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On A Plant-Based Diet But Still Not Feeling Your Best? Here's Why

Bindiya Gandhi, M.D.
November 20, 2017
Bindiya Gandhi, M.D.
By Bindiya Gandhi, M.D.
Dr. Bindiya Gandhi is an American Board Family Medicine–certified physician who completed her family medicine training at Georgia Regents University/Medical College of Georgia.
Photo by Toma Evsiukova
November 20, 2017

I was vegetarian for four years of my life, during high school and a couple of years of college. And I was also the unhealthiest I've ever been. I was overweight, fatigued, and suffered from constant brain fog and hormonal imbalance. I lived on cereals, bagels, waffles, pizza, pastries, lots of bread, and tons of desserts. I had no concept of nutrition at that time. I would exercise but was still gaining weight, and my mentality was "If I exercise, I can eat whatever I want." It wasn't until my dad convinced me to start eating meat again that things finally changed. I lost weight, my energy was better, my brain fog and memory improved, and I felt better. Retrospectively, I know why.

Vegetarians or vegans are not necessarily healthier. And here why: A lot of the time my vegan and vegetarian patients are deficient in essential vitamins as well as fat. Vegans are at risk for B12, iron, vitamin D, zinc, and iodine deficiency. They also tend to have lower body weight, which can hinder pregnancy, and their cholesterol levels are also low, which affects hormonal imbalance, menstrual cycles, and brain fog.

I'm not here to sway you to eat meat or not. You have to listen to your body, your beliefs, and understand the full picture of the nutritional choices you're making. But if you're on a plant-based diet and still not feeling your best, here are five reasons why and what you can do to fix it:

1. Limited protein.

Vegetarians are often not getting enough protein in their diet. Healthy alternative vegetarian protein options include quinoa, hummus, lentils and legumes, buckwheat, nuts and nut butters, hempseed, and even chia. You have to learn to get creative and incorporate these into your diet throughout the day so you will be able to achieve your protein goals. I encourage patients to get about 60 grams of protein each day as a reference. I'm a big fan of protein shakes to start off the day, there are great vegetarian protein options other than soy like sunflower protein, pea, and rice protein powders on the market. I encourage adding avocados and healthy fats into your diet and smoothies as well like MCT or coconut oil for additional health benefits.

2. More grains and carbs.

I often notice that my patients on plant-based diets are eating more high-carbohydrate foods, which tend to be stored as fat and fuel. This often inhibits weight loss, causes fatigue, irritability, weakness, hunger, and thus, more sugar and food cravings. They are often eating more potatoes, rice, pastas, pizzas, cereals, sugars, desserts, pastries, and breads. For a healthy weight, I encourage patients to get about 150 grams of carbohydrate a day; now, of course, this number gets smaller if you're battling diabetes, pre-diabetes, or PCOS (polycystic ovarian syndrome). The goal is to learn to eat whole grain and unrefined carbohydrates like whole wheat pasta, brown rice, sweet potatoes, and quinoa. Healthy carbohydrates tend to be higher in fiber, which is what you need to have healthy elimination. So keep in mind you want to eat at least 35 grams of fiber a day through plant-based fiber sources.

3. Not getting enough veggies.

It may seem counterintuitive, but not all vegetarians are eating enough vegetables. This is often what I see in my practice. You should be getting about seven to nine servings of vegetables each day. You need to get your essential vitamins, minerals, and antioxidants through your greens! A green smoothie each day is a great addition to get more veggies in your diet. My rule of thumb is three veggies to one fruit to balance out sugar levels.

4. Compensating with dairy.

Vegetarians are always being told to make sure they're getting enough dairy in their diet to keep their calcium and vitamin D ratio high to protect their bones. So, they often indulge in cheese, milk, yogurts, ice cream, and sour cream. However, according to the American Journal of Clinical Nutrition, dairy is not mandatory in a vegetarian diet. They can meet these requirements through plant-based vegetables like broccoli, spinach, kale, and okra. In fact, dairy increases the risk of osteoporosis and can contribute to numerous cancers like ovarian and prostate as well as autoimmune conditions.

5. Processed soy.

We often compensate for the lack of meat by eating a lot of soy products, from edamame and tofu to soy meats and milk—all of which is processed, full of preservatives, and often genetically modified. In my practice I also commonly see people who are actually allergic or intolerant to soy products—since it's in everything! Processed GMA soy also increases1 the risk of cancers and hormonal disruption leading2 to fertility struggles in women. When substituting with soy, be mindful to eat it in its purest form and purchase non-GMO and organic only.

The take-home message? When we strictly exclude certain foods from our diet, it can sometimes lead to unforeseen consequences. But when you start eating the right foods for your body, you become healthier and you have more energy; your skin glows, your cognitive function improves, and it's easy to maintain or lose weight. You'll know it when you're there!

On a plant-based diet? Here's how to take it to the next level.

Bindiya Gandhi, M.D. author page.
Bindiya Gandhi, M.D.

Dr. Bindiya Gandhi is an American Board Family Medicine–certified physician who studied family medicine at Georgia Regents University/Medical College of Georgia. She completed her undergraduate training at the University of Georgia with a bachelor's of science in biology and psychology in 2004 and her doctor of medicine at American University of Antigua College of Medicine in 2010. She completed an integrative medicine fellowship at the University of Arizona with Dr. Andrew Weil. She is also currently working on her functional medicine training with the Institute of Functional Medicine. Her interests include integrative, holistic, and functional medicine; women's health; preventive medicine; international medicine; and health care reform. She's also a certified yoga instructor and Reiki master. She enjoys writing and educating everyone on important health matters.