Vegetarians are people that eat no animal flesh, including no seafood and fish. Vegans don’t each any animal products whatsoever, including no dairy, eggs or honey. More and more people are choosing to at least reduce their intake of animal products for various reasons and they too may benefit from some guidance on ensuring adequately balanced nutrition as a consequence of this choice.
The most important principle to ensure adequate nutrition as a person that eats less or no animal products is balance & VARIETY! You will not be a healthy vegetarian if you are lazy with your diet. The more varied your diet, the better your nutrition will be... the better you will feel and
perform physically and mentally. This is because various vitamins, minerals and amino acids (building blocks of proteins) work synergistically with other vitamins, minerals and amino acid to be absorbed and adequately utilized in the body. One example is calcium, which needs the amino acid lysine, plus the mineral boron and vitamin D to be adequately absorbed and used. A second example is iron, which requires the synergistic activity of vitamins C, B6 and B12. Various foods are rich in specific groups of nutrients. Eating many different kinds of fruits, vegetables, whole grains, legumes, beans and nuts means that you will get all the required nutrients.
It is also important to take responsibility for the impact that other factors have on our nutrition. For example: caffeine, alcohol, refined sugar, medical & recreational drugs and even exercise affect nutrient levels in your body. For example excessive coffee, tea and Coca-Cola consumption decreases mineral absorption. Drugs used to treat hypothyroidism deplete iron; statin drugs (used to treat high cholesterol) deplete co-enzyme Q10; aspirin (e.g. grandpa, panado etc) depletes vitamin C, calcium, folic acid, iron, sodium, potassium, and vitamin B5; the oral contraceptive pill depletes folic acid, vitamins B1, B2, B3, B12, vitamin C, selenium, magnesium and zinc; estrogen hormone replacement therapy (HRT) depletes vitamin B6 and magnesium.
Protein
Protein is a major component of enzymes, hormones, body tissues, the immune system, and virtually every cell and fluid in the body. It is made up of building blocks called amino acids. Amino acids can be made in the body, but eight of them, called essential amino acids, must be ingested from food.
The eight amino acids that are generally regarded as essential for humans are phenylalanine, valine, threonine, tryptophan, isoleucine, methionine, leucine, and lysine. Cysteine (or sulphur containing amino acids), tyrosine (or aromatic amino acids), histidine and arginine are additionally required by infants and growing children. Cysteine, tyrosine, taurine and carnitine are not considered essential, but require one or more of the essential amino acids to manufacture them in the body. This is why they sometimes become deficient in vegetarians and vegans.
“Complete protein” sources contain a balanced set of essential amino acids for humans. Animal sources such as meat, poultry, eggs, fish, milk, and cheese provide all of the essential amino acids. Near-complete proteins are also found in some plant sources such as quinoa (14% protein content), buckwheat (18% protein content), hempseed powder (30% protein content) and spirulina (70% protein content), among others. Soya is also near-complete protein. Nowadays a lot of people use a concentrated rice protein powder (e.g. added to smoothies) because very few people develop allergies to rice.
It is not always necessary to consume plant foods containing complete proteins as long as a reasonably varied diet is maintained. By consuming a wide variety of plant foods, a full set of essential amino acids will be supplied and the human body can convert the amino acids into proteins.
The recommended daily allowance for protein is between 0.66g per kg body weight for women and 0.8g per kg body weight for men. This allowance may be increased to between 1g and 2g per kg body weight for athletes, depending on the kind of sport. The average protein recommendation for athletes is 1.5g per kg body weight daily.
Plant proteins typically come from foods such as beans, legumes, peas, nuts, seeds and soya products (including tofu and soya sausages etc). Dairy products and eggs are good sources for lacto-ovo vegetarians. With regards to nuts, just remember that most nuts contain approximately 50% fat and 50% protein). Although the plant fats are good for you, an excess consumption will result in weight gain. I generally recommend limiting nut consumption to a maximum of a small handful daily. Growing children will, however, benefit greatly from the nutrient-density of nuts. Don’t forget that grains and vegetables also contain protein. For example wheat contains 13% protein, barley 14.7%, oats 11%, rice 7.3%, rye 11.5% and corn 8.7% protein. These are however not “complete proteins”, but you can still benefits from including them in your diet if you have a varied protein source.
With regards protein absorption please take note that one requires various vitamins and minerals to adequately absorb protein. If your diet isn’t balanced you will not be able to adequately absorb protein.
Vulnerable nutrients
Vegetarians and especially vegans can become deficient in iron, calcium, vitamin B12, vitamin D, zinc, various amino acids and DHA (a type of omega 3 fatty acid) if not conscientious in their diet.
Iron
Iron is very important for a number of functions in the body, most notably its role in making hemoglobin to carry oxygen in red blood cells. Adequate amounts are needed to prevent microcytic anemia. It is best absorbed when consumed with a source of vitamin C and B6, and works synergistically with vitamin B12 in the body. Remember that calcium competes for absorption with iron, so it’s best to consume sources or iron and calcium separately. Some good sources of iron include blackstrap molasses, lentils, beans, quinoa and tofu.
With regards iron deficiency anemia, the amino acid isoleucine and histadine are also needed to make haemoglobin. If a person is deficient in these two nutrients it may look like they have iron deficiency anemia (due to the low haemoglobin), whereas the blood iron levels are normal.
Calcium
Calcium plays a very important role in health and well being. Bone health is only one of many functions! Research has shown that vegetarians and vegans that consume a balance, varied diet do not develop impaired bone health, despite the fact that their calcium intake is often lower than non-vegetarians. This has been attributed to the fact that a varied vegetarian diet provides more of the calcium co-factors like boron and vitamin K than non-vegetarians generally consume.
Don’t forget that calcium needs adequate vitamin D and the amino acid lysine for maximum effectiveness. Iron, Zinc, Magnesium and Phosphorus compete with calcium for absorption. High soya product intake has also been attributed to adequate bone health in vegetarians. Good natural sources of calcium include blackstrap molasses, turnip greens, kale, bok choy (Chinese spinach), okra, tahini (sesame seeds are very high in calcium), broccoli, almonds and
fortified soya products.
Vitamin D
Vitamin D is not only important for bone health, but many other functions in the bone. Scientist have recently discovered that vitamin D plays an important role in regulating the function of the immune system, helping control autoimmune diseases and allergies. Vitamin D also helps regulate blood sugar and insulin. Vitamin D is found in adequate amounts in eggs and dairy. Dairy and eggs are not consumed by vegans, but they can get some vitamin D from nutritional yeasts (e.g. brewer’s yeast and torula yeast). Small amounts are also found in dandelion greens, oatmeal and sweet potatoes. You can get you vitamin D from the sun by exposing you face and arms to the sun for 20min daily three times a week.
B12 and other B vitamins
All the B vitamins are vitally important to physical, mental and emotional health. Food sources of B vitamins in general include beans, legumes, whole grains, peanuts, brewer’s yeast, broccoli, brussel sprouts, asparagus, molasses, mushrooms, whole wheat, wheat germ, torula yeast, spinach, peas, potatoes, bananas and soya. These all do not convincingly provide vitamin B12, however. Vitamin B12 is available from eggs and dairy products, but these foods are not an option for vegans.
The following important information on vitamin B12 is taken directly from An Open Letter from Health Professionals and Vegan Organizations:
‘B12 is the only vitamin that is not recognized as being reliably supplied from a varied wholefood, plant-based diet with plenty of fruit and vegetables, together with exposure to sun. Many herbivorous mammals, including cattle and sheep, absorb B12 produced by bacteria in their own digestive system. B12 is found to some extent in soil and plants. These observations have led some vegans to suggest that B12 was an issue requiring no special attention, or even an elaborate hoax. Others have proposed specific foods, including spirulina, nori, tempeh, and barley grass, as suitable non-animal sources of B12. Such claims have not stood the test of time. Claimed sources of B12 that have been shown through direct studies of vegans to be inadequate include human gut bacteria, spirulina, dried nori, barley grass and most other seaweeds. Several studies of raw food vegans have shown that raw food offers no special protection.
Reports that B12 has been measured in a food are not enough to qualify that food as a reliable B12 source. It is difficult to distinguish true B12 from analogues of B12 (“false” B12) that can disrupt B12 metabolism. Even if true B12 is present in a food, it may be rendered ineffective if analogues are present in comparable amounts to the true B12.
To get the full benefit of a vegan diet, vegans should do one of the following:
1. Eat fortified foods two or three times a day to get at least three micrograms (mcg or μg) of B12
2. Take one multivitamin or B12 supplement daily providing at least 10 micrograms
3. Take a weekly B12 supplement providing at least 2000 micrograms.
4. Vitamin B 12 injection (1ml every 4 – 8 weeks)
In choosing to use fortified foods or B12 supplements, vegans are taking their B12 from the same source as every other animal on the planet – micro-organisms – without causing suffering to any sentient being or causing environmental damage.
In adults, typical deficiency symptoms include loss of energy, tingling, numbness, reduced sensitivity to pain or pressure, blurred vision, abnormal gait, sore tongue, poor memory, confusion, hallucinations and personality changes. Often these symptoms develop gradually over several months to a year before being recognized as being due to B12 deficiency and they are usually reversible on administration of B12. There is however no entirely consistent and reliable set of symptoms and there are cases of permanent damage in adults from B12 deficiency. Infants typically show more rapid onset of symptoms than adults. B12 deficiency may lead to loss of energy and appetite and failure to thrive. If not promptly corrected this can progress to coma or death. Again there is no entirely consistent pattern of symptoms. Infants are more vulnerable to permanent damage than adults. Some make a full recovery, but others show retarded development.
Most vegans consume enough B12 to avoid anemia and nervous system damage, but many do not get enough to minimize potential risk of heart disease or pregnancy complications. Two subgroups of vegans are at particular risk of B12 deficiency: long-term vegans who avoid common fortified foods (such as raw food vegans or macrobiotic vegans) and breastfed infants of vegan mothers whose own intake of B12 is low.
A blood B12 level measurement is a very unreliable test for vegans, particularly for vegans using any form of algae. Algae and some other plant foods contain B12-analogues (false B12) that can imitate true B12 in blood tests while actually interfering with B12 metabolism. Blood counts are also unreliable as high folate intakes suppress the anemia symptoms of B12 deficiency that can be detected by blood counts. Blood homocysteine testing is more reliable, with levels less than 10 mmol/litre being desirable.’
DHA (docosahexaenoic acid)
DHA is an omega-3 fatty acid. DHA deficiency is associated with cognitive decline and it has been found to be depleted in the cerebral cortex of severely depressed patients. Cold-water oceanic fish oils are rich in DHA. Most of the DHA in fish originates in photosynthetic and heterotrophic microalgae. DHA is also commercially manufactured from microalgae; Crypthecodinium cohnii and another of the genus Schizochytrium. DHA manufactured using microalgae is vegetarian and vegan. Research studies have shown that the plant-based omega 3 fatty acid α-linolenic acid (ALA) does not convert to DHA in the body. The only way people that do not eat fish should get this important nutrient from an organic microalgae supplement.
Special Considerations
Pregnancy
Vegetarian mothers-to-be, as all pregnant women, should increase their intake of calories by approximately 300kcal (in the form of nutritious snacks) from the 2nd trimester. During the 2nd and 3rd trimester it is advisable to consume approximately 25g more protein per day. Other important nutrients to bear in mind during pregnancy are B12, iron (approx. 30mg), calcium, vitamin D, zinc DHA and folic acid.
Infancy & the growing child
Breastfeeding is very important, especially for babies of vegan mothers in order to ensure that the baby gets adequate micronutrients, protein, oils (particularly omega 3 DHA) and calories. It is advisable to breast-feed for 4-6 months. The breastfeeding mother should have an excellent diet in order to produce the best quality breast milk. If breast milk is inadequate in quantity I recommend fenugreek 5g three times per day.
When giving a vegan baby soya milk formulas instead of dairy based formulas beware of soya allergy, what is not uncommon. The biggest threat to vegan babies is inadequate calorie intake. Vegetarian and vegan infants, toddlers and children often grow slower (weight and height) due to the fact that they generally have lower calorie intakes. Fortify calorie intake with calorie dense foods like avo, dried fruit, nuts (and nut butters) and seeds at the appropriate age. It is advisable to reserve adding nut products until after 12 months. Consider iron fortified rice cereals when introducing solids. Consider vegan sausages, schnitzels and burgers for children. Frys has a great range of meat alternative products, suitable for children and adults alike.
Athletes
Some of the top athletes in the world are vegetarian and vegan. There is no excuse for even a vegan not getting adequate energy from their limited diet. Athletes need to be all the more conscientious with following the general nutritional recommendations discussed here. In addition to that they will benefit from supplementation with taurine, creatine and carnitine, all of which are not available from a diet free of animal products. A moderate increase in protein will be beneficial to athletes participating in some sports. Endurance athletes should be more concerned with an increase in calories from carbohydrates.
Anemia
It is important to highlight that anemia is not always caused by nutrient deficiencies. For example infection with H pylori (the bacteria that causes stomach ulcers) can mimic iron deficiency anemia. Once the infection is eradicated (which often requires 3 months of treatment) the anemia disappears. Lead poisoning, copper deficiency and some chronic diseases (e.g. autoimmune diseases, cancer, HIV etc) can also mimic iron deficiency anemia. In such cases the anemia will only disappear once effectively treating the disease and not the anemia. Alcoholism, liver disease, hypothyroidism, and folic acid deficiency can mimic vitamin B12 anemia.
Quite a number of drugs can also cause anemia. Some examples include certain anti-epilepsy drugs, statins (used for high cholesterol), nexium (used for gastric reflux), Levodopa and Methyldopa (used for Parkinson’s disease), certain antibiotics and non-steroidal anti-inflammatory drugs.
Psychological disorders
One of the reasons why it is important for vegetarians and vegans to take care of their nutrition is two ensure their mental/emotional wellbeing. Nutrients that are essential for this include omega 3 (DHA), vitamins (folic acid, B vitamins, vitamin D), minerals (magnesium, zinc, iron) and amino acids (e.g. tryptophan, tyrosine, phenylalanine).
Conclusion
I think it’s best to conclude with the first and central principle for vegetarian nutrition - balance & VARIETY! You will not be a healthy vegetarian if you are lazy with your diet. The more varied your diet, the better your nutrition will be... the better you will feel and perform physically and mentally.
Additional reading:
A new food guide for North American vegetarians
http://www.metabolicdiet.com/pdfs/veg_food_guide.pdf
