Wednesday, 4 September 2013

B-12 and Iron: The Damning Duo

There's this amazing project called "Vegan MoFo" that's happening right now, and the whole world should know about it. I'm participating unofficially (I missed the submission deadline), but there are so many blogs participating and so worth a visit during September, if you want to experience vegan awesomeness.

To check out all my posts connected to this campaign, just check out the Vegan MoFo tag!

So if you're vegan (or even vegetarian), you've probably had at least a few people ask you, "Are you watching your B-12?" And if you're vegetarian of any variety, you've had a ton of people tell you, "You're going to have an iron deficiency if you're not careful!"

And if you're not vegetarian, you may have said something similar to a friend at some point. And it's OK to care about your friends. In fact, last time I checked, it was encouraged. But let's talk about the facts and fictions surrounding these two nuisances, shall we?


Vitamin B-12

Vegans, you really do need to be careful. I take supplements, even with how careful I try to be about my diet, because a B-12 deficiency is no joke. We're talking about irreparable damage if it takes a turn for the worst. We're talking about things as serious as loss of feeling in body parts, depression and even loss of brain function (think along the lines of dementia). It's really nothing to take lightly. (For a really interesting TED Talk related to vitamin B-12, check out Tim Harford on The God Complex.)

There are no plant sources of vitamin B-12. Period. The only way a vegan is going to get it through food is by eating little micro-organisms like yeast (nutritional yeast, Marmite) or eating fortified vegan foods. For ovo-lacto vegetarians, the answer is simpler: animal products (like eggs and milk) do contain vitamin B-12 and will possibly give you as much as you need in your diet. You're on better ground than vegans, by a long shot, but it's still important to keep tabs on it.

Thankfully, a lot of the companies that make foods that are mostly eaten by vegans are throwing us a bone and making sure they're fortifying their products with B-12. A great example of this is non-dairy milk (soy, almond, rice, etc.), which is now fortified with B-12 by default. In fact, it's hard to find a reputable brand of non-dairy milk that isn't fortifying their milk with B-12. It helps a lot. But the thing is, if you're going to use this as your primary source of B-12, you're going to need to load up on non-dairy milk. You need 500ml or 2 cups a day to get your recommended daily intake, and that's a lot of milk. That's also a lot of soy, if you're drinking soy milk, and that much soy can do other things to you that you may not like very much. (Fun fact: soy plays with your estrogen levels. A friend of a friend once had his voice raise and chest swell into breasts because he was drinking so much soy milk. He wasn't amused.)

Nutritional yeast is great, and has relatively little in the way of drawbacks. Marmite is ridiculously high in MSG, and should not be eaten every day, even if it does make the best gravy I've ever eaten.

What would I recommend? Just buy some supplements. Take a tablet every day, and enjoy as much or as little non-dairy milk and MSG as you like. It's the safest bet.

Iron

I've got some bad news for you, my veggie friends: animal iron is easier to absorb. It kind of makes sense, considering the animal has already absorbed it for us, after all. So that means that vegetarians have to be extra careful about getting enough iron. It's possible through diet, but takes some strategy and planning ahead. Calcium hurts iron absorption, meaning that you want to avoid putting those almonds on your spinach salad. Vitamin C can triple your iron absorption, so you do want to put orange slices on your spinach salad. The idea is that if you're trying to get iron in your meal, you're going to need to avoid things that make it harder to absorb it in that meal.

Here are some (otherwise awesome) things that you want to avoid when eating iron-rich foods:

Calcium, zinc, copper and magnesium
Egg (if you're ovo-lacto)
Caffeine (coffee, cocoa, tea)

So, in other words, if you're making a smoothie with kale and banana in it, leave out the cocoa and milk if you're trying to absorb your iron. Instead, use water and add some pineapple or other fruit with a high vitamin C content. It helps a lot.

Are vegetarians and vegans going to absorb enough plan-based iron through diet alone? Well, obviously I'm not a doctor, but my research has led me to few conclusive answers. Supplements can help--assuming that they're not paired with a glass of almond milk.

Omnivore versus vegan diets

There are tons of unhealthy vegans out there. But there are also tons of unhealthy omnivores out there. And please understand that judging isn't the point of this post, but I do want to look at this rationally. Imagine we've got two people: a vegan and an omnivore. They're both eating diets high in fat and relatively low in nutrition. Let's look at what that might look like for each of them, and assess the amount of energy that would be required in both cases to make sure that we're eating healthily while also getting our iron and B-12.

The omnivore
(I always use women in my examples, so we're going to use men today.) This guy is going to be kind of like my brother: you'd swear he was allergic to vegetables. His meal today is going to be a bacon cheeseburger with fries. True to the introduction, this meal is high in fat.

The benefit of eating this way is that he's getting a ton of B-12 and iron from the meat, and he's also getting some nutrients from the potatoes (but then, so will the vegan, so let's ignore that part). He's getting a ton of protein and probably going to feel fuller for a longer time.

The drawback of eating this way is that meat itself in the diet has actually been linked to an increased risk of cancer. That and...uh...where are your vegetables? He's got a thin slice of tomato and a half a leaf of lettuce on his burger. He's not getting most of his vitamins out of that. The calcium in the cheese isn't helping, either, as it's not encouraging the absorption of the iron in the beef. He's also not getting much fiber, which would keep him regular and help make sure his insides are working well, so he'd probably have more trouble going to the loo if he ate like this all the time. And finally, this meal is very high in cholesterol, which has been linked to any number of health issues. If he chooses pork often (which you usually need to, unless you're rich, and he isn't), his meat is going to be higher in cholesterol than if he lives on white chicken meat. And unfortunately, there's no simple and inexpensive tablet he can take to supplement his...uh...lack of cholesterol? (This would be a prescription drug to fight high cholesterol.)

So in sum: he's getting lots of protein, iron and B-12, but also a lot of cholesterol and hardly any fiber or vitamins.

The vegan
This guy is going to be kind of like I am on a really lazy day when I'm craving garbage. I can't feed him exactly what my hypothetical brother ate, but we'll get as close as we can. His meal today is going to be a veggie burger with fries. We're even going to assume that the veggie burger isn't even a vegetable patty: it'll be soy-based, so as not to give unfair advantage. So the vegan is also not eating a ton of vegetables.

The benefit of eating this way is that cholesterol pretty much doesn't exist in the vegan diet. There are small amounts in certain foods, but he'd have to eat a lot of those foods to get even a noticeable amount of cholesterol into his system. He's also getting lots of protein and fiber in the soy of the burger, as well as potassium, phosphorus and other minerals. If it's a commercial soy patty, it's probably also fortified with vitamin B-12 (most are). Also on the plus side, he doesn't have to worry so much about the calcium in the cheese interfering with his iron absorption (however much of it there is), because he can't eat cheese anyway.

The drawback of eating this way is that it's also high in trans fat because of the fries, and it's not high in iron and probably not as high in protein. He's missing out on the benefits of meat, which are that there is a high B-12 and iron content. He's also not getting a whole lot more vegetable than the omnivore (a tomato slice and bit of lettuce), but at least there's a little more in the soy patty than in the beef patty. He will also probably be hungry a little sooner, because meat does make one feel full longer. (Though some people have suggested that eating smaller meals more often is actually healthier, so I'm not sure if this is a drawback or benefit.)

So in sum: he's getting less iron and B-12, but more fiber and so much less cholesterol.

The conclusion
I would propose that the vegan is still ahead for two reasons.

First, the problems with the vegan's diet (that is, low iron and B-12) are pretty standard and should be corrected with supplements anyway, so no matter what they eat, they'll probably need that support. And if this is the primary concern, even for vegans who are eating very, very healthily, then it seems like a very small problem at the end of the day, especially if omnivores would ideally need to take other vitamin supplements to make sure they're staying healthy as well. On the other hand, you can't just take an over-the-counter mineral supplement that will cause the increase of some compound in your body that will undo high cholesterol caused by eating so many animal products. That's something that needs to be medically treated and takes a lot more work. The lack of fiber similarly would need a more significant lifestyle change.

Second, the problems with the omnivore diet are somewhat inherent in being an omnivore, because meat itself seems to have some health risks (study re-linked from above). Even if you're an incredibly health-conscious omnivore, you're going to be getting more cholesterol than a vegan, and you'll need to put in more effort to both eat meat and find enough tummy space for lots of veggies for fiber. It's doable, but by definition, it will be harder, and eating meat is still...well...eating meat.

So in sum: being vegan can be hard in terms of iron and B-12. But the good news is that there are simple ways to fix that (diet and supplements) that are part and parcel of being a vegan. Now, if that isn't good news, I don't know what is.

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