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The Healthy Vegetarian

For years, general health guidelines suggested that individuals could not get all the nutrients they need when following a strict vegetarian diet. Vegetarians were considered by nutritionists to be “at nutritional risk” due to potential deficiencies of essential nutrients. But finally, the tables have turned.

Recent research has shown that populations who eat a vegetarian diet not only can meet their nutrient needs, but also have a lower incidence of common chronic diseases. Rates of cancers, heart disease, high blood pressure, diabetes, and diverticulosis are lower among vegetarians when compared to their meat-eating counterparts.

Vegetarians come in many forms. Some individuals consider themselves vegetarian, but eat fish. Some don’t eat animal flesh, but eat eggs and dairy. Still others avoid any food made with or from animals or animal products. Therefore, strategies for meeting nutrient needs vary, depending upon the definition of “vegetarian” used by each individual.

While a nutritionally complete diet is possible for all vegetarians, individuals accepting this lifestyle change must eat smart. Following a Western diet, but “without the meat” is not always an adequate strategy for meeting the nutrient needs that meat provides. And during a time when controversial high-protein, low-carbohydrate diets are getting all the press, some “vegetarian” diets may pose just the opposite problem. Ordering a portabello mushroom sandwich and a salad for lunch as a vegetarian choice may provide all carbohydrates without any protein, guaranteeing energy and mood swings later in the afternoon.

As always, “balance and moderation” is vital for vegetarians. When removing animal protein, care must be taken to ensure that a balance of protein, carbohydrates and healthy fats are provided in each meal or snack as a means of moderating blood sugar, energy and satiety. The portabello mushroom will offer delicious flavor to the sandwich, but will not provide much in the way of protein. Accenting the sandwich with a bean salad, barley or lentil soup or a glass of dairy or soy milk will balance the meal with dietary protein. Other protein sources include all other legumes, nuts, seeds, nut butters, cheeses, yogurt, tofu, tempeh, whole grains such as quinoa, and eggs.

True vegans who eat no animal products at all generally require vitamin B12 supplementation, as it is only found in animal foods. In the past, popular literature suggested that miso, tempeh, tamari, sea vegetables and some greens were adequate Vitamin B12 sources due to either their fermentation status, or to healthy contamination with Vitamin B12 producing bacteria. However, research has shown that these foods do not consistently provide Vitamin B12, and that even if the vitamin is present, it is generally in an analogue form not easily used by the body. Therefore, all vegans should proactively consume foods fortified with Vitamin B12 as indicated on the food label. Fortified products include breakfast cereals, fortified meat substitute products and fortified soy and grain milks. If such foods are not eaten with regularity, vegans should take a Vitamin B12 supplement to ensure they receive this essential nutrient.

Another nutrient to consider is Vitamin D. Found generally in the food supply in fortified dairy products, Vitamin D is also produced in our bodies from adequate sun exposure to skin. For vegetarians who do not use dairy products and whose local climate or lifestyle does not provide regular bouts of sunshine, supplementation may be warranted.

In addition to balance and moderation, individuals following a vegetarian lifestyle should also be sure to have variety in their diet. Top food allergens are dairy, soy, peanuts, tree nuts, fish, seafood and wheat, and the vegetarian’s over-reliance on any one of these foods as a calorie or protein source may result in an eventual intolerance or sensitivity. Therefore, using soy milk for breakfast, tofu at lunch, tempeh at dinner and edamame as a snack, for some sensitive individuals, may push the soy envelope to the extreme. In this example, enjoying a variety of soy products over the course of a week, and incorporating other protein food sources each day may be a better option.

Concerned with whether or not your vegetarian diet is meeting all of your needs? A registered dietitian can help by completing a quick diet assessment. For specific life cycle needs, such as childhood growth or pregnancy, a nutrition professional can also support your healthy dietary goals.

Recommended Reading:

Becoming Vegan by Brenda Davis, RD and Vesanto Melina, MS, RD For those interested in research, The Dietitian’s Guide to Vegetarian Diets by Mark Messina and Virginia Messina. Feeding the Whole Family cookbook by Cynthia Lair. It’s not vegetarian, but includes only a few fish/poultry recipes and is a great resource. Any of the Moosewood Cookbooks by Mollie Katzen.

Important nutrients, and their sources, for anyone on a vegetarian or vegan diet:

Iron* Fortified breads and cereals Legumes (lentils, garbanzo beans, pinto beans, etc.) Dried apricots, prunes, raisins Sea vegetables (dulse, alaria, kelp, nori) Pumpkin seeds, sunflower seeds Blackstrap molasses

*To optimize iron absorption from non-animal food sources, be sure to eat a food rich in Vitamin C at the same time. Vitamin C sources include citrus fruits, kiwi, strawberries, peppers, tomatoes, cabbage, broccoli, papaya, mangoes, guava, honeydew.

Zinc Legumes Dairy milk, cheese, yogurt Pumpkin seeds, sunflower seeds Brazil nuts, cashews, peanuts, peanut butter Tahini • Tofu, tempeh Sea vegetables (nori, kelp)

Calcium Dairy milk, fortified soy or rice milks Cheese, yogurts Calcium-processed tofu (check label) Turnip greens, Chinese cabbage Bok choy, broccoli, collard greens Fortified orange juice Almonds, tahini, sesame seeds Legumes • Blackstrap molasses Dried figs • Sea vegetables (dulse)

By Debra Boutin, MS, Rd, Nutrition Coordinator, Bastyr Center for Natural Health

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