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Research and general acceptance



Veganism (pronounced VEE-ganism), which is sometimes called strict vegetarianism or pure vegetarianism, is a lifestyle rather than a diet in the strict sense. The term itself was coined in 1944 by Donald Watson, a British vegan frustrated by the fact that most vegetarians saw nothing amiss with consuming eggs or dairy products. He derived vegan from combining the first three and the last two letters of the word vegetarian, maintaining that veganism represents “the beginning and the end of vegetarian.” The Vegan Society, which Watson and Elsie Shrigley co-founded in England during World War II, defines veganism as of 2007 as “a philosophy and way of living which seeks to exclude— as far as is possible and practical—all forms of exploitation of, and cruelty to, animals for food, clothing, or any other purpose.” November 1, the anniversary of the foundation of the Vegan Society, is observed annually as World Vegan Day.

In terms of food consumption, vegans exclude all meat, dairy, fish, fish, poultry, and egg products from the diet, deriving their protein from such sources as beans, tofu and other soy products, nuts, seeds, and whole grains. Vegans go further than most other vegetarians, however, in avoiding items of dress, cosmetics, other products for personal use, or jewelry made from animal products. These would include items made of fur, leather, silk, or wool; jewelry set with pearls, mother-of-pearl, or inlays of white shell or spiney oyster shell (commonly found in Native American jewelry); any food that contains honey, whey, rennet, or gelatin; any cosmetics containing beeswax, glycerin, or lanolin; any cosmetics or personal care products that are tested on animals; soap made with animal rather than vegetable fat; any item made of wood that has been finished with shellac (which is made from a resin secreted by scale insects); and toothpaste containing calcium extracted from animal bones. Vegans also typically avoid zoos, circuses, rodeos, and other activities that they regard as exploiting animals for human amusement.

The numbers of adult vegans in the United States and the United Kingdom vary somewhat depending on the particular population survey or poll. According to a 2002 poll conducted by Time magazine and CNN, 4% of American adults define themselves as vegetarians, and 5% of these vegetarians say that they are vegans, which comes to about 0.2% of the adult American population. Charles Stahler reported in an article in Vegetarian Journal in 2006, however, that a poll conducted by Harris Interactive indicated that vegans comprise about 1.3% of the adult population in the United States, or 2.4 million adults. He estimated that about half the vegetarians in Canada and the United States are vegans, which is considerably higher than the percentage given by Time in 2002. The American Dietetic Association (ADA) and the Dietitians of Canada (DC) accept Stahler's estimate that somewhere between 40% and 50% of vegetarians in North America are vegans. In the United Kingdom, the UK Food Standards Agency stated in 2002 that approximately 0.25% of British adults are vegans. The Times (London) reported in 2005, however, that there are at least 250,000 vegans in Britain, which represents about 0.4% of the adult population.


Although the term veganism was not used before the twentieth century, people have practiced vegan lifestyles for thousands of years. Veganism is not, however, natural to human beings, based on the evolutionary evidence. Archaeological findings indicate that prehistoric humans were not vegans, but obtained about a third of their daily calories from meat or other animal products. The structure of the human digestive tract suggests that humans evolved as omnivores (animals that feed on both plant and animal substances), as human intestines are relatively short in comparison


Ahimsa —A Sanskrit word for non-killing and non-harming, adopted by the American Vegan Society as its official watchword. The AVS notes that the six letters in ahimsa stand for the basic principles of veganism: Abstinence from animal products; Harm-lessness with reverence for life; Integrity of thought, word, and deed; Mastery over oneself; Service to humanity, nature, and creation; and Advancement of understanding and truth.

Glycerin —A sweet syrupy alcohol obtained from animal fats. It is often used in cough syrups and other liquid medications to give them a smooth texture.

Lactovegetarian —A vegetarian who uses milk and cheese in addition to plant-based foods.

Lanolin —A greasy substance extracted from wool, often used in hand creams and other cosmetics.

Omnivore —An animal whose teeth and digestive tract are adapted to consume either plant or animal matter. The term does not mean, however, that a given species consumes equal amounts of plant and animal products. Omnivores include bears, squirrels, opossums, rats, pigs, foxes, chickens, crows, monkeys, most dogs, and humans.

Ovolactovegetarian —A vegetarian who consumes eggs and dairy products as well as plant-based foods. The official diet recommended to Seventh-day Adventists is ovolactovegetarian.

Ovovegetarian —A vegetarian who eats eggs in addition to plant-based foods.

Pepsin —A protease enzyme in the gastric juices of carnivorous and omnivorous animals that breaks down the proteins found in meat. Its existence in humans is considered evidence that humans evolved as omnivores.

Quinoa —A species of goosefoot that originated in the high Andes and is raised as a food crop for its edible seeds, which have an unusually high protein content (12–18 percent). Quinoa is considered a pseudo-cereal rather than a true cereal grain because it is not a grass.

Rennet —An enzyme used to coagulate milk, derived from the mucous membranes lining the stomachs of unweaned calves.

Tempeh —A food product made from whole fermented soybeans that originated in Indonesia. It can be used as a meat substitute in vegan dishes or sliced and cooked in hot vegetable oil.

Textured vegetable protein (TVP) —A meat substitute made from defatted soybean flour formed into a dough and cooked by steam while being forced through an extruder. It resembles ground beef in texture and can replace it in most recipes. TVP is also known as textured soy protein or TSP.

Tofu —Bean curd; a soft food made by coagulating soy milk with an enzyme, calcium sulfate, or an organic acid, and pressing the resulting curds into blocks or chunks. Tofu is frequently used in vegetarian or vegan dishes as a meat or cheese substitute.

Vegan —A vegetarian who excludes all animal products from the diet, including those that can be obtained without killing the animal. Vegans are also known as strict vegetarians or pure vegetarians.

Whey —The watery part of milk, separated out during the process of making cheese.

with the lengthy intestines found in herbivores (plant-eating animals). Like the stomachs of other carnivores (meat-eating animals) and omnivores, the human stomach secretes pepsin, an enzyme necessary for digesting the proteins found in meat rather than plant matter. The human mouth contains pointed teeth (canines and incisors) adapted for tearing meat as well as teeth with flat crowns (molars) for chewing plant matter. In addition to the anatomical evidence, anthropologists have not discovered any primitive societies in the past or present whose members maintained good health and consumed a vegan diet.

The earliest motivation for what would now be called veganism is religious faith and practice. The book of Daniel in the Old Testament, for example, written some time between the sixth and second centuries bc, describes Daniel and his three companions summoned to the court of King Nebuchadnezzar of Babylon as refusing the rich food and drink offered them by the king. In Daniel 1:12, the Hebrew youths tell the master of the palace, “Please test your servants for ten days. Let us be given vegetables to eat and water to drink.” At the end of the trial period, the four youths are found to be in better health than those who had eaten the “royal rations” (Daniel 1:15). During this same time period, the followers of the philosopher and mathematician Pythagoras (c. 582–507 bc) in ancient Greece practiced an ascetic lifestyle that included a vegan diet and abstaining from animal bloodshed, including sacrifices to the Greek gods.

In Asia, the Jain religion, which is an ascetic offshoot of Hinduism that began in the sixth century BC, still requires followers to adopt a vegan diet; they may also not eat roots because to do so kills the plant. Most Jains fast on holy days and at other times throughout the year, as they believe that fasting strengthens self-control as well as protecting the believer from accumulating bad karma.

Mainstream Christianity in both its Eastern (Greek-speaking) and Western (Latin-speaking) forms has never required ordinary laypeople to adopt a vegan diet as a year-round practice. Some monastic communities, however, have practiced a vegetarian lifestyle since the fourth century AD, and a few monastic groups and individual ascetics are vegans. Since the formation of vegan societies in the United Kingdom and North America, some Christian laypeople have chosen to join them. One Christian denomination that was formed in the United States in the nineteenth century, namely the Seventh-day Adventist Church, has expected its members to be vegetarians since its beginning. Although most Adventists follow the denomination's official diet, which is ovolactovegetarian, a significant proportion of the members are vegans.

Most people who have become vegans since World War II, however, do so out of concern for the environment or compassion for animals. The statement of the American Vegan Society (AVS), founded in 1960, is a typical expression of these convictions: “Veganism is compassion in action. It is a philosophy, diet, and lifestyle. Veganism is an advanced way of living in accordance with Reverence for Life, recognizing the rights of all living creatures, and extending to them the compassion, kindness, and justice exemplified in the Golden Rule.” The official slogan of the AVS, “Ahimsa Lights the Way,” refers to the Sanskrit word for not killing and not harming other living creatures.

Many members of New Age groups, as well as some atheists and agnostics, practice a vegan lifestyle out of respect for nature or for the earth, even though they would not consider themselves religious in the conventional sense. One group that broke from the Vegan Society in England in 1984, founded by its former secretary, Kathleen Jannaway, and her husband Jack, is called the Movement for Compassionate Living (MCL), and emphasizes “the use of trees and vegan-organic farming to meet the needs of society for food and natural resources” as well as promoting “simple living and self-reliance as a remedy against the exploitation of humans, animals and the Earth.”


In the past, planning a nutritionally adequate vegan diet was difficult because the standard food choice guides in use in Canada and the United States had not been designed for vegetarians in general, let alone vegans. Although the 1992 revisions of the familiar U.S. Department of Agriculture (USDA) food guide pyramid and Canada's Food Guide to Healthy Eating (CFGHE) were the first to consider overnutrition as a serious health problem and emphasized the importance of plant foods in the diet, they did not include guidelines for planning vegetarian diets. In 2003 the ADA and DC jointly issued “A New Food Guide for North American Vegetarians,” intended to accommodate the needs of vegans as well as those of less strict vegetarians. The 2003 document notes that “... any guide aimed at vegetarians must consider the needs of vegans. Studies also indicate that a substantial percentage of vegan women ... have calcium intakes that are too low, which suggests that calcium deserves special attention in vegetarian food guides. With few exceptions, vegetarian food guides have not provided appropriate guidelines for vegans.”

Vegans vary considerably in their patterns of food intake; as a result, there is no one specific diet regimen that could be called vegan. Most vegan cookbooks contain a chapter on nutritional guidelines, including daily calorie requirements; protein, calcium, and vitamin contents of various foods; and sample menus intended to make the point that a vegan diet does not have to be monotonous or flavorless. A table of vegan menus in an article available from the Vegetarian Resource Group is titled “Sample Menus Showing How Easy It Is to Meet Protein Needs”

  • Breakfast: 1 cup oatmeal (6 g protein); 1 cup soymilk (9 g); 1 bagel (9 g).
  • Lunch: 2 slices whole wheat bread (5 g); 1 cup vegetarian baked beans (12 g).
  • Dinner: 5 ounces firm tofu (11 g); 1 cup cooked broccoli (4 g); 1 cup cooked brown rice or quinoa (5 g); 2 tbsp almonds (4 g).
  • Snack: 2 tbsp peanut butter (8 g); 6 crackers (2 g).
  • Breakfast: 2 slices whole wheat toast (5 g); 2 tbsp peanut butter (8 g).
  • Lunch: 6 ounces soy yogurt (6 g); 1 baked potato (4 g); 2 tbsp almonds (4 g).
  • Dinner: 1 cup cooked lentils (18 g); i cup cooked bulgur wheat (6 g)
  • Snack: 1 cup soymilk (9g)

The first set of menus provides a total of 75 grams of protein, adequate for a male vegan weighing 160 pounds. The second set provides a total of 60 grams of protein, adequate for a female vegan weighing 130 pounds.


The vegan lifestyle is adopted by people in developed countries primarily for ethical or religious reasons rather than economic necessity—although some nutritionists do point out that plant-based foods are usually easier on the household food budget than meat. On the other hand, the ADA notes that soy milk, used by many vegans as a source of calcium and protein, is considerably more expensive than cow's milk. Another more recent reason for veganism is the growing perception that plant-based diets are a form of preventive health care for people at increased risk of such diseases as heart disease, type 2 diabetes and some forms of cancer. Adolescents, however, are more likely to adopt vegan diets as a weight reduction regimen or in some cases as an ethical way to protest their parents' patterns of dress or food comsumption; one Swedish study of vegan youth concluded that veganism was “a new type of status passage.” In a very few cases, adolescents adopt veganism to camouflage an existing eating disorder, as noted by the ADA.


The benefits of a vegan diet are similar to the health benefits of less strict vegetarian diets: lowered blood pressure, lower rates of cardiovascular disease and stroke, lower blood cholesterol levels, and lowered risks of colon and prostate cancer are associated with a vegan diet. Most people lose weight on a vegan diet, especially in the first few months; moreover, weight loss is usually greater on a vegan diet than on a vegetarian diet permitting dairy products. In addition, most vegans have lower body mass indices (an important diagnostic criterion of obesity ) than their meat-eating counterparts. Vegan diets also appear to lower the risk of developing type 2 (adult-onset) diabetes.


As with adoption of any vegetarian diet, people considering a vegan diet should consult a registered dietitian as well as their primary physician before starting their new lifestyle. The reason for this precaution is the strictness of vegan regimens as well as the variations in height, weight, age, genetic inheritance, food preferences, level of activity, geographic location, and preexisting health problems among people. A nutritionist can also help design a diet that a vegan will enjoy eating as well as getting adequate nourishment and other health benefits.

It is particularly important for pregnant or nursing women, or for families who wish to raise their children as vegans, to consult a dietitian as well as a pediatrician. There is some helpful and nutritionally sound information on the Vegetarian Resource Group website regarding meeting protein requirements during pregnancy, the protein needs of infants, and “feeding vegan children.”


The longstanding concern expressed by nutritionists and other health professionals about vegan diets is the risk of nutritional deficiencies, particularly for such important nutrients as protein, minerals (iron, calcium, and zinc ), vitamins (vitamin D, riboflavin, vitamin B12, and vitamin A ), iodine, and n-3 fatty acids. The 2003 vegetarian food guide published by the ADA and DC recommends that vegans in all age groups should take supplements of vitamin B12 and vitamin D, or use foods fortified with these nutrients. It is particularly important for pregnant women to maintain an adequate intake of vitamin B12, as a lack of this vitamin can cause irreversible neurological damage in the infant. In addition, some studies indicate that vegans are at increased risk of osteoporosis and bone fractures compared to either meat-eaters or less strict vegetarians because their average calcium intake is lower.

The ADA states simply that “Unsupplemented vegan diets do not provide vitamin B12. Dairy products and eggs supply vitamin B12; however, depending on food choices, some lacto-ovo-vegetarians may have inadequate intakes [of these nutrients] as well [as vegans]. The Institute of Medicine has recommended that all people over the age of 50, regardless of type of diet, take vitamin B12 in the form found in supplements and fortified foods for optimal absorption. Vitamin B12 is well-absorbed from fortified nondairy milks and from breakfast cereals, as well as from supplements. Because vitamin B12 absorption is inversely related to dosage, a daily supplement of at least 5 mg or a weekly supplement of 2,000.” Vitamin D supplements are recommended and may be particularly important for vegans living in northern latitudes or other situations in which they receive little sun, because this vitamin is synthesized in the skin during exposure to sunlight. The ADA notes that “Many fortified nondairy milks and breakfast cereals provide [vegans with] vitamin D, although the form used to fortify cereals is often not vegan.”


  • Have you ever supervised a patient on a vegan diet?
  • What is your opinion of veganism compared to less strict forms of vegetarianism?
  • Do you agree with the ADA and Institute of Medicine guidelines?
  • Have you ever treated a patient with a health problem related to a calcium or vitamin B12 deficiency from following a vegan diet?

In addition to nutritional concerns, there is some evidence that vegan diets may actually increase the risk of breast cancer in women, particularly in those who use large amounts of soy-based products. Soybeans contain phytoestrogens, or plant estrogens, which have been implicated in breast cancer. The plant estrogens in soy-based products may also explain why committed vegans have a disproportionate number of female babies, and why these girls have a higher rate of precocious puberty than girls born to nonvegetarian mothers.

Research and general acceptance

Studies of the role of vegetarian diets of all types in preventing disease go back to the 1960s, when the National Institutes of Health (NIH) and the National Cancer Institute (NCI) began to study members of the Seventh-day Adventist Church. NIH findings indicate that Adventist men live on average seven years longer than men in the general population, and Adventist women eight years longer than their non-Adventist counterparts.

Studies of vegans as a subpopulation of vegetarians are fewer in number than those of less strict vegetarians; however, the emphasis in medical research has shifted in the early 2000s from concern about nutritional deficiencies in people following these diets to the role of plant-based diets in preventing or treating chronic diseases. In this regard vegan diets and lifestyles appear to be beneficial. One 2005 study of 64 overweight postmenopausal women found that a vegan diet brought about a significant weight loss and improved insulin sensitivity (an important factor in evaluating the patient's risk of developing type 2 diabetes), despite the lack of prescribed limits on food portion size or calorie intake. Two studies published in 2004 comparing a group of overweight adults on a vegan diet with a control group following a National Cholesterol Education Program Step II Diet showed that the low-fat vegan diet was as acceptable to the subjects as the Step II diet, and was equally effective in promoting weight loss. Those on the vegan diet, however, told the researchers that the vegan diet was harder to prepare than their normal meals.

In terms of general acceptance, vegan diets differ from less strict vegetarian regimens in being more difficult to follow and in causing more social friction with nonvegans. Some vegetarians who are not vegans have noted that evaluating foods, clothing, cosmetics, and other items as not containing animal products often requires considerable knowledge of production methods as well as the derivation of the ingredients. In addition, such items as vitamins, dietary supplements, and prescription medications may be processed using non-vegan ingredients (gelatin for capsules, glycerin in some liquid medications), and these are not always listed on the packaging. The complications of replacing animal-derived ingredients in some recipes and the difficulty of finding restaurants offering dishes acceptable to vegans also contribute to a widespread perception of veganism as a potentially problematic lifestyle.



Harris, William, MD. The Scientific Basis of Vegetarianism. Honolulu, HI: Hawaii Health Publishers, 1995.

Stepaniak, Joanne. The Vegan Sourcebook, 2nd ed., with nutrition section by Virginia Messina. Los Angeles: Lowell House, 2000.

Stuart, Tristan. The Bloodless Revolution: A Cultural History of Vegetarianism from 1600 to Modern Times. New York: W. W. Norton &Co., 2006.


Piekarski, Ro, and Joanna Piekarski. Everybody's Vegan Cookbook. Buckingham, VA: Integral Yoga Publications, 2003.

Raymond, Carole. Student's Go Vegan Cookbook: Over 135 Quick, Easy, Cheap, and Tasty Vegan Recipes. New York: Three Rivers Press, 2006.

Sass, Lorna J. The New Vegan Cookbook: Innovative Vegetarian Recipes Free of Dairy, Eggs, and Cholesterol. San Francisco: Chronicle Books, 2001.

Tucker, Eric. The Artful Vegan: Fresh Flavors from the Millennium Restaurant. Berkeley, CA: Ten Speed Press, 2003.

Wasserman, Debra, and Reed Mangels, PhD, RD. Simply Vegan: Quick Vegetarian Meals, Vegan Nutrition, and Cruelty-Free Shopping, 4th ed. Baltimore, MD: Vegetarian Resource Group, 2006.


American Dietetic Association and Dietitians of Canada. “Position of the American Dietetic Association and Dietitians of Canada: Vegetarian Diets.” CanadianJournal of Dietetic Practice and Research 64 (Summer 2003): 62–81.

Barnard, N. D., A. R. Scialli, G. Turner-McGrievy, and A. J. Lanou. “Acceptability of a Low-Fat Vegan Diet Compares Favorably to a Step II Diet in a Randomized, Controlled Trial.” Journal of Cardiopulmonary Rehabilitation 24 (July-August 2004): 229–235.

Goff, L. M., J. D. Bell, P. W. So, et al. “Veganism and Its Relationship with Insulin Resistance and Intramyocel-lular Liquid.” European Journal of Clinical Nutrition 59 (February 2005): 291–298.

Key, T. J., P. N. Appleby, and M. S. Rosell. “Health Effects of Vegetarian and Vegan Diets.” Proceedings of the Nutrition Society 65 (February 2006): 35–41.

Larsson, C. L., U. Ronnlund, G. Johansson, and L. Dahlg-ren. “Veganism as Status Passage: The Process of Becoming a Vegan among Youths in Sweden.” Appetite 41 (August 2003): 61–67.

Smith, A. M. “Veganism and Osteoporosis: A Review of the Literature.” International Journal of Nursing Practice 12 (October 2006): 302–306.

Stahler, Charles. “How Many Adults Are Vegetarian?”. Vegetarian Journal, no. 4 (2006). Available online at (accessed March 4, 2007).

Turner-McGrievy, G. M., N. D. Barnard, A. R. Scialli, and A. J. Lanou. “Effects of a Low-Fat Vegan Diet and a Step II diet on Macro- and Micronutrient Intakes in Overweight Postmenopausal Women.” Nutrition 20 (September 2004): 738–746.

Phillips, F. “Vegetarian Nutrition.” Nutrition Bulletin 30: 132–167.


Farrell, Kate, and Myra Kornfeld. Absolutely Tofu, vols. 1 and 2. New York: B-Rave Studios, 1996. Running time: 60 minutes per video.

Harris, William, MD. The Scientific Basis of Vegetarianism (1994). Includes extra footage of “Hawaii's Vegetarian Athletes.”

Klaper, Michael, MD. A Diet for All Reasons (1992). Running time: 60 minutes.

Vegan Society (UK). Truth or Dairy? The Vegan Society (UK) with Benjamin Zephaniah and a Star-Studded Vegan Cast (1994). Running time: 22 minutes. Benjamin Zephaniah is a rap-style popular singer.


American Dietetic Association (ADA) and the Dietitians of Canada (DC). A New Food Guide for North American Vegetarians. Chicago, IL: ADA, 2003. Available online in PDF format at

Mangels, Reed, PhD, RD. Protein in the Vegan Diet. Baltimore, MD: Vegetarian Resource Group, 2006. Available online at (accessed March 4, 2007).

Mangels, Reed, PhD, RD, and Katie Kavanagh-Prochaska, Dietetic Intern. Vegan Nutrition in Pregnancy and Childhood. Baltimore, MD: Vegetarian Resource Group, 2003. Available online at (accessed March 4, 2007).

Seventh-day Adventist Dietetic Association (SDADA). A Position Statement on the Vegetarian Diet. Orlando, FL: SDADA, 2005. Available online at

Weingartner, Karl E., PhD. How to Make Tempeh at Home, National Soybean Research Laboratory, University of Illinois at Urbana-Champaign. Available online at March 4, 2007).


American Dietetic Association (ADA). 120 South Riverside Plaza, Suite 2000, Chicago, IL 60606-6995. Telephone: (800): 877–1600. Website:

American Vegan Society (AVS). 56 Dinshah Lane, P. O. Box 369, Malaga, NJ 08328. Telephone: (856) 694–2887. Website:

Dietitians of Canada/Les dietetistes du Canada (DC). 480 University Avenue, Suite 604, Toronto, Ontario, Canada M5G 1V2. Telephone: (416) 596–0857. Website:

Movement for Compassionate Living (MCL). 105 Cyfyng Road, Ystalyfera, Swansea SA9 2BT, United Kingdom. No telephone. Website:

Seventh-day Adventist Dietetic Association (SDADA). 9355 Telfer Run, Orlando, FL 32817. Website: SDADA is an official affiliate of the ADA.

The Vegan Society. Donald Watson House, 7 Battle Road, St. Leonards-on-Sea, East Sussex, TN37 7AA, United Kingdom. Telephone: 01424 427393. Website: The oldest organized vegan group, founded in 1944.

Vegetarian Resource Group (VRG). P.O. Box 1463, Dept. IN, Baltimore, MD 21203. Telephone: (410) 366-VEGE. Website: Publishes Vegetarian Journal, a quarterly periodical that contains many articles of interest to vegans.

Rebecca J. Frey, PhD