Recent topics brought up include:

– Vegan Friendly Camps for Kids

– Doctor telling mom to feed her child less soy. VRG shared this info:

From the Vegetarian Nutrition Dietetic Practice Group: https://higherlogicdownload.s3.amazonaws.com/…/Soy…

From U.S. Soy https://www.soyconnection.com/…/2022_soyconnection_soy…

Soy and Children’s Health from U.S. Soy (extensively referenced) https://www.soyconnection.com/…/childrens-health-fact…

– Prenatal Supplements for Vegans

https://www.facebook.com/groups/VRGparentsandkids is intended to be a group that offers support for families raising children on vegan diets and for vegan kids around the world. We envision it as a place to get advice about a wide-variety of topics: pregnancy, birthday parties, school lunches, Halloween, non-leather apparel, cruelty-free products, summer camps, and more. Please use it as a place to share your wisdom, seek advice, or just find a sympathetic ear. The goal is to offer support.

Consequently, any profane, defamatory, offensive, or violent language will be removed. Feel free to disagree, but do so respectfully. Hateful or discriminatory comments regarding race, ethnicity, religion, gender, disability, sexual orientation, or political beliefs will not be tolerated. We expect that posts should relate to vegan diets and lifestyles. The Vegetarian Resource Group reserves the right to monitor all content and ban any user who posts in violation of the above rules, any law or regulation, SPAM, or anything otherwise off topic.

Please share this information with any veggie families that you know! Thanks.

February 20, 2023

The Vegetarian Resource Group (VRG) welcomes the opportunity to comment on the proposed revision in the WIC food package. We especially appreciate the greater flexibility offered by these changes which accommodate participants’ personal and cultural food preferences and special dietary needs. As the number of vegans and other vegetarians in the United States increases (1,2), the inclusion of foods acceptable to vegans and other vegetarians in programs like WIC becomes even more important. We believe that the proposed changes, with modifications as noted below, when implemented, will strengthen the WIC program’s ability to improve the nutrition and health status of millions of families.

Fruits and vegetables

We support the increase in the fruit and vegetable benefit. The increase in the maximum cash-value voucher (CVV) monthly allowance encourages fruit and vegetable consumption. We also support the provisions that increase the variety of fruits and vegetables that are available for WIC recipients to choose from. The proposed increases in variety allow for greater accommodation of cultural and other food preferences.

Milk and milk substitutes

We support the addition of more non-dairy substitution options for dairy milk, such as soy-based cheese and soy-based yogurt. These additions, along with the previously approved soy-based milk, allow vegans and others who avoid dairy products for reasons including milk allergy, lactose intolerance, and cultural preference to have access to acceptable products that provide nutritional benefits. In addition, the removal of the restriction on the amount of milk that can be substituted ensures that those who do not drink dairy milk can receive the same nutritional benefits as those who use dairy milk.

We question the requirement that dairy substitutes be solely based on soy. Since the nutrient content of products is specified, any plant-based dairy substitute (milk/cheese/yogurt) that meets these nutrient requirements should be allowed. For example, plant milks based on pea protein have been developed and have nutrient profiles that are similar to dairy milks (3,4). Products such as these should be eligible for inclusion in the WIC food package. Additionally, products are being developed that are based on a combination of base ingredients such as soy and almond (3). If these products meet nutritional requirements, they should be allowed.

We are concerned that few brands of tofu are currently on the market which meet the requirement that tofu contain a minimum of 200 mg of calcium per 100 grams of tofu. We were only able to find one brand of tofu which met this requirement. We propose a modification of this requirement to better reflect the calcium content of currently available calcium-set products.

Soy-based cheeses rarely, if ever, meet the stated requirements for calcium and protein (5). While few appropriate products currently exist, we are hopeful that their inclusion as options in the WIC program, along with the removal of the requirement that they be based on soy, will increase manufacturers’ interest in producing products that meet the specified nutrient standards.

In the interest of health of vegans, we propose that non-dairy milks, cheese, and yogurt be fortified with vitamin B12. Vitamin B12 is naturally present in foods of animal origin; thus, vegans must obtain vitamin B12 from fortified foods or supplements. The requirement that non-dairy milks, cheese, and yogurt be fortified with vitamin B12 would provide a reliable source of vitamin B12 for those using these products.

We also urge that children be able to receive soy products without “consultation with the participant’s health care provider, if necessary as established by State agency policy.” This requirement is not included for other food substitutions. We question the need for this additional step since soy products used to replace dairy milk are required to be fortified with nutrients in amounts similar to dairy milk and are, for practical purposes, nutritionally similar. Requiring medical documentation will add an unnecessary expense and may potentially deter some who would benefit from access to non-dairy products from choosing this option. This could lead to their missing out on important nutrients.

We support the use of an added sugar limit in place of a total sugar limit for yogurt and soy-based milk. This would be consistent with the public health message to limit added sugars. Since flavored soy milks are available which contain little or no added sugar, we support the continued inclusion of both flavored and unflavored soy milk provided requirements for added sugars are met.

Infant foods

We are concerned by the lack of options to infant meat for infants age 6-11 months who are fully breast-fed. Other foods including tofu and legumes are alternative sources of protein, iron, and zinc for vegans and other vegetarians. Without appropriate options to replace infant meat, vegan and vegetarian families will simply avoid this category and their infant will not receive the same benefits that infants whose families eat meat will. Cooked legumes would need to be well mashed or pureed to be acceptable for infants.

Whole grains

We support the proposed expansion of whole grain options to include foods like quinoa, teff, wild rice, millet, corn meal (including blue), and whole wheat naan, which support wider personal and cultural food preferences and can accommodate wheat allergies. Other whole grains and whole grain products which could be added include red rice, and black rice. If whole-grain chapati and roti become commercially available, they should also be added to the list of whole grains.

Legumes and eggs

We support the proposed change to require State agencies to authorize canned legumes in addition to dried legumes. This is respectful of those who may not have time, knowledge, or cooking facilities to prepare dried legumes and adds flexibility to this part of the WIC package. We propose adding frozen unflavored dried legumes to the list of authorized foods. This addition would add flexibility and allow the inclusion of highly nutritious products such as frozen edamame.

We also support the proposed change which requires authorization by State agencies of peanut butter and legumes as substitutes for eggs for vegans, those with egg allergies, and for “other reasons (e.g., cultural preferences as determined by the State agency’s policy.” We note that lacto vegetarians, who are commonly of Asian Indian origin, also avoid eggs and should be specifically included in the list of those who are eligible for egg substitution without relying on State policy to ensure that this group is included. The proposed change gives State agencies the option to authorize tofu as a substitute for eggs. We question the reason for treating tofu differently from peanut butter and legumes and support a change to require authorization by State agencies of tofu as a substitute for eggs. This would allow for consistency, provide variety, and allow another alternative to eggs.

Other possible replacements for eggs include tempeh and frozen legumes (such as edamame).

It is not clear if the proposed requirement for substitution for dairy milk that tofu provide 200 mg of calcium per 100 grams also is required for tofu substitution for eggs. Since eggs provide limited amounts of calcium, tofu being substituted for eggs should not be required to contain a specified amount of calcium.

Thank you for the opportunity to comment on the proposed changes.

By Reed Mangels, PhD, RD

According to the comprehensive book, Plant-based Sports Nutrition, doing resistance exercise and eating protein both signal our body to build more muscle. Thus, athletes and others who want to increase muscle mass are encouraged to do strength training and meet protein needs. Eating more protein than is needed does not lead to larger muscles.

Protein derived from animals is often touted as being better than plant-derived protein for muscle building. If you walk down the supplements aisle of a grocery store, you’ll see container after container of protein supplements with dairy- (casein or whey) and egg-derived protein. Plant-derived protein is believed by some to be less effective than animal-derived protein because of its amino acid content and lower digestibility.

A recent study calls into question the need for animal-derived protein to build muscle. In this study, dairy milk and a mixture of plant proteins were equally effective in promoting muscle protein synthesis in healthy young men. The researchers randomly assigned 24 healthy, recreationally active young men to either a group who were given 30 grams of dairy protein or to a group who were given a blend containing 15 grams of wheat protein, 7.5 grams of corn protein, and 7.5 grams of pea protein. Over the next 5 hours, muscle biopsies were done in order to assess the rate of protein synthesis. The two groups’ rate of muscle protein synthesis was not significantly different over the 5 hour period. If anything, the rate of muscle protein synthesis increased somewhat more after the men consumed the plant-derived protein than after the animal-derived protein, but this difference did not reach statistical significance.

The researchers conclude, “Balanced plant-derived protein blends can have anabolic [muscle building] properties that do not differ from high-quality animal-derived proteins.”

Reference

Pinckaers PJM, Kouw IWK, Gorissen SHM, et al. The muscle protein synthetic response to the ingestion of a plant-derived protein blend does not differ from an equivalent amount of milk protein in healthy, young males  J Nutr. 2022;152:2734-2743.

To read more about protein for vegans see:

Protein in the Vegan Diet

Protein

To read more about vegan diets for athletes see our website section on athletes.

By Reed Mangels, PhD, RD

Zinc is an essential mineral. We need to get it from food and/or supplements in order to stay healthy. Zinc has many roles in our bodies including helping enzymes work properly, supporting the immune system, helping to make DNA and proteins, promoting growth and development, helping wounds heal,  and supporting the senses of taste and smell.

The Recommended Dietary Allowance (RDA) for zinc is:

Birth to 6 months: 2 milligrams/day (this is the Adequate Intake rather than the RDA)

7-12 months: 3 milligrams/day

1-3 years: 3 milligrams/day

4-8 years: 5 milligrams per day

9-13 years: 8 milligrams/day

14-18 years: 11 milligrams/day (male); 9 milligrams/day (female)

19 years and older: 11 milligrams/day (male); 8 milligrams/day (female)

Pregnancy: 12 milligrams/day (14-18 years); 11 milligrams/day (19 years and older)

Lactation: 13 milligrams/day (14-18 years); 12 milligrams/day (19 years and older)

Many whole plant foods supply us with zinc.

10 Good Sources of Zinc for Vegans

1. Vegetarian baked beans 2.5 milligrams of zinc in ½ cup
2. Wheat germ 2.5 milligrams of zinc in 2 Tablespoons
3. Pumpkin seeds 2.2 milligrams of zinc in 2 Tablespoons
4. Tofu 2 milligrams of zinc in ½ cup of firm tofu
5. Fortified veggie “meats” 0.8-1.4 milligrams of zinc in 1 ounce
6. Chickpeas 1.4 milligrams of zinc in ½ cup
7. Tahini 1.4 milligrams of zinc in 2 Tablespoons
8. White beans 1.2 milligrams of zinc in ½ cup
9. Lentils 1.1 milligrams of zinc in ½ cup
10. Sesame seeds 1.1 milligrams of zinc in 2 Tablespoons

Zinc is often found in whole plant foods along with substances called phytates that reduce zinc absorption. There are ways to help zinc to be better absorbed.

8 Ways Vegans Can Promote Zinc Absorption

1. Choose more yeast-leavened and sourdough breads in place of breads leavened with baking powder like biscuits and muffins.
2. Sprout dried beans and grains/eat more sprouts.
3. Eat foods that supply zinc along with foods containing citric acid like citrus fruits.
4. Eat foods that supply zinc along with foods such as sauerkraut and plant-based yogurt that contain other organic acids.
5. Soak dried beans and grains before cooking and discard the soaking water.
6. Choose yeast-leavened or sourdough breads and rolls in place of unleavened products like crackers.
7. Choose fermented soy foods such as tempeh and miso.
8. Eat foods that supply zinc along with foods that supply protein.

To read more about zinc see:

Zinc Fact Sheet for Consumers (from National Institutes of Health; contains nonvegan sources of zinc)

Veganism in a Nutshell

By Reed Mangels, PhD, RD

Many countries, including the United States, have dietary guidelines. These guidelines provide advice to people about what they should eat and also form the basis for national nutrition policy. Ideally, these recommendations would include information about vegan and vegetarian diets and substitutes for animal-based foods. Including this information could promote changes that would make people’s food choices healthier and more sustainable. A recent report examined the dietary guidelines from 100 countries and assessed whether these guidelines included statements about vegetarian/vegan diets and about plant-based alternatives to dairy products and meat. This report also evaluated whether international dietary guidelines included statements about plant-based diets. This report defined plant-based diets as “a wide spectrum of dietary patterns which emphasize plant products, such as fruits and vegetables, whole grains, legumes, nuts and seeds, and plant-based alternatives and limit or exclude animal-derived products.”

The report stated that 40% of the dietary guidelines that were analyzed contained a position statement about vegetarian/vegan diets. Most of these positions were neutral. Instead of promoting or discouraging a vegetarian/vegan diet, they provided advice on meeting needs for some nutrients (such as iron and vitamin B12) from plant sources or supplements. Some dietary guidelines highlighted the health benefits of vegetarian/vegan diets; eight guidelines described the environmental benefits of plant-based diets. About 8% of dietary guidelines highlighted the risks of vegetarian/vegan diets and about 4% advised against vegan diets.

Plant-based alternatives to meat were mentioned in 38% of guidelines, alternatives to cow’s milk in 37% of guidelines, and alternatives to other dairy products in 13% of guidelines.

The report’s authors noted that of the 100 countries they examined, “47 had a purely animal-based meat food group, which may include eggs. This gives meat a special status by implying that it should be an essential part of a healthy diet.” They concluded, “Removing the special status of meat as a single food group would send a powerful signal to citizens that we need to reduce meat consumption for our own health and the health of the planet.” Additionally, 75 out of the 100 countries that were analyzed, had a purely animal-based dairy food group and did not mention any plant-based alternatives to cow’s milk or dairy products. The authors recommended that more countries follow the example of Canada’s dietary guidelines which lists animal- and plant-based foods together under the name “protein group” in place of a “meat” or “dairy” group.

The authors also called on countries to include more information about meeting nutritional needs with plant foods since many people worldwide, cannot afford animal-based foods and avoid/limit use of dairy products due to lactose intolerance. Less than a quarter of countries included information about obtaining vitamin B12 from supplements or fortified foods in their dietary guidelines.

The report ended with this statement:

“with global planetary and human health goals and targets falling short, it is more important than ever to ensure that FBDGs [food-based dietary guidelines] promote sustainable healthy food choices. This includes recommendations to eat fewer animal products and fostering plant-based diets and plant-based alternatives as part of their positions and food groups. Policy makers, civil society actors, and economic agents have to use all available tools to promote more sustainable, healthy, and equitable consumption patterns. FBDGs that encourage balanced food choices are also more inclusive in that they consider ethical, ecological, religious, and economic aspects that play roles in people’s everyday lives.”

Reference:

Klapp AL, Feil N, Risius A. A global analysis of national dietary guidelines on plant-based diets and substitutions for animal-based foods. Curr Dev Nutr. 2022;6(11):nzac144.

To read more about dietary guidelines see:

The Dietary Pattern in Dietary Guidelines for Americans Could Easily be Made Vegan and Nutritionally Adequate

2020-2025 Dietary Guidelines for Americans Released

The Vegetarian Resource Group Testimony on the Dietary Guidelines

The Vegetarian Resource Group Sends in Testimony Regarding the 2020 Dietary Guidelines

By Jeanne Yacoubou, MS

In April 2022, The VRG received an email from a reader.

She was concerned about a 2015 VRG blog post on magnesium stearate. In that post, we said: “No examples of tallow-derived magnesium stearate in foods or pharmaceuticals are known.”

The reader commented: “Magnesium stearate in pharmaceuticals is not uncommonly sourced from mammals, and medical products containing magnesium stearate have been associated with life-threatening reactions in people with alpha-gal syndrome.”

What is alpha-gal syndrome?

For readers who may not be aware of alpha-gal syndrome (AGS, also called alpha-gal allergy, red meat allergy, or tick bite meat allergy), the Mayo Clinic reports that AGS is a “…recently identified type of food allergy to red meat and other products made from mammals.” The United States Centers for Disease Control and Prevention (CDC) lists “pork, beef, rabbit, lamb, venison, etc., and products made from mammals (including gelatin, cow’s milk, and milk products)” as potential sources of alpha-gal.

“Alpha-gal” is an abbreviation for a type of sugar molecule, galactose-α-1,3-galactose, found in most mammals, excluding humans. (“α” is the Greek letter, alpha.) It is not found in fish, reptiles, or birds.

Currently, researchers believe that humans acquire the alpha-gal sugar through a tick bite. In some people, the sugar sets off an immune reaction.

If affected individuals later consume any of the animal products listed above, mild to severe allergic reactions, including potentially life-threatening anaphylactic shock, may occur. However, the CDC points out “Not all patients with AGS have reactions to every ingredient containing alpha-gal.” (Bold is CDC’s.)

To date, there is no known treatment for AGS. Prevention, by avoiding tick bites, is key.

What is magnesium stearate?

Magnesium stearate is a common food additive with GRAS status (generally regarded as safe) by the U.S. Food & Drug Administration. It has been used for decades in many foods and beverages including baking products, candy, chewing gum, and spices. Magnesium stearate could function as an emulsifier, binder, thickener, release agent, or anticaking agent in foods and beverages.

Magnesium stearate is also a common inactive ingredient in pharmaceuticals and dietary supplements. In these products, it serves primarily as a lubricant or release agent. In this capacity, it prevents tablets, capsules, or powders from sticking to molding or conveyor belts during manufacturing, or from sticking to packaging after purchase.

Magnesium stearate is made from magnesium (a mineral) and stearic acid (a fatty acid).

Is magnesium stearate derived from animals?

Principal commercial sources of stearic acid used today to make magnesium stearate are cottonseed, coconut, and palm oils. Much less common are animal fats such as tallow or lard.

As of 2022, all of the research on magnesium stearate conducted by The Vegetarian Resource Group (VRG) indicates that plant sources, especially coconut and palm oils, are the major ones used to manufacture magnesium stearate for both food and pharmaceuticals.

For this article, we again contacted several major manufacturers of magnesium stearate in June 2022 to see if anything has changed. We learned:

1. From the Roquette website: “For the manufacture of the whole range of its products, Roquette only uses vegetable raw materials like wheat, maize, potatoes, or pea. No additive or ingredient from animal origin is added to Roquette products. No processing aid from animal origin is used for the manufacture of Roquette products.”

magnesium steareate

We also contacted Roquette through their website contact form and asked: “Is your magnesium steareate derived from an animal source?” The company replied: “No raw materials used in the manufacture of Roquette products are of or are derived from animal origin.”

2. Acme-Hardesty was very clear on their website: “Magnesium stearate can be derived from both animal fats and vegetable oils. At Acme-Hardesty, our product is entirely plant-based.”
3. Mallinckrodtt: Only soy and palm are listed on their website as sources for their magnesium stearate.
4. Lupin Pharmaceuticals: We received the following email.

This email is in follow-up to your request for information on Hydrocodone Bitartrate and Acetaminophen Tablets:

You have enquired “Is the source of magnesium stearate in generic Norco (hydrocodone bitartrate and acetaminophen tablets) derived from animals (beef or pork)?”

Below, please find information pertaining to the above topic(s):
“Please note that magnesium stearate used in Hydrocodone Bitartrate and Acetaminophen tablets is not derived from animal sources.”

This information is intended to provide pertinent technical data which will assist you in forming your own conclusions and making your own decisions regarding the use of Lupin Pharmaceuticals products.

Thank you for your interest in Lupin Pharmaceuticals and our products.

-Lupin Pharmaceuticals Medical Information Services

VRG’s researcher wrote the original magnesium stearate entry after contacting major suppliers of magnesium stearate and many companies that use it. Everyone told us that tallow is no longer used as a source. It may have been in the 1990s and previously, but not now. BSE scares and consumer dislike of animal ingredients were the major reasons given to me. (VRG Note: BSE is the acronym for bovine spongiform encephalopathy.)

Thus we used the caveat that none are known to contain tallow. It’s impossible to prove a negative. We can’t say ‘No magnesium stearate today is from tallow.’’Nor can we say ‘All magnesium stearate is plant-based today.’

We asked the inquirer if she knows of a specific case of a product that contains tallow-derived magnesium stearate. Then we can update the entry by listing it.

We were not provided with any specific examples.

We were directed to a clinical communications published in the Journal of Allergy and Clinical Immunology by Dr. Christine Muglia as lead author and several colleagues.

In that letter, Dr. Muglia described the case of a 48-year-old man suspected of having AGS. He appeared to suffer a negative reaction after taking one or more pharmaceuticals, including over-the-counter medications, that contained magnesium stearate as an inactive ingredient.

The patient’s history was recounted in this way:

“He reported that for the last 25 years, he has had episodes of edema of the larynx and tongue, diffuse hives, dyspnea, wheezing, abdominal cramping, diarrhea, edematous testicles, and a sense of impending doom approximately 4 to 5 hours after eating hamburger, steak, or venison. Reactions typically required treatment with epinephrine. The delay in time between eating dinner and the reaction caused a delay in diagnosis for many years. Notably, he had been a hunter since the age of 11 and had sustained countless tick bites over the years.”

Dr. Muglia et. al. wrote in their letter:

“With avoidance of red meats, he has experienced no reactions; however, he has had symptoms with medications that contain magnesium stearate. After taking medications prescribed as a gelatin capsule, including acetaminophen (Tylenol, McNeil Consumer Healthcare, Fort Washington, Pa) and naproxen (Aleve, Bayer HealthCare LLC, Whippany, NJ), he experienced immediate onset diarrhea and chest tightness, which resolved with the use of diphenhydramine (Benadryl, McNeil Consumer Healthcare, Fort Washington, PA). With lisinopril tablets (Aurobindo Pharma Limited, Hyderbad, India), he experienced laryngeal edema, abdominal cramping, nausea, and diarrhea, which resolved after stopping lisinopril. Approximately 3 to 4 hours after taking hydrocodone bitartrate and/or acetaminophen (Vicodin, AbbVie Inc., North Chicago, IL), he experienced hives, which were relieved 4 hours after the use of diphenhydramine (Benadryl). Similarly, he experienced hives after the use of clonidine.”

The VRG investigated all of the suspected pharmaceuticals in the preceding paragraph. We wanted to determine if the magnesium stearate functioning as an inactive ingredient in these drugs had been sourced from an animal, specifically beef.

Source of magnesium stearate in suspected pharmaceuticals

The VRG researched the following five drugs to determine the source of magnesium stearate used: Tylenol, Aleve, lisinopril, vicodin, and clonidine. Our data are summarized in the following table:

Magnesium stearate in Tylenol

When we first contacted Johnson & Johnson, makers of Tylenol, we asked: “Is the magnesium stearate in the regular strength Tylenol sourced from animals?”

Chris from the Customer Care Center at Johnson & Johnson replied: “We can confirm that the magnesium stearate is synthetic.”

The Vegetarian Resource Group responded: “What do you mean by ‘synthetic’? It could refer to microbial or chemical synthesis.”

Gillian Joy from the Customer Care Center at Johnson & Johnson answered: “Apologies but further information about the source of this is not available.”

A week after receiving this email, The VRG called Johnson & Johnson to attempt to get clarification on their meaning of “synthetic.” We spoke with Erla who stated: “There are no animal byproducts in regular strength Tylenol tablets.” She repeated her co-workers’ info and said – in addition to her previous statement about no animal byproducts – that magnesium stearate is “synthetic.” I asked her to explain synthetic and she said “…not natural; it;s artificial.”

Magnesium stearate in Aleve

The VRG contacted Bayer, the maker of Aleve, and asked: “What is the source of magnesium stearate in Aleve tablets?”

Sheena, Consumer Engagement Specialist at Bayer, replied: “Magnesium Stearate is made up of two substances, a saturated fat called stearic acid and the mineral magnesium. Stearic acid can be found in foods such as eggs, salmon, cotton seed oil, palm oil, and coconut oil.”

We responded: “We’re asking specifically about the source of magnesium stearate in Aleve tablets. Other drug companies say it’s plant-based. Or it could be from beef or pork. What about the source of magnesium stearate in Aleve tablets? I’m not asking about stearic acid and magnesium generally which is what your response is.”

Rory, Consumer Engagement Specialist at Bayer, replied to our email by saying: “After consulting with our brand specialist, they have confirmed that the magnesium stearate is derived from a vegetable source.”

Curious to see how Bayer representatives would respond by telephone, The VRG called and asked about the magnesium stearate in Aleve tablets. We spoke with Sandy who replied: “Magnesium stearate is from egg, salmon, cottonseed, palm, or coconut oil.” When I questioned the accuracy of her statement, Sandy put us on hold to check. She returned to the call and stated “It’s not derived from pork or beef. All five sources are in Aleve.” I asked her to confirm with her supervisor. But we only received a repeat of the previous answer, without a check with a supervisor.

Magnesium stearate in lisinopril

The manufacturer of lisinopril listed in Dr. Muglia’s communication did not respond to our multiple requests for source information about magnesium stearate.

So, The VRG sought information from other manufacturers of this drug.

Prinston Pharmaceuticals sells two formulations of lisinopril. The magnesium stearate in both of them are plant-based. Regarding one formulation from China: “Magnesium stearate used in lisinopril tablets was derived from a plant source.”

Concerning the lisinopril made in the USA: “The source of magnesium stearate in lisinopril tablets is vegetable-based.”

Lupin Pharmaceuticals also makes lisinopril. In response to our inquiry, they replied: “Lupin’s lisinopril tablets do not contain animal material and magnesium stearate used is derived from vegetable sources.”

Magnesium stearate in vicodin

In Dr. Muglia’s communication, AbbVie was given as the manufacturer of vicodin (hydrocodone bitartrate/acetaminophen). When we spoke with AbbVie, John, a Medical Services Specialist, told us that MiKart produces vicodin for them. We called MiKart on three occasions and did not receive a reply.

Mallinkrodt is another company that produces vicodin and norco, a similar drug containing the active ingredients hydrocodone bitartrate and acetaminophen. Both are listed on page 10 of their generics catalog.

The first time we called, a customer service representative told us that magnesium stearate in norco “could be animal-based” but she wasn’t sure. She connected us with Chrissy in another department who said the magnesium stearate in a 5mg/325mg (hydrocodone bitartrate/acetaminophen) dosage of norco was beef-derived. No mention of stearic acid was made.

A couple of weeks later, The Vegetarian Resource Group called to verify this information. Anita on the general customer call line didn’t know for sure and put us through to Chrissy again.

This time, Chrissy said that the magnesium stearate in the two dosages we had specified (10mg hydrocodone bitartrate)/325mg acetaminophen) for both norco and vicodin was plant-based. This is in agreement with the Mallinckrodt website page on the stearates that they sell. They are all soy- or palm oil-derived.

However, this time, Chrissy informed us that stearic acid was also in both norco and vicodin. Their stearic acid was derived from beef.

When The VRG asked why the sources of stearic acid and magnesium stearate were different, Chrissy stated “Our ingredient supply changes. At the current time, the stearic acid we use is from a beef source…But all of the stearates we produce for other pharmaceutical manufacturers are plant-based.”

The VRG also contacted Lupin Pharmaceuticals, another manufacturer of norco. On two separate occasions, Lupin informed us that both magnesium stearate and stearic acid in their product is not derived from animals. In their own words:

“…magnesium stearate used in hydrocodone bitartrate and acetaminophen tablets is not derived from animal sources.”

“…stearic acid used in hydrocodone bitartrate and acetaminophen 5mg/325mg tablet is not derived from any animal origin.”

Magnesium stearate in clonidine

Dr. Muglia’s communication on alpha-gal mentioned clonidine as another drug taken by the patient suspected of having AGS. However, no manufacturer was given.

So, The VRG investigated drug companies to find out information on the magnesium stearate used in clonidine.

Teva Pharmaceuticals told us that “magnesium stearate is not derived from animal sources” in their clonidine.

Lupin Pharmaceuticals also manufactures clonidine. They wrote to us: “Magnesium stearate used in clonidine is derived from vegetable origin.”

Stearic acid as well as all stearates may be of concern in alpha-gal syndrome

The clinical communication sent by Dr. Muglia and colleagues to the Journal of Allergy and Clinical Immunology did not even mention the possibility that stearic acid could be responsible for adverse allergic reactions in people with AGS.

In fact, Dr. Muglia et. al. stated in the letter about their patient:

“The correlation between his reactions to meat and to these medications suggests that the medication reactions may have been due to alpha-gal in the magnesium stearate. Alpha-gal has not been definitively found in magnesium stearate, as this study has yet to be conducted. The correlation is theoretical…Our patient’s reactions to gelatin capsules do not allow us to isolate magnesium stearate as the cross-reactive allergen, because gelatin is also a meat byproduct. His reaction to lisinopril tablets that contain magnesium stearate, but not gelatin, makes the case stronger for cross-reaction between alpha-gal and magnesium stearate, but still does not confirm it.”

She and her team were preoccupied with magnesium stearate only.

Likewise, the email we received from the reader spoke only of magnesium stearate as a potential trigger for alpha-gal syndrome. She said nothing about stearic acid.

This is a perfect example of narrow thinking in science. It occurs when you’re fixated on only one item and nothing else – even the possibility, in this case, of chemical cousins possessing the same capability of causing an adverse allergic reaction as the targeted chemical.

In response to our reader who indicated: “Magnesium stearate in pharmaceuticals is not uncommonly sourced from mammals…,” based on this investigation, we learned the opposite.

From what companies are telling us, magnesium stearate in pharmaceuticals is uncommonly sourced from mammals. Magnesium stearate in pharmaceuticals is commonly plant-based. If you learn of a company that uses an animal source, please let us know. Stearic acid in pharmaceuticals, on the other hand, could be beef-derived, as one company told us about their version of norco.

However, since Lupin Pharmaceuticals reported that stearic acid in their norco was not animal-derived, it’s possible that stearic acid in other drugs is also non-animal sourced.

Note: The VRG contacted Dr. Muglia for this article in May 2022 since the journal communication listed her as the corresponding author. The email address in the article is no longer current. We tracked her down at the medical practice where she is currently on staff. She has not responded yet.

Cautions about stearic acid and magnesium stearate in pharmaceuticals and food products

Through our research, The VRG must caution all people with alpha-gal syndrome (AGS) that it’s important to look into all inactive ingredients of all drugs (including over-the-counter products) with “stearic” OR “stearate” in their names.

Because both stearic acid and stearates are food and beverage ingredients, too, be sure to read all food labels very carefully. To be on the safe side, you should consult with your doctor on whether you should avoid all these products. Also, contact the company to confirm. Readers may be interested in our previous research into magnesium stearate in confections.

Our tips for getting ingredient information from food companies may be helpful.

Often, a food or dietary supplement company will specify the source of ingredients on their product labels. This is not required by law. Nor is it required by law on pharmaceutical labels.

All consumers should also be aware that when patents expire, many different generic versions of drugs enter the market.

Unless you request a specific manufacturer, your pharmacy may select any manufacturer depending on their supply and/or what your insurance dictates.

Nor may a pharmacy be able to meet your request all the time. In addition, a pharmacy’s supply could change from refill to refill.

Another likely possibility is the manufacturer’s sources of ingredients could change at any time – without public announcement.

So, The VRG recommends you contact the drug manufacturer listed on the bottle in your hand about any ingredients before taking it.

Be sure to emphasize that you’re concerned about all inactive ingredients with “stearic” or “stearate” in their names in the drug at a certain dosage. Be sure to specify the dosage. (VRG Note: Calcium stearate is another example of an inactive ingredient with “stearate” in its name.)

If you’re not speaking with a pharmacist when you call, do not assume customer service representatives know what you’re talking about. Ask to see a copy of the list of all inactive ingredients. Then ask about specific ones on the list.

If you’re still unsure about the accuracy of what customer service representatives tell you, ask to speak to a supervisor.

The contents of this posting, our email, our website and our other publications, including Vegetarian Journal and Vegan Journal, are not intended to provide personal medical advice. Medical advice should be obtained from a qualified health professional. We often depend on product and ingredient information from company statements. It is impossible to be 100% sure about a statement, info can change, people have different views, and mistakes can be made. Please use your best judgment about whether a product is suitable for you. To be sure, do further research or confirmation on your own.

By Reed Mangels, PhD, RD

Dietary Guidelines for Americans is a document that is produced every 5 years by the U.S. government. It is important because it is used as the foundation for federal nutrition education materials as well as being used by schools, the food industry, and many others. The most recent Dietary Guidelines, released in 2020, endorses “a healthy vegetarian dietary pattern” as one of three recommended dietary patterns. All of the Vegetarian Dietary Patterns call for use of eggs with no suggestions for vegan foods that could replace eggs. We, at The Vegetarian Resource Group would like to see vegan dietary patterns included in Dietary Guidelines for Americans.

A recent study provides evidence that it would be easy to modify the vegetarian dietary pattern in Dietary Guidelines to make it vegan. In this study, the “dairy food group” was replaced with fortified soy milk and fortified soy yogurt. Eggs were replaced with a combination of beans, peas, lentils, nuts, seeds, and soy foods. Vegan patterns were created to be similar in calories to the original Healthy Vegetarian Dietary Pattern. The resulting vegan dietary patterns were analyzed for nutritional adequacy and compared to the original Healthy Vegetarian Dietary Patterns which contained dairy products and eggs.

The vegan patterns were higher in iron, copper, vitamin D, riboflavin, vitamin B12, and vitamin K. Protein was slightly lower but still adequate. Sodium, cholesterol, and zinc were lower in the vegan patterns. Other nutrients were similar in both patterns.

This study only looked at nutritional adequacy for non-pregnant, non-lactating adults. Hopefully, future studies will examine other age and life-cycle groups. Additional studies should examine the use of other fortified plant milks and determine the minimum amount of these products needed and examine the need for supplements if fortified foods are not used as sources of vitamin D, calcium, and vitamin B12.

We hope that the results of these and similar studies will be used to include vegan dietary patterns in the next edition of Dietary Guidelines for Americans.

Reference:

Hess JM. Modeling dairy-free vegetarian and vegan USDA food patterns for non-pregnant, non-lactating adults [published online ahead of print, 2022 Apr 29]. J Nutr. 2022.

To read more about the Dietary Guidelines for Americans see:

2020-2025 Dietary Guidelines for Americans Released

VRG’s testimony about the 2020 Dietary Guidelines and the Scientific Report Underlying the 2020 Dietary Guidelines

By Reed Mangels, PhD, RD

It’s simple, right? We all think we know which foods are good for us and which foods are less likely to be health promoting. But when medications enter the mix, it may get more complicated. Some foods that many of us think of as healthy, can interfere with the actions of some medicines, making the medicine less effective or even dangerous.

For example, there are long lists of medications that grapefruit or grapefruit juice can interact with. These include some drugs to lower cholesterol (some statins), some drugs used to treat high blood pressure, some anti-anxiety drugs, some corticosteroids, and some antihistamines. Seville oranges (often used to make orange marmalade), pomelos, tangelos, pomegranates, and pomegranate juice are sometimes identified as having effects similar to those of grapefruit and grapefruit juice (1).

People taking some types of anticoagulants (medicines to reduce the risk of blood clots) are warned to eat a consistent amount of green leafy vegetables and other food sources of vitamin K rather than eating a lot of kale, say, one day and no green vegetables the next (2).

A type of antidepressant called an MAO inhibitor can have dangerous interaction with foods high in tyramine or histamine. These include aged cheeses, pickled or fermented food (sauerkraut, pickles, kimchi), fermented soy sauce, tempeh, and yeast extract.

Your health care provider or pharmacist can help you determine if you need to avoid or limit certain foods because of medications that you are using.

In addition to foods, other products including dietary supplements, herbs, non-prescription medications, and other prescriptions medications all have the potential to interfere with a prescribed medication. It’s a lot to keep straight.

Johns Hopkins Medicine website (3) has these sensible recommendations:

• Ask your pharmacist or healthcare provider if there are foods, beverages, vitamins, or supplements you should avoid with your medicines.
• Read the prescription label on the container. If you do not understand something, or think you need more information, ask your healthcare provider or pharmacist.
• Read directions, warnings, and interaction precautions printed on all medicine labels and instructions. Even over-the-counter medicines can interact with foods, beverages, or supplements.
• Check with your pharmacist or healthcare provider before taking vitamin pills at the same time you take medicine—vitamins and minerals can interact with some medicines.
• Be sure to tell your healthcare provider and pharmacist about all medicines you are taking, both prescription and nonprescription.

References

1. FDA. Grapefruit juice and some drugs don’t mix. https://www.fda.gov/consumers/consumer-updates/grapefruit-juice-and-some-drugs-dont-mix. 2021.
2. National Jewish Health. Anticoagulants and some drug-food interactions. https://www.nationaljewish.org/conditions/medications/cardiology/anticoagulant-and-drug-food-interactions?modal=1. 2013.
3. Johns Hopkins Medicine. Food-drug interactions. https://www.hopkinsmedicine.org/health/conditions-and-diseases/fooddrug-interactions

The contents of this posting, our website, and our other publications, including Vegetarian Journal and Vegan Journal, are not intended to provide personal medical advice. Medical advice should be obtained from a qualified health professional. We often depend on product and ingredient information from company statements. It is impossible to be 100% sure about a statement, info can change, people have different views, and mistakes can be made. Please use your best judgment about whether a product is suitable for you. To be sure, do further research or confirmation on your own.

By Jeanne Yacoubou, MS

The Vegetarian Resource Group first learned of Every Company (formerly Clara Foods) in March 2021 in an article on its “animal-free” pepsin.

At that time, we were curious to find out more about the source of Every’s pepsin. Since this digestive enzyme, common in many nutritional supplements, is typically derived from hogs on a commercial basis, pepsin is considered an animal-derived ingredient.

So how could pepsin be “animal-free”?

Every Company “animal-free” products

On their website viewed in January 2022, Every Company lists three “animal-free” products they make by precision fermentation.

• egg white protein
• egg white replacer
• porcine pepsin replacement

According to the website, these products are suitable for a wide range of foods and beverages.

For egg white protein and egg white replacer, these include:

• assorted beverages
• protein bars
• bakery
• dry mixes
• sauces
• dressings
• patties
• pasta
• binder in meat analogues

Pepsin, in particular, was noted as a possible food processing aid as well as an ingredient in nutritional supplements.

According to the Food and Drug Administration, processing aids do not have to be listed on food and beverage labels.

At the time of writing this article, Every Company was in partnership to sell a vegan protein smoothie in California and New York as well as online.

In the description for this product, there was an asterisk after the word “vegan” which lead to this disclaimer:

“Contains egg allergens. This is not an animal product and is not created from chickens.”

Here was the complete ingredient statement for this product:

Apple Juice, Water, Pineapple, Banana, Spinach, Avocado Pulp (Avocado, Citric Acid), Lemon Juice, Egg White Protein (Non-Animal Source)

Every Company manufacturing process

On their website, Every Company states that it “…decouples proteins from the animals that make them using fermentation.”

To do this, they use a DNA sequence library. After copying the genetic code for a specific animal protein, they insert it into yeast. Every uses chicken and porcine DNA sequences for their products.

Then the yeast are grown on a medium containing sugar. Through fermentation, the yeast produce the animal protein according to the genetic instructions previously inserted.

Every Company FAQ page

On the website FAQ page, Every Company writes:

Note: Because our egg proteins are nature-equivalent to chicken-made eggs, they are considered egg allergens. People with an egg allergy should not consume our proteins.

Q: Why do you call your proteins animal-free?

A: Every Company conducted extensive consumer research to identify the clearest way to describe our proteins and the fact that no animal or animal cell is involved in our process or product. Our research indicated that animal-free is the clearest, most understandable way to describe animal protein made without using a single animal.

Note to reader: There are varied opinions on the labeling of these types of products, which will continue to evolve. Here is a YouGov national U.S. adult poll concerning how meat and dairy alternatives based on DNA originally from animals should be labeled: https://www.vrg.org/nutshell/CulturedMeatYouGov2022.pdf

What do readers think? Which terms would you suggest be used or not used?

The contents of this posting, our website and our other publications, including Vegetarian and Vegan Journal, are not intended to provide personal medical advice. Medical advice should be obtained from a qualified health professional. We often depend on product and ingredient information from company statements. It is impossible to be 100% sure about a statement, info can change, people have different views, and mistakes can be made. Please use your best judgment about whether a product is suitable for you. To be sure, do further research or confirmation on your own.

By Reed Mangels, PhD, RD

The USDA, FDA, and NIH’s Office of Dietary Supplements recently developed a database of the iodine content of about 425 foods, including some vegan foods. The amount of iodine is given for a serving size of food and for 100 grams of foods.

Iodine is an essential mineral that is needed for the thyroid gland to work properly. An iodine deficiency can cause thyroid problems and poor growth and development in infants and children.  Many people get iodine by using iodized salt. A quarter teaspoon of iodized salt provides about half of the Daily Value for iodine. You can read more about iodine in the vegan diet here.

The RDA for iodine for adults is 150 micrograms a day. According to the USDA, FDA, and ODS-NIH Database for the Iodine Content of Common Foods, Release 2,

• A 2 ounce soy-based veggie burger has 5.4 micrograms of iodine
• 3 cups of raw spinach also has 5.4 micrograms of iodine
• A cup of canned black beans has 2.4 micrograms of iodine
• A cup of almond milk has 0.9 micrograms of iodine
• 2 Tablespoons of nori has 116 micrograms of iodine

You can check some of your favorite foods here by downloading a zipped folder that contains an Excel file with iodine values per serving and another with per 100 gram values.  You can read more about the database here.

To read more about iodine see:

Iodine in the Vegan Diet

Perchlorate Controversy Calls for Improving Iodine Nutrition

Iodine in Prenatal Supplements

Iodine in Plant Milks