Part VI of Dr. Quinn Hand's Series, Understanding the Vegetarian Diet!
Don't Forget These Other Important Nutrients (see chart below for more information).
Iodine
Iodine is a very important nutrient when it comes to thyroid function. Iodine is the primary mineral used to make thyroid hormone. The thyroid is the driving force behind metabolism and without iodine it can become sluggish.
Calcium/Vitamin D
Some vegans may become concerned that due to lack of dairy, they will become calcium and vitamin D deficient. The good news is, that many vegetarian foods are rich calcium sources – think tofu, almonds, green leafy veggies. Also, there is some evidence to suggest that animal protein may cause calcium loss in the urine. So, by not eating meat, vegetarians and vegans may preserve calcium in the body. However, this research is inconclusive and other studies suggest protein intake is required to promote calcium absorption. As such, vegetarians/vegans should try to achieve calcium adequacy of 1000mg per day in adults 19-50 years of age and 1200mg in women over the age of 51 and men 70 years and older.
While many products are vitamin D fortified, the reality is that naturally occurring food sources of vitamin D are limited. Fatty fish is the best dietary source of vitamin D and even then it isn’t abundant. Thus, omnivores and vegetarians alike are best to head out in the sun or take a vitamin D supplement. In particular, those of us that live in the northern hemisphere where we don’t get enough sunlight eight months of the year to allow adequate vitamin D production in the skin, can benefit from vitamin D supplementation.
Essential Fatty Acids (EFAs)
Anything labeled “essential” means that the human body can’t make it and it must be obtained via diet. This is true of our EFAs – we require Omega-3 and Omega-6. Sources of Omega-3 include: flax, hemp, canola, soybean, walnut, safflower, sunflower, dark leafy greens and fish oil. Sources of Omega-6 include: safflower, sunflower, hemp, soybean, walnut, pumpkin, flax and sesame. EFAs are critical to cell membrane function, improving cell communication, and they play an important role in the balance of inflammation in the body. They confer cardiovascular, neurological, eye and skin health benefits. Two of the more critical omega-3 fatty acids are docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), found preformed in fish and fish oil. Many of the health benefits attached to EFAs are a result of these two long-chain fatty acids. If humans aren’t ingesting DHA and EPA, preformed in fish or fish oil, the body needs to convert the omega-3 in vegetable sources. Unfortunately, we are not very good converters. However, for vegetarians, it is still critical to use sources of omega-3 such as flax seed oil, evening primrose oil, walnut, hemp, and pumpkin. Vegetarian algae sources of omega-3 can also be purchased. Algae oils provide high amount of naturally occurring DHA (that’s what the fish eat in the first place) and can be converted into EPA in smaller amounts.
Recognizing and Addressing Deficiencies in Vegetarian Diets
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Deficiency
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Possible Signs of Deficiency
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Foods to Eat
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Possible Supplements
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Protein
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Key building block for all cells and tissues, thus can affect entire body. Symptoms include: fatigue, poor wound healing, brittle hair/nails, decreased immune function, swelling, muscle loss/wasting, difficulty building muscle
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Lacto-ovo
Eggs, dairy
All (vegans/veggies)
Beans, legumes, nuts, seeds
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Whey protein isolate powder (lacto and lacto-ovo) or vegan protein powder,
Vegetarian/vegan friendly protein bars
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Vitamin B12
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Megaloblastic anemia (big red blood cells), weakness, constipation, loss of appetite, weight loss, numbness and tingling in hands/feet, difficulty maintaining balance, depression, confusion, dementia, poor memory, soreness of mouth/tongue
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Lacto-ovo
Eggs, dairy
All (vegans/veggies)
B12 fortified cereals, soy products, beverages
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500mcg per day has been shown to stop depletion and adequately maintain stores in vegetarians
A lower daily dose in a multivitamin or B-complex could also be sufficient
Over deficiency may require higher doses ranging from 1000-5000mcg/d
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Iron
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Anemia, paleness, fatigue, reduced ability to exercise, shortness of breath, frequent infections, brittle nails, decreased appetite, irritability, sore tongue/mouth, thinning hair/hair loss
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Spinach and other leafy greens, tofu, beans, dried fruit, iron-fortified breads/cereals
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Based on blood tests by your health care practitioner, recommended doses can be anywhere from 10-100mg, depending on deficiency status.
Vegetarian men should get 14mg/d and women 33mg/d to avoid deficiency
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Iodine
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Hypothyroidism, symptoms of which are fatigue, weight gain, depression, low body temperature, mental slowing, dry skin, hair and nails, and possibly goiter
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Sea vegetables - kelp, hijiki, dulse, nori (seaweed)
Salt (iodized or naturally mineralized salts like Celtic sea salt)
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Approximately 150mcg is required daily, but I do not typically recommend supplements unless there is overt deficiency. Sea vegetables are a safer more accessible source
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Calcium
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Bone density loss, muscle spasm
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Lacto-ovo
Dairy
All
Green leafy veggies, almonds, tofu, tahini, fortified beverages/foods
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Adults 19-50: 1000mg/d (including diet)
Women 51+/Men 70+: 1200mg
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Vitamin D
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Bone disease (rickets/osteomalacia), loss of bone density, muscle pain/weakness, increased risk of certain cancers, autoimmune disease, immune dysfunction
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Lacto-ovo
Fortified dairy
All
SUNSHINE!
Fortified beverages (soy/rice/almond)
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Minimum: 1000IU/d
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EFAs
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Fatigue, dry skin/mouth/eyes/hair, depression, hypertension, increase risk of cardiovascular disease and neurodegenerative disease
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Nuts, seeds, vegetable oils
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1-2 Tbsp (15-30mL) per day of omega-3 rich vegetable oils like flax seed oil
OR
1-2 1000mg flax seed oil capsules
Evening Primrose oil can be added as a gamma linoleic acid source – 1000-2000mg (1-2 capsules)
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Zinc (not discussed but included for completeness)
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Loss of appetite, reduced taste sensation, impaired immune function, mental lethargy
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Seeds, beans, legumes, whole grains, mushrooms, spinach, corn
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15-50mg per day
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Image source: natural-homeremedies.org, joanmorais.com
Ratatouille. You don't need to have had years of a French chef yelling at you at culinary school, or an extremely talented rat named Remy steering your hands with your hair! Yes, you can cook this deliciously healthy French dish. There are many variations to this recipe, but let me tell you a secret when it comes to French cooking: as long as you find one excellent recipe and make it look gorgeous on the plate, you are golden.
