From telegraph.co.uk
Cutting out meat and dairy can leave us vulnerable to harmful nutrition gaps, but there are ways to fill them
Hardly a week goes by without news of another benefit of plant-based eating, from improving gut health to reducing your risk of cancer. But the recent inquest into the death of Georgina Owens, a 21-year-old student – who took her own life while suffering delusions linked to vitamin B12 deficiency from a vegan diet – has highlighted a less-discussed reality.
Experts warn that giving up meat, fish and dairy without replacing their nutrients may leave us vulnerable to nutrition gaps that can harm everything from our energy levels and brain function to bone and thyroid health.
A review in Journal of the American Nutrition Association found vitamin B12, iron, calcium, vitamin D and omega-3 fatty acids are among the most common deficiencies in vegan diets. And recent research shows that 38 per cent of adults in the UK and Germany are planning to cut down on meat and dairy.
“A well-planned vegan diet with the right foods and supplements can be healthy,” says Dr Carrie Ruxton, a dietitian and spokesman for the Health and Food Supplements Information Service. “The trouble is, many people who adopt plant-based diets, whether vegetarian or vegan, aren’t doing this – they’re eating processed foods and carbohydrates.”
Here are the most common nutrition pitfalls of plant-based diets – and the ways to avoid them.
1. It can leave your brain running on empty
Two years after going vegan, Kim Jakobsen, 57, a former dental services manager, developed chronic fatigue, daily headaches, dizziness and balance issues. Blood tests revealed a vitamin B12 deficiency. Despite trying supplements, she now relies on regular B12 injections to control her symptoms. “I never imagined something as simple as changing my diet could have such an impact,” she says.
“Vitamin B12 is the big one because you don’t get it from plants,” says Dr Ruxton. “It’s found in foods such as meat, dairy or nutritional yeast.”
B12 is also essential for healthy nerves and brain function. Low levels can cause fatigue, numbness, memory problems and cognitive decline. “By the time symptoms appear, you’ve often quite a way down the road,” says Ruxton.
While a palm-sized portion of meat easily provides a day’s vitamin B12, vegans need fortified foods, such as cereals and plant milks, or a supplement to meet their quota.
Cutting out fish can also leave you short of DHA, an omega-3 fatty acid vital for memory and cognition. Symptoms can include poor focus and depression.
How to fix it
Anyone following a vegan diet should consider a vitamin B12 supplement from the outset, advises Dr Ruxton. “Other nutrients worth paying attention to include omega-3, iodine, zinc, iron and vitamin D. If you don’t eat fish, a daily microalgae-based supplement, providing 250-500mg of EPA [another essential omega-3 fatty acid] and DHA, can help cover omega-3 needs.”
Fortified foods are an easy way to fill nutritional gaps. “Two 200ml servings of fortified plant milk can cover your vitamin B12 needs – just check the label because brands vary,” says Hazel Clarke, a dietitian specialising in plant-based diets.
To boost your omega-3, eat one to two tablespoons of chia seeds daily, snack on walnuts, use rapeseed or linseed oil and include soya foods, such as tofu, regularly.
2. Lack of iron can lead to anaemia
Feeling tired and lacklustre? A plant-based diet may increase your risk of iron deficiency which can lead to anaemia.
“Research consistently shows vegetarians and vegans have lower iron stores than omnivores,” says public health dietitian Dr Emma Derbyshire. “It’s particularly common in women of reproductive age.”
Although plant foods such as wholegrains, nuts and seeds contain plenty of iron, it’s the non-haem form that’s less easily absorbed than haem iron in meat and fish. “You need to eat more of foods such wholegrains and spinach and kale to absorb the same amount of iron,” says Dr Derbyshire.
Symptoms include fatigue, poor concentration and hair loss. If you develop anaemia, you may experience breathlessness, dizziness and heart palpitations.
How to fix it
Eat regular servings of wholegrains, beans, chickpeas, tofu and iron-fortified cereals, says Dr Derbyshire: “Pair them with vitamin C-rich foods, such as peppers and citrus fruits to enhance iron absorption. Avoid drinking tea or coffee for an hour after meals as tannins interfere with iron uptake.”
Iron supplements are usually only needed if blood tests show low iron stores or anaemia and should be taken under medical guidance.
3. You might end up with more colds and infections
First, the good news: a plant-based diet may strengthen your immune system. But there’s a catch. The benefits depend on the quality of the foods you’re eating.
A colourful diet rich in fruit, veg and wholegrains nourishes your gut microbiome, helping support immunity. A diet built around ultra-processed vegan foods is a different story.
“If your diet consists of vegan pizza, chips and plant-based eggs, you’re not going to get much vitamin C and may be low in nutrients needed for immune function including iron, zinc and omega-3 fatty acids,” says Dr Ruxton.
How to fix it
Avoid relying on ultra-processed alternatives, such as fake meats and vegan cheese, advises Dr Ruxton. Base your meals around wholefoods and healthy protein, such as beans, pulses and tofu. A daily handful of nuts and seeds will help top up zinc and selenium.
4. You increase your risk of broken bones
Giving up meat and dairy without careful planning could jeopardise your bone health.
“Evidence shows people following a vegan diet can have a lower bone density and higher incidence of fracture,” says Professor Susan Lanham-New, nutrition scientist and advisor to the Royal Osteoporosis Society. “This is particularly the case in older age when bone loss starts to accelerate.”
The EPIC-Oxford study which tracked around 55,000 meat-eaters, vegetarians and vegans, found those eating no meat, fish or dairy had a 43 per cent higher risk of fractures and more than double the risk of hip fractures than meat eaters. Vegetarians had a 25 per cent greater risk of hip fracture.
Experts believe this is because of lower intakes of calcium, vitamin D and protein. While calcium accounts for around 40 per cent of bone mineral mass, we also need vitamin D to help us absorb it, and protein to build and repair bone.
“Adults need 700mg calcium a day,” says Prof Lanham-New. “Studies show if your intake falls below 400mg, you won’t put down sufficient bone and, as you age, you’ll lose more of it.” In the EPIC study, fracture risk was lower among vegans who had higher calcium and protein intakes.
How to fix it
A well-planned, plant-based diet can provide everything your bones need, says Prof Lanham-New. The trick is knowing where to find those nutrients. “Dairy products provide around half the calcium in the average British diet so replacing them takes a little planning,” she says.
First, choose calcium-fortified plant milks and yogurts. A 200ml serving contains 240mg calcium, equivalent to cow’s milk. Build meals around protein and calcium-rich foods such as tofu (180mg per 100g), baked beans (120mg), almonds (60g), hummus (60mg) and wholemeal bread (60mg per two slices).
“If you struggle to reach 700mg through your diet, consider a calcium supplement,” says Prof Lanham-New. “Everyone should take a vitamin D supplement during winter months.”
5. It could make you frail before your time
It’s not just your bones that can suffer. Without enough good-quality protein, a plant-based diet can speed up age-related muscle loss.
From our 30s onwards, we gradually lose muscle and this accelerates after 60. Without enough protein, it becomes harder to repair and rebuild muscle, increasing risk of frailty and falls.
Plant proteins, such as those in tofu, legumes, nuts and seeds, are less digestible than animal proteins and don’t stimulate muscle growth quite as effectively. They lack the complete range of amino acids (building blocks of protein) found in meat and dairy.
“Many people assume they’re getting enough protein but the amount – and sometimes quality – may not be enough to maintain muscle as we age,” says Dr Ruxton. “Soya performs best among plant proteins but you do need to work harder to maintain muscle on a plant-based diet.”
How to fix it
It’s perfectly possible to get enough protein from plants, says Dr Ruxton. Just eat a variety of protein-rich foods to ensure you get all the amino acids your body needs.
“Build meals around minimally processed protein, such as tofu, tempeh, beans, chickpeas, soya yogurt, nuts and seeds,” says Dr Ruxton. Don’t save your protein for dinner. “You need it at breakfast, lunch and dinner so your body can use it throughout the day,” she says.
And don’t forget to exercise. “You can have the best diet in the world but if you’re not strength training, muscle still deteriorates with age,” says Clarke.
6. It could slow your metabolism
Brain fog, fatigue, weight gain, low mood… thyroid problems can play havoc with almost every aspect of our health. Experts say a poorly planned, plant-based diet may leave people short of nutrients needed to keep this vital gland working properly.
“The thyroid is incredibly nutrient-dependent,” says nutritionist VJ Hamilton, who specialises in autoimmune conditions. “Iodine gets most of the attention but it also needs iron, selenium, zinc, vitamin B12 and adequate protein. If any of these nutrients are lacking, thyroid function can become less efficient. I see it in some patients who’ve cut back on meat without replacing the nutrients.”
Thyroid hormones regulate metabolism, energy production, cognitive function and even cellular repair. Iodine is a key nutrient because it’s the essential building block for these hormones. Dairy products and seafood are among the richest sources, so removing both without suitable alternatives can cause problems.
The first signs are easy to dismiss. “Patients are often exhausted, struggling with brain fog, constipation or thinning hair,” says Hamilton. “Many tell me they feel like they’ve suddenly aged years.”
How to fix it
Prioritise protein at each meal, choose iodine-fortified plant milks, consider a B12 supplement and include selenium-rich foods, such as one or two Brazil nuts a day, advises Hamilton. Some table salts have iodine, although they are not widely available in the UK.
“Some seaweeds provide iodine but avoid eating large amounts regularly as certain varieties contain extremely high levels,” she adds. “An iodine supplement can be useful for some people but it shouldn’t be taken blindly. With iodine, balance is really important.”
Six key nutrients you can’t get from plants and why they’re important
Vitamin B12
Vitamin B12 is only found in foods such as meat, poultry and eggs. Because of its role in the metabolism of the nervous system, vitamin B12 is vital for memory, focus and also mood. Emerging research is also connecting vitamin B12 deficiencies with cancer risk.
Calcium
We typically get calcium from dairy products, and while it is present in some plant foods, the body does not absorb it as well. If the body doesn’t get enough calcium from our diet, it will take calcium from bones, which can weaken them over time, making them brittle.
DHA
The typical vegan diet has less of a crucial omega-3 fatty acid called DHA than an omnivorous diet. Symptoms of DHA deficiency include fatigue, poor memory, dry skin, heart problems, mood swings or depression, and poor circulation.
Iron
Haem iron, which is found predominantly in meat, poultry and fish, is far more easily absorbed within the body compared with non-haem iron, found in vegetables, cereals and lentils. Insufficient iron not only raises your risk of anaemia but also mental health conditions such as depression.
Zinc
As with calcium, it is harder for the body to extract the zinc it needs from zinc-rich plant foods such as nuts, seeds, and whole grains, compared with meat, dairy and eggs. Zinc consumption may be associated with mental health problems, skin conditions, diarrhoea, and alopecia.
Selenium
Selenium intakes in vegans and vegetarians have been shown to be lower compared to meat or fish eaters. This is because the amount of selenium in a plant depends on the amount of selenium in the soil where it was grown, while red meat, chicken, turkey and seafood are all rich in selenium. Selenium is known as an essential mineral for the immune system and thyroid health.
https://www.telegraph.co.uk/health-fitness/diet/nutrition/hidden-health-risks-of-vegan-diets/
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