Tag Archives: health

Vital for Vegetarians

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In 1989, a poll found that 3% of the UK’s population was vegetarian. This figure has recently been estimated to be 5.7%. There are, of course, many ethical and environmental reasons to choose a plant-based diet, however, there is debate surrounding the health implications. Is eating meat good for us or are we better off without it? This article considers recent research concerning vegetarian’s health, leaving aside any ethical debate. Is the vegetarian diet the best option for our health and how can common deficiencies be avoided?

There are many statistics that are commonly quoted in favour of vegetarianism. For example, vegetarians have:
Lower cholesterol (LDL) and blood pressure
Lower risk of cancer
Lower risk of type-2 diabetes
Average life expectancy of 9.5 years longer for men and 6.1 years for women
Lower average BMI
Lower obesity rates (16.7% compared to 33.3% for meat eaters)
Lower rate of food allergy development

The BBC’s recent programme ‘How To Stay Young’, follows this line of research. The study of Loma Linda is discussed, highlighting that people here ‘live up to 10 years longer than the average Californian’. Within this town, the main religion encourages vegetarianism and a high proportion of the population is vegan. A questionnaire carried out here also found the vegan diet to be associated with the best overall health, and mortality being reduced by one quarter.

However, vegetarians also generally have a higher level of education, exercise more regularly and are less likely to smoke or drink alcohol excessively. This data has repeatedly been found by studies, for example the American Journal of Clinical Nutrition 2009, and the Journal of American Diet Association. This means that it is difficult to establish a causal relationship between the correlations found between improved health and vegetarianism.

The difficulty of drawing conclusions from this data is demonstrated by the 1996 BMJ study of 11000 health conscious individuals. These people were recruited from health food shops, vegetarian societies and magazines. The group had a mortality rate around half of that of the general population. Within the group, 43% of the subjects were vegetarian, and they were not found to have any significant differences in mortality. It appears that intervention studies would provide clearer health advice than observational studies when assessing the impacts of a vegetarian diet. However, this sort of data is not easy to come by.

Following a vegan or vegetarian diet also increases the risk of several deficiencies. There are ways to avoid these, but this often requires a fair amount of planning that would not need to cross the minds of meat eaters.

Vitamin B12
Deficiency of vitamin B12 is fairly rare amongst meat eaters (only 5%), compared to 68% of vegetarians and 83% of vegans. This is because vitamin B12 is found only in animal-based products, such as meat, fish, eggs and dairy. This means that in a vegan diet this vitamin must be obtained through dietary supplements.
Deficiency is not to be taken lightly, as it can cause anaemia and nervous system damage. Common symptoms include low energy levels, tingling, numbness, blurred vision, confusion and poor memory.

Creatine
This is an amino acid that is found exclusively in meat and fish. It is not an essential amino acid as it can be manufactured by the liver, however, around half of the body’s creatine is obtained from the diet. The synthesis of creatine also requires several dietary substances, including vitamin B6 and B12., which are generally lacking in a vegetarian diet. Creatine is necessary for muscle energy and nervous system function. A deficiency of creatine is not common, however, lower levels are generally found in vegetarians with could still be detrimental. Increasing levels of creatine have, for example, been found to be associated with memory improvement (2010 British Journal of Nutrition). Creatine can also be taken as a supplement, which may therefore be advisable for many vegetarians.

Carnosine
This is a dipeptide formed from beta-alanine and histidine. When carnonise is eaten it is digested by enzymes into these two amino acids. Therefore, the body must produce its own carnosine using the building blocks. Beta-alanine is found in meat and fish, so is usually lacking in vegetarians. Carnosine is a popular supplement against ageing as it protects against several of these processes. Carnosine is mainly found in our muscles and is known to improve their performance. Dietary supplements of Beta-alanine have been shown to be the most effective way of increasing carbonise in the body.

Vitamin D3
Vitamin D deficiency is extremely common amongst both omnivores and vegetarians. The most common dietary sources are meat, fish and eggs, however even eating large amounts of these foods may not be satisfactory. The National Health and Nutrition Examination Survey found 45% of the US population to be deficient between 1988 and 1994, whereas 77% were found to be deficient 10 years later. Statistics on vitamin D deficiency are usually based on a level of 10ng/ml in the blood, whereas several studies have found 30ng/ml to be an optimum level for health. By these standards, 90% of the UK population would be deficient throughout the winter. There are two main types of vitamin D in the diet. These are vitamin D2 (which is found in plant-based foods) ad vitamin D3 (which is found in animal products). These two types of the vitamin are metabolised very differently in the body and a study published in the American Journal of Nutrition very clearly stresses the advantages of D3 over D2. There are, however, vegetarian vitamin D3 supplements available and the body naturally synthesises vitamin D3 when exposed to sunlight. Since over 90% of our vitamin D should be produced due to sunlight anyway, the dietary factors are less significant. The risk for everyone in the population is high, not only vegetarians.

DHA
This is an omega-3 fatty acid which is found in animal products, especially in fish. It is used throughout the body as a structural fat, such as in the brain, eyes and heart. 30% of the structural fat in the grey matter of the brain consists of DHA, and it is thought to be important in the development and maintenance of the brain.
It is possible for the body to manufacture DHA from a different omega-3 (ALA). ALA can be easily consumed as part of a vegetarian diet, as it is found in flaxseeds, chia seeds and walnuts. The trouble here is that the body is not very efficient at this conversion and so lower levels are usually found in the blood plasma of vegetarians and vegans. Lower levels are also found in the breast milk of vegan mothers, however, the impact of this on infants is unclear. Vegan sources of DHA are available in the form of supplements made from algae. It is therefore easily possible to avoid deficiency whilst following a plant based diet.

Heme-Iron
Iron deficiency is the most common deficiency across the world. It is estimated that 30% of the total population are anaemic and this figure varies hugely between different groups. For example, menstruating and pregnant women have larger daily requirements of iron, causing higher incidence of deficiency. 8.7mg or iron are required daily for men, compared to 14.8 for women. The average daily intake of iron from food sources is 16.3–18.2 mg/day in men and only 12.6–13.5 mg/in women.
Vegetarians generally do not have higher rates of anaemia than average, but this is likely to be due to other lifestyle differences. Following a vegetarian diet significantly reduces the number of iron sources available, so paying more attention to iron consumption is important.
There are 2 main types of iron: heme-iron and non-heme iron. Heme-iron is found in meat, and is readily absorbed into the body. Non-heme iron (unfortunately for vegetarians) is less easily absorbed, and is more easily absorbed in the presence of heme-iron. Despite this, it is possible for a vegetarian to consume an adequate amount of iron, without supplementation.
Good sources of non-heme iron include:

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*many other herbs also contain large amounts of iron

Sulphur
Sulphur is mainly found in animal based foods, and is a necessary component of 4 amino acids. Meat and fish are described as ‘complete’ protein sources because they contain all 9 essential amino acids (including methionine which contains sulphur). With these 9 amino acids, the body is capable of synthesising any other amino acid we need.
The sulphur that we need to manufacture amino acids in our bodies is mainly obtained from protein in our diets, and vegetarians are at higher risk of sulphur deficiency. Sufficient sulphur can easily be found in a vegan diet in the form of legumes, soy products, nuts, seeds and grains. Processing of foods can, however, reduce sulphur content, as can growing crops in sulphur deficient soils.

Sources used:
PubMed (Vegetarian diets: what do we know of their effects on common chronic diseases)
BMJ (Dietary habits and mortality in 11,000 vegetarians and health conscious people: results of a 17 year follow up)
The Vegan Society
mercola.com(How to avoid common nutrient deficiencies if your a vegan)
The Health Delusion
The Western A.Price Foundation (Vegetarianism and Nutrient Deficiencies)
British Journal of Nutrition (the influence of creatine supplementation on the cognitive functioning of vegans and omnivores)
Vegetarian Journal (about vitamin)
JAMA International Medicine (Demographic differences and trends of vitamin D insufficiency in the US population 1988-2004)
Livestrong
Journal of the Academy of Nutrition and Dietetics
medscape
The American Journal of Nutrition
lifesdka website
PubMed-Health benefits of docosahexaenoic acid
British Nutrition Foundation (Briefing Paper)
Dr. Fuhrman – Smart Nutrition website
World Health Organisation – Micronutrient deficiencies
The American Journal of Clinical Nutrition – Iron status of vegetarians
nutritionfoundation website
healthise – sources of iron
USDA – National Nutrient Database for Standard Reference Release
The Journal of Nutrition – the sulphur-containing amino acids: an overview
authoritynutrition website

The Value of Veg

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The Department for Environmental, Food and Rural Affairs produced a report in 2013 suggesting that in the UK we consume an average of 4 fruit and vegetable portions each day. This has fallen from an average of 4.4 in 2005. The study also found a strong correlation with socioeconomic status and differences associated with gender. Despite this variation among different groups, the fact is that only 30% of people actually eat their 5 a day.

We are all used to the standard ‘5 a day’ advice which has been around since 1990, but recently there have been several attempts to promote the importance of ‘7 a day’. This could soon become the new NHS recommendation in the UK, fuelled by new research findings.

A 2014 study carried out at UCL found that people who ate 7 or more portions of fruit and vegetables each day had a 42% lower risk of death from any cause than those eating less than one portion. Both cancer and heart disease were highlighted as key factors in this trend. This research also suggested that vegetables have a greater impact on health than fruit. It was stated that each vegetable portion per day reduced ‘overall risk of death by 16%’, whereas the figure for each portion of fruit was 4%.

There is no internationally agreed figure on how much fruit and vegetables we should be eating. Not only do the recommendations here in the UK vary between different organisations, but the suggestions given by each government differ around the world. For example, in Australia it is recommended to eat 5 vegetable portions and 2 of fruit each day, whereas France suggests that people should aim for 10 portions per day in total.

The average consumption also varies hugely between different countries. The mean intake of fruit and vegetables is 33% higher in France than in the UK. This intake is also, shockingly, 2.2 times greater in Poland than in the UK.

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The high sugar content of fruit is often discussed, and leads some people to limit their intake. However, the NHS has produced separate recommendations on the amount of ‘free sugars’ that should be consumed, therefore excluding the amount of naturally occurring sugars in our diet. These recommendations state that less than 5% of our energy intake should come from ‘free sugars’. This has nothing to do with the amount of sugar we are consuming in foods like fruit, vegetables and milk products. Currently the average intake of these ‘free sugars’ is greater than double what it should be in every age group, and around triple the guideline amount for teenagers. Therefore it is safe to say that we have greater issues with our diets than the sugar content of a slice of orange or bunch of grapes.

The Role of Equality in Health and Happiness

It is an interesting observation that there is almost no correlation between GNP per capita and life expectancy, amongst developed countries. Within a society, however, we know that personal wealth does play a large role in determining life expectancy. The difference between these two measures is that within a society, GNP per capita is a measure of relative wealth, and is therefore a comparison with others. By using the difference in wealth of the top 20% and bottom 20%, Richard Wilkinson has drawn attention to the strong positive correlation between income inequality and health and social problems. This is shown on the graph below.

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This does not simply point out that poverty causes poor health and unhappiness. The evidence actually goes beyond the evidence and suggests that inequality actually leads to worse health outcomes and happiness for the most affluent in society as well as those in relative poverty.

It is thought that higher income inequality causes greater feelings of status insecurity due to comparisons against others in society. The fear of this judgement and a lack of social cohesion increases stress and therefore cortisol levels. This results in increased health and social problems.

Evidence from several studies supports this link between inequality and poor health. For example in the USA in 2001, Lochner et. al found that individuals living in states with greater inequality were at a 12% higher risk of death. In 2009 a study published in the British Medical Journal produced some shocking statistics about the impact that inequality is having on people’s lives in the USA. This study concluded that almost 884,000 deaths per year could be attributed to high inequality, and that this number would be prevented if the Gini coefficient value could be reduced to 0.3 (the average for OECD countries), from its value of 0.357. This is one third of deaths in the USA!

Supporting this, a 2009 BMJ meta-analysis by Kondo et al, found an 8% higher mortality risk per 0.05 increase in the Gini coefficient value.

There is also evidence to suggest that income inequality correlates with lower happiness in societies. For example, a 2011 study carried out in the university of Virginia found that from 1972 to 2008, people in America were happiest in years when income inequality was lower.

The 2015 World Happiness Report found that three quarters of differences in happiness between all countries is due to 6 factors: GDP per capita, healthy years of life expectancy, social support, trust, freedom and generosity (measured in donations comparative to income). Although this does not specifically highlight income inequality as a factor in happiness, it has been found to be linked to several of these 6 factors. For example, Richard Wilkinson’s research has also found a strong negative correlation between levels of trust in society and income inequality. There is also a strong correlation between income inequality and social immobility which would therefore mean that there was less freedom in more unequal societies. It is also likely that social support may be reduced by inequality as isolation tends to be higher.

The following maps show happiness rankings, and the Gini Coefficient (a measure of income inequality). It can be seen that there is some correlation, especially when considering the worlds happiest countries: Switzerland, Iceland, Denmark, Norway, Canada, Finland, Netherlands, Sweden, which all have fairly low Gini Coefficient values.

Happiness:

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-from the Washington Post

Gini Coefficient: (higher being less equal)

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-from the Business Insider using World Bank Data

The 2015 World Happiness Report states that ‘happiness is increasingly considered a proper measure of social progress and a goal of public policy’, and there are several organisations, such as Action for Happiness, who encourage people to see the importance of happiness, rather than focusing on financial and status goals.

There is also a large amount of research to suggest that happiness results in a healthier life. For example, Kubzansky’s 2007 paper found that enthusiasm, hopefulness, engagement in life, and emotional balance correlated to a lower risk of coronary heart disease. This is only the tip of the ice burg when it comes to how happiness can be beneficial to your health. It has been suggested that being happy can also reduce the risk of type 2 diabetes, high blood pressure and infection.

Despite happiness having recently gathered interest and making several headlines, there is still a lack of research. An Online Library search reveals around 400,000 results for the word ‘depression’, compared with only 50,000 for ‘happiness’. Now that’s depressing!

Sources used:
inequality.org
TED
PubMed
WHO – obesity and inequalities
BMJ – income inequality, mortality and self rated health
Psychology today
Harvard School of Public Health