6 Dietary Risks When Following an Unbalanced Vegan Diet
Dr. Wala’a Hafez
Plant-based diets have long been associated with a reduced risk of heart disease and certain types of cancer, improved gut health, and enhanced overall well-being. However, experts emphasize that these benefits do not occur automatically simply by abstaining from meat and dairy; they depend on the degree of dietary balance and the ability to compensate for the nutrients the body loses when animal sources are eliminated.
A scientific review published in the *Journal of the American Nutrition Association* indicates that the most common nutritional deficiencies among vegetarians include vitamin B12, iron, calcium, vitamin D, and omega-3 fatty acids. This comes at a time when plant-based diets are gaining popularity worldwide, with an increasing number of people reducing their consumption of meat and dairy products.
According to *The Telegraph*, experts stress that a plant-based diet is not inherently dangerous; rather, poor planning is the main issue. With dietary diversity, the selection of whole foods, and the use of fortified foods and supplements when necessary, a plant-based diet can meet most of the body’s nutritional needs.
Dr. Cary Rockston, a nutritionist and spokesperson for the Health and Dietary Supplement Information Service, states: “A balanced plant-based diet, combined with appropriate food and supplement intake, can be healthy. However, the problem lies in the fact that many people following plant-based diets, whether vegans or vegetarians, do not achieve the desired results.” Relying on highly processed plant-based alternatives and ultra-processed meals, or eliminating entire food groups without replacing essential nutrients, can increase the risk of vitamin and mineral deficiencies. This, in turn, can lead to problems affecting the brain, muscles, bones, immune system, and thyroid gland.
Below are the most common nutritional issues in plant-based diets and how to avoid them:
**First: Vitamin B12 Deficiency**
Vitamin B12 is the most prominent nutrient lacking in vegetarians because it occurs naturally in meat, fish, and dairy products, while plants do not provide it in sufficient quantities. It is essential for nerve health and brain function, and low levels can lead to fatigue, numbness, memory problems, and cognitive decline. Therefore, this vitamin plays a fundamental role in:
• Maintaining nerve health.
• Supporting brain function and memory.
Dr. Rockston notes that symptoms of vitamin B12 deficiency may not appear until the body’s stores are depleted. At that stage, sufferers may experience severe fatigue, tingling in the extremities, weakened memory and concentration, brain fog, and reduced cognitive abilities, along with depression and mood disorders. Additionally, stopping fish consumption can lead to a deficiency in DHA, an omega-3 fatty acid essential for brain and memory health.
Dr. Hazel Clark, a nutrition specialist in plant-based diets, recommends:
1. Taking a vitamin B12 supplement from the start of the plant-based diet.
2. Choosing plant-based milks and cereals fortified with the vitamin.
3. Using algae-derived omega-3 supplements for those who do not eat fish.
4. Increasing intake of chia seeds, walnuts, flaxseed, soybeans, and tofu.
**Second: Iron Deficiency**
Iron deficiency is one of the most common nutritional deficiencies among vegans, especially in women of reproductive age. Although whole grains, legumes, nuts, and leafy vegetables contain iron, the body absorbs plant-based iron less efficiently than the iron found in meat and fish. Therefore, vegetarians need to consume larger amounts to meet their daily requirements.
Symptoms of iron deficiency include persistent fatigue, poor concentration, hair loss, dizziness, and shortness of breath. In advanced cases progressing to anemia, heart palpitations may also appear. To improve iron absorption, experts recommend:
1. Regularly consuming lentils, beans, chickpeas, tofu, and iron-fortified cereals.
2. Combining them with sources rich in vitamin C, such as oranges, lemons, and colorful peppers, as this vitamin enhances iron absorption.
3. Avoiding tea and coffee for an hour after meals, as tannins reduce iron absorption.
4. Not taking iron supplements unless tests confirm a deficiency and under medical supervision.
**Third: Frequent Colds**
Experts confirm that a plant-based diet can support immunity if it is rich in vegetables, fruits, and whole grains, as it improves the diversity of beneficial gut bacteria. However, vegetarians may end up suffering from frequent colds and infections if they rely on highly processed plant-based foods, such as veggie burgers, vegetarian pizzas, manufactured vegetarian cheese, and fried potatoes. These foods are often low in:
• Vitamin C
• Zinc
• Iron
• Selenium
• Omega-3 fatty acids
Experts recommend the necessity of including “legumes, beans, lentils, chickpeas, tofu, and nuts” in the daily diet.
**Fourth: Decreased Bone Density**
Studies indicate that those relying on a strict plant-based diet may be more prone to decreased bone density and fractures, especially with advancing age. According to *The Telegraph*, the EPIC-Oxford study, which followed approximately 55,000 people, showed that vegetarians who did not consume meat, fish, or dairy products were 43% more likely to suffer fractures. Their risk of hip fractures also nearly doubled compared to meat-eaters. This is largely due to reduced intake of:
• Calcium
• Vitamin D
• Protein
Professor Susan Langham-Neu, a nutritionist and advisor to the Royal Osteoporosis Society, states: “Evidence suggests that people following a plant-based diet may suffer from decreased bone density and an increased likelihood of fractures. This becomes more pronounced with age, as bone loss accelerates.” Calcium accounts for about 40% of the bone’s mineral mass, while vitamin D helps absorb it, and protein is essential for building and repairing bones.
Professor Susan Langham-Neu recommends the following:
1. Choosing plant-based milks and yogurts fortified with calcium.
2. Increasing intake of tofu, chickpeas, beans, almonds, and whole wheat bread.
3. Ensuring an intake of approximately 700 mg of calcium daily.
4. Taking a vitamin D supplement during winter months or when tests confirm a deficiency.
**Fifth: Protein Deficiency**
Starting in one’s thirties, the body gradually loses part of its muscle mass, a process that accelerates after age sixty. Experts note that plant proteins are less digestible than animal proteins and often do not contain all essential amino acids in the same quantities, making it more challenging to maintain muscle mass if the diet is not carefully planned. Protein deficiency can lead to muscle weakness, increased fragility, and a higher risk of falls and fractures in the elderly.
It is recommended to distribute protein across all daily meals, relying on:
• Tofu
• Chickpeas
• Lentils
• Beans
• Soy yogurt
• Nuts and seeds
Experts also emphasize that resistance training and weightlifting remain essential for maintaining muscle mass, even with the best diets.
**Sixth: Potential Slowing of Metabolism**
Experts state that following a poorly planned plant-based diet can lead to a deficiency in nutrients necessary for proper thyroid function. The thyroid gland requires a range of nutrients to produce its hormones naturally, the most prominent of which are: iodine, iron, selenium, zinc, vitamin B12, and protein. When fish and dairy products are excluded without replacing these nutrients, thyroid efficiency may decline, leading to symptoms such as brain fog, fatigue, constipation, weight gain, cold sensitivity, and hair loss.
◄ How to Avoid the Problem?
Nutritionists recommend:
1. Consuming protein at every meal.
2. Choosing plant-based milk fortified with iodine.
3. Using B12 supplements when necessary.
4. Consuming one or two Brazil nuts daily to obtain selenium.
5. Being cautious about overconsuming seaweed, as it may contain very high levels of iodine.
