There are three solid reasons a person chooses to be vegan: the animals, the planet and your health. These are all amazing reasons. Vegan diets are free from all flesh foods, eggs and dairy products, and usually honey. However, like many things in life, a vegan lifestyle is not a one-size-fits-all.

What works for one person may not necessarily work for another. For example, a plant-based diet is naturally higher in many foods that trigger IBS (irritable bowel syndrome) symptoms – bloating, pain, gas, etc. Unless the person is able to find their individual tolerance, a vegan diet might not be best for them.

There are a handful of important nutrients almost impossible to get from commonly consumed plant foods. If you follow a vegan diet, I recommend you make a plan for how you’re going to provide your body with the important, missing nutrients. This is even more critical during pregnancy. 

If you can’t find food sources for these nutrients, it’s OK to take a supplement. There are many, high-quality, trustworthy plant-based supplements on the market.

Vitamin B₁₂  

It’s very difficult to get enough of the essential vitamin B₁₂ from plant foods, making vegans at great risk of deficiency (1, 2). A vegan may be consuming enough to avoid anemia and nervous system damage, but are they getting enough to minimize potential risk of heart disease or pregnancy complications?

Vitamin B₁₂ is involved in the development of red blood cells, maintenance of nerves, DNA synthesis, and normal brain function.

A B₁₂ deficiency can result in an increase in total homocysteine concentration (3). High homocysteine levels are pro-inflammatory to the brain, blood vessels and peripheral nerves. It increases risk of heart disease, neuropathy and even depression.

Vitamin B₁₂ is found primarily in animal foods, such as fish, meat, dairy products and eggs. Lacto-ovo vegetarians can get enough vitamin B₁₂ from dairy products and eggs, but it’s more challenging for vegans.

Plant Foods That Naturally Contain the Bioactive Form of Vitamin B₁₂

• Nori seaweed, a type of marine algae (raw or freeze-dried)
• Tempeh, a fermented soy product

An important note though – studies have found consuming these foods does not significantly increase a person’s vitamin B₁₂ levels and can still lead to a deficiency (4).

My Vitamin B₁₂ Recommendations

1) Eat foods fortified with vitamin B₁₂, two or three times a day, to get at least 3 mcg. This includes some non-dairy milk, breakfast cereals, meat substitutes and vegan spreads (such as marmite). Read the labels because some may not be fortified. Spirulina is also a natural source of vitamin B₁₂, and it’s available in powder or capsule form.

2) Take one B₁₂ supplement daily providing at least 10 mcg, such as what’s in this plant based vitamin and mineral supplement. FYI, the most bioavailable forms of vitamin B₁₂ are: methylcobalamin and adenosylcobalamin,

3) Take a weekly B₁₂ supplement providing at least 2000 mcg; however, B₁₂ is best absorbed in small amounts.

4) Get a B₁₂ shot, which bypasses the stomach and is absorbed directly into the bloodstream. See your doctor before getting a B₁₂ shot because it can interfere with common medications.

Collagen

Collagen is the most abundant protein in the human body, found in the bones, ligaments, tendons, skin, hair, and nails. It’s like the frame of a house – it holds the body together, providing strength and structure – and it isn’t vegan. It mostly comes from beef or fish.

If you’re wondering whether you have enough collagen, it depends. As we age, our body loses its ability to produce collagen, contributing to common signs of aging skin, less flexible tendons and ligaments, weakening muscles and joint pain. 

The vegan versions come from genetically modified yeast and bacteria. Researchers have found the bacteria P. pastoris is the most effective and commonly used for genetically engineering high-quality collagen (5).

The bummer is, vegan collagen is hard to come by. The most abundant amino acids in collagen are glycine, lysine, and proline, so look for these foods high in all three of those amino acids:

• soy products: tempeh, tofu, and soy protein
• black beans
• kidney beans
• many other legumes
• seeds: especially pumpkin, squash, sunflower, and chia
• nuts: pistachio, peanut, and cashew

Another way a vegan can get the benefits of collagen is to take individual amino acid supplements. I like this one by Dr. Mercola, which is a very reputable brand. 

Creatine

Creatine is a nitrogenous organic acid that helps supply energy to cells throughout the body, especially muscle cells. It is formed from three amino acids: L-arginine, glycine and L-methionine.

It’s impossible for vegans to get creatine from food because it isn’t found in plant foods. Rather, it occurs naturally in red meat and fish. The body is also able to synthesize its own creatine in the liver; however, vegetarians have significantly lower amounts of creatine stored in their muscles (6, 7). This is especially important news for vegan athletes trying to increase their lean muscle mass.

Essential Fat DHA

This omega-3 fatty acid is crucial for your health, especially maintaining healthy inflammatory levels in the body and promoting a healthy heart. It’s essential because it must come from food (your body can’t make it). It’s found in fatty fish, fish oil, egg yolks and some types of microalgae, and vegan diets provide little, if any DHA (8).

In the body, DHA can be made from the omega-3 fatty acid ALA, which is found in flaxseeds, chia seeds and walnuts. The problem is, the conversion of ALA to DHA is inefficient and unreliable, so vegans are often lower in DHA (8, 9, 10, 11). This is a concern since DHA is the most important fatty acid in the gray matter of the brain, the retina of the eye, and in the testes and sperm. A steady dietary supply is needed to maintain healthy levels, especially if you’re pregnant or breastfeeding.

The most predictable way to increase DHA and EPA in the blood, tissues, and even breastmilk is through supplementation (10). Because of the beneficial effects of omega-3s, it’s recommended vegans make dietary changes to optimize omega-3 fatty acid status. This can be done by maximizing the conversion of ALA to EPA and DHA or providing a direct source of DHA (ie: supplementation) (8).  

Heme Iron

The concern about iron status of a person on a vegan diet is based on low bioavailability of iron from plant foods and inadequate iron intake. Even if a vegan consumes enough iron from plant foods, the bioavailability of non-heme iron isn’t enough to maintain iron balance, especially in women (12). This makes vegans more prone to iron-deficiency anemia (13).

The reason non-heme iron is less bioavailable, compared to heme iron, is because of the naturally occurring absorption inhibitors, which mainly include phytate, oxalate, and polyphenols.

Heme iron, found in meat, is much better absorbed than non-heme iron, found in plants. In fact, when heme and non-heme iron are eaten at the same meat (ie: chicken and beans), the heme iron improves absorption of the non-heme iron, so they make a good team. Heme iron also isn’t affected by antinutrients, such as phytates, often found in plant foods.

Taurine

Taurine is an important amino acid that balances the central nervous system’s stress response, supports normal, healthy rest, relaxation and sleep, and is important in the heart, liver, gallbladder and nervous system. The health of your bile is crucial if you want proper liver function. The thicker your bile, the more sluggish your liver. About 50% of bile salt contains taurocholic acid as its foundation (from sodium taurocholate or potassium taurocholate), and taurine promotes healthy bile consistency. 

Taurine is only found in animal foods such as fish, seafood, meat, poultry and dairy products (14), and levels of taurine are significantly lower in vegans than in meat eaters (15).

My Taurine Recommendation:

I take 1 to 3 capsules of Uckele Taurine at night to support bile consistency and promote deep, healthy sleep.

Zinc

Few plant foods contain zinc, and like iron, zinc’s absorption is limited due to the amount of phytates, fiber, calcium, or other antinutrient inhibitors in plant foods a person eats (16). The requirement for dietary zinc may be as much as 50% greater for vegetarians and particularly for strict vegetarians whose major food staples are grains and legumes and whose dietary phytate to zinc ratio exceeds 15:1 (16).

To maximize your intake, eat a variety of zinc-rich foods throughout the day. These include whole grains, wheat germ, tofu, sprouted breads, legumes, nuts and seeds. Soaking nuts, seeds and legumes overnight, eating enough protein and consuming fermented foods such as miso and tempeh also seems to boost absorption (17).

I must add, I don’t like the idea of a person consuming so much wheat. The protein in wheat, gliadin, is often inflammatory and negatively changes the microbiome. So…. choose your plant-based zinc sources wisely. If you are sensitive to gluten (which you may or may not feel), the immune system’s reaction to gluten turns on the immune system, which triggers inflammation, but it doesn’t stop there. It can also lead to a breakdown of the blood-brain barrier itself, paving the way for the production of yet more brain-crushing inflammatory chemicals (18). 

Vitamin D

Inadequate vitamin D intake isn’t just a vegan problem – the majority of people, regardless of their dietary preferences, are deficient in vitamin D.

Vitamin D deficiency has been associated with poor immune function, poor cardiovascular health, depression, inflammatory bowel disease, osteoporosis and hormone imbalance (19). Along with vitamin A and thyroid hormone, vitamin D regulates the DNA of some cells to favor maturation into specific cell types. This is important in orchestrating tissue development in the fetus and growing child.

There are only small amounts of vitamin D in food, and here are two sure ways to get enough vitamin D: 

• Expose your bare skin to sunlight, but in the winter months this is difficult.
• Take vitamin D supplements (liquid or chewable tablet).

If you purchase a vitamin D supplement in liquid form, it should be suspended in a healthy fat, such as olive oil or MCT oil, in order to boost its absorption. You can also take your vitamin D with food that contains fat, such as nuts, avocado and olives. It's also a good idea to combine Vitamin D and vitamin K2. Here's why.

Final Thoughts

A vegan diet works for people; however, there are a few nutrients that are very important but difficult to get from plant foods. If you eliminate animal foods, do your homework in order to fill your diet with everything your body needs.

Kelly Harrington, MS, RDN

Registered Dietitian Nutritionist for Healthy Goods

References:

1. https://www.ncbi.nlm.nih.gov/pubmed/2801576
2. https://www.ncbi.nlm.nih.gov/pubmed/6897159
3. https://www.ncbi.nlm.nih.gov/pubmed/12816782
4. https://veganhealth.org/vitamin-b12-plant-foods/
5. https://link.springer.com/article/10.1007/s00253-005-0180-x
6. https://www.ncbi.nlm.nih.gov/pubmed/14600563
7. https://www.ncbi.nlm.nih.gov/pubmed/29569535
8. https://academic.oup.com/ajcn/article/78/3/640S/4690006
9. https://www.ncbi.nlm.nih.gov/pubmed/9637947
10. https://www.ncbi.nlm.nih.gov/pubmed/12936959
11. https://www.ncbi.nlm.nih.gov/pubmed/16841856
12. https://www.sciencedirect.com/science/article/pii/S0271531799000317?via%3Dihub
13. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6367879/  
14. https://www.ncbi.nlm.nih.gov/pubmed/2352336
15. https://www.ncbi.nlm.nih.gov/pubmed/3354491
16. https://www.nap.edu/read/10026/chapter/14#479
17. https://jandonline.org/article/S0002-8223(01)00167-5/fulltext
18. J. Visser et al., tight Junctions, Intestinal Permeability, and Autoimmunity: celiac disease and tye 1 diabetes paradigms, Ann. N.Y. Acad. Sci. 1165 (May 2009):195-205.
19. Vitamin D Council. Health Conditions.