Many people adopt a vegetarian diet with the expectation of improved health. While the benefits of vegetarian diets are well-documented, it's important to acknowledge the potential downsides. This article explores the less-discussed aspects of vegetarianism, providing a balanced perspective for those considering this dietary choice.
Nutritional Considerations
A well-planned vegetarian diet emphasizes fruits, vegetables, whole grains, nuts, and seeds. However, a vegetarian diet that relies heavily on processed foods may increase the risk of certain chronic diseases. Many junk foods fit into a vegetarian diet but offer little nutritional value, such as soda, chips, and cookies. Packaged vegetarian meals and snacks may contain high amounts of added sugar, sodium, and fat.
Some essential nutrients, such as vitamins B12 and D, calcium, iron, and zinc, aren’t readily available in many plant-based foods or are not as easily absorbed as from animal sources. Vegetarian diets may provide these nutrients if food intake is planned properly, but supplementation is sometimes necessary.
Vitamin B12: Primarily found in animal products like eggs and milk. Vitamin B12 is necessary to produce red blood cells and prevent anemia. Vitamin B-12 deficiency may go undetected in people who eat a vegan diet because the vegan diet is rich in folate that can mask vitamin B-12 deficiency.
Vitamin D: Found in eggs and fish, as well as fortified plant milks and mushrooms. Vitamin D plays an important role in bone health.
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Iron: Available from eggs, fortified cereal, soy, spinach, chard, and beans. Iron absorption from plant-based sources is less efficient than from animal sources. Iron is important to red blood cells. To help your body absorb iron from plants, eat foods rich in vitamin C at the same time as you're eating iron-containing foods.
Calcium: Helps build and maintain strong teeth and bones. Milk and dairy foods are highest in calcium. Dark green vegetables are good plant sources if you eat enough of them.
Zinc: Not as easily absorbed from plant sources as it is from animal products. Plant sources include whole grains, soy products, lentils, beans, nuts, and wheat germ. Zinc helps the body make proteins and grow cells.
Omega-3 Fatty Acids: Vegetarian diets that do not include fish may be low in two types of omega-3 fatty acids called DHA and EPA. Some evidence suggests that taking in EPA and DHA omega-3 fatty acids may lower the risk for heart disease. Also, these two omega-3s may be important during pregnancy for fetal development.
The Importance of Planning
Starting a vegetarian diet can be tricky when grocery shopping, dining out, and eating in social settings. Over time this becomes easier, but it does require some work. Read labels on products and become familiar with common ingredients derived from animals, such as casein, whey, and gelatin. At restaurants, keep in mind that meatless meals may be prepared with dairy or other animal products, like beef or chicken broth, so ask questions to make a selection that’s right for you.
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To get the most out of a vegetarian diet, choose a variety of healthy plant-based foods, including whole fruits and vegetables and whole grains. At the same time, cut back on less healthy choices, such as sugar-sweetened beverages, fruit juices, and refined grains. Keep in mind that the more foods you cut out of your diet, the harder it can be to get all the nutrients you need.
Social and Lifestyle Challenges
Vegetarianism can sometimes face social pressures, particularly in environments where meat consumption is prevalent. Traveling can present challenges for vegetarians, particularly in regions with limited vegetarian options or cultural norms heavily focused on meat-based cuisine.
Potential for Unhealthy Choices
Some vegetarian diets may rely too heavily on processed foods with too many calories, and too much sugar, fat and salt. Unhealthy vegetarian diets poor in specific nutrients (vitamin B12, iron, zinc, and calcium) and/or rich in highly processed and refined foods increase morbidity and mortality. Consuming vegetarian diets rich in refined grains, potatoes, high-sodium preserved vegetables, fried goods, sweets, juices, and sweetened beverages can increase the risk of developing T2DM and CVD morbidity and mortality.
Heart Health Considerations
For heart protection, it's best to choose high-fiber whole grains and legumes, which are digested slowly and have a low glycemic index - that is, they help keep blood sugar levels steady. Soluble fiber also helps reduce cholesterol levels. Nuts are also heart-protective. They have a low glycemic index and contain many antioxidants, vegetable protein, fiber, minerals, and healthy fatty acids. The downside: nuts pack a lot of calories, so restrict your daily intake to a small handful (about an ounce). Walnuts, in particular, are a rich source of omega-3 fatty acids, which have many health benefits.
Cancer Risk
Many studies suggest that eating lots of fruits and vegetables can reduce the risk of developing certain cancers, and there's evidence that vegetarians have a lower incidence of cancer than nonvegetarians do. But the differences aren't large. If you stop eating red meat (whether or not you become a vegetarian), you'll eliminate a potential risk factor for colon cancer. It's not clear whether avoiding all animal products reduces the risk further.
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Diabetes Prevention
Research suggests that a predominantly plant-based diet can reduce the risk for type 2 diabetes. In studies of Seventh-day Adventists, vegetarians' risk of developing diabetes was half that of nonvegetarians, even after taking BMI into account.
Bone Health
Some women are reluctant to try a vegetarian diet - especially one that doesn't include calcium-rich dairy products - because they're concerned about osteoporosis. Lacto-ovo vegetarians consume at least as much calcium as meat-eaters, but vegans typically consume less. In the EPIC-Oxford study, 75% of vegans got less than the recommended daily amount of calcium. Certain vegetables can supply calcium, including bok choy, broccoli, Chinese cabbage, collards, and kale. People who follow a vegetarian diet and especially a vegan diet may be at risk of getting insufficient vitamin D and vitamin K, both needed for bone health. Green leafy vegetables contain some vitamin K. To boost vitamin D intake, vegans may also need to rely on fortified foods, including some types of soy milk, rice milk, organic orange juice, and breakfast cereals.
Protein Intake
Research shows that lacto-ovo vegetarians generally get the recommended daily amount of protein, which is easily obtained from dairy products and eggs. Eating a variety of plant-based foods throughout the day also can provide enough protein.
Iron Absorption
Studies show that in Western countries, vegetarians tend to get the same amount of iron as meat eaters. But the iron in meat (especially red meat) is more readily absorbed than the kind found in plant foods, known as non-heme iron.
Making the Transition
One way to start on a vegetarian diet is to slowly reduce the meat in your diet. At the same time, increase the amount of fruits and vegetables in your diet. Each week increase the number of meatless meals you already enjoy, such as spaghetti with tomato sauce or vegetable stir-fry. Find ways to include greens in your daily meals. Take favorite recipes and try them without meat. For example, make vegetarian chili by leaving out the ground beef and adding an extra can of black beans. Or make fajitas using extra-firm tofu rather than chicken. Check the internet for vegetarian menus. Buy or borrow vegetarian cookbooks. Check out ethnic restaurants to sample new vegetarian cuisines.
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