Vegetarian and Vegan Diet and Cardiovascular Risk

 

This past year, several people I love and care about were beset with illness. They are vegetarians or eat very little meat. One friend switched to a vegetarian diet for religious reasons and saw her energy level drop substantially and she was no longer able to adhere to her normal exercise routine. When she added meat back to her diet, her energy returned.  Of course, not everyone experiences adverse effects from cutting meat out of their diet, nor do they have such sudden symptoms. Different people thrive on different types of diets (except, Michael Pollan argues in In Defense of Food on the typical American diet.) Other vegetarians I love and care about have experienced cerebrovascular accidents (CVA), otherwise known as strokes.

Is Vitamin B12 deficiency a risk factor for cardiovascular disease in vegetarians? :

There is an inverse relationship between homocysteine levels and some B vitamins, namely Vitamin B12 and Vitamin B6. Because Vitamin B12 is found mainly in meat (it is also found in eggs), vegetarians and vegans are at risk of being Vitamin B12 deficient. This can correlate with a high blood homocysteine level, which has been associated with cardiovascular consequences. Homocysteine levels can be lowered by getting enough vitamin B12 and folate in your diet, or by supplementing these B vitamins. More work needs to be done; I’d love to see more studies related to the relationship between nutrients and health. I’d also like to see routine testing for Vitamin B12 levels in the blood.

In my own experience, doctors have recently been more regularly checking their patients’ serum Vitamin D levels. This is great since Vitamin D is a stem-cell-regulating hormone and good for so many body systems. I’d love to see the same trend happen with Vitamin B12. In my case, only two doctors, out of 20 or more, tested my Vitamin B12 level, despite classic B12 deficiency symptoms. Because my Vitamin B12 level was “low normal,” between 200 – 400 pmol/L, the deficiency diagnosis was initially missed. However, some people at this “low normal” level are actually deficient. I should of had follow-up testing back in 2008, but it wasn’t until late 2011, when a doctors’ office used a scale where their “normal” started at 400 pmol/L of Vitamin B12 and, subsequently, Dr. Joe diagnosed me with a Vitamin B12 deficiency (and later pernicious anemia).

I know a lot of people who are vegetarian or vegan. I am not trying to lure anyone back to being a meat-eater, but am concerned about long-term health effects from a diet often chosen for its health benefits (of which there are many). I have an auto-immune disease that, due to lack of Vitamin B12 in my system, has caused neurological damage from which I am still recovering. Because this has had such a devastating effect on my health and lifestyle, I tend to see the world with my “B12 goggles” on. Because the liver stores Vitamin B12, it can take many years before a deficiency manifests. When it does manifest, symptoms can be sudden and severe. I have good friends who are vegetarians. I admire them for their choice: I take it as a sign of their wanting to live healthfully, mindfully, and with an intentional awareness of their impact in the world.

To my vegetarian and vegan friends:

I love you. I admire you. I want you to be healthy and thrive so you can continue to make amazing, positive contributions to this world. Consider supplementing with Vitamin B12 for your long-term wellness.

Be well and B12.

 

Photo: Organic peanut butter on celery:

Sunshine Vitamin

Sunset at Schwiebert Park, Rock Island, IL

The sun, our life-giving star, sank beneath the Centennial Bridge, and then below the Mississippi River horizon line. Three blue heron had just flown overhead. I was taking in the last rays of the days, and thinking about the shortening days. This lead me to think about “the sunshine vitamin,” vitamin D, which isn’t a vitamin at all, but is a stem-cell regulating hormone.

I first realized how common vitamin D deficiency is from an evening newscast. Dr. John Whitcomb, a member of Aurora Hospital’s Emergency Department, said he gives most patients who walk through the ED doors, a shot of 50,000 units of vitamin D (cholecalciferol). Vitamin D, formerly thought to mainly help with bone formation and healing, has benefits for many body systems. Adequate amounts have been shown to ward off depression and most types of cancer. It is key in cardiovascular, bone, and immunological health.

Arthritis is only one of many conditions that can be ameliorated with the correct level of Vitamin D; read about other conditions that call for more of this sunshine “vitamin” and  other valuable information about Vitamin D.

According to Dr. Whitcomb, even if you spend time outdoors in the sun during the wintertime, the sun angle, at the latitude of Milwaukee, is such that your body cannot manufacture vitamin D. It relies on vitamin D stores in the body, accumulated during late Spring through Summer. There are a few foods that naturally provide vitamin D; they include mostly wild-caught fish, meat, and eggs.

It’s interesting to me, that if you consider indigenous diets, those in Northern latitudes contain a lot of fresh fish.

How much is enough? My primary physician, in Wisconsin, took a 4,000 IU (unit) supplement. At the cardiologist’s office I went to in Milwaukee, one of the cardiologists had all his patients take 4,000 IU. The American Cancer Society recommends 4,000 IU. Dr. John Whitcomb goes into detail about vitamin D and heart health. Here is an explanation of his 20/20/20/20 “rule.” The current RDA is only 400 IU, the amount to prevent rickets. This amount was established at a time when vitamin D was thought to mostly just affect bone health.

Because it is a fat-soluble vitamin, some people have concerns about toxicity. This can be an issue, as well, if you are receiving it by injection in large doses. I’ve heard 2,000 IU recommended as a dose, if you are concerned about toxicity. But, I do not dispense medical advice, and your doctor can check your blood level of vitamin D3 with a simple test. If you are low, you can decide whether to supplement with your diet, oral supplements, or with reasonable amounts of good ol’ sunshine.

Be Well!

(Sidenote: 1/11/16 revision updates some links related to Dr. John Whitcomb that were not working. Apologies for any frustration.)