We’ve all heard about the benefits of being a vegan or vegetarian. Some of the touted benefits include heart health, weight loss, decreased cancer risk, and decreased risk of diabetes. Sounds good, doesn’t it?

But all those benefits to one’s health are potential benefits, not a guarantee. To be a healthy vegan or vegetarian, one has to be knowledgeable and thoughtful about what one is eating.

Some of my sickest patients have been vegetarians. The problem was NOT about eating a vegetarian diet in itself. The problem was HOW the diet was implemented.

When I take a detailed medical history, I often find that the typical vegetarian diet my patients are eating is unhealthy. For example, here’s the diet that Mr. G, a proud vegetarian, related to me when he came for his initial appointment for complaints of fatigue and difficulty concentrating.

A typical breakfast for Mr. G consisted of boxed cereal with milk, agave sweetener and sliced banana, a glass of orange juice and a piece of bread with jam. For lunch Mr. T usually ate a bean burrito or cheese sandwich with a soda. When Mr. G got hungry in the afternoon, he grabbed a power bar for a quick pick me up. A typical dinner included pasta with tomato sauce, garlic bread, a few sprigs of broccoli, dessert and a glass of wine.

This kind of diet is a bomb waiting to happen!

Let’s dissect the diet and see where the potential problems are:

• Heavy use of grains are common in vegetarian diets. Milled grains are grains that have been ground and turned into flour. Bread, pasta and chips are examples of milled grains. They turn to sugar quickly and are considered simple carbohydrates. In fact, as soon as the flour-based food enters the mouth, it mixes with the saliva when the food is chewed. The saliva contains enzymes that instantly turn the flour into sugar. Milled grains cause the blood sugar to rise quickly, making the insulin spike. Insulin helps bring the sugar out of the blood and into the cells. Too much insulin is a troublemaker. Insulin triggers the liver to make cholesterol. High insulin levels are known to contribute to inflammation throughout the body. And high insulin levels have been associated with obesity, diabetes, and heart disease. It surprises people to learn that the liver makes excess cholesterol with a high sugar diet, even if there is no animal food eaten.

• Heavy use of sugars in the diet can cause the same problems as the milled grains. Sugars can lead to sugar-addiction in some people, such that they crave sweets constantly, much like an alcoholic craves alcohol. And sugar can cause yeast colonies in the gut to multiply out of control. Cancer cells use sugar to fuel their growth.

• Fruit juices have concentrated fructose. Drinking a 6 oz. glass of orange juice is like eating 3-4 oranges, the equivalent of eating about 6-8 teaspoons of sugar. Too much fructose is associated with similar problems that arise from eating too many milled grains and too much sugar.

• Power bars are often loaded with sugar. Since they’re sold at health food stores, the health benefits can be misleading. Read on the label the grams of sugar. When counting up grams of sugar, be sure to include not only the added sugar, but also the sugar in the dried fruit used in the power bar in order to get the total sugar intake. The body does not make a big distinction between the natural sugar in the food and the added sugar.

• Alcohol is made from fermented sugars. Alcohol does indeed have plenty of anti-oxidants, as we’ve been told by the cardiologists, but alcohol also raises the blood sugar and insulin levels. It creates the same havoc on the body as does sugar. And alcohol, a socially acceptable toxin, taxes the liver.

What I’ve just described is the downside of a vegan or vegetarian diet with far too many simple carbohydrates and sugars.

The upside of this kind of diet is very positive and does indeed offer all the benefits that have been touted— if the food in the meals are thoughtfully prepared with one’s health foremost in mind.

So, what does a healthy vegetarian or vegan diet look like? Mr. T is a vegan and the picture of good health. He’s 68 years old and a world-class athlete. His diet calls for exclusively unprocessed whole foods, non GMO and organically grown. He is careful to have some form of plant-based protein and fat with each meal to keep his blood sugar stable so he won’t crave sugar and other simple carbs, and so his energy levels can be sustained for several hours.

Mr. T’s breakfast is often a smoothie with freshly made coconut milk, tahini or other nut butter, a handful of berries, and a tablespoon of green powder that represents dozens of green vegetables.

For lunch, Mr. T often makes a cabbage leaf wrap with avocado, homemade bean paste, sprouts, and tomato. If he has time in his schedule, he makes a fresh vegetable juice in his juicer. Sometimes he makes lemonade with freshly squeezed lemons sweetened with Stevia.

Dinner can include a mix of cooked greens and roasted root vegetables, such as parsnips, beets, carrots and sweet potatoes, doused with olive oil and a sprinkle of Himalayan salt. For protein, he’ll add pecans or sprouted pumpkin seeds to his veggies. His dinners often include a portion of his homemade raw sauerkraut for natural probiotics. His desserts are all without added sugar, like half a frozen banana, or perhaps he’ll have coconut cream with a handful of berries and nuts.

Clearly, Mr. T puts thought and care into his diet. He eats plant-based proteins and fats with every meal; he avoids added sugars and all processed foods and limits the amount of fruit he eats to two portions a day. His food is organic and non GMO. He rarely eats milled grains, preferring whole grains. Most of his grocery shopping takes place in the periphery of the store where the fresh produce is located. His diet is a combination of raw and cooked foods and includes a hefty amount of vegetables. Mr. T avoids wheat entirely due to the multiple problems associated with the wheat grown in the US. His snacks are healthy and sustaining.

Mr. T is the picture of good health. He is vigorous and looks ten years younger than his stated age. As you can see, veganism and vegetarianism can indeed be routes to good health, but ONLY when done with a great deal of thought put into each meal. Whatever type of diet you choose to eat, make sure that the basic principles for healthy eating are followed.

Here’s to your good health!