Disclaimer: I do not recommend that anyone make any changes to their diet/health regime without consulting their physician.
There is a lot of debate out there whether vegans and vegetarians suffer adverse health consequences by limiting or eliminating animal products from their diet. Using myself as a guinea pig, I have been posting my annual blood test results on this blog in an effort to answer that question.
If you want to skip to the bottom of this post, there is a chart compiling my last 3 years’ test results, grouped by type of test and what the tests measure (keeping in mind that all nutrients perform multiple functions, but I’ve noted only their primary function). However, if you want to perhaps learn something new, I suggest you read the whole post. I’ve tried to keep everything as brief as possible!
The Old Me – Bad Vegetarian & Vegan
As with any type of nutrition program, vegans and vegetarians can put themselves at risk by not eating a properly balanced diet. I found that out the hard way. When I first went “vegetarian”, I cut out meat (chicken, fish, pork, beef) but continued eating eggs, yogurt, milk, ice cream, cheese and butter. The mistake I made was that those foods, along with pasta and bagels, made up a much larger portion of my diet than fruits and vegetables. As a result, my health deteriorated (see this post and that one). I’ve spent many years since then trying different diets and eating my way back to health.
3 Years On Dr. Fuhrman’s Eat To Live Program
If you are familiar with my blog, you’ll know that I’m a big fan of Dr. Joel’s Fuhrman’s Eat To Live (ETL) program. His focus on eating foods with the highest nutrient density in order to obtain maximum health not only makes perfect sense to me, but after following his weight loss and maintenance programs for 3 years (okay, I might not have been perfect the whole time…), I personally feel that I’m at my healthiest – ever.
How To Measure “Healthy”?
I’ve met people who look like you could knock them over with a feather, yet they claim to feel “healthy”, “great”, “never better”! All of us like to believe that we are doing our best to take care of ourselves, but all you need to do is read the headlines and look around to realize that’s not what’s actually happening out there.
To prove to my readers that I was in fact “healthy”, I decided to start posting my annual blood test results starting in 2014. I was taking a leap of faith because I hadn’t had my blood tested in years. What if it turned out that I wasn’t as healthy as I thought? Would I be giving vegetarians and vegans a bad rap?
2014 Test Results – As A Vegetarian
In 2014, I was following a vegetarian version of the ETL program – not my unhealthy “vegetarian” diet of nearly 20 years ago. My test results showed that my Vitamin B12 was on the low end of the scale. Vitamin B12 is actually a bacteria found in dirt and feces. It used to be abundant in the food supply. However, with increased sanitizing of the food supply, it is now washed off fruits and vegetables. Grazing animals pick up B12 and the bacteria that produces it from soil/feces, and humans then get it from the animals they consume. B12 can be produced industrially and turned into dietary supplements.
My Vitamin D3 level was 25, below the normal scale of 30 – 100. The biggest source of Vit D3 is the sun, so living in the Midwest doesn’t help me out in that department. Luckily, Vitamin D3 is available in a dietary supplement.
Everything else in my blood panel was normal. Overall, based on my results, I felt pretty good about the state of my health.
2015 Test Results – Again As A Vegetarian
In 2015, I still followed a vegetarian ETL diet but, on my doctor’s recommendation, added a Vitamin D3 and B12 supplement. The rest of my diet was the same as in 2014, except that I cut out more animal products, moving closer to a vegan diet. My test results showed that the B12 and D3 supplements worked their magic. My Vit B12 level went from 264 to 918. As the acceptable range is 180 – 946, I went from the low end of the scale to the high end. Yea! And my Vitamin D3 level went from 25 (below normal) to 41.5, so I was now in the normal range. Double Yea!
With all of my other levels in the normal category (except a slight increase in my C-reactive protein/inflammation marker) I felt very confident at this point that I was living proof that a vegetarian/near vegan diet could be healthy.
But just as I was flying high, along came Dr. Mark Hyman and his book Eat Fat, Get Thin…….and it made me question everything!
Dr. Fuhrman vs. Dr. Hyman!
To back up just a bit, in my Eat To Live Q4 2015 Report, I said I planned to start testing other diets every few months during 2016 and then compare them to Dr. Fuhrman’s ETL plan. But I quickly realized I can’t do that! If I truly want to compare how “healthy” these diets are, the only objective measure I have is my blood test results. Since blood tests are quite expensive, I can’t swap out diets every 3 months. Instead, I need to follow each one of these new diets for a year and then take a blood test at the end of the year to see how I fare compared to ETL.
Low Fat/High Carb versus High Fat/Low Carb Diet
I decided to start with Dr. Hyman’s Eat Fat, Get Thin (EFGT) plan and right away noticed a big difference between his approach to fat and carb intake versus Dr. Fuhrman.
Dr. Fuhrman recommends limiting the amount of healthy fats (avocado, walnuts, nuts, seeds, etc.) to 3 ounces per day and eliminating all oils, while consuming unlimited healthy carbs, such as beans and legumes, and 1 cup of starchy vegetables or whole grains per day. He also recommends unlimited fresh fruits but at least 4 per day.
Dr. Hyman, on the other hand, recommends eating 4 – 5 servings of healthy fats per day (such as nuts and seeds , avocado, olive oil, coconut oil, MCT oil, butter from organic, grass-fed cows, and fatty fish), while eliminating all grains and beans (except organic tofu or tempeh). He recommends only ½ – 1 cup per day for a limited variety of fruit, and only 1/2 – 1 cup of starchy vegetables (sweet potatoes, squash) 4 times per week.
Talk about polar opposites! Would my blood tests be able to show which of these approaches was better for me?
Hold on, it gets more complicated…
New vs. Old Cholesterol Tests
To prove that eating large quantities of healthy fats/oils do not have an adverse effect on heart health, Dr. Hyman recommends a series of health screening tests – but many of them are NOT the ones I’ve been using the past 2 years.
Dr. Hyman believes standard blood tests are not sufficient to provide a true picture of overall health. One of his biggest beefs is with the standard total cholesterol/HDL/LDL tests because they don’t measure the “size” or “number” of your LDL (bad) cholesterol. New research apparently shows that “small, dense” LDL cholesterol particles are most correlated with heart disease risk, whereas “large, fluffy” LDL particles do not stick to the arteries causing plaque buildup. So Dr. Hyman recommends that everyone have an NMR lipid test from LabCorp or the Cardio IQ test by Quest Diagnostics – the only 2 companies offering this new test (not a paid endorsement BTW, just stating the facts).
Great – I’ve never had that test before. So how can I compare myself on the ETL versus EFGT programs?
Hold on, it gets worse…
Dr. Hyman’s Concerns Regarding Vegan Diets
Dr. Hyman believes that a vegan diet causes a variety of nutritional deficiencies. Most of his concerns have to do with the body’s ability to convert certain nutrients into a form that the body can properly absorb in the absence of animal products. In the interest of brevity, I will write separate posts to address his concerns on issues such as Vitamin A – retinol, choline, beta-carotene, Vitamins K1 and K2, protein synthesis, Vitamin B12/methylmalonic acid/homocysteine, and Omega-3/EPA/DHA, and Vitamin D3. Hey – I told you it was complicated, so hang in there!
My ‘Vegan’ Blood Test Results For 2016
I had already converted to a totally vegan diet in late 2015 before deciding to try Dr. Hyman’s EFGT program. In order to make an “apples to apples” test of Dr. Fuhrman’s ETL diet versus EFTG, I decided to stay on the ETL diet for another year (was vegan for about 14 months) before having my latest set of blood tests in December 2016.
Using Dr. Hyman’s new set of blood tests, with the exception of two markers (explained below), it doesn’t appear that I have suffered the majority of concerns Dr. Hyman has about a vegan diet – a HEALTHY vegan diet. To be specific:
- I have those desirable BIG, FLUFFY LDL particles – and not too many of them!
- My insulin resistance score looks good!
- My Vitamin B12 levels look good!
- My iron levels and absorption look good!
- My Vitamin D3 level is in the normal range!
In his EFGT book, Dr. Hyman recommends other blood tests that I did not have performed – not that I didn’t try to get them, but the labs I consulted with did not offer them. Bummer, but I did the best I could.
For now, suffice it to say that I’m still pretty happy with where my vegan blood test results came in.
Where I Need To Improve – Vitamin A and Omega-3
You may notice in the chart below, which compares my blood test results over the past 3 years, that there are a lot of “n/a” markers, meaning that they were not tested. Those are the “new” tests recommended by Dr. Hyman that I had done in 2016. I will continue my efforts to have them done in the future, if they are available and if I can afford them.
What To Do About My Omega-3 Level
The Omega-3/DHA/EPA test is designed to measure how well you absorb/convert omega-3 fatty acids, which are important to cardiovascular health. They are primarily found in fish oil/fat such as salmon, mackerel, herring and tuna. It’s found to a smaller degree in leafy green vegetables, beans and some oils, but the body needs to convert the ALA into DHA and EPA, which is hard to do. (Look for a future post explaining this in more detail.)
Based on my test results, I’m not making that conversion very well. Because I don’t want to consume fish/fish oil (because IMHO most things in the oceans are polluted and/or contaminated with mercury), I’ve recently begun supplementing with a product offered by Dr. Fuhrman. It’s made from algae (a vegan source of omega 3) grown in a lab without the contaminants from the sea. I will continue to take it throughout 2017 to see if I can improve my blood test results without eating fish. Stay tuned to see if this works…..
What To Do About My Vitamin A Level
Vitamin A is essential for vision, skin and bone growth and immune function. The body cannot make it and must rely on diet to obtain it. Meat products provide Vitamin A in the form of retinol that can be absorbed by the body. Vegetable sources of Vitamin A, known as beta carotene, need to be converted into an absorbable form. Based on my test results, I’m not making that conversion efficiently. (Look for a future post explaining this in more detail.)
I have to admit that I need to do more research on how to come up with a vegan solution to this Vitamin A absorption problem. Stay tuned….
A Note About The Cost Of These Tests
In 2014, I paid $400 for my blood tests, and $485 in 2015 which I paid for out-of-pocket. In 2016, with all of the additional tests, the cost was over $1000 more than half of which was paid by insurance. Although pricey, I consider these tests as an investment in my health. I wish everyone had access to these tests…..
My 2017 Game Plan – Implementing A Hybrid of Dr. Fuhrman’s and Dr. Hyman’s Plans
As of January 2017, I started a hybrid diet combining the ETL and EFGT plans. I will continue to eat a plant-based diet as recommended by Dr. Fuhrman consisting of primarily nutrient-dense plant-based foods. But I will increase my consumption of (non-animal-based) healthy fats (nuts, seeds, avocados) as recommended by Dr. Hyman, while greatly reducing my intake of healthy, non-refined carbs (beans, legumes), eliminating whole grains, and limiting fruit consumption.
When it comes down to it, as much as I love healthy, non-refined carbs, I’m curious to see whether replacing them with healthy non-animal-based fats (sorry, Dr. Hyman – not willing to go back to animal products!) will make a change in my weight and my blood test results.
Tune in to my mid-year report toward the end of June to see how things are going and more details on what I’m eating!
In the meantime, if you have any questions, please drop me a line!