Vegan: great for your heart, terrible at B12. Plan it or pay for it.
No meat, no fish, no dairy, no eggs, no honey. Done well, a vegan diet is one of the better ways to eat. Done badly, it's crisps, white pasta and a vitamin deficiency that can damage your nerves for good.
The short version
- What it is
- Only plant foods. Nothing from an animal, not even milk, eggs or honey.
- Good for
- Lower cholesterol, a bit of weight loss, less heart disease in the big cohorts. And a much smaller climate footprint.
- Bad at
- Vitamin B12 (you need a supplement or fortified food, no exceptions), plus iodine, calcium and omega-3 if you don't plan.
- Evidence
- Moderate. Good trials on cholesterol and weight; the long-term data is observational.
- Our take
- Your choice, fully respected. We just make sure the plan covers what plants can't.
What a vegan diet actually is
Vegan means no animal products at all. No meat, no fish, no seafood, no milk, cheese, butter or yoghurt, no eggs, and for most vegans no honey or gelatine either. For many people it's an ethical choice about animals, not a health plan. That's fine. We don't argue with it. We just want it to work for your body.
Here's the thing marketing doesn't tell you: "vegan" says nothing about quality. Lentil stew is vegan. So are cola, gummy bears without gelatine, white toast with jam, and a deep-fried plant burger with three kinds of additives. A healthy vegan diet is built on beans, lentils, tofu, whole grains, vegetables, fruit, nuts and seeds. The stuff with a "vegan" sticker on a shiny packet is usually just junk food with better PR.
How it works in your body
Take animal foods out and a few things change at once. Saturated fat drops, because butter, cheese and fatty meat are its main sources. Fibre goes up, because beans, whole grains and vegetables replace them. Cholesterol in food goes to zero, because only animals make cholesterol. Together, that's why blood cholesterol usually falls.
The flip side: some nutrients are mostly or only found in animal foods. Vitamin B12 is the big one. Plants don't make it, and the "B12" in seaweed or unwashed vegetables is not a reliable source. Iodine comes largely from dairy and fish in many countries. Iron from plants is absorbed less well than iron from meat. Calcium is harder to get without dairy. And the long-chain omega-3 fats in oily fish aren't in plants at all; your body has to make them, slowly, from shorter versions in flax, chia and walnuts.1
None of these are deal-breakers. All of them need a plan.
What you eat, what you don't
Eat
- Beans, lentils, chickpeas, peas, every day
- Tofu (calcium-set), tempeh, edamame, unsweetened fortified soy drink
- Whole grains: oats, wholegrain bread, brown rice, barley, quinoa
- Vegetables, especially greens like broccoli, kale and bok choy
- Nuts, seeds, ground flax, chia, walnuts
- Fruit, fresh or frozen
- Fortified foods and a B12 supplement
Forget it
- Meat, poultry, fish, seafood
- Milk, cheese, butter, cream, yoghurt
- Eggs, honey, gelatine
- And, for your health: soft drinks, sweets, white bread
- Ultra-processed "vegan" snacks, burgers and cheeses as everyday food
- Sweetened plant drinks without added calcium and B12
Alcohol on a vegan diet
OK, now and then
- Spirits neat or with soda water and lime
- A glass of wine or beer labelled vegan
- Dry wine topped up with soda water
Not vegan, or not smart
- Cream liqueurs, eggnog, cocktails with egg white or milk
- Wine or beer clarified with gelatine, fish bladder (isinglass), egg white or milk protein
- Sweet cocktails and mixers
50 Club: one small glass of vegan-labelled wine on the weekend.
The sneaky part is clarifying, or "fining": some winemakers and brewers use animal products to make drinks clear. Many now use clay instead, but labels rarely tell you which.10 Look for "vegan" on the bottle. Plant-based or not, alcohol is still alcohol. All the details are in our alcohol guide.
What it's good for, with proof
Lower cholesterol
A 2023 meta-analysis in the European Heart Journal pooled 30 randomised trials with about 2,400 people. Vegetarian and vegan diets lowered total cholesterol, LDL ("bad") cholesterol and apolipoprotein B, a marker of the particles that clog arteries, compared with eating meat.2 The authors are clear that statins lower cholesterol more. But food is a decent start.
Some weight loss
Twelve randomised trials, 1,151 people: those put on vegetarian diets lost about 2 kg more than those who weren't, and vegan diets did best, about 2.5 kg more.3 Most trials were short, a median of 18 weeks. Useful, not magic.
Less heart disease, in the long-term studies
A review of observational studies found vegetarians had about 25% less heart disease, and vegans about 15% less cancer overall.4 Observational means these people were followed, not randomised. Vegans also smoke less, drink less and exercise more on average, so not all of that is the food.
A smaller footprint
The largest analysis of food and the environment, covering about 38,700 farms, estimated that a fully plant-based world diet would cut food's greenhouse gas emissions roughly in half.5 Not a health claim, but plenty of people care about it.
The uncomfortable truth
"Vegans live longer." Maybe, maybe not. In a large UK study of 60,000 people, vegetarians and comparable meat eaters died at similar rates.6 American studies of Seventh-day Adventists found an advantage. The fair summary: health-conscious people live longer, whatever's on their plate. Vegan is not a longevity pill.
"Vegans can't get enough protein." Rubbish, if you eat beans, lentils, tofu and whole grains. Protein isn't the problem. B12 is. Nobody posts about B12 on Instagram, and that's exactly why people run out.
The risks
- Vitamin B12 deficiency. The NHS lists a vegan diet without supplements or fortified foods as a cause of B12 deficiency.7 It can cause nerve damage, memory problems and loss of coordination, and some of that can be permanent.8 Take a supplement or eat fortified foods every day. Not optional.
- Iodine, calcium, iron, selenium, vitamin D. The NHS flags all of these as easy to miss on a vegan diet and recommends fortified foods or supplements.1 Calcium-set tofu, fortified soy drink and greens do a lot of the work.
- Broken bones. In the EPIC-Oxford study, vegans had a 43% higher risk of fractures than meat eaters, and more than twice the risk of hip fractures.9 Lower calcium, lower protein and lower body weight explain part of it. Get your calcium and protein in, and lift something heavy now and then.
- Stroke. The same UK study found vegetarians and vegans together had about 20% more strokes, while having less heart disease.11 Nobody knows why yet. It's one study, and the absolute difference was small, but it's a reason to eat a varied diet rather than a narrow one.
- The junk food trap. Vegan crisps, vegan doughnuts and vegan nuggets are still crisps, doughnuts and nuggets.
Allergies: watch the staples
Vegan cooking swaps meat and dairy for foods that are allergens themselves. Soy and nuts especially.
| Staple | Allergen (EU list of 14)12 | Swap |
|---|---|---|
| Tofu, tempeh, soy drink, edamame | Soy | Lentils, chickpeas, pea protein, fortified oat drink |
| Seitan, wheat bread, pasta | Cereals containing gluten | Beans, tofu, rice, quinoa, buckwheat |
| Cashew cheese, almond drink, walnuts | Tree nuts | Sunflower and pumpkin seeds, oat or soy drink |
| Peanut butter, peanut sauces | Peanuts | Sunflower seed butter |
| Tahini, hummus, sesame seeds | Sesame | Bean dips with olive oil, pumpkin seeds |
| Lupin flour, lupin protein in meat substitutes | Lupin | Pea or soy protein (check the label) |
| Vegan mayo, dressings, sausages | Mustard, celery | Olive oil and lemon, homemade dressings |
Don't go vegan if you…
- won't take a B12 supplement or eat fortified foods
- are pregnant, breastfeeding, or planning a vegan diet for a child, without a dietitian: Germany's nutrition society says it can't make a clear call for these groups and strongly advises professional advice13
- have ever had an eating disorder and are using "vegan" as a way to restrict food
- have osteoporosis or a history of fractures, without checking calcium and vitamin D with your doctor
- have several food allergies at once (soy, nuts, gluten): the plan gets very narrow
Healthen me asks about all of these and gives you a different plan if any apply.
How we use vegan in your plan
Vegan is a filter you choose. Tick it in Healthen me and every animal product disappears from your plan, recipes included.
Then the engine does the boring bit: it checks your week against your needs for protein, B12, iodine, calcium, iron and omega-3, and builds meals around tofu, tempeh, lentils, beans, seeds and greens. Your fast-breaking meal stays low-carb, think tofu scramble with spinach and avocado, or a ketotarian-style bowl. The plan will tell you, plainly, to take B12. Many health bodies, including Germany's nutrition society, now accept a well-planned vegan diet with B12 as healthy for adults.13
Not ready for the full switch? The vegetarian and flexitarian filters are one click away.
This article is general information, not medical advice. If you have a medical condition or take medication, talk to your doctor before changing how you eat.
Sources
- NHS. The vegan diet. nhs.uk/live-well/eat-well/how-to-eat-a-balanced-diet/the-vegan-diet
- Koch CA, Kjeldsen EW, Frikke-Schmidt R. Vegetarian or vegan diets and blood lipids: a meta-analysis of randomized trials. European Heart Journal 2023. doi.org/10.1093/eurheartj/ehad211
- Huang RY, Huang CC, Hu FB, Chavarro JE. Vegetarian diets and weight reduction: a meta-analysis of randomized controlled trials. Journal of General Internal Medicine 2016;31(1):109–116. doi.org/10.1007/s11606-015-3390-7
- Dinu M et al. Vegetarian, vegan diets and multiple health outcomes: a systematic review with meta-analysis of observational studies. Critical Reviews in Food Science and Nutrition 2017;57(17):3640–3649. pubmed.ncbi.nlm.nih.gov/26853923
- Poore J, Nemecek T. Reducing food's environmental impacts through producers and consumers. Science 2018;360(6392):987–992. doi.org/10.1126/science.aaq0216
- Appleby PN et al. Mortality in vegetarians and comparable nonvegetarians in the United Kingdom. American Journal of Clinical Nutrition 2016;103(1):218–230. pmc.ncbi.nlm.nih.gov/articles/PMC4691673
- NHS. Vitamin B12 or folate deficiency anaemia: causes. nhs.uk/conditions/vitamin-b12-or-folate-deficiency-anaemia/causes
- NHS. Vitamin B12 or folate deficiency anaemia: complications. nhs.uk/conditions/vitamin-b12-or-folate-deficiency-anaemia/complications
- Tong TYN et al. Vegetarian and vegan diets and risks of total and site-specific fractures: results from the prospective EPIC-Oxford study. BMC Medicine 2020. doi.org/10.1186/s12916-020-01815-3
- The Irish Times. Are all wines vegetarian or vegan? 26 March 2023 (journalism, not research). irishtimes.com/food/drink/2023/03/26/are-all-wines-vegetarian-or-vegan
- Tong TYN et al. Risks of ischaemic heart disease and stroke in meat eaters, fish eaters, and vegetarians over 18 years of follow-up: results from the prospective EPIC-Oxford study. BMJ 2019;366:l4897. doi.org/10.1136/bmj.l4897
- Regulation (EU) No 1169/2011 on food information to consumers, Annex II (the 14 allergens). eur-lex.europa.eu/eli/reg/2011/1169/oj
- Klug A et al. Update of the DGE position on vegan diet: position statement of the German Nutrition Society (DGE). Ernährungs Umschau 2024;71(7):60–84. doi.org/10.4455/eu.2024.22