As you walk through the aisles of your local grocery store, you might notice a soaring number of "plant-based" alternatives to traditional meat and dairy products. Plant-based diets are increasingly popular among health-conscious individuals and healthcare professionals alike. Social media platforms and best-selling books are filled with stories of people who have experienced significant health improvements by adopting a plant-based diet. However, it's important to note that no diet is perfect, and poorly implemented plant-based diets or prolonged strict adherence can lead to nutritional deficits. Be aware of the potential risks and benefits associated with this eating lifestyle.

Plant-Based Diet Definitions

A plant-based diet is defined as the inclusion of “minimally processed fruits, vegetables, whole grains, legumes, nuts and seeds, herbs, and spices and excludes all animal products including red meat, poultry, fish, eggs, and dairy products.”

Other plant-based diet definitions exist with various inclusions and exclusion of foods. Some of the latter diets listed include fish, eggs, and limited consumption of organic, free-range, animal proteins. These include vegetarian, lacto-vegetarian, ovo-vegetarian, lacto-ovo-vegetarian, vegan, whole food vegan, raw vegan, pesco-vegetarian, flexitarian, portfolio diet, Mediterranean style diet, DASH diet, healthy US style diet, planetary health diet, and Nordic-style diet.

Dietary Restrictions Add to the Challenges

In addition to avoidance of animal products, other dietary restrictions and issues affect food choices on a plant-based diet. These include athletes, pregnant women, those with illness, young children, picky eaters, and those with food allergies. Removal or reduction of foods such as gluten, grains, phytates, soy, tree nuts, or following an anti-Candida, a FODMAP, or low oxalate diet, or other food restrictions further constrict dietary choices when implemented with a plant-based diet. This increases greater likelihood of missing nutrients, leading to loss of health and vibrancy.

Choices and Trend

There are also low-quality plant-based diet choices or imbalances with your trend. Habits and repetition of favorites also influence choices. What about an adolescent favoring crackers, veggie chips, cereal, energy drinks, and Twinkies as “plant-based” foods to the exclusion of other whole foods. These choices will not provide essential nutrients.

Another example is a plant-based diet focused heavily on fruit and vegetable smoothies to the exclusion of other foods. A smoothie provides great plant-based antioxidants and fiber if you consume the pulp, but how does it fit with the remaining foods in your diet?

High intake of fruit and veggie smoothies also raises questions about your total natural sugar intake, especially fructose rich foods. If your diet is predominately fructose rich foods, you must ask how this affects you. Fructose rich fruits, vegetables, and honey contribute to elevated blood sugar and cholesterol issues, obesity, intestinal inflammation, fatty liver, gout, chronic kidney disease, and other metabolic challenges.

Fructose is found in foods and beverages with added high fructose corn syrup. It also naturally occurs in fruit juice, apples, grapes, watermelon, asparagus, peas, zucchini, honey, agave syrup, invert sugar, maple-flavored syrup, molasses, palm or coconut sugar, and sorghum. These foods are not harmful in and of themselves, but I encourage you to look at the balance of things in the context of your entire diet.

Awareness of risks and benefits with your dietary choices and trends are important. The implementation of any plant-based diet requires mindfulness, planning skills, and attentiveness. Often good intentions of a plant-based diet fall short of one or more nutrients. These questions and many others need to be asked when evaluating your diet.

Nutrition Deficits on a Plant-Based Diet

Nutrient deficits more readily occur in a poorly implemented plant-based diet or even a prolonged strict vegan/vegetarian diet. Low intake of iron, zinc, calcium, vitamin B12, vitamin D, omega-3 EPA and DHA, and protein can readily occur. In addition, vitamin A, thiamin (vitamin B1), riboflavin (vitamin B2), niacin (vitamin B3), vitamin B6, iodine, choline, selenium, and conditionally essential amino acids like taurine, carnitine and creatine and other nutrients may be insufficient in a plant-based diet.

Pregnancy

A special mention is warranted about nutrient requirements for women who are pregnant or in family planning stages. If you choose to embark on this route, you must be extraordinarily diligent and proactive about your nutrient status, even more so than women who consume a well-balanced whole foods omnivore diet. Your dietary choices during pregnancy and breastfeeding affect your child’s health lifelong.

For example, a recent German study evaluated healthy pregnant women and their choline intake. Omnivore diets contained an average of 269 mg choline per day. Vegetarian and vegan diet choline consumption was 101-141 mg of choline per day. The RDA for choline and pregnancy is 450 mg/day. Both groups failed to reach basic RDA levels, but the plant-based diets were seriously deficient.

Choline is critical for brain and nerve health especially during pregnancy and neurodevelopment. The American Academy of Pediatrics and American Medical Association strongly advise on proper choline and other nutrient intake during pregnancy and breast feeding as insufficient choline and other nutrients from conception to day 1000 in a child affects their cognitive health for the rest of their life. Even with supplementation later in life, the detrimental neurological effects cannot be fully remedied.

Beef liver and egg yolks have some of the highest amounts of choline in foods. Lesser amounts are found in cod, chicken breast, wheat germ, cauliflower, broccoli, amaranth, spinach, quinoa and others. One cup of wheat germ provides 200 mg choline.

Consequences of an Inadequate Plant Based Diet

A well-thought-out plant-based diet can provide high quality foods and health benefits. A poorly implemented or excessively strict plant-based diet however will have nutritional deficits which ultimately increases the risk for loss of health.

Strict adherence to a prolonged vegan-type diet increases the risk for anemia, bone fractures, depression, and muscle wasting and weakness. It increases the risk for progressive vision loss. Numerous other health concerns can readily develop from insufficient nutrient intake affecting virtually every organ of your body.

Your body requires adequate macronutrients (proteins, fats, carbohydrates, and water) along with optimal micronutrients (vitamins, minerals, enzymes, antioxidants, and cofactors). If your diet does not provide them, then nutritional supplementation is required.

Support to Consider

Extremes of diets and poorly implemented diets of any type raise concerns. Choose a whole foods diet first and foremost. Organic, unprocessed plant-based foods with organic free range animal proteins in modest amounts provides a healthy balanced diet.

Supplement support to consider may include the Daily Super Pack, a convenience pack which contains a vast array of support with omega-3 fish oil. Other options may include the Daily Energy Multiple Vitamin, Daily Bone Xcel, Blood Booster, Daily Detoxify, Daily Protector, Vitamin D, Daily DHA (an omega-3 fish oil), and Strengthener Plus.

More Detailed Information

More detailed information may be found in a March 2023 review article published in the international journal Nutrients. The article is entitled Nutritional Assessment of the Symptomatic Patient on a Plant-Based Diet: Seven Key Questions.

Other articles of interest include:

B Vitamin Deficiency: Are You at Risk?

Choline Helps POTS, Chronic Fatigue Syndrome, and Autoimmune Disorders

What’s Your Iodine Status?