Mythbusters

Answers to the most frequent questions we hear from both healthcare professionals and the wider community about plant-based nutrition and health.

Protein from a variety of plant foods, eaten during the course of a day, supplies enough of all essential amino acids when caloric needs are met [1]. The once-popular recommendation of combining protein sources to achieve a complete essential amino acid profile in each feeding is no longer considered necessary [2]. For athletes, meeting protein needs is first and foremost a matter of increasing caloric intake to meet exercise and recovery demands [3].

Read more about the nutrition needs of athletes.

View key references.

Not all carbs are created equal. While refined carbohydrates such as white bread and sugary snacks should be kept to a minimum and ideally excluded altogether, fibre-rich complex carbohydrates are the body’s main fuel source, and should provide the majority of the calories in a healthy diet.

​Low carbohydrate diets, including the currently popular ketogenic diet, are often promoted for their weight loss potential and even as a diabetes management approach. However, research demonstrates frequent unwanted effects in individuals following these diets, including:

  • ​LDL-cholesterol elevation and increased inflammatory markers [1]
  • Harmful effects on the gut microbiome due to fibre deficiency [2]
  • Reduced life expectancy [3-5]​

A whole food plant-based diet is a proven long-term approach for preventing and reversing type 2 diabetes, and the solution does not lie in excluding nutrient-rich fibre-filled whole plant foods. High blood sugar is a symptom of diabetes, not the cause.

Read more about the positive impact of a WFPB diet on type 2 diabetes.

View key references.

The only supplement that is always required for people following a plant-exclusive diet is vitamin B12. Vitamin B12 is necessary for normal red blood cell formation, tissue and cell repair, nerve health, and DNA synthesis. A B12 deficiency can lead to permanent nervous system problems.

Because Vitamin B12 is made by a microorganism found in soil and water which is then consumed by animals, it is effectively only found in food of animal origin. However, owing to modern farming practices, even the animals are routinely supplemented. The upshot is that B12 supplementation is essential for anyone following a plant-based diet. Supplementation of 50-500 micrograms of cyanocobalamin per day is best practice. This is preferable to relying on fortified foods, which may not meet daily needs without careful planning to ensure correct doses at regular intervals during the day.

As with any eating pattern, nutrient status should be considered on a case by case basis, with testing, supplementation and/or incorporation of fortified foods considered if required. For example, when it is hard to get enough sunlight for adequate vitamin D production a supplement is advisable, and this is always important to consider for people with darker skin tones on any diet.

Want to learn more? Read our articles on bloodwork and iron.

Absolutely. While it’s true that many restaurant and café menus are heavily focused on animal-based and processed foods, ​it is almost always possible to find some go-to outlets and dishes. In fact, Australasia is one of the fastest growing vegan markets, so outlets are keen to capitalise.

The free Happy Cow website is a great resource for finding plant-based and veg-friendly eateries. Also, many cuisines from around the world such as Thai, Indian, Mexican, Ethiopian and Middle Eastern are traditionally plant-predominant and offer a wide variety of dishes that are made with vegetables, chickpeas, tofu and so on: most will be happy to suggest suitable dishes free from meat, eggs and dairy, and many can also offer low-oil or even oil-free options on request.

Even the least veg-friendly venues usually have something that can serve as a standby option, whether it’s a salad, a baked potato and beans or a selection of side dishes that can tide you over and ensure you don’t feel like the odd one out at a work or social gathering.

People sometimes think that going plant based requires time and money that they do not have. Time-wise, the key is adjusting our habits at a suitable pace. And money-wise, the evidence is to the contrary! This health-enhancing way of life is not out of bounds for anyone.

Time

Changing from a conventional western diet to a WFPB diet overnight may seem daunting for people juggling multiple demands on their time, particularly if family and social support is lacking. However, no step in the right direction is too small, and making incremental changes is the way forward. Often the most important first step is learning about the benefits, which can be done gradually over time for example through reading or videos, and committing to make the best nutrition choices we can in each situation that arises day by day.

Money​

Despite subsidies that make animal products artificially cheap, the reality is that plant-based staples such as rice and beans are inexpensive and highly nutritious. We particularly recommend: the Whole Food Plant Based on $5 a Day ebook and website by Australian chef Emma Roche and the ‘Week on WIC’ guide developed in the US by our International Advisor Dr Renae Thomas.

Read our information on simple swaps you can make to your existing cooking or try our basic meal ideas.

Yes. The largest association of dietitians in the world, the American Academy of Nutrition and Dietetics, confirms that plant-based diets, including total vegetarian or vegan diets, are healthy and nutritionally adequate for all stages of life [1], as do the Australian Dietary Guidelines [2].

Eating a healthy plant-based diet provides benefits through all stages of life, starting from pre-conception, supporting growth through pregnancy, childhood and adolescence. Nutrient-dense plant-based diets are a central pillar of a healthy lifestyle, helping to prevent many of the chronic conditions that impair quality of life as we age, as well as premature death [3,4]. By contrast, unhealthy diets, including inadequate intake of fruit and vegetables and overconsumption of processed foods, account for a significant burden of chronic disease, and this impact is growing [5].

Read more about WFPB nutrition throughout life stages. Or, explore our articles on WFPB nutrition for children, athletes and throughout pregnancy.

View key references.

Fibre is essential for staving off gut-related disease, but most people who follow the standard Western diet don’t manage to consume the minimum recommended amount. In contrast, the average plant-based eating pattern easily meets or exceeds our fibre requirements. Simply changing from omnivorous eating to fully plant-based will increase your fibre intake over one-and-a-half times.

Changes to what we eat can very rapidly mean changes are happening to the ratios of bacteria in our colon.[1] The types of dietary fibre found in plant-based foods, such as grains, legumes, fruits, vegetables and small amounts of nuts, selectively stimulate the growth of bacteria known to be health promoting. [2,3] When first switching to a plant-based diet, people may notice an increase in gas and/or bloating. For almost everyone these symptoms are temporary and will ease over time, eventually disappearing completely. It indicates the ratios of bacteria within the gut are undergoing some changes. Legumes in particular, are rich in fibre and provide a good source of food for gut bacteria.[4]

If you’ve had issues with gut symptoms in the past, you may want to ease your microbiome into things gradually. Starting slowly with the introduction of legumes, such as one tablespoon at a time, can help the gut bacteria adjust and reduce initial gas and/or bloating. If the gas or bloating is causing discomfort, it may be also helpful to include less fibrous grains such as white rice for a few days while the bacteria catch up to the new dietary pattern. It has been shown that bacterial populations are capable of adapting very quickly to new dietary patterns [1], so these initial changes will settle quickly, allowing the inclusion of an abundance of nutritious fruits, vegetables, whole grains and legumes at every meal.

For a comprehensive book about plant-based gut health get a copy of Fibre Fueled by gastroenterologist Dr Will Bulsiewicz.

View key references.

Vegetable oils are not wholefoods, they are a highly refined processed and extracted food product, therefore are not recommended as part of a whole food plant-based diet. For example, while whole olives and sunflower seeds provide a nutritious package of fibre, amino acids, vitamins, and minerals, extracting just the oil leaves behind the vast majority of these important nutrients. What remains is a concentrated source of liquid fat, shifting our calorie intake away from the healthier, complete foods. One tablespoon of olive oil (14g) provides 119 calories, and 14g of fat.

Learn more about the optimal WFPB diet.

Research shows eating patterns that emphasize fruits, vegetables, legumes, and whole grains and remove animal products improve risk factors for diabetes, including blood sugar, cholesterol, weight, blood pressure, and cardiovascular disease. Reduced fat intake and increased high-fibre carbohydrate intake improve diabetes and heart disease risk factors and reduce the need for medication for blood sugar control. [1]

The concern has been that because fruits contain sugar, it makes your blood glucose go up. In fact, most fruits have low to medium glycaemic index, and when consumed in their whole forms, the carbohydrates contained within these foods are low in glycaemic index and in fact associated with better glucose control. [2,3,4]

A plant-based diet may control blood sugar three times more effectively than a traditional diabetes diet that limited calories and carbohydrates. [5]

It is worth noting that you should eat the whole fruit and avoid juices, even if freshly squeezed. Fruit juices can be high in natural sugars, it is quick to drink (compared to eating the whole food) and they have less fibre than the whole fruits.

View key references.

Although it’s often referred to as the WFPB ‘diet’, this way of eating is not like other diets that require a restrictive mindset. Firstly, the goal of a WFPB eating pattern is not weight loss, but health improvement. It will often result in weight loss, but this is a by-product, not the purpose of the lifestyle. The benefits occur without any need for restricting or monitoring dietary intake. In fact, this is actively discouraged.

The focus is on what’s included rather than what’s excluded. When you load up on the good stuff, there won’t be any room for processed or animal-derived products. In line with intuitive eating principles, a WFPB way of eating is all about feeling good within ourselves and having a relationship with food that fits with the values of respecting our bodies and honouring our health and wellbeing.

Learn how easy it can be to nutrify your eating pattern.

Firstly, plant-based eating does not necessitate eating a lot of, or even any, soy products. Although if you do enjoy minimally processed soy products you might be wondering if it could be harmful.

Soy contains high amount of isoflavones, a type of plant estrogen (phytoestrogen). These are plant substances that have a very similar structure to oestrogen from the body and can bind to oestrogen receptors. While this may sound concerning, the science is clear: there are numerous health benefits related to phytoestrogen consumption for both men and women, and no convincing evidence that isoflavones affect male or female hormones, thyroid function or fertility.

Soy has been shown to reduce the risk of breast, prostate, colon cancers and cardiovascular disease and improve bone mineral density. [1] Isoflavones are converted to equol by gut bacteria, and higher production of equol has been associated with lower frequency of hot flushes. [2]

‘Second generation‘ highly processed soy foods like tofu sausages and supplements should be avoided.

View key references.

Do plant-based diets provide enough protein?
[1] V Melina, W Craig, S Levin. Position of the Academy of Nutrition and Dietetics: Vegetarian Diets. J Acad Nutr Diet. 2016;116:1970-1980 doi:10.1016/j.jand.2016.09.025
[2] Rogerson D (2017) Vegan diets: practical advice for athletes and exercises. Journal of the International Society of Sports Nutrition. 14:36 doi:10.1186/s12970-017-0192-9
[3] Venderley AM & Campbell WW (2006) Vegetarian Diets: Nutritional Considerations for Athletes. Sports Med. 36(4): 293-305 doi:10.2165/00007256-200636040-00002

Aren’t carbohydrates bad?
[1] Rosenbaum M, Hall KD, Guo J, et al. Glucose and lipid homeostasis and inflammation in humans following an isocaloric ketogenic diet. Obesity (Silver Spring). May 8, 2019. doi:10.1002/oby.22468
[2] Sonnenburg ED, Sonnenburg JL. Starving our microbial self: the deleterious consequences of a diet deficient in microbiota-accessible carbohydrates. Cell Metab. 2014;20(5):779-786. doi:10.1016/j.cmet.2014.07.003
[3] Seidelmann SB, et all. Dietary carbohydrate intake and mortality: a prospective cohort study and meta-analysis. Lancet Public Health. 2018 doi:10.1016/S2468-2667(18)30135-X
[4] Trichopoulou A, Psaltopoulou T, Orfanos P, Hsieh CC, & Trichopoulos D. Low-carbohydrate-high-protein diet and long-term survival in a general population cohort. Eur J Clin Nutr. May 2007;61(5):575–581. doi:10.1038/sj.ejcn.1602557
[5] Noto H, Goto A, Tsujimoto T, & Noda M. Low-carbohydrate diets and all-cause mortality: a systematic review and meta-analysis of observational studies. PLoS One. 2013;8(1): e55030. doi:10.1371/journal.pone.0055030

Are plant-based diets suitable for all stages of life?
[1] V Melina, W Craig, S Levin. Position of the Academy of Nutrition and Dietetics: Vegetarian Diets. J Acad Nutr Diet. 2016;116:1970-1980 doi:10.1016/j.jand.2016.09.025
[2] National Health and Medical Research Council (2013) Australian Dietary Guidelines. Canberra: National Health and Medical Research Council
[3] Aune D et al. Fruit and vegetable intake and the risk of cardiovascular disease, total cancer and all-cause mortality-a systematic review and dose-response meta-analysis of prospective studies. Int J Epidemiol. 2017;46(3):1029-1056. doi:10.1093/ije/dyw319
[4] Li Y, Schoufour J, Wang DD, et al. Healthy lifestyle and life expectancy free of cancer, cardiovascular disease, and type 2 diabetes: prospective cohort study. BMJ. 2020;368:l6669. Published 2020 Jan 8. doi:10.1136/bmj.l6669
[5] AIHW (Australian Institute of Health and Welfare) 2019, Australian Burden of Disease Study: Impact and causes of illness and death in Australia 2015. Australian Institute of Health and Welfare, Canberra

What about bloating and gas resulting from increased intake of dietary fibre?
[1] O’Keefe SJD, Li JV, Lahti L, et al. Fat, fibre and cancer risk in African Americans and rural Africans. Nature Communications. 2015;6(1):6342. doi:10.1038/ncomms7342
[2] Genoni A, Christophersen CT, Lo J, et al. Long-term Paleolithic diet is associated with lower resistant starch intake, different gut microbiota composition and increased serum TMAO concentrations. Eur J Nutr. 2020;59(5):1845-1858. doi:10.1007/s00394-019-02036-y
[3] Conlon MA, Bird AR. The impact of diet and lifestyle on gut microbiota and human health. Nutrients. 2014;7(1):17-44. doi:10.3390/nu7010017
[4] Kouris-Blazos A, Belski R. Health benefits of legumes and pulses with a focus on Australian sweet lupins. Asia Pacific Journal of Clinical Nutrition. 2016;25(1):1. doi:10.6133/apjcn.2016.25.1.23

Shouldn’t I be avoiding fruit if I am a diabetic?
[1] Meghan A Jardine, Hana Kahleova, Susan M Levin, Zeeshan Ali, Caroline B Trapp, Neal D Barnard, Perspective: Plant-Based Eating Pattern for Type 2 Diabetes Prevention and Treatment: Efficacy, Mechanisms, and Practical Considerations, Advances in Nutrition, 12;6, November 2021. doi.org/10.1093/advances/nmab063
[2] Reynolds AN, Akerman AP, Mann J. Dietary fibre and whole grains in diabetes management: Systematic review and meta-analyses. PLOS Med. 2020;17(3):e1003053. doi:10.1371/journal.pmed.1003053
[3] Bondonno NP, Davey RJ, Murray K, et al. Associations between fruit intake and risk of diabetes in the AusDiab cohort. J Clin Endocrinol Metab. Published online June 2, 2021:dgab335. doi:10.1210/clinem/dgab335
[4] Murtaugh MA, Jacobs DR, Jacob B, Steffen LM, Marquart L. Epidemiological support for the protection of whole grains against diabetes. Proc Nutr Soc. 2003;62(1):143-149. doi:10.1079/PNS2002223
[5] McMacken M, Shah S. A plant-based diet for the prevention and treatment of type 2 diabetes. J Geriatr Cardiol. 2017;14(5):342-354. doi:10.11909/j.issn.1671-5411.2017.05.009

Isn’t there too much oestrogen in soy?
[1] 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’. European Journal of Preventive Cardiology, vol. 24, no. 7, pp. 735–747, 2017. doi:10.1177/2047487316686441
[2] Daily JW, Ko BS, Ryuk J, Liu M, Zhang W, Park S. Equol Decreases Hot Flashes in Postmenopausal Women: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. J Med Food. 2019;22(2):127-139. doi:10.1089/jmf.2018.4265

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