Reconciling Supplement Use with Plant-Based Diets

Question 1) How do you reconcile a 100% plant-based diet with the fact that this will cause us to miss out on key nutrients, specifically vitamin B12 which you recommend supplementing multiple times throughout your book. It's not that I'm opposed to supplementation, but I'm having more of a philosophical debate on how healthy a 100% plant-based diet truly is if it would cause our bodies harm by missing key nutrients.

I guess I think of this from a few different angles.

Angle #1) All dietary patterns have pros and cons. Some dietary patterns are more nutritionally complete, some might fall short on a few nutrients. Some dietary patterns have a lighter environmental footprint, some are quite damaging to the planet. Some can be sourced mostly locally, some require more transport miles, The list goes on. So, while a 100% plant-based diet might require vitamin B12 supplementation (a con), it also has a lot of pros (light on the environment, nutritionally rich in other various micronutrients, promotes animal welfare, decreases chances of chronic disease, etc.).

Angle #2) I know that there is often a push in the nutrition world to get all nutrients from whole foods, without any type of modern intervention. And if someone cannot achieve adequate nutrient intake from whole foods alone, they are sometimes viewed as flawed or inferior. But I like to step back and consider all of the different areas where we rely on modern, man-made interventions to allow for a more seamless and healthy existence. We have cell phones, cars, medications, gyms with dumbbells, electricity, refrigerators, etc. These things aren't "from the earth" or "natural". But they can be very helpful in certain situations. So, I don't think using a man-made vitamin B12 supplement to round out a diet makes the diet flawed. There are plenty of omnivorous dietary patterns that lack certain nutrients and also require supplementation. No matter how someone eats, it's very difficult to meet all micronutrient needs with our soils becoming more depleted.

Angle #3) In parts of the world where people eat a highly plant based diet due to income limitations and not as much accessibility to meat, vitamin B12 deficiency still isn't very prevalent. This is because in these parts of the world they are still eating plants that have more bacteria on them (and vitamin B12 is a product of bacterial fermentation). In the US, we have such a sterilized food supply (which can be life saving in some cases, like ensuring that foods don't have harmful microorganisms) that we don't have access to the vitamin B12 on plant foods. So, it might be more of a food system issue rather than a dietary pattern issue.

Angle #4) Why does someone need to draw a line at 100% plant-based eating? In the past several years I’ve really transitioned away from encouraging people to adopt a vegan/vegetarian diet. Instead, I talk about the idea of ‘finding your minimal effective dose of animal products’. This is the amount that allows you to be happy, healthy, and sane while also minimizing environmental damage and harm to animals. Finding this minimal dose could allow someone to avoid supplementing other nutrients, if that makes them uncomfortable.

Thoughts on Non-Dairy Milks

A couple of big picture thoughts to begin with:

  • While crop products like almonds, oats, rice, peas, etc. don't completely eliminate animal welfare concerns (because an indirect outcome of crop production can be harm to surrounding wildlife), these plant-based milks allow consumers to avoid the notable inhumane practices towards animals on industrialized dairy farms. Not all dairy farms treat animals inhumanely, but the vast majority in the U.S. have questionable practices. For more about humane forms of dairy, see Cornucopia and Certified Humane.  

  • Non-dairy milks can be purchased heavily sweetened or unsweetened (with options in-between). For most people in developed countries, consuming more added sugars isn't a smart idea for long-term health. Further, sugar production presents an environmental burden. So, when possible, aiming to get non-dairy milk lightly sweetened or unsweetened makes the most sense for personal and planetary health.  

  • Whenever someone is thinking about adding a new food/beverage into their rotation, it's worth asking the question "What's the alternative?" In other words, if you eat or drink X, what are you not eating or drinking? When it comes to milk, this is especially worthwhile to ask, because a straight swap from cow's milk to a non-dairy option will offer pros and cons, but rarely is it an equivocal nutritional swap. While drinking any form of milk (dairy or non-dairy) isn't essential for human health, some people do rely on milk as a source of important nutrients in their diet, so it's important to know the nutritional trade offs.   

  • There's an obvious benefit or detriment to any one of these milks when considering food intolerance/sensitivity. If someone is allergic to tree nuts, then almond milk is a bad idea. If someone doesn't tolerate quinoa milk, then quinoa milk is a bad idea. And so forth.  

Almond milk

Pros: Offers beneficial fats. Not a very strong taste. Good for low-fodmap eaters.

Cons: Doesn't offer much overall nutrition, as most store versions of almond milk contain mostly water (this changes if you make it at home). Almond production, especially on farms without any sustainability measures in place, can have negative outcomes on the environment (this goes for all tree nut based milks). 


Soy milk

Pros: Legumes in general offer a lot of nutritional bang for your buck. You get some beneficial fats, protein, fiber, vitamins, and minerals. Also, when grown under certain conditions, soy can be a more environmentally efficient form of milk than most others (including tree nut and cow's milk).   

Cons: If someone consumes high quantities of soy foods each day, along with soy milk, this might be a cause for concern (I would echo this with any single food that dominates ones diet). 


Oat milk

Pros: Generally a more environmentally efficient crop to grow. And oat consumption is linked to beneficial health outcomes. 

Cons: Conventional varieties of oats are treated with a notable pesticide (glyphosate). Residues can be of concern when consumed regularly over time. 


Rice milk

Pros: Good for low-fodmap eaters.

Cons: Arsenic was applied to crops in the 1970s to control pests, and it accumulated in the soil. Now it turns up often in rice. If someone is consuming whole rice, rice crackers, rice protein powder, and/or rice flour, then they should be concerned about getting too much arsenic in their body (for more, see here).  


Coconut milk

Pros: More environmentally efficient to produce than almond, walnut, macadamia, and cashew milk. If someone isn't getting any saturated fats from other sources, this will offer some.  

Cons: Some would argue that too many of the saturated fats in coconut milk might present negative outcomes with cardiovascular health. It's likely less of an issue when someone's diet is made up of mostly unprocessed foods, and overall fat intake is balanced (equal amounts of unsaturated and saturated fats being consumed). 


Cashew milk

Pros: All tree nuts contain a mix of beneficial fats. But nothing notable beyond what you'd find in almond, walnut, or macadamia. 

Cons: There have been reports of human labor concerns related to cashew production overseas. The chemicals applied to cashews can be very toxic, especially to the laborers handling them. 


Macadamia milk

Pros: Can offer a creamy consistency/taste for baking. Good for low-fodmap eaters.  

Cons: Like other tree nuts, there's a steep environmental cost in production.  


Hemp milk

Pros: Hemp is one of my favorite crops, as it offers a lot of nutrition with not a lot of negative environmental repercussions. Good for low-fodmap eaters.

Cons: Tough to get from the U.S. due to legal barriers around hemp farming. 


Quinoa milk

Pros: Nothing stands out. To get the most nutrition from quinoa, you're probably better off eating it whole. 

Cons: American demand for whole quinoa has already led to some economic repercussions in areas of the world that produce quinoa as a staple. Putting quinoa in milk form might skew these economic repercussions even more. 


Peanut milk

Pros: Similar to soy, this offers a nice mix of nutrients, including fats and proteins. An environmentally efficient crop to produce, especially when grown on a sustainable farm. Good for low-fodmap eaters.  

Cons: Peanuts can contain molds, mostly depending on how they're grown/stored. 


Pea milk

Pros: Americans consume a staggeringly low amount of legumes (7 pounds per person per year), so I'm in favor of any method to boost intake, including pea milk. Consumption of legumes is linked to all sorts of beneficial health outcomes. Also, legumes tend to be an environmentally efficient crop to produce.  

Cons: Nothing I can think of when consumed in reasonable amounts.  


Plant-protein milk

Pros: Most obviously, it's a nice product for someone looking to get more protein in their diet. 

Cons: A bit more processed, which could have questionable long term health outcomes. 


Hazelnut milk

Pros: In the world of tree nuts, this one is less commonly consumed, so it offers a way to expand variety in ones diet. 

Cons: Like most other tree nut milks, it doesn't offer much in the way of substantial nutrients (unless made at home). And it has the environmental cost that comes along with tree nuts. 


Banana milk

Pros: A way to potentially use bananas that are about to go bad and be wasted. 

Cons: Bananas are one of the most popular fruits in America, so I'm not sure incorporating them into milk does us any favors in terms of expanding our dietary diversity. Plus, in milk form, it doesn't offer much in the way of nutrition.  


Walnut milk

Pros: Walnuts are one of the notable plant sources of omega-3 fats. A fat that most people aren't getting enough of. 

Cons: The environmental cost that comes with tree nut milks. 


Flax milk

Pros: Seeds are generally nutrient dense and environmentally efficient to produce. 

Cons: If someone is also eating flax, adding flax milk as well might be a bit much for the body on a daily basis, since flax is a rich source of lignans. 

Interview About Vegan Diets

I was recently interviewed about vegan diets. I wanted to share my full response here.

*Can a vegan diet can truly lend itself to a fit, active, and healthy lifestyle? What are the most important to things to keep in mind / be aware of to make that happen? 

There are many ways in which someone can build a dietary pattern that will support health and performance. A vegan diet is one way. 

Keep in mind that healthful dietary patterns have more in common than most people realize. Most healthful dietary patterns a) get people thinking about daily food choices; b) emphasize the consumption of more minimally processed foods; and c) ensure a greater nutrient intake. Together, this often leads to a healthier body size, more energy, improved sleep, a better mood, and so forth. A vegan dietary pattern can accomplish these same basic tenants. 

I guess the real question then becomes: If various dietary patterns can lead to improved personal health and performance, why bother with a more plant-based diet? A plant-based diet stands apart in two big ways. 1) How it supports environmental sustainability and 2) How it minimizes the high demand for animal products, which can allow more humane animal welfare practices to take precedence. 

A final note here, many people I come across aren't ready, willing, or able to eat a vegan diet for various reasons. And because of this, they feel like the only alternative is dietary status quo -- which usually includes animal products at most every meal. This is binary thinking and prevents us from exploring the middle ground (a more plant-based diet, rather than 100% vegan diet). So I would challenge people reading this to think about how you use dietary labels, and observe how these labels influence your decision making process around food.   

*What are the biggest nutrients people tend to fall short on when switching over to vegan?

Vegan diets can differ quite radically. Some vegan eaters emphasize minimally processed legumes, vegetables, and seeds. Some vegan eaters emphasize sugary cereals, non-dairy ice cream, and macaroons. And of course, some vegan eaters fall somewhere in-between. 

Generally speaking, the nutrients that vegan eaters will want to keep an eye on include:

Vitamin B12 - It's important that highly plant-based eaters use a vitamin B12 supplement regularly. Any form will do, including cyanocobalamin, methylcobalamin, or hydroxocobalamin. Not getting enough can result in neurological problems, inadequate red blood cell/white blood cell production, fatigue, lightheadedness, elevated heart rate, pale skin, depression, and mouth inflammation.

Vitamin D - While this vitamin can be obtained when the skin is exposed to adequate sunlight, it's probably not happening unless you live near the equator and spend most of your time outside with minimal clothing on. Thus, supplementation could be helpful, especially in the winter months (check levels with your doctor first). In terms of supplements, D3 seems to be a bit more effective than D2. 

Zinc - Zinc recommendations for the general population are based on diets lower in phytic acid. Highly plant-based diets are higher in phytic acid. Thus, highly plant-based eaters have zinc requirements that are just about doubled. Not getting enough can result in lowered immunity, hair loss, loss of appetite, dry eyes, and a lowered white blood cell count. Foods rich in zinc include quinoa, lentils, chickpeas, tofu, black beans, cashews, sesame seeds, sunflower seeds, almonds, peanuts, pumpkin seeds, mushrooms, spinach, cocoa powder, and dried apricots (among others). If getting enough zinc from food is problematic (best to assess this with a doctor or dietitian), find a supplement, any form will do, but zinc picolinate might be optimal. 

Iron - Absorption of iron varies tremendously based on body status and dietary source. Similar to zinc, plant-based eaters have iron requirements that are about 1.8 times higher (due to lower overall iron absorption). Folks who are physically active will require even more. Consuming foods rich in vitamin C along with iron rich foods can increase iron absorption. So before increasing iron rich foods, simply try increasing vitamin C rich foods along with iron. If you're a man or woman who eats a highly plant-based diet and donates blood, or if you're a pre-menopausal woman eating a plant-based diet, then an iron supplement can be very helpful. Not getting enough iron can result in spoon shaped nails, lowered immunity, fatigue, rapid heart rate, palpitations, rapid breathing on exertion, increased lactic acid production, irritation to corners of lips and tongue, gastritis, pica, and abnormal temperature regulation. Foods rich in iron include spinach, swiss chard, lentils, tempeh, chickpeas, pinto beans, green peas, tahini, almonds, pistachios, sunflower seeds, dried figs, and molasses (among others). 

Protein - Deep breath. :) First, I would encourage people not to classify plant foods as “complete” or “incomplete” proteins. This is antiquated categorization and really only useful when someone is relying on one or two foods to meet protein needs for an extended period of time. Here are three general principles for getting enough protein: 1) Eat enough food to support a healthy body size. 2) Eat a variety of food. 3) Eat at least 1 cup of cooked legumes per day. If someone likes numbers, plant-based eaters who are physically active should aim for around 1.4 grams or protein per kilogram of bodyweight.  

Omega-3 fats - While it's possible to get enough of these from plant sources, it really depends on the persons individual make up. Including an algae supplement with DHA/EPA might be helpful to ensure the minimum intake is being met. 

Finally, I have a theory (translation: not rooted in much science) that taurine and choline might also be an issue for certain plant-based eaters. I’m not sure if it’s a genetic thing or not, but it’s worth keeping these two on your radar as a plant-based eater.

*What are some mistakes you think athletes tend to make when going vegan?

Mistake: Eating a vegan diet as a way to lose weight fast, 'detox', or dramatically improve performance

Why it's a mistake: It likely won't lead to any real long-term behavior changes, and the next new dietary fad will derail your plan

What to do about it: Yes, a balanced vegan diet can support a healthy weight and athletic performance. But weight and performance are fleeting. Try getting clarity around your deeper values. And consider your "bigger-than-self" goals, such as how your food choices influence environmental sustainability, animal welfare, and farmworker welfare  

Mistake: Eating a bunch of ultra processed plant foods (e.g., vegan cookies) in place of minimally processed animal foods (e.g., hard boiled eggs)

Why it's a mistake: It likely doesn't support health, and will lead to feeling crummy and abandoning a plant-based diet

What to do about it: Emphasize minimally processed plant foods, including legumes, whole grains, vegetables, fruits, nuts and seeds. And figure out your minimal effective dose of animal products.

Mistake: Getting too hung up on purity/perfection when it comes to dietary labels/identity/tribalism 

Why it's a mistake: Trying to live a perfect vegan lifestyle (or paleo, or intermittent fasting, and so forth) can be exhausting. And really, it sets people up for burnout and/or frustration (and/or feelings of isolation from family/friends).

What to do about it: Don't be afraid to abandon dietary labeling/identity/tribalism, and instead find a way of eating that's based around your values/lifestyle. While it might not fit nicely under a clear label/identity/tribe, it will likely better support your long term well being   

Mistake: Eating a plant-based diet that's really low in fats or 100% raw

Why it's a mistake: It can lead to a diet that doesn't provide enough overall food/nutrients

What to do about it: Don't be scared by minimally processed foods that are higher in fats (e.g., avocados, nuts, seeds, etc.). And don't be scared by cooked foods. 

thoughts on gmos

I was recently interviewed about GMO foods. I wanted to share my full response here.

*What exactly are GMO foods/what are examples of them?

When the DNA of a plant or animal is altered to introduce or modify genetic traits, you have a Genetically Modified (GM) food, also known as Genetically Engineered (GE) food. 

The most common GE food crops in the U.S. include soybeans and corn. This is NOT because America has an insatiable appetite for tofu and polenta. The vast majority of these GE soy and corn crops are grown to eventually become either livestock feed for CAFOs (concentrated animal feeding operations), biofuel for automobiles, or highly processed food additives (e.g., high fructose corn syrup, soybean oil, etc.).  

*If you think people should NOT eat GMO foods, please explain why in a few sentences.

Consider this: What do you think the majority of GE food crops in the U.S. are being engineered to do? You might suspect that they are being engineered to taste better, to be more nutritious, or to withstand drought. But this isn't the case. The vast majority are being engineered to withstand direct pesticide application (meaning that they can be directly sprayed with pesticides, killing pests, but not harming the crop itself). This can help farmers save time and money in the short term, but in the long term, liberal use of pesticides may lead to various ecological problems, including pest (both insect and weed) adaptation, dependency on chemical inputs, harm to pollinators/wildlife, and harm to microorganisms in the soil.  

The application of certain pesticides has risen exponentially since GE crops were introduced in the 1990s. United Nations Humans Rights experts (Ms. Hilal Elver and Mr. Baskut Tuncak) have concluded the following: “Excessive use of pesticides are very dangerous to human health, to the environment and it is misleading to claim they are vital to ensuring food security.”  

*Is there a certain "threshold" of GMO foods you'd need to eat in order to see negative side effects, etc.?

Widespread adoption of GE crops are recent phenomenon, so it's hard to say. Many countries are taking a cautious approach by declining the import of GE crops and/or banning the growth of GE crops domestically. The U.S. hasn't taken this cautious approach so far.   

Also, there is a concern with food allergies. If genes from an allergenic plant are introduced into another plant, it might provoke an allergic response in someone with an existing allergy. Further, new allergens might be created from new gene combinations.   

*What would your advice be to people when it comes to GMO foods in their diets? Please explain.

To be clear, I'm not against GMO foods, I'm against how most of them are being used today.

Remember, the reason we're growing so many GE crops in the U.S. is because of our collective demand for animal products (meat, dairy, eggs) from CAFOs, fuel for automobiles, and highly processed foods. If we can minimize those, we can minimize how many GE crops are being produced. This might in turn allow for a more sustainable and healthy agricultural system to take hold. 

With that said, I would also encourage anyone who is strongly opposed to GE to be open to learning more about advancements in the future, as GE might offer some real benefits to sustainable food production.