Today’s post is a bit different than what we typically talk about here on the blog. Earlier this week on Instagram, I reached out on Stories to see what you all would like to learn more about. I got an overwhelming amount of responses to help break down some myths regarding popular diets and nutrition trends. Often, I think many of us want to genuinely take care of our health, but there is a lot of messaging encouraging us to adopt a more restrictive pattern of eating. These can be quite seductive. All eating plans claim to improve your health, so it’s difficult to sort out which ones actually will, and which ones won’t.
The vegan or plant-based style of eating is one that is close to my heart. I was a vegan for awhile when I was struggling with disordered eating. At the same time, however, I really resonated with the ethical and compassionate component of veganism. This made things incredibly difficult to sort through.
This post is designed to be an informational guide to help you make the best decision for your own personal health. I always say that I write this blog because it is what I would have needed when I was in my eating disorder. I hope it is helpful for you too.
What is a vegan diet?
A vegan diet is one that is free from all animal products – meat, eggs, fish, poultry, and dairy. There are variations, but this is the general guideline. Again, this guide is absolutely not a guide encouraging or discouraging you to become a vegan. It is intended to be an informational guide to help you make the best, most informed decision.
What does the research say?
Research on nutrition is vast and exciting and I love it. Though my career goals in nutrition have slightly shifted, I’m always going to be such a nutrition research nerd. I love it. With all of the nutrition misinformation out there, I believe all people should be adequately informed with evidence-based information before making health decisions.
Research has shown that a plant-based style of eating has been associated with a lower risk of cardiovascular disease (CVD). This reduced risk comes from higher intakes of fruits and vegetables, combined with lower intakes of saturated fat, trans fat, sodium, and sugar. Note: I did not say animal products specifically. The association between plant-based eating and lower CVD risk could exist for numerous reasons. Vegans tend to eat more fruits and vegetables, which have high amounts of inflammation-lowering antioxidants. Whole grains high in fiber can also help to bind our blood cholesterol to excrete it, so that the liver has to use the amount we consume to make more, and thus cause lower blood cholesterol levels. Omega-3’s have also found to help lower inflammation to keep our heart healthy, but are primary found in fish .
But nutrition is not everything in CVD risk. Stress (both psychological and physiological) increases your cortisol and level of inflammation in the body, which increases your CVD risk. Focusing so much on food increases your stress and likely will be worse for you than just eating non-vegan food. If you’re freaking out of whether a food is vegan or non-vegan, you’ve probably made things worse. That’s why we also tell people at CVD risk to lower the amount of stress in their life and find relaxation techniques.
As you can see, plant-based diets absolutely have their place in reducing CVD risk. But you don’t have to go full-on vegan to see the benefits. Just eating fruits and vegetables and whole grains can reduce your risk. You don’t have to 100% restrict to see benefits.
Observational studies have shown that those who consume a plant-based diet tend to have lower risks of type 2 diabetes. As with CVD, most of the risk reduction appears to come from the lowering of saturated and trans fat, in addition to an increase in fiber. In type 2 diabetes, a person has sufficient insulin, but it simply does not work correctly. Insulin is released in response to carbohydrate ingestion to work as the key to allow carbs (glucose) into the cell. If insulin does not work, the glucose stays in the blood – what we call “high blood sugar”. Chronic high blood sugar can raise a person’s A1c lab value, which may indicate type 2 diabetes if high enough.
Having an increased intake of fiber helps to slow the absorption of glucose from the gut to the blood. This sloooooow absorption allows blood glucose to remain relatively stable. That’s why nutritionists and RD’s often recommend to have some type of protein or fat with a meal – because when blood glucose peaks and crashes, we tend to not feel too great. Fiber, fat, and protein help to prevent the peak and crash. Plant-based diets tend to be high in fiber, so this could be one explanation for a lower incidence of type 2 diabetes.
Another thought is that the lower saturated fat consumption common in vegan and plant-based diets helps to keep insulin working efficiently. The idea is that high amounts of saturated fat prevents insulin from working, thus not allowing glucose into the cell. Plant-based diets tend to be lower in saturated fats, but again, their found in all types of foods. You don’t have to be full-on vegan to lower your intake of saturated fat and see some benefits. (also just a reminder, saturated fat is not “bad” and you are not “bad” for eating it. it’s in food, it has it’s purpose, and cutting it out completely is more likely to cause harm than good.)
*note: Please skip this section if any information on weight is triggering for you. This section is absolutely not intended for information on weight control. Remember: Weight does not matter for anything in terms of health. I’m only including this because I think that knowing the research on nutrition and weight is important so that you can make the most informed decision on how to best take care of yourself.
Research has shown that a vegan or plant based diet is correlated with a lower weight. Remember though – correlation does not equal causation. When something is correlated, it means very simply that they are associated together. Causation means that one thing (food intake) causes the other (weight) – this is not what research is saying. Just because you eat more plants does not automatically mean that you will lose weight. All it is saying that people who eat more plants have been seen to have lower body weights. That’s it.
We know that each person has a set-point weight, so the explanations for why plants are correlated with a lower weight are numerous. One of those explanations is that those who experience weight stigma due to being in a larger body tend to engage in more maladaptive eating behaviors and eat fewer fruits and vegetables. Thus, it’s not the food intake causing the weight, but the stigma that accompanies a certain weight causing the food intake.
Research on intuitive eating also shows us that those who eat intuitively vs. those who eat with even the most flexible dietary restraint tend to weigh less, even though weight is never the point in intuitive eating. One reason for this, in addition to the food rebel point discussed earlier, might be because of the concept of giving yourself unconditional permission to eat. When on a diet, plants are often portrayed as gross, unappetizing, or a “health” food we have to force ourselves to eat. When eating intuitively, all foods are morally neutral. Ice cream and salad have different nutrient profiles, but they’re the same morally. When salad isn’t something you have to dread eating, you can add fun toppings and dressing and enjoy eating it. Thus, you’re more likely to eat more of it because you genuinely enjoy it.
Another point to consider is the satisfaction factor. If you’re not satisfied eating vegan food, you’re going to require more of it to fill that void. I recently spoke with a person who once craved a cookie, but because the cookies had butter in them, she ate multiple vegan chocolate-chip flavored granola bars instead to fill the void. She noticed gradual weight gain because she was requiring a lot more food to be satisfied, than if she just ate the cookie. Again, not that weight gain matter, but if you’re not satisfied in your food choices, no amount of vegan foods will cause a health change.
Eating more fruits and vegetables will not automatically cause you to lose weight if you’re not physically and psychologically satisfied.
It’s important to look at the research on weight closely because we have so much conflicting research out there. Weight management research enjoys special immunity from accepted standards of clinical practice and publishing ethics, so we have to look at it with a critical eye.
All of that being said, eating more plants may cause you to lose weight, it may cause you to gain weight, or you may stay the same. Remember, body weight is not a marker of health.
What does the media say?
This is where everything on the vegan diet gets super tricky and super frustrating. For the sake of this post, I recently re-watched Forks Over Knives and got incredibly frustrated with the lack of evidence-based information. They make it sound pretty darn real, though, which is why so many of us get sucked in. I could talk about a million different things in this section, but for today, we’re only going to focus on a few main points the media portrays and what nutrition research actually says.
Myth 1 – Cholesterol found in eggs and other animal products causes dietary cholesterol to build up in the bloodstream and clog your arteries. You’ll never get heart disease if you eat a plant-based diet.
Truth – Dietary cholesterol has no impact on blood cholesterol. Diets high in saturated and trans fats have been shown to contribute to blood cholesterol and have been associated with higher risks of cardiovascular disease. Saturated and trans fats are found in plenty of vegan and non-vegan foods alike. The fear of dietary cholesterol is one that is founded in the diet industry, not in current nutritional science.
Myth 2 – The meat and dairy industries are lying to you. They know that these foods are killing us, but keep producing them to keep making money for themselves.
Truth – I know of so many awesome RD’s who work in the meat, dairy, and agriculture field who absolutely know their stuff and absolutely are not lying to you. Yes, high consumption of animal products may not be great for our health, but avoidance isn’t either. Focusing so dang much on food is also pretty terrible for our health, but these movies encourage that. Also with the restriction of animal products – Those that do not consume adequate calcium and vitamin D are at a greater risk for fractures later in life. Supplementation with calcium has actually been shown in some studies to contribute to a greater risk of fractures, so the real stuff tends to be better than supplementation. Supplementation with vitamin B12 and iron is also necessary. These movies claim we can survive without protein and yes, we don’t need to eat protein at every meal, but I cannot even begin to tell you how many disordered eating clients I have seen whose hair is falling out from malnourishment and protein deficiency. Or how many patients in the hospital I have seen with malnutrition because of muscle wasting. These industries are not lying to you – they’re using evidence-based information to help you.
Also side note… one thing I’ve noticed about these “health” documentaries is that they call out leaders of major organizations for not commenting on their movie. They claim that it’s because these people are hiding something and holding the truth away from the public to make money. I don’t know these people personally, but I can imagine that they have too many important things going on to talk to a movie producer who is not producing an evidence-based film. No one is trying to hide anything. These people are working to improve the public’s health. Why spend your day talking to someone who is trying to do the opposite and isn’t going to show what you said in the film anyway? Be wary of those movies that call out major organizations for “hiding” something – they’re not hiding, they just have better things to do.
Myth 3 – The “obesity epidemic” is because we’re eating so much meat.
This probably goes without saying if you’re reading this blog. But,
1) We don’t have an obesity epidemic.
2) We have an epidemic of people fearing obesity.
3) Weight research shows a U-shaped curve with mortality, meaning that those in the “overweight” or “obese” BMI categories have a lower mortality than those in the “underweight” or “normal weight” categories (note: these classifications are not designed to shame or stigmatize, I’m only using them because they are common to the general public. there is no specific weight you are over or under.”
Our food intake does not affect our weight as much as we’d like to think it does. It’s easy, simple, and honestly very lazy to think that food intake directly impacts our weight. As mentioned previously, there are a ton of factors that influence our weight. Reducing weight down to only food intake and activity level is entirely too simplistic and not founded in strong research.
How does this fit into eating disorder recovery?
As mentioned earlier, I have nothing but respect for those who adopt a vegan diet for ethical reasons. However, in your decision to continue being a vegan, I would encourage you to be curious about the energy you are putting into your own recovery vs. the energy you are putting into others. We cannot take care of others effectively until we first take care of ourselves. This extends to many different areas of life, but I think it’s especially relevant in this case.
If greater food restriction is compromising, delaying, or extending your own recovery, you are not taking care of yourself. You need to let go of the food restriction in order to heal. It does not matter if you are avoiding meat and dairy for ethical reasons if it is killing you in the process. Eating disorders are life threatening, no matter what size you are, or how long you have restricted. You will not be an effective vegan advocate if you’re deep within an eating disorder. Once recovered, going back to veganism is absolutely something you can do.
If you find that a vegan diet has no affect on your recovery, then by all means continue. However, I do think it’s easy to think, “Yep I’m fine, I like eating this way” and not actually get to the heart of the issue. If you’re continuing to be a vegan because of “health”, “nutrition”, or fear of weight gain, then veganism is holding you back in recovery. You do not have to go full-on vegan to receive the health benefits from nutrition – this is a lie sold to you by the die industry. If you genuinely don’t like or crave those foods, I’d again be curious again about why only those foods and not others.
Once recovered, you’ll actually be doing it for ethical reasons. I would absolutely encourage you to be curious, however, because it can be a slippery slope with all of the nutrition misinformation out there. But once you learn, you’ll be much more empowered, informed, and in a truly good place to make the best decisions possible.
Again: This is all intended to be general information and not specific medical advice. This is a topic I hold so dearly, so if you’d like more specific, individualized nutrition counseling on eating disorder recovery and veganism, send me a message and we’ll set something up.
What now? What do you recommend?
Based on the research provided (and others that I have reviewed), I made the decision to not classify myself as a vegan because it caused too much food and life restriction. The health risks I was putting myself under due to the stress of finding vegan food, not feeling satisfied with my food choices, and missing out on social opportunities was worse for my health than eating a higher amount of sweets, meats, and “fun” foods.
Nutrition science supports eating a variety of food for optimal health. When I work with others, I recommend a style of eating that will make you feel your best, physically and psychologically. I still like to eat fruits and veggies (and other plant-based foods) on a regular basis because they will me with fiber and nutrients to keep my gut and mind happy. But on other days, I really just crave a burger and need that protein and fat to fill me up, so that I can focus on more important things in life. I have days where I eat lots of fruits and vegetables, and days where I eat none. Both are great for my health. Both physically and psychologically, eating a variety of all foods is the healthiest pattern of eating for me.
Ask yourself: Does this pattern of eating allow me to focus more on LIFE than FOOD? If so, it’s probably the best one for you.