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The University of Mississippi NUTRITION 101: A Taste of Food and Fitness Lesson 6 Vegetarian Diets LESSON 6 National Food Service Management Institute N U T R I T I O N 1 0 1 : A TA S T E O F F O O D A N D F I T N E S S CONTENTS 1 Lesson at a Glance–Vegetarian Diets 2 Pre-Quiz 3 Lesson–Vegetarian Diets 4 Lesson Activity–Protein Predictions 5 Slides–Vegetarian Diets Key for Icons SAY 6 Physical Activity Booster–The Perfect Complement 7 Taste Activity and Personal Discovery Assessment–TASTE, ASSESS, DISCOVER DO 8 Post-Quiz PREPARE TASTING ACTIVITY Resource–Garden Variety Vegetarian Diets and Lesson Activity–Protein Predictions PHYSICAL ACTIVITY Handout–Complete Proteins SLIDE Cafeteria Connection–Vegetarian by Choice VIDEO SCENARIO Nutrition Nuggets–Health Benefits of Vegetarian Diets N U T R I T I O N 1 0 1 : A TA S T E O F F O O D A N D F I T N E S S Lesson 6 at a Glance Vegetarian Diets What to Do Ahead of Time • Review the lesson and the slides for Vegetarian Diets. • Review all the handouts and activities; make copies of Lesson 6 of the Participant’s Workbook. • Practice the Physical Activity Booster. Decide if menu cards will be printed on different colored papers. Prepare menu cards. • Prepare the Taste Activity supplies. Decide if the tasting activity will feature new vegetarian products, recipes, or plant-based protein-rich foods. Have samples and tasting supplies organized on table. 1. Identify food choices of three vegetarian diets (lacto-ovo, lacto, and vegan). 2. Describe how plant-based foods can provide complete proteins. 3. Apply current nutrition guidance to personal food choices, including vegetarian eating styles. 4. Describe how school nutrition programs can meet the eating preferences of students choosing a vegetarian eating style with varied menus and Offer Versus Serve options. Learning Objectives Time Content Area of Lesson 6 Resource to Use 30 seconds Welcome Slide 1 Vegetarian Diets Present lesson. Resource–Garden Variety Vegetarian Diets and Lesson Activity–Protein Predictions Slides 2-15 Resource–Garden Variety Vegetarian Diets Handout and Lesson Activity–Protein Predictions Pre-Lesson 1 minute 7 minutes Participant Registration, 1 HR Sessions Participants volunteer questions they have written about vegetarian diets on pre-quiz. National Food Service Management Institute Pre-Quiz Lesson 6 6–1 N U T R I T I O N 1 0 1 : A TA S T E O F F O O D A N D F I T N E S S Time Content Area of Lesson 6 7 minutes Vegetarian Diets Presentation continued. Nutrition Nuggets–Health Benefits of Vegetarian Diets 5 minutes 2 minutes Physical Activity Booster–The Perfect Complement Cafeteria Connection and USDA Fact sheets Cafeteria Connection– Vegetarian by Choice. 2 minutes Tasting Activity and Personal Discovery Assessment–TASTE, ASSESS, DISCOVER 2 minutes Post-Quiz Review Post-Quiz Answers. 1 minute Conclude Lesson. National Food Service Management Institute Resource to Use Slide 16 Menu Cards for the Perfect Complement Slides 17-24 Nutrition Nuggets–Health Benefits of Vegetarian Diets Handout Slide 25 Cafeteria Connection– Vegetarian by Choice Handout Slide 26 Tasting supplies; Tasting Activity and Personal Discovery Assessment– TASTE, ASSESS, DISCOVER Handout Slide 27 Slide 28 Lesson 6 6–2 N U T R I T I O N 1 0 1 : A TA S T E O F F O O D A N D F I T N E S S Lesson 6 Vegetarian Diets DO: As participants check in for the class, distribute a copy of the pre-quiz. Allow about 5 minutes for the pre-quiz. Stress that the purpose of the pre-quiz is to measure how much they have learned at the end of the lesson. Have the participants put the pre-quiz aside for use during the lesson. Pre-Lesson Activities Instructor’s Note: The pre- and post-quiz can be copied on the front and back to save paper; or you can ask the participants to underline their answers for the pre-quiz and circle the answers for the post-quiz. Be sure to have the pre-quiz completed at the beginning of the lesson. SLIDE 1 Nutrition 101: A Taste of Food and Fitness • Lesson 6–Vegetarian Diets SAY: Welcome to Nutrition 101: A Taste of Food and Fitness, Lesson 6, Vegetarian Diets. Today we are going to explore vegetarian diets. Before we get started, you answered a few questions about vegetarian diets on the pre-quiz. You also had a chance to write down a question that you wanted answered today. What are some of your questions about vegetarian diets? Instructor’s Note: Allow one minute for participants to share questions. We are going to spend our time looking at questions and finding answers about vegetarian diets. SLIDE 2 What is a vegetarian diet? • A vegetarian diet excludes meat, poultry, and fish. SAY: The first question we need to answer is, What is a vegetarian diet? The term can mean different things to different people. For the purposes of this session, we will use this definition: A vegetarian diet excludes meat, poultry, and fish. National Food Service Management Institute Lesson 6 6–3 N U T R I T I O N 1 0 1 : A TA S T E O F F O O D A N D F I T N E S S SLIDE 3 How common is it to be a vegetarian in America? • Nearly 5 million American adults • 3% of youth ages 8- to 18- years SAY: You may wonder, How common is it to be vegetarian? According to a survey, nearly 5 million American adults say they choose vegetarian diets. In another survey of youth ages 8 to 18 years, three percent identify themselves as vegetarian. SLIDE 4 Why do people choose to eat vegetarian diets? • Religion • Heritage • Personal philosophy • Health • Economics SAY: Another common question is, Why does a person choose to be vegetarian? There are many reasons. Religious practice is the basis for some people. An example is Seventh Day Adventists. For others, their family heritage includes vegetarian diets. People with roots in Asia or India often eat vegetarian diets. For some people, the choice reflects a personal philosophy, such as concern for animal welfare. Others choose the eating style for health reasons. Another reason may be economics; vegetarian diets can be less expensive than a diet including animal products. SLIDE 5 Do all vegetarians eat the same food choices? The answer is, it depends on the specific vegetarian diet. Three main vegetarian diets • Lacto-Ovo Vegetarian • Lacto Vegetarian • Vegan Vegetarian SAY: Do all vegetarians eat the same choices? The answer is another question. The answer to this question is, it depends. There are many different options for eating vegetarian meals. National Food Service Management Institute Lesson 6 6–4 N U T R I T I O N 1 0 1 : A TA S T E O F F O O D A N D F I T N E S S The three most common vegetarian diets in the United States are lacto-ovo, lacto, and vegan vegetarian diets. Our discussion today will focus on these three main diets. SLIDE 6 Lacto-Ovo Vegetarians eat: • Grains, Vegetables, Fruits, Legumes, Nuts, and Seeds • Milk and Milk Products (lacto) • Eggs (ovo) SAY: Lacto-ovo vegetarian diets are based on plant-based foods such as grains, vegetables, fruits, legumes, nuts, and seeds. Milk and other dairy products (lacto) and eggs (ovo) are included. SLIDE 7 Lacto Vegetarians eat: • Similar to Lacto-ovo diet, except does not include eggs. • Baked items and pastas may need to be prepared differently. SAY: Lacto vegetarian diets include plant-based foods and milk and dairy products, but not eggs. Baked goods and pasta products are often made with eggs. Different food preparation methods may be needed to avoid eggs. SLIDE 8 Vegans eat: • Only plant-based foods • No animal products • Strict vegans avoid honey and products made with animal by-products, such as gelatin. SAY: Vegan diets include only plant-based foods. Vegans often follow a strict diet and do not include any foods of animal origin, such as honey or products made from animal by-products such as gelatin. Most vegans do not use leather and other animal products. The lesson resource, Garden Variety Vegetarian Diets Handout in your workbook, summarizes the questions we have just answered. It also provides information on other variations of vegetarian diets. National Food Service Management Institute Lesson 6 6–5 N U T R I T I O N 1 0 1 : A TA S T E O F F O O D A N D F I T N E S S SLIDE 9 What are the health and nutrition benefits of vegetarian diets? Health Benefits include: • Lowers blood cholesterol and blood pressure levels • Reduces the risk of heart disease, high blood pressure, and stroke • Lowers body mass index (BMI) • Reduces the risk of type 2 diabetes and some cancers SAY: A central question often asked is, are vegetarian diets healthy? Since one of the reasons people may choose to eat this way is for health benefits, let us look closer at that topic. Research studies show that vegetarians tend to have lower blood cholesterol and blood pressure levels. This reduces the risk of heart disease, high blood pressure, and stroke. Vegetarians as a group have a lower body mass index or BMI. BMI is a ratio of weight to height. A lower BMI reduces risk of type 2 diabetes and some types of cancer. SLIDE 10 Nutrition Benefits include: • Higher intakes of some vitamins, minerals, fiber, and phytonutrients • Lower intakes of saturated fat and dietary cholesterol SAY: Vegetarian diets can be higher in some vitamins, minerals, dietary fiber, and phytonutrients. The health benefits of these nutrients may in part explain the reduced risk of chronic diseases seen in vegetarians. Vegetarian diets are often low in saturated fat and cholesterol, which may explain the health benefits. SLIDE 11 Are there nutrients of concern for vegetarian diets? • Nutrition Concerns–Protein • Quantity • Can a vegetarian diet provide enough protein? • Lesson Activity–Protein Predictions SAY: A good question to ask about vegetarian diets is, Are there any nutrients of concern? Option: Ask the participants to suggest nutrients that may be of concern in vegetarian diets. Allow 30 seconds or so for answers. National Food Service Management Institute Lesson 6 6–6 N U T R I T I O N 1 0 1 : A TA S T E O F F O O D A N D F I T N E S S The answer is yes. There are nutrients of concern for vegetarian diets. One nutrient that raises questions is protein. Protein in vegetarian diets usually raises a couple of different questions. The first question we will look at is, do vegetarian diets provide enough protein? The lesson activity, Protein Predictions, will help us answer this question. Our next activity Protein Predictions is located in your workbook. SAY: MyPlate suggests the amount of each food group to eat for various calorie levels. The amounts listed on the lesson activity are for a 2000-calorie diet. This activity, Protein Predictions, features three different eating styles: a mixed diet, a lacto-ovo vegetarian diet, and a vegan diet. The food choices for the three food groups that provide consistent amounts of protein–Grains, Dairy, and Protein Foods–are listed. Fruits are not included because this group is not a good source of protein. Vegetables are not listed because the amount of protein varies from one choice to another. Here is what I want you to do. Quickly review the food choices listed for each diet. Predict which diet–the mixed, lacto-ovo, or vegan diet–provides the greatest amount of protein. Circle the letter H under that food column. Then predict the diet that provides the least protein and circle the letter L under that food column. Circle the M under the remaining column to show you predict it is somewhere between the other two for protein content. If there is any diet that you predict does not provide enough protein, put a star next to the circled letter. DO: Allow 1-2 minutes for participants to make their predictions. If necessary, clarify instructions. SAY: Before we see how accurate your predictions are, I want to give a perspective on the amount of protein needed. The Dietary Reference Intake for protein varies according to age, gender, and growth stage. Boys ages 14- to 18- years old have the highest protein need of all the student groups we serve in schools. They need 52 grams of protein to meet their minimum needs and avoid protein deficiency. An adult male needs about 56 grams of protein each day. Each of the sample menus provides the following amounts of protein: Mixed diet 74 grams Lacto-Ovo 63 grams National Food Service Management Institute Vegan 61 grams Lesson 6 6–7 N U T R I T I O N 1 0 1 : A TA S T E O F F O O D A N D F I T N E S S The diet with the most protein is the mixed diet, the vegan diet provides the least, and the lacto-ovo vegetarian diet falls in the middle. SLIDE 12 Lesson Activity–Protein Predictions • Teen males need 52 grams protein • Adult males need 56 grams Mixed 74 grams H Lacto-Ovo 63 grams M Vegan 61 grams L Ask the participants if their predictions were right. DO: Allow a few seconds for responses. SAY: Were you surprised to find out that even the diet with the least amount of protein exceeded the needs of a male 14- to 18- years of age by nearly 10 grams? DO: Allow a few seconds for responses. SAY: We have answered the first question about the quantity of protein in vegetarian diets. These diets can provide enough protein. SLIDE 13 Do vegetarian diets provide quality protein? • Animal proteins are complete • Plant-based proteins are incomplete SAY: A second question remains. What is the quality of the protein in these diets? When vegetarian diets gained popularity in the 1960s and 1970s, the advice was to make sure complete proteins were eaten at each meal. Optional comment: As we learned in Lesson 3, amino acids are the building blocks of protein. Of the 22 amino acids, nine are considered essential because our bodies cannot make them. Proteins are complete when they provide all the essential amino acids. Animal proteins are complete. National Food Service Management Institute Lesson 6 6–8 N U T R I T I O N 1 0 1 : A TA S T E O F F O O D A N D F I T N E S S If an essential amino acid is lacking, the protein is incomplete. Most plant-based proteins are low in one of the essential amino acids. Plant-based proteins are limited by that amino acid and are considered incomplete. For example, if the only source of protein in a diet was corn, a lysine deficiency would occur. Grains and nuts and seeds are often limited by the amount of the amino acid lysine; vegetables and legumes are often limited by the amino acid methionine. When two foods combine to create a complete protein, the foods are called complementary. Grains provide the methionine lacking in legumes. Legumes provide lysine missing in grains. Together the two groups complement each other; they provide complementary proteins. SLIDE 14 Complementary Proteins–combine to make complete proteins SAY: Locate the Complete Protein Handout in your workbook. This chart shows how different plant-based foods with incomplete proteins can combine to form complete proteins. The solid line in between two foods means most foods in the two groups can combine to provide complete protein. The dotted line between grains and nuts and seeds means some but not all foods in those two groups will combine to provide complete protein. You have been sitting for quite a while. We are going to do a physical activity booster to help us understand complete proteins. We will also answer the question of quality of protein in vegetarian diets. SLIDE 15 Menu Card Sample SAY: Our activity will use menu cards. Here is a sample of what a menu card looks like. This is a menu card for a lacto-vegetarian diet. The two pieces of the card are Cheese and Pizza sauce and crust. The crust is made from grains, an incomplete protein source. The pizza sauce, from vegetables, also provides incomplete protein. The cheese is a complete protein because it is animal-based. The combined food, cheese pizza, provides complete protein. When vegetarians include milk or eggs in their food choices, these foods create menus with complete proteins. DO: Distribute a physical activity booster card to each participant or show where it is in the session materials. National Food Service Management Institute Lesson 6 6–9 N U T R I T I O N 1 0 1 : A TA S T E O F F O O D A N D F I T N E S S Instructor’s Note: The resources for this activity can be printed on card-stock paper. The cards are then cut into two pieces, each card with a unique cut pattern (zig zag, rounded to right, arrow to left, etc.) To make finding the matching card pieces faster, use different colored paper for each card. Decide ahead of time if you will randomly distribute or pre-assign the cards to specific participants. SLIDE 16 Physical Activity Booster–The Perfect Complement SAY: Everyone has a half of a menu card. Your goal is to find the matching half of your menu card as quickly as possible. The completed card is a menu item that provides complete protein. The card describes the two foods that complete the protein profile. Here is how the activity works: Everyone moves in the room to find the matching half of their menu card as quickly as possible. When you have found your match, put your pieces together. Decide quickly which person will read the card details to the entire group once all the matches are made. Our goal is to have all the matches made and read in less than 4 minutes. Let’s go! Option: To help activity go quickly, • Tell participants to look for colored paper, if different colors are used for each card. • Tell participants to look for cut design, if different cut patterns are used for each card. DO: Have participants find matches. When all matches are found, ask participants to stand in a large circle so that each pair is together and can be seen by every other pair at the training. Have each pair share the information on the cards as they hold the pieces of the card together so others can see the card. Option: As participants share information on their combined menu cards, consider displaying slide #14 to emphasize the complementary relationship between the various plant-based foods. If slide #14 is displayed, advance back to slide #16 before continuing the lesson. Once every pair has shared, ask the participants to quickly take their seats. National Food Service Management Institute Lesson 6 6–10 N U T R I T I O N 1 0 1 : A TA S T E O F F O O D A N D F I T N E S S SAY: Nutrition science has advanced since the early 1960s. Today’s advice for vegetarians is to eat a variety of plant-based protein sources throughout the day to assure enough complete proteins. A healthy vegetarian diet does not need to have complete proteins at each meal. However, complementary proteins are delicious and make menu planning easier. Vegetarian diets can provide adequate protein quality as well as quantity. You may be wondering, What are the other nutrients of concern for vegetarian diets? Most nutrients of concern are related to vegan vegetarian diets. SLIDE 17 Nutrient of Concern–Adequate Calories • Adequate calories are needed to assure protein needs are met. SAY: Adequate calorie intake can be a concern. Because plant-based foods generally provide less calories than animal-based foods, there exists the chance of low calorie intake, especially when children eat vegan diets. Plant-based foods also provide more fiber, which is filling. Frequent meals and snacks and foods higher in unsaturated fats, such as nuts and seeds, help supply adequate calories. Adequate calories are needed to assure protein needs are met. In your workbook, locate the Nutrition Nuggets Handout with information on health benefits for vegetarians. SLIDE 18 Nutrient of Concern–Iron • Plant foods have non-heme iron. • Serve vitamin C rich foods with plant sources of iron. SAY: Iron is a nutrient of concern for all vegetarian diets. We will learn in Lesson 7, that iron from red meat, also called heme iron, is easily absorbed and used by the body. The iron in plant-based foods is called non-heme iron. It is not as easily absorbed as heme iron. Eating foods rich in vitamin C along with non-heme iron foods increases iron absorption. Fortified grains, beans, and leafy greens such as spinach are good sources of iron in vegetarian diets. SLIDE 19 Nutrient of Concern–Calcium • Check milk substitutes to assure they are fortified with calcium and other nutrients found in milk. SAY: Calcium is a nutrient of concern when milk and other dairy products are not included. Vegans need to make sure their milk substitutes are fortified with calcium. The name rice National Food Service Management Institute Lesson 6 6–11 N U T R I T I O N 1 0 1 : A TA S T E O F F O O D A N D F I T N E S S milk might suggest it can replace milk in the diet. However, rice milk provides less protein, calcium, and other essential nutrients that we find in milk. Vegans need to read labels carefully and select products that will provide the nutrients naturally occurring in milk and other dairy products. Legumes, almonds, and leafy greens will provide some calcium. SLIDE 20 Nutrient of Concern–Vitamin B-12 • Vitamin B-12 is only found in animal foods. Vegan diets need supplements of B-12. SAY: Vitamin B-12 is another nutrient of concern. Only animal foods provide vitamin B-12. The body can draw upon B-12 stores for up to 4 years before deficiency symptoms appear. Vegans need to make choices for adequate B-12 intake. Those choices include eating fortified foods, nutritional yeast, or taking supplements. SLIDE 21 Other Nutrients of Concern • Vitamin D • Zinc • Iodine • Omega-3 fatty acids DHA and EPA SAY: Other nutrients of concern for vegetarian diets include vitamin D, zinc, iodine, and the omega-3 fatty acids DHA and EPA. Vegetarians may need to use fortified foods or supplements to get enough vitamin D, in addition to sun exposure. Plant-based foods are low in zinc. The high phytate content of vegetarian diets may further reduce absorption rates. Phytate is found in unrefined grains and legumes. Phytate binds with zinc. Plant foods are also low in iodine. Unless iodized salt is used, vegetarian diets can be low in this nutrient. DHA and EPA are two of the omega-3 fatty acids found in fish, seafood, and some eggs. Optional Comment: We learned about these fatty acids in Lesson 5’s resource Alphabet Letters, Labels, and Lipids. SAY: Experts suggest that vegans may need to pay special attention to these fatty acids. Our bodies convert some of the plant-based ALA omega-3 fatty acid to DHA or EPA, but it is a low amount. Microalgae is a possible food source of DHA. Some DHA is converted to EPA National Food Service Management Institute Lesson 6 6–12 N U T R I T I O N 1 0 1 : A TA S T E O F F O O D A N D F I T N E S S by the body. So what is the bottom line on nutrition and vegetarian diets? SLIDE 22 According to the American Dietetic Association, “…appropriately planned vegetarian diets, including total vegetarian or vegan diets, are healthful, nutritionally adequate, and may provide health benefits in the prevention and treatment of certain diseases. Well-planned vegetarian diets are appropriate for individuals in all stages of the life cycle…” SAY: According to the American Dietetic Association, “…appropriately planned vegetarian diets, including total vegetarian or vegan diets, are healthful, nutritionally adequate, and may provide health benefits in the prevention and treatment of certain diseases. Well-planned vegetarian diets are appropriate for individuals in all stages of the life cycle…” SLIDE 23 According to the American Dietetic Association, “…appropriately planned vegetarian diets, including total vegetarian or vegan diets, are healthful, nutritionally adequate, and may provide health benefits in the prevention and treatment of certain diseases. Well-planned vegetarian diets are appropriate for individuals in all stages of the life cycle…” SAY: I want to call your attention to the words well-planned. Vegetarian diets must be well-planned to provide adequate nutrition. When entire food groups, such as milk or meat are eliminated, diets may not be well-planned and balanced. Appropriate substitutions are necessary. People who eat vegetarian diets need to know how to meet their nutrition needs without meat, poultry, fish, eggs, or milk and dairy products. These foods are nutrient rich. Lean meats, fish, and low fat or fat-free milk products are part of the Dietary Guidelines for Americans. SLIDE 24 Dietary Guidelines for Americans Food Groups to Encourage • Whole grains • Vegetables • Fruits • Legumes • Low fat and fat-free milk/milk products National Food Service Management Institute Lesson 6 6–13 N U T R I T I O N 1 0 1 : A TA S T E O F F O O D A N D F I T N E S S SAY: The Dietary Guidelines for Americans include several food groups to encourage. Those food groups are: • Whole grains • Vegetables • Fruits • Legumes • Nuts and Seeds • Milk and other low fat or fat free dairy products Many of these foods are major players in vegetarian diets. Most Americans can benefit from increasing the amount of plant-based foods they eat. SLIDE 25 Are vegetarian diets a special nutrition need? What tools do school nutrition programs have to meet the preferences of students that want a vegetarian meal? SAY: The students in our child nutrition programs benefit from eating more plant foods, too. Two questions often come up in school nutrition related to vegetarian diets. The first question is, are vegetarian diets a special nutrition need diet? The answer is no, vegetarian diets are a personal preference. While schools are not required by law to provide vegetarian meals, customer service best practices suggest we try to meet our customers’ wants and expectations. The second question is, what tools do schools have to use to meet vegetarian diets? School nutrition programs have two options available to meet the needs of students who eat vegetarian diets. This Cafeteria Connection in your workbooks highlights how offer versus serve and creative menu planning can help schools serve all students a delicious meal that meets each student’s wants and expectations. On the www.ChooseMyPlate.gov Web site, USDA has developed a Ten Tips Nutrition Education Series. One of the tips is Healthy Eating for Vegetarians. These are suggestions to help you choose wisely for a vegetarian diet. Under the Related Topics is a section on Vegetarian Diets. Here you can find information on how to get the key nutrients you need while eating a vegetarian diet. SLIDE 26 National Food Service Management Institute Lesson 6 6–14 N U T R I T I O N 1 0 1 : A TA S T E O F F O O D A N D F I T N E S S Taste Activity SAY: Most of us can benefit from more plant foods in our diets. The questions we may need to ask ourselves are • How many different protein-rich plant foods have I tried? • How often do I include plant-based foods in my food choices? Our tasting activity features vegetarian food. As you enjoy the tasting, think about ways you can include more plant-based foods in your own diet. DO: Have tasting samples easily available. Allow up to 3 minutes for the tasting activity. If time is limited, have participants continue to taste while they complete their post-quiz. Use the Personal Discovery Assessment Handout in your workbook to see how many plantbased sources of protein you have tasted or regularly include in your diet. Use the resources listed in this lesson to discover more about vegetarian diets. SLIDE 27 Post-Quiz SAY: We have answered many questions about vegetarian diets. Now it is time to see how much we have learned. Please take out your post-quiz. Circle you answers now that we have completed the lesson. DO: Allow a minute or two to complete the post-quiz and review the answers. SLIDE 28 Conclusion Conclude the lesson and remind participants to bring all materials to the next lesson. SAY: Does anyone have any questions? Please remember to bring all the materials with you to each lesson. National Food Service Management Institute Lesson 6 6–15 Legume Red Beans Grain Rice Sunflower Butter Seed Bread Grain Rice Grain Curried Lentils Legume Cheese Milk (lacto) (animal–complete) Macaroni Grain Chopped Egg Egg (ovo) (animal–complete) Tossed Salad Vegetable Legume Hummus Grain Pita Tortilla Grain Refried Beans Legume Milk Milk (lacto) (animal–complete) Cereal Grain Dried Cherries Fruit (not a protein source) Quinoa Rare complete protein grain