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Vegan meal
Dr Neal Barnard, Prof Jennie Brand-Miller, Dr Alan Barclay and Matthew Lore answer the most common questions we are asked about vegan diets.

Whether it’s for better health, a better environment or animal welfare, choosing to go vegan is one of the biggest diet trends. The plant-based/vegan world has exploded in the last decade, with hundreds of books, many of them major bestsellers says Matthew Lore, whose company, The Experiment Publishing, has published 30+ plant-based/vegan books including #1 NYT bestseller Forks Over Knives: The Plant-Based Way to Health.

WHERE DOES “VEGAN” COME FROM? “Vegan” was coined by Donald Watson and his wife Dot in 1944 when they launched Vegan News which they sent to 25 subscribers in November. He had quit eating meat at the age of 14 after seeing a terrified pig being slaughtered on his uncle’s farm, and later gave up dairy foods. As an adult, finding many others shared his interest in a plant only diet, he produced a magazine. In issue 1 he writes: “We should all consider carefully what our Group, and our magazine, and ourselves, shall be called. ‘Non-dairy’ has become established as a generally understood colloquialism, but like ‘non-lacto’ it is too negative. Moreover, it does not imply that we are opposed to the use of eggs as food. We need a name that suggests what we do eat, and if possible one that conveys the idea that even with all animal foods taboo, Nature still offers us a bewildering assortment from which to choose. ‘Vegetarian’ and ‘Fruitarian’ are already associated with societies that allow the ‘fruits’(!) of cows and fowls, therefore it seems we must make a new and appropriate word. As this first issue of our periodical had to be named, I have used the title The Vegan News. Should we adopt this, our diet will soon become known as a VEGAN diet, and we should aspire to the rank of VEGANS.” Donald Watson lived to the age of 95.

WHAT’S THE DIFFERENCE BETWEEN A VEGAN DIET AND A PLANT-BASED DIET? “As the Washington Post reported in February 2019,” says Matthew Lore, “the rebranding of ‘vegan’ to ‘plant-based’ has been a long time coming. T. Colin Campbell introduced the term ‘plant-based’ in his 2005 book The China Study. Campbell, and Cleveland Clinic cardiologist Dr. Caldwell Esselstyn, Jr., are the major intellectual godfathers of the documentary, Forks Over Knives, which promotes a ‘whole foods, plant-based’ way of eating that both have long championed. Plant-based and vegan both refer to the same way of eating – but vegan now implies more of an identity with all-things animal-free (of course including eating no animal products whatsoever); whereas plant-based can be deployed pretty much everywhere meat is absent (surely not for nothing does Beyond Meat’s Beyond Burger packaging ID what’s inside as ‘Plant-Based Burger Patties’).”

DOES A VEGAN/PLANT-BASED DIET HAVE HEALTH BENEFITS? Yes, says Dr Neal Barnard, author of Dr Neal Barnard’s Program for Reversing Diabetes. Vegan diets skip the cholesterol and most of the saturated fat found in animal products, and are richer in fiber and some vitamins. Studies have shown that a low-fat vegan diet has enormous health benefits. “The DASH diet was one of the first studies to put plant-based diets on the map,” says Barnard. “Not that it used a vegetarian or vegan diet, but the DASH investigators openly acknowledged that the study was in large part inspired by the observation that vegetarian diets are associated with lower blood pressure. They modified the diet, partly hoping for broader acceptance, but their work led to more interest in plant-based regimens and what they could achieve.

Dean Ornish’s heart studies (Lancet 1990, JAMA 1998) were perhaps the next major advance. The regimen was nearly vegan, apart from a small amount of nonfat dairy and egg whites. And it showed that diet changes can do more than fight a battle of attrition; they can reverse disease. David Jenkins showed that it’s not just a question of what one avoids. By emphasizing foods with a low GI and, later, by introducing a portfolio of foods with special lipid-lowering properties, one can really put nutrition to work.

Epidemiologic studies showed that people following vegan diets are slimmer, with healthier cholesterol levels and a much lower risk of type 2 diabetes, compared with meat-eaters, pescatarians, and ovo-lacto-vegetarians.

Our randomized studies on diabetes, especially our Diabetes Care article in 2006 (with follow-up in AJCN 2009), established vegan diets for managing type 2 diabetes. I would argue that they are the regimen of choice.”

WHAT’S OUT? WHAT IN? Switching to a vegan/plant-based diet means cutting out all animal products – meat, poultry, seafood, dairy foods, eggs and even honey. What’s in are the good carbs, many of which are low GI – fruit, veggies, legumes (beans, chickpeas and lentils), nuts and seeds, and grains. These plant foods power our brain, fuel our muscles, and provide us with energy, vitamins and minerals. They are also packed with “keep it regular” fibre. However, people following a vegan diet do need reliable sources of vitamin B12, such as fortified foods or supplements, as this vitamin can be difficult to get if meat, milk and eggs are off the menu.

WHAT ABOUT CALCIUM? Leafy greens like kale, broccoli and bok choy are rich in absorbable calcium. Fortified plant milks and cereals are good sources of calcium, too. Check the nutrition information panel. Other plant foods providing calcium include firm tofu, almonds, Brazil and pecan nuts, figs, oranges, and kiwi fruits, unhulled tahini, and chickpeas.

WHAT ABOUT B12? Found almost exclusively in animal foods, vitamin B12 in vegan diets comes from fortified foods or supplements. Some plant-based milks, like soy milk and almond milk, are fortified with B12. Check the nutrition information panel and choose products that contain 0.4ug (mcg) /100mL of B12. Some meat alternative products are fortified with B12 as are some brands of nutritional yeast. We check out B12 fortified foods in Product Review, and in Perspectives, Dr Alan Barclay discusses vitamin B12.

WHAT ABOUT IODINE? Iodine is in short supply for many people – not just those on a vegan diet. Eating sea vegetables is one strategy to ensure you get the iodine you need, and iodized salt makes it a nonissue for those using it.

WHAT ABOUT IRON? Iron is abundant in green leafy veggies (spinach, silverbeet/Swiss chard and broccoli); legumes (beans, chickpeas and lentils); nuts and seeds; grains (whole wheat, brown rice, quinoa), and dried fruit. You’ll also find it in fortified breakfast cereals. Check the nutrition information panel.

WHAT ABOUT OMEGA-3? When seafood (especially fatty fish) is off the menu, you’ll find the omega-3 you need in plant foods like chia and flax seeds, walnuts, soy beans and oil, wheat germ and green leafy veggies. Our body can convert these plant-based omega-3s to the longer chain form, like the omega-3 found in seafood.

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