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I Eat Mostly Plants. What Am I Missing?
Vegan and Vegetarian Nutrition Without Guessing: The Nutrients to Watch and the Worries to Drop
by An Thanh Tùng
About this book
A plant eater's blind spots are few and predictable, and the top of the list is B12, not protein.Chapter 1
A plain-language, evidence-labeled guide for adults who eat vegan, vegetarian, mostly plants, or plants on certain days, and wonder what they might be missing. Instead of guessing, it maps your blind spots by the way you actually eat, from B12, the one you cannot skip, to iron, iodine, calcium, protein and omega-3. It separates the worries you can drop, like soy and protein combining, from the few worth keeping, takes an honest look at mock meat and ultra-processed plant foods, explains which blood tests are worth asking for and how to read them, and ends with a five-line Minimum Kit, seven-day menus for three ways of eating and twelve recipes from around the world.
What you'll learn
- Ch. 4B12 is made by bacteria, not plantsVegans need a reliable, regular source. “Now and then” is not enough.
- Ch. 3No need to combine proteinsBeans at the centre of the plate do the work. You don't have to pair proteins at every meal.
- Ch. 6Iron depends on what you eat it withAdd vitamin C to meals, move tea and coffee between meals, and soak your beans.
- Ch. 8Don't use kelp for iodineIt's easy to overshoot. Iodised salt or fortified foods are the safer route.
- Ch. 9The worries worth droppingSoy, lectins and protein combining need no worry. Arsenic in rice and lead in protein powder deserve more attention.
- Ch. 12A “normal” result can misleadA normal B12 can be borderline, and hair and IgG tests are not nutrition tests.
How the book is organized
- Part IWhat Kind of Plant Eater Are You?
- Part IIThe Nutrients to Watch
- Part IIIWorries to Drop, and a Few to Keep
- Part IVYour Plan
Look inside
Pages from the book
From the review draft.
- How to read this book
- Chapter 1 opens
- Every claim carries a label
- Try it at home
- If you remember one thing
- The evidence at a glance
- A printable worksheet
Free with your email
Worksheets from this book
From the review draft. Final versions are posted on publication day.
- Worksheet The Blind-Spot Map Get the PDF
- Worksheet Your Personal Minimum Kit Get the PDF
- Worksheet The No-Guesswork Plant Kitchen Get the PDF
- Worksheet Seven-Day Menu: Vegan Get the PDF
- Worksheet Seven-Day Menu: Lacto-Ovo Vegetarian Get the PDF
- Worksheet Day Vegetarian Menu: Seven Plant Days to Get the PDF
- Worksheet Twelve Recipes Get the PDF
- Worksheet The Card for Your Doctor Get the PDF
- Worksheet The Plant Plate: Score Three Meals Get the PDF
- Worksheet Moving Tea Time: Two Weeks Get the PDF
- Worksheet Four-Week Diary Get the PDF
- Safety card Safety Flags at a Glance Get the PDF
- Reference table If You Notice… Read… Get the PDF
- Reference table Plant Foods Dictionary Get the PDF
- Reference table Calcium, Iron, Iodine and B12 Sources Get the PDF
78 references
Notes and sources
Ch. 1I Eat Mostly Plants. What Am I Missing?6
- Planned vegetarian and vegan diets for adults Raj S, Guest NS, Landry MJ, Mangels AR, Pawlak R, Rozga M. Vegetarian dietary patterns for adults: a position of the Academy of Nutrition and Dietetics. J Acad Nutr Diet 2025;125(6):831–846.e2. This position does not cover pregnancy or breastfeeding.
- Nutrients that run lower in plant eaters Neufingerl N, Eilander A. Nutrient intake and status in adults consuming plant-based diets compared to meat-eaters: a systematic review. Nutrients 2021;14(1):29. doi:10.3390/nu14010029. Both authors are employees of Unilever, which sells fortified foods and supplements, as declared in the article.
- How many people eat plant-based diets in the US Gallup. In U.S., 4% identify as vegetarian, 1% as vegan. 2023. Academy of Nutrition and Dietetics, news release on the 2025 position, February 2025.
- Plant-based eating in Europe Smart Protein Project (ProVeg International, University of Copenhagen and partners). European consumer survey on plant-based foods.
- Vegetarianism in India Pew Research Center. Religion in India: Tolerance and Segregation. 2021.
- Seventh-day Adventists Orlich MJ, et al. Vegetarian dietary patterns and mortality in Adventist Health Study 2. JAMA Intern Med 2013. doi:10.1001/jamainternmed.2013.6473.
Ch. 2Five Lunches, Five Places3
- Who is most likely to be short of B12 Pawlak R, Parrott SJ, Raj S, Cullum-Dugan D, Lucus D. How prevalent is vitamin B12 deficiency among vegetarians? Nutr Rev 2013;71(2):110–117. doi:10.1111/nure.12001.
- B12 stores Rizzo G, Laganà AS, Rapisarda AMC, et al. Vitamin B12 among vegetarians: status, assessment and supplementation. Nutrients 2016;8(12):767.
- Tea and iron, iodine and plant milk, calcium in tofu, salt in plant-based burgers See Chapters 6, 8, 7 and 10.
Ch. 3The Plant Plate That Covers You4
- No need to combine proteins at each meal Mariotti F, Gardner CD. Dietary protein and amino acids in vegetarian diets: a review. Nutrients 2019;11(11):2661. doi:10.3390/nu11112661.
- Healthful and unhealthful plant-based diets and heart disease Satija A, Bhupathiraju SN, Spiegelman D, et al. Healthful and unhealthful plant-based diets and the risk of coronary heart disease in U.S. adults. J Am Coll Cardiol 2017;70(4):411–422.
- Fortified foods as a shield Eveleigh ER, Coneyworth LJ, Avery A, Welham SJM. Vegans, vegetarians, and omnivores: how does dietary choice influence iodine intake? A systematic review. Nutrients 2020;12(6):1606. doi:10.3390/nu12061606. Academy of Nutrition and Dietetics position, 2025 (see Chapter 1).
- Protein combining in popular books Lappé FM. Diet for a Small Planet. New York: Ballantine Books; 1971; tenth anniversary edition 1981.
Ch. 4B12: The One You Can't Skip8
- B12 deficiency in vegetarians and the need for a reliable source Pawlak et al. 2013. See Chapter 2. Raj et al. 2025. See Chapter 1.
- Forms and doses of B12 in vegans Fernandes S, Oliveira L, Pereira A, et al. Exploring vitamin B12 supplementation in the vegan population: a scoping review of the evidence. Nutrients 2024.
- Spirulina, seaweed, fermented foods and mushrooms Watanabe F, Yabuta Y, Bito T, Teng F. Vitamin B12-containing plant food sources for vegetarians. Nutrients 2014;6(5):1861–1873. doi:10.3390/nu6051861.
- Nori in a human study Yamada K, Yamada Y, Fukuda M, Yamada S. Bioavailability of dried asakusanori (Porphyra tenera) as a source of cobalamin. Int J Vitam Nutr Res 1999;69(6):412–418.
- Older vegetarians Foster M, Chu A, Samman S. Vegetarian nutrition for the older adult: vitamin B12, iron, and zinc. Curr Nutr Rep 2017;6(2):93–100.
- Metformin, acid-reducing medicines and testing Patel H, McGuirk R. Vitamin B12 deficiency: common questions and answers. Am Fam Physician 2025;112(3):294–300. Medicines and Healthcare products Regulatory Agency. Metformin and reduced vitamin B12 levels: new advice for monitoring patients at risk. Drug Safety Update, 2022.
- B12 and breastfeeding Centers for Disease Control and Prevention. Vitamin B12 and Breastfeeding.
- Nerve symptoms Rizzo et al. 2016. See Chapter 2.
Ch. 5Protein: The Biggest Worry, the Smallest Gap4
- Vegetarians and protein Mariotti and Gardner 2019. See Chapter 3. Neufingerl and Eilander 2021. See Chapter 1.
- Protein for older adults Bauer J, Biolo G, Cederholm T, et al. Evidence-based recommendations for optimal dietary protein intake in older people: a position paper from the PROT-AGE Study Group. J Am Med Dir Assoc 2013;14(8):542–559. doi:10.1016/j.jamda.2013.05.021.
- Plant protein and resistance training Hevia-Larraín V, Gualano B, Longobardi I, et al. High-protein plant-based diet versus a protein-matched omnivorous diet to support resistance training adaptations: a comparison between habitual vegans and omnivores. Sports Med 2021. doi:10.1007/s40279-021-01434-9.
- Heavy metals in protein powder See Chapter 9.
Ch. 6Iron and Zinc: Enough on Paper, Low in the Blood5
- Iron stores, absorption, tea, vitamin C and phytate Saunders AV, Craig WJ, Baines SK, Posen JS. Iron and vegetarian diets. Med J Aust 2013;199(4 Suppl):S11–S16. doi:10.5694/mja11.11494. One author worked for Sanitarium, a plant-food company that sponsored the supplement in which this review appeared, as declared in the article.
- Iron status in vegetarian adults Pawlak R, Berger J, Hines I. Iron status of vegetarian adults: a review of literature. Am J Lifestyle Med 2016. doi:10.1177/1559827616682933.
- Vitamin C and iron absorption Heffernan A, Evans C, Holmes M, Moore JB. The regulation of dietary iron bioavailability by vitamin C: a systematic review and meta-analysis. Proc Nutr Soc 2017;76(OCE4):E182. doi:10.1017/S0029665117003445.
- Tea, coffee and iron absorption Hurrell RF, Reddy M, Cook JD. Inhibition of non-haem iron absorption in man by polyphenolic-containing beverages. Br J Nutr 1999;81(4):289–295.
- Zinc Foster M, Chu A, Petocz P, Samman S. Effect of vegetarian diets on zinc status: a systematic review and meta-analysis of studies in humans. J Sci Food Agric 2013;93(10):2362–2371. doi:10.1002/jsfa.6179. Foster et al. 2017. See Chapter 4.
Ch. 7Bones: The Study Plant Eaters Don't Like to Read3
- Fractures in EPIC-Oxford Tong TYN, Appleby PN, Armstrong MEG, et al. Vegetarian and vegan diets and risks of total and site-specific fractures: results from the prospective EPIC-Oxford study. BMC Med 2020;18(1):353. doi:10.1186/s12916-020-01815-3.
- Bone density and fractures in vegans Iguacel I, Miguel-Berges ML, Gómez-Bruton A, Moreno LA, Julián C. Veganism, vegetarianism, bone mineral density, and fracture risk: a systematic review and meta-analysis. Nutr Rev 2019;77(1):1–18. doi:10.1093/nutrit/nuy045.
- Calcium absorption from plant foods Weaver CM, Proulx WR, Heaney R. Choices for achieving adequate dietary calcium with a vegetarian diet. Am J Clin Nutr 1999;70(3 Suppl):543S–548S. Weaver CM, Plawecki KL. Dietary calcium: adequacy of a vegetarian diet. Am J Clin Nutr 1994;59(5 Suppl):1238S–1241S.
Ch. 8Iodine and Omega-3: The Quiet Two3
- Iodine in vegans, vegetarians and omnivores Eveleigh et al. 2020. See Chapter 3.
- Risks of excess iodine and kelp American Thyroid Association. ATA Statement on the Potential Risks of Excess Iodine Ingestion and Exposure. 2013, updated 2024.
- Omega-3 in vegetarians Saunders AV, Davis BC, Garg ML. Omega-3 polyunsaturated fatty acids and vegetarian diets. Med J Aust 2013;199(4 Suppl):S22–S26. doi:10.5694/mja11.11507. The lead author worked for Sanitarium, a plant-food company that sponsored the supplement in which this review appeared, as declared in the article. Neufingerl and Eilander 2021. See Chapter 1.
Ch. 9Keep the Worry or Drop It8
- Soy and breast cancer Wei Y, Lv J, Guo Y, et al. Soy intake and breast cancer risk: a prospective study of 300,000 Chinese women and a dose–response meta-analysis. Eur J Epidemiol 2020;35:567–578. doi:10.1007/s10654-019-00585-4. Shu XO, Zheng Y, Cai H, et al. Soy food intake and breast cancer survival. JAMA 2009;302(22):2437–2443.
- Soy and male hormones Reed KE, Camargo J, Hamilton-Reeves J, Kurzer M, Messina M. Neither soy nor isoflavone intake affects male reproductive hormones: an expanded and updated meta-analysis of clinical studies. Reprod Toxicol 2021;100:60–67. doi:10.1016/j.reprotox.2020.12.019. Co-author Mark Messina is executive director of the Soy Nutrition Institute and has consulted for the United Soybean Board.
- Lectins in dried beans Health Canada. Lectins in Dry Legumes.
- Oxalates and kidney stones North Bristol NHS Trust. Additional Information if You Form Calcium Oxalate Stones.
- Arsenic in rice Harvard Health Publishing, reporting US Food and Drug Administration advice on arsenic in rice, 2016.
- Lead in protein powders Consumer Reports. Protein powder and shake testing. October 2025.
- Plant-based eating and disordered eating McLean CP, Kulkarni J, Sharp G. Disordered eating and the meat-avoidance spectrum: a systematic review and clinical implications. Eat Weight Disord 2022;27(7):2347–2375. doi:10.1007/s40519-022-01428-0.
- Weight change in trials Wang et al. 2023. See Chapter 11.
Ch. 10Mock Meat: Plant Food or Ultra-Processed Food?12
- Defining ultra-processed food Monteiro CA, Cannon G, Levy RB, et al. Ultra-processed foods: what they are and how to identify them. Public Health Nutr 2019;22(5):936–941.
- Ultra-processed food and health outcomes Lane MM, Gamage E, Du S, et al. Ultra-processed food exposure and adverse health outcomes: umbrella review of epidemiological meta-analyses. BMJ 2024;384:e077310. doi:10.1136/bmj-2023-077310.
- Ultra-processed diets and calorie intake Hall KD, Ayuketah A, Brychta R, et al. Ultra-processed diets cause excess calorie intake and weight gain: an inpatient randomized controlled trial of ad libitum food intake. Cell Metab 2019;30(1):67–77.
- Plant foods, processing and heart disease Rauber F, Louzada MLC, Chang K, et al. Implications of food ultra-processing on cardiovascular risk considering plant origin foods: an analysis of the UK Biobank cohort. Lancet Reg Health Eur 2024. doi:10.1016/j.lanepe.2024.100948.
- Salt in meat alternatives Action on Salt. Meat Alternatives Survey. October 2018.
- Labelling of packaged vegetarian meat Consumer Council, Hong Kong. Vegetarian meat. CHOICE magazine, press release, 15 August 2019.
- Vegetarian restaurant dishes Centre for Food Safety and Consumer Council, Hong Kong. Sodium, Sugar, Fat and Energy Contents in Local Vegetarian Dishes. February 2021.
- Fortification and salt in plant-based meats The Food Foundation. Rethinking Plant-Based Meat Alternatives. August 2024.
- Nutritional profile of plant-based meats Wu J, El Sadig R. Are novel plant-based meat alternatives the healthier choice? Food Res Int 2024;183:114184. doi:10.1016/j.foodres.2024.114184.
- Swapping meat for plant-based meat: trials Crimarco A, Springfield S, Petlura C, et al. A randomized crossover trial on the effect of plant-based compared with animal-based meat on trimethylamine-N-oxide and cardiovascular disease risk factors in generally healthy adults: Study With Appetizing Plantfood—Meat Eating Alternative Trial (SWAP-MEAT). Am J Clin Nutr 2020. doi:10.1093/ajcn/nqaa203. Funded by Beyond Meat; the analysis plan was registered in advance and the analysis was done independently. Toh DWK, Fu AS, et al. Plant-based meat analogs and their effects on cardiometabolic health: an 8-week randomized controlled trial comparing plant-based meat analogs with their corresponding animal-based foods. Am J Clin Nutr 2024. doi:10.1016/j.ajcnut.2024.04.006.
- Seizure of expired mock meat Pháp luật Việt Nam newspaper, 21 October 2020.
- Salt limit World Health Organization. Guideline: Sodium Intake for Adults and Children. Geneva: WHO; 2012.
Ch. 11Heart, Blood Sugar, Weight: How Real Are the Benefits?6
- Heart disease and stroke in EPIC-Oxford Tong TYN, Appleby PN, Bradbury KE, et al. Risks of ischaemic heart disease and stroke in meat eaters, fish eaters, and vegetarians over 18 years of follow-up: results from the prospective EPIC-Oxford study. BMJ 2019;366:l4897. doi:10.1136/bmj.l4897.
- Pooled cohort studies Dybvik JS, Svendsen M, Aune D. Vegetarian and vegan diets and the risk of cardiovascular disease, ischemic heart disease and stroke: a systematic review and meta-analysis of prospective cohort studies. Eur J Nutr 2023;62(1):51–69. doi:10.1007/s00394-022-02942-8.
- Adventist Health Study 2 Orlich et al. 2013. See Chapter 1.
- Trials of vegetarian diets Wang T, Kroeger CM, Cassidy S, et al. Vegetarian dietary patterns and cardiometabolic risk in people with or at high risk of cardiovascular disease: a systematic review and meta-analysis. JAMA Netw Open 2023;6(7):e2325658. doi:10.1001/jamanetworkopen.2023.25658.
- Healthful and unhealthful plant-based diets and type 2 diabetes Satija A, Bhupathiraju SN, Rimm EB, et al. Plant-based dietary patterns and incidence of type 2 diabetes in US men and women: results from three prospective cohort studies. PLoS Med 2016;13(6):e1002039. Qian F, Liu G, Hu FB, Bhupathiraju SN, Sun Q. Association between plant-based dietary patterns and risk of type 2 diabetes: a systematic review and meta-analysis. JAMA Intern Med 2019;179(10):1335–1344. UK Biobank analysis of plant-based diet indices and type 2 diabetes in 113,097 adults.
- Vegetarian diets and diabetes in India Analysis of the National Family Health Survey (NFHS-3, 2005–2006). Nutr J 2014;13:89. doi:10.1186/1475-2891-13-89.
Ch. 12Reading Rachel's Blood Test5
- B12 cut-offs, MMA and who to test Patel and McGuirk 2025. See Chapter 4.
- Ferritin and iron stores World Health Organization. WHO Guideline on Use of Ferritin Concentrations to Assess Iron Status in Individuals and Populations. Geneva: WHO; 2020.
- Hair mineral analysis Seidel S, Kreutzer R, Smith D, McNeel S, Gilliss D. Assessment of commercial laboratories performing hair mineral analysis. JAMA 2001;285(1):67–72.
- IgG food tests Carr S, Chan E, Lavine E, Moote W. CSACI position statement on the testing of food-specific IgG. Allergy Asthma Clin Immunol 2012;8(1):12. Association for Diagnostics and Laboratory Medicine. Optimal Testing Guide.
- Biotin and lab tests US Food and Drug Administration. Safety communication on biotin interference with laboratory tests.
Ch. 13Starting, Switching, and Eating With Everyone Else5
- Why people stop eating vegetarian Faunalytics. Study of Current and Former Vegetarians and Vegans. 2014. Faunalytics is a research organisation that serves the animal-protection movement.
- Beans and gas Winham DM, Hutchins AM. Perceptions of flatulence from bean consumption among adults in 3 feeding studies. Nutr J 2011;10:128. doi:10.1186/1475-2891-10-128. UCLA Health, patient information on beans and gas.
- Pregnancy and breastfeeding Academy of Nutrition and Dietetics position, 2025 (see Chapter 1). Centers for Disease Control and Prevention. Vitamin B12 and Breastfeeding.
- Warfarin and vitamin K Cambridge University Hospitals NHS Foundation Trust. Patient information for people taking warfarin.
- Plant-based diets in chronic kidney disease Ikizler TA, Burrowes JD, Byham-Gray LD, et al. KDOQI clinical practice guideline for nutrition in CKD: 2020 update. Am J Kidney Dis 2020;76(3 Suppl 1):S1–S107.
Ch. 14Your Minimum Kit1
- The five things in the Minimum Kit See the sources for Chapters 3, 4, 5, 6, 7 and 8.
BackWorksheets and kitchen section at the back of the book5
- Kitchen section, menus and recipes Built on the five-part plate (Chapter 3) and the Minimum Kit (Chapter 14). Kidney bean safety: Health Canada (Chapter 9). Kombu and iodine: American Thyroid Association (Chapter 8).
- Blind-Spot Map and personal Minimum Kit See Chapters 1 and 14.
- The plant plate and moving tea time See Chapters 3 and 6.
- The card for your doctor See Chapter 12 (Patel and McGuirk 2025; WHO 2020).
- Four-week diary See Chapter 14.
Updates and corrections
Evidence last reviewed October 28, 2026
Each evidence label shows how solid the evidence was on the day it was last reviewed. Corrections are posted here with the date they were made, and included in the next printing.
No corrections have been posted for this edition. Spotted an error, or a study that should change a label? Email [email protected]
Most likely to change
- Fortified foods and plant milk labels in different countries (Chapters 3, 8)
- Research on ultra-processed food and plant-based meats (Chapter 10)
- Research on bone health and stroke in vegetarians (Chapters 7, 11)
- Lab cut-offs for B12 and vitamin D (Chapter 12)
- Testing of heavy metals in protein powders (Chapter 9)
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