Make sure your vegetarian diet is healthy

As obesity rates in the U.S. continue to climb and cardiovascular disease remains the leading cause of death, many Americans — adults as well as teenagers — are turning to a vegetarian diet as one step toward a healthier lifestyle. Unlike carnivores, who eat meat and dairy products, vegetarians don’t have to worry as much about consuming artery-clogging saturated fats found in animal protein sources. On top of this, vegetarian foods also have heart-healthy fats.

But vegetarians, especially teenagers, need to make sure they get the right nutrients in their diets to maintain their health. With a little planning, a vegetarian diet can be satisfying, healthy, and good for your waistline.

While there are many different vegetarian diets, there isn’t one “right” one. The choice is entirely up to you based on your tastes and lifestyle. Keep in mind, though, that the more you restrict what you eat, the more challenging it becomes to meet your body’s daily nutritional requirements. Here are the options:

• Vegan: The “total” vegetarian, vegans only eat foods from plant sources, such as fruits, vegetables, legumes, grains, seeds, and nuts. They don’t eat any animal products or byproducts, including dairy products and eggs. This group is at the greatest risk for nutritional deficiencies, including protein, calcium, vitamin B12, and iron.
• Lacto-vegetarian: This plan is a vegan diet that also includes dairy products. Choose non- or low-fat dairy products for best health, such as milk, cheese, and yogurt. Dairy foods provide much needed protein and calcium.
• Lacto-ovo vegetarian:The most familiar of the vegetarian plans, this diet excludes beef, chicken, and fish, but includes both dairy products and eggs. This is one of the easiest vegetarian plans to follow, with minimal risk of nutritional deficiencies.
• Semi-vegetarian: This is a catch-all term for those who don’t eat red meat, but may eat some chicken and/or fish in addition to dairy and eggs.

While there are no downsides to a vegetarian diet, it does take more effort to make sure you’ve covered all the nutritional bases. Our bodies have one set of nutrient requirements, no matter what the food source. So vitamin and mineral supplements — that contain 100 percent of the recommended daily allowance — are usually needed to round out any vegetarian plan.

Vegetarians need to focus particularly on getting adequate protein, as well as vitamins and minerals such as calcium, vitamin B12, and iron. These are the most common nutrient deficiencies among vegetarians:

• Protein: Plant proteins can meet your total nutritional needs, but they must be varied and abundant to provide the right mix of complete proteins. (This means eating both essential and non-essential amino acids, the building blocks of protein). So mix and match your protein sources — try a variety of whole grains, legumes, seeds, and nuts. Soy protein is also a great choice, since it’s a complete protein and can be your sole protein source. To add more soy to your diet, you can prepare tofu or purchase prepared soy cold cuts, soy chicken patties, or soy hamburgers.
• Iron: The richest sources of iron are animal products, such red meat, liver and egg yolks. But they’re also all high in cholesterol. Dried beans, dark green veggies, such as spinach, Swiss chard and kale, enriched products (with added iron), and dried fruit (like plums and apricots) are all good plant sources of iron.
• Vitamin B12: This vitamin is only naturally found in animal sources. You can find it, though, in fortified foods like breakfast cereals, some soy beverages, brewers yeast (which has a strong taste and takes an adventurous eater), and some other foods. Vegans, in particular, should take a supplemental source of this vitamin. While a pill is OK, the vitamin is better absorbed from sub-lingual (under the tongue) sources. Some people also get a B12 shot periodically from their doctor.
• Vitamin D: Only vegans are at risk of a vitamin D deficiency, particularly if they don’t get enough sunlight (UV rays from the sun trigger vitamin D synthesis in your skin). Vegans are likely to require a supplement.
• Calcium: Getting enough calcium isa real problem, particularly for teenage girls. Deep green vegetables, such as spinach, kale, and broccoli, and some soybean products have calcium, though the best source is low- or non-fat dairy products. Don’t count on supplements alone to manage your requirement of 1,000 to 1,200 mg of calcium per day.
• Zinc: This mineral is also especially important for growing teens. Grains, nuts, and legumes have plenty of zinc and shellfish is packed with it. A zinc deficiency is not a real worry, except for vegans.

Just because you don’t eat animal products doesn’t mean you’ll have one of these nutrient deficiencies, though. Follow these nine steps to maximize your health, whether you’re new to vegetarianism or want to improve your existing plant-based diet:

1. Eat adequate protein.
2. Take a daily multiple vitamin with 100 percent RDA that also contains iron.
3. Consume at least 1,000 mg of dietary calcium per day (aim to get half of this from dietary sources.)
4. Take a vitamin B12 supplement.
5. Focus on eating fiber-rich carbohydrates and vitamin-fortified grains and cereals.
6. Choose a variety of colorful fruits and vegetables.
7. Consume low- or non-fat dairy products.
8. Limit whole eggs to two daily (especially if cholesterol is an issue) and use more egg whites.
9. Get your blood checked to rule out low iron or other deficiencies, which may need additional supplementation.

And while heart-healthy fats and high-fiber foods are often associated with vegetarian diets, you still need to be mindful of both your portion sizes and the amount of fat you’re consuming to avoid unwanted weight gain — even calories from healthy sources can add up quickly.

Dr. Fernstrom’s Bottom Line: There are a variety of vegetarian eating plans out there, though no one plan is the “right” one. A vegetarian diet can maximize your health, even for teenagers, as long as you follow some fundamental rules to avoid nutrient deficiencies. With a little pre-planning, a vegetarian-style eating can be a great step to healthful eating.

Madelyn Fernstrom, Ph.D., CNS,is the founder and director of the An associate professor of psychiatry, epidemiology, and surgery at the University of Pittsburgh School of Medicine, Fernstrom is also a board-certified nutrition specialist from theAmerican College of Nutrition.

PLEASE NOTE: The information in this column should not be construed as providing specific medical advice, but rather to offer readers information to better understand their lives and health. It is not intended to provide an alternative to professional treatment or to replace the services of a physician.