WFPB across life stages

A WFPB diet can not only meet the nutritional needs of every family member, but also provide a tremendous head start in both maintaining and regaining good health through all life stages.

Nutritional requirements throughout the life cycle

A whole food plant-based (WFPB) diet is healthy and nutritionally adequate for all stages of the life cycle.[1]

The specific nutrition recommendations made for the different phases in human life apply to everyone, no matter what eating pattern they follow. Most of the time they are not different for those following a WFPB eating pattern.

A WFPB diet is high in nutrients, fibre, anti-oxidants, and cancer fighting phytonutrients. It is low in calories and optimises our immune system. The starting position is better on a WFPB diet compared to a standard western diet.

It is important to note:

  • The predominant nutritional problem in developed countries is overnutrition, at least regarding energy and macronutrients (especially saturated fat, protein, and refined sugar) and insufficient intake of the fibre and micronutrients provided by vegetables, fruits, whole grains, and legumes. Excessive intake has led to unprecedented epidemics of obesity and chronic diseases. A renewed emphasis on vegetables, fruits, whole grains, and legumes can help prevent weight problems and chronic illnesses, including cardiovascular disease, diabetes, and cancer, among others.[2][3],[4],[5],[6],[7],[8]
  • Plant-based diets meet or exceed recommended intakes of most nutrients and have the advantage of being lower in total fat, saturated fat, and excludes dietary cholesterol unlike typical Western diets, with measurable health benefits.[9],[10] Plant-based diets are appropriate across the lifespan may help prevent or treat many chronic diseases.[11]

Pregnancy and lactation

Irrespective of diet choice, certain supplements are recommended in these stages. Usually a specific multivitamin is prescribed which includes folic acid to prevent neural tube defects and iodine to prevent congenital hypothyroidism. A WFPB diet is by nature high in folate. Plant-based omega-3 supplements are recommended.

Protein requirements in pregnancy rise to allow for fetal growth and milk production, much more during the third trimester and lactation. Adequate dietary energy intake will ensure sufficient protein intake. Read more about protein in the nutrients of note section.

Read our article ‘Are plant-based pregnancies safe?‘ for more details.

Infancy and early childhood

Irrespective of diet choice, breast milk is the healthiest choice for the first 6 months of life. After 6 months solids are gradually introduced while breastmilk still continues. If breastfeeding is not feasible, a plant-based formula is a good alternative. Note that this is not a standard plant-based milk.

Young children have a small stomach and a high energetic lifestyle which asks for relatively more calories which can be obtained by concentrated carbohydrates such as smoothies and whole grain breads and, if needed, through increasing the fat content by including nut butters, nuts and seeds, avocados and olives for instance. Coconut and coconut products are high in saturated fat and not appropriate for any life stage.

It is vital that a plant-based child is supplemented with vitamin B12 (low-dose chewable B12 supplement or a spray in the cyanocobalamin form) once solid foods start to substantially displace breast milk or fortified formulas. B12 levels should be tested once every year.

Research shows there are already atherosclerotic changes as young as age ten, regardless of geographic or ethnic origin.[1] Healthy low fat plant-based nutrition [2] is important for endothelial health and for the prevention and treatment of cardiovascular disease, from a young age onwards.

Read our article ‘Full of beans‘ for more details.

Adolescence

As for everyone irrespective of diet choice, the energy content of the diet might still be slightly higher compared to adults and can be addressed by concentrating carbohydrates in the form of smoothies and whole grain breads. Tubers such as potatoes and sweet potatoes are known as satiating foods.[1] If needed the fat content can be slightly increased with plant foods such as nut butters, nuts and seeds, avocados and olives.

Adolescents on a WFPB diet will not have trouble meeting required nutrient intakes. For most micronutrients, recommendations are inline with adults. Exceptions are made for certain minerals needed for bone growth (e.g., calcium and phosphorus).[2] However, these recommendations are controversial, given the lack of evidence that higher intakes are an absolute requirement for bone growth. Evidence is clearer that bone calcium accretion increases as a result of weight bearing exercise, among other factors, rather than from simply from increases in calcium intake.[3]

Iron levels may be considered in female adolescents due to menarche. Read below for details on sources and earn more in our nutrients of note section.

Whole food plant-based nutrition may be a useful therapeutic dietary intervention for common conditions seen in pubescent years including; increased weight gain, skin conditions such as acne [4,5], menstrual and hormone irregularities [6], and a decline in mental health.[7]

Read our article ‘Growing gains not pains‘ for more details.

Middle-age

For many keeping a healthy weight is important and can be a challenge. Whole plant foods are low in calories and high in fibre making weight control easier. A high fibre diet is also useful for hormonal regulation.

Menopause is better managed on a WFPB diet, especially with the addition of soy beans.[1] The isoflavones (a phytoestrogen) contained in soy – specifically genistein – have been shown to improve vasomotor symptoms and bone mineral density, while reducing the risk of breast, prostate, colon cancers and cardiovascular disease.[2]

Furthermore, some evidence suggests that reducing dietary fat may improve vasomotor symptoms.[3],[4] In the Women’s Health Initiative, perimenopausal women following reduced-fat diets scored significantly lower on the vasomotor symptoms subscale (including hot flushes and night sweats), compared with those whose diets derived approximately 30% of energy from fat, [5] a WFPB diet has a fat content of 10-15% of total calories.

Later years

Irrespective of diet choice, maintaining a healthy weight is important. Elderly people can become underweight due to ageing related muscle loss (sarcopenia), reduced physical activity and a decline in food intake. Some have difficulty getting adequate nutrition because of age- or disease-related impairments in chewing, swallowing, digesting, and absorbing nutrients.[1] Nutrient status may also be affected by decreased production of digestive enzymes, senescent changes in the cells of the bowel surface, and drug-nutrient interactions.[1]

Although diets that are modest in protein have been associated with health benefits, including reductions in diabetes and cancer incidence and overall mortality for people aged 65 and under, for those over aged 65, it remains important to ensure adequate protein intake for older people.[2] Legumes, lentils, peas, whole grains, tofu, tempeh are good sources of protein. All adults, regardless of diet, aged over 50 should consider receiving their vitamin B12 from a supplement. For more information on B12 see below and visit our nutrients of note section.

In general for all life stages

Vitamin B12 needs to be supplemented for everyone on a WFPB diet. First via the mother during pregnancy and providing breastmilk for her infant, later via sprays or chewable tablets. Sometimes regular intramuscular injections are necessary. Yearly monitoring of vitamin B12 levels is recommended.

Vitamin D needs to be monitored and increasing sun exposure is the first choice for elevating blood levels or else taking a plant-based supplement.

Plant-based foods offer enough iron. If more iron intake is needed iron-fortified foods such as wholegrain cereals are an option. Combining plant foods with Vitamin C-rich foods can increase iron absorption. WFPB foods high in iron include dark green leafy vegetables, dried fruits such as apricots, beans, lentils, and sprouted and wholegrains. Combining with Vitamin C-rich foods can increase iron absorption.

Bone calcium accretion increases as a result of weight bearing exercise, among other factors, rather than from simply increases in calcium intake.[22] A WFPB diet offers enough calcium for bone health during all stages of the life cycle.[14] The absorption is more efficient from plants.

Plant based omega-3 fatty acids are recommended during pregnancy, lactation and infancy and can be considered if there is uncertainty about adequate intake. Higher concentrations are found in flaxseed meal, chia seeds, hemp seeds, walnuts and leafy greens.

Iodine levels can be low depending on the soil where the produce is grown. Seaweeds are a good source of iodine, especially dulse, wakame, and nori (kelp should be avoided because its iodine content is too high) or an iodine supplement can be taken.

Looking for more information on individual nutrients of note?

Introduction

[1] Craig WJ, Mangels AR; American Dietetic Association. Position of the American Dietetic Association: vegetarian diets. J Am Diet Assoc. 2009;109(7):1266-1282. doi:10.1016/j.jada.2009.05.027

[2] Crowe FL, Appleby PN, Travis RC, et al. Risk of hospitalization or death from ischemic heart disease among British vegetarians and nonvegetarians: results from the EPIC-Oxford cohort study. Am J Clin Nutr. doi:2013;97(3):597-603

[3] Hu FB. Plant-based foods and prevention of cardiovascular disease: an overview. Am J Clin Nutr. 2003;78(3 Suppl):544S-551S. doi.org/10.1093/ajcn/78.3.544S

[4] Salas-Salvadó J, Martinez-González MÁ, Bulló M, et al. The role of diet in the prevention of type 2 diabetes. Nutr Metab Cardiovasc Dis. 2011;21 Suppl 2:B32-48.  doi.org/10.1016/j.numecd.2011.03.009

[5] Jenkins DJ, Kendall CW, Marchie A, et al. Type 2 diabetes and the vegetarian diet. Am J Clin Nutr. 2003;78(3 Suppl):610S-616S. doi.org/10.1093/ajcn/78.3.610S

[6] Nishino H, Murakoshi M, Mou XY, et al. Cancer prevention by phytochemicals. Oncology. 2005;69 Suppl 1:38-40. doi.org/10.1159/000086631

[7] World Cancer Research Fund/American Institute for Cancer Research. Continuous Update Project Expert Report 2018. Diet, Nutrition, Physical Activity and Breast Cancer. World Cancer Research Fund/American Institute for Cancer Research. https://www.wcrf.org/sites/default/files/Breast-cancer-report.pdf

[8] Fraser GE. Associations between diet and cancer, ischemic heart disease, and all-cause mortality in non-Hispanic white California Seventh-day Adventists. Am J Clin Nutr. 1999;70(3 Suppl):532S-538S.  doi.org/10.1093/ajcn/70.3.532s

[9] Messina V, Mangels AR. Considerations in planning vegan diets: children. J Am Diet Assoc. doi: 2001;101(6):661-9

[10] Fraser GE. Vegetarian diets: what do we know of their effects on common chronic diseases? [published correction appears in Am J Clin Nutr. 2009 Jul;90(1):248]. Am J Clin Nutr. 2009;89(5):1607S-1612S. doi:10.3945/ajcn.2009.26736K

[11] Melina V, Craig W, Levin S. Position of the Academy of Nutrition and Dietetics: Vegetarian Diets. J Acad Nutr Diet. 2016;116(12):1970-1980. doi:10.1016/j.jand.2016.09.025

Infancy and early childhood

[1] Strong JP, McGill HC. The pediatric aspects of atherosclerosis. J Atheroscler Res. 1969 9(3):251 – 265. doi:10.1016/S0368-1319(69)80020-7.

[2] Physicians Committee for Responsible Medicine website. https://p.widencdn.net/ktho8u/Power-Plate-Brochure.

Adolescence

[1] Holt SH, Miller JC, Petocz P, Farmakalidis E. A satiety index of common foods. Eur J Clin Nutr. 1995 Sep;49(9):675-90. PMID: 7498104.

[2] Institute of Medicine. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Washington, DC: National Academies Press; 1997.

[3] Lanou AJ, Berkow SE, Barnard ND. Calcium, dairy products, and bone health in children and young adults: a reevaluation of the evidence. Pediatrics. 2005;115(3):736-743. doi:10.1542/peds.2004-0548

[4] Adebamowo CA, Spiegelman D, Berkey CS, Danby FW, Rockett HH, Colditz GA, Willett WC, Holmes MD. Milk consumption and acne in teenaged boys. J Am Acad Dermatol. 2008 May;58(5):787-93. doi: 10.1016/j.jaad.2007.08.049

[5] Simonart T. Acne and whey protein supplementation among bodybuilders. Dermatology. 2012;225(3):256-258. doi:10.1159/000345102

[6] N. D. Barnard, A. R. Scialli, P. Bertron, D. Hurlock, K. Edmonds. Acceptability of a Therapeutic Low-Fat, Vegan Diet in Premenopausal Women. JNE 2000 32(NA):314 – 319. doi.org/10.1016/S0022-3182(00)70590-5

[7] U Agarwal, S Mishra, J Xu, S Levin, J Gonzales, N D Barnard. A multicenter randomized controlled trial of a nutrition intervention program in a multiethnic adult population in the corporate setting reduces depression and anxiety and improves quality of life: the GEICO study. Am J Health Promot. doi.org/10.4278/ajhp.130218-quan-72

Middle-age

[1] Barnard ND, Kahleova H, Holtz DN, Del Aguila F, Neola M, Crosby LM, Holubkov R. The Women’s Study for the Alleviation of Vasomotor Symptoms (WAVS): a randomized, controlled trial of a plant-based diet and whole soybeans for postmenopausal women. Menopause. 2021 Jul 12;28(10):1150-1156. doi: 10.1097/GME.0000000000001812

[2] Yan Z, Zhang X, Li C, Jiao S, Dong W. Association between consumption of soy and risk of cardiovascular disease: A meta-analysis of observational studies. Eur J Prev Cardiol. 2017 May;24(7):735-747. doi: 10.1177/2047487316686441

[3] Liu ZM, Ho SC, Xie YJ, et al. Whole plant foods intake is associated with fewer menopausal symptoms in Chinese postmenopausal women with prehypertension or untreated hypertension. Menopause. 2015;22(5):496-504.  doi.org/10.1097/gme.0000000000000349

[4] Beezhold B, Radnitz C, McGrath RE, et al. Vegans report less bothersome vasomotor and physical menopausal symptoms than omnivores. Maturitas. 2018;112:12-17. doi.org/10.1016/j.maturitas.2018.03.009

[5] Kroenke CH, Caan BJ, Stefanick ML, et al. Effects of a dietary intervention and weight change on vasomotor symptoms in the Women’s Health Initiative. Menopause. 2012;19(9):980-8. doi.org/10.1097/gme.0b013e31824f606e

Later years

[1] Roseboom TJ, van der Meulen JH, Ravelli AC, Osmond C, Barker DJ, Bleker OP. Effects of prenatal exposure to the Dutch famine on adult disease in later life: an overview. Mol Cell Endocrinol. 2001;185(1-2):93-98. doi:10.1016/s0303-7207(01)00721-3

[2] Levine ME, Suarez JA, Brandhorst S, et al. Low protein intake is associated with a major reduction in IGF-1, cancer, and overall mortality in the 65 and younger but not older population. Cell Metab. doi: 2014;19(3):407-17

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