Supplementation for Vegans and Vegetarians

Navigating the Supplement Spectrum: A Guide to Supplementation for Vegans and Vegetarians

Introduction

Vegan and vegetarian diets are common for various reasons, including health, ethical, and environmental concerns. Plant-based diets are increasing in popularity, so it is important to be aware of health benefits and concerns within these diets. Plant-based diets can be helpful in aiding in weight control, cardiac health, diabetes, hypertension, and cancer. Plant-based diets has also been seen to help increase dietary fiber, which is proactive against insulin resistance, hypertension, cancer, gastrointestinal disease, obesity, heart failure, and digestion-related disorders (1). However, while a plant based diet is rich in many micronutrients, protein intake, nutrient consumption and bioavailability may be a concern.

Protein

While following a plant based diet, it is important to be consuming all essential amino acids. These are typically found in animal protein, but can be found in brown rice, quinoa, beans, and legumes. For those with high protein goals such as athletes, plant-based protein supplements, such as plant-based protein powders, are widely available (1).  As an example, a 6 oz grilled chicken breast gives about 54 grams of protein, meeting about 108% of daily needs for an average adult. This lean protein source is rich in essential amino acids vital for the body. For a vegan option, eating a cup of cooked quinoa provides around 8 grams of protein, covering about 16% of daily needs for an average adult (2, 3).

Vitamin B12

Micronutrient absorption and consumption of Vitamin B12 is lower in a plant-based diet. Vitamin B12 is essential in red blood cell formation, cell metabolism, nerve function, and DNA production. B12 is naturally found in animal products, but is also fortified in some foods (4).

However, non-animal sources of B12 are not as readily absorbed in the body compared to animal sources of the vitamin. Consuming a 3 oz serving of cooked salmon provides a notable amount of vitamin B12, covering more than 80% of the daily recommended intake. For a vegan option, consuming a cup of fortified almond milk can contribute around 50% of the daily recommended intake of vitamin B12. Fortified foods, such as plant-based milk (like almond, soy, or oat milk) and breakfast cereals, can be good sources of vitamin B12 for individuals following a vegan diet (5).

It is uncommon to be B12 deficient, however, those following plant based diets may be more susceptible. Vitamin B12 deficiency can lead to anemia, fatigue, weakness, and intestinal problems. Because of this, vegans and vegetarians may benefit from oral supplements. Supplementation is generally safe, as any excess amount is typically excreted in the urine. However, high doses may cause headache, nausea, vomiting, diarrhea, and weakness (2).

For those choosing a plant-based diet, a daily vitamin B12 supplement taken with food such as animal meat, fish, eggs, and dairy for optimal absorption may be recommended. While taking B12 supplementation, it is important to seek expert advice from a registered dietitian and have blood vitamin B12 levels monitored by a doctor (6).

Iron

Iron plays an important role in the body, primarily as an essential component of hemoglobin for oxygen transport throughout the body. Iron is also important for growth, cellular function, and hormone synthesis. The RDA for iron is 8 mg for adult men, and 18 mg for adult women.

Iron has two forms, heme and nonheme. Heme iron is found in lean meat and seafood, whereas non-heme iron is found in nuts, beans, vegetables, and fortified grains. Heme iron has higher bioavailability (more readily absorbed) than non-heme iron (3). Consequently, plant-based diets may put individuals at risk of iron deficiency, related to both inadequate iron intake and low bioavailability of iron from plant foods (7).

Vegans and vegetarians do not ingest meats, pouty, or fish, so they may not be consuming adequate amounts of iron. Plant-based individuals may consider iron supplementation to avoid deficiency, a noticeable reduction of iron supply to the tissues, which may lead to anemia (3). However, maintaining optimal iron levels is achievable through a well-balanced plant-based diet rich in legumes, dark leafy vegetables, nuts, and seeds. For instance, consuming 1 cup of cooked lentils can provide approximately 36% of the daily iron needs for men and 16% for women. Pairing non-heme iron sources like lentils with vitamin C-rich foods, such as tomatoes or bell peppers, enhances iron absorption. On the other hand, incorporating lean beef into the diet can be an effective way for both men and women to meet their iron needs, with a 3 oz serving providing about 15% of the daily requirement. Beef liver, in particular, stands out as an excellent source of heme iron, known for its higher absorption rate compared to non-heme iron found in plant-based foods (8).

Nevertheless, iron levels can be easily maintained by consuming adequate amounts of legumes, dark leafy vegetables, nuts, and seeds. Plant-based individuals who eat a well-balanced diet do not have an increased risk of iron compared to non-vegetarians (6). It’s helpful to remember to consume iron-rich foods with sources and vitamin C to enhance absorption, which can aid in avoiding the need for shots or supplements.

If consuming adequate amounts of iron-containing foods is a concern, it is important to seek expert advice from a registered dietitian and have iron levels monitored through blood work.

Calcium and Vitamin D

Calcium and Vitamin D are both essential for bone health, so consuming adequate amounts is important for bone maintenance.

Calcium is a mineral that helps build bones, maintain bone health, enables blood clotting, allows muscles to contract, and enables heart functions. Dairy products are high in calcium, but some green vegetables and fortified foods also have calcium in smaller amounts. For example, consuming 1 cup serving of plain yogurt provides approximately 30% of the daily recommended calcium intake. For those following a vegan diet, fortified plant-based milk like almond or soy milk can be excellent alternatives, offering around 30% of the daily calcium needs (11).

Calcium can be lost daily through our body, so consuming adequate amounts is vital for health to avoid an imbalance, causing brittle bones and other health issues. The RDA of calcium for women aged 50 and younger and men aged 70 and younger is 1000 mg daily. This increases to 1200 mg daily for people of older age (9). Because vegans are not consuming dairy products, ensuring calcium is obtained in adequate amounts through other foods or supplements is important. It is important to discuss with a doctor or registered dietitian, as excess calcium intake can cause constipation, kidney stones, or excess heart calcification (11).

Vitamin D is a fat soluble vitamin that helps your body absorb calcium. Therefore, adequate Vitamin D intake is imperative for strong bones. The RDA for women and men under 50 is 400-800 IU daily, and increases to 800-1000 IU daily for those of older age. Vitamin D can be obtained by sunlight and food – fatty fish, fortified dairy products, fortified orange juice, and fortified cereal. Vitamin D is difficult to obtain solely from sunlight, especially living in certain parts of the world for several months of the year. Fatty fish like salmon is a natural source, with a 3 oz serving providing about 570 IU, covering over 70% of the daily recommended intake. For those following a vegan diet, fortified plant-based milk, orange juice, and breakfast cereals can contribute to vitamin D intake. A cup of fortified soy milk, for example, can provide around 30% of the daily recommended intake (12).

Supplementation may be useful to avoid deficiency, and may be particularly useful for vegans and vegetarians who are not eating fatty fish. Just remember, it is important to discuss with a registered dietitian or doctor before implementing supplementation.

Conclusion

Plant-based diets may provide health benefits, however, restricted-diets can also pose some health risks. Because of this, it is important to consider dietary components that may be restricted in these diets, such as protein, vitamin B12, calcium, and vitamin D. Overall, most plant-based individuals have a healthy lifestyle, but research indicates that these diets may cause implications on bone health related to reduced intake of vitamin B12, calcium, and vitamin D (9). To avoid deficiency risks, supplementation may be useful for these individuals.

 
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