Plant-based eating is one of the best ways to achieve optimal health — from weight management to maintaining healthy blood pressure to reducing cholesterol. Many individualized studies uphold these findings, and hundreds of personal experiences relate to the positive side effects of a plant-based diet. Plus, plant-based diets also have wonderful environmentally-friendly side effects as well.

With that said, the effectiveness of a plant-based diet is dependent on understanding how and where to get nutrients that are essential for a healthy, functioning human body.

To this end, a few recent studies have uncovered that many plant-based eaters aren’t getting these essential nutrients and also happen to not be consuming enough cholesterol and are therefore suffering some unforeseen consequences. If you combine both of these factors, you get a scary result: an increased risk of stroke.

Let’s take a closer look at how nutrient deficiency and low cholesterol can affect your neurological health and increase your risk of stroke.

All About Plant-Based Foods and the Brain

When you think about nourishing your body, you may start out wanting to build lean muscle mass or considering your waistline or nourishment may be about feeling better overall. Yet, how often is the first thing that we consider regarding food for the brain?

This is somewhat unfortunate given that our diets are incredibly influential on the health of our brains.

And this is especially true when it comes to those practicing a strictly plant-based diet.

Plants are essential for the health of your brain. They provide antioxidants that protect it and healthy fats that keep it fed. On top of that, plant-based foods have been found beneficial for gut health, which is important for mental health and emotional stability. Dr. Michael Greger, a Fellow of the American College of Lifestyle Medicine and a clinical nutritionist, explains that “plant-based eating can improve not only body weight, blood sugar levels, and ability to control cholesterol, but also emotional states, including depression, anxiety, fatigue, and sense of well-being, and daily functioning.”

Plants not only increase antioxidants in the brain but they also decrease the “intake of glycotoxins,” which are referred to as “aging toxins” created in “heat-processed foods — hamburgers and hot dogs, chips and crackers, and processed cheese — and [they] cause an increase in oxidant stress and inflammation.” On top of that, plant-based diets are generally low in harmful agents called nitrates and nitrites, which “have been suggested to increase the risk of dementia.”

Plant-based diets not only increase healthy and necessary brain-boosting nutrition, but this type of lifestyle also decreases the risk of ingesting harmful processed compounds that have been linked to brain sluggishness and long-term illnesses such as dementia.

The Science: Low Cholesterol, Nutrient Deficiencies, and Strokes

Plant-based diets are great for the brain, so what’s the problem?

Recent studies are finding that some plant-based dieters — those strictly practicing only plant-based eating such as vegans and strict vegetarians — are experiencing an increased risk of stroke. Yet, it’s important to note that it’s not exactly a plant-based diet that is causing this increased risk, but poor implementation of a plant-based diet.

Specifically, those implementing a vegetarian or vegan lifestyle without recognizing that certain nutrients are difficult to obtain via plants, as well as the fact that you’ll be ingesting far less cholesterol than those consuming animal-based products.

The study that illuminated these findings was a European Prospective Investigation into Cancer and Nutrition (EPIC) performed at Oxford University and it included “information on 48,188 people in their 40s with no history of coronary heart disease or stroke” all of which were “divided into meat eaters, pescatarians (fish eaters), and vegetarians and vegans.” While plant-based eating participants experienced a reduced risk of heart disease, the study found that vegetarian eaters experienced “a roughly 20 percent higher stroke risk than meat eaters.”

And, it’s not just any type of stroke. The study found an increased risk of hemorrhagic stroke.

Per Dr. Ishwara Sankara, a medical staffer and neurointensivist with Neurocritical Care Associates of Fort Worth in Texas, “Hemorrhagic stroke is a type of stroke caused because of a rupture of a weakened blood vessel causing spillage of blood into the brain. Most common causes include uncontrolled high blood pressure, rupture of a brain aneurysm, or rupture of an abnormal blood vessel in the brain.” Hemorrhagic strokes often “cause more damage and be more deadly than ischemic strokes caused by blood clots.”

Let’s take a closer look at these factors!

Nutrient Deficiencies and Increased Stroke Risk

First off, let’s take a look at the lacking nutrients part of the study.

While practicing a plant-based diet has been found in various studies to decrease the risk of a slew of conditions — lower blood pressure, reduced weight, smaller risk of heart disease, increased energy, etc. — there are a small handful of nutrients that are difficult to naturally obtain by just consuming plants. Many seasoned and educated plant-based practitioners focus on the regular integration of these nutrients via specific foods or supplements.

The lead researcher of the study, Tamy Tong, Ph.D. of the Nuffield Department of Population Health, “suggests the increased stroke risk associated with a vegetarian diet may reflect low blood levels of total cholesterol or a low intake of certain essential nutrients.”

In particular, plant-based eaters are generally deficient in B vitamins such as B-12, B-9 (folic acid), and B-6, as well as vitamin D. Choline, a compound mostly found in animal-based products, is also another dietary element that some plant-based eaters may be deficient in. All of these compounds are important for overall bodily health, as well as brain health, and a deficiency “could contribute to neurological illnesses.”

Low Cholesterol and Increased Stroke Risk

Plant-based foods generally contain zero cholesterol. This is one of the many benefits of eating mainly plants, as the Standard American diet promotes high LDL “bad” cholesterol, which can lead to atherosclerosis, heart disease, heart attack, and other issues.

Yet, cholesterol is not all bad. Our bodies need cholesterol to build cells.

Cholesterol comes from two sources: naturally produced by your liver and via dietary cholesterol consumed in animal-based foods such as “meat, poultry, and full-fat dairy products.” While healthy cholesterol numbers are a great way to deduce overall health — low LDL, triglycerides, total cholesterol, and a higher HDL — it turns out that having too little cholesterol in your diet may also lead to other health concerns. Recent research has “suggested that very low cholesterol levels might be linked to a higher risk of hemorrhagic stroke, although low cholesterol level is protective against heart disease.”

With that said, it’s important to note that, when looking at absolute numbers in the study, “the lower risk of coronary heart disease does exceed the higher risk of stroke in the vegetarians.” Plus, it’s also important to note that this was one study and more research is necessary to truly deduce the underlying causes.

Plant-Based Sources of Common Deficiencies

Before making any adjustments to your diet, it’s important to speak with a nutritionist or medical professional. With that said, here are some plant-based sources of nutrients that are generally deficient for those on a plant-based diet. It’s also important to note that — after speaking with your doctor — you may also need to use synthetic supplements to obtain a recommended dose of these nutrients.

Vitamin D

This is one of the most difficult vitamins to get for anyone practicing any diet. That’s because the best source isn’t food, but sunlight. Those living in overcast environments (think the Pacific Northwest), often are lacking in this vital nutrient. Yet, while getting those rays of the sun is truly the best way to increase vitamin D, there are a few dietary sources that can lend a hand, including mushrooms, tofu, fortified cereals, and milk.

Mushrooms and tofu are super easy to integrate into a plant-based diet — such as in this Mushrooms and Spinach Sandwich or this Silverbeet and Mushroom Soup, — or using tofu as a meat replacement — such as in this ‘Chicken’ Thai Red Curry With Fried Rice or this Tofu Bacon.

When choosing fortified food, take care to look at the label. Make sure that there are no added sugars or hydrogenated oils. Many processed and packaged foods include these health-harming agents, so make sure to steer clear!

Vitamin B-12

A deficiency in vitamin B-12 is one of the most common for vegetarians and vegans, as well as one of the most dangerous. This type of deficiency leads to “anemia and nervous system damage,” as well as a “potential risk of heart disease or pregnancy complications.” Per the Vegan Society, “the only reliable vegan sources of B12 are foods fortified with B12 (including some plant milk, some soy products, and some breakfast cereals) and B12 supplements.” This is why so many plant-based eaters are deficient in vitamin B-12, especially those who avoid processed foods.

If you’re avoiding processed foods, try adding a few of these vegan-friendly vitamin B-12 enriched products to your diet: vitamin B-12 supplements, — such as this Mary Ruth Organics Vegan Vitamin D3 + B12 Gummy — enriched nutritional yeast, — such as Anthony’s Premium Nutritional Yeast Flakes — or enriched cereal — such as this Kashi Heart to Heart Organic Warm Cinnamon Oat Cereal. 

Vitamin B-9 (Folate)

Most likely, you’ve heard about folic acid or folate during pregnancy. While folate or vitamin B-9 is crucial for the development of a fetus, it’s also incredibly important for overall bodily health.

First off, is it folate or folic acid?

Folate refers to the vitamin that is naturally sourced from food. Folic acid refers to a synthetic form that is produced in supplements or added to foods. Even though folic acid is developed to be more easily absorbed into the body, it’s always best to try and get the natural source of folate.

Luckily, folate can be found in abundance in plant-based foods. The reason it makes the list of deficiencies is for two reasons. First off, it’s incredibly important for forming “DNA and RNA and is involved in protein metabolism,” therefore a deficiency is a dangerous one. Secondly, folate is difficult for the body to absorb meaning, even if you’re getting a healthy dose, your body may not be getting all of what you eat.

What are the best sources of folate? Try incorporating lots of green leafy veggies, — Superfood Kale Salad — beans, — Columbian Black Bean Stew — peanuts, — Peanut Butter Energy Bars — sunflower seeds, — Garlic and Onion Sunflower Seed Crackers — whole grains, — Winter Wheat Berry Salad — and fresh fruit — Breakfast Quinoa Fruit Salad.

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• Beans: The More You Eat, The More You Lower Bad Cholesterol (with Recipes!)
• Let Food Be Thy Medicine! Clean, Plant-based Foods That Can Help Lower Cholesterol

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