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Vegan Diet

Vegan diets exclude all animal products. Veganism has rapidly increased in popularity, although randomized trials are still few in number. Trials do show promise for a variety of outcomes, from weight loss to autoimmunity, although comparisons to other popular diets are rare. A vegan diet should be balanced and low in processed foods (e.g. a "Whole Food Plant-Based diet") for optimal results.

Our evidence-based analysis on vegan diet features 228 unique references to scientific papers.

Research analysis led by and reviewed by the Examine team.
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Summary of Vegan Diet

Primary information, health benefits, side effects, usage, and other important details

What is a vegan diet?

A vegan diet has only one rule: no animal products.

This takes the vegetarian diet one step further by also removing eggs, dairy, and honey from your plate.

A person who follows a vegan diet is known as a vegan — a term first coined by Watson and Morgan in 1944.[1] 

But veganism can be more than just a diet: The Vegan Society defines veganism as “a philosophy and way of living which seeks to exclude — as far as is possible and practicable — all forms of exploitation of, and cruelty to, animals for food, clothing or any other purpose.”

That said, it’s important to mention that the most popular motive for becoming vegan is not health, but animal welfare.[2][3][4] Click here to read more about why vegans are motivated to avoid animal products.

How do vegans eat?

A vegan diet is defined by what it excludes: animal products.

Sounds simple, but this raises the question: What should vegans eat instead?

To answer this question, take a look at a healthy food plate as recommended by the German Nutrition Society:[5]

The DGE nutrition circle*

*Adapted from the German Nutrition Society (Deutsche Ernährung für Gesellschaft, DGE) [5]

For omnivores, 75% of a healthy food plate is already plants (cereals, vegetables, fruits, and fats). The remaining 25% is made up of animal products (mostly dairy and, to a smaller extent, eggs, meat, and fish). In other words, the difference between a healthy vegan and a healthy omnivore diet is only a quarter of a healthy food plate.[5]

For a vegan diet, this remaining 25% of animal products could be replaced as follows:

  • Plant-based milk, yogurt, and cheese alternatives can substitute dairy products.

  • Flax seeds are a good replacement for eggs when baking.

  • Tofu, tempeh, and other plant-based substitutes can replace meat and fish.

  • Peas, lentils, and legumes are also valuable protein sources for vegans.

  • Nuts and seeds provide essential nutrients and are a tasteful add-on to a meal.

Even meals that contain a lot of animal products can be made vegan with some effort and creativity. For instance, a vegan alternative to eggs with bacon and cheese is a plate of scrambled tofu with smoked seitan and cashew-based vegan cheese.

However, some critics have argued that vegan substitute products are not as healthy as "real" animal and dairy products.[6] However, this is not necessarily the case.[6] For example, rumors have demonized soybeans and processed soy products for (allegedly) lowering men’s testosterone levels, impairing thyroid function, and raising the risk of Alzheimer’s disease. Click here to find out why this is probably not the case.

Is a plant-based diet the same thing as a vegan diet?

The umbrella term “plant-based diet” is often used synonymously to a vegan diet — with a caveat.

While veganism is clearly defined in a nutritional context (no animal products are eaten), the definition of a “plant-based diet” varies widely when used in research. For example, a review of 44 studies found that more than half of the prescribed plant-based diets were not strictly vegan because they allowed for small amounts of animal products, such as fish or dairy.[7] 

This ambiguity around the term “plant-based diet” is important to keep in mind in order to analyze research studies accurately. This page uses the term ‘vegan’ instead of ‘plant-based’ to avoid such confusion.

What are the main benefits of a vegan diet?

Even though eating a large variety and amount of plant foods is healthy, a vegan diet per se is not necessarily healthy — but it certainly can be. But what makes a vegan diet healthy?

As discussed in the previous question, a healthy vegan diet is based on whole foods and ideally includes a variety of food sources to ensure all critical nutrient needs are met. Appropriate supplementation can also help. If this is the case, a vegan diet is not only healthy, but may even have some advantages over a standard omnivorous diet.

First, a vegan diet can be more satiating than a regular omnivorous diet. This is because vegans eat more fiber-rich, low-calorie plant foods while avoiding nutrient-dense, processed animal products. Consequently, vegans often consume fewer calories than people eating a regular diet.[8][9] 

Second, a vegan diet may lower the risk of certain lifestyle diseases. For instance, a plant-based diet is linked to lower incidence and mortality from ischemic heart disease (-25%) and incidence from total cancer (-8%), according to a comprehensive meta-analysis of 86 cross-sectional and 10 prospective cohort studies.[10] 

To find out more about how a vegan diet could reduce the risk of lifestyle diseases, click here.

Overall, a vegan diet — if it is well designed — can be considered healthy. However, it’s unclear if a vegan diet is healthier than an omnivorous diet, assuming both diets are well designed. In the context of the current body of literature, claims that imply the superiority of a vegan diet over an omnivorous diet lack any scientific basis.

What are the main potential drawbacks of a vegan diet?

There are two main drawbacks to a vegan diet. First, a vegan diet can be restrictive and inflexible, making it more effortful to adhere to for some people — though not for everyone[11] — than an omnivorous healthy diet.[12] Second, a vegan diet, if it is not well designed, can result in nutrient deficiencies, thus causing undesired health outcomes.[13] 

The art of adopting and sustaining a vegan diet boils down to two aspects: transitioning to a new lifestyle and getting enough critical nutrients, some of which may be sparse in a purely plant-based diet.

Why can adopting a vegan diet be challenging?

Adapting to a new vegan lifestyle mainly revolves around the challenges of eating in a new way, both outside and at home, and abstaining from animal products entirely. This can be a difficult habit to break, since most people have probably been eating animal products since childhood.

New vegans may need to find new favorite meals and restaurants, not to mention overcome all the awkward conversations with friends and family, explaining repeatedly why you are ordering tofu instead of spare ribs. Clearly, “it ain’t easy eating greens,” as researchers investigating the attitude of omnivores toward vegetarians and vegans put it.[14] This phenomenon of aversion to, or dislike of, vegetarians and vegans (also called vegaphobia) can lead to social friction with friends or family members.[15][16] 

Eating at home, though, also poses challenges. Adopting a vegan diet requires learning to cook nutritious meals without any animal products, which can be difficult, at first. Plant-based meat and dairy substitutes such as tofu and soy milk can help make the transition easier.[17] However, you may also want to explore new plant-based foods to bring your vegan cooking skills to the next level.

Why is it difficult to cover all of the essential nutrients on a vegan diet?

Since there are certain nutrients that are more difficult to obtain on a vegan diet, compared to an omnivorous diet, eating an unbalanced vegan diet may lead to nutrient deficiencies.[13] 

The most important nutrients to consider when eating a vegan diet are:[13] 

  • Vitamins B2, B3, B12, and D

  • The minerals zinc, calcium, iodine and selenium

  • Protein and omega-3 fatty acids.

If you want to learn more about these critical nutrients and how to obtain them through a vegan diet, click here.

Overall, the two major challenges of a vegan diet — adopting the habit of eating a new diet that may be more restrictive than an omnivorous diet while still covering all essential nutrients — can be difficult at first. However, these drawbacks can be overcome once you have adapted to your new lifestyle and learned what foods and supplements to consume on a regular basis to avoid nutrient deficiencies.

How does a vegan diet affect the body?

What are the most common effects of a vegan diet on the body?

A vegan diet may affect your body in a variety of ways.

First, adopting a vegan diet may change the quality and quantity of the foods and nutrients you consume:[18] 

  • Macronutrients (proteins, carbohydrates, and fats)

  • Micronutrients (vitamins, minerals, and phytochemicals)

  • Other dietary compounds (antibiotics, chemicals, heavy metals)

Relative nutrient intakes of a typical vegan, vegetarian, and conventional diet.[19][18]
NutrientVeganVegetarianOmnivore
Protein
medium
medium
high
Carbohydrates
high
medium
medium
Fats
medium
medium
high
Fiber
high
high
medium
Phytochemicals
high
high
medium

These differences may affect different aspects of your body and health. To date, the best-studied effects of a vegan diet include changes in body composition, glucose and fat metabolism, and cardiovascular health:

Body composition (discussed in more detail here)

  • Reduced body weight and fat mass,[20] but also reduced lean body mass in some cases.[21][22]

  • Lower bone mineral density[23] associated with a higher fracture risk if calcium, protein, and vitamin D3 needs are not met.[24][25]

  • In children, a vegan diet can be safe if all critical nutrients are met, leading to normal growth and development.

  • In infants, there is a lack of evidence regarding whether a vegan diet is appropriate for normal growth and development.

Glucose and fat metabolism (discussed in more detail here and here)

  • Improved glucose metabolism and diabetic markers such as glycemic status,[26][27][28][29] β-cell function,[22] and insulin resistance.[30][31][30]

  • Improved fat metabolism and blood lipids such as total cholesterol and LDL. However, HDL may be decreased, and triglycerides may be increased for a vegan diet.[32]

  • Changes in bile acid metabolism due to a low intake of cholesterol in a vegan diet.[33][34]

Cardiovascular system (discussed in more detail here)

  • Slightly improved blood pressure.[35][36][37]

  • Notably improved risk factors of cardiovascular disease, such as blood lipids.[32]

Also, a vegan diet may affect cognition and mental health, inflammation status, and the gut microbiome. However, more solid evidence is needed to draw any strong conclusions.

Cognition and mental health

  • Unclear effects on cognitive abilities (e.g., logic and memory) due to a lack of studies.[18] 

  • Potentially small positive effects on certain aspects of mental health (e.g., stress, anxiety, and depression), but more evidence is needed to investigate this effect.[18] 

Inflammation status

  • Linked to lower inflammatory markers, such as c-reactive protein (hs-CRP) and interleukin-6.[18] 

  • Small, short-term clinical trials suggest that an improved inflammatory status (among other factors) may be one mechanism by which a vegan diet may alleviate some of the symptoms in certain diseases, such as fibromyalgia[38] and rheumatoid arthritis.[39][40] More research is needed to confirm these findings.

Gut microbiome (discussed in more detail here)

  • Increased abundance of Bacteroidetes.[41][42] However, the health implications of this effect are unclear.[18]

  • Evidence from cross-sectional studies is mixed and indicates that there is no consistent association between a vegan diet and microbiota composition.[43] 

What are the underlying mechanisms of a vegan diet?

Researchers have been interested in studying the underlying mechanisms of a vegan diet to better understand its positive health effects.

Generally speaking, these mechanisms describe either direct or indirect effects (see sidebar).

Three potential mechanisms are: higher dietary fiber intake, higher phytochemicals intake, and lower calorie intake.

First, a higher intake of dietary fiber — defined as non-digestible carbohydrates that pass through the intestines to be excreted unaltered or fermented by intestinal microbes — is associated with improved health outcomes.[44] In a vegan diet, dietary fiber intake is increased compared to a classical omnivorous diet due to a higher consumption of fruits, grains, legumes, and vegetables. This increased intake of dietary fiber is hypothesized to have positive effects on the body,[18] including improved short-chain fatty acid production[45] and favorable fermentation processes in the intestines (e.g., upregulated carbohydrate fermentation and downregulated protein fermentation).[46]

The second mechanism that could explain the positive health effects associated with a vegan diet is a higher intake of phytochemicals from fruits and vegetables.[47][48] In general, a higher intake of phytochemicals — which can only be found in plants, not animals — has proven anti-inflammatory[49] and immune-enhancing effects.[50] As such, it is not surprising that phytochemical intake is linked to a number of beneficial health effects.[51] Consequently, researchers hypothesized that, since a vegan diet provides more phytochemicals than an omnivorous diet, phytochemicals could partially explain the positive health effects of a vegan diet.[48] 

Lastly, a vegan diet tends to be lower in calories compared to a normal omnivorous diet,[13] which may also explain a large chunk of its associated health benefits. Besides obvious effects on weight-related disease factors, such as improved cardiovascular risk and glycemic control,[52] caloric restriction potentially induces benefits for cellular mechanisms, such as autophagy, apoptosis, and lower oxidative stress.[53] 

Even though these three mechanisms explain some of a vegan diet’s health benefits, the picture remains complex, with many caveats.

On the one hand, it’s difficult to boil down the entirety of health benefits to a single factor, like a nutrient or group of nutrients. Instead, nutrients may have additive or even synergistic effects.

On the other hand, individual differences in genetics and lifestyle further complicate the picture: what may be healthful for one person may be detrimental for another.

More research is needed to better understand the mechanisms that could explain the observed positive health effects that a vegan diet has on the body.

🔍 Digging Deeper: Direct and indirect effects of adopting a vegan diet

The proverbial saying ‘you are what you eat’ has become a cliché to describe the importance of eating the right foods. However, while it’s technically true that eating the right foods is healthy, it’s also true that avoiding the wrong kinds of food is equally important for your health.

This is where direct and indirect effects come in. These are the changes in nutrients that are added or increased (direct effects) and removed or reduced (indirect effects) when adopting a new diet. Both effects can lead to positive and negative health outcomes.

Direct effects: On the one hand, adopting a vegan diet may increase vitamin C and phytochemical intake, leading to direct benefits for the immune system.[54][50] On the other hand, eating large amounts of processed meat substitutes may skyrocket sodium and saturated fat intake beyond the recommended levels,[55] leading to direct detrimental health effects.

Indirect effects: On the one hand, a vegan diet — if not well planned — may reduce calcium and vitamin D3 intake, leading to indirect negative effects on bone health.[19][56][25] On the other hand, a vegan diet may exclude potentially dangerous dietary compounds, such as opioid-peptides derived from casein,[57] carry-over antibiotics found in animal products,[58] or food-related carcinogenic toxins (e.g., dioxin[59] in eggs or nitrosamines in processed meat[60]), leading to indirect positive health effects.

That said, it becomes evident that eating a vegan diet — like every other healthy diet — is a balancing act: eating the right amounts of healthy foods and nutrients while avoiding a detrimental surplus of any nutrient. This simple, but not simplistic, idea sounds trivial in theory but can be complex in practice. If you want to learn more about the critical nutrients in a vegan diet, click here.

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Human Effect Matrix

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The Human Effect Matrix summarizes human studies to tell you what effects Vegan Diet has on your body, how much evidence there is, and how strong these effects are.

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Grade Level of Evidence
Robust research conducted with repeated double-blind clinical trials
Multiple studies where at least two are double-blind and placebo controlled
Single double-blind study or multiple cohort studies
Uncontrolled or observational studies only
Level of Evidence
? The amount of high quality evidence. The more evidence, the more we can trust the results.
Outcome Magnitude of effect
? The direction and size of the supplement's impact on each outcome. Some supplements can have an increasing effect, others have a decreasing effect, and others have no effect.
Consistency of research results
? Scientific research does not always agree. HIGH or VERY HIGH means that most of the scientific research agrees.
Notes
grade-a Notable Very High See all 10 studies
In a meta-analysis from 2016 (PMID: 26138004) of 1151 participants, a vegan diet reduced body weight by ~2.5 kg compared to a regular diet after a median follow-up of 18 weeks.
grade-a Minor Very High See all 14 studies
Three earlier meta-analyses showed that a vegan diet could lower systolic and diastolic BP by 2–4 mmHg, respectively, compared to a regular diet. These changes in BP would be associated with an up to 10% lower risk of death from CVD.
grade-b Notable Very High See all 4 studies
A vegan diet notably decreases fasting plasma glucose in obese and overweight adults with type 2 diabetes. The effects are similar to a conventional diabetes diet. However, even though vegan diets are linked to lower fasting glucose levels, clinical evidence is needed to prove a causal relationship.
grade-b Notable Very High See all 6 studies
Vegan diets effectively reduce HbA1c (glycated hemoglobin, which is a measure of your average level of blood sugar over the past 2 to 3 months) in randomized controlled trials. However, it's not clear if vegan diets are better than conventional diabetes diets in reducing HbA1c. While some RCTs find greater reductions in HbA1c compared to the control diabetes diet (which is usually the conventional diabetes diet recommended by the leading Nutrition Society of the country), others found no differences. One possible explanation is the higher dietary fiber intake of vegan diets. In studies where fiber intake was higher for the vegan group, greater reductions in HbA1c than for the conventional diabetes diet are more commonly found. Nevertheless, from a general perspective, the evidence for recommending the conventional diabetes diet is still more compelling than for vegan diets, for which the evidence is only in its infancy.
grade-b Minor Very High See 2 studies
Two randomized controlled trials of 2 and 18 weeks with 32 and 291 participants, respectively, found that a low-fat vegan diet improved self-perceived anxiety scores compared to a control diet.
grade-b Minor Very High See 2 studies
A handful of randomized controlled trials indicate that a vegan diet could reduce CRP and hs-CRP in populations with autoimmune diseases compared to no dietary intervention. However, more high-quality data is needed.
grade-b Minor - See 2 studies
Two randomized controlled trials of 2 and 18 weeks with 32 and 291 participants, respectively, found that a low-fat vegan diet improved self-perceived depression scores compared to a control diet.
grade-b Minor Very High See 2 studies
A vegan diet was shown to reduce inflammatory markers such as interleukin-6 in obese and overweight adults. Longer studies show higher reductions in IL-6.
grade-b - - See study
A systematic review and meta-analysis of 25 human interventional studies found no effects of a plant-based diet on adiponectin.
grade-b - - See study
grade-b - - See study
A systematic review and meta-analysis of 25 human interventional studies found no effects of a plant-based diet on leptin.
grade-b - - See study
A systematic review and meta-analysis of 25 human interventional studies found no effects of a plant-based diet on
grade-b - - See study
A systematic review and meta-analysis of 25 human interventional studies found no effects of a plant-based diet on TNFa.
grade-c Strong Very High See all 5 studies
Several randomized controlled trials showed that a vegan diet induced a substantial reduction in HOMA-IR in the range of -0.8 to -1.3 in overweight adults within 12–16 weeks. These findings indicate that a vegan diet is effective in improving insulin resistance in the short term in this high-risk population. However, more studies are needed to investigate the effect of a vegan diet on insulin resistance in other populations and for longer time frames.
grade-c Notable Very High See all 10 studies
A vegan diet effectively reduces low-density lipoprotein cholesterol (LDL-C) in overweight adults who are at high-risk for cardiovascular disease (CVD) compared to no or minimal dietary intervention. The evidence suggests that a vegan diet is as effective as other dietary interventions aimed to reduced LDL-C.
grade-c Notable Very High See all 8 studies
A vegan diet effectively lowers total cholesterol levels in obese and overweight populations within 3–6 months. More research is needed on other populations.
grade-c Minor Very High See all 6 studies
A vegan diet decreases high-density lipoprotein cholesterol (HDL-C) to a small extent in obese and overweight populations. Data on other populations is needed.
grade-c
Minor
- See all 5 studies
Adopting a vegan diet either slightly increases or has no effects on triglycerides in healthy or obese adults (who are at high risk for CVD) compared to no or minimal dietary intervention. Compared to another dietary intervention, there is probably no effect on triglycerides in healthy or high-risk adults. In adults with established cardiovascular disease (CVD), a vegan diet did not change triglycerides. These findings are in stark contrast to observational evidence showing that vegans have lower triglyceride levels than omnivores and vegetarians. The reasons behind these inconsistencies is unknown.
grade-d Notable Very High See all 3 studies
A number of randomized controlled trials and meta-analyses suggest that a vegan diet is very effective in reducing body fat mass.
grade-d Notable Very High See all 3 studies
A vegan diet reduces BMI and body weight to a notable extent in overweight and obese adults compared to no or minimal dietary intervention. It's uncertain if a vegan diet is more effective than other weight-loss diets. Personal preference may play a crucial role here.
grade-d Notable - See study
Adopting a vegan diet may notably reduce your energy intake since plant-based foods are often more satiating (due to the higher fiber intake) and less calory-dense.
grade-d Notable - See study
According to a systematic review and meta-analysis of 112 randomized controlled trials, plant protein in substitution for animal protein can decrease non-HDL cholesterol by -0.18 mmol/L (95% confidence interval, -0.22 to -0.14 mmol/L; P<0.00001; I2=52%; moderate-quality evidence)
grade-d Minor Very High See 2 studies
A vegan diet reduces apolipoprotein B to a modest extent in obese and overweight adults. Eating plant protein instead of animal protein in obese and overweight and healthy adults (who previously consumed an omnivorous diet) also reduces apolipoprotein B. However, a major limitation is that only a few clinical trials are available to date. The overall certainty of the evidence is low.
grade-d Minor - See study
An unbalanced vegan diet is associated with an increased bone fracture risk. However, vegans who consume enough calcium, protein, and vitamins D3 and B12 do not show an increased bone fracture risk.
grade-d Minor Very High See 2 studies
An unbalanced vegan diet decreased bone mineral density to a small extent (3–4%). However, vegans consuming enough calcium, protein, vitamin D3, and vitamin B12 show a normal bone mineral density. Eating a balanced vegan diet is crucial to build and maintain bone health.
grade-d Minor - See study
Two randomized controlled trials found that a vegan diet improved fatigue levels compared to no dietary intervention.
grade-d Minor - See study
A systematic review and meta-analysis of 4 clinical trials and 2 prospective cohort studies found that a plant-based diet (vegetarian or vegan) led to significant improvements in biochemical parameters, quality of life, quality of sleep, pain at rest, and general health status in patients with fibromyalgia. However, the interpretation of these findings is limited by the methodological quality of the studies. Since only two trials utilized a vegan diet, more clinical trials are needed to consolidate if a vegan diet is appropriate for fibromyalgia patients.
grade-d Minor Very High See 2 studies
A handful of randomized controlled trials indicate that a vegan diet could reduce CRP and hs-CRP in populations with autoimmune diseases compared to no dietary intervention. Also, a randomized controlled trial of 100 obese subjects with coronary artery disease (CAD) found that a vegan diet is more effective in reducing hs-CRP than the American Heart Association (AHA) recommended diet.
grade-d Minor Very High See 2 studies
Adopting a vegan diet may slightly decrease plasma insulin in obese and overweight adults.
grade-d Minor - See study
A small number of randomized controlled trials suggest that a vegan diet may improve insulin secretion in obese and overweight adults.
grade-d Minor Very High See 2 studies
A vegan diet is effective in reducing BMI, body weight, and fat mass in obese and overweight adults. These improvements are often accompanied by small but notable reductions in lean mass. However, the benefits gained by the reductions in body weight and fat mass may outweigh the disadvantages of losing a small amount of lean mass during the process of dieting.
grade-d Minor - See study
There is some evidence that a vegan diet can reduce lipoprotein A by a small amount. However, more research is needed to further understand the effects of a vegan diet on lipoprotein A.
grade-d Minor - See study
A 9-month randomized controlled crossover trial of 42 adult migraine sufferers found improved migraine severity and frequency after participants adopted a low-fat vegan diet. However, the study has some methodological issues such as the presence of potential confounding factors and a suboptimal placebo control. More research is necessary to verify if a vegan diet can reduce migraine severity and frequency.
grade-d Minor - See study
A 9-month randomized controlled crossover trial of 42 adult migraine sufferers found improved migraine severity and frequency after participants adopted a low-fat vegan diet. However, the study has some methodological issues such as the presence of potential confounding factors and a suboptimal placebo control. More research is necessary to verify if a vegan diet can reduce migraine severity and frequency.
grade-d Minor - See study
Two randomized controlled trials of 2 and 18 weeks with 32 and 291 participants, respectively, found that a low-fat vegan diet improved self-perceived well-being scores compared to a control diet.
grade-d Minor Very High See 2 studies
Adopting a vegan diet may increase the thermic effect of food, especially when dietary fiber intake is increased. However, more clinical trials are needed to substantiate these findings.
grade-d Minor - See study
A vegan diet was shown to significantly decrease urinary albumin in overweight adults in the context of type 2 diabetes. The reductions in urinary albumin secretion were even higher than in a control diet recommended by the American Diabetes Association (ADA).
grade-d - - See study
One randomized controlled trial investigated the effects of a gluten-free vegan diet on oxidised LDL in 66 subjects with rheumatoid arthritis and found no changes after 12 months.

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Also Known As

Plant-Based Diet

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