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Is the vegan diet healthy or unhealthy?
Are you looking for THE healthy diet?
Do you want to eat vegan, or someone you know wants to and asked you for help?
If this is the case, then you are probably wondering whether the vegan diet can be healthy and what health benefits or health risks it may bring. Statements from some (supposed) experts can seem contradictory. In this article, you will get an insight into the current state of science on this topic.
Is the Vegan Diet Healthy?
Vegans do not eat any foods of animal origin. If you eliminate meat, fish, eggs, and milk from your diet you get less of the nutrients they contain. At the same time, the increased consumption of plant foods increases the intake of other nutrients; the average composition of a vegan diet differs from that of a mixed-food diet. So is this difference in a vegan diet healthy or unhealthy?
Healthy Plant Substances
When analyzing vegan diets, studies show that vegans often have healthier diets overall: They consume more fruit, vegetables, legumes, whole grains, nuts, and soy products, and they usually take in fewer calories than mixed-food eaters. As a result, they consume less saturated fat and more antioxidants, vitamin C, vitamin E, fiber, and phytochemicals (Menzel et al., 2020).
These nutrients, or the overall dietary pattern, may theoretically have a positive effect on body weight, plasma lipids, inflammatory markers, blood glucose levels, and cancer, among others (Medawar et al., 2019). A dietary pattern rich in those nutrients has also been associated in studies with a lower risk of coronary heart disease, hypertension, type 2 diabetes mellitus, and other chronic diseases (Hemler and Hu, 2019; Guo et al., 2020).
A diet rich in fruit, vegetables, legumes, and whole grains is recommended for the prevention and treatment of type 2 diabetes mellitus. This may explain why positive health effects are also observed in patients on a vegan diet (Medawar et al., 2019).
Because plants have a low energy density, vegans consume fewer calories on average and are less likely to be affected by obesity than those on a mixed diet. This reduces the risk of a number of chronic diseases. However, vegan diets have also been shown to have positive health effects in the short and medium term, regardless of body weight and caloric intake (Hemler and Hu, 2019).
With the increasing life expectancy, there is a growing interest in cognitive health research. In this regard, vegan diets are coming under the spotlight, as many plant substances have shown positive effects on cognition and related pathologies (Rajaram et al., 2019).
There is also evidence of a positive effect of vegan diets on gut health, but the current body of evidence is not strong enough to draw more precise conclusions about the magnitude and mechanisms (Medawar et al., 2019). What is clear is that plant components enrich the microbiome. Probably the most important substances are dietary fibers, which people on vegan diets tend to consume a lot of. On the one hand, fiber reduces energy intake by increasing satiety, thus reducing the risk of obesity and its complications. The composition of the intestinal microbiota can also be changed for the better by dietary fiber. The resulting production of health-promoting short-chain fatty acids can have a beneficial impact on gut health, improving metabolic processes, increasing carbohydrate fermentation, and decreasing protein fermentation (Guo et al., 2020).
Higher fiber intake is also associated with a reduction in risk factors for coronary heart disease. In addition to body weight, these include high blood pressure and elevated total cholesterol (Hemler and Hu, 2019). However, even if the abundant constituents in plants suggest positive effects on cardiovascular disease, it is not yet clear what role a vegan diet may have. In this regard, no clear advantage of a vegan diet over a mixed-food diet can be inferred from existing epidemiologic studies (Rees et al., 2021).
Thus, fiber, phytochemicals, micronutrients, and low energy density are health-promoting features of vegan diets. However, the health benefits of a diet are likely not the result of individual foods or ingredients alone, but rather the interaction of multiple factors, some of which remain unexplored (Medawar et al., 2019).
Is Soy Healthy ?
As a high-protein food, soy is regularly consumed by many vegans, for example in the form of tofu. At the same time, it is sometimes viewed critically and people claim negative effects. However, according to the current state of science, this criticism is unfounded, as there is no evidence of negative effects with moderate consumption. On the contrary, there is evidence of positive health effects for both women and men, for example in relation to breast and prostate cancer, inflammatory markers and glucose metabolism (Reed et al., 2021; Rezazadegan et al., 2020; Guo et al., 2020). However, the effects appear to be individualized and dependent on the type of soy-containing foods and the phytoestrogens they contain (Rizzo and Baroni, 2018).
Is a Vegan Diet Always Healthy?
A vegan diet rich in fruit, vegetables, whole grains, legumes, and nuts provides many beneficial nutrients and is therefore potentially very healthy. However, the composition of vegan diets can vary widely. Especially with the increasing availability of highly processed vegan (substitute) products, there is also an increased likelihood that micronutrient-poor foods will make up a large part of the vegan diet. At this point, the vegan diet is no longer as healthy.
Researchers have developed a “plant-based diet index” (PDI), as well as a “healthy plant-based diet index” (hPDI) and an “unhealthy plant-based diet index” (uPDI). Only a high hPDI was associated with health benefits (Hemler and Hu, 2019). You will learn more about the differences in a moment.
Is a Vegan Diet Unhealthy?
Not only a vegan diet that includes many highly processed and micronutrient-poor foods can be unhealthy. A vegan diet of only unprocessed foods also poses the risk for nutrient deficiencies. On a vegan diet, some nutrients may be inadequately taken in, which is associated with adverse health effects. This is due to lower levels in the food as well as reduced bioavailability of nutrients. Potentially critical nutrients in vegan diets include iron, calcium, vitamin B12, vitamin B2, vitamin D, selenium, iodine, and the omega-3 fatty acids.
Probably the best-known potentially critical nutrient in vegan diets is vitamin B12. A deficiency of this important vitamin leads to fatigue, susceptibility to infection, and eventually anemia and neurological disorders. It must be supplemented in a vegan diet. However, most vegans know this by now, and almost all of them supplement and monitor their status, so that deficiency is rare among vegans (Weikert et al., 2020; Menzel et al., 2021).
The consequences of poor iron status include fatigue, paleness, difficulty concentrating, and reduced performance due to iron deficiency anemia. Vegans may be at increased risk for iron deficiency because although they often consume a lot of iron in their diets, the body does not utilize it as well.
Calcium is found in small amounts in most plant foods, and bioavailability is low. This is often considered a risk factor for low bone density in vegans. In fact, vegans sometimes have lower bone density in studies, but this is not always associated with higher fracture rates. Therefore, the clinical relevance of lower bone density is unclear, as are the specific causes. This is because not only calcium, but also many other nutrients and factors influence bone health. These include low body weight, low physical activity, and deficiencies in other important nutrients such as vitamin D, vitamin A, lysine, and vitamin B6. In addition, vitamin K and magnesium, among others, play a role in bone metabolism (Iguacel et al., 2019; Menzel et al., 2021; Ho-Pham et al., 2009). Because a vegan diet may make it more difficult to get enough of some of these nutrients, it may at first appear to be unhealthier for bones. However, a vegan diet can be “bone-friendly” and does not necessarily lead to lower bone density and increased fracture risk. In particular, vitamin D and calcium supplementation may reduce the risk of fractures in vegan diets (Thorpe et al., 2021).
There are no direct sources of the omega-3 fatty acids EPA and DHA in the vegan diet other than certain types of algae, which can be ingested in the form of oils. Inadequate intake appears to increase the risk of cardiovascular disease, Alzheimer’s disease, and rheumatic diseases, among others (Farukhi et al., 2021; Melo van Lent et al., 2021; Kostoglou-Athanassiou et al., 2020). Therefore, a healthy vegan diet should probably include an oil rich in both fatty acids. It is available in the form of pure algae oil, vegetable oil enriched with it (for example flaxseed oil), or algae oil capsules.
Whether a vegan diet is healthy or unhealthy, as with any diet, depends on its composition. Official nutritional institutions also come to this conclusion. They attribute potential benefits to the vegan diet if it is composed in an informed manner (Richter et al., 2020).
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What Do Nutritional Institutions Say?
The position paper of the German Nutrition Society (DGE) states that a vegan diet can be adequate and therefore healthy if vitamin B12 is supplemented and attention is paid to the other potentially critical nutrients (Richter et al., 2016).
The Academy of Nutrition and Dietetics from the United States, as well as the Italian Nutrition Society, classify vegan diets as healthy and adequate and point out the potential benefits in the prevention and treatment of certain diseases for all populations (Melina et al., 2016; Agnoli et al., 2017). In its most recent dietary guidelines, the United States Department of Agriculture (USDA) also lists soy drinks and yogurts fortified with calcium, vitamin A, and vitamin D as equivalent alternatives to dairy products (USDA, 2020).
What is a Healthy Vegan Diet?
Back to the “healthy plant-based diet index”: As mentioned above, in studies, a diet with a high index has been associated with positive health outcomes. The following foods (groups) have been classified as having health benefits:
- whole grains
- fruit
- vegetables
- nuts
- legumes
- vegetable oils
- tea
- coffee
On the other hand, the following were rated less beneficial:
- fruit juices
- refined flours
- potato products
- sugar-sweetened drinks
- sweets/desserts
For a vegan diet to be considered “healthy” or “unhealthy,” it is not so much about the diet consisting exclusively of the foods that have been found to be beneficial, but rather about the amounts of those foods. So how much of certain foods can you eat as part of a healthy vegan diet? Our Vegan Food pyramid can help you answer this question. It gives you practical recommendations for your food choices. You can see at a glance what ratio of each food group should make up your daily diet. You can choose the absolute amounts according to your individual needs. Fruit and vegetables are the foundation, followed by whole grains and legumes, as well as fortified dairy products and nuts. Fats, oils, and higher-processed foods in moderate amounts complete our healthy Vegan Food Pyramid. The composition is thus similar to the above pattern of the “healthy plant-based diet index”.
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How Can I Tell if my Vegan Diet is Healthy?
You do not need to calculate your individual Healthy Eating Index to know if your diet is “healthy”. Keeping an honest food diary can help you get an overview. You can use it to determine your macronutrient intake and, with the help of a tool such as a software or our Nutrient Database, your micronutrient intake. But even without these precise calculations, you can use your food diary to see which foods you eat and how often, and which foods you might want to include more often. Further information can be obtained from a medical examination. A complete blood count, supplemented by other relevant parameters, observation of your state of health, skin and hair appearance, body weight, abdominal circumference, and similar factors, can provide clues as to whether your diet is healthy.
Important to know: It is not just what you eat that determines whether you are healthy. Genetics and environmental factors affect how you absorb and use nutrients and your risk of disease. Your mental health also is important. If you are stressed about making your diet look healthy, it is anything but. So do not just worry about “optimizing” your diet, or even blame yourself for failing because your blood work is not perfect, you might have a cold, or you might get sick in some other way. Keep your diet varied and diverse to meet your needs, and try to keep your overall lifestyle active and stress low.
Conclusion
Whether the vegan diet is healthy or unhealthy cannot be said with any certainty. As with any diet, the health value is determined by the food choices and thus the nutrient intake. Those who pay special attention to the potentially critical nutrients in their diet will realize the health-promoting potential of the vegan diet. Vitamin B12 and vitamin D supplements are now widely available, and you can use a few tricks to increase your intake and absorption of the other nutrients and, if necessary, optimize it through supplementation. The same is true for people on mixed diets. Many of them would also be well advised to regularly check their nutrient intake and supplement if necessary. One thing is certain: a healthy diet is one that includes a high proportion of plant-based foods. A well-designed vegan diet can therefore be healthy, as beneficial substances are consumed in large quantities and potentially harmful ones in small quantities, and an adequate energy intake and thus weight management are facilitated.
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