March 8, 2019
Clinical Contributors to this Story
Leigh Ettinger, M.D. contributes to topics such as Pediatrics.
Marissa Winters, MA, RDN contributes to topics such as Integrative Health & Medicine.
By Brianna McCabe
Plant-based restaurants are sprouting in local neighborhoods, ‘meatless meat’ products are being stocked in frozen food aisles and vegan athletes are crushing stigmas that you can’t be solely powered by plants – is the nature of our food consumption shifting?
Forecasts are most certainly in favor of an increased global demand for plant-based items and vegan foods. In fact, the number of self-identifying vegans in America has grown from 1 percent in 2014 to 6 percent in 2017, a 600 percent increase.
Though rising in popularity, the core understanding and acceptance of veganism is sometimes still in question. Vegan Hackensack Meridian Health Medical Group providers Leigh Ettinger, M.D., and Marissa Winters, MA, RDN, outline common questions they find themselves answering about their lifestyles:
- Why did you decide to turn vegan? Individuals explore veganism for moral, environmental, spiritual and health reasons, notes Dr. Ettinger, a pediatric nephrologist. “For me, I started diving into the medical literature,” says the vegan of four years. “I researched plant-based diets and the positive effects on chronic disease prevention, treatment and overall health. With a deeper understanding, it seemed pretty obvious that this was a lifestyle I wanted to pursue.”
- Are there other health benefits to turning vegan? According to Dr. Ettinger, research studies appearing in respected medical journals and consensus statements by major national and international organizations describe the connection between a plant-based diet and improvements in weight loss, cholesterol, reducing the risk of diabetes, outcomes with Type 2 diabetes, heart disease and hypertension.
- So wait, you really don’t eat cheese? As defined by the Vegan Society, veganism is a plant-based diet avoiding all animal-derived food products such as meat, dairy, eggs and honey. “So no, we don’t eat cheese,” explains Marissa, a registered dietitian and integrative nutritionist. “However, we eat grains, greens and beans from all around the world, all year long. Trust me, it’s possible to find other foods that better satisfy those hungers.”
- But you must crave meat sometimes, right? “Hamburgers to me still smell delicious, but I probably couldn’t digest it,” admits Marissa, a vegan for nearly two years. “The bacteria in my gut has evolved and couldn’t handle these foods at this point.”
Dr. Ettinger adds, “Your taste buds change after converting to a plant-based diet, too. You might slip and eat something meaty or cheesy, but it’s more than likely going to taste too salty or oily and be unappealing.”
- If you’re not eating meat, where are you getting your protein? “Where does the cow get protein to make a juicy steak?” rebuts Dr. Ettinger. “Grass.” Despite some misconceptions, protein is available in plant-based foods, including:
- Seitan, or wheat gluten (21 grams per 1/3 cup)
- Tempeh, an Indonesian dish comprised of fermented soybeans (15 grams per ½ cup)
- Tofu, also known as bean or soya curd (10 grams per ½ cup)
- Lentils (9 grams per ½ cup)
- Quinoa (8 grams per ½ cup)
- Chickpeas (roughly 7 grams per ½ cup)
- Medium-sized potatoes (roughly 2-4 grams per serving)
The recommended dietary allowance (RDA), or the average amount, of protein you need to be healthy is 0.8 grams per kilogram of lean body weight per day. This breaks down to 46 grams of protein per day for women and 52 grams of protein per day for men of average weight. Marissa says, “It’s nearly impossible to miss out on your protein needs if you eat a varied plant-based diet.” In fact, both Dr. Ettinger and Marissa explain that most people are actually eating twice that amount per day.
- And what about calcium? Marissa acknowledges that this should be of consideration, particularly for women. Recommended calcium intake per day depends on an individual’s age and life stage:
- 9-18 years old – 1,300 milligrams
- 19-50 years old – 1,000 milligrams
- 51-70 year old males – 1,000 milligrams
- 51-70 year old females – 1,200 milligrams
- 70 years and older – 1,200 milligrams
- 14-18 year old pregnant/lactating females – 1,300 milligrams
- 19-50 year old pregnant/lactating females – 1,000 milligrams
However, there are a number of plant-based sources of calcium. “You can certainly contribute to your calcium needs with tofu, arugula and almonds—and many vegan dairy alternatives are also fortified with calcium,” she reassures. “It might even be helpful to take a supplement.” If you are at risk for osteoporosis, though, Marissa advises talking with your primary care physician.
- Aren’t you eating too many carbs? “You can, though I think everyone in this country pretty much eats too many carbs,” says Marissa. “That is just the nature of our food supply.” When deciding on carbs, choose items that contain the whole grain, like oatmeal, brown rice, and whole wheat rather than ones that have been processed, like white flour, and added sugars like corn syrup.
- Are there any health risks with not eating animal-based products? The main concern is vitamin B12, shares Dr. Ettinger, which is only found in animal products. “Vitamin B12 is made by soil bacteria,” he explains. “The fruits and vegetables found in the supermarket are too clean—some plants are grown hydroponically and have never even touched dirt. On the other hand, animals live in dirt and eat dirty food so they get their Vitamin B12.” According to Dr. Ettinger, without taking an inexpensive weekly supplement, a deficiency can cause anemia or permanent nerve damage.
- What do you eat at restaurants? “This way of eating can definitely make you feel lonely in certain social situations,” shares Dr. Ettinger. “I make sure to prepare beforehand and scope out the menu. If necessary, I’ll eat before I go out.” It takes a bit of preparation, but if an individual makes his or her health a priority, it really isn’t much of a problem, adds Dr. Ettinger.
- Isn’t being vegan expensive? “It’s actually a whole lot cheaper,” boasts Marissa. “Vegan ‘meat’ products, such as Tofurky and the Beyond Burger, and other substitutes can be a bit pricey, though.” While these products can be helpful for transitioning to a vegan lifestyle, she wouldn’t consider these grocery items as a staple for a long-term diet. “They are highly processed soy protein products,” she adds. “We encourage whole foods that look closer to the way they are found in nature.”
Dr. Ettinger comments, “It is eating like the poor people of the world to avoid the diseases of the rich. I eat like people from thousands of years ago: most people were eating these starches that fed civilizations of the world, while the kings and queens indulged and suffered from chronic illnesses. Nowadays, many people in this country are eating like kings and queens multiple times a day with meats, cheeses and rich desserts.”
- Is this a sustainable lifestyle? “For human health, absolutely,” claims Dr. Ettinger. “Initially you might feel that the diet is bland without all of the salt, oils and added sugars, but after time you notice the subtle flavors and hopefully recognize the power of this diet. Additionally, you’re decreasing your carbon and water footprint which might encourage you to remain vegan for life.”
- Do you have the energy to exercise and build muscle? Dr. Ettinger believes there is a fallacy that in order to build muscle and harvest energy your body requires a tremendous amount of protein. “Eating many times the RDA of protein isn’t going to give you more muscle. Resistance training builds muscle,” he states. “As for overall exercise, I biked to work 57 days in 2018. So, yeah, I have the energy.”
- Just because it’s vegan, is it healthy? “You can screw up any diet,” jokes Marissa. “I know of pizza and potato chip ‘vegetarians’ and ‘vegans’ who live off of Oreos (yes, they are vegan). However, if you appropriately plan your dishes to ensure you are getting your necessary nutrients, you can be healthy.”
“You don’t want to just eat greens—you want the rainbow,” shares Marissa. “The oranges and yellows of peppers, the tans of mushrooms and those beautiful blues and purple hues of eggplants and berries. It’s not part of our culture to think about our vegetables. Becoming vegan requires a shift in focus and understanding that there are an array of foods out there that can take center stage.”
Dr. Ettinger rotates between Hackensack Meridian Health Medical Group – Pediatric Nephrology in Hackensack and Neptune. Marissa practices at Hackensack Meridian Integrative Health and Medicine in Old Bridge. To find a provider near you, visit HackensackMeridianHealth.org.
The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.
Calcium and Vitamin D: Important at Every Age
How Much Protein Do You Really Need?
Top 15 Sources of Plant-Based Protein
Top Trends in Prepared Foods 2017
What to Know about Eating Vegan
The Vegan Society