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Alyssa Luck

Alyssa Luck

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Is it Possible to be Healthy on a Vegan Diet? [Part One]

Alyssa Luck · Jul 12, 2013 · 4 Comments

Note: this is one of my oldest posts, written when I was 19. I’m sure there are FAR better and more comprehensive summaries out there of the nutritional risks of a vegan diet, but this post (along with part two) do cover the high points, so I’ve left them up!

In my last post in this series on veganism, I looked at anthropological evidence to establish that as a species in our natural habitats, humans are omnivores, and we thrive on an omnivorous diet. But although we are still humans (most of us, anyways), we don’t quite live in our natural habitats anymore, so what applied to the natives that Weston Price studied doesn’t necessarily apply to us. In a modern-day setting with greater access to a variety of foods, can humans thrive on a vegan diet without needing to supplement? Is it biologically possible for humans to get what they need on a diet devoid of animal products?

In this two-part post, I’ll try to answer that question by looking at some of the nutrients that are hardest to come by on a vegan diet. In part one, we’ll look at three nutrients that are vital to bone health: vitamin D, calcium, and vitamin K2.

Vitamin D

One potential risk of a vegan diet is inadequate vitamin D, which could lead to osteoporosis and dental problems. While lacto-ovo vegetarians don’t appear to have significantly lower bone density than omnivores, a few studies of vegan women show that their bone density is lower than that of omnivores and other vegetarians, and their risk of fracture is higher. (1)

Vitamin D is a bit of an unusual case, because there aren’t many foods (animal-derived or otherwise) that supply significant amounts of vitamin D. However, the few foods that do contain vitamin D tend to be animal-based, including fish, liver, and egg yolks. Additionally, the most usable forms of vitamin D are vitamin D3 and its metabolite 25-hydroxyvitamin D, which are only found in animal products. (2)

Luckily for vegans, the body can produce vitamin D3 when the skin is exposed to sunlight. Of possible concern is the availability of vitamin D precursors such as cholesterol, which also tend to be less prevalent in a vegan diet, but in a healthy person this shouldn’t be too much of an issue.

It’s worth noting that meat has been shown provide unique protection against rickets and osteomalacia (vitamin D deficiency diseases) that its vitamin D content alone cannot fully account for. (3) Meat doesn’t contain that much vitamin D (an average of 7 μg vitamin D/kg), but a study of Asians showed that a diet including ‘high intakes’ of meat, fish, and eggs was completely protective against softening of the bones, even though the diet as a whole was low in vitamin D and they lived at a high latitude with low exposure to sunlight. Diets high in dairy – but not meat – did not have the same protective quality, despite the fact that vitamin D and calcium intake were the same between groups.

As this is an observational study, it’s possible that the findings resulted from factors other than meat consumption, but it appears that small amounts of meat could be necessary to maintain bone integrity at higher latitudes where exposure to sunlight is limited. A vegan diet alone isn’t enough to cause softening of the bones, but a vegetarian or vegan diet along with limited sunlight appears to be detrimental to bone integrity.

In other words, it’s vital for vegans to get plenty of sun exposure, and if that’s not possible due to the environment, vegans probably need to supplement with vitamin D3. It’s easy to get your vitamin D levels tested with a quick blood draw, and Denise Minger recommends supplementing with a vegan form of D3 to get your blood levels up to at least 35 ng/mL. However, recent research suggests that levels between 20 and 30 ng/mL might be most optimal, so if you’re otherwise healthy and get plenty of sunlight, a level as low as 20 is probably fine.

Calcium

Calcium can be a thorn in the side of strict paleos and vegans alike, due to the popular belief that one can only obtain sufficient calcium levels by consuming dairy. However, unlike those on a paleo diet who can fall back on bone broth (or just straight-up bones) as a source of calcium, the vegan diet appears to be sorely lacking in this much-publicized mineral.

First, I’d like to point out that calcium probably gets more airtime than it really deserves. Yes, calcium is important, but other nutrients such as magnesium and vitamin K2 are just as, if not more, important to bone health than calcium, but they don’t get nearly as much attention.

As I mentioned above, studies indicate that long-term vegans have lower bone density than omnivores and lacto-ovo-vegetarians. (4) However, that association disappears when vegans are consuming adequate levels of protein and calcium. In this case, the association disappears at 525mg of calcium per day, which I think is a very reasonable goal.

A possible problem is that many vegan sources of calcium aren’t particularly well absorbed, due to compounds such as phytates, oxalates, and fiber that are also present in plants. However, several studies show that the calcium bioavailability for cruciferous vegetables such as kale, cabbage, and mustard greens is even better than that of milk! (5) Keep in mind that these vegetables were boiled for a few minutes before testing, which probably has an effect on the bioavailability of their nutrients. If you’re a raw vegan and don’t plan on cooking your kale, you might not be getting as much calcium as you think you are.

Also, even though the calcium in kale and other cabbage-family veggies appears to be well absorbed, they still don’t provide that much calcium per serving. For instance, 1 cup of cooked kale will only net you about 45mg of absorbable calcium, and the same amount of bok choy should give you about 85mg. (6) According to the same analysis, nuts and legumes are poor sources of calcium due to higher levels of phytates and oxalates, although it’s unclear whether the samples studied were properly prepared by soaking or sprouting.

In general, I think that getting adequate calcium on a vegan diet isn’t nearly as big of an issue as some people make it out to be, as long as grains, legumes, nuts, and seeds are prepared properly and plenty of greens are eaten. Plus, it looks like calcium supplementation often does more harm than good, so I think I’d avoid that option if possible.

Vitamin K2

Vitamin K2 works with vitamin D and calcium to ensure bone health, and it’s a nutrient that many people (not just vegans) are deficient in. Vitamin K2 was relatively unknown – or at least misunderstood – until recently, but more and more health professionals are acknowledging how important it is. Its primary role is to ensure that calcium is deposited in the correct locations of your body, such as your bones and teeth, rather than in soft tissue like arteries. You can read more about it here.

Luckily for vegans, the richest food source of vitamin K2 is natto, which is a completely vegan, fermented, soy…um, thing. (Product? Condiment? I’m actually not quite sure how to classify natto, and while I’ve never tried it myself, there’s definitely sliminess involved. Here’s a picture. And another one, just for kicks and giggles.)

If you’re a fan of natto, then your vitamin K2 status (and dental health) probably rivals that of the lauded hunter-gatherer populations studied by Weston A. Price. However, if you’re a vegan and don’t eat natto, you may be deficient in vitamin K2.

Vegans get plenty of K1 in the form of leafy greens and other plant foods, but other than natto, the only good sources of vitamin K2 are animal products. Cheese and butter from grass fed cows are particularly good sources, as are organ meats. Animals can convert K1 into K2, and a couple studies indicate that humans can as well, but the evidence that vitamin K2 is more therapeutic than vitamin K1 indicates that the conversion process in most humans isn’t efficient enough to supply adequate K2. (7, 8, 9) Thus, vegans who don’t regularly consume natto probably need to supplement with vitamin K2.

Okay folks, that’s it for part one. Here are all the posts in the series:

Veg*n is Not a Curse Word
Plant-Based Diet or Plant-Based Diet?
Are Humans Herbivores?
Is it Possible to be Healthy on a Vegan Diet? [Part One]
Is it Possible to be Healthy on a Vegan Diet? [Part Two]
A word on raw meat, carnivory, and compassion towards animals

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Comments

  1. Molly (Sprue Story) says

    July 19, 2013 at 7:02 am

    Ew, ew, ew, I don’t think I will ever try natto. Then again, I’ve been less and less of a wannavegan lately anyway (because eggs are just too good).

    Reply
    • Alyssa Luck says

      July 19, 2013 at 9:09 am

      Haha it does look nasty! I want to try it someday. I think I would want homemade natto though. Fermented things from the grocery store just don’t do it for me.

      Reply
      • Molly says

        July 19, 2013 at 9:45 am

        Maybe if I closed my eyes while I tried it…those photos you turned up are priceless, by the way.

        Reply
        • Alyssa Luck says

          July 19, 2013 at 12:46 pm

          Oh yes. Looking at it definitely wouldn’t help matters. And thankya (:

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Hi! I’m Alyssa. I like thunderstorms and cats, hate wearing shoes, and enjoy devising extensive research projects for myself in my free time. This is me in Bali with a monkey on my shoulder. And this is my blog, where I muse about health-related topics and document my relentless self-guinea pigging. If you want to know more about me, click here!

alyssa.luck

alyssa.luck
Photo dump from the last year. Thanks to everyone Photo dump from the last year. Thanks to everyone who made 28 the best yet - excited for 29🥰

(PS. In case anyone wants to know what it’s like in my head, I was going to write something like “year 28” or “my 28th year” but then I realized that the year between your 28th and 29th birthdays is not your 28th year of life, it’s your 29th year. I am turning 29 because I have been alive for 29 years. So then I had a whole thing about how to word it without being inaccurate and ended up going with what you see above which is vague and weird but the point is it was a good year and I love all the people in my life dearly)
Biology of Belief (2005) was written by Bruce Lipt Biology of Belief (2005) was written by Bruce Lipton, who earned a PhD in developmental biology in 1971 and was an anatomy professor and academic researcher in the 70s and 80s. Despite the book's presentation and Lipton's background, this is not a science book. It is an exposition of an ideology, supported by haphazard and poorly contextualized nuggets of evidence, rhetorical leaps, and a mind-boggling overuse of analogies. 

The book largely failed to deliver on its promised content. What it does is argue for the primacy of the environment over DNA in controlling life; propose that the cell membrane rather than the nucleus is the "brain" of the cell; invoke quantum physics to explain why modern medicine fails; explain that our behavior is largely controlled by our subconscious mind; inform parents that they therefore have a great deal of control over the destiny of their children; and conclude that humans must become nonviolent protectors of the environment and of humanity because Everything Is Connected.

It’s not that these points aren’t relevant to the topic at hand - they are. But they were not connected in a coherent way that would explain how “belief” actually works (like…biologically), and the treatment of scientific concepts throughout was careless, or perhaps disingenuous.

I think he's correct about many things, some of them being common knowledge. For instance, the "new" science of epigenetics is now old news, as is the critical role of parenting and early environment in shaping a child’s future. But however important these and attendant concepts may be, the book did not do a good job explaining, supporting, or connecting them. 

As far as practical guidance, he refers the reader to a list of resources on his website, which is fine, but I expected some scientific insight into how/why those modalities work. None was given. 

On the plus side, the book was quite thought-provoking, and I came away with loads of references and topics to follow up on. My favorite line? "There cannot be exceptions to a theory; exceptions simply mean that a theory is not fully correct."
Friedrich Nietzsche, The Gay Science (section 382) Friedrich Nietzsche, The Gay Science (section 382), as quoted in the introduction to Thus Spoke Zarathustra because I like the translation better.
This paper totally changed the way I think about e This paper totally changed the way I think about early nervous system development and the relationship between physiology and sociality. 

The authors propose that newborn babies are not inherently social, and have just one goal in life: physiological homeostasis. I.e. staying alive. This means nutrients, warmth, and regulation of breath and heart rate, i.e. autonomic arousal (it’s well-accepted that newborns sync their breathing and heart rate with caregivers through skin to skin contact). 

All these things are traditionally provided by a loving caregiver. So what the baby experiences during the first weeks of life, over and over, is a shift from physiological perturbation to homeostasis (a highly rewarding event inherently) REPEATEDLY PAIRED with things like the sound of a caregiver’s voice and seeing their face. Thus, over time, the face/voice stimuli become rewarding as well. 

The authors argue that THIS is the beginning of humans’ wiring for sociality, and may explain why loving social interactions can have such a profound regulating effect on physiology throughout life: because the brain was trained for it at an early age. 

This framework holds all kinds of fascinating implications for what happens if that initial “training” isn’t so ideal. What if the return to nutritional homeostasis via feeding is paired with negative expressions and vocalizations rather than loving ones, perhaps as could occur with PPD? What happens if the caregiver has poor autonomic regulation, such that social stimuli become paired with cardiorespiratory overexcitement in the baby? Could that have potential for influencing later introversion vs extroversion? (Because if social interaction is paired with autonomic overexcitement, that could lead to social interaction literally being more energetically draining, which is what introverts experience. Thoughts?)

For my energy metabolism enthusiasts: Table 1 in the paper draws a link between metabolic rate and sociality across species. Swipe for a screenshot. 

Anyway, check out the paper! It’s free, just google “growing a social brain pdf.”
I’ll be under general anesthesia in a couple day I’ll be under general anesthesia in a couple days to have two tooth implants placed, and I think I’ll take the opportunity to have a little heart-to-heart with my subconscious mind. A bit of medically-assisted self-hypnosis, if you will. 

I randomly stumbled upon these papers a couple months ago - an RCT showing reduced post-op pain in patients who listened to recorded positive messages while under general anesthesia, plus a post-hoc analysis of the same data that found reduced post-op nausea and vomiting in a subset of high-risk patients. 

The full review paper from the first slide is unfortunately in German, but it has long been recognized that even when unconscious, the patient is listening (for better or for worse). 

It boggles my mind that it isn’t standard of care to have patients listen to recordings like this while under sedation, considering that almost nothing could be easier, safer, or cheaper, and we have at least some evidence of significant efficacy. I mean c’mon, what more could you want from an intervention? 

(Yeah, I know. Profit. If anyone still thinks that our medical system operates with patient well-being as the foremost goal, you’re deluding yourself.)

“There should be a fundamental change in the way patients are treated in the operating room and intensive care unit, and background noise and careless conversations should be eliminated.”

“Perhaps it is now time to finally heed this call and to use communication with unconscious patients that goes beyond the most necessary announcement of interventions and is therapeutically effective through positive suggestions. When in doubt, assume that the patient is listening.”
If you've seen "vagus nerve exercises" that have y If you've seen "vagus nerve exercises" that have you moving your eyes or tilting your head, you've probably encountered the work of Stanley Rosenberg. The exercises he created and introduced in his 2017 book now appear in instructional videos all over the internet. 
 
The book itself has much to recommend it: it's accessible, it's practical, it's inspiring. But it has one major flaw: the solid practical and informational content regarding the cranial nerves is framed in terms of the scientifically dubious polyvagal theory. 
 
I particularly enjoyed the book as an introduction to the therapeutic arena of bodywork, of which Rosenberg is a skilled practitioner. His book is full of case reports that demonstrate how immensely powerful extremely subtle movements and physical manipulations can be. These do need to be kept in perspective: it's a small sample size of the most remarkable cases, and the results were achieved within the supportive clinical environment of a skilled practitioner. You can tell from his descriptions how refined his technique is. But nevertheless, it was a paradigm-shifting read for me, and the exercises give you something concrete to play around with. 
 
The book also brought the cranial nerves and the concept of “social engagement” to the fore as arbiters of health. Rosenberg has a solid background in cranial nerve anatomy and shares many interesting tidbits and considerations that you don’t typically hear; for instance, the potential impact of dental and orthodontic work on cranial nerve function.
 
So, is it worth reading? If any of the above piques your interest, go for it! Just read my post on polyvagal theory first – you can use the book to practice separating the wheat (solid informational content) from the chaff (pseudoscientific framing). If nothing else, the book is a nice reminder that genuine healers who get lasting results for their patients do exist.

But if you just want to try the exercises, you can easily find them all on YouTube. 

“You learn techniques to understand principles. When you understand the principles, you will create your own techniques.” -Stanley Rosenberg
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