When I told my parents I was going vegetarian in my last year of high school, they thought I was crazy. No one had ever been a vegetarian in my family. In fact, my parents had never even known a vegetarian.
Needless to say, they didn’t quite take me seriously initially. With my mom being the chef of the household, despite my continued veggie persistence, I’d often appallingly discover a piece of meat or chicken in my food, which brought a very speedy end to mealtimes for me.
“You need the protein!” my mom would say.
“It’s just one little piece.”
“I thought I separated it all out.”
I eventually boycotted almost everything she made. Now, I feel some guilt over causing her any stress. It wasn't her responsibility to become a short-order cook and cater to each of our food whims.
But because of my persistence, she eventually realized that I was serious about vegetarianism and gave up trying to “trick me.”
Now, I have been a vegetarian for over 20 years, and I’ve learned a few things along the way. At the time I initially gave up meat/chicken/seafood products, it was not a popular choice. As a result, I would frequently be questioned (and not just by mom, but seemingly everyone I dined with):
“Why are you a vegetarian?”
“Don’t you crave meat? I could never do it.”
“You still eat fish, though, right?”
However, I have seen patients converting to a vegetarian diet throughout the years for more than a number of reasons:
1. Animal rights
2. Improved heart health
3. Religion
4. Undesirable taste and/or texture
5. How the food is produced (this is one of the most common reasons)
6. The thought of what they are eating
For me, it was initially due to a combination of number 4 and 6. It all began when my eldest sister would refuse to eat seafood or red meat. “Ew, this is disgusting” is a sentence I heard almost every day in our house. I now simply do not enjoy the taste, nor the thought of what it is that I'm consuming. But it doesn't bother me to see others consume meat. In fact, I even prepare and feed my own kiddos with it.
Living in California, I was lucky. Eating out is not a challenge. Most restaurants already cater to vegetarians because of an ever-growing plant-food lover population now. But after having moved back to the East Coast for medical school, I realized that it was still a foreign concept there. I was much more restricted when eating out.
For whatever reason it may be, however, we are now seeing a surge of vegetarians everywhere in our advanced society. Foods and supermarkets are dramatically increasing their supply of foods catered towards vegetarians. More restaurants are catering to vegetarians with special meal options.
Now as a physician, do I recommend a vegetarian diet to my patients? No, I don’t think it is right for everyone and never initially suggest it. But if someone has already made that decision, then I just think it’s essential that they are supported, and informed as to how to be a healthy vegetarian and avoid any medical pitfalls.
It’s an achievable diet, but one with some health risks if the patient is not educated on how to devise a well-planned and nutritionally adequate diet. So, how can you be a healthy vegetarian?
Types of Vegetarians
Not all vegetarians follow the same food rules. Here are the most common categories, with labels you may have heard thrown around but perhaps didn't quite grasp:
Lacto-Ovo Vegetarians: “Lacto” means milk, and “ovo” refers to eggs. Hence, these vegetarians eat dairy (like milk and eggs), but simply no animal flesh products. This is the base of vegetarianism and the least restrictive type.
Lacto Vegetarians: Now that you’ve learned the basic terms, you can make an educated guess on this one. Yep, these vegetarians consume milk and milk products but no eggs. This makes it more of a challenge to find desserts, most especially, because most contain eggs in their batter mix.
Vegan Vegetarians: This is the most restrictive type, excluding all milk products, eggs, cheese, yogurt, etc. Kudos to those who follow this diet successfully, because it is not easy to find food that lack dairy altogether. Yet, it is definitely achievable.
Pros/Cons of A Vegetarian Diet
The pros of vegetarianism are plentiful, as long as it is done correctly. Studies so far show that vegetarians tend to have decreased risk of:
· Obesity
· Elevated Cholesterol Levels
· Prostate and Colon Cancer
· Diabetes
But it is not risk-free either. If not careful, a vegetarian diet can predispose you to:
Vitamin B12 Deficiency: Those who consume animal products tend to have lifetime stores of vitamin B12. But vegetarians, vegans in particular, are at risk for a deficiency over time. Vitamin B12 deficiency can cause anemia, and neurologic symptoms (such as peripheral neuropathy).
Low Bone Density: Vegetarians who lack sufficient calcium intake have a higher risk of developing osteoporosis and osteopenia, and are hence at risk for fractures.
Weight Gain: For those who consume an overabundance of carbohydrates, weight gain is also a possibility. But if done right, it is often the opposite.
Nutrient Considerations in Vegetarians
As a vegetarian, you may be wondering, how do you know if you are getting “enough”? And enough of what, exactly? It’s imperative to understand in case you are contemplating going vegetarian.
Protein: The Recommended Dietary Allowance (RDA) for daily protein is 0.8 g/kg of body weight. Nuts/seeds, peanut butter, eggs, tofu, lentils, beans, soy products, bread. Here's a list of vegetarian protein sources and their content amount.
Iron: Iron-fortified cereal, kidney beans, peas, nuts, lentils, spinach, whole wheat bread, and some dried fruits are good sources of iron. Here's a helpful list of iron-rich food sources.
Calcium: Some vegetarians, most especially vegans, need to make sure they are receiving their calcium from other resources. Many foods are now fortified with calcium: orange juice, cereal, tofu, soy milk and products, etc. Leafy greens, carrots, broccoli and other veggies are also a good source of calcium. Here are some calcium-rich food sources.
Vitamin D: If you don’t get enough sunlight, it’s also important to take Vitamin D supplements. Many calcium supplements also contain Vitamin D, as it also aids in absorption of calcium. For vitamin D resources besides sunlight (which is not always the right answer either, given the risk of skin cancer), here's a great list.
Vitamin B12: Only contained in animal products, but this does include dairy for Lacto-Ovo vegetarians. But a daily supplement is often recommended for vegans. Here's some more information on vitamin B12.
If you are a picky eater, are reluctant to eat a variety of food groups, or are not certain if you are receiving enough of the recommended nutrients in your diet, a multivitamin daily is also a good addition to your daily regimen.
Vegetarian Resources:
There now is an immense amount of information online about vegetarianism, including recipe ideas and meal planning. Here is my personal running list of resources:
· Vegetarian Nutrition Resource List
· USDA 2015 Dietary Guidelines
· The food pyramid was replaced by “my plate” in 2011. Here’s the vegetarian version.
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Please note that all content here is strictly for informational purposes only. This content does not substitute any medical advice, and does not replace any medical judgment or reasoning by your own personal health provider. Please always seek a licensed physician in your area regarding all health related questions and issues.
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