How not to die of heart disease, stroke or diabetes if you’re vegan

A US study has shed light on which foods to eat, and which to avoid, if you don’t want to die of heart disease, stroke or diabetes… and vegans, vegetarians and plant-based eaters should take note.

The study took data from 4 sources:

1. The National Health and Nutrition Examination Survey (NHANES), a government-run periodic survey of dietary habits in the US population, that takes into account demographic factors such as sex, age, race, and education. These data were used to quantify what Americans actually eat.
2. Meta-analyses (syntheses of data from numerous different studies) of prospective cohort studies – in which a large segment of the population is followed up over a lengthy time period to see how their dietary habits correlate with what diseases they develop – and randomised clinical trials – in which people who already have, or are at risk of developing, a particular disease are allocated at random to receive either a dietary intervention, or ‘standard care’. These data were used to calculate the impact that 10 foods and nutrients had on risk of death from heart disease, stroke, or type 2 diabetes (‘cardiometabolic mortality’), segmented by age group. The 10 foods and nutrients studied were fruits (excluding juices), vegetables (including legumes), nuts and seeds, whole grains, unprocessed red meat, processed meat, sugar-sweetened beverages (i.e. soft drinks/soda), polyunsaturated fat as replacements for either carbohydrates or saturated fats, and omega 3 fats.
3. Observational studies documenting the associations between various levels of intake of each of the 10 dietary factors, and the risk of cardiometabolic mortality. These data were used to estimate what Americans should be eating to have the lowest risk of dying of heart disease, stroke and diabetes.
4. Data from the National Center for Health Statistics (NCHS) on disease-specific cardiometabolic deaths, segmented by sex, age, race and education level. These data were used to calculate how many Americans died from heart disease, stroke and diabetes over the study period.

By combining all these data, the researchers were able to estimate how many Americans died from cardiometabolic causes due to eating too much, or too little, of each of the foods and nutrients studied.

Plant eaters are exempt from some of the bad news: eating any processed meat (including bacon, ham, salami, pastrami, sausages, hot dogs, corned beef, beef jerky, canned meat and lunch meats) was calculated to have caused over 12% of heart disease deaths and 17.5% of diabetes deaths, while eating more than a measly 14.3 g per day of red meat caused just over 4% of diabetes deaths. (For reference, the average weight of a steak sold as a single adult serving in Australia is 195 g, although this ranges up to 552 g.)

But many vegetarians and vegans simply aren’t eating enough of the protective factors, and may be consuming just as much of the risky ones as omnivores.

For example, eating less than 300 g of fruit per day – around 2 pieces of whole fruit – caused over 22% of strokes (including nearly 32% of haemorrhagic, or bleeding strokes, which are much harder to treat than the more common ischaemic or clotting stroke that plant-eaters’ generally lower cholesterol levels protect them against). Many of my clients are eating next to no fruit when I see them, often due to being scared off fruit because ‘it has too much sugar’. See my article Does fruit make you fat? for a detailed rebuttal of this silly idea.

Eating less than 400 g of vegetables per day caused about the same amount of strokes as insufficient fruit – nearly 22% – and almost 25% of haemorrhagic strokes. When I review food journals from my new clients – even vegans – they often contain virtually no vegetables.

Eating less than 125 g per day of whole grains such as brown rice, quinoa and rolled oats was estimated to cause 17% of diabetes deaths and 10.5% of stroke deaths. Unfortunately, the vegan community is not immune from carbophobia; I’ve seen many posts on vegan Facebook groups from people who are avoiding grains because they mistakenly believe they cause weight gain and gut problems.

Drinking any sugar-sweetened beverages whatsoever caused nearly 11% of coronary heart disease deaths. Unfortunately, many ethical vegans continue to consume soft drinks because ‘as long as an animal wasn’t harmed in making it, it’s OK’.

Finally, consuming more than 2000 mg per day of sodium was estimated to cause over 21% of deaths from hypertensive heart disease (high blood pressure). In fact, in the over 65 age group, high salt intake was the single nutritional factor most associated with cardiometabolic mortality.

How much sodium do vegans and vegetarians eat? Generally speaking, way too much. Here’s how easy it is to exceed that 2000 mg per day cut-off point, using foods that I often see in my clients’ food journals, or posted with enthusiasm on vegan Facebook groups:

Sodium content in common vegan foods

Over 2000 mg of sodium… from just a handful of foods.

In contrast, a whole kilogram of frozen mixed vegetables contains just 180 mg of sodium, while 1 kg of fruit has just 21 mg. A cup of cooked brown rice has only 5 mg of sodium; 1 cup of cooked chick peas, 12 mg. On a diet of whole natural plant foods such as as fruit, vegetables, whole grains, legumes, nuts and seeds, you’ll get exactly as much sodium as you need, which is the amount humans consumed throughout the vast majority of our evolution – around 768 mg per day, according to research.

The bottom line: avoiding animal products is not enough to protect our health. Most of the ethical vegans I see in my practice are eating way too much salt from processed foods, and not eating enough fruits, vegetables (including legumes), whole grains and legumes to give them optimal protection against dying prematurely from heart disease, stroke or diabetes.

Confused about what you should be eating? Don’t know how to plan an optimal plant-based diet? My EmpowerEd health and nutrition education program is packed with resources on how to implement a healthy 100% plant-based way of eating, including video recordings of my full-day Empowered Eating seminar and Plant-Powered Oil-Free Cooking workshop; Healthy Eating 101 which covers kitchen set-up, meal planning and batch cooking; and 2 live webinars per month – an open Q&A session and an in-depth exploration of an important health topic. Your first month of membership is 100% free. Register here and get EmpowerEd to live your best life!