What do NBA superstar Kyrie Irving and The Office’s Dwight Schrute (well, actor Rainn Wilson) have in common? They both have joined a growing list of celebrities and athletes who have adopted a vegan diet—Kyrie to improve his athletic performance and Rainn because of his two pet pigs, Snortington and Amy. Other newcomers to this list include fellow The Office actor Craig Robinson, actress Ruby Rose from Orange Is the New Black, singer Ellie Goulding, NBA stars Damian Lillard and Jahlil Okafor, NFL linebacker Derrick Morgan, and Formula One world champion Lewis Hamilton. These high-profile individuals reflect a growing trend across the United States and other developed countries where veganism is on the rise. But before we go any further, what exactly is “veganism”?
Veganism is a lifestyle practice that seeks to minimize animal exploitation and cruelty as much as possible. It is based on the idea that animals should not be treated as commodities or exploited for food, clothing, entertainment, etc. While animal welfare is the foundation of veganism, the recent surge of interest is coming from multiple directions, including concern about the environment, social justice, and religious philosophies. There is also a growing interest in adopting a vegan diet for health reasons. Whether it’s an athlete looking to boost their performance, or your average Joe hoping to lower their risk of heart disease, people all over the world are choosing a vegan diet to improve their health. But is a vegan diet actually healthy?
A vegan diet can be extremely healthy and can offer benefits beyond a traditional healthy diet. On the flip side, a vegan diet can also be quite unhealthy, promoting the same chronic diseases that tend to develop when consuming the typical American diet, although to a lesser extent. This is precisely why I’m writing this post—to help people thrive on a health-promoting vegan diet. So, whether you’re totally new to veganism, or are a long-term ethical vegan looking to wean off vegan junk food and improve your health, consider the following information your “healthy vegan starter kit”.
What is a “healthy” vegan diet?
A vegan diet is defined by what it avoids—animal products. This alone may offer some health benefits, as population-based studies suggest that vegans/vegetarians have lower rates of cardiovascular disease, cancer, obesity, metabolic syndrome, type-2 diabetes, high blood pressure, and all-cause mortality, compared to their meat-eating counterparts. (1-5). This is a good start, but for ideal health we need to take it a step further and specify not just which foods to avoid, but which foods to include and encourage. What you choose to eat is just as important as what you choose not to eat. This is precisely where a “plant-based, whole food” diet enters.
There is no standard definition for a plant-based, whole food (PBWF) diet, but I like the following: A plant-based, whole food diet is centered on whole, unrefined, or minimally processed plants. It’s a diet based on fruits, vegetables, tubers, whole grains, legumes, nuts/seeds. It excludes or minimizes animal products (meat, poultry, fish, seafood, dairy products, eggs), as well as highly refined foods like refined flour and added sugar, salt, and oil.
On a PBWF diet you’re not just avoiding animal products, but also vegan junk food, such as vegan doughnuts, vegan ice cream, soda, french fries, and other products rich in added sugar, added fats, and refined flour. A PBWF diet should be based on the following foods:
- Whole grains such as oats, barley, quinoa, teff, corn, amaranth, buckwheat, whole wheat, brown rice, wild rice, millet, rye, etc. Products made from 100% whole grains can also be included, such as breads, tortillas, crackers, pasta, noodles, and couscous.
- Legumes, which includes all varieties of beans, split peas, lentils, and soy products. Products made from legumes can also be included, such as hummus, black bean burgers, tofu, tempeh, soy milk, and falafel.
- All types of fruit, such as berries, apples, mango, bananas, watermelon, avocado, pineapple, etc. Stick to whole fruit that is either fresh or frozen. Fruit juice should be avoided and dried fruit should be limited.
- All types of vegetables, such as dark leafy greens, carrots, broccoli, onion, zucchini, mushrooms, tomatoes, cabbage, etc. Stick with frozen or fresh veggies as much as possible. Vegetable juice can be included, as it’s typically low in sugar.
- All types of tubers and starchy vegetables, such as potatoes, sweet potatoes, winter squash, yams, taro, cassava, corn, and peas.
- All varieties of nuts and seeds, such as walnuts, pecans, almonds, pistachios, hemp seeds, chia seeds, flaxseeds, sunflower seeds, pumpkin seeds, etc. Products made from nuts and seeds can also be included, such as peanut/almond butter, tahini, and almond milk.
While our diet should be centered on these foods, processed foods can be used in small amounts as condiments, in sauces, or to season food. These include things like soy sauce, hot sauce, barbecue sauce, olive oil, maple syrup, salt, sugar, etc. Spices, herbs, and vinegars, on the other hand, can be used liberally, as these have numerous health benefits.
A PBWF diet is the gold standard when it comes to health.
The benefits of eating this way are overwhelming. A low-fat version of this diet has been shown to not just prevent heart disease, but actually reverse it (6-7)! Let me say that again. A low-fat, PBWF diet can reverse heart disease—our leading cause of death. To paraphrase Dr. Michael Greger, if this was the only thing a PBWF diet can do—reverse our leading cause of death—then shouldn’t it be the default diet recommended by everyone until proven otherwise? Yet heart disease isn’t the only condition that can be prevented, treated, or even reversed with a plant-based diet.
A PBWF diet is strongly associated with a lower risk of developing type-2 diabetes (8-9). For those who already have type-2 diabetes, a low-fat, PBWF diet has been shown to be more effective at lowering blood sugar levels than the standard “diabetic diet” recommended by the American Diabetes Association (10-11). Plant-based diets are also strongly associated with improved blood pressure and blood cholesterol levels, and can be more effective than the medication used to treat these conditions (12-13).
What about cancer? In 2015, the International Agency for Research on Cancer, a branch of the World Health Organization, listed processed meat as a group-1 carcinogen, based on sufficient evidence that processed meat causes cancer, especially cancers of the gastrointestinal tract. It listed red meat as a group-2 carcinogen, based on evidence suggesting that it is “probably carcinogenic”, meaning it likely causes cancer. With a PBWF diet you will be avoiding these pro-cancer foods, while consuming dozens of anti-cancer foods. The consumption of each major food group within this diet—whole grains, legumes, fruits, vegetables, tubers, and nuts/seeds—has been independently associated with lower rates of cancer and cancer mortality (14-17). There are literally dozens of nutrients in plants that have been shown to prevent or suppress cancer growth. Acknowledging this information, the American Cancer Society rightfully encourages a diet centered on plant-based foods for cancer prevention.
While cancer prevention is preferred, a healthy lifestyle and PBWF diet has also been shown to reverse the progression of early, low-grade prostate cancer in men (18). Although these results can’t be extrapolated to other types of cancer, and they should not be used in place of standard cancer treatment, they suggest that a PBWF diet and healthy lifestyle can influence the trajectory of cancer progression. Plus, there’s really no downside, as all of the side effects from such a diet and lifestyle are beneficial.
Looking to lose some unwanted pounds? A PBWF diet is the healthiest way to lose weight. Simply adopting a vegetarian or vegan diet will likely lead to weight loss (19-22). But a low-fat, PBWF diet appears to be the most effective and healthiest way to lose weight (23-24). The best part about this diet, is that calories and portions often don’t need to be restricted. This is because unprocessed plant-based foods tend to be lower in calories and higher in water and fiber, so they fill you up before you overeat. In fact, a study published last year using a PBWF diet for weight loss reported “greater weight loss at 6 and 12 months than any other trial that does not limit energy intake or mandate regular exercise”.
To summarize the health benefits of a PBWF diet, it is the only diet proven to reverse heart disease. It is also strongly associated with a lower risk of developing any form of cardiovascular disease in the first place. It works better than a standard diabetic diet at improving blood sugars in people with type-2 diabetes and can improve insulin sensitivity in type-1 diabetics. Replacing animal products with whole, plant-based foods is the best dietary strategy for lowering your overall cancer risk. It is also the only diet shown to reverse early, low-grade prostate cancer. It is the healthiest diet for sustainable weight loss and often works without the need for calorie restriction or portion control. Numerous other conditions can be prevented or treated with a PBWF diet. These include: GERD, Crohn’s disease, dementia (including Alzheimer’s disease), erectile dysfunction, stroke, fatty liver disease, kidney stones, gallstones, kidney disease, macular degeneration, and it has even been shown to improve fertility. In other words, a PBWF diet is the best dietary strategy to fight back against the epidemic of chronic diseases that are plaguing our nation and the world.
But what about protein?
Despite the abundance of evidence showing that a PBWF diet is ideal for human health, many people fear that they will be missing out on certain nutrients. In all fairness, there is so much misinformation floating around on the internet, I can see why people express concern. And although some nutrients do need a little extra consideration on a PBWF diet, the truth is that all essential nutrients can be easily obtained on a well-planned, PBWF diet. However, to help reduce any anxiety, here’s a list of nutrients that people often worry about when considering a PBWF diet. Along with these nutrients, I’ll list some good sources and recommended supplement doses when appropriate.
- Iron: There are two types of iron in our diet—heme (found mostly in the blood and muscle of animals) and non-heme (found in plants). Heme iron is better absorbed by our body, but it’s consumption is linked to a variety of health issues, including: type-2 diabetes, colon cancer, cardiovascular disease and increased oxidative stress. We’re better off sticking with non-heme iron from plants. Plus, the absorption of non-heme iron can be improved by consuming plants rich in vitamin C (bell peppers, citrus fruit). Good sources of plant-based iron include: dark leafy greens (kale, collards, bok choy, etc), legumes (beans, split peas, lentils, tempeh), whole grains such as quinoa and barley, nuts and seeds such as sesame, pumpkin, and cashews, and dark chocolate. Premenopausal women have higher iron needs than men and postmenopausal women. Because of this, they should regularly consume foods rich in plant-based iron, and may need to include fortified foods, such as breakfast cereal, or a supplement.
- Calcium: Despite the U.S. recommended daily allowance for calcium of 1,000-1,200mg per day (which is heavily influenced by the dairy industry), the ideal amount of calcium for adults to consume is around 700-800mg per day. This is the amount recommended for adults in the UK dietary guidelines. It can easily be achieved by consuming a variety of plants. Good sources include: Dark leafy greens (collards, kale, bok choy, swiss chard, etc.), legumes (beans, peas, lentils, tofu, tempeh, soy milk), nuts, seeds (sesame and chia), broccoli, and oranges.
- Vitamin D: Very few foods contain vitamin D. This is because we can make it from the sun’s UV rays. During the summer months, 15-20 minutes of sun-to-skin exposure (without sunscreen) on a sunny day will provide roughly 10,000-25,000 IU of vitamin D (we only need about 600 IU per day). Vitamin D can be stored in our body for those rainy days and winter months. If you’re not much of an “outdoor person”, good dietary sources include fortified plant-based milks and UV-treated mushrooms. Taking a vitamin D supplement during the winter months is a good idea for anyone living greater than 30 degrees latitude north or south of the equator. A 5,000 IU supplement, taken every few days during the winter months, is likely sufficient.
- Omega-3 Fat: Omega-3 fats are essential in our diet, yet consuming large amounts or taking supplements, is unlikely to result in any significant health benefit. Most people only need a small amount of these fats (pregnant/breastfeeding women are an exception). Although plant-based omega-3 fats differ from those found in fish, they contain far less environmental pollutants. Good sources of plant-based omega-3’s include: ground flaxseed, chia seeds, hemp seeds, walnuts, mung beans, soybeans, tofu, and dark leafy greens. If you do not consume these foods, or are pregnant/breastfeeding, you should consider taking an algae-based omega-3 supplement (which provides the same omega-3 fat found in fish). A daily 250mg dose, or 2,000mg dose taken every few days, is likely sufficient.
- Protein: All plants contain protein. The idea that animal-based protein is “better” than plant-based protein is wrong. People getting more of their protein from animals tend to have higher rates of disease, whereas people getting more of their protein from plants tend to have lower rates of disease. Plant-based protein is clearly the healthier option. It is also a myth that you need to combine certain plant foods to get a “complete protein”. If you are eating a variety of whole, plant-based foods, and consuming sufficient calories (not starving), you will be getting enough protein. In fact, it is nearly impossible to develop a protein deficiency while consuming adequate calories. Most Americans consume 2-3 times more protein than they physiologically need. But, for the sake of it, here are some good plant-based sources: Legumes (these are probably the best source), whole grains, nuts, seeds, and yes, even vegetables. In fact, pound for pound, spinach contains more protein than beef. Popeye was right all along! A plant-based protein powder can be used by high-level athletes and extremely active individuals, but they’re not necessary on a well-planned diet.
- Iodine: Most people get their iodine from salt that has been “iodized” and dairy products. Dairy products don’t naturally contain much iodine, but an iodine solution is used to disinfect the udders of dairy cows. Some of that iodine solution drips into the cow’s milk which we then ingest. Given that we should limit our salt intake, and shouldn’t consume dairy products, we need to ensure a regular source of iodine in our diet. Iodine can be obtained from plants, but levels vary based on iodine levels of the soil in which they were grown. Those on a PBWF diet who avoid iodized salt, should regularly include seaweed in their diet, as it is the best natural source of iodine (although levels can vary). Pregnant/breastfeeding women on a PBWF diet may want to get their blood levels tested, and add seaweed, iodized salt, or supplements, as needed.
- Vitamin B12: B12 is not made by plants or animals, but by microorganisms that blanket our natural environment. When humans lived “closer to nature”, foraged for food, and drank untreated spring or lake water, we inadvertently consumed these microorganisms (and the B12 they produced). Nowadays, we are rarely in close contact with soil and drink treated water, so our environmental sources of B12 are negligible. We could eat meat as a source B12 (animals obtain it through various routes and it accumulates in their tissue), but we would also get all of the unwanted nutrients found in meat. Thus, the healthiest sources of B12 are fortified foods and supplements. Plus, the B12 from these sources is better absorbed than the B12 from meat. The following are good sources of B12: fortified breakfast cereals, fortified milk, or any other fortified plant-based food. Nutritional yeast and algae may contain a little B12, but these are unreliable sources and should not be the only source in our diet (unless the nutritional yeast has been fortified). Our gut bacteria produce small amounts of B12, but again, this amount is unreliable and should not be our only source. If you’re not consuming fortified foods on a regular basis, you should take a supplement. A 2,500mcg dose once a week is the best option. There is no toxic upper limit for B12. Any excess that our body doesn’t need will simply be excreted. Everyone eating a plant-based diet should have a reliable source of B12, from either fortified food, a supplement, or both.
As you can see, all essential nutrients can easily be obtained on a well-planned PBWF diet. Interestingly, the two nutrients that most people are deficient in, are potassium and fiber, both of which are largely (potassium) or exclusively (fiber) found in plants. Additionally, animal products are some of the most contaminated foods we can consume. Meat, seafood, egg, and dairy products contain unwanted substances, such as environmental pollutants, antibiotics, and animal hormones. On a PBWF diet, you’ll be loading up on all the good nutrients, while avoiding the detrimental ones.
We don’t eat individual nutrients; we eat food. To get you started on a PBWF diet, here’s a list of meal ideas. Many of these can be found in the Recipe section of my blog.
- Oatmeal cooked in water or almond milk and topped with fruit and nuts/seeds.
- Fruit smoothie with banana, frozen berries, soy milk, hemp seeds, and kale.
- Whole grain toast topped with smashed avocado and garnished with red pepper flakes.
- Whole grain, low-sugar, cold cereal with plant-based milk.
- Buckwheat pancakes topped with sliced bananas and a berry puree.
- Tofu scramble with peppers, onions, and zucchini.
- Black bean tacos with corn tortillas topped with diced onion, pepper, avocado, and topped with salsa or hot sauce.
- Whole wheat pasta with marinara sauce, cannellini beans, and sautéed mushrooms, onions, and spinach.
- Tofu and vegetable stir fry using broccoli, carrots, and cabbage. Served over brown rice and drizzled with a healthy Asian sauce.
- A bean and vegetable soup or chili.
- A large salad with mixed veggies, garbanzo beans, and plant-based dressing.
- Black bean burger on a whole-wheat bun with all the fixings, served with a side of baked sweet potato fries.
- Vegan lasagna using whole wheat noodles and crumbled tofu instead of ricotta.
- Vegan enchiladas with pinto beans, sweet potatoes, and spinach.
- Homemade pizza using a whole-wheat crust, pasta sauce, and topped with a variety of chopped veggies.
- Baked falafel served with hummus, vegan tabbouleh, and whole grain pita.
- African peanut stew made with butternut squash, collard greens, lentils and peanut butter served over brown or wild rice.
- Indian curry with chickpeas and veggies served over brown rice
When you think about it, we only consider a handful of animals to be “food”, but there are literally thousands of edible plants we can consume. Some of our most popular dishes (pizza, pasta, tacos, burgers) can easily be tweaked to fit within a PBWF diet. Additionally, you’ll likely be introduced to dozens of new foods that you may have never come across while eating a meat-based diet. Foods such as polenta, jackfruit, acorn squash, and acai berries. Think of this as an opportunity to try new plant-based foods and meals. Ethnic cuisine is a great source of inspiration. Look for plant-based dishes from the Mediterranean region, Middle East, Thailand, or Ethiopia. Who knows, you may find your new favorite food!
Brace for (positive) change
A PBWF diet is almost the complete opposite of the typical American diet, which is a good thing, considering that the standard American diet promotes disease and mortality. However, when transitioning to this new way of eating, you may notice some unwanted gastrointestinal issues, such as bloating and gas. This is likely due to the higher fiber content of your food. Although some people are naturally more gassy, most people adjust to the higher fiber diet and symptoms improve with time. Being gassy, although socially unacceptable, is actually a good sign. It means that you’re feeding your healthy gut bacteria an all-you-can-eat buffet of fiber, which keeps them healthy, and in turn, they keep you healthy. If, however, the symptoms are too much to manage at first, vegan digestive enzymes can be taken until your body adapts.
Beyond some mild gastrointestinal symptoms, most changes will be positive. People often report improvements in their energy level, sexual function, sleep, joint pain, skin complexion, and bowel function. In addition, blood pressure, cholesterol levels, blood sugars, body weight, and inflammation are all expected to improve. These improvements can be so drastic that people taking medication for high blood pressure, high cholesterol, diabetes, or blood thinners, should inform their physician before adopting this diet [this is especially true for those on blood pressure medication, diabetes medication (especially insulin), and blood thinners, as the combination of diet and medication can lead to life-threatening changes]. Your physician will likely want to monitor your labs more closely and, if you stick with this new healthy way of eating, may be able to reduce or discontinue certain medication.
What are you waiting for?
Ideally, this will be a lifelong change. If you’re totally ready to eat better and improve your health, you could start cold turkey. If, however, you’re not ready to commit 100 percent, try a “one-month challenge”. Eat a plant-based, whole food diet for a month. See how you feel at the end. Considering your blood pressure, cholesterol, body weight, and energy will likely all improve, you’ll probably want to stick with it. The key is to give it at least a month, as it takes time for your taste preferences to adapt. Once this happens, it’s a beautiful thing. When you remove most of the added sugar, salt, and fat from your diet, you begin to taste the true flavor of foods. Your taste buds become more attentive to subtle flavors in plants, which you’ll begin to prefer over the fatty/salty foods you once consumed. Another option, is a more gradual approach. Slowly start to wean off animal products and processed foods, replacing them with whole, plant-based options.
Health is wealth. A PBWF diet puts you in the best possible position to achieve good health. But don’t just stop at diet. Combine your new way of eating with other healthy behaviors and you’ll be unstoppable! In addition to a PBWF diet, engage in some form of daily exercise, even if it’s just going for a long walk or leisurely bike ride. In addition to structured exercise, stay moving throughout the day and avoid sitting for long periods of time. Find ways to minimize, or manage, stress. Meditation, exercise, spending time in nature, and restorative yoga are great ways to reduce stress. Ensure adequate sleep—at least seven hours per night for adults. If you’re a troubled sleeper, check out my post on how to create the ideal sleep environment. In addition to these lifestyle behaviors, do things that bring happiness to your life. This could be socializing with friends, playing board games, reading, or volunteering. Work toward these goals and you’ll be shocked at how good you feel, both inside and out! Your health is a long-term investment, so make it a priority and invest wisely.
Peace, love, health
For some additional support, check out the following resources:
Websites for nutrition information:
- Physicians Committee for Responsible Medicine (pcrm.org)
Websites for PBWF recipes:
Websites for vegan/vegetarian (not necessarily PBWF) recipes:
- Forks Over Knives
- What The Health
- Food Choices Documentary
- Eating You Alive
- The Game Changers
- How Not to Die by Dr. Michael Greger, MD
- Eat to Live by Dr. Joel Fuhrman, MD
- The China Study by T. Colin Campbell, PhD
- The Plant-Based Solution by Dr. Joel Kahn, MD
- The Spectrum by Dr. Dean Ornish, MD
- Proteinaholic by Dr. Garth Davis, MD
- The Alzheimer’s Solution by Drs. Dean and Ayesha Sherzai, MD
- Cardiovascular disease mortality and cancer incidence in vegetarians: a meta-analysis and systematic review.
- Diet and body mass index in 38000 EPIC-Oxford meat-eaters, fish-eaters, vegetarians and vegans.
- Vegetarian dietary patterns and mortality in Adventist Health Study 2.
- Vegetarian diets in the Adventist Health Study 2: a review of initial published findings
- Vegetarian diets and incidence of diabetes in the Adventist Health Study-2.
- A strategy to arrest and reverse coronary artery disease: a 5-year longitudinal study of a single physician’s practice.
- Plant-Based Dietary Patterns and Incidence of Type 2 Diabetes in US Men and Women: Results from Three Prospective Cohort Studies.
- A plant-based diet for the prevention and treatment of type 2 diabetes
- A low-fat vegan diet improves glycemic control and cardiovascular risk factors in a randomized clinical trial in individuals with type 2 diabetes.
- A low-fat vegan diet and a conventional diabetes diet in the treatment of type 2 diabetes: a randomized, controlled, 74-wk clinical trial.
- Association between plant-based diets and plasma lipids: a systematic review and meta-analysis
- Whole grain consumption and risk of cardiovascular disease, cancer, and all cause and cause specific mortality: systematic review and dose-response meta-analysis of prospective studies
- Legume consumption and risk of all-cause, cardiovascular, and cancer mortality in the PREDIMED study
- Quantity and variety of fruit and vegetable consumption and cancer risk.
- Nut consumption and risk of cardiovascular disease, total cancer, all-cause and cause-specific mortality: a systematic review and dose-response meta-analysis of prospective studies
- Intensive lifestyle changes may affect the progression of prostate cancer.
- A plant-based diet for overweight and obesity prevention and treatment
- Vegetarian Diets and Weight Reduction: a Meta-Analysis of Randomized Controlled Trials.
- A systematic review and meta-analysis of changes in body weight in clinical trials of vegetarian diets.
- Comparative effectiveness of plant-based diets for weight loss: a randomized controlled trial of five different diets.
- The effects of a low-fat, plant-based dietary intervention on body weight, metabolism, and insulin sensitivity
- The BROAD study: A randomised controlled trial using a whole food plant-based diet in the community for obesity, ischaemic heart disease or diabetes