Q: Is the vegan diet healthy?

A: A vegetarian diet can be very healthy --
vegetarians have a lower than normal incidence of
heart disease and cancer and lower risks of obesity
and diabetes. But the vegan diet, in which you eat
only plant-based foods -- no cheese, eggs, honey or
any other animal-derived foods -- does require you to
think about the nutrients you might be missing.

You can certainly get adequate amounts of protein from
plant foods -- whole grains, legumes, vegetables,
seeds and nuts. Soy protein is equivalent to the
protein you would get from meat, chicken, fish or
eggs. Apart from that, the specific nutrients you
should focus on include:

- Vitamin B12: Although this is found naturally only
in foods from animal sources, you can get sufficient
amounts from fortified breakfast cereals, fortified
soy beverages and some types of brewer's yeast. Still,
I recommend taking a supplement of 50 to 100
micrograms of B12 in the form of a good multivitamin,
sublingual tablet, nasal spray or gel.

- Iron: Good vegetable sources include cereals,
grains, legumes, dates, prunes, raisins and greens.
You can help your body absorb iron by taking 200 to
250 mg of vitamin C, preferably in divided doses when
you consume these foods or by including foods high in
vitamin C when you eat iron-rich foods. Do not take
iron supplements unless prescribed by a physician.

- Zinc: The best plant sources are grains, nuts,
legumes and spinach.

- Calcium: Good sources include sesame seeds,
collards, kale, broccoli, sea vegetables as well as
orange juice and soy milk fortified with calcium. Look
for tofu fortified with calcium. Women need 1,000 to
1,200 mg of calcium per day from all sources; men need
only 500 to 700 mg from all sources and do not need to
take calcium supplements. Women who don't get adequate
dietary calcium should take 500 to 700 mg of calcium
in supplement form in two divided doses with meals
(take magnesium with calcium in a two-to-one ratio --
that's twice as much calcium as magnesium.)

- Essential fatty acids: By not eating fish, you're
missing out on natural sources of omega-3 fatty acids.
Instead, make sure to include in your diet whole or
unrefined grain products plus walnuts, freshly ground
flaxseeds or hemp seeds. Be aware that the vegetarian
sources of omega-3s are not as good as oily fish.
Consider taking a fish oil supplement or, at least, an
algae-derived supplement of DHA.

- Vitamin D: As a vegan, you won't get D from such
dietary sources as fortified milk, eggs, salmon, tuna,
mackerel and sardines. Some cereals are fortified with
D, as are soy milk and fake meats, and our bodies make
vitamin D with exposure to sunlight (still, most
adults don't get nearly enough). I recommend a daily
supplement of 1,000 IU of vitamin D3 --
cholecalciferol -- for everyone (vegan or not).

Dr. Andrew Weil is director of the program of
Integrative Medicine of the College of Medicine,
University of Arizona. He is an internationally
recognized expert on medicinal plants, alternative
medicine and the reform of medical education.

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