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Any diet that is poorly planned will be missing nutrients, vegan or otherwise. In vegan diets, the nutrient of greatest concern is vitamin B12. The more restrictive the diet, the more of an issue this becomes. Plant foods are not reliable B12 sources, not even fermented foods, sprouts, mushrooms, seaweeds, spirulina, sprouts, or raw plant foods. We obtain little or no true vitamin B12 from these, and we may obtain inactive analog forms of B12 that are worse than useless because they fail to meet human requirements and can interfere with the action of true B12. The only reliable sources for vegans are supplements and fortified foods. Vegans eating unprocessed, whole food or raw diets need to take a B12 supplement. Although B12 is efficiently recycled, eventually it runs out, and this can happen in 6 months for some individuals and 6 years for others. Although people make B12 in their intestines, most is produced in the large intestine, but absorbed in the small intestine, so insufficient amounts make their way to the bloodstream. If people are using 3 or more servings of fortified foods such as soymilk, meat analogs, B12 rich nutritional yeast and fortified cereals, they are likely getting enough, but it is still a good idea to take a weekly 1000 mcg supplement – just to be on the safe side. If fortified food use is limited, take 1000-2500 mcg 2-3 times a week – seniors are often advised to take 500-1000 mcg daily. I would suggest using cyanocobalmin or both methylcobalamin and adenosylcobalamin. If using methylcobalamin and adenosylcobalamin, it is best to take it daily. Those who are B12-deficient need to take at least 1000 mcg/day – better still would be 1000 mcg twice a day or 500 mcg 4 x day. The IOM recommends that everyone over 50 NOT rely on animal products as B12 sources. This is because our ability to cleave B12 off the protein it is bound to in animal products diminished as we age. So everyone over 50 – vegan, vegetarian or omnivore should rely only on fortified foods and supplements for vitamin B12.

Certainly, other micronutrients such as iron, zinc, calcium, vitamin D and iodine can also be issues in poorly designed plant-based diets. The nutrition challenges commonly faced by vegans are relatively easy to overcome – my new books, Becoming Vegan: Express Edition and Becoming Vegan: Comprehensive Edition were written specifically to help individuals avoid any potential pitfalls.

The best plant-protein source is legumes. Most of us did not grow up eating beans, lentils and tofu, so it is common for Western vegans to drop meat from the diet and not to replace it with protein-rich plant alternatives. Some people end up living on pasta and bagels, or worse yet, fries and soda. While protein can be an issue for some individuals, it is relatively easy to ensure sufficient intake. Simply including legumes in the daily diet, and other protein-rich foods such as seeds, nuts, whole grains and non-starchy vegetables, will do the trick, especially if fat and sugar intakes are kept very moderate.

To boost protein, think about a source of protein for each meal. For breakfast, if you are using almond milk or other non-dairy beverages with low protein content (1-2 grams per cup), boost the protein content by blending every quart with about a 1/2 cup (125 ml) of hempseeds. This makes the milk much creamier, but also much higher in protein and trace minerals. Add hempseeds, sunflower seeds, soft tofu to your smoothies. Try scrambled tofu or even beans and greens for breakfast. At lunch and dinner, always include a protein rich legume choice – lentil soup, black beans on your salad, tofu or tempeh in your stir-fry, etc. Snack on protein-rich foods such as pumpkin seeds.

A few health advocates have suggested that the body doesn’t adequately convert vitamin K1 to K2 and that people require dietary sources of vitamin K2. While vitamin K1 serves blood-clotting processes and activities such as bone building, vitamin K2 is needed for protection against heart disease, arthritis, and cancer.

Although vitamin K2 has a wider range of biological activity, individuals with a healthy, normal supply of gut bacteria are well-equipped to convert K1 to K2. Scientific evidence supporting a requirement for a direct source of vitamin K2 is lacking, and the IOM doesn’t suggest that any direct intake of vitamin K2 is necessary. However, people who’ve had significant antibiotic therapy and are concerned about a temporary loss of ability to convert K1 to K2 can obtain a vegan source of vitamin K2 by taking a supplement or consuming natto. Natto (fermented soybeans) contains 23 mcg of vitamin K1 plus 941 to 998 mcg vitamin K2 per 100 g (a little more than ½ cup).