Over the last decade, the number of annual research papers on plant-based diets has continued to increase exponentially. We now have enough data to make pretty confident conclusions about the pros and cons of plant-based diets. For generations, we've known that plant-based dietary patterns were more ethical. Then we started to notice how our food system was harming the environment and using finite resources irresponsibly. Now, thanks to over 20 000 studies getting published on plant-based nutrition in 2021 alone, we have a much clearer understanding of how adopting a plant-predominant dietary pattern can impact health, both positively and even negatively, if not well planned.
Plant-based diets have gained popularity for the many positive impacts they have on various health outcomes. They're shown to be associated with lower all-cause mortality and to have protective properties when looking at some of our top killers, like heart disease and cancer. The term "plant-based" has quickly become associated with perceptions of health. Soon enough, plant-based labels started to decorate highly processed and unhealthy foods, a clever marketing attempt for those trying to take advantage of the plant-based health halo, further confusing the uneducated consumer.
By itself, the term "plant-based" isn't always synonymous with health. Rather, it should be seen for what it is, an umbrella term used to describe a "plant-forward" type of dietary pattern that can include anything from flexitarianism to veganism. Considering the wide variety of healthy dietary patterns, plant-based diets could appear on either side of the spectrum. Ultra-processed foods with added sugar, fat and sodium can be called plant-based too and aren't always health promoting. So from now on, when I use the term "plant-based diet" and associating it with health, I'll be referring to a whole food plant-based diet that minimizes animal products and ultra-processed foods.
Nutrients Of Concern
Without minimizing the risk of possible nutrient deficiencies of plant-based diets, I think it's very important to state that nutritional gaps are commonly seen with all dietary patterns. This is not solely an issue seen with plant-predominant diets. We've known about nutrient shortfalls for hundreds of years. Salt has been getting iodized for almost a century and we've been fortifying foods with folic acid for more than 20 years. No diet is perfect, unless it is carefully planned and perfectly executed day in and day out, which sounds great but remains unrealistic. Omnivorous diets are typically low in fiber, excessively high in cholesterol and saturated fats and low in potassium. These dietary characteristics contribute to higher levels of blood cholesterol, higher blood pressures and fasting glucose, all of which contribute to heart disease. Yet many consumers don't seem to be bothered by the nutritional gaps of these diets. Skeptics quickly point out the nutrients of concern associated with plant-based diets and then conclude that these theoretical risks of deficiencies make this an inadequate or unsafe dietary pattern. Meanwhile, our population's lack of fiber is contributing to incredibly high rates of heart disease and the abysmal intake of antioxidants in our diet is contributing to increased cancer rates and auto-immunity. These are the medical conditions that we are seeing in the clinic on a daily basis, not theoretical selenium deficiencies because of consuming too many plants.
Again, I'm not avoiding the fact that plant-based diets can be associated with nutrient deficiencies, since these shortfalls can have major negative impacts on health and have to be taken very seriously. Since many of us, including me, did transition towards this diet for its health benefits, it would be hypocritical to do it irresponsibly, when simple and effective strategies can be used to fill in the nutritional gaps.
The first step of filling in the nutritional gaps is simply identifying which nutrients are at a particularly higher risk of becoming a concern. The science is already pretty clear on this. A plant-based diet that doesn't pay any special attention to nutrient content does pose a risk for deficiencies of specific vitamins like B2, B3, B12 and vitamin D, as well as minerals like iodine, zinc, calcium and selenium. Meeting daily intake requirements for these nutrients doesn't have to be complicated. They can be easily met through some careful, yet easy planning. Let's review how nutrient concerns can become a thing of the past!
Bridging The Nutritional Gaps
If health through proper nutrition is a priority for you and you're adopting a new dietary pattern of any type, going in blind and unprepared could be problematic. It's important to consider that very simple strategies can be used to mitigate the risks of nutrient deficiencies. A few basic strategies have proven to be very useful when trying to meet nutritional requirements and help bridge nutritional gaps. Consider:
educating yourself on which foods contain specific nutrients of concern
choosing fortified foods when possible
coupling nutrients of concern with other nutrients that boost their absorption
not combining nutrients of concern with nutrients that could reduce their absorption
using supplementation when required and when it offers additional protection
I've witnessed people who made the plant-based transition without ever considering how this could affect nutritional adequacy. Knowledge is power and no one living in the modern world should ever be deficient in iodine or selenium. Yet soil depletion makes iodine content in plants unreliable and unless you're using iodized table salt, or very specific types of food, like sea vegetables, you can get iodine-deficient. Not everyone is aware of that and it's our responsibility to spread the word and to look out for each other so no one suffers needlessly from very avoidable deficiencies. Once I learned that a single Brazil nut could help meet my daily selenium requirements, I quickly started mixing them in with the other nuts that I was already eating! Sprinkling some nuts, seeds or nutritional yeast on foods you already eat is also an easy way of improving nutritional adequacy. If I haven't had as many legumes or nuts on a specific day, I'll make sure to add hemp seeds to whatever snack I'm having to boost zinc intake. Get informed! The nutrients of concern are relatively easy to find if you know where to look!
Choosing Fortified Foods
We've been fortifying foods for over a century, and there's no shame in using iodized salt instead of non-fortified pink Himalayan salt. Calcium-set tofu is an easy way of increasing the amount of calcium, the most abundant of all minerals in the human body. Many foods are routinely fortified with B12, and vitamin D is routinely added to plant milks and B vitamins are commonly added to nutritional yeast. Choosing these great tasting fortified foods is an easy and convenient way of helping you achieve nutritional adequacy without much effort.
Boosters And Blockers
Many people already know that vitamin D increases calcium absorption, but how about combining apricots with strawberries? The iron in apricots will be even better absorbed when combined with the vitamin C found in strawberries. A spritz of lemon could help absorb more minerals from spinach. Other compounds in foods can even block nutrient absorption. Phytates and oxalates are compounds that can bind to minerals and limit their absorption. Something as simple as boiling or soaking can significantly reduce these compounds and increase the availability of other nutrients. Other compounds, like some found in coffee for example, can also limit the absorption of iron. For this reason, it's best to enjoy tea or coffee either a few hours before, or after your dark leafy greens! All of these practical tips are relatively easy to implement and can help bridge nutritional gaps that could be seen with plant-based diets.
Increasing vitamin or mineral intake through supplementation can be a convenient way of guaranteeing adequate intakes. Although some may see multivitamins or single nutrient supplements as unnecessary crutches, I see them as an insurance policy that can help you hit nutrient requirements when life gets in the way. Don't get me wrong, prioritize food first, but if uncontrollable circumstances keep you from hitting your goals, a multi-nutrient or single nutrient supplement could be a reasonable insurance policy. B12 and vitamin D supplements are advised, due to the high rates of deficiencies even in people using fortified foods, and deficiencies in these vitamins and other nutrients are not specific to plant-based diets. They're part of most of our modern dietary patterns. Science has come a long way, through supplements and fortification, to help us enjoy the foods we love, without worrying as much about deficiencies. There's no shame in benefiting from scientific advancements, especially when they're proven to improve health and quality of life.
My Plant Prescription
Nutrient deficiencies are a big deal, but they don't have to be. There are easy and convenient ways to make sure you're getting adequate intake of the nutrients of concern. Many people transitioning towards a plant-based diet are doing it for health and want to do it the right way. No diet is perfect unless it's perfectly planned and executed. The incredibly high rates of chronic diseases, proven to be less common in populations eating a plant-predominant diet, should be enough to convince most to consider this dietary pattern.
Let's not forget that people are dying from heart disease, cancer and strokes or needlessly suffering from auto-immune conditions at alarming rates. When compared to the Standard American Diet that kills millions per year, a theoretical risk of selenium deficiency, which is easily avoidable and rarely seen in the clinic, shouldn't be as scary as fiber deficiency or cholesterol excess. Easily preventable nutrient deficiencies that can be seen with plant-based diets should never deter someone from choosing this dietary pattern!
Check out my website plantbaseddrjules.com and look for the “How To” section in the menu. There, you’ll find tips and tricks that helped me on my journey towards a plant-predominant diet. Everything there is completely free, no catches! If you're looking for quick, easy and healthy plant-based recipes, check out plantbaseddrjules.com and download my free recipe eBook!
Look for me on the socials, @plantbased_dr_jules on Instagram and go like my Facebook Page, Plant-based Dr. Jules. If you’re looking for some fitness motivation and are curious to see what a plant-based athlete can accomplish, follow me, @maritimeninja, on my fitness account on Instagram or check out my fitness group on Facebook, called Maritime Ninja Warrior. Me and my wife Melissa have recently qualified for the Las Vegas Ninja Warrior World Championships, an obstacle racing course that will be held in July 2022, and you can follow our journey to Vegas on IG! If you’d like to see what a plant-based athlete looks like, then check out our youtube channel here!
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Plant-Based Dr. Jules 💚🌱