How To Defend Your Vegan Diet To Your Skeptical Doctor
In this piece, renowned cardiologist Dr. Joel Kahn shares the benefits of a plant-based diet and explains how to present them to your own health care provider. If you're interested in learning more, check out his mindbodygreen course, Everyday Hacks for Long-Lasting Health: How to Eat, Move & Live for Longevity.
I've followed a plant-based diet since 1977, when the salad bar at my freshman dormitory at the University of Michigan was the only choice that looked edible. Today, I'm now an academic cardiologist as well as the owner of an award-winning plant-based restaurant in Ferndale, Michigan. That means I receive many questions about plant-based nutrition. One of the most common questions I get: "My doctor isn't supportive of a plant-based diet. What information can I share?”
Fortunately, the Kaiser-Permanente Medical Group, one of the nation's largest health plans, produced an excellent document, “Nutritional Update for Physicians: Plant-Based Diets,” that's a great resource to share with your health care provider. It appeared in a peer-reviewed journal and includes many scientific references your provider should respect. The paper presents a balanced view of plant-based nutrition—including five main benefits of the diet and five concerns—and can help your doctor understand your health journey. Here's a summary:
The key benefits of plant-based nutrition
1. It fights obesity.
In a review of studies on the topic of weight management, the report notes a number of main findings:
- “A vegan diet caused more calories to be burned after meals in contrast to nonvegan diets."
- “Vegetarian diets are nutrient dense and can be recommended for weight management without compromising diet quality."
- “A plant-based diet seems to be a sensible approach for the prevention of obesity in children."
- "Plant-based dietary patterns should be encouraged for optimal health.”
This information, along with the supporting references, can assist you in explaining why you're following a plant-based diet.
2. It can prevent diabetes.
The report also reviewed the fact that plant-based nutrition may offer an advantage for the prevention and management of diabetes. They noted that a "low-fat, plant-based diet with no or little meat may help to prevent and treat diabetes” and that “people on the low-fat vegan diet were able toreduce their medication."
3. It lowers high blood pressure.
When it comes to managing blood pressure, the report also found that “vegetarian diets were associated with lower systolic blood pressure and lower diastolic blood pressure."
4. It can reverse heart disease.
The strongest data for the health benefits of plant-based nutrition are for heart issues. The authors reviewed data from Dean Ornish, M.D., including the startling finding that “regression of even severe coronary atherosclerosis after only one year” was observed. In another study group, “vegetarians had a 24 percent reduction in ischemic heart disease death rates compared with nonvegetarians." Those are pretty convincing statements.
5. It could reduce mortality.
Need one more powerful reason to choose plant-based nutrition for your health goals? The Dietary Guidelines Advisory Committee notes that “plant-based diets were associated with a reduced risk of cardiovascular disease and mortality compared with non-plant-based diets."
The main concerns about plant-based nutrition:
The authors note that “generally, patients on a plant-based diet are not at risk for protein deficiency." They go on to say that “a well-balanced plant-based diet will provide adequate amounts of essential amino acids and prevent protein deficiency." Let’s give a giant supportive cheer—that should help answer the #1 objection you'll likely hear from your doctor.
Iron stores may be lower if you follow a plant-based diet. But the authors also note, "iron-deficiency anemia is rare even in individuals who follow a plant-based diet."
3. Vitamin B12
According to the report, “individuals who follow a plant-based diet that includes no animal products may be vulnerable to B12 deficiency and need to supplement their diet with vitamin B12." That is a fair statement and a good plan of action.
4. Calcium and vitamin D
There are a number of plant-based sources high in calcium, including greens and tofu. And vitamin D is found in soy milk and cereal grains. The report also notes: "Supplements are recommended for those who are at risk for low bone mineral density and for those found to be deficient in vitamin D." I'd advise you to ask for a blood level of your vitamin D-25OH.
5. Fatty acids
Linoleic acid (an omega-6 fatty acid) and alpha-linolenic acid (an omega-3 fatty acid) are the two essential fatty acids. Vegans are most likely to be deficient in omega-3. “Foods that are good sources of n-3 fats should be emphasized," the report says. "They include ground flaxseeds, flax oil, walnuts, and canola oil." Increasingly, blood tests that measure omega-3 levels are available and not expensive. I advise them for all of my patients, vegan or not.
Overall, the Kaiser-Permanente update is a great resource to help you explain your diet to your health team. The authors note that “the major benefits for patients who decide to start a plant-based diet are the possibility of reducing the number of medications they take to treat a variety of chronic conditions, lower body weight, decreased risk of cancer, and a reduction in their risk of death from ischemic heart disease”—that's a powerful endorsement that more in the medical world need to read and incorporate.
I recently handed out many copies of the Kaiser-Permanente paper to guests of my restaurant, which is often populated by medical residents, students, and health care providers. Print out the paper yourself, and share it with your health care team—I hope it makes your journey easier.
Joel Kahn, MD, FAAC