Vegetarian Diets

Vegetarian diets encompass a wide variety of eating patterns that are plant-based. There are a number of health benefits to eating a plant-based diet including:

  • Lower LDL (low density lipoprotein)
  • Lower risk of death from a heart attack
  • Lower blood pressure
  • Lower rate of hypertension
  • Lower rate of Type 2 diabetes
  • Lower body mass index (BMI)

Vegetarian diets are generally lower in dietary saturated fat, cholesterol, and higher in fruit, vegetables, nuts, whole grains, fiber, soy, and phytochemicals (e.g. antioxidants). Many of us have our own definition of vegetarianism, so I have listed three common types here:

Vegan
plant foods only. No animal products whatsoever
Lacto-vegetarian
plant foods, milk, and milk products. No meat, fowl (e.g. chicken), seafood, or eggs
Lacto-ovo-vegetarian
plant foods, milk, milk products, and eggs. No meat, fowl (e.g. chicken), or seafood

Vegetarian diets are among the healthiest for reducing risk of chronic disease but they require planning and knowledge of foods to meet nutritional needs from fewer food groups. Eliminating an entire food group typically means a loss of or a lower intake of essential dietary nutrients. Essential dietary nutrients are those that we need to consume since our bodies cannot make them or cannot make enough of them. With certain vegetarian diets, fortified foods and possibly nutritional supplements are necessary to insure adequate intake of those nutrients.

Food Groups & Their Nutrients

Foods can be grouped by the nutrients that they provide – this helps us plan meals that are nutritionally balanced. Understanding which food groups provide the best sources of essential dietary nutrients allows us to make informed food choices to meet our nutritional needs. According to the American Dietetic Association’s position statement on vegetarian diets , dietary intake of protein, calcium, iron, zinc, Vitamin D, Vitamin B12, Iodine, and DHA might be low unless fortified foods/beverages and/or supplements are regularly consumed.

The chart below identifies which food groups naturally contain the eight nutrients listed above. Information in this chart was adapted and modified from an article about food groups for The Pyramid Food Guide (J Nutr Educ Behav. 2006;38:S93-S107).

Nutrient Fruit Dark Green Veggies Orange Veggies Legumes* Other starchy veggies Whole grains** Meat / Seafood / Fowl / Egg Milk & Milk Products Nuts & Seeds
Protein Best Good Best Best Good
Calcium Good – Figs Good Good Best – Seafood with edible bones Best Good
Vitamin D Best – Cod liver oil and fish
Iron Best Best Best Good
Zinc Best Best Best Best Best
Vitamin B12 Best Best
DHA*** Best – Algae Best – Seafood Fair – Eggs
Iodine Good – Sea vegetables (e.g. kelp) Good – Seafood Good

* Legumes include dried beans/peas such as kidney, garbanzo, navy, pinto, and adzuki beans, soybeans, lentils, black eyed peas, and split peas.

** Fortified refined grain products are high in folate and iron.

*** DHA, docosahexaenoic acid, is a potent omega-3 fatty acid.

Easy Nutrient Tracking with MyNetDiary

MyNetDiary helps you plan as well as assess the nutritional adequacy of your preferred vegetarian eating style in addition to tracking calories for weight control. In “Plan” section, simply select those higher risk nutrients for tracking so that you can monitor your intake daily, weekly, monthly, per 6-months, and yearly. Note that because there is very little DHA data in non-research food databases, DHA is not a nutrient that you can track at in MyNetDiary at this time. However, the other seven nutrients can be tracked.

Nutrient Detail

Most of the information contained in this chart is based on information from American Dietetic Association’s position statement on vegetarian diets

Nutrient Notes
Protein Lacto- and lacto-ovo- vegetarians typically do not have trouble meeting their protein needs since dairy and eggs are concentrated sources of all essential amino acids and are digestible (the issue of lactose sugar intolerance is not related to protein digestibility). Vegans who consume adequate calories and a variety of plant sources of protein (e.g. legumes, whole grains, nuts, and seeds) will also meet their protein requirements. The older notion of “complementing” proteins is not necessary at every meal, but eating a variety of plant protein sources during the day does make it easier to consume enough essential amino acids to meet total protein needs. For more information, see The Vegetarian Society’s website. If you like technical papers, see the FAO link on protein quality.
Calcium Adequate calcium can be obtained in the diet without milk products or fish bones if you eat about eight servings a day of legumes, leafy greens, nuts, and seeds. If you do not eat those foods and/or are restricting your intake well below 2000 calories, then consider consuming calcium-fortified beverages such as soy milk, rice milk, and calcium-fortified orange juice. Also consider a calcium supplement if you find you cannot meet your goal by food or fortified beverages. Note: do not rely on a large portion of spinach to obtain calcium since the oxalate binds it and makes it mostly unavailable. Supplements: spread out intake since we can’t absorb more than about 500 mg of calcium at a time. Hate big pills? Try calcium chews – it’s an easy way to get your calcium.
Vitamin D The “sunshine” vitamin - pre-vitamin is formed in the skin with sunlight exposure. Fortified foods and supplements are needed in northern latitudes (e.g. the further North you live from the equator) or for any individual who uses a lot of sunscreen. Cow’s milk sold in the U.S. is fortified with Vitamin D and is a good source for lacto- and lacto-ovo-vegetarians if you consume about 4 servings a day. Fortified soy and rice milks are also good sources of Vitamin D. It takes about 4 servings of these fortified beverages to meet the current recommendation of 400 IUs (10 micrograms) daily. There are also Vitamin D dietary supplements available in most shops. Vitamin D is also important to take if you are breastfeeding – if you are low in this vitamin, then your breast milk will be as well. Unless your baby gets a lot of sunshine every day, your baby will need vitamin D from you. Some guidelines even recommend Vitamin D drops for infants. FYI, Vitamin D2 is considered vegan whereas Vitamin D3 is considered non-vegan sources of Vitamin D.
Iron This is the most common nutrient deficiency in the world, regardless of diet type. Highly absorbable “heme” iron is found in animals, especially liver, oysters, red meat, and clams. When these foods are excluded from the diet, it is very important to choose a variety of good plant sources of iron (“non-heme” iron) such as legumes (especially edamame, lentils, and kidney beans), fortified grains and cereals, and nuts/seed (especially pumpkin and sesame seeds). Cook these iron-rich foods with vitamin C- rich and/or acidic fruits and veggies to help improve iron absorption. As well, cooking in a cast iron skillet (especially with acidic fruits or veggies) will increase the iron content of dishes. Note that green leafy veggies contain oxalates which greatly inhibit iron absorption so are not considered the best plant sources of iron in a vegan’s diet.
Zinc Zinc is also more bioavailable in animal forms (especially oysters and crab) since plant phytates can bind both zinc and iron. Anything that lessens phytate content will help zinc absorption from plants. For instance, yeast-leavened breads and sprouting beans, grains, and seeds will improve zinc bioavailability. Try to eat a variety of plant sources of zinc. Ask your doctor about zinc if you are taking iron supplements as it can interfere with zinc absorption.
Vitamin B12 Vitamin B12 cannot be obtained reliably in amounts necessary for health from plant foods that are not fortified. Algae, spirulina, alfalfa, comfrey, amaranth, greens, mushrooms, seaweeds, nuts, legumes, and non-fortified fermented soy foods are NOT reliable sources of Vitamin B12. To meet nutritional needs, consume several servings a day of foods fortified with Vitamin B12 (e.g., fortified soy milk), Red Star Vegetarian Support Formula Nutritional Yeast, and/or take a daily Vitamin B12 supplement (sublingual form is more easily absorbed than the pill form). If you have problems producing stomach acid then ask your doctor if you need a Vitamin B12 supplement (poor acid production compromises Vitamin B12 absorption further down in the gut).
DHA DHA, a potent omega-3 fatty acid, is being studied extensively for health benefits during pregnancy, breastfeeding, and for adult cardiovascular health. DHA is found in good supply in large cold-water fish, and to a lesser extent in eggs and algae (unless concentrated). DHA is not considered an essential fatty acid at this time. Alpha-Linolenic acid (ALA) is an essential dietary fatty acid needed in very small quantities in the human diet. Unfortunately, very little ALA is actually converted to DHA. Vegetarians might want to consider microalgae DHA supplements (with vegan capsules) rather than relying on nut and seed sources of ALA if they are hoping to increase their DHA blood levels. These supplements are common at local vitamin shops or online.
Iodine For vegans, plenty of sea veggies will help you get enough iodine if you do not use foods that are processed with regular salt. Regular salt is “iodized” but sea salt is not. Also, check favored sauces – not all use iodized salt. Iodine deficiency is not common but it is possible to develop a deficiency if a diet is devoid of animal products, processed food (that uses iodized salt),iodized salt, and sea vegetables.

Vegan Food Guide

For an excellent guide on eating well as a vegan, I recommend “Becoming Vegan.” The authors, Vesanto Melina and Brenda Davis, are registered dietitians who provide sound information on meeting essential dietary nutrients through vegan foods as well as when to use fortified foods and supplements. I especially like their “Vegan Food Guide” – since it provides portion sizes and recommended number of portions to meet needs, as well as contains sample menus. If you would like to view the Vegan Food Guide online, see Vesanto Melina’s website.

To eat healthfully on a vegan diet, it is important to become knowledgeable about foods, eat a variety of plant-based foods, especially legumes, whole grains, nuts, and seeds, and consider incorporating fortified vegan foods and supplements into the diet to insure nutritional adequacy.

Resources for Vegetarians

American Dietetic Association’s position statement on vegetarian diets

Davis B and Vesanto M. Becoming Vegan: The Complete Guide to Adopting a Healthy Plant-Based Diet. Book Publishing Company: 2000.

United States Department of Agriculture’s Tips & Resources for Vegetarian Diets. Online at: MyPyramid

Vegetarian Food Guide. Online at: http://www.dietitians.ca

Vegetarian Resource Group. Online at: http://www.vrg.org/nutrition/

Vegetarianism & Vegetarian Nutrition Website. Online at: http://www.vegetarian-nutrition.info/

Parting Thought

Good luck with your adventure, new or old, in eating vegetarian. A diet filled with healthful foods such as fruits, vegetables, whole grains, and nuts/seeds, will provide nutrients supportive of good health. Of course, in all of this, calories still count, so continue tracking intake and calories burned to meet your weight goals.

If you have questions about the material covered in this article, please be sure to post them in Community Forum.

Best,

Katherine Isacks, MPS, RD, CDE

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Disclaimer: Please note that we cannot provide personalized advice and that the information provided does not constitute medical advice. If you are seeking medical advice, please visit a medical professional.

This article can be found at http://www.mynetdiary.com/vegetarian-diets.html