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Moving toward a plant-based diet More and more people are exploring a vegetarian way of eating for a variety of reasons including health, religion, animal rights, ecological concerns, and economics. A vegetarian eating plan is based on fruits, vegetables, grains (preferably whole grain), legumes, nuts, and seeds. There are many kinds of vegetarians including: •Semi-vegetarian or flexitarian – will eat dairy foods, eggs and occasionally fish, poultry or meat. •Pesco-vegetarian – will not eat meat or poultry, but will eat fish, dairy foods and eggs. •Lacto-ovo vegetarian – will not eat meat, poultry or fish, but will eat dairy foods and eggs. •Lacto-vegetarian – will not eat meat, poultry, fish or eggs, but will eat dairy foods. •Ovo-vegetarian – will not eat meat, poultry, fish or dairy foods, but will eat eggs. •Vegan – will not eat animal flesh or animal products including dairy foods, eggs, and often honey. The Academy of Nutrition and Dietetics states that a well planned vegetarian diet provides enough nutrients and is appropriate for people of all ages. Furthermore, it may also help in the prevention and treatment of certain diseases. However, a few nutrients may require special attention to be sure intake is adequate including protein, calcium, iron, zinc, vitamin D, vitamin B12, and omega 3 fatty acids. Getting started •Identify meatless meals you already eat, e.g., cereal with milk, peanut butter sandwich, pasta with marinara sauce, split pea or lentil soup, red beans and rice or cheese pizza. •Modify your current recipes or meals. Replace meat, chicken or fish with legumes, tofu, tempeh, seiten, soy crumbles, or veggie burgers. •Look for vegetarian recipes and meal ideas in cookbooks, magazines and on the Web. •Plan 1 to 2 meatless meals per week. Try a soy based meal one day and a legume based meal another day. Building a plant-based pantry Stock your kitchen (cupboards, refrigerator and freezer) with the foods and food items you will need to make meatless recipes. Most of these can be found in a well-stocked grocery store. Whole Foods, Trader Joe’s, My Organic Market, and ethnic markets (Asian, Latino, Middle Eastern or Indian) are also good sources. Soy foods There are a variety of soy items readily available in most grocery stores including tofu, soy milk, soy cheese, soy nuts, tempeh, soy burgers, meat analogs (food product that looks and tastes like meat), and textured vegetable protein. Legumes (dried beans, peas and lentils) Grains Popular dried beans include black beans, black-eyed peas, garbanzo beans, great northern beans, kidney beans, lima beans, navy beans and pinto beans. Keep both canned and dried varieties on hand. Dried peas include yellow, red and split peas. Lentils sold in grocery stores are usually brown, but visit an Indian store and you will find many more choices. Make at least half your grains whole grains Focus on whole grains like amaranth, brown or wild rice, barley, buckwheat, oats, quinoa and wheat berries. Check the ingredients list on product labels for the words “whole or whole grain” as the first ingredient on the list. Keep on hand quick-cooking grains like bulgur, couscous, oatmeal, pasta, and quick brown rice for when time is limited. Nut and seed butters Seasonings Peanut butter is the old stand by, but other spreads to try are almond butter, soy butter, sunflower seed butter, and tahini (sesame seed spread). Keep on hand a variety of seasonings to add flavor and taste to any meal. These include fresh and dried herbs, spices, lemons, limes, vegetarian boullion cubes, miso, flavored vinegar and oils, soy sauce, and sesame seeds. Meat substitutes These items can be used to replace meat in meals. They are available in a variety of forms including veggie burgers (made from soy, grains or vegetables), meatballs, bacon, sausage, lunch meat, chicken nuggets and hot dogs. They are usually found in the frozen food section of the store. Fruits and vegetables Fill half your plate with fruits and vegetables. Buy fresh, frozen, canned and dried fruits and select fresh, frozen or canned (no salt added) vegetables. Choosing a variety of fruits and vegetables adds color to your plate and provides important nutrients. Planning vegetarian meals •To ensure a healthy plant based diet choose a variety of foods on a daily basis including whole grains, legumes, soy foods, fruits, vegetables, nuts, and seeds •Choose heart healthy plant based fats like nuts, olives, vegetable oils, and avocado •Limit the intake of sweets and high fat snacks •If you choose to include dairy foods, choose fat free or low fat versions Dietary supplements Most vegetarians can get the nutrients they need from the foods they consume by choosing a variety of healthy foods. However, some people may benefit from a multivitamin-mineral or specific supplement such as vitamin B 12, vitamin D or calcium. Check with your doctor or dietitian to find out what is appropriate and safe for you. Nutrients needing special attention Nutrient Alternative sources Comments Protein Legumes, nuts & nut butters, seeds, soy foods, whole grains, eggs, egg whites or egg substitutes, dairy foods Vegetarians can meet their protein needs as long as they include plant sources of protein on a daily basis. It is no longer necessary to combine proteins in the same meal as long as a variety of food groups is consumed throughout the day. Calcium Soy milk (calcium fortified), tofu (calcium-set), almonds, soy nuts, collard or turnip greens, kale, broccoli, dried figs, blackstrap molasses, calcium-fortified juice and milk alternatives, dairy foods Vegetarians absorb more calcium from foods than non-vegetarians. If food intake is inadequate, consider taking a calcium supplement. Alternatives to cow’s milk e.g., rice, almond and coconut milks, do not contain the same protein content as cow or soy milk. Iron Legumes, soy foods, potatoes, spinach, nuts and seeds, whole grains (bran flakes, oatmeal), wheat germ, enriched grains (cream of wheat), blackstrap molasses Consume foods or fluids rich in vitamin C (citrus fruits/juices, tomatoes, strawberries, peppers) to increase the iron absorption from plant foods. Using iron cookware can increase the iron content of food. Zinc Whole grains, wheat germ, soy foods, dairy foods The higher content of phytates in a vegetarian diet may decrease zinc absorption. Vitamin B12 Fortified foods (cereal, nutritional yeast, Found only in animal foods. Sea soy milk), eggs, meat analogs, dairy foods vegetables are not a reliable source. If you do not consume any animal products or fortified foods, take a supplement. Vitamin D Fortified foods (milk, juice, cereal), sunshine Few foods are naturally high in vitamin D. About 10-15 minutes of sun exposure on your face, hands and arms (without sun screen) per day provides adequate vitamin D. People who do not consume fortified foods or sun exposure should take a supplement. Omega 3 Fatty Acids Fortified foods (soy milk, breakfast bars). Good sources of ALA include flaxseed meal, canola oil, walnuts, tofu, soybeans Diets that do not contain fish are usually low in the omega 3 fatty acids eicosapentaenoic acid (EPA) and docasahexanenoic acid (DHA) which are important to heart, brain and eye health. Alpha linolenic acid (ALA) can convert to DHA in the body but the conversion is low (~4-10%). DHA supplements from algae are available. Comparison of animal and vegetarian foods Food Serving size Calories Protein (g) Fat (g) Carbohydrate (g) Fiber (g) Sodium (mg) Animal foods Chicken breast Salmon Tilapia Top round Beef, grd (93/7) Pork tenderloin Egg 1% milk Cheddar cheese 3 oz, cooked 140 26 3 0 0 63 3 oz, cooked 3 oz, cooked 3 oz, cooked 3 oz 175 109 174 19 22 26 11 2 8 0 0 0 0 0 0 52 48 35 3 oz, cooked 122 22 3 0 0 49 1 large 8 ounces 1 ounce 72 110 110 6 9 7 5 3 9 0 13 1 0 0 0 70 130 180 Legumes Black beans Kidney beans Lentils Split peas ½ cup, cooked ½ cup canned 114 110 8 7 0 0 20 19 8 6 1 360 ½ cup, cooked ½ cup, cooked 115 116 9 8 0 0 20 21 8 8 2 2 1 0 2 5 1 23 17 20 4 3 1 4 3 4 1 1 5 7 0 380 5 4 7 8 4 1 10 11 9 13 2 6 5 1 2 7 1 4 5 95 50 5 3 280 14 14 19 6 5 4 3 1 2 0 5 1 Grains Brown rice Bulgur Quinoa Flaxseed Seitan ½ cup cooked ½ cup, cooked ½ cup, cooked 2 tbsp, ground 3 oz 109 76 111 60 90 2 3 4 3 18 Soy foods Edamame Soy milk Soy nuts Tempeh Tofu, firm Soy burger ½ cup, cooked 1 cup, vanilla ¼ cup 4 oz 3 oz 1 patty 120 100 140 220 71 70 13 6 11 23 8 13 Nuts Almonds Peanuts Walnuts ¼ cup ¼ cup ¼ cup 160 170 185 6 8 4 Source: The Food Processor SQL® Nutrition Analysis Software from ESHA Research, Salem, Oregon, USDA National Nutrient Database for Standard Reference and Manufacturer labels. REGIONAL HEALTH EDUCATION, HEALTH PROMOTION AND WOMEN'S HEALTH 0039-0672 Revised/reprinted 7/12 Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. 2101 East Jefferson Street, Rockville, MD 20852