John E. Lewis, Ph.D.

1
Getting Adequate Protein andVitamin B12 as a
Vegan

• John E. Lewis, Ph.D.
• Assistant Professor and Director of Research
• The Division of Complementary and Alternative
  Medicine
• University of Miami School of Medicine
• 1400 NW 10th Avenue, Suite 310B
• Miami, FL 33136
• Phone [phone]
• Fax [phone]
• E-mail jelewis_at_miami.edu

2
What are the consequences of our dietary habits
due to

• Culture
• Politics/Lobbying activity
• Sociology
• Psychology
• Advertising/Marketing
• Taste preferences

3
They Are VERY Significant!

• Most Chronic Diseases, including
• Coronary arterial and cardiovascular (1
  US/worldwide killer)
• Cancer (2 US killer)
• Obesity (2 US public health threat rapidly
  approaching smoking as 1)
• Diabetes
• Osteoporosis
• Arthritis
• are in large part due to our dietary choices.

4
What are the other contributing factors of
chronic disease?

• Physical inactivity a sedentary lifestyle
• Smoking/tobacco use
• Stress
• Environmental exposure toxins, pesticides,
  herbicides, and other chemicals
• Genetic predisposition/heredity

5
Different types of vegetarians include

• Vegans eat only food of plant origin.
• Ovo-vegetarians eat almost a totally plant-based
  diet, except for eggs.
• Lacto-vegetarians eat almost a totally
  plant-based diet, except for dairy products.
• Pesco-vegetarians eat a plant-based diet, but eat
  fish and shellfish.
• Semi-vegetarians eat plant-based foods and
  sometimes eat meat, chicken, eggs, fish, and
  dairy products.

6
Principles of a Vegetarian Diet

• A diet of no animal products, and with a good
  variety of plant-based foods, can satisfy all
  nutritional requirements and will be beneficial
  for health.
• A whole-food vegetarian diet is consistent with
  the current idea of healthy nourishment, since it
  reduces saturated fats and proteins of animal
  origin and increases unsaturated fats, complex
  carbohydrates, and fiber.
• Whole, unprocessed plant foods are rich in
  vitamins, minerals, enzymes, phytonutrients, and
  antioxidants, do not contain hormones or
  antibiotics that are applied in the production of
  most animal foods, and do not contain as many
  toxins.

7
So, now what about protein? How can I possibly
get all of the protein I need just from plants?
8
Where do our relativesget their protein?
9
If you believe that the 1-3 difference in our
DNA and theirs justifies or explains our
increased need for dietary protein.
10

• Then, its only fair to acknowledge that so much
  pharmaceutical and chemical research done on
  rats, mice, lower primates, and other species
  that translates to acceptable use for humans is
  thus worthless because we share much less DNA
  with these other species.

11
So why our obsession over protein?

• The protein molecule was discovered by Mulder in
  1839 and it became synonymous with meat for
  almost everyone and this association has
  perpetuated and persisted for nearly 200 years.

12
Since then, protein (meat) consumption has been
associated with

• Civilization
• Virility
• Prosperity
• Intelligence
• More is Better

So the cultural determinants and biases were
planted well over 100 years ago by the first
nutrition researchers.
13
What about protein quality? Surely, animal
proteins are of higher quality than plant
proteins.
Proteins from animal foods are considered higher
quality because they have the right amounts and
ratios of amino acids that we can efficiently use
to promote growth.
14
Unfortunately, Quality and Efficiency are
misleading terms when it comes to describing
protein.
The highest quality and the greatest efficiency
of our use of protein does not equate to the best
health. Plant proteins of lower quality, but
being utilized to synthesize new protein at a
slower rate are now being shown to be healthier
for us.
15
So, do plant foods have to be carefully combined
to ensure the correct mixture of all amino acids?
This has been shown to be untrue according to the
American Dietetic Association. As long your
dietary habits consist of a variety of grains,
legumes, fruits, and vegetables, protein needs
are easily met.
The American Dietetic Association. (1988).
Vegetarian diets. J Am Diet Assoc, 88, 351-355.
16
Protein is quite abundantin nearly all foods

• If you eat a variety of
• Vegetables
• Fruits
• Beans
• Peas
• Lentils
• Grains
• you will get all of the essential amino acids.
• Unlike animal products, plant foods are
  predominantly low in fat and contain no
  cholesterol.

17
Greens have plenty of protein!
Selected nutrients in a 100-calorie portion of
four foods Broccoli Romaine Kale Sirloin
Lettuce Protein 11.2 g 11.6 g 9.5 g 5.4
g Calcium 182 mg 257 mg 455 mg 2.4
mg Magnesium 71.4 mg 43 mg 59 mg 5
mg Iron 2.2 mg 7.9 mg 3.1 mg .7
mg Fiber 10.7 g 12 g 6.7 g 0 Vitamin C 143
mg 171 mg 83 mg 0 Cholesterol 0 0 0 55
mg Saturated Fat 0 0 0 1.7 g Weight 357
g 714 g 333 g 24 g
Adams, C. (1986). Handbook of the nutritional
value of foods in common units. New York Dover
Publications.
18
Regardless, many people still believe that you
cannot eat too much protein.
This belief plays a role in the popularity of
high-protein weight loss diets, such as Atkins,
Zone, South Beach, and others. However, the
typical American eats more than twice the amount
of needed protein.
19
In 1988, Dr. C. Everett Koop, the Surgeon General
of the United States issued his Report on
Nutrition and Health, which concluded "The
average man in the US eats 175 more protein than
the recommended daily allowance and the average
woman eats 144 more."
20
What if you eat too much protein?
21

• Too much protein equals too much nitrogen,
  resulting in an increased burden on the kidneys
  (1).
• Consistent meat eaters have a higher risk of
  colon cancer, which could be a proxy indicator of
  not only too much protein, but also too much
  fat, carcinogens, and hormones and no fiber (2,
  3).

• El Nahas AM, Coles GA. (1986). Dietary treatment
  of chronic renal failure Ten unanswered
  questions. The Lancet, 15 March, 597-600.
• Pellet PL. (1990). Protein requirements in
  humans. Am J Clin Nutr, 51, 723-737.
• Committee on Diet, Nutrition, and Cancer of the
  National Research Council. (1982). Diet,
  Nutrition, and Cancer. Washington, DC.

22
Diets high in protein, especially animal
protein (1), cause an excess amount of calcium to
be excreted (2), which increases the risk of
osteoporosis. Countries that eat the lowest
amount of protein have the lowest rates of
osteoporosis and hip fractures (3), and this
relationship remains true even in countries with
low calcium intake. Increased calcium excretion
also increases the risk for kidney stones.
Adding five ounces of fish (about 34 grams of
protein) to a normal diet increased the risk of
urinary tract stones by as much as 250 (4).
1. Zemel MB. (1988). Calcium utilization Effect
of varying level and source of dietary protein.
Am J Clin Nutr, 48, 880-883. 2. Sherman HC.
(1920). Calcium requirement in man. J Biol Chem,
44, 21. 3. Hegsted DM. (1986). Calcium and
osteoporosis. J Nutr, 116, 2316-2319. 4.
Robertson PJ, et al. (1979). The effect of high
animal protein intake on the risk of calcium
stone-formation in the urinary tract. Clin Sci,
57, 285-288.
23
"Osteoporosis is caused by a number of things,
one of the most important being too much dietary
protein."
Kolata, G. (1986). How important is dietary
calcium in preventing osteoporosis? Science,
233(4763), 519-520.
24
In contrast, those who eat the most fruits and
vegetables have denser bones because these foods
are rich in K, Mg, and Ca, and these foods are
alkaline, not acid-forming, and do not induce
urinary calcium loss."
Tucker, K. Hannan, M., Chen, H., et al. (1999).
Potassium, magnesium, and fruit and vegetable
intakes are associated with greater mineral
density in elderly men and women. Am J Clin
Nutr, 69(4), 727-736. New, S., Robins, S.,
Campbell, M., et al. (2000). Dietary influences
on bone mass and bone metabolism further
evidence of a positive link between fruit and
vegetable consumption and bone health? Am J Clin
Nutr, 71(1), 142-151.
25
Death by protein?
26
Studies have found that reducing ones
consumption of animal protein actually slows the
aging process."
Torosian, M. (1995). Effect of protein intake on
tumor growth and cell cycle kinetics. J Surg Res,
59(2), 225-228. Youngman, L., Park, J., Ames,
B. (1992). Protein oxidation associated with
aging is reduced by dietary restriction of
protein calories. Proc Nat Acad Sci, 89(19),
9112-9116.
27
Meat consumption is an important factor in the
etiology of human cancer."
Tavani, A., La Vecchia, C., Gallus, S., et al.
(2000). Red meat and cancer risk A study in
Italy. Int J Cancer, 86(3), 425-428.
28
Data from 59 countries showed that men who ate
the most meat, poultry, and dairy were the most
likely to die from prostate cancer, while those
who ate the most unrefined plant foods and nuts
were the least likely to die from prostate
cancer."
Hebert, J., Hurley, T., Olendzki, B., Tea, J.,
Ma, Y., Hampl, J. (1998). Nutritional and
socioeconomic factors in relation to prostate
cancer mortality a cross-national study. J Nat
Cancer Inst, 90(21), 1637-1647.
29
Germans who have been vegetarians for over 20
years have a 75 decreased risk of cancer and
all-cause mortality."
Frentzel-Beyme, R., Chang-Claude, J. (1994).
Vegetarian diets and colon cancer the German
experience. Am J Clin Nutr, 59(supp.),
1143S-1152S.
30
High-protein diets age the kidneys and
age-related loss in renal function may be
cumulative injury secondary to such dietary
habits."
Kasiske, B., Lakatua, J., Ma, J., Louis, T.
(1998). A metaanalysis of the effects of
dietary protein restriciton on the rate of
decline in renal function. Am J Kidney Dis,
31(6), 954-961. Holm, E., Solling, K. (1996).
Dietary protein restriction and the progression
of chronic renal insufficiency A review of the
literature. J Intern Med, 239(2),
99-104. Brenner, B., Meye, T., Hostetter, T.
(1982). Dietary protein intake and the
progressive nature of kidney disease the role of
the hemodynamically mediated glomerular injury in
the pathogenisis of progressive glomerular
sclerosis in agin, renal ablation, and intrinsic
renal disease. N Eng J Med, 307(11), 652-659.
31
Diabetics who ate too much animal protein lost
over half of their kidney function, and almost
all of the damage was irreversible."
Pedrini, M., Levey, A., Lau, J., Chalmers, T.,
Wang, P. (1996). The effect of dietary protein on
the progression of diabetic and nondiabetic renal
disease a meta-analysis. Ann Intern Med,
124(7), 627-632.
32
In summary, more than 3,500 studies conducted by
over 15,000 scientists have found associations
between consuming meat, poultry, eggs, and dairy
products and the incidence of cancer, kidney
failure, CVD, osteoporosis, and other diseases.
33
How much protein do you need?
In 1985 the World Health Organization published
recommendations that translate into 56 g of
protein a day for a 75 kg man and 48 g for a 64
kg woman. The recommendation suggests that
eating 10 of our daily energy as protein will
provide an adequate amount.
34
What is the RDA for protein?
Adults, on average, need little more than 0.5
grams of protein per kilogram of body weight
daily, but because individuals vary in their
ability to utilize proteins 0.3 grams per
kilogram are added as a safety factor.
35
How much protein is that?
Divide your weight in pounds by 2.2 to get your
weight in kilograms. Then multiply your weight
by 0.8 to calculate the RDA recommendation for
you. For example, if you weigh l85 pounds and
divide it by 2.2, you will find you weigh 84.1
kilograms. Multiplied by 0.8, you'll come up
with about 67 grams for your daily protein
requirement.
36
How can I adequately meet my daily protein
requirements?
The following very simple meal plan shows you how
easy it is to get your minimum protein
requirements. Numbers following menu items are
amount of protein in grams.
37
Breakfast
Cooked oatmeal (1.5 cups) 9.2 Soy milk (1 cup)
6.6 Orange juice (1 cup) 2.0 Whole-wheat bread
(2 slices) 5.0 Total 22.8 g
38
Lunch
Tabouli salad (1 cup, cooked bulgur wheat)
8.4 Hummus spread (1/2 cup) 6.1 Romaine lettuce,
tomato, cucumber 4.0 Whole-wheat pita bread (1
pocket) 4.0 Grapes (1 cup) 1.5 Total 24 g
39
Dinner
Sir-fry tofu (1/3 cup) 13.3 Broccoli (1 cup,
steamed) 6.0 Cashews (1 oz) 4.6 Brown rice (1.5
cups) 6.9 Fruit fresh fruit salad (1.5 cups)
1.5 Total 32.3 g
40
One Snack
Popcorn (3 cups) 2.7
41
What is the total?
Total Protein 81.8 grams Total Calories
2,300 with about 14 of calories as protein If
you weigh 185 pounds, the RDA for protein is 67
grams/day.
42
This sample plan is one of thousands of a
plant-based diet
If desired, any number of fruits, vegetables, and
grains, might be added and shows that the amount
of needed protein is easily attainable without
any reliance on animal products.
43
Complementing foodsis not necessary
You do not need to carefully complement your
proteins, nor do you have to have different
types of foods at every meal. The 1988 position
paper of the American Dietetic Association
emphasized that because amino acids obtained from
food can combine with amino acids made in the
body it is not necessary to combine protein foods
at each meal.
44
So, maybe you can get plenty of protein as a
vegan.However, what about your Vitamin B12?
How are you going to do it?
45
Vitamin B12 is known as Cyanocobalamin
In humans, Vitamin B12 is primarily stored in the
liver. The liver typically stores enough Vitamin
B12 for 5 years. The RDA for Vitamin B12 for
adults is 2.9 mcg/day.
46
Cyanocobalamin is a very fascinating substance.
While cyanocobalamin is generally recognized as
only being found in animal products, the only
site of cyanocobalamin synthesis in nature
appears to be in cyano-bacteria. Neither animals
nor higher plants are capable of making vitamin
B12 derivatives.
47
Cyano-bacteria live on the surface of all plants
and are unlike bacterial pathogens that can cause
disease in humans and in animals. All of the
cyano-bacteria, or flora-symbiotic bacteria,
which include the vitamin B12 producing
cyano-bacteria, prefer light and require abundant
free oxygen.
48
Therefore, cyano-bacteria cannot survive in
animal (human) hosts and cannot cause disease.
The bacterias metabolic by-product is vitamin
B12, which is consumed, collected, and
conservatively used by all animals which eat
plants (1).
1. Smith, L., Their, S. (1985).
Pathophysiology The biological principles of
disease 2nd Edition. W.B. Saunders Company,
Philadelphia, PA.
49
Since B12 producing cyano-bacteria love light and
air, and they flourish on the surfaces of all
plant matter, the more surface of a plant food
you can consume, the more cyanocobalamin you will
obtain. In other words, the higher the surface
ratio to consumed volume, the more the
cyanocobalamin you receive.
50
Greens with a large surface area to weight of
consumed product will supply the most
cyanocobalamin. Juicing plants like wheat grass,
barley grass, parsley, or spinach will have a lot
of concentrated cyanocobalamin. The skins of
tubers like potatoes, carrots, and beets are also
a good supply of cyanocobalamin and should not be
discarded when possible.
51
Also, like all microbiota, cyano-bacteria are
impaired or killed by pesticides, so organic or
pesticide-free produce should be chosen whenever
possible. If organic is not available, plenty
of greens should be consumed. Grasses or greens
can be spouted and grown at home on a window sill
and the wind blown air-carried cyano-bacteria
will land and multiply on them (1).
1. Rogers, T. (2005). Vitamin B12 /
Cyanocobalamin. Retrieved March 30, 2005, from
http//www.lifesave.org/VitaminB12.htm.
52
One study found that the addition of organic
fertilizer to soil significantly increased the
concentration of Vitamin B12 in plants.
Mozafar, A. (1994). Enrichment of some
B-vitamins in plants with application of organic
fertilizers. Plant and Soil, 167, 305-311.
53
The investigator wanted to know if plants
fertilized with organic matter (cow dung in this
case) rather than those grown in control soils
might acquire higher levels of vitamin
B12. Other studies have shown that plants grown
in soil fertilized with organic matter contained
more of some B vitamins, including B12, than
those plants grown in chemically fertilized soil,
thus yielding plant products better able to
sustain growth in experimental animals. The
author hypothesized that vitamin B12 produced by
soil microorganisms might be absorbed through the
roots into the plant itself.
54
Mozafar investigated the question in two ways.
First, he showed that soybeans, barley, and
spinach grown in soil fertilized with cow dung
had substantially higher levels of vitamin B12
than those grown without cow dung, and the
increases for barley and spinach were
statistically significant. Then, he examined the
vitamin B12 content of soils that had been
routinely fertilized over the previous 16 years
either with inorganic or with a mixture of
organic plus inorganic fertilizers, and found
that those receiving organic fertilizer had
significantly higher levels of vitamin B12.
55

• He concluded that root uptake of vitamin B12
  from animal wastes and its transport to edible
  plant parts could be an important route in the
  cycle of this vitamin between microorganisms,
  soil, plants, and animals.
• Thus, plants fertilized with manure may contain
  higher amounts of vitamin B12 a situation which
  may have implications for those who live by
  choice or necessity on pure vegetarian diets.

56
If you dont buy organically-grown greens and
other plants.
Then you may want to take a daily supplement of 1
mcg/day. However, Mozafars results indicate that
a diet high in green plants should provide enough
Vitamin B12.
57
You can also consider eating fortified cereals
and soy and rice milk, as some of the processed
sources of Vitamin B12.
58

• Thank you for your attention!