A proper vegan diet will cause no harm

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Dear Doctor: Is a vegan diet totally safe and healthy? I have a daughter and granddaughter who are eating a vegan diet, and I am worried. What can’t they eat? Are they getting all of the vitamins and minerals and protein that they need? Any information you have is welcome.

Dear Reader: Vegan diets have gained in popularity in recent years. Considering that the majority of people in the U.S. are more familiar with a diet that includes meat, seafood and dairy products, your trepidation about your daughter and granddaughter embarking on a plant-based diet is understandable. We’re happy to reassure you that, when done right, a vegan diet is not only safe, but also healthful.

Let’s start with the basics. Vegans don’t eat animal flesh, animal byproducts, or foods containing an ingredient from animal origin. Instead, they focus on vegetables, legumes, grains, beans, nuts and nut butters, seeds, fruits, plant-based fats, and a wide range of food products made from non-animal sources. These include protein-rich meat alternatives such as tofu, tempeh and seitan, and dairy alternatives, including oat, soy and almond milks.

Vegans also avoid a number of other foods and food products that have sometimes surprising connections to animals. These include honey, which is produced by bees; gelatin, which is derived from cartilage and bone; certain types of soy sauce, which use fish in the fermentation process; and even table sugar, which is often filtered using bone char.

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Elizabeth Ko, MD and Eve Glazier, MD

It’s true that any type of restrictive diet can make it more challenging to get the full range of nutrients you need. For vegans, this means paying special attention to vitamin B12. It’s essential to red blood cell production, plays a role in the health of nerve cells, and helps in DNA synthesis. Vitamin B12 is found almost exclusively in animal products, so vegans need to take steps to add it to their diets. This is easy because B12 is available as a vitamin supplement and is added to a wide range of fortified and enriched cereals and soy products. The same care must be taken in getting adequate protein, calcium, omega-3 fatty acids, iodine, zinc, iron and vitamin D. It may sound complex, but a healthful vegan diet just takes a bit more planning.

There’s a lot of good news coming out of recent research into people who follow a plant-based diet. This includes a measurably lower incidence of cardiovascular disease and certain cancers, better blood glucose control, a lower rate of Type 2 diabetes, better blood pressure numbers, and lower rates of obesity in young adults.

It’s important to note that these studies looked into healthful vegan diets. That means eating from a wide range of fresh, whole foods. The advice to steer clear of highly processed foods holds true for vegans. We think it could be useful for the three of you to meet with a registered dietitian to talk over the specifics of eating vegan. It will bolster your daughter's and granddaughter’s understanding, and can help ease your concerns.

(Send your questions to [email protected]. Owing to the volume of mail, personal replies cannot be provided.)