Health & Fitness

Why veganism may help your heart

Dr. Athanassios Tsoukas, a cardiologist with Miami Cardiac & Vascular Institute at Baptist Health who eats a mostly vegan diet.
Dr. Athanassios Tsoukas, a cardiologist with Miami Cardiac & Vascular Institute at Baptist Health who eats a mostly vegan diet.

In less than a decade, a vegan diet has gone from far-out to fashionable. Former President Bill Clinton, Natalie Portman, Ellen DeGeneres and Woody Harrelson have all helped put veganism in the spotlight.

The now trendy diet has long been linked to the animal rights movement, excluding meat, eggs and dairy products and foods that contain those ingredients. Many extend veganism to go beyond food. They also avoid clothing like leather, fur or wool and personal and household products tested on animals.

“Veganism can be pretty extreme,” said Sheah Rarback, a registered dietitian on the faculty of the University of Miami Miller School of Medicine and a Miami Herald columnist. “It’s not eating anything that has a face or a mother. I’ve heard my patients refer to it that way.”

Proponents now call veganism a lifestyle movement, touting benefits like improving heart health and diabetes and lowering obesity, aside from ethical and environmental considerations.

In a July 2012 Gallup poll on diets, 2 percent of Americans — about 6 million people — responded that they were vegans. It was the first time the poll had asked the question.

Since that time, a growing number of millennials have embraced the diet, but it’s also reaching a broader, cross-generational group.

“Eight or nine years ago, you’d be hard-pressed to find a vegan restaurant in Miami,” said Dr. Athanassios Tsoukas, a cardiologist with Miami Cardiac & Vascular Institute at Baptist Health, who eats a mostly vegan diet. “Now there’s a vegan option in most restaurants. It has to do with the public requesting it.

“But I have a disclaimer that I’m not a strict vegan,” Tsoukas said. “I eat fish once or twice a month or sometimes once a week. I was born in Greece, so when we celebrate Greek history, it’s impossible not to eat lamb.”

Still, Tsoukas said he has primarily chosen a regimen of plant-based foods since he began changing his diet about eight years ago.

“I started leaving out red meat, then came chicken and then eggs and milk,” he said. ”I left out foods one by one.”

Tsoukas also found that he was more flexible during yoga when he didn’t eat meat. The yoga helped him when he experienced lower back problems from years working as a vascular surgeon. He also dropped 30 pounds, though he wasn’t trying to lose weight.

“The diet helped my well-being,” Tsoukas said.

As he began exploring veganism, the cardiologist was impressed by conclusions he read In “The China Study,” by Drs. T. Colin Campbell and Thomas Campbell, who detailed the connection between nutrition and heart disease, diabetes and cancer. Their book, based on studies conducted in rural China and urban Taiwan, found that people who ate more of a plant-based diet seemed to have less coronary disease and less cancer.

“These were significant conclusions,” Tsoukas said.

One bonus of being on a specific diet like veganism is that “It’s a good way to become thoughtful about what you’re eating,” said Dr. Nanette Bishopric, a University of Miami Health System cardiologist and director of the cardiac intensive care unit. “I think we all agree that we must do a better job educating people how and what to eat.”

As veganism becomes more popular, cardiologists and nutritionists note there are pros and cons.

“As with any other eating pattern, you can be a pretty healthy vegan or you can eat white rice and corn all day and still be a vegan but you would be missing a lot of nutrients,” Rarback said. “You have to plan to get the benefits.”

Experts said the benefits of veganism include:

▪ High fiber. A plant-based diet is usually higher in dietary fiber, which can help reduce the risk for diabetes, said Rarback. “It’s giving your gut great fiber to help feed the good bacteria.”

▪ It may help reduce chronic heart disease “depending on what you eat,” said Lucette Talamas, a dietitian with Baptist Health. A diet of wholesome foods is loaded with antioxidants, and reducing saturated fats can help control blood cholesterol levels.

▪ If you’re eating a lot of fruits and vegetables, you’re getting a lot of potassium and you’re going to help control blood pressure, Rarback said. “There are probably benefits of eating vegetables that we haven’t even identified yet.”

▪ A 2009 position paper by the American Dietetic Association stated that “appropriately planned vegetarian diets, including total vegetarian or vegan diets, are healthful, nutritionally adequate, and may provide health benefits in the prevention and treatment of certain diseases.”

▪ Vegetarian eating is linked with a decreased risk of death from ischemic heart disease, according to the dietetic association report, which also found that people who eat a vegetarian diet tend to have lower LDL levels and lower rates of hypertension and Type 2 diabetes, compared with non-vegetarians.

While benefits of a vegan diet can “help reduce the risk” for heart problems and diabetes, Rarback said, it’s just one part of the picture, along with genetics, exercise, stress level and sleep patterns. “It’s the whole lifestyle.”

“You can do all those things without being vegan,” she said. “Everyone, whether vegan or vegetarian or a regular omnivore, should make about three-fourths of their diet plant-based foods. Everyone should eat five or more servings of fruits and vegetables per day, eat whole grains.’’

Portion control is also a crucial part of any diet, said Bishopric.

“A staggering percent of U.S. adults are overweight or obese,” she said. “It’s really scandalous that childhood obesity has skyrocketed.”

A Centers for Disease Control and Prevention report released in October showed that almost 40 percent of Amercian adults and nearly 20 percent of adolescents were obese from 2015 to 2016.

Vegans often report losing weight during the diet, but “it comes down to eating a healthy pattern of food,” Talamas said. “French fries and potato chips are vegan.”

Committing to a more challenging diet isn’t an easy path, said both medical professionals and vegans.

“Being a vegan poses a lot of challenges,” Bishopric said.

She should know. Her 26-year-old daughter, Julia Webster, has been a vegan since August 2016.

“I strongly recommend someone try it for a month and see how they like it,” said Webster, a University of Miami graduate who’s a researcher in California when she’s not traveling the world.

Julia Webster, 26, a University of Miami graduate who is a researcher in California, has been a vegan since August 2016. “I strongly recommend someone try it for a month and see how they like it,” she said.

Webster said she began “dancing around a vegetarian diet” for some time before she went vegan.

“I was going to try a vegan diet every other month but after two weeks, I felt so different, I swore I’d never go back” to either a vegetarian or omnivore diet, she said.

Her initial reasons for adapting a vegan diet involved environmental concerns and water resources used for livestock but Webster now also avoids clothing or products made with animals. “You start feeling it in your soul,” she said.

“It’s a lifestyle and not just a diet,” said Webster, talking from Chile, part of a 15-month trip to seven continents. Traveling means trying to avoid meat in places like Mongolia. “I grew to appreciate pickled vegetables and bread but I’ll probably never eat that again.”

While cardiologist Bishopric has reservations about certain elements of a vegan diet, she said, “I’d never condemn it.

“It’s a very comprehensive, worthy and thoughtful way to live that seeks to minimize the impact of humans on the animal world and minimize the dangerous human impact on the environment,” she said. “It’s just very important that you check all the nutritional boxes.”

If you’re thinking of becoming a vegan ...

▪ You want to be sure to get enough vitamin B-12 because that’s found in animal products,” Rarback said. The use of B12 supplements or fortified foods are recommended.

▪ Incorporate sources of dairy and Vitamin D,” Talamas said. “There are fortified milks, like almond and rice milk. We encourage reading labels because companies fortify different amounts.”

▪ Just giving up fat or animal fat doesn’t guarantee you’re going to have a healthy heart,” said Bishopric. Americans have had a war on fat but it hasn’t stopped obesity, she said. “You have to control your intake of refined sugars and carbohydrates. They look like the bad actors.” Avoid white rice, white flour and other simple carbohydrates.

▪ You can get enough protein that the body needs in a well-planned vegan diet,” Talamas said. The key is becoming educated about the amount of protein in vegetables, beans and grains.

▪ Eating whole soy foods should be fine for most women, Rarback said. “Eating tofu or edamame is not a big concern, but what is a concern is if someone’s taking soy supplements or estrogen supplements.”

“Veganism is the same as other diets,” Rarback said. “Whatever you choose, you want to load up on nutritional foods.”

Key nutrients for vegans

An all plant-based diet may lack these nutrients, making supplements a good idea.

▪ Vitamin B12 (cobalamin)

▪ Vitamin B6 (pyridoxine)

▪ Vitamin B2 (riboflavin)

▪ Vitamin D

▪ Calcium

▪ Zinc

Source: Medical News, American Dietetic Association, Nemours Foundation