5. May 2023
There are many risks associated with a vegan diet, especially for children and people with allergies

Vegan diets are currently attracting a great deal of attention. The decision to follow a vegan diet can have various reasons. However, avoiding animal-based foods restricts the diet and is associated with risks such as deficiencies of certain nutrients, especially in children. Caution is also advised for people with allergies, because the many industrial products in the supermarket do not always provide accurate information about all the ingredients. The Deutsche Gesellschaft für Allergologie und Klinische Immunologie (“German Society for Allergology and Clinical Immunology” – DGAKI) e. V. has therefore just published a position paper that deals in detail with the benefits, disadvantages and limitations of a vegan diet. It is directed at experts from science and medicine as well as at all those who want to eat a vegan or predominantly plant-based diet.

According to a market research institute, around 1.6 million people followed a completely vegan diet last year. The reasons are manifold: religious or health aspects as well as efforts for more sustainability, animal welfare or climate protection. It is usually the health benefits of a vegetarian or vegan diet which are emphasised, although a Mediterranean diet with plenty of fish, poultry, eggs, and dairy products has also been shown to reduce the risk of heart disease, cancer, and type 2 diabetes mellitus.

Consciously embracing a vegan diet requires actively addressing this issue, says Dr. Imke Reese, a nutritionist and therapist specialising in allergology: “It’s not about what to stop putting on the plate, but what dietary alternatives you need to get all the vital nutrients in sufficient quantities.” More and more young people who want to switch to a purely plant-based diet for climate protection reasons are seeking her advice, as are parents who want to feed their children a vegan diet. “Unfortunately, few people really realise how much knowledge is required for this.”

Together with other members of the food allergy working group of the German Society for Allergology and Clinical Immunology (DGAKI), Dr. Reese has now published the position paper “Vegan diets from an allergy point of view.” The 30-page paper presents the latest scientific findings on vegan nutrition, adequate protein supply, the risks of protein and mineral deficiencies, and an evaluation of plant-based substitutes. “More and more people are thinking about how they can make a personal contribution to the climate and the environment through their eating habits,” explains Prof. Dr. med. Margitta Worm, President of the DGAKI and co-author of the position paper, “but this should not be at the expense of their health.”

To prevent malnutrition, a vegan diet must include legumes, especially soya, nuts and oilseeds, as well as vegetables, in particular potatoes, and wholemeal products on a daily basis. The inferior protein quality of plant-based foods can be compensated for by consuming larger quantities. However, this leads to a higher energy intake and thus to an increased risk of becoming overweight. The position paper lays out a suggested daily diet for adults. “However, this cannot simply be applied to children,” warns Dr. Reese. For infants and small children, the increased amounts of vegan food they would have to eat would not be practicable at all. Moreover, substitute products often lack the necessary amount of high-quality protein, calcium, iodine, and other important nutrients. “Through my work with children with allergies, I know how difficult it is to find an adequate alternative for cow’s milk. Prolonged avoidance of cow’s milk can lead to impaired growth and poorly mineralised bones. These risks are unfortunately completely underestimated by parents.”

Though the industry is responding to the high demand for vegan products, this poses but another risk – especially for people with allergies. “Just because it says ‘vegan’ on the packaging does not mean that it does not contain any animal protein,” says Prof. Dr. Worm, President of the DGAKI, “the labelling refers to the ingredients, not to production-related unintentional addition.” Patients who react to animal allergens should therefore not rely on foods labelled vegan. Plant-based alternatives make use of wheat, soya, peanuts, lupines, peas, fenugreek, cashew, hazelnut, sesame, or hemp. “Of course, these all have the inherent potential to cause allergic reactions,” adds Dr Reese. The position paper also deals with this in detail.

Last but not least, many vegan products are subjected to such an intensive manufacturing process that the quality of the overall diet is compromised and the benefits associated with a plant-based diet disappear. “A traditional vegan diet using high-quality products to cook your own food can work, but it needs well-founded knowledge and time,” says nutritionist Dr Reese, “a pure vegan diet has limitations for many people that they need to be aware of.”

Position paper:

Reese, Schäfer, Ballmer-Weber et al; Vegan diets from an allergy point of view – Position paper of the DGAKI working group on food allergy, Allergology, vol. 46, no. 4/2023, pp. 225-254.

Contact details:

Prof. Dr. med. Margitta Worm, President of the DGAKI, Clinic for Dermatology, Allergology and Venereology, Allergy Centre Charité, Charité – Universitätsmedizin Berlin, margitta.worm@charite.de Dr. Imke Reese, Nutrition Counselling and Therapy, Allergology Specialist, reese@ernährung-allergologie.de

DGAKI Office, info@dgaki.de