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Vegans (pronounced “VEE-guns”) are the strictest type of vegetarians.

They avoid all animal products–even American staples such as milk, eggs and cheese.

“For the true vegan, it can even go beyond clothes,” said Dr. Tim Highley, a 16-year vegan and osteopath in Lexington, Ky., who avoids wearing leather clothing. “You can go so deep into it that you drive yourself crazy.”

Highley refers to himself as a “honey vegan.” That means he occasionally eats honey, so he’s not the strictest of vegans.

“There are different degrees of vegan,” said Hetty Carriero, owner of Everybody’s Restaurant in Lexington, which serves vegetarian and vegan food.

Her bookkeeper, Nate Hotler, is what she jokingly refers to as a “militant vegan.” He doesn’t eat honey.

Both Highley and Hotler lost significant amounts of weight after going vegan. Hotler, 36, weighed 331 pounds and is now about 100 pounds lighter after being vegan for four years. He smoked three packs of cigarettes a day, drank at least a 12-pack of Mountain Dew daily and felt like “walking death.”

Becoming a vegan “totally changed his life,” Carriero said.

Hotler said his own health was the primary motivator to becoming vegan.

Studies have shown that vegan (and vegetarian) diets help people reduce their cholesterol, blood pressure and increase fiber. Some studies show a longer, healthier lifespan for vegetarians.

Hotler, like most vegans, is also highly concerned about the health of the planet and cruelty to animals.

“Now nothing has to die or be abused in order for me to live,” Hotler said. “I’ve never felt better in my whole life. You know that feeling, the little kid on the first day of summer? Now, I have that all the time.”

It’s not easy to live the vegan way. His stepson once called Hotler a “grass eater.”

Hotler acknowledges that the vegan concern for all living things can be complicated. For instance, does it also extend to mice, cockroaches, termites?

“You have to draw the line someplace,” said Hotler, who will exterminate roaches.

He had a squirrel family removed from the walls of his home last year, and one squirrel accidentally was killed, which Hotler felt bad about.

“But I’m not going to eat animals or go out of my way to hurt animals.” The challenge of being a vegan is so great that many devoted vegetarians have a hard time becoming long-term vegans.

Leslie Dodd, 46, a Lexington accounting software consultant, chuckles that she’s been a “vegetarian aspiring to be a vegan for six years.” But technically, she’s only been “a vegan since Saturday,” when she ate a non-vegan baked good. Cookies are her major weakness.

Eating at a regular restaurant or with non-vegan family and friends can be stressful. Highley wonders about ordering veggie burgers at non-veggie restaurants; so does Hotler. No vegans want residual meat juice from the grill getting on their soy burger or grilled vegetables.

“It can be very isolating,” said Teri Landers, 40, a yoga instructor and associate director of the Lexington Wellness Center.

She has been a vegetarian since her mid-20s and was a strict vegan for several years, an offshoot of her practice of yoga.

“It’s very hard,” she said. “Some people handle it very well, always telling people `This is what I eat, this is how I eat.’ . . . People make a big meal for you, and you can eat two items of it.”

There’s no obvious way to make sure a food item doesn’t have eggs, milk, butter or other products without asking.

“I got so tired of it,” Landers said of the predinner inquisition about the exact ingredients of each item on the menu. “I finally did come to the point that it’s OK for me to accept the hospitality of someone and be gracious about it. I decided that I can only do the best I can do.”

Not everyone in a family has to become vegan, but vegans acknowledge that it’s easier that way.

“My husband is a meat eater,” said Lexington’s Terri Fann-Boytzun, 43, who has been a vegetarian for six years and a vegan for the past year. But her spouse eats only free-range meat untreated by antibiotics or steroids, perhaps once or twice a week, and he cooks it himself.

“I don’t cook meat,” Fann-Boytzun said. “Being vegetarian is about choice. I have no problem with him eating meat. I’m just glad he chooses clean sources.”

And holidays, with the table of traditional meat-based fare, can be touchy.

Highley brings along a tofu turkey with vegan stuffing and gravy to family holiday gatherings.

“At first, my parents would go ape over it,” he said. “It was like, `What, my turkey’s not good enough for you?’ “

With proper planning, the whole family can be vegan; Highley’s wife and two children, ages 4 and 7, all eat vegan. Highley’s kids are perfectly comfortable telling people that they don’t drink cow’s milk. Highley doesn’t plan ever to cook meat for his kids.

Even the American Dietetic Association has OK’d well-balanced vegan diets as appropriate for all ages, including children and pregnant or breast-feeding women. The late child-care guru Dr. Benjamin Spock also advocated plant-based vegan diets for kids over age 2.

But vegans have to make sure they get enough calcium, vitamins B12 and D and other minerals, which most Americans get from meat and dairy products, said Maria Boosalis, a University of Kentucky associate professor of clinical nutrition.

“It can be difficult for groups who can’t consume a lot of volume,” Boosalis said of children and the elderly. “I don’t know that a total vegan diet is the healthiest diet.”

Vegans usually drink soy milk, calcium-fortified orange juice, leafy green vegetables, beans and other high-nutrition items to get important nutrients.

Some also take supplements, such as B-12, which are more difficult to get from plant-based foods.