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Vegetarian Diets Fact Sheet No. 9.324 and Series| by J. Clifford and A. Kozil includes a variety whole , nuts, soy products, Quick Facts of patterns that rely heavily , and . These on , while avoiding meat. dietary features help to produce • Following a vegetarian While some vegetarians exclude lower LDL levels, better can be a healthful way to all animal products from their diets serum glucose control, and reduce eat. (vegans), others simply limit the the risk of chronic in amount of animal products in their those who follow a vegetarian diet. • Vegetarians are overall diet. Vegetarianism is growing Research also shows that vegetarian categorized by which in popularity in the , diets are more environmentally animal foods are restricted with an estimated 3.3% of American sustainable and use fewer natural in the diet. adults identifying as vegetarian in resources than diets rich in animal • Nutritional requirements 2016, up from 2.3% in 2012. About products. are the same for 46% of vegetarians in the United States are vegan. vegetarians and Types of Vegetarian Diets nonvegetarians but some According to the Academy of require special Nutrition and Dietetics, well planned Vegetarians have different attention. vegetarian diets can be healthful and dietary practices, but most can be nutritionally adequate throughout the categorized into one of the following lifecycle, while providing potential groups: health benefits in prevention and Vegans eat only plant foods; treatment of chronic . including , , In fact, the 2015-2020 Dietary (dried , , and ), Guidelines for Americans, includes grains, and nuts. the vegetarian diet as one of its highlighted healthy eating patterns, Raw vegans eat only plant foods; demonstrating that vegetarian including vegetables, , nuts and diets can successfully meet the seeds, legumes (dried beans, peas, Dietary Guidelines and its key and lentils), and sprouted grains. recommendations. The amount of uncooked food varies from 75% to 100%. Vegetarian diets have been associated with lower levels of Lacto vegetarians eat plant (), and foods as well as products, reduced risk of cardiovascular such as and cheese. disease, type 2 , Lacto-ovo vegetarians eat plant hypertension, and certain types foods, dairy products and eggs. of . Compared to non- Most vegetarians in the U.S. fit into vegetarians, vegetarians tend to this category. consume fewer overall calories; a lower proportion of calories from (particularly ); and Key Nutrients of a Vegetarian Diet higher quantities of fruits, vegetables, Because of the variability in © Colorado State University Extension. 8/94. Revised 9/17. *J. Clifford, Colorado State University Extension food vegetarian diets, it is important for and nutrition specialist , A. Kozil, graduate student. individuals to become familiar with extension.colostate.edu Updated fact sheet revised by L. Bellows, Colorado State their individual nutritional needs University Extension food and nutrition specialist and assistant professor. 1/2012 . Revised 9/17. and act as an anti-inflammatory can adapt to absorb plant based agent in the body. The primary (non-heme iron) almost as sources of omega-3 fatty acids effectively as animal based iron in the diet are , meats, (heme iron). One study found that and DHA-enriched foods such total iron absorption increased as eggs. Based on these food by almost 40% after 10 weeks of sources, vegetarians may not consuming a plant-based diet. get enough omega-3 fatty acids Even so, the daily recommendation in their diet. However, evidence for iron intake is 1.8 times higher suggests the healthy individuals for vegetarians than those who eat can meet their omega- 3 needs by meat. consuming adequate amounts of Among plant foods, dark green omega-3 containing plant foods leafy vegetables have the highest and potential dietary deficiencies. like flaxseed, chia seeds, hemp iron content. Dried fruits (such People following a vegetarian seeds, , canola oil and as , , and diet generally receive adequate soy. Vegetarians can also choose ) also are high in iron. For amounts of most nutrients. from the increasing variety of maximum iron absorption, it is However, the following nutrients DHA-enriched foods sold in the beneficial to eat plant sources of may be lacking so it is important to marketplace, such as some soy iron at the same as foods assure adequate amounts of these and breakfast bars. Finally, high in C (Brussels sprouts, nutrients in the diet. supplements made from , fruits, broccoli, DHA-rich microalgae are available, collard greens, mustard greens, but it is always important to consult cantaloupe or -rich fruit a healthcare provider before taking Protein is needed for growth ). Vitamin C increases the a supplement. and maintenance of body tissues. availability of iron in the intestinal It also is necessary for enzymes, tract. When vitamin C and iron hormones, antibodies and milk Iron are eaten together, more iron is production in women who are Iron combines with protein to absorbed into the body. breastfeeding. Plant sources of form hemoglobin, the substance in protein can provide adequate the that carries and amounts of essential and dioxide. An adequate intake As with iron, zinc is a nonessential amino acids, if they of iron is necessary to prevent that is present in plant foods are reasonably varied and caloric . Many Americans, both but better absorbed from intake is sufficient to meet energy meat-eaters and vegetarians, have animal sources. As a result, needs. Whole grains, legumes, a difficult time consuming enough some vegetarians have lower vegetables, seeds and nuts all iron. concentrations of zinc in the body contain essential and nonessential While vegetarians generally than non-vegetarian diets, but amino acids. Textured consume as much, or slightly more most vegetarians still have levels and meat analogues, iron than , vegetarians within the normal range. True zinc such as and (usually typically have lower iron stores deficiencies are rare in Western made from and fortified than non-vegetarians. This is due civilizations. Vegetarians can with amino acids) are good protein to the fact that the iron in animal make sure they consume zinc sources. is also a good foods is more easily absorbed by including foods such as soy source of protein as it contains the by the body than the iron in plant products, legumes, grains, cheese same amount of protein per serving foods. The iron in plant foods and nuts. Like iron, zinc can be as cow’s milk. An assortment of may be less available to the body better absorbed when eaten in plant foods eaten over the course because of the high fiber content combination with vitamin C-rich of a day can provide all essential in . Fiber is not absorbed into foods. amino acids; thus, complementary the body and may tie up , proteins do not need to be eaten at such as iron, so they, too, are not the same meal. absorbed. For these reasons, vegetarians may be at a higher Calcium is needed for strong Omega-3 Fatty Acids risk for developing . bones and teeth, for normal blood clotting and for normal muscle and An increasing body of research Because women need more iron nerve function. Most calcium in the shows the many benefits of than men they especially need to American diet comes from milk and omega-3 fatty acids. These pay attention to iron. milk products. When these foods may reduce the risk for Recent research has shown are avoided, calcium must come , improve however, that some individuals from other sources. Dark green cognitive function and vision, Table 1: Healthy Vegetarian Eating Pattern: Recommended Amounts of Food From Each Daily Amount of Food From Each Group in Cup and Ounce Equivalents

Healthy U.S.-Style Healthy Vegetarian What counts as a cup or ounce Eating Pattern Eating Pattern equivalent (c-eq or oz-eq)?

Fruit 2 c-eq 2 c-eq 1 cup-equivalent is:1 cup raw or cooked vegetable or fruit, 1 cup vegetable or fruit , 2 cups leafy greens, ½ cup or vegetable. Vegetables 2 ½ c-eq 2 ½ c-eq Dark green vegetables 1 ½ c-eq/week 1 ½ c-eq/week

Red and 5 ½ c-eq/week 5 ½ c-eq/week vegetables Legumes 1 ½ c-eq/week 1 ½ c-eq/week (beans and peas) Starchy vegetables 5 c-eq/week 5 c-eq/week Other vegetables 4 c-eq/week 4 c-eq/week Grains 6 oz-eq 6 ½ oz-eq 1 ounce-equivalent is: ½ cup cooked , , or ; 1 ounce dry pasta or rice; 1 medium (1 ounce) ; 1 ounce of ready-to-eat cereal (about 1 cup of flaked cereal). Whole grains 3 oz-eq 3 ½ oz-eq Refined grains 3 oz-eq 3 oz-eq Dairy 3 c-eq 3 c-eq 1 cup-equivalent is: 1 cup milk, , or fortified soymilk; 1½ ounces natural cheese such as cheddar cheese or 2 ounces of processed cheese. Protein Foods 5 ½ oz-eq 3 ½ oz-eq 1 ounce-equivalent is: 1 ounce lean meat, poultry, or ; 1 egg; ¼ cup cooked beans or tofu; 1 Tbsp ; ½ ounce nuts or seeds. Seafood 8 oz/wk Meat, poultry, eggs 26 oz/wk Nuts, seeds, soy 5 oz/wk products Eggs 3 oz-eq/wk Legumes 6 oz-eq/wk (beans and peas) Soy Products 8 oz-eq/wk Nuts & Seeds 7 oz-eq/wk Oils 27g 27g leafy vegetables are the plant foods Vitamin B-12 as broccoli and , are that provide the most calcium. is needed for considered goitrogens, because Certain plant components, like normal red blood cell formation they interfere with oxalates, may inhibit the absorption and normal nerve function. The absorption. These foods however, of dietary calcium. Calcium from body needs only small amounts have not been associated with low-oxalate green vegetables and can store it in large amounts. thyroid insufficiency in healthy (broccoli, turnip greens, bok choy, Therefore, a deficiency takes individuals with adequate iodine chinese cabbage, collards, kale) a long time to develop, maybe intake. is absorbed as well as or better several years. Once a deficiency than calcium from cow’s milk, at a does develop, however, it results rate close to 50%. In high-oxalate in irreversible nerve damage. Planning a Nutritious Vegetarian vegetables (, beet greens, Vegetarians need to pay special Diet and Swiss chard), as low as 5% of attention to this , as it is not Vegetarians should follow the the available calcium is absorbed. found in common plant foods. diet principles recommended in the Fruit juices and plant milks fortified Vegetarians who consume Dietary Guidelines for Americans. with calcium and calcium-set tofu dairy products and/or eggs daily Well-planned vegetarian diets can are also good sources of calcium. should get enough vitamin B12 effectively meet these guidelines Calcium deficiency in in their diets. Vegans, however, and be a health-supporting vegetarians is rare, and there have little or no vitamin B12 in their dietary option. The 2015-2020 is little evidence to show that diets and must obtain the vitamin Dietary Guidelines includes the calcium intakes below the Dietary through regular use of a vitamin Healthy Vegetarian Eating Pattern Reference Intake cause major B12 supplement or through food as one of three eating patterns, health problems in vegetarians. sources, such as, nori, spirulina, along with the Healthy U.S.-Style U.S. recommendations for calcium , , unfortified Eating Pattern and the Healthy are relatively high compared to , fermented foods Mediterranean-Style Eating Pattern, those for populations that eat (such as tempeh fermented with that can be adapted based on a more plant-based diet. High beneficial ), commercial cultural and personal preferences levels of animal protein increase breakfast , or fortified soy to meet the Dietary Guidelines and urinary loss of calcium. U.S. beverages. its Key Recommendations. The recommendations are designed to recommendations, as outlined in Table 1, the Healthy U.S.-Style compensate for this. Studies show Iodine that vegetarians absorb and retain Eating Pattern and the Healthy Iodine is as an essential Vegetarian Eating Pattern are more calcium from food than do component of the thyroid non-vegetarians. similar for fruit, vegetables, grains hormones thyroxine (T4) and and dairy. The overall amount of triiodothyronine (T3), which protein recommended is less for regulate a number of biochemical the Vegetarian Eating Pattern and Vitamin D is required to absorb reactions in the body. The primary the types of protein foods and calcium from the digestive tract and food sources of iodine are sea amounts for each of these foods to incorporate calcium into bones vegetables, sea food, and dairy vary. and teeth. Few foods contain large products, so plant-based diets are amounts of vitamin D and the best often low in iodine Vegans may sources–fortified milk, egg yolks be at risk for , Vegetarian Protein Options and –are all of animal origin. so they should make a point to include sea vegetables (such as Therefore, vegetarians, especially Beans and Peas vegans, may not get enough. kelp, nori, kombu, and wakame) and iodized salt in their diets. It is Dry beans and peas, as well as Sunlight is another source of also important to note, that while lentils, are considered legumes. vitamin D. The body makes vitamin iodized salt contains iodine, sea Legumes are an excellent food to D from sunlight on the skin. People salt and kosher salt do not. Salty extend or replace meat. Legumes are regularly exposed to sunlight can , such as tamari and low cost, high in nutritive value, and get enough vitamin D without soy sauce are generally not iodized contribute iron, B , and fiber to having any come from food. either. Lacto-vegetarians can get the diet. Like most plant sources they However, sun exposure can be iodine from dairy products, but are not a , meaning limited by several factors, including iodine content in dairy foods varies they do not contain all of the essential , pollution and northern considerably. amino acids the body needs. When latitudes. If sun exposure is limited combined with a variety of other plant Some vegetables, such as and there are no animal products foods throughout the week, dried soybeans, sweet potatoes and in the diet a vitamin D supplement beans and peas can become valuable cruciferous vegetables such is recommended. protein sources in the diet. Dry beans: Rich in protein, iron, cheese and can be eaten fresh or Well planned vegetarian diets can calcium, and . cooked in many different ways. Tofu is be healthful, nutritionally adequate, Many varieties of dry beans include an excellent source of protein. Types and may provide health benefits in black beans, garbanzo beans (also and uses of tofu: prevention and treatment of chronic called chick peas), kidney beans, lima • Extra-firm tofu: frying, roasting, grilling or diseases during all phases of the beans, navy beans and pinto beans. marinating lifecycle. Dry peas: Good sources of protein, iron, potassium and thiamin. They are • Firm tofu: stir-frying, boiling or to use as green or yellow and can be purchased filling References split or whole. • Soft tofu: pureeing Academy of Nutrition and Dietetics. Lentils: Disc-shaped legumes (2016). Position of the Academy similar in size to peas. They are rich in • Silken tofu: pureeing, simmering, egg of Nutrition and Dietetics: protein, iron, potassium, calcium and substitution, used in vegan and Vegetarian Diets. Retrieved phosphorus. from: http://www.eatrightpro.org/ resource/practice/ Soy Products Nuts and Seeds position-and-practice-papers/ Soy products include tofu, soymilk, position-papers/vegetarian-diets tempeh and other products. All are Nuts are one of the best plant derived from soybeans and are a sources of protein. They are rich Academy of Nutrition and Dietetics. rich source of plant-based protein. in fiber, folic acid, potassium, (2014). Vegetarian Glossary of Protein in soybeans contains as much ( and ) Terms. Retrieved from: http:// complete protein as meat and they and phytochemicals as well. Nuts www.eatright.org/resource/food/ are a good source of and are high in monounsaturated and nutrition/vegetarian-and-special- essential fatty acids, including some polyunsaturated fatty acids, including diets/vegetarian-glossary-of- omega-3s. Soy foods are generally omega 3 fatty acids. Seeds have a terms low in saturated fat and trans fat and similar nutrient profile to nuts, thus National Institutes of Health: are cholesterol free. They also contain they’re considered interchangeable Office of Dietary Supplements. which may help lower the with nuts. Because nuts and seeds are (2016). Iodine: Fact Sheet for risk of some chronic diseases. The high in fat, portions should be limited. Healthy Professionals. Retrieved following are common soy products nuts: Includes , from: https://ods.od.nih.gov/ that you will find in the marketplace: Brazil nuts, cashews, , factsheets/Iodine macadamias, , nuts, : A , which is -HealthProfessional/National an excellent, inexpensive source of pistachios and walnuts. Seeds: Includes , sesame, Institutes of Health: Office of protein and iron. Soybeans can be Dietary Supplements. (2016). eaten in their whole form and, but sunflower, and flaxseed. Seeds have a similar nutrient profile to nuts. Iron: Fact are also used to make a number of Sheet. Retrieved from: https:// vegetarian substitutions for meat, dairy, : Peanut butter is the most popular but other nuts and seeds ods.od.nih.gov/factsheets/Iron- and eggs. HealthProfessional/ Soy cheese: A cheese-like product make healthful butters: sunflower, made from soybeans. Soy cheeses , and soy. United States Department of come in most of the same varieties . (2016). 2015 Dietary as dairy cheeses, such as parmesan, Summary Guidelines for Americans. mozzarella and cheddar. However, Retrieved from: http://health. some soy cheeses are not vegan as A vegetarian diet can be a healthy gov/dietaryguidelines/2015/ they contain the animal protein . way to eat. The key is to consume a guidelines/ Soymilk: A milk-like product made variety of foods in the right amounts to from soybeans, with the same amount meet your energy and nutrient needs. of protein and less fat than cow’s milk. For vegetarians, it is important to: Not all soymilks are vegan as some • Be conscious of protein-rich foods. Your contain the animal protein casein. protein can easily be met by eating a Tempeh: Made from fermented variety of plant foods, such as beans, soybeans, tempeh is a replacement for peas, soy products, nuts, and seeds. meat. • Eat a variety of fruits and vegetables to Textured Vegetable Protein: Commonly used as a substitute for provide a wide range of nutrients. ground ; TVP is derived from soy • Include whole grains and other fiber rich Colorado State University, U.S. Department of Agriculture and Colorado counties cooperating. flour. foods. CSU Extension programs are available to all without Tofu: Made from curdled soymilk discrimination. No endorsement of products mentioned and pressed into blocks. It is a • Get enough omega-3 fatty acids, is intended nor is criticism implied of products not replacement for meat, eggs and calcium, and vitamin B12. mentioned.