Keto vs Vegan: Both Are Deficient
How to Fix the Vegan Diet and Keto Diet Nutrient Deficiencies
Both the vegan diet and the keto diet produce nutrient deficiencies.
[Related Article: Keto vs Vegan: Diet Wars: Diet Strategy]
We can cover most of these without a challenge.
[Related Article: 5 Core Essentials: The Basic 5 Health Supplements]
While the vegan diet is more challenging to cover its nutrient deficiencies, it can be done, assuming one is not genetically deficient, as discussed in the previous Keto vs Vegan article on diet strategy.
#1 Vitamin D3 (More Important than Vegan Proteins?)
The sunshine vitamin, vitamin D, along with calcium, magnesium, and vitamin K play an essential role in maintaining bone health.
One can get vitamin D from the sun, yet deficiencies remain common, especially in the vegan diet.
We can make the argument vitamin D might be even more important than supplementing vegan proteins.
Vitamin D is an essential nutrient with many important actions, most recently seen in both influenza-A and coronavirus studies linking deficiency and insufficiency with adverse patient outcomes.
Some researchers suggest as much as 80% of humans have insufficient blood levels of this critical micronutrient.
There are two types of dietary vitamin D — plant-based ergocalciferol (D2) and cholecalciferol (D3) we can derive from animal-based foods.
Cholecalciferol (D3) increases blood levels of vitamin D much more efficiently than ergocalciferol (D2).
The best sources of vitamin D3 are fatty fish and egg yolks.
D3 supplements, cod liver oil, or enriched foods such as cereals and milk provide other sources.
As vitamin D3 is not plant-based, this poses a problem for veganism, which increases in places with less sun exposure during winter months.
Vitamin D Insufficiency/ Deficiency Conditions
- Bone Issues: Osteoporosis (Increased Risk of Fractures)
- Cancer
- Cardiovascular Disease
- Cognitive Function
- Depression
- Muscle Deterioration
- Multiple Sclerosis
- Respiratory Infections (Influenza-A and Coronavirus)
- Strength Issues
(Dosage and use: Vegan vitamin D3 supplements made from lichen are now available and recommended. New research suggests the old 20–50 ng/ML vitamin D blood levels are too low and to optimize vitamin D, instead of a target of 50–70 ng/ML is optimal. If not receiving vitamin D from the sun, then this equates to 5,000 IU on average depending on weight and other factors. Aging, skin pigment, and metabolic disease increase the need. We should take D3 as a combined D3/K2 supplement. Sufficient magnesium is required in order to absorb supplemental vitamin D3. And magnesium is another common deficiency across all diet types.)
#2 Vitamin B12 (Primary Vegan Diet Deficiency)
As another primary vegan diet deficiency, those practicing veganism almost certainly need to supplement vitamin B12.
We can also make the argument vitamin B12 might be even more important than supplementing vegan proteins.
Bacteria make b12, which we find in animal products such as dairy, eggs, fish, insects, and meat.
B12, or cobalamin, is a water-soluble vitamin which develops red blood cells and maintains nerves and healthy brain function.
Studies confirm vegans and some vegetarians are at high B12 risks without supplements or enriched foods.
Vegetarians can get sufficient B12 from dairy and eggs.
Vitamin B12 Insufficiency/ Deficiency Conditions
- Alzheimer’s Disease
- Cardiovascular Disease
- Chronic Fatigue and Weakness
- Cognitive Dysfunction
- Mood Disorders
- Megaloblastic Anemia
- Neurological Disorders
(Dosage and use: Plant foods such as bread, breakfast cereals, meat substitutes, soy products, and yeast extracts are B12 fortified. A safer, smarter, better route is taking methylated B-12 either as a standalone supplement or within a high-quality multi-vitamin. A two a day product can promote better absorption.)
#3 Omega-3 (What is Veganism?)
Another critical vegan diet deficiency is omega-3's.
Plentiful in fish and shellfish and eggs, essential long-chain omega-3 fatty acids contain EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid).
This is another common deficiency we still see in all forms of the modern western diet.
As a key veganism problem, the body can not make omega-3’s.
Vegans will typically use chia seeds, flaxseeds, hemp seeds, and nuts such as walnuts, as their omega-3 source.
These plant-based omega-3 sources provide alpha-linolenic acid, ALA, which the body must convert into DHA and EPA.
This is highly problematic as ALA plant conversion to EPA and DHA is less than 5% efficient.
Vegan omega-3 supplements are algae-derived.
While algae oil research is new, studies suggest its bioavailability and health benefits are comparable to fish or krill-based omega-3 supplements.
This is a natural, original, and sustainable omega-3 source as these are the same fatty acids we find in fish which consume the same algae.
(Dosage and use: We don’t know dosages for vegan supplements, but many suggest taking 1–2 algae oil softgels with meals.
#4 Zinc (A Key Deficiency with Veganism)
Needed by the body for creation of over 300 enzymes and vital for proper body function, zinc is the most abundant metal in the body after iron.
Zinc enhances immune function, influences wound healing, and reduces the duration of symptoms of the common cold, along with providing many other key functions such as testosterone and mood regulation
Deficiency of zinc leads to diarrhea, hair loss, impotence, diarrhea, dysfunction in taste, impairment in wound healing, and mental fatigue.
As zinc availability is lower in plant foods than animal foods, vegetarians and those on the vegan diet should count zinc intake.
Further problematic for veganism is the amount of zinc in plant-based foods varies depending on the zinc soil-content where the plants are grown.
Phytates, phytic acid, or “anti-nutrients”, we find in cereals, legumes, nuts, seeds, and whole-grain bread, can block the absorption of zinc, to some degree.
This means vegans and vegetarians can aim for 200% consumption of the daily value of zinc to offset their lower bioavailability of zinc.
(Dosage and use: Soak beans, nuts, and seeds with baking soda and apple cider vinegar to lower phytic acid content. Taking a high-quality multivitamin for insurance makes the most sense.)
#5 Iron (What is Veganism?)
While iron from plants is not as easy to absorb on a vegan diet, a diet rich in an array of whole plant foods should deliver sufficient iron even for those practicing veganism.
We find iron in dried fruits, leafy green vegetables, lentils, peas, and whole grains.
Heme iron is the iron we only find in meat, especially red meat, which is better absorbed than non-heme iron, we find in plant-based foods.
Heme iron also improves your absorption of non-heme iron from plant foods.
Non-heme iron has the same issue as zinc with its lowered absorption levels.
(Dosage and use: Consume plenty of vitamin C to increase iron absorption. Soak beans, nuts, and seeds with baking soda and apple cider vinegar to lower phytic acid content. Females and those deficient can derive iron from supplements or a high-quality multivitamin.)
#6 Taurine
While not essential in the diet, as our bodies produce small amounts, taurine is a sulfur we carry in various body tissues, including the brain, heart, and kidneys.
Taurine regulates blood flow and is one of the top supplements promoting blood circulation.
We cannot derive taurine from plants, so this is a recommended supplement for those on the vegan diet.
While the function of taurine is unclear, besides blood flow, we believe it plays a role in antioxidant defenses, bile salt formation, eye health, and muscle function.
Unsurprisingly, studies show those practicing veganism as their ongoing diet have lower taurine levels.
(Dosage and use: Synthetic taurine supplements are widely available and suitable for vegetarians and vegans. Dosages vary widely from 500 mg to 2 grams 1 to 3 times per day.)
#7 Creatine (micronized)
Creatine is a molecule we find solely in animal foods and is also deficient in the vegan diet.
While also not considered essential, more research continues supporting creatine for health optimization as arguably the number one most researched non-vitamin and amino supplement.
Most creatine, we store in the muscles as phosphocreatine, however, significant amounts of creatine also concentrate in the brain.
Despite creatine being made in the liver and not being essential; however, we find lower phosphocreatine brain levels in vegetarians, vegans, and females.
Creatine, which supports methylation and mitochondria, is an easily accessible energy reserve for our cells, delivering greater strength and endurance.
Releasing energy and boosting ATP energy from mitochondria, muscle stores of phosphocreatine can provide both physical and cognitive energy bursts when needed.
It remains possibly the world’s most popular supplements for muscle building and strength.
A notable study shows even those on short-term lacto-ovo-vegetarian diets cause significant decreases in their creatine levels.
As more research is showing a connection between creatine levels and cognition and mood, an emerging finding is a disparity in mood and cognition between meat-eaters and non-meat eaters.
Researchers, like myself, are following the research on creatine with Alzheimer’s disease, general cognition, and depression closely expecting an eventual connection will be made.
(Dosage and use: 5 grams per day. Micronized forms or Creapure® are better absorbed with less gastrointestinal disturbance.)
#8 Carnosine/ Beta-alanine (What is Veganism?)
This final supplement is only for serious health optimizers on the vegan diet and cannot be confused with essential nutrient deficiencies.
Perhaps one could argue having it on this list is digging in the weeds.
Also not found in plants, beta-alanine can be a useful supplement for health optimization.
Beta-alanine is a non-essential amino acid our body uses as a precursor to carnosine production, helping boost exercise performance.
Beta-alanine enhances performance by increasing exercise capacity and decreasing muscle fatigue.
Emerging research confirms beta-alanine also delivers important anti aging, antioxidant, and immune-stimulating actions.
(Dosage and use: 2 to 5 grams per day. Can be taken as part of an energy or pre-workout supplement or taken as a stand-alone supplement. One of my favorite supplements, C4, has 3.2 grams of CarnoSyn® Beta-Alanine.)
Keto Nutrient Deficiencies: What is the Keto Diet?
The keto diet can cause constipation, kidney stones, an increased risk of heart disease, low blood pressure, and like the vegan diet contains nutrient deficiencies.
Emerging research shows red meat eaters have three times the levels of TMAO, a dangerous compound linked to cancer and heart disease.
Compensating for this makes supplementation even more critical.
Some maintain the keto diet is not safe for those with gallbladder, liver, pancreas, or thyroid conditions.
#1 Biotin (B7), Folate (B9), Chromium, Iodine, Manganese, Molybdenum, Selenium and Vitamins A, E
Studies show the keto diet leaves several key nutrient deficiencies which can be easily covered with a simple multivitamin.
While the keto diet does not increase the risk of Vitamin D deficiency is also normal today and a supplement can still be valuable
We can derive vitamin D from egg yolks along with critically important choline.
An avocado contains 27.7% RDA vitamin E, while also providing a whopping 13 grams of fiber.
Avocados are arguably the single most important food for the keto diet.
Nuts and seeds can provide added vitamin E.
(Dosage and use: Take a high-quality multivitamin for wide daily nutrient coverage. Using a two a day multivitamin can promote better absorption taking one capsule with two meals per day.)
#2 Magnesium (Keto Salts) (Electrolytes)
As one of the most commonly used supplements in the world, magnesium acts in 300 enzymes in the human body, including cell-to-cell communication and production of ATP, DNA, RNA, and proteins.
This includes protein synthesis, muscle and nerve function, blood glucose control, and blood pressure.
Serving a crucial role in calcium balance, magnesium as one of the primary electrolytes, keeps calcium in the bones, preventing arterial plaque buildup.
The amount of magnesium, even in a quality multi-vitamin, is insufficient.
Most notably, coronavirus, COVID-19 remind us we need sufficient magnesium to absorb vitamin D supplements.
A recent study shows the modern diet provides only 50% of our 320 mg to 420 mg magnesium intake needs.
Many suggest this makes supplementation essential for all health optimizers, and even more so on the keto diet, as the keto flu is a common complication.
While outright deficiency rates are low, studies show magnesium insufficiency rates are as high as 80% in some populations.
Because of the modern diet and lifestyle, humans are consuming less magnesium than ever before.
(Dosage and use: Use a good magnesium supplement. Absorption of a chelated or amino acid-based magnesium supplement is about 5% of the total dosage listed. For this reason, many will underdose. Keto salts include magnesium as part of their product formulas.)
#3 Potassium (Keto Salts) (Electrolytes)
The RDA for potassium is 3,500 to 4,700 mg per day, making it a common dietary deficiency, especially on the keto diet.
Many maintain the keto diet, exercise, and intermittent fasting all increase the need for electrolytes, which can help correct conditions known as the “keto flu.”
Potassium removes excess sodium from the body, making it one of the key electrolytes when we talk about the need to balance electrolytes.
When we think of potassium, most will think of bananas, (which are not a part of the keto diet).
However, there are many low-carb foods with more potassium than bananas, such as avocados, dark chocolate, green leafy vegetables, mushrooms, nuts, and even meat.
Potassium is a key nutrient for heartbeat regulation and normal blood pressure.
With increased sodium intake, comes the need for increased potassium intake, at least meet the upper portion of the RDA.
Too much potassium can be harmful, as it’s optimal to get potassium from whole food, instead of supplements.
The caveat to this is when one is experiencing a kidney stone, potassium citrate appears to be the single most effective supplement to break the stone.
(Dosage and use: Potassium like fiber are best derived from food sources. Those on potassium-sparing blood pressure medication need to take caution of using potassium supplements. Keto salts include potassium as part of their product formulas.)
#4 Sodium (Keto Salts) (Electrolytes)
As hard as it may sound to hear, those on the keto diet are most at risk for sodium deficiency.
When the body eliminates water after carbohydrate restriction, we also eliminate sodium with other key electrolytes.
As there is an important ongoing balance of sodium with the other electrolytes, losing sodium can disrupt other electrolytes.
Many believe this can contribute to symptoms known as the keto flu, which is easily corrected.
Sodium is the first of the electrolytes to monitor when one goes on the keto diet.
With the “War on Salt,” conventional advice was to keep sodium intake low.
While this advice ignores the role of potassium, this only applies to those on a modern western diet of processed carbohydrates and sugar, and the less than 2% of all people with genetic salt sensitivities.
(Dosage and use: Adding trace mineral-rich pink Himalayan salt to food is a best practice. Some will mineralize their water with Himalayan salt. Keto salts include sodium as part of their product formulas.)
#5 Choline
This keto diet deficiency is hard to believe.
Along with a host of other nutrients and vitamins, such as omega-3’s and lutein for your eyes, one large egg contains 164mg of choline.
This provides about 30–36% of the daily requirement.
The egg yolk is key as egg whites do not contain any choline.
Choline is essential for brain health, cognition, heart health, liver, memory, metabolism and more.
(Dosage and use: 3 to 4 not fully cooked large organic, pastured or free-range omega-3 eggs.)
#6 Fiber (Gut Health) (Gut-Brain Axis)
While more on the keto diet embrace the role of dietary fiber, many continue to push back.
As we know, there is 0.0000000 grams of fiber in meat products.
Fiber has evidence dating back for decades for lowering all-cause mortality and disease risk.
This is notable as recent research shows red meat eaters have 3 times the level of dangerous TMAO as non-red meat eaters.
Fiber provides protection and support for the gut barrier.
As more research leads us to the gut-brain connection in overall health and disease management, thinking of fiber as only a constipation supplement is limiting.
While those with mood and cognitive disorders might still produce the short-chain fatty chain, butyrate in the gut using butter, is this a complete replacement for the real thing?
Some researchers do not believe this to be the case.
Viscous types of soluble fiber have the best evidence for gut-brain, gut health, metabolism, and disease prevention.
(Dosage and use: Women should have 25 grams of fiber per day, while men should aim for 38 grams. A large avocado provides 13 grams of fiber. Nuts and seeds can provide additional fiber. A fiber supplement of 5 to 15 grams daily soluble fiber for gut-brain and gut health for would be a wise choice.)
Keto vs Vegan Deficiency Conclusions
As the keto vs vegan debate rages on, it is most important to customize and cover the holes.
The role of omega-3’s cannot be understated.
Krill oil is superior to fish oil and cod liver oil is superior to fish oil.
Algae oil is superior to chia, flax, and hemp and might even be superior to cod liver and fish oil while performing equally to krill oil.
Both those on the vegan diet and keto diet can probably benefit from a D3/K2 supplement along with a magnesium supplement.
Both can likewise benefit from watching their potassium and fiber intake while taking a high-quality multivitamin.
What is your favorite diet supplement?
Your Friend in Health
Mark Stein
