Why Vegetarians and Vegans Should Supplement with DHA

Why Vegetarians and Vegans Should Supplement with DHA

by Chris Kresser

Last updated on

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DHA is a crucial nutrient for developing babies, children, and adults, yet there are no sources of DHA in vegetarian or vegan diets. Some advocates of vegetarian diets have claimed that vegans can get enough DHA by consuming plant-based forms of omega-3 like flaxseeds and walnuts. But is that really true? Read on to find out.

A couple of weeks ago, Joe Rogan invited me to be a guest on his top-ranked podcast. Joe is a fantastic guy, a skilled interviewer, and knowledgeable about health and nutrition in his own right.

We covered a variety of topics, including Paleo and vegan vs vegetarian diets; Big Pharma, Big Food, and Big Science; functional vs. conventional medicine; and the importance of lifestyle and behavior change.

One of the particular issues we discussed related to vegetarian and vegan diets was the importance of long-chain omega-3 fats like EPA and DHA. I summarized research indicating that vegetarians, and particularly vegans, have lower levels of EPA and DHA than omnivores and that plant-based omega-3 fats like flaxseed and walnuts are not adequate sources of EPA and DHA in most cases. I argued that most vegetarians and vegans will need to supplement with preformed DHA—from microalgae, for example—in order to ensure adequate levels of these important fatty acids. I stand by this claim, and, as you’ll see below, the evidence clearly supports it.

What I got wrong on the show was that vegans need to take several capsules of microalgae supplements in order to meet their daily DHA needs. In fact, with most microalgae products on the market today, vegans can take one or two capsules a day to meet that need. I was basing the larger number of capsules on a higher target of DHA per day that I previously recommended, but I have since revised my view on based on new research suggesting potential harm from too much omega-3 fat. That’s an important difference, and I apologize for any confusion it may have caused.   

One final note before we dive in. As I said numerous times on the show, I am not arguing that it’s not possible to be healthy on a vegan diet. Spectacular athletes like Rich Roll demonstrate that it is. My argument is that 1) there is a higher risk of nutrient deficiencies on a vegan diet (including DHA, the subject of this article), especially without smart supplementation, and 2) there are numerous factors that determine whether one becomes nutrient deficient on a vegan diet, which explains the wide range of responses. If someone is going to commit to a vegan diet, these are the facts they need to be aware of in order to increase their chances of success.

DHA and Vegans in a Nutshell

This is going to be a long article filled with a lot of scientific references because I want to provide a comprehensive summary of what the research says on this topic. But I also want to make it accessible to people who aren’t scientists or healthcare professionals. I’m going to summarize the key takeaways right up front, and then I’ll go into further detail on each of them below.

Here’s the 30-second summary:

  • In all but one study I’ve seen, omnivores have the highest DHA levels, followed by vegetarians, followed by vegans.
  • Conversion of ALA to EPA and DHA is inefficient: less than 5 to 10 percent for EPA and 2 to 5 percent for DHA.
  • Even those low numbers may be optimistic because most studies show that supplementing with plant-based forms of omega-3 (alpha-linolenic acid, or ALA) like flaxseed oil does not increase serum or breast milk levels of DHA.
  • The conversion of ALA to EPA and DHA is inhibited by linoleic acid (plant-based omega-6), nutrient deficiency, genetics, health status, and sex. This may explain why ALA is a sufficient source of DHA for some vegetarians and vegans, but not for others.
  • DHA plays a crucial role in fetal and childhood brain development (affecting visual acuity, intelligence, problem solving, etc.), and a growing body of evidence shows that adults that consume higher amounts of DHA have lower risk of many diseases, including cognitive decline, Alzheimer’s disease, depression, schizophrenia, psychosis, and other behavioral disorders.
  • Therefore most vegetarians and vegans should supplement with preformed DHA to ensure adequate levels of this crucial fatty acid.

Omnivores Have Higher Levels of DHA Than Vegetarians or Vegans

Numerous studies have shown that, on average, omnivores have higher levels of DHA than vegetarians and vegans, with vegans at the bottom of the scale. For example, one study in 196 meat-eating, 231 vegetarian, and 232 vegan men in the United Kingdom found the following EPA and DHA levels, by group (1; see Table 2):

EPA levels (mg/L):
Omnivores: 0.72
Vegetarians: 0.52
Vegans: 0.34

DHA levels (mg/L):
Omnivores: 1.69
Vegetarians: 1.16
Vegans: 0.7

Lest you think this effect is limited to white males in the UK, similar results have been found in studies of Austrian, Dutch, Australian, Finnish, Chinese, and US adults. (2, 3, 4, 5, 6, 7, 8) The authors of the Austrian study noted that vegetarian diets promote “biochemical tissue decline” and that vegetarians and vegans “should supplement with preformed EPA and DHA, regardless of age and gender.” (2)

This leads to three conclusions:

  • There is less EPA and DHA in the typical vegetarian and vegan diet than in an omnivorous diet
  • Vegetarians and vegans are not converting ALA into EPA and DHA at a rate sufficient to match the serum DHA levels of omnivores
  • Vegetarians and vegans are either not supplementing with DHA at all, or they are not taking enough, since their blood levels are lower than those of omnivores

Why Do Vegetarians and Vegans Have Lower Levels of DHA Than Omnivores?

Now that we’ve established that vegans and vegetarians have lower levels, on average, of DHA than omnivores, let’s explore why this is the case. There are two primary reasons:

  1. Lower intake
  2. Reduced conversion

Lower intake

This one is quite simple: EPA and DHA are found almost exclusively in animal foods. Seafood and marine oils are the primary source, but pasture-raised meat and dairy products (and, to a lesser extent, conventionally raised meat and dairy) also contain modest amounts. The only significant source of preformed DHA in plant foods is microalgae (which is why most vegan DHA supplements are made from it). (9)

Reduced conversion

This one requires a bit more explanation, but it’s crucial to understand, so please bear with me.

A fatty acid is a chain of carbon, oxygen, and hydrogen atoms with a carboxyl group on one end. Fatty acids are classified on the basis of how many carbon atoms are in the chain, as well as how many double bonds exist within the molecule.

As you can see from the chart below, it is also possible for the body to synthesize EPA and DHA from the short-chain omega-3 alpha-linolenic acid (ALA). ALA is found in plant foods such as flax, hemp, and pumpkin seeds and walnuts.

diagram-650-1

Adapted from Das UN. Biotechnol J. 2006 Apr;1(4):420-39

 

Looking at this chart, it’s easy to see why a vegetarian or vegan might assume that they can meet their DHA needs simply by consuming flaxseeds and walnuts.

However, research indicates that the conversion of ALA to EPA and DHA is inefficient and extremely limited. Less than 5 to 10 percent of ALA gets converted to EPA, and less than 2 to 5 percent gets converted to DHA. (9)

Even these low conversion rates may be a best-case scenario, especially in the case of DHA. Why? Because ALA supplements have little effect on blood or breast milk DHA levels in adults, and although adding ALA to infant formula does raise DHA in babies, it doesn’t raise it to the level that babies get from consuming breast milk. (10)

This is hugely important because, as we’ll see below, DHA is an essential nutrient for fetal brain development, and low maternal DHA levels are associated with lower IQ and visual acuity and suboptimal brain development.

Another important point to understand is that a wide variety of factors—some of which are common in people following a vegetarian and vegan diet—may further inhibit the conversion of ALA to DHA. Studies have shown that the conversion of ALA to EPA and DHA is inhibited by linoleic acid, nutrient deficiency, genetics, health status, and sex. (11, 12) Let’s look at each of these in turn.

Linoleic acid

Linoleic acid (LA) is a plant-based omega-6 fat, found in things like nuts and seeds, avocados, and industrial seed oils used in virtually all packaged, processed, and restaurant foods. Studies have shown that vegetarians and vegans have a high intake of LA compared to ALA—an average ratio of 10:1—which would impair conversion of ALA to DHA. (2) In addition, a large proportion of dietary ALA is oxidized, and thus unavailable for conversion into DHA. (13)

Recent research suggests that the optimal conversion of ALA to DHA occurs at a ratio of LA to ALA of 1:1. (14) However, reducing LA intake that significantly is extremely difficult to achieve when following a vegetarian or vegan diet. Other studies have shown that a ratio of between 2 and 4:1 may still allow for adequate conversion, but note that this is still significantly lower than the average omega-6 to omega-3 ratio of 10:1 for vegetarians and vegans. (2, 15)

Nutrient deficiency

If you look back at the chart above, which demonstrates the conversion pathways of essential fatty acids, you’ll see that there are several important enzymes in that pathway: delta-5-desaturase, elongase, and delta-6-desaturase. Like all enzymes, these require certain nutrients as cofactors in order to function properly. These include vitamins B3 and B6, vitamin C, magnesium, calcium, selenium, iron, and zinc. (16, 17, 18, 19)

As I’ve written elsewhere, vegetarians and particularly vegans are at higher risk of deficiency of some of these nutrients—especially iron. Vegetarians and vegans have lower iron stores than omnivores, and vegetarian diets have been shown to reduce nonheme iron absorption by 70 percent and total iron absorption by 85 percent. (20, 21)

This suggests that deficiencies in vegetarians/vegans of nutrients that are required for optimal conversion of ALA to DHA may further explain why their levels of DHA are lower than omnivores.

Genetics

Delta-5- and delta-6-desaturases are encoded respectively by the FADS1 and FADS2 genes. Recent research has shown that different FADS1 and FADS2 genotypes are associated with significant differences in DHA levels. (24) This shouldn’t be surprising, since, as you now know, the delta-5- and delta-6-desaturases play an important role in the conversion of ALA to DHA. A variety of other genes have been shown to affect this conversion as well. (18)

Quite simply, this means that there are genetically determined individual differences that affect the rate of conversion of ALA to DHA. This could explain why some vegans are able to maintain higher levels of DHA without supplementation than are others.

Health status

Studies have shown that the delta-5 and delta-6 conversion enzymes don’t function as well in people with diabetes, metabolic syndrome, hypertension, or certain metabolic disorders. (16, 18) Like genetics, differences in health status can influence individual conversion of ALA to DHA and may explain some of the variation observed in vegetarians and vegans.

Sex

Finally, it appears that young women convert significantly more ALA to DHA than young men. The most likely explanation is that this is nature’s way of ensuring adequate levels of DHA in pregnant and lactating women, which, as you will see below, is crucial to the health of the developing baby and child.

One study showed that women converted 21 percent of ALA to EPA and 9 percent to DHA, whereas men converted 8 percent of ALA to EPA and 0 percent for DHA. (25) Yes, you read that correctly: zero percent conversion in men. This led to an average conversion of ALA to DHA in men and women combined of 4.5 percent, but obviously that average doesn’t tell the whole story. This may explain why, anecdotally at least, men don’t do as well on vegan diets as women.

Why Is DHA so Important—and How Much Do We Need?

The importance of DHA in the diet has been widely covered in both the mainstream media and the scientific literature for the last two decades. DHA is an essential nutrient for fetal brain development, and low maternal DHA levels are associated with lower IQ and visual acuity and suboptimal brain development. (26, 27, 28, 29, 30, 31)

Some studies argue that the lower DHA levels observed in vegetarians and vegans do not constitute overt deficiency and that evidence of harm is limited. Vegans have used this as an argument that DHA supplementation isn’t required.

However, a growing body of evidence suggests that even adult requirements for DHA may be higher than currently recognized and that adults who consume higher amounts of DHA have lower risk of cognitive decline, Alzheimer’s disease, cardiovascular disease, depression, schizophrenia, psychosis, and other behavioral disorders. (32, 33)

This shouldn’t be surprising, given that the RDA for each nutrient is the amount required to avoid deficiency symptoms—not the amount required to promote optimal health, which is often much higher than the RDA. There are numerous examples of where the RDA is likely insufficient for promoting optimal health—such as zinc, iron, and B12—and given the research above, DHA seems to be another.

But how much DHA do we need? Recommendations vary widely depending on the country and organization, ranging from 100 mg/d on the low end to 300 mg/d on the high end. Based on research linking DHA with all of the benefits mentioned above, a panel of experts at the National Institutes of Health (NIH) recommended a daily intake of EPA and DHA combined of 650 mg/d, with at least one-third of that amount (approx 215 mg/d) coming from DHA. (34)

In theory, with a conversion rate of 2 to 5 percent of ALA to DHA, this means vegans and vegetarians would need to consume between 4.3 and 10.8 grams of ALA per day to produce 215 mg/d of DHA, depending on where they fall in the conversion spectrum.

How does that compare to the average intake of ALA in the United States? According to a study of more than 14,000 men and women in the US, the intake of ALA is 0.97 g/d in vegetarians and 0.86 g/d in vegans. (35) This is obviously well below the range needed to produce 215 mg/d of DHA.

Some vegans have argued that even the higher dose of 10.8 grams of ALA per day is easily obtainable simply by taking a tablespoon of flaxseed oil. However, as I mentioned earlier in the article, most studies show that supplementing with ALA does not increase DHA levels in the serum or breast milk, so it seems that in many cases flaxseed oil will not solve the problem. (10, 36)

Given the high intake of LA and low or nonexistent intake of EPA and DHA in vegetarians and vegans, it wouldn’t be surprising to see low tissue levels of EPA and DHA in these populations. That’s exactly what research shows. For example, one study found that EPA levels of vegans were only 12 to 15 percent and DHA levels were 32 to 35 percent of those of omnivores. (37) Another study found that EPA levels in vegans were only 22 percent of those of omnivores, and DHA levels were 38 percent of those of omnivores. (38) Finally, and most concerning, a study found that vegan infants had less than 30 percent of the EPA and DHA of omnivorous infants. (39)

Conclusions

I started with the conclusions of the article in the introduction, but let me review them again here:

  • Vegetarians and vegans have lower levels of EPA and DHA than omnivores. This indicates that they aren’t getting enough ALA in their diet to produce sufficient DHA and that most vegetarians and vegans aren’t supplementing with preformed DHA.
  • The conversion of plant-based forms of omega-3 found in foods like flax seeds and walnuts into EPA and DHA is inefficient.
  • Supplementing with ALA  (e.g., flaxseed oil) does not adequately increase serum or breast milk levels of DHA.
  • DHA is crucial to human health during gestation, childhood, and adulthood.
  • Therefore, most vegetarians and vegans should supplement with preformed DHA to maintain optimal blood levels.

This is especially true for populations with higher DHA requirements, like pregnant and lactating mothers, and in those with poor conversion, like men, people with nutrient deficiencies, and people with chronic illness. As discussed in the article, ALA supplements like flaxseed oil aren’t sufficient in most cases, and supplementation with preformed DHA is necessary for maintaining optimal blood DHA levels.

The best option for those unwilling to consume seafood is a microalgae supplement. Algae is the base of the food chain for fish, and it is rich in DHA. (DHA can be retro-converted to EPA, so it is not necessary to supplement with EPA separately.) Most products on the market contain about 200 mg of DHA per capsule, so a dose of one to two capsules per day would suffice.

For those who are not vegetarian or vegan, however, the best option is to simply eat 12 to 16 ounces of cold-water fatty fish per week. This not only provides adequate amounts of preformed EPA and DHA, but it also provides highly bioavailable protein and other nutrients like selenium that are important to health. Although I’ve written extensively about why concerns about mercury in most fish species are overblown (here, here, and here) and why the benefits of eating fish far outweigh the risks, if you’re concerned, you can simply choose low-mercury species (which is what virtually all public health organizations recommend). And contrary to what some have claimed, dioxins and PCBs are not a significant health concern when it comes to seafood consumption.

I’ll close by recognizing that there are many reasons why people choose to go vegetarian or vegan. Some are compelled by the environmental impact of confinement animal feeding operations (CAFO). Others are guided by ethical concerns or religious reasons. I respect these reasons and appreciate anyone who thinks deeply about the social and spiritual impact of their food choices—even if my own exploration of these questions has led me to a different answer.

If you do choose a vegetarian or vegan diet for yourself and/or your children, understanding how to mitigate any possible adverse effects of that choice—in this case, suboptimal intake of DHA—will maximize your chances of success and minimize your chances of harm. I hope that this article serves that purpose.

220 Comments

Join the conversation

  1. I’m glad that I found this article. For the longest time, I thought flaxseed oil was enough. I’m now taking nordic naturals “algae omega” with DHA(390mg) and EPA(195mg). I feel a little better i guess, it’s hard to put my finger on it. I’ve been vegan for 3 years, but I’ve messed up a few times by going out, and eating meat or dairy products for a couple weeks at a time.

    The thing is though, I feel better after eating meat, eggs, and certain dairy products. I now know a lot of the stuff that I was originally told, that convinced me to go vegan, isn’t actually true. I feel a bit duped, and angry. One thing I can’t deny is I never ate fruits or vegetables before I went vegan, so that’s a plus.

    I think I’ll listen to my body, and keep a mixed diet from now on, with some animal products, some grains, and a bunch of fruits and veggies. And of course, my epa/dha supplement, since I don’t eat seafood.

  2. Chris, the UK study you’ve referenced shows what the average DHA levels were for omnivores (1.69) vegetarians (1.16) and vegans (0.7) but no where in your article do you say what you believe to be the target/desired level?

    FYI i recently had my fatty acid levels tested and as a vegan (2 years) my score came back at 1.36 DHA which isn’t far off the average omnivore score from the UK study you’ve cited. FYI I am sure to have some flax/chia on my breakfast each day.

    However somewhat interestingly the company that did my Omega 3 test (HQT Diagnostics, UK) suggested that my DHA score of 1.36 was very low and stated that my target DHA level should be at least 6.0 and recommended i start supplementing with fish oil right away! (which they just so happened to sell i might add).

    Their recommendation of 6.0 DHA is significantly higher than the average omnivore from the UK study you’ve cited, and every other study i’ve come across. So i’m keen to know what your recommended target would be, given your extensive research on the subject.

    FYI I’m happy to send you the results of my extensive fatty acid tests, if you think you would find them helpful.

    For the record, as a vegan i take no issue whatsoever with people like yourself critiquing the diet, if the diet can’t stand up to science then to be frank people shouldn’t be doing it. My personal belief is that with the right supplementation then it is a good diet, fantastic if you have a family with a history of heart disease like mine, but i would also add that even if vegans are consuming the right supplements they should also be sure listen to the wisdom and signals their getting from their own body, and make sure they are thriving. We need to be fit and healthy if we’re to fight for the animals!

  3. I have been vegan for 2 years, but all the recent DHA/EPA talk like this article has concerned me. Before i jump on the supplement bandwagon though i would appreciate your thoughts on the following.

    A handful of my friends and relatives who are omnivores choose not to eat ANY fish and haven’t for decades, and i think it’s fair to say there are A LOT of omnivores who choose not to eat ANY fish purely because they don’t like the taste, yet they don’t give their DHA/EPA levels any thought, and no one is advising them or encouraging them to.

    So my question is where are they getting their DHA/EPA from if they don’t eat ANY fish? I know there are trace amounts of DHA/EPA in eggs, but nothing like the amounts that CK is saying are needed to be heathy.

    I just find it a bit odd forcing myself to supplement with DHA/EPA, if some of my closest friends and family that don’t eat ANY fish aren’t at all concerned, and no one is telling them they should be.

    Would appreciate your thoughts… Thank you.

    • Hi jon, dont be surprised noone is advising anyone on anything! This is self education, as we realise everything we were ‘taught’ in regard to nutrition was wrong. Those who are aware and interested in wellness and longevity, take on the task of finding the best solution for their and their families health. This is all new and rapidly advancing knowledge as we recover from the industrial revolution. We try to stem a cancer epidemic born from sugar, its derivertives and the simple carb nonsense that surrounded us growing up. Krill oil and algae supplements should be enough to rebalance your omegas but dont forget about gut health. Regards

      • Krill oil? Do you know how they harvest that and what impact it has on the oceans? Honestly this world is completely upside down!

  4. I’d have some respect for vegans and vegetarians if they weren’t so lame as human beings. All the preaching and moralizing and holier-than-thou posturing gets old REAL QUICK.

  5. Chris,

    A wise man once said that it’s so easy for propaganda to work and dissent to be mocked.

    Who says that Omega 3 fatty acids are even essential when sufficient Omega 6 fatty acids are consumed from raw whole foods?

    I’ve dried algae EPA/DHA supplements and my brain started to bleed. Says enough on the safety of Omega 3 supplements.

    I consume a plant only diet rich in Omega 6 fatty acids from whole foods with the magnesium; mainly from Hulled sesame seeds, sunflower seeds, hazelnuts, pistachios and rarely hemp hearts or other seeds with a good amount of ALA. My brain functions faster and my cursive hand writing is elegant and precise compared to the sloppy and illegible hand writing of those who consume a lot more Omega 3 fatty acids.

    Everything isn’t as black and white as everyone keeps writing.

    • Dear Essere, it appears that you really don’t understand the “omega-3/omega-6 fats” controversy, judging by your comment. We are not dealing here with “propaganda” NOT in the USA!
      May I suggest you look-up Dr. Mark Hyman (a US specialist on FATS) who has published several books on this topic and states the following:
      “Increased consummption of omega-6 oil, which are highly inflammatory to the body and unstable, has subsequentlly increased inflammatory diseases. Over-consumption of omega-6 and unter-consumption of omega-3 fats increases numerous health issues including CVD, type 2 diabetes, obesity, pre-diabetes, IBS, arthritis, astma, cancer and autoimmune diseases. Thats because omega-6 fats fuel your body’s inflammatory pathways and counteract the benefits and availability of anti-inflammatory omega-3 fats, creating even more diseases.”

      Dr. Hyman is talking about vegetable oils like soybean, sufflower, canola oils…but, you can gather your own info re. these and his recommended oils on: drhyman.com

      In fact, he states “consuming too many omega-6 fats also increases mental illness, suicide & homocide, studies show a connection to mental illness with inflammation in the brain.”

      You mentioned you had a STROKE from consuming too many omega-3 oils? They can be blood-thinning…but it depends on the QUANTITY of your intake. – Anything over or under-consumed can be detrimental to your health…even water!

      • Re-read my comment and your comment.

        ““Increased consumption of omega-6 *****OIL******, which are highly inflammatory to the body and unstable, has subsequently increased inflammatory diseases.”

        I don’t consume OILs.

        Fatty acids don’t cause inflammation. When fatty acids become oxidized from oxidizing agents such as oxygen or air pollution, they turn into lipid peroxides. Lipid peroxides found in vegetable oils cause inflammation and so does air pollution and many other toxins.

        I’ve never stated that I consume oils. I consume FRESH RAW WHOLE PLANT FOODS and take my time chewing my food.

        I tried taking 1 of the following capsules of Omega 3 supplement daily:

        EPA: 300mg, DHA: 500mg
        Total Omega-3: 835mg

        Definitely not a lot of Omega 3’s.

        NON-OXIDIZED Omega 6 fatty acids from fresh raw plant foods are superior and in time everyone will understand that we need non-oxidized Omega 6 fatty acids to repair our cells and prevent degeneration. Gingivitis is a sign of Omega 6 fatty acids deficiency since Omega 6 fatty acids are required to initiate the inflammatory response therefore our immune system can repair the damage caused by the toxins of the present messed up society.

  6. I am glad you mentioned:

    Why do vegetarians and vegans have lower levels of DHA than omnivores?

    Lower intake
    Reduced conversion

    Increasing intake has already been discussed: Nori seaweed does have EPA (see package direction, needs to be run over burner, turning green, before eaten) rather than just ALA, but ALA is rich in chia, flax, hemp, walnuts,

    And also found winter squash, whole soy, black lentils, cauliflower.

    AND… because omega-3’s compete with omega-6 for use in body, definitely eliminate all omega-6 oils, and prefer omega-3 rich nuts like walnuts, vs. cashew, and others high in omega-6’s.

  7. I am experiencing voice suppression of my very respectful and appropriate, but contrary views in your other vegetarian article comments section.

    An article written directly to someone like me, veganish thinking going 100 percent, is vegan for me or should I think twice? as your article title states.

    This happening amongst Americans who have a deep reverence and constitutional right to free speech is both sad and bothersome to me.

    Chris, if you do read most of the comments on your blog, is this what you want a blog, with your name on it, to represent? Respectful Contrary view voice suppression, right here in America in year 2016? I am hoping it is not.

    • D aka antonymous, how about a view on diets and an argument against veganism being contrary maximum health rather than a worry of having your views suppressed? Are you that feeble a character to worry about being confronted in a debate when a blog is exactly that, a debate with arguments for or against. Give me some science, some relevance to read instead of a sob story please. Vegans and veggies I hope you don’t keep pets and if you do, that you don’t try to turn them into herbivores as that is evil

      • What happened is I was trying to post in another section, and the moderators were not posting my comments- suppressing my voice, by either not posting or significantly delaying posting my comments.

        I do not think you would like not having what you posted, appropriate and respectful, but contrary comments, being delayed or disgarded, rather than being posted quickly for others to read.

  8. Well planned whole plant-based diets, legumes, whole grains, vegetables, fruits, omega 3 rich seeds, some seaweed, and B-12 including vegan are nutritionally complete (algal sups, may be a good idea for vegans, vegetarians (no fish) and definitely pregnant women in a SAFE dose) This diet pattern avoids many negative excesses: sodium, saturated fat, cholesterol (recently shown to “feed”/proliferate breast cancer cells, heme-iron, carnitine, choline, natural growth hormones, exogenous estrogen and other hormones…

    And no other diet seems able to compete with the 65+ grams of fiber including prebiotic fiber, such as resistant starch etc. and total antioxidants and other beneficial phytonutrients from whole plant foods as this one.

    One study, not sure how well done, and to be fair was a low study number 40+ people found significant reductions in thiamin, riboflavin, and calcium in a diet eliminating whole grains, dairy and legumes, but not limiting fruit.

    http://www.mdpi.com/2072-6643/8/5/314/htm

    If going low carb, and minimizing fruit, significant reductions in total potassium, magnesium, fiber and vitamin C is also likely.

    • 4 month study only so hard to back up? Not sure why fruit is relevant here when vegetables Trump them, no pun intended! They have more fibre vitamin’s and minerals than fruits. Legumes are carbs and reaching ketosis will be difficult with them featuring heavily in diet but you are staying on a glycemic system I guess

  9. For plant-based eaters, including vegan and vegetarians. This is one of the best articles from a vegan RD on omega-3’s.
    See link: http://www.veganhealth.org/articles/omega3

    It is important, particularly for pregnant women and lactating mothers to get enough DHA in their diet, including omnivore mothers. Natalie Portman changed her diet a bit to accommodate pregnancy and lactation. With algal DHA, it is easy to get without eating fish, and B-12 supplementation is critical, also. Talk to your doctor about dosage.

    Also, in addition to algal supplement, foods eaten by cultures thriving with very low intake of animal products may be a wise addition and include soaked chia seeds, copious greens, and winter squashes. Also, fermented whole organic soy like tofu, and a little seaweed. These foodshave omega-3’s and many other nutrients that likely help your body more efficiently convert, but will still be a small conversion, so.. think about taking out any junk, including the excess omega 6 fats in oils and peanut butter, and add plenty of foods listed and talk to doctor about dosing of algal supplement.

    But one caveat to Chris. Some things, though very likely does not apply to DHA, are actually better in lower amounts. Cannot always assume different/lower is bad. For example, lower, not excessive amounts of LDL cholesterol and heme iron in tissue (not iron in blood) is a good thing, found in plant based eaters, though once considered, not good in comparison to high levels in eaters of Western diets.

    • Just wanted to add, some new information, for me at least.

      Nori seaweed (used in sushi), which has more modest amounts of iodine, than other seaweeds, does have EPA. Though researchers, need more study in the area of omega-3’s, it may be sensible to assume that EPA would have much better, more efficient conversion to DHA than the ALA (alpha linoleic acid) in flax and chia.

      So, plant based dieters should be encouraged to eat a bit of Nori, rather than other excessively high iodine seaweeds, on a regular basis to POTENTIALLY raise DHA levels. Algal supplements can be used but, under supervision and approval of doctor. Algal supplements can thin blood too much and cause aberrant bleeding and easy bruising, you can get too much omega-3’s.

      Besides homemade sushi, I like to put just a few flakes in a stir fry, vegetable soup or miso soup.

  10. Chris Kresser is extremely poor at logic.

    (A) In all but one study I’ve seen, omnivores have the highest DHA levels, followed by vegetarians, followed by vegans.

    so what?

    (B) Conversion of ALA to EPA and DHA is inefficient: less than 5 to 10 percent for EPA and 2 to 5 percent for DHA.

    it’s not INEFFICIENT! it is what it is, just like the efficiency of a gas engine. the fact that it is “LOW” percentage wise does not imply something is wrong, or that people will be deficient.

    (C) DHA plays a crucial role in fetal and childhood brain development

    so what? that’s what breast milk is for

    conclusion?

    Therefore most vegetarians and vegans should supplement with preformed DHA to ensure adequate levels of this crucial fatty acid.

    what a bunch of garbage.

    the conclusion does not follow from the statements.

    • Our bodies are not gas engines my friend…
      low levels of DHA from vegetarian and vegan diets have been extensively demonstrated to be detrimental.
      And I sincerely hope that your brain haven’t stopped its development at the end of breastfeeding…
      Chris wrote an extensive article about ALL the shortcomings of vegetarians and vegan diets. DHA is only one aspect.
      Eme-iron, zinc, taurin, carnitine, B12, etc. are some of the others…
      the point is always the same here.
      you vegans are free and respected for your choice from my standpoint.
      I have vegan friends who say: “it’s my choice” and I respect it. They don’t push craps as fascist truth. Otoh the sectarian extremist fringe of veganism preachers of a biblic truth are just patetic

      • Talk about the pot calling the kettle black!
        You pretend to have respect for vegans and vegetarians, but 99% of your ubiquitous diatribe reflects exactly the opposite.

        • I just don’t have respect for bogus arguments to justify fascist campaigns toward meat eating when the evidence clearly shows all the other way around.
          I have huge respect for people who make their own choices without having to justify them with bogus biased claims.
          I apologize if my point has been misunderstood.
          If you are fine with a vegan diet good for you, but don’t try to sell it as the healthy and sustainable way, because it’s not the case

          • I am a vegetarian and perfectly happy with my diet thank you.
            I’m not selling anything to anyone, especially dubious supplements.

          • Sorry, but it is sustainable for the 100+ year old vegans from Loma Linda, CA, and, yes, they take a B-12 supplement. But you do too, at least, second hand.

            95% of farm production animals get B-12 supplemented in their grains/feed to pass B-12, to consumers. Their water and other means of B-12 extraction is gone due to our chlorinated treated water, and lack of dirty grass they used to be eating, a similar B-12 dilemma for modern day humans and primate relatives living in the zoo.

            Vegan cows, pigs, sheep, chimps, and humans are all taking B-12 supplements; this is all good. B-12 is important!

      • The only things vegans need to supplement with are B12, Iodine, DHA and vitamin D. What’s funny is most people who eat meat also need to supplement with B12, DHA and Vitamin D. Some vegan women need to supplement with iron, but so do some omnivores. From cleveland clinic, to pritikin, to Harvard Med, to WHO, a vegan died is the Healthiest diet on planet earth. all your opinions and blogs won’t change peer reviewed science.

        • Great post. It is so true. Omnivores are just as likely to need extra vitamin D and, if over 50, definitely B-12. Salt became iodized in America, because omnivores had low iodine levels in the Goiter belt! Many omnivores in the studies, not looking only at the averages, also had low DHA levels so you are spot on!

          Wish they would do routine DHA testing for plant-based eaters, so we could now how well we are converting, and whether fudging omega ratios is the key to increased conversion or what level of supplementation would be ideal.

        • Also, wanted to mention, that there is an opportunity for EPA in vegan diet, with modest rather than excessive levels of iodine- Nori seaweed, the type used to make sushi. Though research needs to be done, I believe, it is sensible that EPA from Nori seaweed would be more efficiently converted to DHA than ALA, and may be a great way for vegans and vegetarians to increase DHA levels.

          I put a couple Nori seaweed flakes in my miso, stir fry and veggie soup. Just follow package directions and cut off a bit with kitchen shears. It’s faster than homemade sushi and cheaper than always buying sushi at store.

      • Just for clarity, respectfully want to point out more is not always better.

        You said, ” Eme-iron, zinc, taurin, carnitine… etc. are some of the others…”

        Stating it is bad/unwanted for vegans/vegetarians to have these in less amounts. Cannot speak definitively for zinc, does not appear to be a problem, however, heme-iron and carnitine have been shown to have profound negative effects in excess.

        Carnitine, beyond what your body makes, ingested from food produces TMAO in gut which acts as a pro-oxidant and catalyst in atherosclerosis. A good article for those interested:

        https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3650111/

        Heme iron accumulation has been associated with a number of debilitating Western diseases including Alzheimers, diabetes, and cardiovascular disease. Some of the ill effects of too much iron, such as diabetes risk, have been known for decades in those with hemochromatosis, disease with loading excess heme iron.

        http://newsroom.ucla.edu/releases/ucla-study-suggests-that-iron-247864

        http://www.berkeleywellness.com/supplements/minerals/article/good-and-bad-iron

      • Want to respectfully point out that more is not always better.

        You said, heme-iron, taurine, carnitine as things better in larger amounts. But these in excess have significant negative effects in Western diseases including Alzheimers, atherosclerosis and diabetes.

        Excess carnitine, more than body produces, hits the gut and creates TMAO which acts as pro-oxidant and catalyst to atherosclerosis. Great article for those interested:

        https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3650111/

        Diabetes and cognitive risks of iron overload have been know for decades with persons with iron overload disorder, hemochromatosis and now, UCLA found iron overload as a key player in Alzheimer’s.

        http://www.berkeleywellness.com/supplements/minerals/article/good-and-bad-iron

      • B-12 is given to animals so you can get it too. Please do not shame plant-based eaters because they need to take B-12, you are getting a synthetic version via animal consumption, also.

        Carnitine and choline are not something that you want a lot of. Carnitine that you need is made by your body; it is not considered an essential nutrient. Choline and carnitine both create TMAO when they hit your gut, which is known to accelerate atherosclerosis, and recent study suggests, not good for kidneys either.

        https://consultqd.clevelandclinic.org/2015/02/gut-flora-dependent-tmao-new-studies-extend-its-reach-beyond-the-arteries-to-the-heart-and-kidneys/

        Besides the high levels of carnitine and choline in meat and eggs, the saturated fats will increase LDL-C, which are the building blocks of atherosclerotic plaque.

        Heme iron overload (too much heme iron) has demonstrated to increase risk of diabetes, particularly in post menopausal women.

        From article: women who consume too much heme iron (the kind found in animal foods) have as much as a 28% increased risk of developing Type 2 diabetes. This research, published last year, is based on a study of over 85,000 middle-aged women over a 20-year time frame. Another study from 2004 showed similar results: About 33,000 healthy women with high iron stores followed for 10 years had a significant increase in the incidence of Type 2 diabetes. (taken from Diabetes Self-Mananagemnt, 2007, March by Amy Campbell)

        This article is addressed to vegans and vegetarians; that’s why the plant-based eaters are here.

        • Deanna, I hate when tricky words like “excess” are used. Of course “excess” of anything is not good. Your eliminating meat and that is suboptimal for most.

          I know you mean well. but most long-term vegans appear clearly malnourished, and or pale complected. Even the experts.

          Not being rude it’s just a fact, were all just looking for a middle ground here. 84% of people return to meat. It’s a fact. Go look at that study too.

  11. Matthew Legge at atpscience.com claims the following:

    Turmeric helps to efficiently convert dietary omega 3 oil linolenic acid into the active DHA, resulting in elevated levels of DHA available! Fish oil is famous because it naturally contains DHA and vegetable sources of omega 3 are often less efficient because they have to convert linoleic acid to DHA; well turmeric enhances this conversion and makes dietary oils work better.

    http://atpscience.com/turmeric/

    I didn’t see any reference to studies to back up the claim but it sounds interesting.

  12. Hi there. I wanted to comment on your appearance on Joe Rogan’s podcast. First off, thank you for providing useful information on possible nutritional deficiencies among vegans and vegetarians. It seems to me after weighing all the nutritional information, that it does not take much for a vegan to be nutritionally complete and healthy. All it takes is a balanced diet and some supplementation, all of which is readily available in this day and age. So I am curious why you mentioned that you needed to bring animal foods back into your diet for health, while in the same breath acknowledging that it is possible to be very healthy without consuming animal products? It sounds like you defeated your own statement.

    Another thing I wanted to mention. I heard you and Joe make some defensive and comments about vegans questioning eating meat. So eating meat has had an evolutionary place in humanity. Understandable. But now we’re here. Evolution would also say that we have a biological drive to reproduce. Many people choose not to. We are highly conscious beings. We have the power to decide which way we want to take a step. We are not bound by instinct and habit, but they make for common excuses for behavior. Veganism is not about you or me. It’s not about having a diet. It’s not about an image. It’s about saving the world. Billions and billions and billions of animals from land and sea are enslaved beyond their worst nightmares to feed humans’ picky appetites. Meanwhile, animal agriculture shits in our rivers into our oceans creating dead zones. Rainforests are dying at 1-2 acres per second. 91% of Amazon rainforest deforestation is because of animal agriculture. And this is just the tip of the iceberg. I want to make it very clear that your claim to have sympathy and reasonable conclusion to eat animal products, makes NO actual change in the world. Speaking the word sympathy does not save any animals, or any trees, or any oceans. The world does not need more sympathy. The world needs more vegans. If you have really studied buddhism and meditation, you would know that any need for defensiveness and roundabout reasoning comes from the ego. If you really have practiced buddhism, look deeply into your own actions and intentions. That will tell you why you eat dead sentient beings. Take yourself out of the equation for a moment and take a look at the big picture. Nobody granted us the power or the right to enslave the world, we assumed that power. Every moment we have a choice. So don’t tell me about why yours is reasonable. Actions speak for themselves.

    And if anyone wants to mention that killing plants is wrong or that plants feel pain.. Tell me, since when did you care about plants? Humans have to eat. We all understand this. Can’t we eat the things that don’t have emotions and central nervous systems?

    • Actually, Chris is not convinced in any way about veganism.
      He’s just polite and since he runs a clinic where he also have vegan clients, he is just respectful of any choice and he tries to provide the best solution for anyone irrespective of their path.
      I was disappointed at first but then I understood that he has to do it to be balanced and over the parts due to his practice.
      I respect any choice either, but don’t sell that being vegan is environmental friendly neither toward yourself and the other animal.
      it breaks the natural chain and you’ll pay the bill at the end.
      grazing ruminants can restore the ecosystem and biodiversity, while agriculture is destroying the planet. That’s the apparent fact that can’t be denied. If you want to be vegan good for you anyway, it’s your choice but don’t sell it as the best choice otherwise people will bite back

      • I do NOT think it breaks the natural chain to be 95-100 percent plant based.
        Beyond America, Canada, Europe and Australia, humans have been very plant based. Many of these diets are 95-100 percent plant based, a few spots with insects being the main animal sourced foods.

        Because humans cook, and have amylase genes to produce amylase enzyme in saliva …nutritionally it is proven, you can get the nutrients you get in animal sourced foods, from cooked plant foods, with b12, and D fortification, also done in animal foods.

        Beans, tubers, whole grains, seeds and sea vegetables can replace most or all animal sourced foods.

        Hopefully, research will provide clear answers on DHA and conversion soon! So, those not eating fish, can make best decisions. Algal sups for pregnant and nursing Moms seems essential and wise, for both omnivore and plant based.

        Most people are eating domesticated v. Wild animals, so there really is no natural chain here. We can produce as much as we want, and I think this is part of the reason human health and health of planet have declined so rapidly.

        Additionally, anthropologists recognize humans and primates are actaually pretty low on chain. Many believe we were more scavengers in some areas and more insect or very small game (lizard, small bird) opportunists/hunters. We are much closer to chimps, orangutans and gorillas than lions. They are all very plant- based, close to 100 percent.

    • With all due respect, I have to disagree that vegans are going to save the world. The world will be here long after humans have destroyed it or it hits the reset button and destroys us. I don’t disagree with the fact that we are certainly screwing things up based on the need to feel and give shelter to the globe on a scale that has never been seen before, (factor in capitalism and greed on top of that, and that’s where things really get weird and complicated).

      Unfortunately there’s a price for all of this. If 7 billion people were to become vegans, we’d have a different set of food shortage problems, and also an unprecedented animal control problem. (I’m a vegan by the way). This discussion could go on for years with varying degrees of opinions. I don’t disagree that commercial fishing and factory farming are a huge problem. The only solution to this is for everyone to grow and\or hunt your own. Right now, I do neither, so I have to make a change myself and am just as much a part of the problem as anyone else. However, just speaking about 300+ million people in a capitalistic United States, how is everyone going to find time to grow their own garden and hunt their own meat while maintaining a 40 hour work week?

      I also know the whole argument of “there’s enough land to grow everything to feed everyone on the planet instead of feeding animals that we then eat”. The problem is that you would still have to do that commercially, which means a whole host of other problems. (Pesticides and a lack of enough crop farmers, just to scratch the surface of how to accomplish this.)

      As I’ve heard “someone” say before, and I agree, “Life Eats Life”.

      You mentioned at the bottom of your post: “And if anyone wants to mention that killing plants is wrong or that plants feel pain.. Tell me, since when did you care about plants? Humans have to eat. We all understand this. Can’t we eat the things that don’t have emotions and central nervous systems?”

      You said it yourself “Humans have to eat” That is most certainly correct…..and wee have to eat life. Again with all due respect, who are you to say that it can’t be anything with “emotions or a central nervous system” This stance is where things get very weird to distinguish what is edible and what is not. Also, when insinuations are made about vegans saving the world, IMO, that’s precisely the attitude and viewpoint as to why people sterotypically think vegans are pompous assholes.

      I don’t disagree with many of your other points amount how animals are treated to do these things commercially, but how are you going to change it? We have no idea of the long term evolutionary effects of synthetic supplementation in place of nutritionally dense, natural foods. Perhaps that is a path that would lead us to a different type of human experience\existance, I have no idea. However, there’s no denying that the consumption of meat is what got us to the point of where I’m typing this on a computer and sending it out over the air and others are reading my thoughts…..crazy!

      At the end of the day, to each his\her own. If you want to eat meat, eat it. If you want to be a vegan and supplement, do it. If you have the means to be a savage and hunt wild game, grow your own garden and plan for the apocalypse, DO THAT SH&T!

        • Actually, Tim’s comment is by far the greatest here out of hundreds and it’s very well balanced. This is the persons that I respect irrespective of their choices. He’s right when he says that if we go on reasoning with the old paradigma, whether we are paleo, vegans or something else, we’ll go nowere. As Einstein used to say, it’s not possible to solve a problem if you think in the same way that generated it. Until production economy will be our God, we’ll suffer and go on with destroying our health and our planet. It takes to change. Really.
          You see that most of you Vegans are distespectful extremists that directly go even against your fellows that don’t agree at 100%.
          You are like Geova preachers that rely on fake evidence or anedoctal fables. You can go around with claiming that you are a healthy superathlete, but none of us can verify if you are actually healthy, actually vegan or actually natural drug free. In this regard, I wouldn’t trust even in Paleo people that go out with these claims. It takes much more than fables and tales. It takes to complete a puzzle made of archeological and antropological evidence, comparative physiology, RCTs etc… that together make sense for the biological plausibility toward causation. If we just take one of these piece alone and try to sell a Bible, we are not reliable.

        • I’m really astonished at the idea: “you are not vegan because you don’t think like me, i.e follow the sectary dogma. Do you have rituals and sacrifice meat eaters?
          So far, I still haven’t heard such hostility among the paleo community, though there’s still a lot of debate.
          however, it’s useful because it perfectly enlights the sectary extremist organization of most vegans.

      • Hey, thank you for the reply. I wanted to clear a few things up. I did say that being vegan is about saving the world. It’s about being a part of saving the world. Its about taking it upon yourself to align your actions with common sense, peace, and your heart. I understand that being vegan alone is not going to save the world of all its problems, but I didn’t claim that. It’s funny how far down a tangent this discussion often strays. All the sudden were talking about problems that don’t exist yet. Right now, billions of animals are suffering. What’s my solution? Not eating animals. Whatever anyone predicts might happen if everyone stopped eating animals, is something to be dealt with quite a bit further down the road. I’m talking about whats happening right now, and what actions are helping the world right now. And yes, corporate business models and GMO’s are very important problems as well, but really, it’s not the main problem that being vegan is fighting. But somehow it always ends up as a way to discredit vegan actions.

        About plants, I am not telling people what they should or should not eat, what I’m saying is that we do not have to eat animals. It’s not required. We decided that we deserve to eat meat at the expense of another conscious beings’ birthrights. If you wanna play complete objectivity, if you believe that eating flesh is no worse than eating plants, why don’t we just start cooking humans then? We’re the ones so heavily overpopulating this planet. Were the ones fucking everything up. I’ll tell you why, because deep down, something feels off when we see another “blood relative” suffering or dying. We convince ourselves otherwise and are deeply conditioned feel indifferent. But that deep intution is there. Just look at the difference in treatment between pets and wild animals. The only differences are emotional attachment and emotional distance. If we spent time with cows and pigs, we would see that they are conscious beings with personalities and emotions, just like us.

        Look, animals are desperate for our help. They’re literally screaming. Lets cut all the bullshit and at least see that clearly.

      • Like the open mind to allowing people to make their own food choices and tolerance of diverse eating.

        My view, is I just wish kids, adults, everyone would have a better grasp of the positive and negative consequences of their food choices for personal health and the health of the environment.

        Knowing how wonderful greens are for are health (though too low in calories to be staples), why are we not growing them hydroponically and vertically everywhere- offices, schools, restaurant, they are so beautiful.

        And, many crops like sweet potatoes, peas, beans etc.. can be grown with so little space, fertilizer and pesticides and create a caloric and nutritionally rich option. Why are we not producing these en masse.

        When people know better, they do better. I just feel too many industries, are interfering with the massing knowing better and, thus, doing better.

  13. Hi Chris – I listen to Joe’s Podcast regularly. It’s such an entertaining, enlightening resource for me, (and I’m sure for millions of others). Anyway, your Podcast, was the first that I actually stopped to take notes on. I need to go back and do the same on the Dr. Rhonda Patrick podcasts. Such a wealth of scientific information from you two regarding diet and biochemistry.

    I’m currently a vegan, (2 years now), and was a vegetarian for 7 years previous to that.

    Like you and Joe covered, there are too many variables for me to take any kind of stand on ethical eating. I’m just looking to get the most nutritional value out of my diet that optimizes my body to its’ full potential.

    I’m actually considering introducing meat back into my diet, specifically fish to start so that I can get the good brain benefits of B12 and everything else that comes with it. I’m okay with supplementing and think it’s important, but my mindset has shifted a bit to the thought of if I can get it from food, why supplement unless I’m still lacking specific nutrients.

    However, I would like to consider having a full blood lipid profile done just to see where my current diet has me at.

    My “normal” food day consists of:

    Upon Awakening: Kombucha

    Breakfast: Coffee with 2 TBSP Coconut Butter, (no sugar)

    Mid-Morning: Roasted\Salted Pumpkin Seeds

    Late-Morning: Smoothie (Greens, Coconut Milk, Water, Various Fruits, Hemp Seeds, Flax or Chia Seeds, Goji Berries or Maca Powder (no sugar)

    Early Afternoon: Raw Veggies, (Carrots, Celery, Peppers, Tomatoes, Broccoli, Cucumber, with Guacamole and\or Baba Ganouj or Hummus)

    Mid-Afternoon: Unsalted Mixed Nuts, (Walnuts, Cashews, Almonds, Pistachios & Pine Nuts)

    Late Afternoon: Tea

    Dinner: Obviously this varies, but I gravitate toward some protein and vegetables, and try to incorporate something fermented (I.E. Tofu with Kim-chi or Bubbies Pickles)

    From here, I usually do intermittent fasting for about 13 to 15 hours.

    I take a B12 and Vitamin D3 supplement daily\weekly

    I feel like my diet is pretty decent. However some of my concerns are that I’m lacking something but don’t really know it and it may show up later. Some of these vegan\vegetarian foods in stores are just as processed as anything else and I’m thinking are probably not good for you. (Examples would be Tofu, Tofurky Dogs, Veggie Burgers, etc.). I buy mostly organic foods, but again, I’m gravitating toward wanting to get back to the most nutrient dense, least processed diet. I feel like I’m on a good path, but I’m always looking to improve and optimize.

    Any thoughts on the blood lipid profile or anything else for that matter?

    I’m not one of those overly sensitive vegans or folks who lose their mind when you critique their diet. I welcome it.

    Thanks for all the great information you give and for any insight you might provide here.

    • sounds like good stuff tim! I would TRY and introduce your fasting into your daily eating routine as practised by dominic d’agostino . I have been trying for a few months to eat like this, a big breakfast and a big dinner in this modified ketogenic diet. If I have to, I have a fatty snack for lunch, maybe (macadamias, eggs, fish +veg) to get me through, alongside a ketone supplement. I am able to get through the day without hunger if I eat enough for breakfast and I work outdoors heavy lifting and burn thousands of calories. Eating low carb high fat is expensive and needs organisation for sure but the simplicity of not having to snack with multiple meals is welcome for me. Breakfast is tricky, waking up earlier to give time to build an apetite. I have not looked at my blood since this effort but it feels logical eating like this, not putting stress on the system by eating often and I am enjoying the integrity and quality of this diet. Not missing the carbs too badly although there is some craving still. I am working hard on gut health, more mushrooms, lots of organic vegetables (large part of diet), and this turmeric sauerkraut they sell at the market which is a fixture in the fridge. My weekly diet will include; avocados,macadamias,chicken livers/hearts,organic beef steaks/chicken,mackerel,mussels,oysters,sourdough bread(in moderation),organic cheese,plenty organic salad and vegetables,sauerkraut,biodynamic eggs (3 per day min),lots of butter,avocado oil,hemp oil,mct oil. The best part of the podcast for me was reminder to eat organ meat more, just like the predators do, its so logical. If I can cram in more goodness into a smaller and compact meal, its feels beneficial. good luck with life

    • The best vegan resource, in my opinion, is Becoming Vegan written by long term vegans, and dietitians Brenda Davis and Ginny Messina. Very comprehensive. Check it out on Amazon

  14. Great information I have read in this article, I was trying to search some information about the importance of DHA in our body I found this article which proved helpful for me.
    Thank you for sharing such a great information.

  15. Wow! I love this information. Nutrient depletion in my vegan customers is always a concern of mine. I will link this to my customers for sure. In addition, I have had significant improvement in my patients that add the fats, A,D,E,K and DHA in mood disorders ie, depressive mood, major depression and even improvement in my ADHD patients with adequate DHA intake. Again, love the info and keep up the great work. I am very happy to have found you.

    • Despite having significantly lower intakes of EPA and DHA (from fish or fish oil), blood levels of EPA and DHA in vegans and vegetarians were approximately the same as regular fish eaters.

      The results indicate that the bodies of vegetarians and other non-fish-eaters can respond to a lack of dietary omega-3 EPA and DHA by increasing their ability to make them from omega-3 ALA.

      And as they said, “The implications of this study are that, if conversion of plant-based sources of n-3 PUFAs were … sufficient to maintain health, it could have significant consequences for public health …” (Welch AA et al. 2010).

    • Actually industry have little interest on advising animal food in a cereal grains based economy.
      This is the main reason why meat is continuously demonized, also because grain fed cows compete with humans for that junk to eat.
      Veganism is a perfect way to induce people to eat more grains.
      Indeed, ironically, vegans end up with eating far less vegetables than paleo dieters because of the grain-legumes based diet.

      • Beans and whole grains are less calorie dense than meat. So using these for protein, gives you more calories for vegetables, seeds etc…

      • Beans and whole grains are less calorie dense than meat. Getting protein from these gives more calorie budget for vegetables, seeds etc..

  16. Would adding bivalves to an otherwise vegan diet aid in avoiding having to supplement with DHA? If so, are there easy (ha-ha) ways or guidelines to know how they are sourced or brands/companies that can be trusted more than others? For example, buying frozen X versus fresh X.

    Thanks!

  17. I am mostly raw vegan for 7 years. Been through a super healthy pregnancy with no EPA DHA supplementation. Breastfeeding our 2.5 year old, who is super smart and developing well – height, weight, milestones. Actually even ahead of her age. It’s important to not consume too much Omega 6, which can negatively affect ALA to EPA and DHA conversion. I know hundreds of vegans who don’t supplement with Omegas and are thriving. Why do we need to have DHA similar to meat eaters anyway?

    • @Yulia. You make a good point. Maybe it is time they developed a different set of standards when testing vegetarians/vegans. About blood count – how is it that so many vegetarians feel good, look good, etc., yet are told their blood is “too low”?

      It is not a simple issue of what we eat, but of what we are able to digest and assimilate. It can get pretty complicated.

  18. I would like to know the difference of these two terms : vegetarians and vegans……thank you. And thank you very much for all the diet-knowledge you are sharing with your followers…God bless you…

      • This is correct. Vegans don’t eat any animal byproducts. This also would rule out any products that contain whey, casein, gelatin, cochineal, etc. There is quite a long list of foods/ingredients that are not compatible with a vegan diet.

        And if you want to get more complicated, ‘ethical vegans’ do not buy items that use animal products such as wool or animal hair, nor do they buy products that aren’t cruelty-free.

  19. One important point left out here is biological need.

    Maybe vegans just require less DHA?

    I can definitely see the need for smart supplementation in some cases – but we shouldn’t be working towards one rda for everyone. For example, we know that althetes need more water, electrolytes and calories – why shouldn’t this viewpoint extend to all nutrients and all lifestyle choices?

  20. I was vegetarian for a while in the late 1960’s and then I floated out of my body. It is very nice to know that I am not this body, but it scared the be-jesus out of me. My spiritual mentor said that I should eat some meat as meat is heavy enough to keep me anchored to my body. That worked.

  21. I’m not a vegan…but will pass your article on to one, who makes a lot of “food choices” that do not contribute to his health!

  22. I am shocked at this jumbled collection. Not up to the usual standard by any means.

    A few courses in statistics, how to interpret studies, etc are needed.

    • I would suggest rather than doing that. Pass on Becoming Vegan writteb by two world renowned vegan dietitians and the cover DHA needs.

      No vegan wants to get advice from someone shaming and disparaging their choice and …beans, cooked tubers and some grains are essential for plant proteins and calories. So they should not get advice from someone wanting to reduce those in diet to reduce your carbs- a recipe for disaster!

  23. To Chris Kresser: Would you please post a recommendation for an algal oil that would be high quality. I see these supplements in stores but never know what is a good one from a not-so-good one. Most fish oil supplements cause boils for me, as well as cod liver oil. I have tried several and have now decided to try algal oil. I would probably be low in DHA but have not been tested for that yet.

  24. Thanks for excellent science synthesis, Chris.

    In an article at veganhealth.org from 2014 there are warnings about negative health issues from too much ALA (pertaining to eye vision in particular). I have a patient, a 60 y o strictly vegetarian man with declining vision, which is why I am interested in this issue.

    What are your thoughts on negative effects of ALA per se?

    Article:
    http://www.veganhealth.org/articles/omega3#SumBenCon

    Excerpt from article:
    “If it weren’t for the (small chance) for potential eye problems, I would suggest either adding 3 g of ALA per day or taking DHA supplements. Because of the eye issues, that much ALA is not worth the risk when DHA supplements are available. I would still recommend adding about .5 g of ALA per day for its own benefits for heart disease and to help increase EPA levels. If using such small amounts of uncooked, plant sources of ALA the risk to the eyes should be minimal.”

    • The problem with consuming a lot of ALA as a means of reaching DHA targets is that most people are already eating large amounts of linoleic acid (LA), another polyunsaturated fat. These fats are highly unsaturated and susceptible to oxidative damage, and most studies have suggested limiting them to 7% of overall calories if possible.

      This is why it’s better to simply consume a smaller amount of pre-formed DHA than eating larger amounts of ALA.

  25. Hi Chris,

    Thank you for the article and consideration. I know you are big into paleo/ ancestral diet. I see nutrient deficiencies with most patients in my practice. When I first started practicing medicine 16 years ago, I didn’t address diet (because it’s a loaded topic- many levels, emotional being a big component). I wasn’t getting the health results I get now by addressing everyones diet. You add in sensitivities to food, toxic load, genetics, etc and it gets interesting. What I”m getting at- education is the best piece of this. There is no ideal diet out there, they all have their pitfalls. I think as medical professionals, it’s best (as you do), to educate folks about their choices. I’d like to see the tone of the discussion turned down. Yes vegetarians and vegans have to be aware of this along with B12 levels and absorption. Though I’d say EPA/DHA is lacking in the majority of peoples diets I see day to day. Thank you for what you do! Keep up the great work.

    • Totally agree, the tone feels very disrespectful to me.

      I would go so far as rewriting an edited, more respectful version.

  26. Two questions:

    1) Why is Alzheimers and dementia lower in vegans and vegetarians if they are sub optimal DHA?

    2) Do meat-eaters need more DHA because the meat is causing the dementia and Alzheimers?

    • 1) You can’t look at observational studies showing an *association* between lower incidence of dementia and Alzheimer’s in vegetarians and vegans and conclude that is a causal relationship. Observational studies don’t prove causality, and they can be very misleading because of something called the “healthy user bias”.

      I explain the healthy user bias in this article: https://chriskresser.com/why-you-should-think-twice-about-vegetarian-and-vegan-diets/

      “…is the scientific way of saying that people who engage in one behavior that is perceived as healthy (whether it is or not) are more likely to engage in other behaviors that are healthy. For example, vegetarians tend to be more health conscious on average than general population; they are less likely to smoke or drink excessively and more likely to exercise, eat fruits and vegetables and take care of themselves.” http://www.ncbi.nlm.nih.gov/pubmed/17411462/

      Fortunately, there have been studies that have attempted to control for this bias. For example, one study compared the mortality of people who shopped in health food stores (both vegetarians and omnivores) to people in the general population. This was a clever study design. People who shop in health food stores are more likely to be health conscious, regardless of whether they eat meat, which reduces the likelihood that the study results will be thrown off by the “healthy user bias”. What did the researchers find? Both vegetarians and omnivores in the health food store group lived longer than people in the general population—not surprising given their higher level of health consciousness—but there was no survival difference between vegetarians or omnivores. Nor was there any difference in rates of heart disease or stroke between the two groups. In other words, omnivores who are health conscious live just as long as vegetarians that are health conscious. http://www.ncbi.nlm.nih.gov/pubmed/8842068

      2) This become a moot point when my answer to #1 above is considered. Since consuming meat has been viewed as “unhealthy” for so many years, omnivores in observational studies showing a correlation between meat consumption and dementia/Alzheimer’s are more likely to smoke, be physically inactive, not eat fruits and vegetables, and engage in other behaviors that have been shown to increase the risk of cognitive decline. Therefore it’s impossible to say that the meat consumption is what’s causing the higher incidence of cognitive disorders.

      Given that animal products are the only source of B12 and DHA (outside of algae in the case of DHA), it’s in fact likely that B12 and/or DHA deficiency could contribute to Alzheimer’s/dementia, and may even be misdiagnosed as those conditions:
      B12
      http://www.ncbi.nlm.nih.gov/pubmed/15681626
      http://www.ncbi.nlm.nih.gov/pubmed/10589285
      http://www.ncbi.nlm.nih.gov/pubmed/11994220
      http://www.ncbi.nlm.nih.gov/pubmed/10713580
      http://www.ncbi.nlm.nih.gov/pubmed/7976784
      DHA
      http://www.ncbi.nlm.nih.gov/pubmed/9060973
      http://www.ncbi.nlm.nih.gov/pubmed/27358067
      http://www.clinicalnutritionjournal.com/article/S0261-5614(07)00189-6/abstract

      • B-12 deficiency could look a lot like Alzheimer’s, but lack of eating animal products is not to blame. The vast majority 95%+ of those with B-12 deficiencies are not from lack of eating animal products. So… will not be solved by trying to get people not to adopt vegetarian and vegan diets. The key is to get all people over 50 to take B-12 supplements and/or eat fortified foods, stop prescribing proton pump inhibitors, but rather change diets, as first line of treatment, and to quickly respond to food intolerances, such as lactose, gluten etc.. before GI disruption and dysbiosis occurs.

        And lowered DHA in AD, which has much higher prevalence in omnivore, does not prove causality. Heavy meat eaters population worldwide is actually much higher prevalence and the lowest known prevalence of AD in Ballabgrth,India was in a vegetarian population.

        AD is a vascular disease and the comorbity of atherosclerotic plaque in the brain, as well as comorbidity of hyperlipidemia in midlife and beyond is well documented. Also, well documented his iron accumulation in amyloid plaques.

  27. Dr. Kresser,

    Please supply a bibliography at the bottom of your informative articles so that one may follow up the references at leisure.

    If you believe that some of your readers would respond negatively to such documentation, please follow the practice of Dr. Mercola (mercola.com) and allow interested readers to display the bibliographic information with a single click.

    • Alexandra,

      As with every article I write, the references are listed at the end of each sentence, in numeral form, and they are hyperlinked. You can click on the number and go right to the study. This method is superior to a bibliography because it is clear what study relates to what claim I am making in the article.

  28. Deeply disappointed. I am 72, veggie/vegan and only rarely on a special occasion eat marine , and don’t ever consume fish oils. My health is very good. The arguments that veggie/vegans have less w-3 components in their bloodstream and tissues is believable. Low conversion from such things as flax seed oil is believable. Both outcomes are measurable and can rely on short term testing. However, the argument that we need supplementation or need to consume more fish in order to reach certain levels is based only short term studies, which are not at all consistent or conclusive, especially with respect to long term usage and health effects. I believe Chris suffers from confirmation bias. He should report on the many studies that conflict with his point of view if he is to be considered a scientist. Frankly, theories as espoused in the article absent conclusive data on long term effects (over many years) are not worth the paper they reside on, and can even be dangerous.. Look up yellow fat disease.

    • What many studies? I’m still waiting for someone to show me these. I have 40 citations in this article. All but one study I’ve seen reported higher levels of DHA in omnivores than vegetarians and vegans. All studies I’ve seen show low conversion of ALA to DHA. Most, if not all, studies I’ve seen show that ALA supplementation doesn’t lead to increases in serum or breast milk DHA that are equivalent to what DHA supplementation does.

      You are free to disagree, but your comments would carry more weight with readers if they were backed up by actual evidence, rather than general statements and ad hominem attacks of “confirmation bias”. When someone accuses another of confirmation bias, but prevents no evidence to support their view, who is guilty of the bias?

    • This is my concern too. The Cornucopia Institute has been trying to get this Martek Biosciences’ DHA off the approved organic list since it isn’t! And many quality supplement companies continue to use it in their products lines. Worse, baby infant formulae (except Baby’s Own) derive their plant based DHA from this algae source.

  29. My mother was a vegetarian when I was in the womb and breastfeeding for 2 years, right on the heels of her first pregnancy–no recovery time!. My studies in nutrition and health, it became clear, were about taking deeper charge of my health, to a good extent due to that. I was born with a short second third (nose) which later reversed probably from raw milk in childhood. I have spent a life, first just trying to survive, then succumbing to vegetarianism for enough years to intuitively push me back to selective meat consumption. For my northern Euro background, and hers, not eating meat has tricked downhill to land me with a host of issues that only after serious study on my own, I have mostly in hand.

  30. Chris, does your somewhat negative/cautious view of high dose (6g EPA/DHA per day) fish oil apply to people like me who are trying to control/reduce high Lipoprotein(a)? As far as I know high dose fish oil is one of the few therapies that at least has some data indicating that it can reduce Lpa, unlike statins or other traditional cholesterol lowering therapies that seem to have no impact. If high dose fish oil has more risk than benefit for Lpa, what do you think would be better?

    • That’s a good question. In my practice I’ve seen reductions of >40% of Lp(a) by addressing underlying mechanisms that contribute to dyslipidemia, such as GI pathology (SIBO, leaky gut, etc—even when the patient doesn’t have gut symptoms), thyroid hypofunction, chronic infections (like H. pylori), environmental toxicity (heavy metals), and metabolic dysfunction.

      Beyond that, there are new drug options like PCSK9 inhibitors and anti-sense that have a lot of promise.

      I would be uncomfortable with high-dose EPA & DHA supplementation *especially* for someone with high risk of CVD for the reasons I outlined in this article: https://chriskresser.com/should-you-really-be-taking-fish-oil/

      • Thanks Chris. Appreciate your views. Unfortunately, my history is that I already have CVD. Had an almost complete LAD block, angionplasty with stent placement, about 13 years ago (age 46), despite having fairly normal cholesterol, normal weight etc. About 5-6 years ago, through publications/sites like yours, I decided to go pretty much paleo, cutting way back on the grains/sugar and other inflammatory foods that I had been consuming for so long. Soon after, I accidentally discovered Lpa through a variety of resources like Davis’ Wheat Belly/Dayspring/Masterjohn etc., got tested and voila, finally discovered why a skinny, young guy almost died of CVD – high LDL particle counts exacerbated by inherited, high Lpa, plus systemic inflammation/gut dysbiosis due to an out of balance, relatively high carb diet.

        It was primarily Dr. Davis’ view on Lpa that convinced me that using high dose fish oil to reduce inflammation could be useful. So, I’ve been following this path, realizing that it’s probably not a silver bullet. I know that eating whole foods like sardines, salmon and lots of leafy greens/berries/other nutrient dense veggies is also important, in addition to trying to keep fit.

        Beyond watching my diet and doing CrossFit, I will surely follow drug developments like PCSK9 (IonisPharma Apo(a)?). I will also get my thyroid markers assessed along with my lipid particle counts shortly. We’ll see if the Lpa numbers are down after more than a year on the fish oil. If they aren’t maybe I’ll reassess my strategy and pull way bay on the fish oil. Not sure there is much else that people like me with known CVD can do.

        Thanks again for all your work re: diet, health etc. It played a critical role in helping me to finally get some kind of handle on my predicament.

  31. Unfortunately, you left one important factor out: the vegan DHA is made out of seaweed, and not fish (for obvious reasons). It is well established that the seaweed DHA is not the same form as the one found in fish (similar problem as retinol vs b.carotene, or active vs inactive B12, or heme vs non-heme iron). So getting seaweed DHA won’t actually help all that much. On top of that, vegan DHA supplements almost never have more than 500 mg of DHA, while they have bucketloads of EPA in these same pills. Omnivores have much better DHA pill options, with as high as 1000 mg, and 250 mg of EPA (EPA is not as good as DHA to have too much of). Bottom line, if veg*ns want to be truly healthy, they need fish-derived DHA supplements, not a vegan one. Which is something that won’t sit well with them, making the whole argument moot, since they won’t be convinced.

    • Eugenia, you missed a couple of important factors also:

      1. If you read the links I submitted, you see that vegans on average do a much better job of making their own DHA from the parent omega-3 (ALA) that they consume. So on average, they will need LESS supplementation than average omnivores.
      2. If you read Chris’s chart of the Eicosanoid cascade to see how DHA is derived in the human body you will discover that nobody, vegan or omnivore included, needs to start from the parent ALA to derive DHA. If a person has plenty of EPA, there is only one more step from that to derive DHA (notice Sprecher’s shunt). Thus the supplements that you say vegans often use are actually very close to supplying a lot of DHA, lacking only one more step of conversion. And again, if you read the links that I supplied elsewhere, you’ll see that vegans are very good at doing all the conversions in order to derive DHA. So supplements high in EPA are good things for vegans, right?

      I’ll mention one more thing. These studies worked with average “vegans” and average “omnivores”. No special diets to exclude excess and ruined omega-6 oils that hamper the conversions to DHA that this article is focused on. Get a test group together that actually cleans their diets of high ratios of omega-6 to omega-3 and who knows what nice conversions you might find, even in the vegans. So far, I haven’t seen a study that shows what truly healthy eaters accomplish to convert basic food to DHA, but considering how healthy, whole food is so remarkable generally, I rather think that humans astute enough to read this article are very likely doing just fine without supplements.

      BTW, I’m not a vegan, and I still take some supplements, though I am a bit afraid of supplemental omega-3 as it’s so hard to know the quality (rancidity) of a polyunsaturated oil supplement. One must be advised that DHA is about 3 times as perishable as parent omega-3, so anyone making or taking supplements better make sure they are consuming safe products, or they are worse off than ever.

      • Glenn, that is not entirely true. Young women are efficient converters of DHA (9% in one study), which makes sense given the evolutionary imperative. But men in that same study converted 0%. I think it’s crucial to understand these differences.

        I don’t believe the evidence is strong enough regarding differences is algal sources of DHA and fish sources. Studies have shown that algae supplements do increase serum levels of DHA.

    • Chris you disappoint me here…it’s a good think to be fair, but don’t claim that you may thrive in the long run with vegan diets…if nature, through evolutionary selection, made us carnivores-frugivores, you can be sure that in the long run you have deficiencies. Nature is a complex system of billions of variables working at the same time, and you dude know it perfectly. In light of that, supplements are not real food and you can never reach the amazing complexity of a real animal food through a supplemented vegan diet.
      If being fair means betraying the truth, I don’t want to be fair and you shouldn’t disguise the truth with an “half” lie to make the pill (vegan propaganda) less bitter.
      I appreciate your effort to be unbiased, but the vegan issue requires to be treaten with bias, because in this case we have all the reasons to be biased against it.
      That said, everyone should be free to decide for himself, but don’t sell that stuff to the others please. You have against the evolutionary and antropological evidence, rct, etc… Chris, if you claim to be an evolutionary based clinician, don’t feed the vegan dogma in any way.

    • How can you claim that one may be healthy in the long run in a vegan diet? Aside from DHA, What about B12, zinc, vitamin D, taurine, creatine, carnitine, bioavailable complete proteins?
      Do you think to supplement all of this stuff ignoring the food synergy crucial role? Food is so muuuuch more than A or B…and real animal food is much more than DHA or any other single compound taken alone. Chris, you should know it better than any other since you run an evolutionary based clinic. We evolved through selection to be carnivores-frugivores and humans can never thrive on a vegan diet on the long run.

      • I appreciate that you want to be unbiased and fair, but being fair toward vegan diets through half lies is going to ridiculize your practice.
        Have the guts to take strong positions since in this case we have evolutionary and antropological evidence, studies and direct evidence from vegan populations (indians for ex) about the nutritional disaster of vegan diets. It doesn’t fit with our evolutionary path, that’s all, and have the courage to say it.

        • So what about top vegan athletes who are clearly thriving? Many long term vegans are in excellent health…

          The evolutionary argument is stupid, since you are sitting in a warm, comfy house typing away on a computer. There are many things that are not part of the evolutionary path that we humans are using to enrich our lives…and even those people eating an ‘ancestral diet’ are eating very different foods to our ancestors. So please, allow Chris to do what he does best, which is supporting people’s health regardless of their personal belief systems.

      • RE, the comment: “…evolved through selection to be carnivores-frugivores and humans can never thrive on a vegan diet on the long run.”

        the, mostly vegetarian, population of India has doubled in less than 50 years -from 600 millio to 1.2+ billion.

      • “How can you claim that one may be healthy in the long run in a vegan diet? Aside from DHA, What about B12, zinc, vitamin D, taurine, creatine, carnitine, bioavailable complete proteins?”

        It is astonishing that someone still swallows the myth, created by agro industry, that plant proteins can’t be complete.

        Perhaps you would care to educate yourself. There are
        ample proteins in a plant based diet and complete ones.

        https://ndb.nal.usda.gov/ndb/
        http://michaelbluejay.com/veg/protein.html

            • To be sincere, I don’t like to force people and though I’m strongly against veganism, I agree to a certain point that we are getting less free.
              That said, you make cherry picking with a couple of very weak supporting articles, against the hubris of evidence you have for the other way. If this is not religious bias…

                • Are you aware about antinutrients?
                  This is getting very silly.
                  The digestive tract of animals reflects their ability to handle plant or animal proteins. Carnivores have shorter guts and they have to take proteins from animals, while herbivores have fermentative guts able to digest plant proteins. To be honest, even ruminants are not theoretically vegans, since they digest their gut bacteria as “animal” source.
                  You are denying the evidence of nature. If any animal is able to eat plants, why speciation occured?
                  Of course you vegans can’t understand it since your dogs and cats are vegan too.

                • All the grumpy mountain goats that you have consumed, have affected your grumpy levels. All the excess protein you are consuming is making you myopic and automatically dismissive of any other science to the contrary of what you believe.
                  I suggest less animal protein might level out your dogma.

                • You just love your myth. You were actually found out, when you used the term, complete protein, this nutritional clap trap has been roundly dismissed in the last decade as a myth, mostly created by vested interests. Your studies and knowledge are out of date,

                • Yes, the laws of nature are indeed outdated, and logic either. No need to argue anymore…this post is self commenting and perfectly enlights the vegan religions. We have to respect it as we respect the new religion to sake Maradona

                • As it happens I am a life long vegetarian. Your, almost religious dogma, and dismissive attitude regarding vegans is indeed also “self commenting”. No need to argue anymore? Good.

                • You always go on with mocking the others to have myths or outdated science while you are not able to provide any single reliable evidence to support your hypothesis.
                  You go on with linking vegan sites as sources, like they were bibles

              • “We don’t have herbivores digestive tract, thus we are not able to completely digest plant proteins.”

                This is an absurd argument. I can also make the same argument that we don’t have a carnivore’s digestive tract, which is actually closer to the truth. Our stomachs, intestines and colons are way closer to herbivores than carnivores. And omnivores tend to be closer to carnivores.

                Also, it depends on the plant protein. For example, unfermented soy is a indigestible protein. But in general, good forms of plant protein will be more easily digested than good forms of animal protein. In fact, to better digest animal protein it should be paired with non-starchy vegetables. Protein requires more acid and starches require a more alkaline digestion.

                Furthermore, high heat cooking methods of meat and animal protein ruin your ability to properly assimilate it because they form advanced glycated end products, which are difficult to metabolize.

                • If you compare our digestive tract is a middle way between carnivores and other primates. Are you aware about Leslie Aiello? We had to rely on meat to raise our big brains and our gut shrank as consequence.
                  You totally ignore the comparative physiology of animals, there are some good books about the argument, otherwise it just takes to read dr.Cordain’s articles about the issue. Why he’s not certainly a God and may be not 100% right on all, the comparative physiology and hunter gatherers studies are masterpieces.
                  anyway if you want I can give you some lessons about the issue…

                • COOKING of foods is the hypothesis we got bigger brains, which led to more nutrients and calories, and meat was suggested as the most likely food. Newer research points to starchy plants.
                  Are you aware of Dr. Karen Hardy’s research from last year?

                  As for physiology, the question is, have we fully adapted internal structures and metabolism that are in harmony with eating meat? I really found this fascinating and I truly thought it made sense that yes, we probably did to some degree, so I started looking at comparing our own anatomy, physiology, digestive capabilities with that of other omnivores, carnivores and herbivore/frugivores.

                  What you find is that omnivores and carnivores are generally 90%+ similar in these respects and herbivores/frugivores are likewise 90%+ similar. And when we analyze humans we find they fit the description closer to herbivores/frugivores. There is some pretty significant analysis for this in my opinion.

                  Omnivorous animals all share traits with carnivores. Such as intestines length, the smooth or rough nature of the gut (carnivores are smooth, ours are rough), the saliva content (carnivores have acidic saliva, ours doesn’t and ours only has digestive amylase in it), our teeth and the list goes on and on and on.

                  Just because humans can eat like omnivores, doesn’t mean we must therefore be omnivores. This is of course false because mere behavior doesn’t indicate suitability.

                  We can definitely survive on meat and that’s exactly what we did. However it’s a second rate meal that promoted disease and shorter lifespans, as it does today. When we started eating meat it is clear that we had weaker bones and disease. The ancient greeks even spoke of this. Have you read the Hippocratic writings or the works of Plato and Pythagoras who predicted the eventual decline in health due to usage of grains and meat in the diet? Yeah. They were the same “crackpots” who said “first do no harm.” Imagine that.

                • Thank you for this, very illuminating and indeed, a fascinating approach to this whole dilemma. Congratulations on presenting a balance of history, anatomy and most of all, without slagging off someone else’s belief system. Many thanks.

                • That cooking made us human is a very weak argument still when debunked by Cordain, and even Lieberman, ironically colleaugue of Wrangham, found that it was about slicing meat, not cooking tubers and veggies.
                  The curve of brain development was already at the exponential increment when we started to domesticate fire, thus it’s highly unlikely that it was about that.
                  and here’s the latest evidence
                  http://thepaleodiet.com/archeological-breakthrough-indicates-hominin-predecessors-were-sophisticated-hunters/

                • This isn’t “evidence” at all. Its conclusion references hunters and animal consumption. There is no proof that this consumption was a major part of the diet. Just that it occurred.

    • Is it possible that vegans are so stubborn in their beliefs because they don’t get enough DHA and EPA? Talking to a vegan is like talking to brick wall.

      This is called a positive feedback loop in engineering, or a vicious circle in common parlance. Not a good thing. It means that they cannot get out of their trap until they get much sicker.

      But that is just a theory.

      • Yeah, Bird. That MUST be it!

        That or you lack the intellectual stability to maintain a scientific discussion outside of your comfort zone, and your perception can’t handle it.

        But yeah, we’re all just stubborn individuals who’ve gone down the closed minded path of normal.

        • Oh, my goodness. All this hostility. Hostility is one of the symptoms of veganism. I love the fact that vegans have compassion for all animals but hate everyone who disagrees with them.

          • Given that you must have been talking to brick walls at some point, so as to have a comparison between them and vegans, might you be up for some alternative supplements? Ones that are able to help you distinguish between humans and brick walls?

      • Yes, indeed, there’s a cognitive decline with the lack of DHA and other crucial nutrients.
        It probably enworse their collective delirium.
        Maybe, since they are able to deny the evidence, they can claim to be healthy even in point of death.

        • It is time for some more Sicilian grumpy goat protein for you. Obviously you haven’t had enough animal in you recently, as your replies are losing their usual caustic sarcasm.

    • Comments from first-time commenters need to be approved first. I see that your comment appeared below after it was approved.

      The only comments we delete and do not publish are those that contain personal attacks and are not constructive or don’t add to the discussion in any way.

  32. “I summarized research indicating that vegetarians, and particularly vegans, have lower levels of EPA and DHA than omnivores” This is a quote from chris’s article.

    The fact that you *summarised* this and may or may not amend the information at a later date, might be borderline irrelevant to millions of people like myself.

    I have been a vegetarian all my life bar the first few years.
    I am over 60, full time gardener, cyclist, climber, walker, logger in winter, sailor and won’t be considering taking supplements at all.

    Although this is obviously anecdotal evidence and only pertinent to many millions like me, suggesting vegetarians and or vegans should supplement is, in my view, totally missing the point that millions of us vegetarians just don’t need them at all.

    If I can’t go by my own experiential evidence, which I would rather trust, than with the endless suggestions and recommendations of endless health practitioners, I should be taking, perhaps, dozens of supplements, none of which I need.

    My food suffices, even if yours doesn’t. This does not equate to you requiring supplements, on the contrary, it may require that as a consumer of any food regime at all, it is that which might be examined, before you are palmed off with something you just might not need at all.

    Those that just might, I wish you good luck with your choice of a replacement, in this world of charlatans and so called health suppliers, where barely a real, food grade supplement. exists.

    • Sorry you have all the answers. Must make life really boring.
      To be scientific, which is to be curious, is to be open to the world. If DHA is essential to the development of the brain and especially the retina of the neo-nate, then your attitude would put a large number of babies/people at significant risk. The kicker is that some people might make enough DHA from ALA by a mechanism or larger activity of that mechanism than we currently understand. There is precedent, finding some DHA even in people who eat foods that never went near an ocean. The consequences of being unable to make that conversion could make one surprisingly smug.

      I am a psychiatrist, and I have a small question. If you are doing so well, why are you reading Chris Kesser, and why would you mock others for trying to improve their health?

    • This comment is the perfect example of the saying “You can’t fight faith with facts.”

      This is why I never try to convince anyone that they should follow a particular diet. Most people don’t base their choices on facts; they base them on something else entirely.

      My job is to provide the evidence-based information. It’s up to each individual to do whatever they will with it. If the response is “none of that evidence applies to me”, well, there’s always the possibility that you’re correct, and I wish you the best.

      As I said in the article, there are differences in genetics and other factors that make it possible for some people on plant-based diets to be more efficient in converting precursor nutrients to their active forms, and that explains why some vegetarians and even vegans can thrive (though every vegan I know that is thriving does supplement).

      • Had you considered Chis, just for one moment, that your title for this topic, “Why Vegetarians and Vegans SHOULD Supplement with DHA” might have instead been.

        Why Vegetarians and Vegans MIGHT NEED to Supplement with DHA, you wouldn’t have to defend your stance when people tell you that they don’t need to supplement.

        What we SHOULD do is not for you to say.

        As for the FAITH quip, my experiential observations have nothing to do with faith, they are born out of experience.

      • Being able to deal in someway is not thriving. If you have to supplement, aside maybe from vitamin D and something to fix temporarily issues, it means that it doesn’t work. Because we are not cows or rabbits, we don’t have 4 stomachs, we don’t have very fermentative guts either. Even chimps are not vegan. Have you seen videos of chimps fighting for a prey? They are probably 90% plant based, but not vegan at 100%.
        And supplements are not real food.
        How can you say that they thrive?
        Based on a couple of blood markers in the short term?
        It takes much more as you perfectly know. No traditional population known was vegan. Okinawas and Kitavans ate less animal products, but far from being zero.
        We have to define HOW much someone is able to convert plant products.
        If you compare a man without hair with a half haired one, you can say that the latter has plenty of hair, but what happens when you take one with actually plenty of hair?

      • The most likely hypotesis is that we became humans thanks to meat consumption, otherwise our primate brain would never have grown.
        In light of that, we released the converting features getting more or less like cats in some metabolic patways. Thus, to thrive on a vegan diet, we should go back even at a previous step than chimps, since they are not vegan either, becoming another species, a farcry..

  33. Hi Chris. I have heard vegan Joel Furhman say that the optimum diet is a plant-based vegan diet with DHA supplementation. Is there room for agreement about that? Thanks so much

      • Thank you – you’re the best. This article is very helpful. I often get persuaded by the promises of a vegan diet so hopefully this keeps me on track.

        • Just keep in mind that your genes have been selected for millions of years from ancestors who eat meat and needed meat in order to survive. There were NO vegan paleolithic folks.

          • Fun fact: this isn’t the ice age. If you think your body or your food is the same, then you have a lot of reading ahead of you.

          • So true. What are your thoughts on the Blue Zones? This always stumps me – those folks eat little meat, eat lots of beans, legumes, whole grains. Also the 7 Day Adventist folks. Not paleo and living well and long. Thank you for your thoughts.

            • SDA’s aren’t into boozing, smoking and taking drugs for the main part. These are confounding factors for influencing longevity.

              • They actually did some studies within their group called the Adventist Health Studies. One of them showed:

                “-Reducing consumption of red and white meat was associated with a decrease of colon cancer.
                -Eating legumes was protective for colon cancer.
                -Eating nuts several times a week reduces the risk of heart attack by up to 50%.
                -Eating whole meal bread instead of white bread reduced non-fatal heart attack risk by 45%.
                -Drinking 5 or more glasses of water a day may reduce heart disease by 50%.
                -Men who had a high consumption of tomatoes reduced their risk of prostate cancer by 40%.
                -Drinking soy milk more than once daily may reduce prostate cancer by 70%.”

                SDA’s actually vary as to whether they are vegan, semi vegetarian, pesco vegetarian, or meat eater. This study showed that the non-meat eaters lived longer. And those who are strictly vegan tend to do even better than their nearly vegan counterparts.

                Vegetarian dietary patterns and mortality in Adventist Health Study 2.
                http://www.ncbi.nlm.nih.gov/pubmed/23836264
                “Vegetarian diets are associated with lower all-cause mortality and with some reductions in cause-specific mortality.”

            • They eat less meat, not zero meat!
              Furthermore, the book is a personal biased interpretation of fact.
              Indeed, traditional Okinawas ate pork and tubers, not rice.

              • I think you’re the one with personal bias. The traditional Okinawans ate about 1% of calories from fish and <1% from meat. They ate 12% from rice and almost 70% from sweet potatoes. If you think this is justification for consuming a lot of animal products then you're deluding yourself.

                Go to table 1 for diet breakdown.

                https://www.researchgate.net/publication/5859391_Caloric_Restriction_the_Traditional_Okinawan_Diet_and_Healthy_Aging_The_Diet_of_the_World's_Longest-Lived_People_and_Its_Potential_Impact_on_Morbidity_and_Life_Span

                The idea should be to focus on getting to the healthiest reasonable diet that is able to be adhered to. There's virtually no difference health wise from being 100% vegan vs. eating tons of plant foods and then having small amounts of animal foods, which make it easier to get a few nutrients here and there. Key word: SMALL.

                The groups that consume the least amount of animal products live the longest. The cultures that historically rely on much meat, eggs, milk and fat do most poorly. For example the Inuit, who in contrast have the lowest life expectancy and disease is rampant in their world, yes even their traditional and historic examples, eating 100% organic, unprocessed animal food.

                • Really interesting. Thank you John. I struggle with this information and I appreciate your thoughts. I feel my best on a “paleo” diet though I can’t stand that term and I get tired of the limited food choices.

                  But I do see that there are no real long term studies on longevity rates for paleo adherents but there are long term population studies that support very low if any animal consumption. That said I feel horrible on a low protein, higher carb diet like a Blue Zone diet. And I gain weight! What gives? Any advice for this? Thank you!

                • Don’t believe to scams…there is evidence from about 230 tribes of hunter gatherers, most of them getting more than 50% of their caloric intake from animal food.
                  all of them disease free…
                  Don’t listen to their delirium, I perfectly agree that under selective pressure someone may be more efficient to process vegetables stuff, but under the boundaries of a species.
                  thus, a race may do well with 20% of meat while others may need much more. Nobody vegan, neither chimps!!

                • Download for free the PDF of Hillard Kaplan’s work: A theory of human life history evolution…
                  don’t listen to weak vegan fables and tales

                • Indeed indians are so well adapted to a vegan diet that 70% have severe nutritional deficiencies…see my aforementioned link, directly from “times of India”.
                  And FAO is pushing fortified food to avoid malnutrition…and it’s not a matter of undernutrition as stated in their official documents

                • Hi again John – what are your thoughts on nutrient density – a Joel Furhman approach v an approach that Chris outlines above? Thank you!

                • What foods are you eating on paleo and what are you eating that makes you feel horrible? When that happens and you gain weight that sounds more like a processed american diet. When you eat whole plant-based foods, – veggies, fruits, legumes, and whole grains, you usually lose weight.

                  And I know how you feel about meat making you feel good. You are used to getting much of your calories in the form of protein/fat and so your body becomes used to this.

                • I eat a super clean mostly non starchy veggie diet on the Paleo plan. A little pastured meat and wild fish. Not much else. I feel great on this but its crazy boring. I enjoy ethnic foods and feel very persuaded by the Blue Zones/Joel Furhman way of eating (low protein, IGF-1 considerations, etc). When I eat a BZ kind of diet I am eating again super clean – lots of veggies, lots of beans, quinoa, hummus. I feel foggy headed, hungry, and bloated and I lose muscle.

                • Yes there indeed are cultures who remain/remained healthy on such high fat and meat based products. However, no culture which predominantly consumed high fats or meats as their staple has had any semblance of longevity.

                  As I said, the Inuit for example are notorious for short lifespans. Although they do not die of heart disease, or even cancer, very often…they do die as a general trend, much earlier (by decades) than surrounding populations. The traditional one’s lifespan was no longer than an average of 45-50 years. They didn’t live long enough to get cancer. But they do have very high rate of rheumatoid arthritis, systemic lupus erythematosus, connective tissue diseases, and the highest rate in the world of spondyloarthrosis.

                  Same goes for the Maasai in Africa. Short lifespans. They consume raw milk and meats. They also tend to get osteoporosis quite regularly.

                  And before you consume all that fat and meat, you should know the Inuit most likely have genetic adaptations that allowed them to do better on a high-fat diet.

                  The Secret To The Inuit High-Fat Diet May Be Good Genes
                  http://www.npr.org/sections/thesalt/2015/09/17/441169188/the-secret-to-the-inuit-high-fat-diet-may-be-good-genes

                • First of all, average lifespan is different from life expectance.
                  Almost all the hunter gatherers who didn’t die at birth or for an accident in childhood, lived as much as we do nowadays, but quite disease free.
                  Second, the Inuit example is an extreme one, and yes they had a selective pressure to handle such extreme conditions better.
                  They lack of sun exposure, etc..etc..
                  Nobody here is claiming to eat like a Inuit, also because it’s not possible here, and veggies for me are really important, I’m not a fan of very low carb diets either. Nevertheless, though the extreme meat eaters managed to live well, there’s no example of vegan tribe in human history.
                  They went from 20% to 99% of the caloric intake from animal food, but nobody without!

                • As for India, they are not vegan, about 30-40% of them are vegetarian. And that usually means they are lacto-vegetarians (eat dairy products such as milk, etc). I have no idea where you are getting your info from.

                  https://en.wikipedia.org/wiki/Vegetarianism_by_country#India

                  And you cannot categorize people like that. Most vegetarians/vegans are unhealthy and uninformed. They make choices solely based on animal cruelty. Which I find nothing wrong with, but they don’t understand nutrition at all.

                • I actually tend to take an approach very similar to Dr. Fuhrman, which is, I stress and promote a high micro-nutrient rich diet. Nutrient dense foods give you the most nutrients for the fewest amount of calories. Plant foods are the highest in this respect. This is best obtained with a plant-based diet high in raw foods, berries, dark leafy greens and cruciferous veggies and fresh fruits as a base. The foods I cook tend to be starchy veggies and occasionally I’ll eat salmon or shrimp but that’s rare. I avoid dairy of any kind and refined grains. You don’t have to do that exactly, as many PBD doctors allow fish and low fat dairy (Ornish), eggs (Fuhrman) or even some meat on occasion (McDougall) etc.

                  Organ meats? Are we predators? The wild animals that go for organ meats are predators, not omnivores. And of those, ALL of them have the ability to for instance detox active vitamin A. And get rid of excess cholesterol. Humans cannot do this. It’s a moot point.

                  The low carb crowd constantly uses the notion that these animal foods represent “nutrient dense” calories. But they never mention WHICH nutrients. Yes they are high in vitamin A. So high, in fact, that you can get too much. Yes they are high in iron, so much so, that you can get too much. Yes high in saturated fat, so much so that you can get too much.

                  Kresser even mentions in the video that there had to be all kinds of caveats to put organ meats at the top. Calories, saturated fat, sodium… yes these are things you don’t want too much of. And then fruits and vegetables would be way higher if you didn’t remove, oh you know, PHYTOCHEMICALS and ANTIOXIDANTS. I guess Robb Wolf doesn’t think these are that important. They are very important and guess what foods have low levels, if not nonexistent levels of antioxidants? ANIMAL FOODS. Which is why they need to be eaten raw, on the spot. You kill it, you eat it immediately and you eat the blood, the liver, the stomach, and some of the muscle as well. You don’t store it, cook it later, salt it, season it, etc.

                  But yes if you’re gonna eat meat, eat organ meats, because what most people eat is the muscle, which is the most nutrient POOR, and the most likely to have all kinds of pesticides, herbicides, antibiotics etc in it. Most of the time there’s no reason to because virtually every single mineral, vitamin, compound that we can get from meat, we can get from plant foods. If you are deficient in something, then yeah a little bit of animal foods may help with things like b12 and some other nutrients. Or you could just supplement.

                • Please for nutrient density take the table that Lalonde made a while back.
                  The delirium is reaching its top…
                  If you want to be a prey, good for you, I’m a predator, carnivore frugivore like bears and boars.
                  beware of the predators when you are grazing!

                • Christy- It’s hard to diagnose the problem but you basically are gonna have to do a trial and error. The bloating is most likely caused by eating a lot of beans. The way to prevent this is soaking the beans. Google it to find out more.

                  You could also have a food allergy to grains for instance and might wanna get tested. Some people can have wheat allergy, gluten can be very harmful in celiac patients, and there are potential drawbacks of some grains some of the time. All the more reason to figure out which is bad and which is OK for you. For the vast majority of people, whole grains are perfectly fine and perfectly healthy. And great sources of fiber, vitamins, minerals, etc.

                  It also sounds like an issue of carbs. You are not getting enough carbs, and more importantly calories/energy. You will feel more satiated consuming meat and fat. Plant foods are less calorie dense (especially veggies).

                  So you WILL have to increase your portion sizes a great deal for certain plant foods in comparison to the other foods, BUT it’s kind of like a visual illusion because it’s mostly water volume (which is absolutely necessary btw, and a good thing). It just makes it appear as though there is more volume being eaten.

                  This is a problem because many people respond to portion sizes, not just calories. And this is why it’s easy to lose weight on raw foods. You eat a plate full of fruits and veggies and mentally you feel like you should have just gotten the same calories as a plate full of steak and potatoes. Not so. You would need 2-3x more food to equal it with raw food.

                  Also, if your goal is a variety of foods then you may have to sacrifice health to some degree. But you can stick with the healthiest plant foods that are more calorie dense – fruits, starchy veggies (potatoes etc), nuts, seeds, legumes, and whole grains.

                • Yes life expectancy is obviously more important. But our early human ancestors were not eating lots of meat.
                  “Human Ancestors Were Nearly All Vegetarians” -Scientific American

                  Depending on which arbitrary period you decide to choose to zero in on, yes you can find periods of time where our ancestors were eating more animal foods. These were times of scarcity. Obtaining animal foods is always much more risky and unpredictable than gathering and foraging. And this was our default. Our bodies resemble this. Our physiology corresponds to this.

                  “there’s no example of vegan tribe in human history.”

                  This is not a question that actually wants an answer. This is intended to be a conversation closer. Question asked when one has formed their opinions before examining the evidence. But no I am not aware of any indigenous tribe or culture that has relied solely on a vegan diet.

                  If we are interested in the merits of vegan diets however, or just plant based diets in general, the questions would be quite different. For instance “as any given culture’s diet more closely approximates a plant-predominated intake, do they live longer and have better health?” The answer to that is a resounding and loud yes.

                  Once again, the longest lived culture we know of is the traditional Okinawans in the early 1900’s. That link you posted was describing the more MODERN Okinawans in the 1970’s. They indeed did eat pork but you forgot this part:
                  “However, pork is primarily only eaten at monthly festivals and the daily diet is almost entirely plant based.[7]”
                  They have been becoming more modern over the years. Today they are the fattest of the Japanese and now have KFC’s. Lol.

                  Anyway, when we ask about if any culture was 100% vegan the answer is absolutely 100% no. Animal food does have nutrients and obviously calories. So it represents an option. Especially in times of scarcity. But the big picture look at things reveals that the less of that we eat the better. As I said, interesting studies on 7th day Adventists corroborate this.

                  I hope you get my point though. No, not everyone needs to be vegan. Just like not everyone needs to abstain from alcohol 100%. Just all I am asking is that we don’t go around trying to justify drinking alcohol as though it’s good for us in terms of health. And likewise with nutrition. Nutrition is a science, it’s not an opinion poll.

                  That doesn’t mean there isn’t individual variability. There is. Lots of it. But I see most people interested in using that phrase as again, an excuse to end discussion, not clarify it.

              • In fact, many SDA’s eat no meat at all including 102 year old, Dr. Ellmsworth Wareham, who was still performing surgical rounds at age 95.

  34. Thanks for this insight into the importance of DHA, and the almost certain shortage that vegetarians an vegans may suffer, Chris.
    I want to add that, from my recent studies, the vegan body seems to be aware of this shortage, and takes great pains to derive as much DHA as possible from the ALA that is provided. That doesn’t mean there may not still be a shortage at times, even usually. It does mean however that the human body senses what it needs, and does convert ALA to DHA in higher percentages than you will find in a typical “omnivore”. There are studies that show vegans routinely having double the conversion rate of omnivores.

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3257695/

    http://www.nutraingredients-usa.com/Research/Omega-3-ALA-intakes-enough-for-EPA-DPA-levels-for-non-fish-eaters

    Notice in the second article, vegans actually ended up with more DHA circulating in the plasma than any omnivore group, even though their intake was zero.

    You might want to review the information from these studies for validity and possibly use some of it to enhance your “Reduced Conversion” section of this article.

    • At the end of the day what matters most is the average levels of DHA in serum amongst omnivores vs. vegetarians and vegans. Everything else is just speculation on mechanisms. And what the studies clearly show is that in virtually all populations omnivores have higher levels, and that DHA intakes are likely below the optimal levels in vegetarians and vegans.

      The studies you linked to only further highlight the importance—and perhaps essentiality—of DHA. If someone isn’t consuming it, the body will do everything it can to accelerate conversion of ALA. Likewise, women are better converters than men because DHA is so crucial for fetal development that women have evolved to be more efficient at this process. Note that this is only true for *young* women, which strengthens the argument that this is an evolutionary mechanism.

      • I recall that many anthropologists claim, with no dietary political ax to grind presumably, that human beings could not have developed such a big brain if they had not first learned how to obtain sufficient animal-based food.

        I hear the call of compassion, so I eat as low on the animal evolutionary ladder as possible, like fish. And I have no compassion problem with milk and eggs. I buy eggs from a free range farmer dude who brings the four cartons per week (for 3 people and 2 dogs) to my door. These chickens are loved and would never see the light of day if we did not eat their eggs. Same with milk and honey. But compassion demands that I do not give human beings a hard time if they put beef or pork in front of me and expect me to eat it.

        • Do you have compassion for plants. They are living beings as well and the latest studies shown that they do suffer when you eat them.
          At this point you can try with stones or maybe soon vegans will be able to complete the photosynthesis, since they can evolve quickly 🙂

              • you claimed in your previous post that

                “latest studies shown that they vegetables) do suffer when you eat them.”

                I pointed out that my vegetables don’t suffer when I eat them, for obvious reasons.

                Your studies are either inaccurate, misquoted or misrepresented.; as it is untrue that my vegetables suffer when I eat them.

                May I suggest you look at studies that understand grammar and sentence structure. This way they won’t appear flawed.

                Your steak is none of my concern.

        • I addressed this in the article. There is plenty of evidence showing that higher DHA levels are associated with better outcomes in terms of cognitive, neurological, and cardiovascular health.

          It’s easy to cherry-pick a single study that supports your view.

          • Right, but I think you are making a leap and assuming just because higher levels are better for the general population (maybe they need more) and vegetarians tend to have lower levels than omnivores, that means “DHA intakes are likely below the optimal levels in vegetarians and vegans.”

            I think you would need evidence that vegetarians (not just the general population) are negatively affected by lower intake, especially since they tend to have better cognitive, neurological, and cardiovascular health than omnivores (yes I know there are other confounding factors).

            If I’m cherry picking, please link studies showing that vegetarians have adverse effects with lower DHA intake.

          • I think that serum levels may also be misleading.
            What about the actual amount properly embedded in cellular membranes.
            We have to choose given the evolutionary and antropological evidence TOGETHER with trials, to make a puzzle, not cherry picking.

  35. Thank you for this article. I’m interested to also know what other deficiencies might be lurking in a vegan diet. i used to be vegan but am now experimenting with Paleo. Are legumes such a problem eg hummous? I keep off soya now. But what about pea protein?
    My further question for you other readers is could a vegan who is crabby, rigid and argumentative be suffering brain inflammation due to insufficient DHA?

    • Hi Tara,

      Check this article out which reviews the potential nutrient deficiencies on a vegetarian/vegan diet. https://chriskresser.com/why-you-should-think-twice-about-vegetarian-and-vegan-diets/

      I can tell you from my clinical experience having treated hundreds of patients, that nutrient deficiency is definitely more common in people on plant-based diets, though of course it can still happen in omnivores (especially when gastrointestinal malabsorption is present).

      And yes, I think it’s possible that a lack of B12 and/or DHA, along with other nutrients like iron and zinc, can adversely affect cognitive function and mood.

      • With all due respect, your small practice cannot be generalized in the general population.

        I do think think we are experiencing a problem with people being raised on very animal-based/centered diets, going plant-based without any real nutrition education at school or from parents that help them.

        Living in Bay area, at one time, amongst many traditional (from childhood) plant-based eaters, here in US working with visas, from a variety of countries: China, India, Africa, Denmark, etc…

        These eaters knew instinctively what to eat by cultural norms. Their traditional meals always included plentiful amounts of legumes (beans, lentils, peas, fermented soy) paired with whole grains and some starchy veggies. These cultures also include seeds and nuts and, things like seaweed (source of EPA), and yes, sometimes eggs, fish, chicken were used like condiments added to dish, not served as the entree, beef and dairy not on the menu.

        Legumes, grains, starchy vegetables are the staples of a plant-based diet for calories and protein; the vegetables and fruits provide lots of nutrients, but not the bulk of the calories, b-vitamins, zinc, etc. .

        It is sad that the vegan parents mentioned on this site, with undernourished, kids. If it is the case I am aware of, the parents were trying to be healthy by feeding their kids tons of fruits and vegetables; they did not have the knowledge from their own health class in school or from pediatrician or traditional plant-based eaters or other resources, on the need for legumes, grains, starchy vegetables and sources of omega-3’s, such as seaweed, chia seeds, flax seeds and flax oils for plant-based including vegan diets. We need education in schools about all diet types, people might experience as adults!!!

        What, at least the EPIC Oxford Study shows, with tens of thousands of people studied, vs. your client pool is vegans were not getting RDA for calcium, iodine, and B-12. ( I don’t believe they tested blood DHA levels in this particular nutrient study).

        So I would shout out to plant based eaters, like me, to take your B-12, eat your chia seeds, bok choy, broccoli, lucinato kale (tasted better than curly) and collard greens (cook them and try splash balsamic vinegar-won’t regret it!), fortified plant milk, and iodized salt and nori seaweed (add it to stir fries, soups, homemade veggie burgers…) for iodine or take supplement in safe amount-see vegan sources like Brenda, Davis, vegan dietitian.

        Nori seaweed can also up your EPA, only one step away from DHA and also adds iodine, or with green light from doctor an algal supplement at SAFE dose.

        For omnivores, they did not meet RDA for these nutrients: calcium, iodine, magnesium, vitamin C, vitamin E, calcium fiber and folate.

        A recent study of those on a Paleo diet, Paleo dieters had low levels of riboflavin, thiamin and calcium. Also, if going low carb (reducing fruits, legumes and grains) will also give you much decreased intake of magnesium, fiber, resistant starches, pectin and vitamin C.

        http://nutritionfacts.org/video/omnivore-vs-vegan-nutrient-deficiencies-2/

        https://mic.com/articles/146162/paleo-diet-may-be-linked-to-major-nutritional-deficiencies#.Q8GIjou

        • From memory the article said the paleo folks were just under the RDI for thiamine at around .9 versus 1.1, and a bit over the RD1 for riboflavin (which is found in dairy products). I’ll keep eating my vegemite. 10g or 2 servings/day should do it.

    • “could a vegan who is crabby, rigid and argumentative be suffering brain inflammation due to insufficient DHA?”

      Perhaps you are crabby, rigid and argumentative simply because that is in your nature to be so.

      • “just your nature” has no meaning. A person with a crabby personality with determination can build new pathways in their brain for a cheerful, friendly, etc. personality. And it is easier if they get the right nutrients. So, one’s nature is dependent upon the choices and actions that one has made in the past, and they can change their nature by practicing different choices.

        • No one is saying they can’t. Except that you have chosen to infer, that which I have not implied.

          Her biography may well have become her biology, no one said she couldn’t change it, or her nature, which, to some, has meaning, even if not for you.

    • Alright, i have a huge list of references to go along with this but i will only post the individual nutrients themselves because my whole copy and post (which i wrote myself, not a rip) is 1000 words long, i can post it if you want me to but i would prefer to not. Anyways there is Calcium, Vitamin b12,
      Choline, Glycine (semi essential), iron and zinc (both are poorly absorbed from plants) Creatine, dha,
      Taurine (conditionally essential), k2 and vitamin a (several people dont convert provitamin a carotinoids well, beta carotene metabolites also have anti vitamin a properties so the poor conversion may actually have poorer effects. IMO, beta carotene and retinol have different benefits so its a good idea to get both)

  36. i would be interested know peoples thoughts on a few things i read along the lines that…
    DHA is best when in the “sn-2” position (basically the middle of a triacylglycerol or phospholipid).
    eg. from here; caloriesproper.com/vegetable-oil-fatty-acids-are-not-essential/
    1) DHA is more stable in this position (eg, Wijesundera et al., 2008).
    2) It’s more bioavailable here (eg, Christensen et al., 1995).
    3) sn-2-DHA is more effectively incorporated into brain lipids (eg, Thies et al., 1994 and Lagarde et al., 2001). Again, it’s not all-or-nothing, but more is likely gonna get in your brain if you eat seafood.

    I have also read ~ ‘DHA in the sn-2 position in phosphoglycerides is the predominant form in mother’s milk. It is the form that is required for optimal brain development in nursing infants’

    • also for the same caloriesproper.com site;

      “This [DHA in sn-2 position] is how DHA is present in seafood but not always in fish oil supps (eg, Litchfield 1968 and Ando et al., 1996).”

  37. I enjoyed this article. I am an omnivore and eat the fish that you recommend. Good to reinforce that I am on the right track. My health has been excellent and has gotten much better since I started that fish eating regime

    • Continuing.. Especially my HDLs which shyrocketed from 42 to 64.. Would be related to eating more fatty fish or could also be related to my losing 30 pounds :-). Not sure. Chris, do you have input to this.. Just curious

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