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Vegetarian Nutrition

A well-balanced vegetarian diet provides all the nutrients you need for good health, as well as reducing your risk of high blood pressure, heart disease and some cancers.

As the American Dietetic Association has stated: "It is the position of the American Dietetic Association that vegetarian diets are healthful and nutritionally adequate when appropriately planned" (1).

The ADA suggests the following foods as essential in the daily diet:

Food group	Suggested daily serves	Serving sizes
Bread, cereal, rice, pasta	6 or more	1 slice bread 1/2 cup cooked rice or pasta 30gr dry cereal
Vegetables	4 or more	1/2 cup cooked or 1 cup raw
Legumes and other meat substitutes	2 to 3	1/2 cup cooked beans (lentils, chickpeas, kidney beans, etc) 125 gr tofu or tempeh 250ml soy milk 2 tbl nuts or seeds
Fruits	3 or more	1 piece fresh fruit 3/4 cup fruit juice

The rest of this document describes the main nutrients and where you find them in a vegetarian diet. Much of the information comes from the excellent book called Vegan Nutrition by Dr Gill Langley (2). This book is highly recommended for anyone who wants to find out more about well-balanced vegan diets and their health benefits.

A more recent book with a wealth of information about why a vegan diet is optimal for your health is The China Study (16) by T. Colin Campbell.

Protein

Proteins are made up of smaller molecules called amino acids. When proteins are digested, they are broken down into amino acids before being absorbed into the bloodstream. The body then uses the amino acids to build the kinds of proteins it needs to grow and maintain body tissues such as muscles and organs.

There are 20 amino acids. Of these there are 8 that are called essential or indispensable. These are the amino acids that can't be made by the body and have to be absorbed from food.

Plant foods contain all the essential amino acids. Some foods are low in one kind of amino acid, for example, grains are low in lysine. However, legumes such as lentils are much higher in lysine, so by eating a variety of food you will get all the amino acids you need. In fact, soy protein is equivalent in value to proteins of animal origin, so it can be used as the only source of protein (3).

Plant proteins provide a complete and well-balanced source of amino acids. In fact, plants provide around 65% of the protein eaten by people around the world (4).

The American Dietetic Association has said in its Position Statement (1): " Plant sources of protein alone can provide adequate amounts of the essential and non-essential amino acids, assuming that dietary protein sources from plants are reasonably varied and that caloric intake is sufficient to meet energy needs. Whole grains, legumes, vegetables, seeds and nuts all contain essential and non-essential amino acids ".

Where do you find protein?

• The best source of protein is legumes, including soy products such as tofu, lentils, kidney beans, chick peas, split peas and baked beans . The highest source per 100 grams is cooked soy beans, with 14 grams of protein.

• Nuts and seeds are very high in protein, but because they also contain fat, you should eat them in moderation. The highest source per 100 grams is peanuts, with 26.4 grams of protein.

• Grains, such as breakfast cereals, bread, rice or pasta are lower in protein, but still contribute useful amounts to the diet. In a 100 gram portion you will find 8.1 grams of protein in wholemeal bread, and 8.6 grams of protein in corn flakes.

• Some vegetables have useful amounts of protein, especially, broad beans, peas, brussel sprouts, broccoli and corn . In a 100 gram cooked serving you will find 8.4 grams of protein in broad beans, and 4.1 grams of protein in brussel sprouts.

• Non-vegans can get protein from dairy products and eggs, but these products also contain fat and are not cruelty-free.

There are several advantages to eating plant rather than animal protein. You will be eating less cholesterol, which is associated with heart disease. Plant foods contain no cholesterol. You will be eating more fibre, which reduces the risk of bowel diseases, including cancer. Soy protein has a beneficial effect on women. In a Singapore study, women who regularly ate soy products halved their risk of breast cancer.

Some non-vegetarians eat too much protein, which can have harmful effects. Protein increases the amount of calcium that is excreted from the body, so a high protein diet can increase bone loss. Meat protein increases the uric acid in the urine and makes the urine more acidic, increasing the risk of kidney stones.

Carbohydrates

Carbohydrates are the main source of energy in the diet. Sugars, starches and fibre make up this category.

Starches or complex carbohydrates are found in grains, tubers such as potatoes, and legumes such as lentils and peas . Starches are long chains of sugars that are broken down into simple sugars during digestion. They are absorbed into the bloodstream gradually and provide energy over a period of time. This is why marathon runners eat a meal like pasta or rice a few hours before a race. This is also why it is a good idea to not to skip breakfast, but to eat cereal or bread to get energy for the day.

Sugars or simple carbohydrates are found mainly in fruits , but of course also in refined sugar and honey. Unlike refined sugars, fruits don't cause tooth decay, and they also supply vitamins and fibre.

Fibre comes come the cell walls of plants - there is no fibre at all in animal products. Most of it passes undigested through the gut. Its main function is to provide bulk in the faeces. It produces soft stools that pass through the system quickly. Fibre is found in all unrefined plant foods: grains (wholemeal bread, brown rice, etc) legumes, nuts, fruit and vegetables .

Vegetarians eat more carbohydrates, especially more fibre than meat eaters. Fibre protects against several common bowel problems, including constipation (and therefore varicose veins and haemorrhoids), irritable bowel, diverticular disease, and bowel cancer.

Fats

Most people eat too much fat, although some fat, of the right kind, is essential in the diet.

The main types of fats are:

• saturated fat, which is solid at room temperature and comes mainly from animal products (meat, eggs, cheese, butter, etc), but also coconut or palm oil;
• transfatty acids, which are produced when vegetable oils are processed into margarines, and which behave like saturated fats in the body;
• monounsaturated fat, as in olive oil;
• polyunsaturated fat, as in safflower, sunflower or canola oil, etc.

Fat provides energy and is necessary to absorb the fat-soluble vitamins A, D, E and K from food. Fatty acids are a vital part of cell membranes, and are involved in the production of chemicals vital for blood clotting and the immune response. The fat-like substance cholesterol is part of nerve cells and some hormones.

However, the body can produce most of the fats that it needs. There are only 2 polyunsaturated fatty acids that are essential in the diet because they can't be made. They are:

• linoleic acid (omega 6 family), found in nuts, grains, seeds, fruit and vegetables, as well as oils such as safflower, corn, evening primrose, or sunflower;
• alpha-linoleic acid (omega 3 family), found in grain, green leafy vegetables, soy beans and soy products, walnuts, as well as oils such as canola or soy.

Since cholesterol is found only in animal products, vegetarians eat much less cholesterol than meat eaters, especially if they are vegans and avoid all animal products. Vegetarians also eat less saturated fat. Because of this, lifelong vegans have 57% less chance of suffering from heart disease, and vegetarians have 24% less chance (5).

Vegetarians eat about the same amount of alpha-linoleic acid as meat eaters, but eat more linoleic acid. Overall, the fat intake of vegetarians is healthier than that of meat eaters.

Vitamins

Vitamin A

Plant foods provide large amounts of carotenes, which the body converts to vitamin A. Orange coloured fruit and vegetables , such as carrots, sweet potatoes, apricots and mangoes, as well as leafy green vegetables such as spinach are good sources of carotenes. Vitamin A is stored in the body.

B-group vitamins

This group includes B1 (thiamine), B2 (riboflavin), niacin, B6, B12, folate, pantothenic acid and biotin. With the exception of B12 they are not stored in the body and so have to be eaten regularly. They can be destroyed by cooking. Overall the best sources of these vitamins are whole grains, nuts and seeds . Breakfast cereals are fortified with B vitamins.

B1 (thiamine) - good sources include breakfast cereals such as cornflakes or rice bubbles, peanuts and other nuts, wholemeal bread, wheat germ, peas and broad beans and yeast extract such as Vegemite.

B2 (riboflavin) - good sources include breakfast cereals, wholemeal bread, wheat germ, mushrooms, almonds, soy beans, avocados, and yeast extract.

Niacin - good sources include nuts and seeds (especially peanuts), wholemeal bread, wheat germ, breakfast cereals, yeast extract, avocados, peas, mushrooms, and some other vegetables such as asparagus, broccoli, brussel sprouts and corn.

B6 - good sources include nuts (especially peanuts), wholemeal bread, wheat germ, avocados, and soy beans.

Folate - good sources include almonds and peanuts, black-eyed beans, soy beans, wheat germ, and green vegetables such as spinach, broccoli, brussel sprouts and asparagus.

Pantothenic acid - good sources include peanuts, cashews and hazelnuts, wheat germ, avocados and sunflower seeds.

Biotin - good sources include a wide range of fruit and vegetables.

All of the B vitamins are available in plant food -- the frequent exception is vitamin B12 . Vegans are advised to take a supplement of this vitamin, which is manufactured by bacteria. It is stored in the body, so a supplement doesn't have to be taken every day.

Many algae, such as Spirulina are rich sources of B12 however this form of B12 isn't well absorbed by people and shouldn't be used. (15).

The full story on B12 is complex. Contrary to popular belief, even among trained medical specialists, plants do absorb B12 (14). However they can't absorb it if it isn't in the soil. Most commercial crops are grown with inorganic fertiliser which means the soil is deficient in a variety of nutrients (the B group being particularly important). Further information on this and many nutrition issues can be found in The China Study (16).

Vitamin C

Anyone who regularly eats fruit and vegetables will have more than enough of this vitamin.

Vitamin D

The most important source of Vitamin D is the action of sunlight on the skin, which produces the chemical. It doesn't have to be bright sunshine, or a long exposure time. Vitamin D is stored in the body, so enough will be available to cover cloudy winter days when people stay indoors.

In terms of food, vitamin D is found naturally only in animal products such as liver, oily fish, cod liver oil, eggs and butter. Some manufactured foods, such as margarine, have vitamin D added. However, food sources of vitamin D are relatively unimportant for people in Australia who have exposure to sunlight for regular, short periods.

Vitamin D is essential for the absorption of calcium and the formation of bone.

Vitamin E

This vitamin is found in many plant foods, including vegetable oils, wheat germ, nuts and seeds, and whole grains. It is stored in the body and so doesn't have to be eaten every day. One role of this vitamin is to protect cells from the damaging effects of free radicals, which may be involved in arthritis, cataracts and cancers.

Vitamin K

Vitamin K is common in plant foods, such as green vegetables (spinach, broccoli, cabbage, lettuce), cauliflower, vegetable oils, fruits and grains. It is essential for blood clotting.

Minerals

Major minerals are needed in larger quantities, and include calcium, phosphorus, magnesium, sodium and potassium. Trace elements are just as important, but are needed in smaller quantities. They include iron, zinc, selenium, iodine, copper, manganese, cobalt and molybdenum. Calcium, iron and zinc are discussed below as minerals people should pay particular attention to.

Calcium

Calcium is the most abundant mineral in the body. It is found in the bones, teeth and the blood. It is essential for bone formation, muscle contraction, some nerve functions, blood clotting and several enzymes.

Many plant foods contain some calcium, but the best sources are almonds, brazil nuts, sesame seeds, sunflower seeds, tofu (if made with calcium sulphate), fortified soy milk, soy beans, chickpeas, and green vegetables such as spinach, broccoli and brussel sprouts . Kale is a leafy green vegetable not often eaten in Australia, but absorption of calcium from kale is as higher than from cow's milk (6).

Several studies have shown that people excrete more calcium in their urine as their intake of protein increases (7-9). People lose calcium from their body on a high protein diet even when they have a very high intake of calcium (1400mg/day) (10). A person eating such a diet, that is, high protein/high calcium, is still likely to end up with osteoporosis.

When protein is mainly from animal sources, a doubling of protein leads to a 50% increase in calcium excretion. However, when the protein is from soy beans, a high protein diet doesn't increase calcium loss (11).

Young males can be in calcium balance, that is absorbing the same amount of calcium as they excrete, when they take in 500mg/day. This is lower that some dietary recommendations. As the American Dietetic Association points out, recommended daily intakes are set with meat eaters in mind (1):

" The relatively high US recommendations for calcium intake compared with those for populations consuming a more plant based diet, are designed to compensate for the calciuric effect of high intakes of animal protein, which are customary in the United States. Studies have shown that vegetarians, on the other hand, absorb and retain more calcium from foods than do non-vegetarians ".

A person who eats moderate quantities of plant protein will need less calcium than a meat eater. However, vegetarians should still make sure that they have plenty of calcium rich foods in the diet, especially for children. It may be worth choosing brands of soy milk that contain extra calcium.

Iron

While many foods contain iron, it is a difficult mineral to absorb. The iron from plant foods is particularly difficult to absorb. However, vitamin C dramatically increases the rate of absorption. Iron absorption was 3 times higher when a serving of cauliflower (containing vitamin C) was added to a vegetarian meal (2).

Iron is found in legumes (lentils, chickpeas, soy beans, etc), nuts and seeds, whole grains, dried fruits (figs, raisins , apricots, etc), and leafy green vegetables . Many breakfast cereals are fortified with iron.

The meat industry has tried to convince people that they can't get enough iron without eating meat. However, this claim is not correct (for more information go to Vegetarian Questions and Answers ).

The American Dietetic Association has stated: " Vegetarians are not at greater risk of iron deficiency than non-vegetarians " (1). Everyone, whether vegetarian or not, should regularly include iron rich foods in their diet, although as the list above shows, this doesn't have to be meat.

It is a good idea to eat vegetables, salad, fruit or fruit juice with a meal, because iron absorption with vitamin C will be 3-4 times higher. Also, it is a good idea not to drink tea with meals, because the tannin in tea inhibits iron absorption.

Zinc

Zinc is important for wound healing and immune function. It is high in animal products, but is also found in nuts and seeds, wheat germ, whole grains, beans (lentils, chickpeas, etc), tofu, soya protein, peas, bean sprouts and mushrooms .

While vegetarians generally consume less zinc than meat eaters, the level in their blood is within the normal range because their ability to absorb the mineral is greater (12-13).

The UK Vegetarian Society has more information about specific aspects of vegetarian diets, including:

Pregnancy
Infants
Children
Cat food
Dog food

I would like to see References for this document on Vegetarian Nutrition.

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