In recent years, the vegan diet has become increasingly popular. According to a 2017 report on dietary trends, the percentage of individuals who considered themselves vegans in the United States grew significantly from 1% in 2014 to 6% in 2017. (23) In 2018, 850,000 Canadians reported following a vegan diet. (25) It seems the highly-touted health benefits of being vegan have seen an uptick in perception.
Unlike many other diets, being “vegan” often involves more than just eating or omitting certain foods for a period of time. It’s a lifestyle choice that excludes the consumption and use of animals and animal-derived products. Vegans, like vegetarians, don’t eat meat, fish, or poultry. In addition, they also avoid all foods from animal sources, such as eggs, dairy, and honey. Strict vegans also avoid using animal-based products like leather, oils or supplements.
While weight loss may be one reason to follow a vegan diet, there are a variety of reasons individuals choose this approach to diet and lifestyle. Common reasons include health benefits, ethical concerns, spiritual beliefs, and environmental preservation. (24)
What are the benefits of a vegan diet?
A vegan diet is largely made up of vegetables, fruits, grains, nuts, seeds, beans, and legumes. (11) A well-planned vegan diet is typically rich in carbohydrates, fiber, and several beneficial nutrients including folic acid, vitamin C, vitamin E, potassium, magnesium, essential fatty acids, and many phytochemicals. (5)(11) Compared to vegetarian diets, vegan diets also contain less saturated fat and cholesterol, likely a result of omitting eggs and dairy. (5)
One of the most well-established health benefits of a plant-based, vegan diet is the reduced risk of cardiovascular disease. This benefit can be attributed to an increase in the consumption of cardioprotective foods, such as whole grains, vegetables, fruits, nuts, legumes, and unsaturated fat. It was found that a vegan diet composed primarily of refined grains, processed starchy vegetables such as potato chips or french fries, and sugary foods and beverages is linked to an increased risk of cardiovascular disease. (9) This indicates that the benefits of a vegan diet are dependent on the increased intake of healthy, nutrient-rich foods, rather than simply the omission of animal products. However, compared to vegetarians, it was also noted that vegans tend to be leaner and have lower blood pressure, cholesterol, and risk of heart disease. (5)
A systematic review and meta-analysis of clinical trials examining the health effects of plant-based diets found that these diets were associated with decreased cardiovascular risk factors. Compared to omnivorous diets, plant-based diets were associated with decreased total cholesterol, low-density lipoprotein (LDL), and high-density lipoprotein (HDL). (29) One study also found that individuals following a vegan diet, without caloric restriction, demonstrated favorable changes in blood pressure comparable to individuals following conventional and portion-controlled diet recommendations for high blood pressure. (13)
Weight management & metabolic health
In addition to improvements in cardiovascular health, numerous studies have demonstrated the beneficial effects of the vegan diet in the prevention and management of obesity, glycemia, insulin resistance, metabolic syndrome, and type 2 diabetes. (14)(27)(28) Compared to vegetarians, vegan diets appear to be even more effective in protecting against obesity and type 2 diabetes. (12) A 16-week randomized clinical trial in which individuals followed a plant-based diet determined that this dietary approach may be effective in addressing obesity, improving body composition, and improving insulin resistance. The researchers attribute these improvements in part to the increased consumption of plant-based protein and decrease intake of the amino acids leucine and histidine. (10) Another 18-week study following corporate employees found that following a vegan diet resulted in improvements in body weight, plasma lipid levels, and glycemic control in individuals with diabetes. (15)
Compared to various other diets, the vegan diet may be the most effective when it comes to preventing and addressing type 2 diabetes. A study comparing the effects of a low-fat vegan diet and a conventional diabetic diet found that — when accounting for medication changes — the vegan diet resulted in greater improvements in glycemia and plasma lipid levels. (2) Similarly, a study comparing the prevalence of type 2 diabetes in vegans, vegetarians, and non-vegetarians, found that mean body mass index (BMI) and risk of type 2 diabetes was lowest in vegan individuals. (26)
Several studies have demonstrated a positive effect between the vegan diet and the intestinal microbiota, the collection of microbes that live in your gastrointestinal tract. Your microbiota plays an integral role in maintaining overall health, including proper digestive and immune function. Compared to omnivores, vegans have a distinct composition of bacteria that appears to be similar to vegetarians, indicating that plant-based diets may have a distinctive and unique effect on the microbiota. The microbiota in vegans includes a greater number of protective species and a reduced number of pathobionts, or pathological microbes. (7) A study of 144 vegetarians, 105 vegans, and 249 omnivores found that, compared to omnivores, individuals following a vegan diet had significantly lower counts of Bacteroides, Bifidobacterium, Escherichia coli, and Enterobacteriaceae. Another study found that both vegetarians and vegans have lower counts of Bacteroides fragilis. These differences may be attributed to higher carbohydrate and fiber consumption, as well as a lower pH in vegans, which creates an unsuitable environment for the growth of certain bacteria such as E. coli and Enterobacteriacea. (4)
While more research is needed to understand the effects of dietary interventions for rheumatoid arthritis, some evidence indicates a connection between diet, the microbiome, and rheumatoid arthritis (RA) disease activity. Benefits of the vegan diet in relation to RA may be attributed to changes in the intestinal flora and the diet’s higher content of antioxidants, lactobacilli, and fiber. (1)
One study of 53 patients with RA who transitioned from an omnivorous diet to a vegan diet demonstrated significant changes in microbiota compositions after one year on a vegan diet. Microbiota composition also varied between individuals who demonstrated high versus low improvements, further indicating that the composition of an individual’s intestinal flora may be related to RA disease activity. (4) Supporting this theory, a study compared the effects of an lactobacilli-rich, uncooked vegan diet in individuals with RA, compared to a control group. The vegan diet resulted in improvements in subjective RA symptoms, which were aggravated by returning to an omnivorous diet. (22)
Another study of examining the effects of a gluten-free, vegan diet in patients with rheumatoid arthritis noted reductions in immunoreactivity to food antigens, indicated by a decrease in immunoglobulin G (IgG) antibody levels. (8) A similar study demonstrated that RA patients following a gluten-free, vegan diet had decreased levels of LDL and oxidized low-density lipoprotein (oxLDL), and elevated levels of anti-PC IgM and IgA compared to individuals following a well-balanced non-vegan diet for one year. (6)
Meat and animal products are typically considered an integral part of an athlete’s diet. With the emerging plant-based trends, however, the vegan diet is now being considered a viable option for athletes and may actually offer performance advantages. Plant-based diets have been associated with leaner body compositions and improved glycogen storage as a result of high carbohydrate intake. (3)
Endurance athletes may be at a higher risk for developing atherosclerosis and myocardial damage. As discussed earlier, plant-based diets can improve cardiovascular risk factors, such as plasma lipid concentrations, body weight, and blood pressure. High intake of antioxidants (i.e., fruits and vegetables) may also lead to reductions in oxidative stress and inflammation. Further, a reduction in blood viscosity and improvement in arterial flexibility and endothelial function may improve blood flow and oxygenation of tissues. (3)
The rules of engagement: tips for a successful vegan diet
Wondering what exactly veganism is and how you can be successful at it? Well Dr. Holly Lucille, ND, RN, gives her rules to being a successful vegan.
The key to any successful diet is education and a little planning. The following information provides an overview of the vegan diet, important considerations, and tips for success.
On a vegan diet, all animal products, including by-products and derivatives, should be avoided, including:
- Honey and other bee products (e.g., pollen)
- Insects or products made from insects (e.g., dyes, silk)
- Foods/products in which animal ingredients or animal by-products are used in the manufacturing process (i.e., sugar filtered with bone char)
- Any animal-derived GMOs or animal-derived genes used to manufacture ingredients or finished product
- Any products tested on animals
- Animal-derived materials such as leather, silk, feathers, wool, etc.
Vegan & vegetarian certifications
When purchasing prepared and packaged foods or products, third-party certifications — that ensure the validity of vegan claims — can help you make accurate choices. Common vegan and vegetarian certifications include Vegan Action, the Vegan Society Trademark, VegeCert, and American Vegetarian Association. Certified products are easily recognized by the presence of a certification mark on a product’s packaging.
When purchasing supplements, always look for vegan third-party certifications to ensure that no animal products or by-products are used within the formulation or during the manufacturing process.
Planning a healthy vegan diet
While a vegan diet is most often defined by the omission of animal products, it’s important to discuss what makes up a healthy vegan diet. When it comes to following this diet, two of the most common mistakes include failing to plan and depending too much on refined or packaged foods. It’s important to understand that just because a product is labeled vegan, it does not mean it’s healthy. Research has shown that the health benefits gained from following a vegan diet, including those highlighted in this article, apply to properly planned, healthy vegan diets based on whole, fresh foods. Vegan diets comprised primarily of refined foods do not provide the same beneficial effects. (9)
Base your vegan diet around a variety of fresh foods, including plenty of vegetables, fruits, nuts, seeds, legumes and plant oils. A common misconception about the vegan diet is that this type of diet doesn’t contain enough protein. On the contrary, by combining a variety of plant-based sources, you will ensure you consume the necessary essential amino acids. To learn more about plant-based protein, visit our blog.
Common nutrient deficiencies & supplementation
While a well-planned diet can help ensure that your body is getting all the nutrients it needs, it’s important to be aware of common nutrient deficiencies that may arise as a result of following certain diets. When omitting animal and animal-derived foods from the diet, individuals may be at risk for deficiency in a number of nutrients found abundantly in these foods. These nutrients include vitamin B12, vitamin D, calcium, iron, zinc, and essential fatty acids. (5)(11) When planning a vegan diet, it’s important to incorporate alternative plant-based sources of these nutrients and to supplements when necessary.
Below are the Recommended Dietary Allowances (RDA) and plant-based sources for each of these nutrients. The RDA is the “average daily level of intake sufficient to meet the nutrient requirements of nearly all (97%–98%) healthy individuals.” (19)
- RDA: 2.4 mcg
- Sources: fortified foods, nutritional yeast (19)
- RDA: 600 IU (15 mcg)
- Sources: sun exposure, fortified foods, some mushrooms (D2) (20)
- RDA: 1,000 mg
- Sources: tofu, turnip greens, kale, bok choy, broccoli (16)
- RDA: 8 mg for men and 18 mg for women
- Sources: beans, legumes, spinach, tofu, cashews (17)
- RDA: 11 mg for men and 8 mg for women
- Sources: pumpkin seeds, cashews, chickpeas, oats, almonds (21)
Omega-3 fatty acids
- RDA: 1.6 g for men and 1.1 g for women
- Sources: flaxseeds, chia seeds, walnuts (ALA only) (18)
The bottom line
While following these rules of engagement can help you get the most out of your diet, you may require additional support and guidance, especially if making the leap from an omnivorous diet to a vegan diet plan. If you’re a patient, speak to your integrative healthcare provider before adding new supplements to your treatment plan. Integrative healthcare practitioners can provide further education and tools for dietary planning. They can also help monitor your health and prevent common nutrient deficiencies. Keep in mind that extreme dietary changes can be overwhelming. To ease the transition, try gradually incorporating and substituting animal products for plant-based alternatives.
- Badsha, H. (2018). Role of diet in influencing rheumatoid arthritis disease activity. The Open Rheumatology Journal, 12(1), 19-28
- Barnard, N. D., Cohen, J., Jenkins, D. J., Turner-Mcgrievy, G., Gloede, L., Green, A., & Ferdowsian, H. (2009). A low-fat vegan diet and a conventional diabetes diet in the treatment of type 2 diabetes: A randomized, controlled, 74-wk clinical trial. The American Journal of Clinical Nutrition, 89(5).
- Barnard, N., Goldman, D., Loomis, J., Kahleova, H., Levin, S., Neabore, S., & Batts, T. (2019). Plant-based diets for cardiovascular safety and performance in endurance sports. Nutrients, 11(1), 130.
- Chen, C., Wong, M., Yi, C., Liu, T., Lei, W., Hung, J., . . . Lin, S. (2018). Impact of vegan diets on gut microbiota: An update on the clinical implications. Tzu Chi Medical Journal, 30(4), 200.
- Craig , W.J. (2009). Health effects of vegan diets. The American Journal of Clinical Nutrition, 89(5), 1627S-1633S.
- Elkan, A., Sjöberg, B., Kolsrud, B., Ringertz, B., Hafström, I., & Frostegård, J. (2008). Gluten-free vegan diet induces decreased LDL and oxidized LDL levels and raised atheroprotective natural antibodies against phosphorylcholine in patients with rheumatoid arthritis: A randomized study. Arthritis Research & Therapy, 10(2).
- Glick-Bauer, M., & Yeh, M. (2014). The health advantage of a vegan diet: Exploring the gut microbiota connection. Nutrients, 6(11), 4822-4838.
- Hafstrom, I. (2001). A vegan diet free of gluten improves the signs and symptoms of rheumatoid arthritis: The effects on arthritis correlate with a reduction in antibodies to food antigens. Rheumatology, 40(10), 1175-1179.
- Hemler, E. C., & Hu, F. B. (2019). Plant-based diets for cardiovascular disease prevention: All plant foods are not created equal. Current Atherosclerosis Reports, 21(5).
- Kahleova, H., Fleeman, R., Hlozkova, A., Holubkov, R., & Barnard, N. D. (2018). A plant-based diet in overweight individuals in a 16-week randomized clinical trial: Metabolic benefits of plant protein. Nutrition & Diabetes, 8(1).
- Key, T.J., Appleby, P.N., & Rosell, M.S. (2006). Health effects of vegetarian and vegan diets. Proceedings of the Nutrition Society, 65(1), 35-41.
- Le, L., & Sabaté, J. (2014). Beyond Meatless, the Health Effects of Vegan Diets: Findings from the Adventist Cohorts. Nutrients, 6(6), 2131-2147.
- Lopez, P. D., Cativo, E. H., Atlas, S. A., & Rosendorff, C. (2019). The effect of vegan diets on blood pressure in adults: A meta-analysis of randomized, controlled trials. The American Journal of Medicine.
- McMacken, M., & Shah, S. (2017). A plant-based diet for the prevention and treatment of type 2 diabetes. Journal of Geriatric Cardiology, 14(5), 342-354.
- Mishra, S., Xu, J., Agarwal, U., Gonzales, J., Levin, S., & Barnard, N. D. (2013). A multicenter randomized controlled trial of a plant-based nutrition program to reduce body weight and cardiovascular risk in the corporate setting: The GEICO study. European Journal of Clinical Nutrition, 67(7), 718-724.
- National Institutes of Health: Office of Dietary Supplements. (2018) Calcium: Fact Sheet for Health Professionals. Retrieved from https://ods.od.nih.gov/factsheets/Calcium-HealthProfessional/
- National Institutes of Health: Office of Dietary Supplements. (2018) Iron: Fact Sheet for Health Professionals. Retrieved from https://ods.od.nih.gov/factsheets/Iron-HealthProfessional/
- National Institutes of Health: Office of Dietary Supplements. (2018) Omega-3 Fatty Acids: Fact Sheet for Health Professionals. Retrieved from https://ods.od.nih.gov/factsheets/Omega3FattyAcids-HealthProfessional/
- National Institutes of Health: Office of Dietary Supplements. (2018) Vitamin B12: Fact Sheet for Health Professionals. Retrieved from https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional/
- National Institutes of Health: Office of Dietary Supplements. (2018) Vitamin D: Fact Sheet for Health Professionals. Retrieved from https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/
- National Institutes of Health: Office of Dietary Supplements. (2019) Zinc: Fact Sheet for Health Professionals. Retrieved from https://ods.od.nih.gov/factsheets/Zinc-HealthProfessional/
- Nenonen, M.T., Helve, T.A., Rauma, A.L., & Hänninen, O.O. (1998). Uncooked, lactobacilli-rich, vegan food and rheumatoid arthritis. British Journal of Rheumatology, 37(3), 274-81.
- Report Buyer. (2017, June). Top trends in prepared foods 2017: Exploring trends in meat, fish and seafood; pasta, noodles and rice; prepared meals; savory deli food; soup; and meat substitutes. Retrieved from https://www.reportbuyer.com/product/4959853/top-trends-in-prepared-foods-2017-exploring-trends-in-meat-fish-and-seafood-pasta-noodles-and-rice-prepared-meals-savory-deli-food-soup-and-meat-substitutes.
- Rosi, A., Mena, P., Pellegrini, N., Turroni, S., Neviani, E., Ferrocino, I., . . . Scazzina, F. (2017). Environmental impact of omnivorous, ovo-lacto-vegetarian, and vegan diet. Scientific Reports, 7(1).
- Statista. (2019, November 20). Vegetarian and vegan population Canada 2018. Retrieved from https://www.statista.com/statistics/954924/number-of-vegetarians-and-vegans-canada/
- Tonstad, S., Butler, T., Yan, R., & Fraser, G. E. (2009). Type of vegetarian diet, body weight, and prevalence of type 2 diabetes. Diabetes Care, 32(5), 791-796.
- Trapp, C.B., & Barnard, N.D. (2010). Usefulness of vegetarian and vegan diets for treating type 2 diabetes. Current Diabetes Reports, 10(2), 152-8.
- Toumpanakis, A., Turnbull, T., & Alba-Barba, I. (2018). Effectiveness of plant-based diets in promoting well-being in the management of type 2 diabetes: A systematic review. BMJ Open Diabetes Research & Care, 6(1).
- Yokoyama, Y., Levin, S. M., & Barnard, N. D. (2017). Association between plant-based diets and plasma lipids: A systematic review and meta-analysis. Nutrition Reviews, 75(9), 683-698.