You Can't Manage What You Don't Measure

Over the years I’ve helped many women successfully transition to a plant-based (mostly whole food) diet, and time and time again I’ve seen that one of the biggest concerns is the health aspect. Bookshops are full of books explaining how healthy a vegan diet is, but gossip magazines are also full of celebrities who gave up being vegan because they felt unhealthy. What gives?

The right vegan diet is much more healthy than a Standard American Diet, but the whole truth is unfortunately a little bit more complicated than that.

When college-age kids first become socially conscious they can go vegan and just eat ramen and Oreos for the next six months, while they figure out how to eat well. The women I work with are older, and professional. They have children, and many run their own businesses. They can’t afford for their health to suffer because they have employees who rely on them, they have soccer games to take their kids to, mortgage payments to make. As a college age kid when I felt a bit sick I just had an extra energy drink and got on with it. These days I can’t get away with that approach.

So with that in mind, it can sometimes feel scary to step into the world of veganism. All the talk of foggy minds and anaemia, and celebrities who stopped being vegan because they felt unhealthy (“and then I ate fish and felt amaaazing!”). Couple that with all the talk of how healthy it is, and it can be hard to know what’s going on! That uncertainty can be confronting.

That is why I tell people to take the uncertainty out of it. Remove the guesswork from veganism and all of a sudden it’s not nearly as scary, because you know what is going on inside your body.

How? Simple. Measure what’s going on. Get the cold hard data in front of you and you’ll feel confident in your approach, and you’ll know how you need to tweak your diet or take supplements if need be. Measuring is done in two ways: blood tests, and nutrition tracking.

Blood Tests

A baseline blood test will give you a clear picture of the current state of your health, and will give you important information about areas of possible deficiency or excess you may need to focus on.

What to test for?

This is a question best left to discuss with your doctor, as there are so many factors that could affect what YOU should be testing for. Your doctor may recommend including additional tests – over the ones listed below – based on your health history, circumstances, or symptoms.

I’ve compiled the below as a list of common areas of concern for plant-based eaters, but if you’re interested in seeing a complete picture then a full micronutrient assessment would be optimal. From this article’s point of view we’re trying to establish, with this blood test, specifically how your body is responding (and has responded) to its dietary needs, and how well you are meeting those needs. 

Full blood count

The full blood count is included as a standard test in almost all blood tests ordered by your GP. The test is used to get a general picture of your health, and can screen for a variety of issues like anaemia and infection. It can also indicate nutritional status and exposure to a range of toxic substances.

Blood Lipids

Most people transitioning to a plant-based diet will see a significant improvement in their blood lipid profile. Getting an understanding of your profile before you transition is a great way to track your improved health over time. This can serve as a great motivator down the line!

Iron

A vegan or plant-based diet usually doesn’t contain quite as much iron as a non-vegan one. The iron that we do eat is also a bit harder for our body to absorb, so anaemia is a concern to be aware of when transitioning or sticking to a plant-based diet.

Discuss a “serum ferritin” test with your doctor, as this will paint a clear picture of your internal iron stores and saturation, and may indicate whether an iron supplement is needed.

Vitamin B12

It’s difficult to get enough B12 as a plant-based eater without supplementation (or fortification), so it’s important to get a clear understanding of your body’s relationship with it. A “serum B12” test may give an artificially high reading, so ideally ask for an “Active” B12 test, which measures Holotranscobalamin. Also known as Holo-TC, this is the only form of vitamin B12 which is taken up and used by the cells in your body.

B12 deficiency is no joke, as it can lead to memory problems, fatigue, numbness, as well as a type of anaemia.

Vitamin D

Especially important if you live in a part of the world where sunlight is a rare commodity, or if you get less than about 30 minutes of sunlight on your skin each day. Most sources of vitamin D are non-vegan, so it would be a good idea to keep a supplement handy – the vitamin plays an important role helping your body absorb calcium and phosphorus (leading to healthy bones), as well as a range of other, smaller, functions in your body.

Calcium

It can be tricky to get enough calcium when you’re starting out on a vegan diet. Because it’s so important in building healthy bones, calcium is one of the micronutrients you should strive to reach RDA on each day – this is especially important for older women. A calcium test will typically go hand in hand with the Vitamin D test mentioned above, just double-check with your doctor that they’re ordering it.

Omega 3

This test measures the amount of EPA and DHA fatty acids in your red blood cell membranes. The test can sometimes be done as part of a broader Fatty Acid Profile test, which will also check your Omega 6 to Omega 3 ratio (which can indicate increased risk of a number of diseases), as well as blood inflammation.

Iodine

Iodine is an important mineral that aids thyroid function, and is well worth testing – especially if you’re not using iodised salt or regularly eat sea-based vegetables (like nori). This is a urine test though, not a blood test.

My blood test showed a problem!

That’s great! The problem was there already, but now that you know about it you can work out a plan – with your doctor – to help fix or improve it.

For each test you’ve taken, the blood test should show a range that indicate a “normal” (healthy) range, as well as where you fall on the scale. If you’re showing an unhealthy level in any test your doctor will be able to help you come up with an action plan to address it.

Also pay attention to “normal but low” readouts. These can happen when your levels are close to the unhealthy range, and by addressing them early you can fix problems before they even become problems! For example, if a blood test shows your iron levels are “normal but low” it may be a good idea to start supplementing before you become anaemic.

How often should I get tested?

If you’re starting out on a vegan transition I usually recommend a blood test every 3 months for a year (four tests in total). If you take these tests at regular intervals while your body settles into being vegan then you can become familiar with how it is responding to your new lifestyle, and adjust your diet if necessary. Once you’re a confident and experienced vegan the blood tests can reduce in frequency, but at least one per year is a good way to stay confident you’re on the right track, and can raise age-related physiological changes before they become problems.

Discuss the timing with your doctor though – the advice here assumes there are no health issues or confounding factors to complicate matters.

Nutrition Tracking

The second half of the measurement goal is tracking your nutrition. When you keep close, accurate track of what you’re putting into your body you will be able to know – with a high degree of confidence – whether your dietary health is on track.

I use Cronometer, and recommend it to pretty much everyone I meet. It is the most comprehensive nutrition tracker I’ve been able to find, and keeps an eye on a huge number of macro- and micronutrients. Curious about your Selenium or Tryptophan levels? Cronometer has you covered and it’s free!

It can be a bit of a chore to get things up and running, but once your favourites and “normal” meals and drinks have been set up it usually becomes a fairly simple activity to log what you eat and drink (and exercise).

Cronometer will give you a daily readout of 60+ different nutrients, but it’s not necessary to hit every single nutrient every single day. If you’re normally healthy it’s usually good enough – as a general rule of thumb – to try hit your macros (protein, fat, carbs) each day, and your micronutrients (vitamins and minerals) averaged over the course of a week.

As you can see here, Cronometer is really helpful with reports, making all your information super easy to access and understand. Cronometer is also pro-friendly – you can invite your favourite health coach (hi!) to view your data inside the app, where they can add in meal plans, review your food diary, and make suggestions for improvements.

Even if you’ve been vegan for a long time I would encourage you to use Cronometer, if only to track your eating for a week at a time, at regular intervals. This will give you a clear picture of whether you’re giving your body all the nutrients it needs.

In Conclusion

Uncertainty causes a lot of anxiety and worry when you’re vegan, especially when you first transition. A vegan diet becomes a lot less scary if you keep in mind that you can’t manage what you don’t measure. When you get regular blood tests and consistently track your nutrition you can stop guessing, because you have the data to know at your fingertips.

The only thing left to worry about will be… what’s for dinner?

I know it can be daunting to try climb this mountain on your own – I’ve been there, I completely get it. If you feel like you need help with a coach that can provide you advice, motivation, or accountability please get in touch!

Gabrielle is an evidence-based vegan coach who believes that health transformation begins when you switch to a plant-based diet. Her mission is to help midlife women eat in alignment with who they are and what they value so that they can lead a happier, healthier and more fulfilling life.