Why don’t you come out and recommend a vegan diet? The evidence is so overwhelmingly in favor of it.



The answer, of course, is that we do not see the evidence as overwhelming. We also are painfully aware of wide geographic and socioeconomic variety in foodstuff availability.
 
In recommending a lacto-ovo vegetarian diet (a diet that includes no meat but does include dairy products and eggs), we are advocating the optimal diet for the vast masses of the world’s population. We are concerned about the low vitamin B12 levels in vegans, as well as the lower calcium intakes. The vitamin B12 levels in vegans are significantly below those in others. The Adventist Health Study I was not able to show an advantage to all-cause mortality of a vegan diet, and did not have sufficient power to answer this question. We expect the Adventist Health Study II to answer the questions we all have about the comparative value of a vegan versus a lacto-ovo vegetarian diet.
 
We are aware of differences favoring vegans when it comes to blood pressure, body mass index, and blood lipids, but these advantages are not of a very large order and—so far—have yet to be translated into documented health and longevity outcomes.
 
It is very possible that, in optimal conditions, a vegan diet (total plant-based diet) is best; in less-than-optimal conditions, we believe a lacto-ovo vegetarian diet is the best one for us to recommend.
 
It should be understood that only because of the fortification of dairy alternatives with vitamin B12, vitamin D, and calcium is a total plant-based diet adequate. Should such fortification not be available, we would be derelict in our duty to recommend such total plant-based diets.
 
  


I would like to get my HDL cholesterol higher. How do you recommend I do this?



HDL stands for high-density lipoprotein, and the cholesterol bound to this type of protein is generally a “good” cholesterol. Individuals with a low HDL cholesterol, in proportion to the LDL cholesterol, have an increased risk of cardiovascular disease caused by atherosclerosis, which is a narrowing of the blood vessels because of a buildup of plaque deposits. HDL cholesterol is important because it removes LDL cholesterol from plaque.
 
Unfortunately, it’s not easy to raise HDL cholesterol levels, but significant changes can be achieved by the following:
 
Regular exercise has been shown to improve HDL levels. The latest findings suggest that the inclusion of berries as part of the fruit intake raises HDL.
 
Just as important as HDL being raised is the lowering of LDL cholesterol, which is achieved by reducing saturated fat. This is achieved, to a large extent, by eating a vegetarian diet. The total plant-based diet is superior in its ability to lower LDL, and we recommend our lacto-ovo vegetarian readers reduce their intake of dairy fat by avoiding butter, hard cheeses, and full-fat dairy products should they choose to not give up dairy products and eggs altogether.
 
In summary, exercise more, eat more blueberries, blackberries, and strawberries, and cut your saturated fat.

Allan R. Handysides, M.B., Ch.B., FRCPC, FRCSC, FACOG, is director of the General Conference Health Ministries Department; Peter N. Landless, M.B., B.Ch., M.Med., F.C.P.(SA), F.A.C.C., is ICPA executive director and associate director of Health Ministries.
 
______________________
Send your questions to: Ask the Doctors, Adventist Review, 12501 Old Columbia Pike, Silver Spring, Maryland, 20904. Or you may send your questions via e-mail to blackmers@gc.adventist.org. While this column is provided as a service to our readers, Drs. Landless and Handysides unfortunately cannot enter into personal and private communication with our readers. We recommend that you consult with your personal physician on all matters of your health.
  



 
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