This week, we speak with a plant-based nutrition expert to debunk commonly shared misinformation about only eating plants and explore some of the most frequently asked questions people have when adopting a plant-based diet. Last week's overview of what you can eat on a plant-based diet may have brought up some questions about how to live healthfully – such as where you’ll get key nutrients from like B12 and protein – if and when you stop consuming animal products, or even take steps to consume less of them. Below, Dr. Judy Brangman, MD, answers some of the most common questions people have when transitioning to a plant-based diet.
Meet Dr. Judy Brangman: The Plant-Based MD
Dr. Judy Brangman is both a board certified physician in internal and lifestyle medicine and a certified plant-based nutrition knowledge expert who has adopted a fully plant-based lifestyle herself. On top of regularly seeing patients in Raleigh, North Carolina, she is a knowledge leader for her community in plant-based nutrition and her website is chalk full of excellent tips and tricks.
Q: I want to start a plant-based diet, but I am worried about becoming nutrient deficient, should I be worried about this?
A: I recommend that everyone gets their blood levels checked for hemoglobin blood counts, B12, vitamin D and iron no matter what type of diet they eat before supplementing.
Surprisingly enough, the only nutrient that you really need to worry about not getting from plant foods is B12. Not many plant sources have B12 in enough volume to get it from a daily meal plan. However, just because one consumes meat and dairy products, does not mean they shouldn’t be weary of B12. It is difficult to get for everyone! The only plant source that I know of that contains high levels of B12 is nutritional yeast and sea moss. Obviously, eating large quantities of nutritional yeast and sea moss is a bit difficult so I advise anybody who eats vegetarian, vegan or plant-based to take a daily B12 supplement.
“...Just because one consumes meat and dairy products, does not mean they shouldn’t be weary of B12. It is difficult to get for everyone!”
Omega 3 fatty acids are another important nutrient for everyone to get. Having the right ratio of Omega 3s, an anti-inflammatory, with Omega 6’s which are high in meat and dairy products is very important. Too many Omega 6’s lead to inflammation. Omega 3’s occur in plant snacks like flax seeds, walnuts and pumpkin seeds. I garnish almost every meal with these so that I don’t need the supplement.
Iron is another big one. This goes for everyone, not just people who are plant-based! Especially for women of menstruating age. These women often have lower iron levels because of blood loss, regardless of whether they eat meat or not. So, get those iron levels checked!
Q: Which supplements do you recommend I buy?
A: I take the following supplements, and I get them on Amazon:
Q: What about calcium? Does drinking milk make my bones strong? If I don’t drink milk will I have a higher risk of fractures or weak bones?
A: Absolutely not! There are more than plenty of plant-based calcium sources, dark leafy greens being the main source. People often think that dairy is the best source of calcium, but actually it’s not. I repeatedly find studies that show the opposite problem of people who frequently consume milk have higher frequencies of weak or broken bones and bone-related diseases like osteopenia.
Q: How much more do I need to pay attention to how I eat on a plant-based diet vs. a diet that contains meat and dairy products?
A: In any diet you should be paying attention to what you are eating. For example, in the Standard American Diet you have to be careful about getting too much cholesterol/saturated fat, and not enough fiber. On a vegan diet, you have to watch how much vegan junk food you are eating. I have to remind patients all the time that just because it is vegan, doesn’t mean it’s healthy. On a plant-based diet, you have to make sure you are getting enough nutrients through eating unlimited quantities of fruits vegetables, nuts, seeds, mushrooms, whole grains, herbs and spices.
“In any diet you should be paying attention to what you are eating…”
Q: What notable health benefits you have seen in your clients from a plant-based diet?
A: Aside from most of my patients being able to maintain weight better and control their blood sugar by simply increasing the amount of vegetables they eat, I have seen some pretty remarkable things when it comes to reversing type 2 diabetes. Recently, a healthy fifty-year old patient came in and was diagnosed with type 2 diabetes. I started him on insulin and diabetes medications and recommended he adopt a plant-based diet. Within four months, he was completely off of his medications and has been off them for about two years. This was just from eating plant-based!
Q: I have heard rumors that my libido and/or sex drive will decrease on a plant-based diet because I am not eating meat. Is this true?
A: This is such a great question. So actually, one of the first signs of heart disease in males is erectile dysfunction – which is when males cannot get aroused. This happens because arteries in their genital area get clogged from a diet high in saturated fat and cholesterol, the same way fatty build up occurs in the heart. So, eating a plant-based diet will actually have the opposite effect on sex drive in most cases.
Q: Where do I get my protein from?
A: Plants! Most people get way more protein than they need. The average person needs about 0.8 grams of protein per kilogram of bodyweight which is on average, about 56 grams per day. Too much protein can be difficult for your kidneys and your metabolism to process as well as your digestive system.
If you are eating a balanced diet, chances are you are still getting too much protein! As an experiment, try tracking your daily food without changing anything using the nutrition tracker app ‘Cronometer’. You will be shocked with how much protein you are getting without even thinking about it.
“...For plant based protein alternatives, every single plant mentioned in Izzy’s first post contains plenty of plant protein (vegetables, legumes, fruits,whole grains, nuts, seeds, mushrooms, herbs and spices)...”
For plant based protein alternatives, every single plant contains plenty of plant protein (vegetables, legumes, fruits, whole grains, nuts, seeds, mushrooms, herbs and spices). However, sources like tofu, tempeh, nuts/seeds, grains like quinoa and legumes are especially high in protein.
Q: I often hear that it’s better to eat rice with beans instead of separate, otherwise I won’t get the ‘complete’ protein. Is that true?
A: People often think that plant proteins are not complete proteins and this is completely false. Plant proteins are not only complete, but you can get all nine of your essential amino acids from eating a variety of plants. You also don’t need to get complete proteins at every meal. If you are eating a variety of foods throughout the day, you will get all the protein and nutrients that your body needs.
Q: Will eating a plant-based diet regulate the digestive system? How many times should one go to the bathroom a day? What is normal and healthy?
A: Everybody should have at least one healthy bowel movement a day, and no more than three. Follow up with your general practitioner about what is considered normal stool consistency to be sure you are having healthy bowel movements. Due to the high amount of fiber you consume by eating plant-based, you will never struggle with constipation or regulation of bowel movements again. Often times, patients come in with stomach problems and all I have to do is prescribe them a daily dose of plants to ease their digestive issues. It’s absolutely amazing to watch.
Q: Are all sugars bad? Or just refined? Are there health benefits to natural sugars like honey or maple syrup and fruits? I have been told too much fruit is bad because it is high in sugar.
A: Sugar is a form of carbohydrate. There are three different types: fiber, starch and sugar.
Starches are things like potatoes and grains, fiber is in all plant foods and absolutely necessary for your diet and sugars are in a variety of plant foods, mostly in fruits.
I generally recommend people limit the added processed sugars which come in the form of things like table sugar, high fructose corn syrup and even agave or maple syrup. These three different types of carbohydrates metabolize differently in your body. Fruit will metabolize differently than a spoonful of table sugar, even if you are matching gram for gram the amount that you are consuming. They are just not comparable which is why I do not recommend people track their macronutrients. You need about 30 grams of fiber a day which is extremely difficult to get without fruits and vegetables, aka carbs.
In general, I recommend people limit added sugars and instead of paying attention to the carbohydrates in foods, they can look up the glycemic index here. The higher the index, the quicker the food will raise your blood sugar. Fruits, vegetables and starches are low in this index compared to processed sugars you will find in baked goods, candy and chocolate sweets. However, if you are going to have a baked good, using something naturally occurring like maple syrup or dates to sweeten it is a much better alternative than using processed sugar.
Q: Do you have anything else you want to share that I can include for our readers?
A: Don’t think too hard about it. Stop overcomplicating food! Gradually increase fruit and vegetable intake by making at least half of your plate fruits and vegetables, and do it for one month before you decide to go fully plant-based or not.
Q: What are some of your favorite plant-based resources?
A: Favorite movies: Game Changers (Netflix) and Eating You Alive
Favorite books: How Not to Die by Michael Greger and Becoming Vegan by Brenda Davis
Recipe books: Forks Over Knives
About the Author:
Izzy Fischer, born and raised in Boulder, Colorado, as a musician, triathlete and outdoor junkie, found a plant-based lifestyle through a combination of her personal battles with inflammation and food allergies. Currently, she lives in Boston and works as a data analyst at the Jean Mayer Human Nutrition Research Center on Aging at Tufts University while pursuing her Masters in Science in Nutrition at the Friedman School of Nutrition Science and Policy.