Can you believe that some people promote plant-based whole foods, vegan diets, but still tell you to take vitamins? If vegan diets are so healthy, then why didn’t Mother Nature provide every single cofactor and supplement we need?
OK, I admit it! I'm one of those folks who considers a vegan diet to be the best blend of health and kindness. In fact, I recommend it to patients with heart disease hoping to reverse atherosclerosis and to anyone who wants to avoid blockages in the blood supply to their brain, heart, and sex organ arteries. (Eating healthy for erections proves to be a more compelling argument in my clinic than eating to prevent a heart attack!)
And despite all these wonderful benefits of a plant-based diet, I still recommend vegans take supplements. If this is a flaw, then, to be fair, we should also consider the processed food and animal-rich diets eaten by most “civilized” societies as seriously flawed. Unfortunately, the “supplements” of Western diets are called insulin, statins, and chemotherapy.
If you choose to shun eggs, meat and dairy, and exist on the cornucopia of vegetables, legumes, seeds, beans and nuts, then consider the following additions to your diet.
1. Vitamin B12
Vitamin B12 is important in brain, nerve and hematologic health and is a factor in a key process called methylation, which regulates homocysteine levels and plays an important role in the control of DNA regulation called epigenetics. It's well known that animal products are richer in Vitamin B12 than plants. Actually, neither plants nor animals make B12. It's produced by bacteria that reside in the gastrointestinal tract of animals other than humans. When animal products are eaten, often B12 is ingested as a bystander.
By some estimates, 50% of vegans 10% of vegetarians are deficient in Vitamin B12. I recommend taking about 3,500 ug once a week of Vitamin B12, ideally as a liquid, sublingual, or chewable form for better absorption or 500 ug daily if that schedule works better for you.
This is an amino acid that has been in the news of late for its possible role in promoting hardening of arteries. L-carnitine plays an important role in shuttling fatty acids across membranes to fuel the production of energy in the heart and other muscles. In vegans, the ingestions of L-carnitine did not raise levels of factors promoting blocked arteries.
L-carnitine is found mainly in meat (think carne as in chile con carne) and vegetarians have lower levels of L-carnitine in their muscles. There are reports of heart disease in patients lacking this amino acid. Although long terms studies of L-carnitine supplementation in vegans are not available, I consider supplementing vegans with 500 mg a day as a recommendation for optimal health, particularly in those who are athletic or with heart disease.
Taurine is the most abundant amino acid in the body and you've probably never heard of it beyond the world of energy drinks. But taurine is important to your cardiac health, immune system, insulin action, hearing, and electrolyte balance, and it's typically found in meat and seafood. Vegans often have low levels of taurine.
Supplementation with 1,000 mg a day is a reasonable option, although a dose of 15 to 3 gm a day are used in diabetic and cardiac patients. Energy drinks often contain taurine, but they're not advised due to the caffeine, sugar, and other components.
4. Vitamin D
The last, but not the least, supplement to consider for optimizing a vegan diet is Vitamin D. This is known to promote bone health but is proving to be essential in blood pressure and blood glucose control, in heart function, and in brain function. Measurements of blood levels are the best way to assess adequacy of Vitamin D.
In a study of over 65,000 residents of England, researchers found that vegans had higher levels of fiber, magnesium, and Vitamins E and C compared to their carnivorous counterparts. Vegans, however, had lower levels of Vitamin D.
Direct sunshine on exposed skin for 20 to 30 minutes a day can provide adequate Vitamin D, but for many of us (especially those further from the Equator!), oral supplementation is necessary. Vitamin D3 is the form most commonly recommended, but is usually derived from animal sources such as lanolin. If this is not acceptable, vegan versions of Vitamin D3 are now available.
Vitamin D2 comes from plant sources and is rich in mushrooms, but is not as reliably absorbed. While the standard recommendation is to supplement with 800 IU a day, I started routinely adding 4-5,000 IU a day in order to reach blood levels of 50 -70 ng/ml.
Scientific research has shown that plant-based, whole foods, vegan diets reduce the risk of obesity, dementia, diabetes mellitus, heart disease, cancer, erectile dysfunction and arthritis among other benefits.
Animals are not harmed and the carbon footprint of a vegan is a fraction of an omnivore. The multiple benefits of a vegan diet supplemented with four inexpensive nutrients a day for optimal health is a lifestyle that I hope you will bring to your mat and life.
Joel Kahn MD