a known fact that our soil & sanitation is much different than in the past, and therefore, vegans must supplement. Picking one single study that blatantly uses a non-supplementing (small) population to show prevalence of deficiency is wrong to do in my eyes because avoiding B12 deficiency as a vegan is very easy to do. It is well established that those taking B12 supplements or consuming fortified foods are able to meet the B12 recommendations.The author fails to mention how easily deficiency is avoided. The cherry picking continues throughout the article because studies are constantly cited which also show the overall advantages of a vegetarian/vegan diet…and there is no mention of that by the author.

    Based on what the author wrote, I am not sure if he would agree that green leafy veggies are an excellent source of calcium? In the original article, he states, “So while leafy greens like spinach and kale have a relatively high calcium content, the calcium is not efficiently absorbed during digestion.” Spinach has a high oxalate content limiting its absorption while kale does not.

    My post isn’t one bashing Paleo or the premise on which it is based. As stated, I could not care less about dwelling on such things. Today’s food system (and all the factors which combine to create it) is far, far different than those of the Paleo age.

    Cheers!

  5. Ben March 5, 2014 at 8:40 am - Reply

    Hello. I don’t see how it’s cherry picking to legitimately cite a study that indicates the greater tendency toward B12 deficiency in vegetarians. You agree with him that veg*ns need to supplement B12. Cherry picking would be if there were other studies that didn’t support this but he chose the one that did. Confusing point.

    Vitamin D may be necessary because modern people (especially those in colder climates) often do not have enough exposure to natural light. He does not make this recommendation across the board and the nuances are described in detail in his book and in other blog posts.. And modern humans are often deficient in magnesium due to soil degradation and the use of synthetic fertilizers. In the Paleolithic period, these supplements would not have been necessary.

    Your point about milk and calcium is also misleading. First off, he only recommends dairy for a subgroup of people that tolerate it well. I’m sure he would agree that leafy greens are an excellent source. But so are bone broths and fish bones, foods that were plentiful in the diet of dozens of modem hunter gartherers, all of whom were free or nearly free modern diseases like heart disease and cancer.
    Veg*ns seem to be interpreting this article as “don’t be a vegan” when it is simply a evidence based, logical cautionary tale that it may not be a great choice for every human. Your mileage may vary.

    Best. Ben

  6. Ellen Jaffe Jones March 5, 2014 at 8:35 am - Reply

    7th in the US in my age group in the 1500 meters (National Senior Games) here. Placed in top 20 in other events there too. Placed in 65 5K races or longer for my age group since ’06 ‘just’ on plants. 2 marathons, 6 half marathons, though rare for anyone with my sprint times to have ever finished a marathon, experts tell me.

    I got so tired of hearing the flock back to the high-protein, meat-based, lard/tallow-rich paleo diets that I wrote “Paleo Vegan.” It is burning up in pre-sales on Amazon…topping at 8000 last night with 2 more weeks to go before it is available.

    Who says wild boars roamed through backyards for meat-consumption three times a day? The reality is while men might have been lucky to catch meat once every 2 weeks, the women were doing fine eating the gathered plant-proteins at home.

    –Emmy-winning TV reporter for 18 years just wanting to find out the truth about food to dodge breast cancer that nailed my mom, aunt and both sisters. Not to mention heart disease, diabetes, Alzheimer’s and arthritis that got the other adults as well. I’m the only healthy one. Did I get all the good genes? No money in broccoli…

  7. Anya Todd March 4, 2014 at 7:56 pm - Reply

    Thanks for the feedback, Melissa. I appreciate it!

  8. Melissa March 4, 2014 at 1:41 pm - Reply

    Great piece, Anya. I’ve read a lot of articles where vegans dissect the arguments for paleo diets, and of course, I’ve read several from the pro-paleo community that are anti-vegan. Personally, I’m happy if people are able to meet their fitness goals on a paleo diet – it’s their choice after all, but I would never go there. (Will be a vegan for the rest of my life.) What I like about your piece is that it dissects the facts about veganism from the fiction of the article in question, point out some logical flaws in the argument, but never denigrate a paleo person’s right to choose what’s right for them. Glad to see people staying classy.

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