Vegetarian diets: Getting all the nutrients you need.

A healthy, well-planned vegetarian diet can provide all the nutrients for a healthy body. Still, since plant‐based foods have smaller amounts of specific vitamins and minerals compared to animal products, or they aren’t absorbed as efficiently, you could be missing out on critical nutrients if you don’t plan well.

A vegetarian diet usually excludes poultry, meat and seafood but may include eggs and dairy products.

Studies have shown that poor vegetarian diets can lead to deficiencies in the following nutrients.

Protein and vegetarian diets

Proteins consist of amino acids; some of these are known as essential amino acids as the body can’t make them. Proteins are needed as the building blocks for the body’s tissues and organs. Animal foods contain all essential amino acids, whereas most plant foods contain some but not all. A diverse vegetarian diet containing a variety of legumes, grains, eggs and dairy products consumed daily should provide you with all the essential amino acids your body needs.

Vegetarian sources of protein

Excellent sources of proteins for vegetarians include:

• Grains and pseudo-grains — Quinoa (contains all essential amino acids), brown rice, Kamut, teff, millet and couscous are all excellent sources of protein.

• Legumes — Legumes such as chickpeas, kidney beans, soya beans and pinto beans, tofu, tempeh and lentils contain a wide variety of amino acids.

• Eggs — Eggs contain all essential amino acids.

• Dairy foods — Dairy foods are complete proteins and also contain other nutrients required by vegetarians, including vitamin B12.

• Nuts & seeds — Nuts and seeds contain plant proteins and include peanut butter, almonds, walnuts, pistachios, pumpkin seeds, chia seeds and sunflower seeds.

Vitamin B12 deficiency in vegetarians

Vitamin B12 is needed for red blood cell replication and formation. People who follow a diet low in animal products may be vulnerable to vitamin B12 deficiency.  Although B12 is in dairy products and eggs deficiency is relatively common among both vegetarians and vegans.  Symptoms of B12 deficiency include fatigue, light-headedness, rapid heart rate, easy bruising and bleeding, weight loss, bowel upset and sore tongue.  Absorption of Vitamin B12 also decreases with age. Speak to your healthcare practitioner if you are concerned about your vitamin B12 levels.

Vitamin B12 sources for vegetarians

• Dairy foods — Dairy foods are a rich source of vitamin B12 and include cheese, yoghurt, milk, kefir and cream.

• Fortified foods — Vitamin B12 fortified foods including, cereals, soy milk, bread, tofu, plant-based meat alternatives and yeast spreads are readily available in Australian supermarkets and health foods stores.

• Eggs — Eggs contain vitamin B12.

• B12 supplementation — B12 is available in supplement form for when dietary intake is inadequate. Supplements come in two forms cyanocobalamin and mecobalamin. Both forms of B12 are readily absorbed by the body. Mecobalamin is an active form of B12.

Omega-3 fatty acids

Omega-3 fatty acids are needed for eye health and brain function. There are three types of omega-3 fatty acids: Eicosapentaenoic acid (EPA), Docosahexaenoic acid (DHA) and alpha-Linolenic Acid (ALA). EPA & DHA are found in animal foods. ALA is found in plant foods.

The body can take ALA from your diet and convert it to DHA and EPA, but only in small amounts, so it’s important to include foods with EPA & DHA and plant foods high in ALA in your diet.

Sources of Omega-3 fatty acids for vegetarians

Sources of ALA include:

• Plant oils — Plant oils such as flaxseed oil, canola oil and soybean oil.
• Legumes — Legumes, including edamame and navy beans.
• Grains — Grains, including whole-wheat bread and oatmeal.
• Seeds — Seeds, including chia seeds, hemp seeds and flaxseeds.

Eggs may also be a source of omega-3 fatty acids. Some eggs also come fortified with Omega-3.

Vitamin D3 and plant foods

Vitamin D is needed for strong bones and a healthy immune system.  You get vitamin D from your diet and sunlight exposure. The amount of vitamin D you get from the sun is influenced by where you live, whether you cover your skin, the season, time of day, your skin pigmentation, how much sunscreen you use and your age.

Vitamin D2 and vitamin D3 are used to fortify foods and are available as supplements. Vitamin D2 is considered acceptable by vegetarians, while vitamin D3 is considered an animal source. When consumed daily, vitamin D2 appears to be as effective as vitamin D3 in supporting Vitamin D levels in the body.

Dietary sources of vitamin D for vegetarians

• Vitamin D2 foods — Fortified dairy products, fortified plant milk and fortified cereal products are all available with added vitamin D to boost dietary vitamin D levels.

• Vitamin D3 foods — Eggs contain approximately one mcg of vitamin D3 per egg. Milk also contains vitamin D3.

Iron from plant foods

Dietary iron is available from non-heme (plant) and heme (animal) sources Non-heme iron is not absorbed as well as the heme iron found in meat. Also, most plant foods contain iron absorption inhibitors such as polyphenols or phytic acid, which reduce the bioavailability of iron even further. Iron is needed to transport oxygen in your blood and to make energy. Adding foods rich in vitamin C can help you absorb the iron from foods.

Dietary sources of iron for vegetarians

• Plant sources of iron — dark leafy greens, legumes including tofu, fortified grains, nuts, fortified breakfast cereals, dried fruit
• Foods to increase iron absorption — Include a vitamin C source like citrus fruits, leafy greens, capsicum, potatoes and cauliflower to increase absorption

Calcium deficiency common in vegetarian diets

Vegetarians who eat the recommended amounts of milk and dairy products (or fortified plant-based alternatives) as part of a varied healthy diet should get enough calcium from their food. However, many adults (regardless of whether they are vegetarian or omnivore) do not get enough calcium in their diets. Therefore it’s recommended that calcium levels be monitored in everyone’s diet, including vegetarians.

Dietary sources of calcium for vegetarians

• Dairy — Milk and dairy products including yoghurt, cheese and kefir
• Fortified products — Calcium-fortified beverages such as soy milk and orange juice, calcium-fortified tofu and calcium-fortified cereals are all now available in supermarkets.
• Plant foods — dark green vegetables such as kale, broccoli and collards, almonds and legumes contain calcium.

Zinc — 50% more needed by vegetarians

Studies have shown Zinc status to be lower in people with a vegetarian diet. Zinc from plant foods is less bioavailable than zinc from animal foods. Plant foods containing zinc are also high in phytic acid, which can inhibit zinc absorption. Calcium-fortified foods can also inhibit zinc absorption. Vegetarians may require as much as 50% more zinc in their diet than nonvegetarians. Zinc is essential for immune function, connective tissue formation and for normal growth and development.

Dietary sources of zinc for vegetarians

• Legumes — Legumes such as baked beans, kidney beans, chickpeas and soy products.
• Dairy products — Dairy products are high in zinc, look for dairy that is not fortified with extra calcium.
• Nuts & seeds — Cashew nuts, brazil nuts and pumpkin seeds are rich sources of zinc.
• Wholegrains — Fortified breakfast cereals, oats and leavened bread. Leavened bread has lower phytic acid content and improved zinc absorption.

Iodine is low in plant food

Iodine is a mineral needed by the body to make thyroid hormones. Thyroid hormones help regulate your metabolism. Iodine content in plant foods is generally lower than in animal foods due to a low iodine concentration in soil.

Dietary sources of iodine for vegetarians

• Seaweed — Seaweed (such as kelp, nori, kombu, and wakame) is one of the best food sources of iodine, but the amount of iodine in seaweed can vary.
• Dairy — Yoghurt, milk and cheddar cheese all contain iodine.
• Grains — Most bread in Australia is fortified with iodine from iodised salt.
• Eggs — Eggs are a rich source of iodine.

Eating a varied diet of whole foods should ensure you get all the nutrients you need while reducing animal foods in your diet. Planning how you’re going to replace essential minerals such as zinc and iron, which are more readily absorbed from animal foods, as well as vitamin B12 and omega-3 fatty acids will help you avoid deficiencies and stay healthy and full of energy.

Supplementation may be beneficial if your dietary intake is inadequate or you have issues absorbing certain nutrients. Speak to your healthcare practitioner to see if supplementation is right for you.

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