Vitamin A Deficiency -- Mowing Down Vegans?
This time my journey started because I just had to know for myself if those discussing a particular issue on-line (and I have now completely forgotten what it was) were cherry picking studies or taking lines from research papers out of context to shore up their perspective -- the plant-based proponents or the die-hard omnivores, so down the rabbit hole I went. Although I certainly don't have time to deeply pursue every point-of-disagreement between bloggers with differing nutritional perspectives, sometimes when the disagreement is over specific, "facts." I just have to know for myself, who is really misrepresenting the science.
It was a recent such foray that led me to yet another alarmist post declaring that vegan diets are dangerously deficient in many nutrients. The writer mentioned the usual ones which some vegans (and many non-vegans too) have been found to be deficient in, but which are easily and safely supplemented from non-animal sources (B-12, Vegan D3, zinc and DHA/EPA from algae.) They also mentioned nutrients, for which evidence of deficiency being common does not exist but since there is no evidence of harm from supplementing them (Taurine and K2) one could choose to supplement those too. Then they mentioned the one that I have never personally met any plant-eater who was diagnosed deficient in, but which there IS evidence of harm if it IS supplemented...Vitamin A.
As you may know, vitamin A (also called, "Retinol" or "preformed vitamin A") is made in the body of animals and stored primarily in their liver. Animals make vitamin A from eating beta-carotene (the yellow pigment in carrots, spinach, papaya and many other plants). Everyone agrees It is easy for vegans to get plenty of beta carotene, but organizations like the Weston A Price Foundation (who make no secret of the fact that their primary mission is to promote the economic interests of small meat, dairy and egg farmers) have long claimed humans have problems converting beta carotene into preformed vitamin A and so we should eat animal foods to assure adequate levels of vitamin A.
Now those who know me well, know that I am first and foremost a mother -- and I just happen to come from a long line of very anxious mothers to boot. In my 26 or so years of being vegan, with two dozen of those also being a mother of vegans, anxiety is my frequent companion. When I became pregnant, two years after becoming vegan, I had yet to meet a single other woman who had gone through her entire pregnancy as a vegan. Yet at every turn, my culture (and many family members too) told me that I would surely harm my children if I deprived them of animal protein. None-the-less, my convictions to not intentionally harm animals, combined with my knowledge of the medical literature enabled me to remain vegan amidst the anxious attention I was awash in from concerned others.
But I will tell you with all honesty, not a year has gone by, that when something happened (fatigue during my second pregnancy, for example or an incident of dislocated elbow in my toddler, or my eight-year old falling 10 feet out of a tree, or academic struggles at various points-- you name it) the FIRST PLACE my brain goes, is to wonder if it might have anything to do with our being vegan. "What if..." my anxious brain screams at me, "What if we are deficient in something critical?!" That perhaps is why I have spent so much time studying nutritional issues.
And that anxious concern continues -- even though both my lifelong vegan children have survived all the way to adulthood, (Read my daughter's essay: My Parent's 'Forced' Veganism on Me.) with significant academic successes, and some noteworthy athletic achievements. Neither has ever broken a bone (in spite of falls, and competitive gymnastics through level 7 - doing back handsprings on the balance beam) nor been sick enough to ever require antibiotics...and both have far fewer cavities than I did when I was just half their ages, but still from time to time, my anxiety lands on them causing concern about whether they are getting adequate nutrition It's not like there's any reason for anyone to be anxious at this particular time in history right now anyway....right?
Although I have never wavered in my dedication to veganism, during these last two decades, I have watched plenty of others -- be vegan until they encountered one of life's many challenges, and then go back to eating animals. Mothers it seems are especially vulnerable. And while I certainly understand that pressure, I look back on my own history, GRATEFUL that somehow I managed to remain vegan, in spite of the pressure, life-challenges and anxiety that I've seen derail others. And it doesn't matter that I've made it to my mid-fifties without diabetes, or that I can now run 5 miles without stopping, (even though as an overweight child I couldn't keep up on hikes, or even run around the track in elementary PE class without stopping.) My joints are all functional, I've needed no surgeries, my dental exams the past ten years have been the best of my life and most days I have sufficient energy to accomplish a lot of work -- like hauling 60 lb bags of concrete so I can build raised garden beds of stone. But I AM getting older and things are definitely changing with my body. Watching older loved ones develop chronic diseases makes me constantly scrutinize myself for evidence of the same. Oh...I should mention too -- I am type, O blood -- which according to the popular book, "Eat Right for Your Type" means I could NEVER be vegetarian. (BTW published science has debunked the Eat Right for your Type theory.)
And yet, in spite of all this, my recent reading about this supposed vitamin A deficiency being a bonafide threat to vegans got my anxiety revved up again....What if my children and/or myself are vitamin A deficient? I mean after reading what folks over at Weston A. Price have to say, it made me wonder...after 26 years without meat, dairy or eggs how can I still be standing?
I have long admired the work of Joel Fuhrman M.D., author of so many excellent books, I first met Dr. Fuhrman at a conference back in the 1990s. Although his focus is exclusively on health and he does not promote veganism, his nutritional recommendations are solidly evidenced-based. Fuhrman's Nutritarian Approach emphasizes eating greens, beans, onions, mushrooms, berries and seeds but does permit occasional consumption of meat as long as it is kept to a very minimal amount. So recently, I asked Dr. Fuhrman if there was any evidence that long term vegans are deficient in vitamin A. Dr. Furhman told me that out of tens of thousands of patients he has counseled, he has found only a few (probably due to rare genetic mutations) that did not convert beta carotene very well, and he cautioned against consuming preformed vitamin A (as opposed to beta carotene) because doing so is linked with some cancers. Then he referred me to this study:
Click on the image of the study if you'd like to read it for yourself. However, here are two excerpts I'd like to share with you:
"...among women who did not take supplemental vitamin A, retinol from food was significantly associated with fracture risk...That is, long-term intake of a diet high in retinol may promote the development of osteoporotic hip fractures in women."
"carotenoid-rich yellow and green leafy vegetables need a certain minimum amount of fat (2.4 g fat/meal) to ensure the absorption of fat-soluble provitamin A carotenoids and to improve vitamin A nutritional status"
So the bottom line is this: Most people consuming a diet rich in fruits and vegetables that contain beta carotene, who also consume ample fat in the same meal (like a small handful of raw nuts or seeds which help with absorption and conversion of beta carotene to vitamin A) will have sufficient levels of this vitamin, although there may be a few people with rare genetic mutations who could have problems. But supplementing vitamin A, or consuming vitamin A enriched foods, (read labels on soy and almond milk!) or consuming meat naturally high in vitamin A, as an insurance policy against vitamin A deficiency, is a risk factor for osteoporosis and some cancers.
If vegans want to assure themselves that they are adequately converting beta carotene to vitamin A, there is something they can do. Drink a nice big glass of carrot juice (along with eating a handful of raw nuts or seeds) every day for a week, and then go and get a Vitamin A blood test. Here is one lab that offers this test for $83.00 (put, "Vitamin A" in the search box.) You pay on-line or via the phone, and then report to any of hundreds of local labs across the nation to get a blood draw (at no additional charge). No doctor's visit nor prescription is necessary, results are available on-line in about a week.