• Section 3. Health Benefits and Dietary Recommendations

    Video Lecture #3 - Vegetarian Diet Health Benefits

    Vegetarian Diet Health Benefits

    Many people make the switch to a vegetarian diet because of the potential health benefits. According to the 2010 Dietary Guidelines, vegetarian eating patterns have been associated with improved health outcomes including lower levels of obesity, a reduced risk of heart disease and lower blood pressure.

    A well-planned vegetarian diet can provide good nutrition. It often helps a person to have better health. Eating a vegetarian diet may help:8

    • Reduce the chance of obesity
    • Reduce the risk of heart disease
    • Lower blood pressure
    • Lower the risk of type 2 diabetes

    Compared to non-vegetarians, vegetarians usually eat:

    • Fewer calories from fat (especially saturated fat)
    • Fewer overall calories
    • More fiber, potassium, and vitamin C

    Despite the different definitions for vegetarians, “there’s tremendous agreement among nutrition experts and health organizations that a more plant-based diet is beneficial, whether you’re a true vegetarian or not,” says Dr. Susan Krebs-Smith. “Most Americans don’t eat enough fruit, vegetables, legumes or whole grains. There’s a huge consensus that eating more of these foods would be a good idea for everyone.”9

    Vegetarian diets tend to have fewer calories, lower levels of saturated fat and cholesterol, and more fiber, potassium and vitamin C than other eating patterns. Vegetarians tend to weigh less than meat-eaters, and to have lower cancer rates. “Evidence also suggests that a vegetarian diet is associated with a lower risk of death from certain heart diseases, and that those who follow a vegetarian diet tend to have lower LDL [“bad”] cholesterol levels,” says Jody Engel. 

    In some cases, though, it’s unclear if certain health benefits come from plant-based eating or from the healthy lifestyle of most vegetarians. Dr. Krebs-Smith notes: “Vegetarians are generally more physically active and have healthier habits than non-vegetarians. They also typically have a higher socioeconomic status, at least in the United States”.

    Because vegetarians by definition don’t eat meat, some people jump to the conclusion that simply cutting meat from your diet will lead to health benefits. “But it’s actually more complicated than that,” says Cardiologist Dr. Gary Fraser. “Differences in life expectancy and other health matters might be related to the extra fruits, vegetables, nuts and legumes—including soy—that vegetarians tend to eat. You can’t necessarily conclude it’s based on the absence of meat,” he says.

    Experts generally agree that vegetarians who eat a wide variety of foods can readily meet all their body’s needs for nutrients.  However, vegetarians need to be sure they take in enough iron, calcium, zinc and vitamin B12. Studies show that most vegetarians manage to get enough vitamins and minerals, in part because so many cereals, breads and other foods are fortified with these nutrients. “Vegans in particular need to be certain to get enough vitamin B12 and Omega-3 fatty acids,” says Rachel Fisher, a registered dietitian involved in nutrition research at NIH. Omega-3—found in fish, flax seed, walnuts and canola oil—is important for heart health and vision.

    Some vegetarians take dietary supplements to make sure they’re getting everything they need. Rachel Fisher comments “At any stage of life, you should be able to eat a healthy diet by consuming vegetarian foods. But it does take a little planning”.  Whether a person is a vegetarian or not, Fisher says, a person can benefit from the high fiber, low fat and rich nutrients of a vegetarian diet.

    Nutrients to Focus on for Vegetarians 

    Vegetarian diets can meet all the recommendations for nutrients. The NIH dietary recommendation is to consume a variety of foods and the right amount of foods to meet calorie needs that follow the food group recommendations for age, sex, and activity level to get the right amount of food and the variety of foods needed for nutrient adequacy.10

    Certain groups of people may need to plan carefully, such as:11

    • Young children and teens
    • Pregnant or breast-feeding women
    • Older adults
    • People with cancer and some chronic illnesses

    Vegetarian diets that include some dairy products and eggs have all the nutrition that is needed. If they choose to avoid most or all animal foods, pay close attention to make sure they get all of the following nutrients which include protein, iron, calcium, zinc, and vitamin B12.12

    • Protein has many important functions in the body and is essential for growth and maintenance. Protein needs can easily be met by eating a variety of plant-based foods. Don't overload meals with high-fat cheeses to replace the meat. Protein needs can easily be met by eating a variety of plant foods. 

    Combining different protein sources in the same meal is not necessary. Sources of protein for vegetarians and vegans include beans, nuts, nut butters, peas, and soy products (tofu, tempeh, veggie burgers). Milk products and eggs are also good protein sources for lacto-ovo vegetarians.

    • Iron functions primarily as a carrier of oxygen in the blood. Iron sources for vegetarians and vegans include iron-fortified breakfast cereals, spinach, kidney beans, black-eyed peas, lentils, turnip greens, molasses, whole wheat breads, peas, and some dried fruits (dried apricots, prunes, raisins).

    Because of their high nutrient content, consuming beans and peas is recommended for everyone, vegetarians and non-vegetarians alike. Enjoy some vegetarian chili, three bean salad, or split pea soup. Make a hummus filled pita sandwich.

    Eating foods that are high in vitamin C at the same meal as iron-rich foods increases iron absorption. Foods high in vitamin C include, tomatoes, potatoes, citrus fruits, bell peppers, and strawberries.

    • Calcium is used for building bones and teeth and in maintaining bone strength. Sources of calcium for vegetarians and vegans include calcium-fortified soymilk and other non-dairy milks such as almond milk, calcium-fortified breakfast cereals, fortified orange juice, tofu made with calcium sulfate, and some dark-green leafy vegetables (collard greens, turnip greens, bok choy, mustard greens). Calcium-fortified soymilk provides calcium in amounts similar to milk.

    The amount of calcium that can be absorbed from these foods varies. Consuming enough plant foods to meet calcium needs may be unrealistic for many. Milk products are excellent calcium sources for lacto vegetarians. Calcium supplements are another potential source.

    • Zinc is necessary for many biochemical reactions and also helps the immune system function properly. Sources of zinc for vegetarians and vegans include many types of beans (white beans, kidney beans, and chickpeas), zinc-fortified breakfast cereals, wheat germ, and pumpkin seeds. Milk products are a zinc source for lacto vegetarians.

    • Vitamin B12 is only found in animal products and some fortified foods. Vegetarians should choose fortified foods such as cereals, soy products, veggie burgers, and nutritional yeast. Or, take a vitamin B12 supplement if they do not consume any animal products. It is recommended that they check the Nutrition Facts label for vitamin B12 in fortified products. Animal sources of vitamin B12 for lacto-ovo vegetarians include milk products and eggs.

    Additionally, the National Institutes of Health recommendation includes:13

    • Omega-3 fatty acids: Omega-3s are important for heart and brain health. Vegetarians can get Omega-3s from these foods:

      • Fatty fish, such as halibut, mackerel, salmon, herring, and sardines (this only applies to pescetarians and semi-vegetarians)
      • Nuts and seeds, such as walnuts, pumpkin seeds, ground flaxseed, canola oil, chia seeds
      • Soybeans and soy oil
      • Foods fortified with Omega-3s, such as bread, eggs, juice, and milk

    Dietary Recommendations for Vegetarians

    A vegetarian eating pattern can be a healthy option. The key is to consume a variety of foods in the right amounts to meet calorie and nutrient needs.14

    Many foods that typically contain meat or poultry can be made vegetarian. This can increase vegetable intake and cut saturated fat and cholesterol intake. Consider the following options:15 

      • pasta primavera or pasta with marinara or pesto sauce
      • veggie pizza
      • vegetable lasagna
      • tofu-vegetable stir fry
      • vegetable lo mein
      • vegetable kabobs
      • bean burritos or tacos

    A variety of vegetarian products look (and may taste) like their non-vegetarian counterparts, but are usually lower in saturated fat and contain no cholesterol. 

      • For breakfast, try soy-based sausage patties or links.
      • Rather than hamburgers, try veggie burgers. A variety of kinds are available, made with soy beans, vegetables, and/or rice.
      • Add vegetarian meat substitutes to soups and stews to boost protein without adding saturated fat or cholesterol. These include tempeh (cultured soybeans with a chewy texture), tofu, or wheat gluten (seitan).
      • For barbecues, try veggie burgers, soy hot dogs, marinated tofu or tempeh, and veggie kabobs.
      • Make bean burgers, lentil burgers, or pita halves with falafel (spicy ground chick pea patties).
      • Some restaurants offer soy options (texturized vegetable protein) as a substitute for meat, and soy cheese as a substitute for regular cheese.

    • Most restaurants can accommodate vegetarian modifications to menu items by substituting meatless sauces, omitting meat from stir-fries, and adding vegetables or pasta in place of meat. These substitutions are more likely to be available at restaurants that make food to order.

    • Many Asian and Indian restaurants offer a varied selection of vegetarian dishes. 

    Many popular main dishes are or can be vegetarian— such as pasta primavera, pasta with marinara or pesto sauce, veggie pizza, vegetable lasagna, tofu-vegetable stir-fry, and bean burritos.

    Be aware that some foods marketed as vegetarian can be high in calories and fat, such as soy hot dogs, soy cheese, refried beans and snack bars. The basics of achieving and maintaining a healthy weight are the same for all people a healthy diet should balance calories eaten with calories burned.

    Vegetarian Meal Myths and Facts 

    Vegetarian diets can be healthful and nutritionally adequate but there are still many myths regarding vegetarian diets. Five of the most common myths associated with vegetarian diets are discussed in an article by Alexandra Caspero, MA, RD, published by the Academy of Nutrition and Dietetics.16

    Myth #1: Vegetarians and vegans have a hard time getting enough protein.

    Although meat is most commonly associated with protein, plant-based sources of protein are a healthy alternative. These include legumes, soy products, whole grains, and nuts. That's "because protein from whole grains and legumes have lower digestibility than animal protein," says Reed Mangels, PhD, RD.

    Myth #2: To build strong bones, you must include dairy in your diet.

    There are other alternatives to dairy products such as kale, broccoli, bok choy, and fortified soymilk. Fortified foods such as ready-to-eat cereals, orange juice and tofu are other options.

    Myth #3: Consuming soy products increases the risk of breast cancer.

    "Soy doesn't appear to have any effect on risk for breast cancer one way or the other," says Ginny Messina, MPH, RD. In fact, she says, "there is evidence that girls who consume soy in childhood and adolescence have a lower lifetime risk for breast cancer; soy in adulthood doesn't appear to have that effect."

    Myth #4: Vegetarian diets are not appropriate for pregnant women, children or athletes.

    Caspero says “a vegetarian diet can meet the nutrient needs of people from all stages of life, including pregnant and lactating women, children, and even athletes”. A well-planned diet including a diversity of foods can promote normal growth.

    Myth #5: Just because it is vegetarian it is healthy.

    It is recommended that consumers read food labels and look for low levels of saturated fat, cholesterol and sodium. “The vegetarian or vegan label doesn't automatically equal good health” says Caspero.

    Even some foods marketed as vegetarian can be high in calories and fat, such as soy hot dogs, soy cheese, refried beans and snack bars.

    To Summarize – Tips for a Vegetarian Diet

    The National Institute of Health developed the following additional tips for a Vegetarian Diet.17

    1. Meet protein needs by eating a variety of plant foods, nuts, eggs or dairy foods.
    2. Snack on unsalted nuts and use them in salads or main dishes.
    3. Vitamin B12 is naturally found only in animal products. Choose fortified foods such as cereals or soy products, or take a vitamin B12 supplement if you don’t eat animal products.
    4. Get calcium from dairy products and calcium-fortified soy milk, breakfast cereals or orange juice.
    5. Beans and peas have many nutrients and are recommended for everyone, vegetarians and non-vegetarians alike. 

    Section 2. Types of VegetariansSection 4. Case Study Introduction