What is a vegan diet
Almost everyone knows the phrase "Health is the greatest good", has already been comforted with the words "The main thing is that you are healthy!" Or has talked to sick people who, instead of material wealth, want health above all else. Already the Greek doctor Hippocrates pointed out with his well-known quote "Your food is your medicine and your medicine your food" almost two and a half thousand years ago that illness and well-being are directly related to nutrition.
People who are on the way to a vegetarian or vegan diet often deal very intensively with general health aspects as well as the advantages and disadvantages of a change in diet. Countless sources of information are now available for this. However, especially in the public discussion regarding a vegan diet, there are also a number of mostly unjustified ambiguities and controversies that can lead to uncertainties when changing one's diet. This article is intended to give you an overview of how healthy a vegan diet is, which nutrients are particularly important and what you should be aware of in general.
Official positions and recommendations
The Academy of Nutrition and Dietetics (AND, formerly American Dietetic Association), an association of more than 70,000 nutritionists, researchers and medical experts, considers vegan-vegetarian nutrition - along with other nutrition organizations - to be healthy and for all ages - and phases of life suitable:
»It is the position of the Academy of Nutrition and Dietetics that well-planned vegetarian diets, including strictly vegetarian or vegan diets, are healthy and nutritionally appropriate and that they can have health benefits in terms of the prevention and treatment of certain health conditions. Well-designed vegetarian diets are suitable for people at all stages of life, including pregnancy, breastfeeding, infancy, childhood and adolescence, as well as for athletes. «(Excerpt) You can read more about this in our summary with comments.
This position is followed by the Australian and Canadian nutrition organizations, including in their guidelines for a healthy vegan diet with useful tips. The British national health service, the National Health Service, provides information and advice without reservation.
The German Nutrition Society (DGE) is (still) reluctant to make such statements, but also published a position paper on vegan nutrition in 2016, including: with helpful tips on a healthy vegan diet. Here is a summary and our comments on it.
Vegan diet and lifestyle diseases
Vegetarians and vegans often have a lower risk of so-called "widespread diseases" such as type 2 diabetes, heart disease and obesity - in contrast to people who consume a lot of meat and meat products such as sausage.
The finding that the body mass index (BMI; a value that indicates the relationship between body weight and height) of people with a predominantly or purely vegan diet is much more often in the normal range (BMI in the range 20-25) is particularly evident of people with mixed diets. The nutritional reasons for this are v. a. the higher supply of fiber as well as the lower fat and protein intake with a vegetarian diet assumed. Other causes are the generally healthier lifestyle, such as more physical activity.
The cholesterol levels in the blood are also significantly lower for people who eat vegan than for those who eat meat. The reasons for this are the lower or non-existent intake of animal fats, which supply saturated fatty acids and cholesterol, as well as the higher intake of monounsaturated and polyunsaturated fatty acids. Less overweight and lower cholesterol levels, among other factors, lower the likelihood of cardiovascular, i.e. H. Diseases affecting the heart and blood vessels, such as high blood pressure, stroke or heart attack, decrease.
The risk of developing type 2 diabetes is also reduced. Patients with type 2 diabetes can improve their values (e.g. blood sugar and insulin) with a vegan-vegetarian lifestyle and reduce their drug dose or even stop it altogether.
Those affected by rheumatoid arthritis can also often relieve symptoms by switching to a vegan diet.
A high consumption of fruit and vegetables, as often occurs in a vegan-vegetarian diet, can also increase life expectancy. In this respect, there is an increased risk of cancer with a high consumption of red and especially processed meat such as sausage and smoked meat, as an assessment by the WHO shows.
In summary, a well-planned and wholesome vegan-vegetarian diet can reduce the risk of numerous diet-related diseases.
Important nutrients and their occurrence
Studies show that a sufficient supply of nutrients can be easily implemented through a vegetarian or vegan diet. However, special attention should be paid to some nutrients.
Protein, also known as egg white, is mainly used by the body to build tissue (1). Many people do not know that sufficient amounts of protein are also found in many plant-based foods. With vegetable proteins, it should be noted that all nine indispensable (formerly: "essential") amino acids are absorbed in sufficient quantities. By combining different vegetable protein suppliers throughout the day, this can be implemented and an adequate protein quality can be achieved. A particularly good "biological value" - how well a food protein can be converted into the body's own protein - has, for example, the combination of legumes and cereals, e.g. B. Lentils with rice. In addition to legumes, tofu, and other soy products, whole grains, nuts, oil seeds, and potatoes are good plant sources (1). You can find more about protein on our nutrient pages.
Vitamin B12 (cobalamin) plays a vital role in cell division, blood formation and in the nervous system and is probably the most discussed nutrient in a vegan diet. Natural occurrences in sufficient quantities are only found in animal foods, which is why the supply through food can be critical, especially for vegan and vegetarian people who only consume very small amounts of dairy products and / or eggs. But many older people who eat mixed foods also suffer from a vitamin B12 deficiency. Although they take in enough vitamin B12 through food, their physical capacity is usually reduced. Particularly in high-risk groups such as pregnant women, breastfeeding women, children and the elderly, care must be taken to ensure that the intake is sufficient, which is best checked regularly in a blood test (see below).
The first unspecific signs of a vitamin B12 deficiency can be tiredness, dizziness, paleness and general weakness. If a vitamin B12 deficiency is left untreated, blood formation disorders as well as neurological and psychiatric impairments such as sensory, coordination and balance disorders, apathies, hallucinations and even paralysis and psychoses occur in the long term. These nervous system disorders are potentially irreversible.
Some sources report that vitamin B12 is found in beer, sauerkraut, algae or other plant-based foods; However, their content is either only marginal or the effect on humans has not yet been proven. Some of these foods contain compounds (analogues) that are structurally similar to vitamin B12, but cannot fulfill the vital functions of the vitamin (1). Therefore, fortified foods, dietary supplements, medical injections or a vitamin B12 toothpaste are the only ways to safely meet the vitamin B12 requirement in a vegan diet - you can find out more here.
Vitamin B2 (riboflavin) is an important vitamin for the production of energy in the metabolism, which, in addition to animal products, is mainly found in nuts, seeds, mushrooms, legumes, the outer layers and germs of cereals and thus in whole grain products. Vegetarians and mixed dieters hardly differ in their intake of vitamin B2 and almost always achieve the recommended intake. Studies with vegans revealed that the riboflavin status was partly sufficient and partly too low. In addition to a wholesome food selection, it can be helpful to have the vitamin B2 status checked regularly in blood tests (1). You can find more information about vitamin B2 at Vegan Taste Week.
Omega-3 fatty acids
Omega-3 fatty acids are essential for life and are particularly important for the health of the heart and blood vessels and as components of the brain and nerve cells. The question often arises as to how the need for omega-3 fatty acids can be met with a purely or predominantly vegan diet. In fact, in addition to fish, many plant foods also contain omega-3 fatty acids, especially alpha-linolenic acid. Good sources are linseed, rapeseed, hemp or walnut oil or walnuts.
The omega-6 fatty acid linoleic acid is also vital. Vegans and vegetarians in particular consume too much omega-6 and too little omega-3 fatty acids. A ratio of omega-6 to omega-3 fatty acids of 5: 1 is recommended, but most people do not achieve this. Omega-6 fatty acids can adversely affect the conversion of the omega-3 fatty acid alpha-linolenic acid into the health-promoting long-chain omega-3 fatty acids EPA and DHA (1).
More and more experts recommend supplementing EPA and DHA with supplements for a vegan-vegetarian diet. In any case, according to the DGE, pregnant and breastfeeding women should take at least 200 mg DHA daily. You can find more about this on our detail page.
The mineral calcium builds up bones and teeth, is important for blood clotting and ensures that nerves and muscles can be excited. About 1 kilogram of calcium is stored in the human body (1). In the industrialized countries, the calcium requirement is largely covered by milk and dairy products, but calcium-rich mineral water and many plant-based foods also contribute to an optimal supply. The latter include, among others. Sesame (also called sesame / tahini), almonds, dark green vegetables such as kale and broccoli as well as plant-based drinks fortified with calcium.
The DGE recommends a daily intake of 1,000 mg calcium for adults. This recommendation is made against the background of western eating habits; as the intake of animal protein and salt increases, so does the excretion of calcium. In the case of a predominantly or purely vegan diet, a sufficient calcium supply could already be guaranteed with a minimum intake of around 700 mg calcium / day, although the absorption can be hindered by oxalic acid and no official recommendation for vegan diets has yet been given (2). Nevertheless, calcium is a critical nutrient and (not only) vegans should pay attention to an optimal supply in order to, among other things, Prevent osteoporosis. Here you can find more information.
Iron is particularly important for the transport of oxygen in the red blood cells, but also for energy production and the immune system. A variety of plant foods contain iron, such as: B. Whole grains, legumes, nuts and oil seeds. In the case of iron, however, it is not just the amount that is decisive, but also how well the iron contained in a food can be absorbed by the body at all. The absorption can be significantly improved, especially with vitamin C and other organic acids - just a little lemon juice in a salad or in pasta and cereal dishes, paprika with wholemeal bread or a glass of orange juice with muesli can have this effect (1). You can find more iron tips here.
Zinc is a trace element that, among other things, plays an important role in the metabolism, the acid-base balance, the immune defense as well as cell growth and wound healing. A deficiency can impair numerous metabolic processes due to the diverse modes of action. While a severe deficiency rarely occurs in industrialized countries, a mild zinc deficiency is more common. Children and adolescents as well as pregnant women, breastfeeding women and the elderly should ensure adequate care. Studies have found no greater risk of zinc deficiency in adult vegan or vegetarian people than in omnivorous people. Although the zinc intake was lower, the average zinc level in the blood was sufficient. There is plenty of zinc in pumpkin seeds, oatmeal and lentils, for example, as well as whole grains, nuts and legumes in general (1). You can find more information about zinc on our nutrient pages.
Iodine is important for the function of the thyroid gland and the associated hormonal balance (1). The DGE recommends that adults consume 200 µg iodine per day. Since our soils are very low in iodine, the foods grown on them also contain hardly any iodine. The most important source is iodized table or sea salt, which, however, should not cover the entire iodine requirement due to the negative effects of excessive salt consumption: 200 µg iodine corresponds to about two teaspoons of salt. The DGE advises, however, not to consume more than 6 g of pure salt or salt in processed products per day. In addition, the iodine supply can be improved by consuming seaweed, e.g. B. the moderate iodine-containing nori seaweed, which is used for sushi. However, algae, which contain a lot of iodine, should only be consumed rarely or in very small quantities. These include B. Arame, Kombu, Wakame or Hijiki. Excessive iodine intake, like iodine deficiency, can lead to thyroid disorders (1). Dietary supplements containing iodine are another safe source. However, they should only be used if the iodine supply from iodized salt and algae is insufficient - especially during pregnancy and breastfeeding. More information about iodine can be found here.
Vitamin D provides the body with, among other things. for adequate calcium absorption and the incorporation of calcium into the bones. It can be produced by the body itself when sunlight hits the skin. Adequate care, however, requires that you spend at least 15 to 30 minutes a day in the sun around lunchtime with uncovered arms and without sun protection. In Germany, this is particularly difficult in the months with little sunshine: most of the UV-B light, a component of solar radiation that is important for vitamin D synthesis, is filtered out by the atmosphere between mid-October and mid-March due to the changed angle of incidence of sunlight (1). A vitamin D deficiency not only affects calcium absorption and bone formation (e.g. increases the risk of osteoporosis), but can also increase the risk of numerous diseases such as: B. Increase cardiovascular problems. Few foods contain enough vitamin D to meet human needs (1). This is why most mixed foodists are insufficiently supplied with vitamin D in the months with little sunshine.
Therefore, in our latitudes, the vitamin D supply should generally be ensured through fortified foods or dietary supplements in the months between mid-October and mid-March. For vegans, caution is advised here, because added vitamin D (D3) is often obtained from the wool fat of sheep and is therefore not of vegetable origin. Vitamin D2 and vitamin D3 from lichen, on the other hand, are vegan. You can read more about vitamin D on the Vegan Taste Week website.
Medical advice and examinations for vegan diets
In traditional medical studies, nutrition and the influence of nutrition on health unfortunately play only a minor or no role at all. In some cases, outdated nutrition pyramids are taught and students hardly have the opportunity to get to know and deepen the peculiarities of the vegan-vegetarian diet. So it is hardly surprising that many medical professionals are particularly skeptical of the vegan diet. The advantages mentioned above, such as disease prevention or the alleviation of certain complaints, are hardly known.
Important values for the blood test
The most important values for vegans and vegetarians are various vitamin B12 parameters (see below). Regardless of the diet, women of childbearing age should have their iron levels (hemoglobin, ferritin) checked regularly.
The determination of the vitamin B12 supply is usually not taken over by the health insurers and must therefore be paid for yourself. The best thing to do is to talk to your doctor's office. Since a deficiency can have serious consequences, regular blood tests should be carried out if you are on a vegan or predominantly vegan diet.It is important to ensure that the holo-transcobalamin value, the so-called holo-TC or "active vitamin B12", is measured, because this is the only way to assess the body's vitamin B12 supply. For a detailed clarification of low holo-TC, the status of the methylmalonic acid (MMA) can be determined - in the optimal case already with the same blood sample or in a second step. You can find more information about this on our practical information sheet for checking the vitamin B12 status to take with you to the practice.
Some experts recommend checking every two to three years; other sources recommend annual testing. Since the necessity and frequency of such controls and blood tests as well as any therapy depends on your own values, supplementation and health status, please always discuss this with your doctor in confidence.
It is also useful to check vitamin D, especially in autumn, as the body can only produce it with the help of sufficient sunlight (see above). Often this is not covered by the health insurances, but can be examined in the blood count if desired. The occasional examination of the supply of zinc (zinc level in the blood), vitamin B2 (EGRAC; Erythrocyte Glutathione Reductase Activation Coefficient) and iodine (excretion in the 24-hour urine) is useful for a vegetarian and vegan diet.
According to the findings of numerous scientific studies, statements from renowned institutions and, last but not least, many personal experience reports, a balanced vegan or predominantly vegan diet is a health-promoting diet. With a varied, wholesome food selection, the supply of all nutrients can be ensured (exceptions: vitamin B12 must generally and Vitamin D should be supplemented in the winter months). Regular monitoring of potentially critical nutrients makes sense. If you pay attention to these points, nothing stands in the way of a vegan diet - on the contrary, it can help prevent and alleviate diseases.
If you would like to take advantage of the many advantages of vegan nutrition, our Vegan Taste Week will help you, through which we will provide you with recipes and tips.
You can find our other articles on health here.
(Numbers in brackets always apply to the preceding text part, until no other source is linked or specified.)
- Leitzmann, C. & Keller, M. (2013). Vegetarian diet (3rd ed.). Publisher Eugen Ulmer: Stuttgart.
- Schumann, L., Martin, H. H. & Keller, M. (2014). Calcium, Milk, and Bone Health - Claims and Facts. Focus on nutrition 14 (11-12), 326-31. In addition: written exchange with Dr. Markus Keller (2014).
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