Public Health

Is Veganuary healthy?

Introduction

Veganuary was launched in the UK in 2014. The website Veganuary.com says “Since 2014, Veganuary has inspired and supported more than half a million people in 178 countries to try vegan for January – and beyond.”

This seems harmless enough – go vegan in January. January is a well-chosen month, not just because it works for ‘Veganuary’ but because most people eat and drink their body weight in junk over the holidays and thus any diet will make them feel better.

The vision statement is not so harmless. The site continues: “Our vision is simple; we want a vegan world.”

A pie chart on the home page of the website, Veganuary.com, shared that the reasons for participating in Veganuary were as follows: 46% gave health reasons; 34% cited animals; 12% cited the environment and 8% gave other reasons.

Given that health was the number one reason given and given that that’s our area of interest in this Monday note, let’s explore whether Veganuary is a healthy thing to do…

A vegan diet

A vegan diet involves the consumption of no foods whatsoever that have come from an animal or for which an animal is deemed to have been exploited or harmed in any way. That means no meat, no fish, no eggs, and no dairy products. It also means no cochineal (a food colouring derived from beetles); no gelatin (a protein that comes from animal collagen); no confectionery glaze (a sheen that is harvested from trees in which the lac insect resides); no L. Cysteine (a dough conditioner found in some breads and baked goods, which is often sourced from feathers or human hair); no honey (bees are exploited); and so on. All these non-vegan substances are found in processed foods. Hence you can see that a vegan diet has the health benefit, from the outset, of avoiding many processed foods. (Many/most vegans take the food theme further and refuse to wear any products from animals e.g. leather, silk and wool.)

Health claims

Interestingly, I didn’t see any claims on Veganuary.com that going vegan is healthier than following an omnivore diet (I didn’t read every word of every post, but it’s fair to say that health claims were not prominent). Health may be the main reason that people sign up, but the site is very much focused on animal welfare. The health information on the site could be found in blog posts. Blog posts were categorised into five groups: animals; environment; food; health; and press releases. I focused on the health posts. There were 72 on the UK site. The US site contained a subset of these, so I focused on the UK site.

Of the 72 health posts, 15 were about athletes – usually individual (usually amateur) athletes who wrote a post about the fact that they were vegan, and it wasn’t a problem for their chosen sport. Eight posts were comments on studies or news items e.g. “One in three Brits reducing meat in diet.” Eight posts were about meals/eating tips e.g. “How to grow herbs for a nutritious addition to mealtimes.” Nine were random questions and answers e.g. “My 80-year-old granddad has eaten meat and dairy his whole life – doesn’t that show it’s healthy?” Six were about specific conditions e.g. Type 2 diabetes. Five I categorised as other e.g. “Angelina Jolie’s breast surgeon says meat grows cancer.” Finally, 21 were about nutrition. Those are the ones to focus on.

In support of my observation about the lack of health claims on Veganuary.com, many of the health/nutrition posts were defensive – answering common concerns about a vegan diet e.g. “Is a vegan diet dangerous for children?” “How to get enough protein as a vegan.” “Is it safe to be vegan while pregnant?” “Don’t vegans need to take several supplements to stay healthy?” and “Is a vegan diet healthy?

The answer to the last question was presented as a quotation from the US Academy of Nutrition and Dietetics: “All the major dietetics societies have published papers stating that a vegan diet is nutritionally adequate for all stages of human health”.

I addressed the dangerous errors in the Academy of Nutrition and Dietetics’ beliefs here (Ref 1). The American Academy for Nutrition and Dietetics (AND) admits that a vegan diet is not safe by listing the nutrients that need to be taken as fortification and supplements. If a vegan diet were safe per se, it would provide all nutrients required for life and health. Notwithstanding this, “nutritionally adequate”, albeit false, would still hardly be a health claim.

Many of the other posts were about individual nutrients, which are of concern in a vegan diet: vitamin A; vitamin B12; vitamin D; iodine; iron; omega-3; protein; selenium; and zinc. Let’s go through these to see what was said and what wasn’t.

Vitamin A

The entire vitamin A blog post is as follows: “Vitamin A is essential to human health. It is great for our eyesight, our immune system and bone growth (their ref – Ref 2). Our bodies convert beta-carotene to Vitamin A. This means that good sources of Vitamin A are vegetables that are high in beta-carotene – carrots, butternut squash, sweet potatoes, pumpkin, spinach, cantaloupe, mango, apricots, and kale – so eat some of these every day! (Ref 3).

That is not the whole truth. The post should say “our bodies CAN convert beta-carotene to retinol, which is the form in which we need vitamin A, but conversion is poor, if it happens at all.”

Vitamin A comes in two forms – carotene comes from plants and retinol comes from animal foods. Retinol is the form of vitamin A that the body needs. Carotene can be converted to retinol by the body but even with Beta-carotene, the carotene most easily converted into retinol, there is substantial loss such that the conversion ratio was long held to be at best 6:1 (Ref 4). This has since been revised to 12:1 (Ref 5). Also, not every person is capable of converting carotene to retinol “Diabetics and those with poor thyroid function cannot make the conversion. Children make the conversion very poorly and infants not at all” (Ref 6). Finally, carotenes are converted by the action of bile salts and very little bile reaches the intestine when a meal is low in fat. Our grandparents put butter on their vegetables for good reason. Animal food generally, and liver particularly, is the best source of the vitamin A that we need.

Vitamin B12

The blog post on B12 admits that B12 is “the biggie (and probably the most controversial)” but adds “It need not be.” The post recommends “Ensure that you get a reliable source of vitamin B12 through fortified foods (eat at least two a day at different meals) or cyanocobalamin supplements” (Ref 7).

That’s an honest admission that a vegan diet is nutritionally deficient. A vegan diet does not provide B12 and thus it must be obtained either from supplements or from fortified foods (think of fortified foods as high calorie supplements).

Vitamin D

The vitamin D blog ducks the issue of vegan deficiency in this nutrient by generalising the issue. The post reports: “Public Health England now recommends that everyone in the UK take a vitamin D supplement in autumn or winter of 10mcg (400 IU) a day.” The post also promotes a supplement: “The Vegan society makes a supplement containing 800 IU of vegan vitamin D3 a day (which also contains vitamin B12, iodine and selenium)” (Ref 8).

The post should make it clear that vitamin D comes in two forms: D2 from plants and D3 from animals. As with every nutrient that comes in both plant and animal form, the body wants the animal form and conversion from one to the other is poor, if possible. While it is true that a vitamin D supplement may be of benefit for people not able to sunbathe at any particular time, this post neglects to tell people that the only dietary sources of D3 are animal foods – especially oily fish and dairy products. It is far more likely that a vegan will be deficient in D3 and thus required to take supplements.

Iodine

The iodine post rightly summarises the importance of this nutrient: “Iodine helps make the thyroid hormones, which keep cells and the metabolic rate healthy” (Ref 9). As for getting iodine, the post says: “If you regularly eat seaweed (multiple times a week), you will probably get adequate iodine from the seaweed.” This was followed by the caution: “However, the availability of iodine from seaweed is variable and it can provide too much iodine.”

Given that people don’t eat seaweed multiple times a week, and given that this might not be a good idea anyway, the post recommends supplements: “75-150 µg every few days.”

That’s another admission of nutrient deficiency in a vegan diet.

Iron

The post rightly notes the importance of this vital nutrient: “Your body needs iron to be healthy and strong. It is needed to make proteins, such as haemoglobin and myoglobin.” The post is also honest about plants being a poor provider of iron: “Popeye, however, wasn’t entirely accurate; while spinach does contain iron, it doesn’t have significant amounts of it – just 2.71mg in 100g, in fact!” (Ref 10).

Fortified cereals were the top food recommended for iron intake for vegans – that’s a high calorie supplement again and an admission of likely deficiency in this vital nutrient.

The post shared that the (UK) recommended daily intake of iron is 8.7mg for men aged 19-50 and 14.8mg for women of the same age. The post didn’t share that “The RDAs for vegetarians are 1.8 times higher than for people who eat meat” (source: US National Institutes of Health) (Ref 11). And that’s for vegetarians – not vegans. That’s because absorption from non-meat and fish sources is so relatively poor. And, as with calcium and zinc, phytates in plant-foods substantially impair iron absorption. The post didn’t share that it is extremely likely that vegan diets are deficient in iron and this will be particularly serious for females of menstruation age.

Omega-3

This is one of the longer blog posts in the health section and it has some good bits and some bad bits. First it does stress that the omega-3 fatty acids that the body needs are EPA and DHA. It also admits that “there are no dietary sources of EPA and DHA available for vegans beyond sea greens, they must rely on the body’s natural ability to convert it” (Ref 12). (The issues with the body’s far-from-natural ability to convert it were not shared – see these below).

Second, it correctly reports that the conversion of omega-3 into EPA and DHA is impaired by omega-6 “which is found in the highest quantities in wheat products, wholegrain foods and vegetable oils.” It doesn’t spell out that this means that the foods most commonly eaten by vegans are the ones that further impair the conversion of ALA into EPA and DHA. “With a diet rich in n-6 PUFA, conversion is reduced by 40 to 50%” (Ref 13).

The post was called: “Where do vegans get their omega-3?” and it didn’t give a clear and correct answer. The only option for vegans to get omega-3 in the form that they need it (DHA and EPA) is to consume algae. (Algae is the green scum that you can see in a fish tank). The post mentioned sea greens (also known as edible algae), but it did not emphasise that vegans must supplement with algae – usually taken as algae capsules. The post recommended pumpkin seed oil, nuts and seeds (especially flax and chia seeds), sprouted beans, squashes, vegetables and blueberries. These are sources of ALA, not DHA and EPA. As with other plant vs animal sources of nutrients, conversion is very poor, if it happens at all (Ref 14). Most studies find a conversion rate of less than 10% and some studies find no conversion at all (Ref 15).

The balance of DHA and EPA is critical for health but the conversion of ALA to DHA and EPA is not balanced. “More specifically, most studies in humans have shown that whereas a certain, though restricted, conversion of high doses of ALA to EPA occurs, conversion to DHA is severely restricted” (Ref 16).

The human brain is approximately 60% fat (Ref 17) and approximately 20% of that fat is DHA (Ref 18). As noted above, the conversion to DHA is particularly compromised. It should be expected that brain health will be compromised too (Ref 19).

Interestingly, algae supplements have only been available since the late 1970s. Arguably veganism has only been possible since this time (Ref 20). Amusingly, algae are creatures too! (Ref 21).

Protein

The protein blog surprised me. It should have explained that protein from plant foods is incomplete (it does not contain all nine essential amino acids that the body can’t make and in the right amounts), while protein from animal foods is complete. A useful blog post on a vegan site would explain how plant foods can be combined to provide essential amino acids. Instead, this blog post was an advert for “Nutristrength pea protein” – a vegan protein supplement.

If people doing Veganuary buy this pea protein product, will this provide all that they need? I couldn’t see any claims on the Nutristrength web site that their vegan products would provide complete protein. I did some general research, therefore, and found a well-researched and written post, which set out the World Health Organisation Essential Amino Acid recommendations per 100g of protein and per kg of body mass (Ref 22). The post averaged eight sources of pea protein – two from scientific papers and six from manufacturer claims. The results were that pea protein was an acceptable provider of eight of the Essential Amino Acids, per 100g of protein, but that it was deficient in Methionine.

The post went on to examine how much pea protein an 80kg person would need to consume to meet their Essential Amino Acids requirements. The conclusion was that “we should have around 0.7g of protein per kg of body weight, an 80kg person should eat around 60g of protein per day. So we’re 17g over our recommended dietary intake.” i.e. because pea protein is a relatively inefficient provider of protein, people would exceed the overall protein intake requirements while trying to meet the Essential Amino Acid requirements. This isn’t a big deal, as protein intake can be 1g of protein per kg of weight and still be healthy, but pea protein is still deficient in one Essential Amino Acid and the blog would have been far better had it explained how to get complete protein from combining plant foods.

Selenium

The entire selenium blog post states: “Selenium is an essential trace element that plays a key role in helping the immune system and preventing damage to cells and tissue. In some countries, the UK included, selenium levels in the soil are very low. Plants get selenium from the soil, and so the levels of selenium available in the soil will affect how much is available in plant-based foods. Brazil nuts are a brilliant source of selenium. Just one a day can provide all your needs, or you can make sure you get some via a supplement” (Ref 23).

Eat a brazil nut a day or supplement – I agree.

Zinc

The entire zinc post is: “Zinc helps our body grow new cells, promotes healing and aids with processing carbohydrates. Good sources of zinc include legumes, nuts, seeds and oats, leafy green vegetables, and sprouted seeds and beans” (Ref 24).

The post doesn’t say that a 280g steak would provide your entire recommended daily zinc intake (Ref 25). The post doesn’t say that vegans had the lowest intake of zinc when 65,000 meat-eater, fish-eaters, vegetarians and vegans were compared in a UK cohort of the European Prospective Investigation into Cancer (Ref 26). The post doesn’t say that plant foods rich in zinc, such as legumes, whole grains, nuts, and seeds, are also high in phytic acid, an inhibitor of zinc bioavailability (Ref 27). Zinc is thus another nutrient likely to be of concern in a vegan diet (as is calcium, which was not addressed).

Supplements

There were two blog posts in the health section about supplements. One, which was called “Don’t vegans need to take several supplements to stay healthy?” said “No. All the nutrients you need – with perhaps one exception – can be found easily and plentifully in a vegan diet. That one exception is Vitamin B12” (Ref 28).

This is not true, as we have shown above, and as is admitted elsewhere on the site.

Having said that B12 is the only issue, the last sentence of this post was: “As for all those other vitamins, minerals and nutrients, you’ll find them aplenty if you eat a varied vegan diet. Take a look at Dr Michael Greger’s Daily Dozen chart to guide you as to what else we should be eating for optimum nutrition.”

This is not true. I analysed Greger’s Daily Dozen in this post (Ref 29). Greger put forward the optimal vegan diet in his Daily Dozen diet. It contained no B12, no retinol, no D3, no heme iron, and no omega-3 in the right form. It was also deficient in calcium, iron overall and zinc (iodine would have been deficient too – my nutrition evaluation tool didn’t include iodine). And that’s with the best vegan diet that one of the world’s leading vegans can design.

The second post on supplements was a guest post by a supplement seller (Ref 30). This was called “How to supplement on a vegan diet” and it recommended D3, B12, calcium, zinc, iodine, and omega-3. That’s lucrative, but far more honest.

The Veganuary press pack

The Veganuary press pack on Veganuary.com was full of stats and data from Veganuary 2019 (Ref 31). The gender split of the people who signed up for Veganuary was 87% female and 11% male. No explanation was given for that not adding up. A worrying 3% were aged 13-17; 22% were aged 18-24; 28% were aged 25-34; 21% were aged 35-44; 17% were aged 45-54 and 9% were over the age of 55. The diet of people who signed up to Veganuary was reported as 44% omnivore, 23% vegan, 17% vegetarian and 16% pescatarian. Almost a quarter of people who signed up for Veganuary were already vegan!

Despite the fact that the number one reason that people gave for doing Veganuary was “health”, the recent press release was all about animals and the planet, with no mention of health benefits (Ref 32). Perhaps that’s because there aren’t any. There are just concerns about the nutrients that are naturally found in animal foods: complete protein; essential fats; retinol; B12; D3, heme iron etc.

Briefly, but for completeness, Veganuary does not help the planet, as a vegan world would eliminate the part of the food chain that protects and rejuvenates topsoil (ruminants – which provide meat and dairy products) (Ref 33). It would take but a few seasons in a vegan world to achieve desertification of areas that currently provide food. How plant foods would then feed the planet, I know not. How far can hydroponics go? As for the animals, there would be no, or extremely few, cows, sheep, pigs, chickens, goats etc in a vegan world (farmers don’t keep pets). Domestic cats would need to slaughter birds, rabbits, mice and voles or starve to death. Multiples of millions of animals would still die, if we were able to continue plant agriculture, as field animals and birds have no chance of avoiding combine harvesters (Ref 34). And how many fish would die because we’d eaten all of their food i.e. algae?

The bottom line

I was pondering the fact that little harm can be done doing Veganuary for just a month and wondering how to close this post when I happened to catch an interview on BBC breakfast on 4th January 2020. The co-founders of Veganuary were being interviewed. One was Jane Land (who has been vegan for seven years). The other was Ursula Philpot – a dietitian. Philpot was asked about the health aspect of doing Veganuary and her reply included these words: “Just doing it for a month, you’re not going to run into problems really – even if you eat a pretty poor diet. But, longer than that, it has to be fairly well planned… There are gaps in the diet – things like iron, B12, vitamin D, omega-3 fats.”

And there you have it. From one of the founders of the Veganuary campaign. Swap the word planned for supplemented and we have agreement.

People promoting a vegan diet – for any length of time – are not being honest unless they tell you what you must supplement and the serious consequences of not doing this. Let’s have no more dishonest statements that a vegan diet is nutritionally adequate – “oh – but you need to get all of these nutrients from supplements” in the small print. We need promoters of a vegan diet to be up front about what a vegan diet lacks – each and every time they mention it – and what you need to supplement to make up for these many deficiencies. They might like to add that you should then hope or pray that supplements are as good as the nutrients found naturally in what we’ve evolved to eat.

A healthy diet provides the nutrients that we need. A healthy diet does not require supplements. A vegan diet requires supplements. De facto, a vegan diet is not healthy.

Summary

* Veganuary was launched in the UK in 2014. The campaign encourages people across the world to go vegan in January. The vision statement for Veganuary goes much further than this: “we want a vegan world.”

* Vegans consume no foods whatsoever that have come from an animal, or for which an animal is deemed to have been exploited or harmed in any way.

* The number one reason given by people for trying Veganuary was health.

* I analysed the health content of the campaign website: Veganuary.com to evaluate whether Veganuary is a healthy thing to do.

* The answer to the site’s own question “Is a vegan diet healthy?” was a quotation from the US Academy of Nutrition and Dietetics that “a vegan diet is nutritionally adequate.” This is not true. A vegan diet is not nutritionally adequate – it requires supplementation.

* A vegan diet does not provide retinol, B12, D3, heme iron or omega-3 in the forms needed by the body. A vegan diet is likely deficient in calcium, iodine, iron and zinc.

* The health information on the Veganuary.com campaign site did state the importance of vital nutrients. It rarely clarified the form of the nutrient required by the body (the animal form) and the fact that conversion from plant to animal forms of nutrients is poor, if possible, at all.

* Recommendations to supplement/consume fortified foods (which are merely high calorie supplements) were inconsistent across the website, but did include vitamin B12, vitamin D, iodine and iron and should have included algae and probably calcium and zinc. Recommendations to supplement are admissions of deficiencies.

* People who do Veganuary will probably feel short term benefit after Christmas indulgences and because many processed foods will need to be avoided. However, health problems will emerge if people don’t supplement well to avoid the deficiencies that exist in a vegan diet. People who happen to be poor, or non-converters of plant to animal forms of nutrients (e.g. carotene to retinol) may find themselves unable to sustain a vegan diet without serious harm.

* A healthy diet provides the nutrients that we need. A healthy diet does not require supplements. A vegan diet requires supplements. De facto, a vegan diet is not healthy.

References
Ref 1: https://www.zoeharcombe.com/2019/02/is-a-vegan-diet-safe-for-infants-and-children/
Ref 2: https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-a/
Ref 3: https://uk.veganuary.com/blog/vitamin-a-in-a-vegan-diet
Ref 4: “The accepted 6:1 equivalency of beta-carotene to preformed vitamin A must be challenged and re-examined in the context of dietary plants.” Solomons, N. W. and J. Bulux. “Plant sources of provitamin A and human nutriture.” Nutrition Review, July 1993
Ref 5: Guangwen Tang. Bioconversion of dietary provitamin A carotenoids to vitamin A in humans. American Journal of CLinical Nutrition. (2010) (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2854912/)
Ref 6: Sally Fallon and Mary G. Enig, “Vitamin A”, (March 2002).
Ref 7: https://uk.veganuary.com/blog/vitamin-b12-vegan-diet
Ref 8: https://uk.veganuary.com/blog/vitamin-d-vegan-diet
Ref 9: https://uk.veganuary.com/blog/iodine-vegan
Ref 10: https://uk.veganuary.com/blog/iron-vegan-diet
Ref 11: https://ods.od.nih.gov/factsheets/Iodine-HealthProfessional/
Ref 12: https://uk.veganuary.com/blog/where-do-vegans-get-their-omega-3
Ref 13: Gerster. Can adults adequately convert alpha-linolenic acid (18:3n-3) to eicosapentaenoic acid (20:5n-3) and docosahexaenoic acid (22:6n-3)? Int J Vitam Nutr Res. 1998 https://www.ncbi.nlm.nih.gov/pubmed/9637947
Ref 14: Gerster. Can adults adequately convert alpha-linolenic acid (18:3n-3) to eicosapentaenoic acid (20:5n-3) and docosahexaenoic acid (22:6n-3)? Int J Vitam Nutr Res. 1998 https://www.ncbi.nlm.nih.gov/pubmed/9637947
Ref 15: Cholewski et al. A Comprehensive Review of Chemistry, Sources and Bioavailability of Omega-3 Fatty Acids. Nutrients. 2018. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6267444/
Ref 16: Gerster. Can adults adequately convert alpha-linolenic acid (18:3n-3) to eicosapentaenoic acid (20:5n-3) and docosahexaenoic acid (22:6n-3)? Int J Vitam Nutr Res. 1998 https://www.ncbi.nlm.nih.gov/pubmed/9637947
Ref 17: Chang et al. Essential fatty acids and human brain. Acta Neurol Taiwan. 2009. https://www.ncbi.nlm.nih.gov/pubmed/20329590
Ref 18: https://www.psychologytoday.com/gb/blog/diagnosis-diet/201903/the-brain-needs-animal-fat
Ref 19: Joanne Bradbury. Docosahexaenoic Acid (DHA): An Ancient Nutrient for the Modern Human Brain. Nutrients. 2011. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3257695/)
Ref 20: https://www.webmd.com/vitamins/ai/ingredientmono-923/blue-green-algae
Ref 21: https://www.sciencedaily.com/releases/2007/06/070619182508.htm
Ref 22: https://www.brightaroundthecorner.com/diet/is-pea-protein-complete/
Ref 23: https://uk.veganuary.com/blog/selenium
Ref 24: https://uk.veganuary.com/blog/zinc-vegan-diet
Ref 25: https://nutritiondata.self.com/facts/beef-products/7493/0
Ref 26: Davey et al. EPIC-Oxford: lifestyle characteristics and nutrient intakes in a cohort of 33 883 meat-eaters and 31 546 non meat-eaters in the UK. Public Health Nutrition. 2003. (https://www.ncbi.nlm.nih.gov/pubmed/12740075)
Ref 27: Harland BF, Oberleas D. Phytate in foods. World Rev Nutr Diet 1987;52:235–59
Ref 28: https://uk.veganuary.com/blog/vegans-supplements-healthy
Ref 29: https://www.zoeharcombe.com/2018/01/food-to-help-you-live-longer/
Ref 30: https://uk.veganuary.com/blog/how-to-supplement-on-a-vegan-diet-guest-post-from-together (since removed)
Ref 31: https://uk.veganuary.com/press
Ref 32: https://uk.veganuary.com/blog/statistics-show-the-positive-impact-of-trying-vegan-this-january
Ref 33: https://www.zoeharcombe.com/2017/05/red-meat-human-and-planet-health/
Ref 34: Fischer and Lamey. Field Deaths in Plant Agriculture. Journal of Agricultural and Environmental Ethics. (2018). https://link.springer.com/article/10.1007%2Fs10806-018-9733-8