Veggie Diets

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Vegetarian Nutrition

Reed Mangels, PhD, RD, LDNOctober 4, 2012


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Plan for Today

Introduction and Definitions

Health Effects of Vegetarian Diets Key Nutrients for Vegetarians

Meal Planning Tools


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What is a Vegetarian?


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What Is a Vegetarian?

Vegetariansdo not eat meat, poultry, or fish.

Lacto-ovo vegetarianseat dairy products andeggs.

Lacto vegetarians use dairy products but not

eggs.

Vegansare vegetarians who avoid all animal

products including dairy products and eggs.


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Other Types of Vegetarian or Near-

Vegetarian Diets

Raw foods

Fruitarian Macrobiotic diet may include limited amounts

of fish. Diet based on grains, vegetables,soups.

Semi-vegetarian (poorly defined)


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Some Foods Excluded from VegetarianMenus

Products containing meat, poultry and fish

Gelatin Chicken or beef broth

Worcestershire sauce (contains anchovies)

Lard Animal-derived flavoring

Oyster sauce


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How Many Adults are Vegetarian?


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How Many Adults are Vegetarian?

About 3% of adults in the United States are

vegetarian. 5% of women, ages 18-34 are vegetarian.

1% of US adults are vegan.

An additional 1% of US adults are veganexcept for honey.

2009 Harris poll, VRG


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How Many Children Are Vegetarian?

8-18 year olds in the United States:

3% are vegetarian

1% are vegan An additional 1% would be vegan, except

for honey

Based on 2010 Harris poll:

http://www.vrg.org/press/youth_poll_2010.php


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Reasons For Vegetarianism


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Reasons For Vegetarianism

Health benefits

EcologicalReligious concerns & spiritual beliefs

Dislike of meat

Compassion for animalsBelief in non-violence

Economics


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Vegetarianism and Religion

Seventh-day Adventists

Widely studied

~40-50% are vegetarian

No smoking, alcohol

Emphasize healthy lifestyle

Jains Only religion unconditionally vegetarian

Frequently lacto vegetarian; may be vegan


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Health Effects of Vegetarian

Diets


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Life Expectancy at Birth

66

68

7072

74

76

78

80

82

84

86

Age(years)

Female Male

SDA

Veg SDA

US

Arch Intern Med 2001;161:1645-52.


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Diet, BMI, DM, Htn: Results from AHS-2

Diet group Mean

BMI

Diabetes

(RR)

Hypertension (RR)

Nonvegetarian 28.26 1.00 1.00

Red meat, fish, poultry< once/wk 27.00 0.72 0.77

Fish 25.73 0.49 0.62

Lacto-ovo 25.48 0.39 0.45

Vegan 23.13 0.22 0.25

Am J Clin Nutr.2009;89(suppl):1607S-12S.

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Results are based on preliminary analyses adjusted for age, gender, and race.


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Health Benefits of Vegetarian Diets

Decreased mortality from CHD

Lower blood total and LDL cholesterol

Reduced risk of:

Obesity

Hypertension

Type 2 diabetes Colon and prostate cancer


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Vegetarian Status and Obesity among SDAs

22

22.5

2323.5

24

24.5

25

25.5

26

26.5

BMI

Female Male

Veg

Semi-Veg

Non-Veg

Am J Clin Nutr 1999;70:532S-8S.


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Why do you think vegetarians have a lowerrisk for many chronic diseases?

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Potential Health Benefits of Vegetarian

Diets

HIGHER IN:

Fiber

Magnesium and

potassium

Vitamin C, vitamin E,

and folate Carotenoids, flavonoids,

plant sterols, and other

phytochemicals

LOWER IN:

Saturated fat

Cholesterol

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Potential Concerns with Lacto-ovo

Vegetarian Diets

Bioavailability of iron and zinc

Excess intake of saturated fat and cholesterol (if

over-reliant on high-fat dairy products and eggs)

Vitamin B12?

DHA/EPA (omega-3 fatty acids)


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Potential Concerns with Vegan Diets

Bioavailability of iron and zinc

Vitamin B12

Calcium

Vitamin D

DHA/EPA (omega-3 fatty acids)

Calories (pregnancy and childhood)


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Key Nutrients for Vegetarians


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Protein


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Myths about Vegetarians and Protein

We need meat to get enough protein

Plant protein lacks essential amino acids and

is poor quality Vegetarians must carefully complement

protein at each meal

Athletes cannot be vegetarian because oftheir high protein needs

Vegetarian diets cannot meet needs ofpregnant/lactating women or of children


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Sample Menu Showing How Easy it is

to Meet Protein NeedsBreakfast: 1 cup Oatmeal 6 grams

1 cup Soymilk 7 grams

1 Bagel 9 grams

Lunch: 2 slices Whole Wheat Bread 5 grams

1 cup Veg. Baked Beans 12 grams

Dinner: 5 oz firm Tofu 11 grams

1 cup Broccoli 4 grams

1 cup Brown Rice 5 grams

2 Tbsp Almonds 4 gramsSnack: 2 Tbsp Peanut Butter 8 grams

6 Crackers 2 grams

TOTAL 73 grams

Protein recommendations for avg male: 56-70 grams


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Protein in Common Vegetarian Foods

Soybeans, 1 c 29 g

Tofu, firm, 5 oz 24 gDried beans, lentils, 1 c 10-18 g

Tempeh, c 15 g

Veggie burger, 1 13 g

Peanut butter, 2 T 8 g

Soymilk or Cows milk, 8 oz 8 g

Grains, cooked, 1 cup 4-8 g


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Myths about Vegetarians and Protein

We need meat to get enough protein







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Amino Acids in Vegetarian Foods

0

10

20

30

40

50

60

70

80

Kidney Beans Brown Rice Soybeans Broccoli Scoring

Pattern

Lysine

Threonine

Sulfur Aas


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If you only ate one food, how much would

be needed to provide the recommended

amount of all essential amino acids?

6-1/2 large potatoes

OR 2-1/2 cups of tofu

OR

15-1/2 cups of rice

Any one of the above foods, eaten in the amount

specified would provide the recommended amounts

of all essential amino acids for an adult man.

Women would need about 20% less of each food.


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Myths about Vegetarians and Protein We need meat to get enough protein







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How much protein do athletes need?

What is an athlete?

The average person needs 0.8 grams of

protein per kilogram body weight or about

0.45 grams of protein per pound.


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Protein for Athletes

Protein recommendations for athletes are

controversial

Endurance athletes involved in heavy training

may need 1.2 to 1.4 grams of protein per

kilogram body weight (0.5 to 0.6 grams per

pound) Strength athletes involved in heavy training may

need 1.6 to 1.7 grams of protein per kilogram

body weight (0.7 to 0.8 grams per pound)


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Myths about Vegetarians and Protein We need meat to get enough protein







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Protein in Pregnancy and Lactation

RDA is 25 g higher in 2ndand 3rdtrimesters and when

lactating (1.1 g/kg)

Many women have this amount of protein in their

diet before becoming pregnant

Additional calories (+340 calories 2ndtrimester, +450

calories 3

rd

trimester) Focus on good sources of protein (soy, dairy, eggs,

beans, nuts)


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Sample Menu Showing How Easy it is

to Meet Protein NeedsBreakfast: 1 cup Oatmeal 6 grams

1 cup Soymilk 7 grams

1 Bagel 9 grams

Lunch: 2 slices Whole Wheat Bread 5 grams

1 cup Veg. Baked Beans 12 grams

Dinner: 5 oz firm Tofu 11 grams

1 cup Broccoli 4 grams

1 cup Brown Rice 5 grams

2 Tbsp Almonds 4 gramsSnack: 2 Tbsp Peanut Butter 8 grams

6 Crackers 2 grams

TOTAL 73 grams

Protein recommendations for pregnancy/lactation: 71 grams


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Protein for Children

Vegan children may have somewhat higher protein

needs than nonvegan children due to the amino acid

composition and digestibility of plant proteins.

A conservative estimate is a 30-35% increase for 1-2

year olds, 20-30% for 2-6 year olds, 15-20% for >6

years.


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Protein for Children

Using these estimates, a 1-2 year old vegan would

need 15-16 g of protein per day; a 2-3 year old would

need 17-18 g/day.

These foods together provide a total of 23-39 g of

protein:

2-3 cups soymilk or breast milk2 servings (1/4 cup each) beans, tofu

6 servings (1/2 slice bread or cup grains or pasta)

2 servings (1/4 cup each) vegetables.


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Protein

Vegetarian diets generally contain adequate

amounts of protein if energy is adequate and

a variety of foods are eaten.

Choosing a variety of protein sources can

ensure amino acid adequacy

Combining complementary proteins at meals

is not necessary to ensure adequate protein

intake.


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Meeting Protein Needs

Be sure to meet energy needs and get

adequate carbohydrate.

Generally, athletes meet or exceed protein

requirements without supplements.

Calculate protein intake vs protein needs.

If necessary add 1 or more serving of protein-

rich foods.


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Iron


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Iron Status

Studies report no significant difference in

incidence of iron deficiency anemia invegetarians compared to nonvegetarians

Vegetarians typically have lower iron stores as

indicated by serum ferritin levels


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Iron Heme vs. non-heme iron

Inhibitors

Enhancers

Do vegetarians need more iron?


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Inhibitors of Iron Absorption inVegetarian Diets

Phytates (whole grains, legumes including

soy, nuts, seeds, vegetables)

Tea, coffee, cocoa (polyphenols)

Calcium from foods and supplements


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Enhancers of Iron Absorption inVegetarian Diets

Vitamin C (ascorbic acid) Other organic acids including citric acid

Fermented foods including sauerkraut, soy

sauce, and sourdough bread


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Iron RDA

Men, 19 and older 8 mg

Women, 19-50 18 mg

Women, 51 and older 8 mg

Vegetarians may need as much as 1.8 times more

iron because of factors in a vegetarian diet that

interfere with iron absorption.


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Vegetarian Sources of IronFood Portion Iron (mg)

Tofu cup 6.6

Instant oatmeal 1 packet 8.2

Fortified breakfast

cereal 1 oz


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Zinc

Phytate inhibits zinc absorption.

Vegetarians may require as much as 50% morezinc than non-vegetarians.

Little is known about zinc status of vegetarians.


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Calcium


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Factors Affecting Calcium Absorption

Enhancers Lactose

Inhibitors Phytates (from beans, nuts, whole grains)

Oxalates (from spinach, chard, beet greens,

rhubarb)

Excess Phosphorus and Magnesium (from

supplements, usually)


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Calcium Sources for Vegans

Tofu processed with calcium sulfate

Calcium-fortified juice

Calcium-fortified soymilk

Collard greens, turnip greens, kale

Broccoli

Bok choy

Soybeans


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1 cup of milk has 96 mg absorbable

calcium. So do these foods:

cup Chinese cabbage

0.6 - 1 cup calcium-fortified juice

1 cup bok choy

1-1/3 cups calcium-fortified soymilk

1-1/2 cups kale

5.4 ounces calcium-set tofu 2 cups white beans

2-1/4 cups broccoli


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Vitamin B12Status

0% 20% 40% 60% 80% 100%

Non Vegetarians

Vegetarians

Vegans

Defiicient

Depleted

Sufficient


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Vitamin B12

LOVs get vitamin B12from dairy products and

eggs

Vegans get vitamin B12from fortified foods

Vitamin B12supplements are another source

of this vitamin Foods like tempeh, sea vegetables, and miso

are not reliable sources of vitamin B12


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Foods Reported to Provide

Vitamin B12That DontAlgae Miso Rainwater Most sea

vegetables

Shiitakemushrooms

Sourdough bread Soybeans Spirulina Tempeh Umeboshi plum


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Vitamin B12 Content Of Selected

Foods Vegetarian Support Formula

Nutritional yeast, 1 T 1.5 g

Fortified soymilk, 8 oz 0.8-3.2 g Fortified ready-to-eat cereals,

1 oz 0.6-6 g

Fortified meat analog, 1 oz 0.5-1.2 g Cows milk, 8 oz 1 g

Large egg 0.6 g


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Menu Planning


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Appendix 8 Lacto-Ovo Vegetarian Adaptation

of the USDA Food Patterns...........81Appendix 9 Vegan Adaptation of the USDAFood Patterns .......................................82

http://health.gov/diet

aryguidelines/


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Position of the American Dietetic

Association: Vegetarian Diets; 2009It is the position of the American Dietetic Association

that appropriately planned vegetarian diets,

including total vegetarian or vegan diets, arehealthful, nutritionally adequate, and may provide

health benefits in the prevention and treatment of

certain diseases. Well-planned vegetarian diets are

appropriate for individuals during all stages of the

lifecycle, including during pregnancy,lactation,infancy, childhood, and adolescence, and for

athletes

Documents

Veggie Diets