I'm not gonna lie... I'm not a huge fan of plant based eating as I firmly believe I was born a carnivore. I do, however, respect people's choices regarding healthy foods and I have even been known to embrace some vegetarian dishes as they cross my path. Since my audience is global, I thought I should do at least one Ramble on the subject.
To that end, here is a very good article originally published by Beth Israel Lahey Health's Joslin Diabetes Learning Center
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Vegetarian and Plant Based Eating
Joslin Education Team - March 29, 2022
A plant-based diet consists of mostly whole grains, fresh
fruits and vegetables, legumes (pulses), unsalted nuts, and healthy oils such
as olive oil or canola oil. Meat, fish, poultry, and other animal products are
included but eaten less often and only in small portions. A vegetarian diet
eliminates meat, fish, or poultry or any foods that contain animal protein. It
includes whole grains, legumes (pulses), nuts, seeds, vegetables and fruits
with or without the use of dairy products and eggs.
There are several different types of a vegetarian diet:
- Semi-vegetarian: Does not eat red meat(s), but
occasionally eats fish or poultry and dairy products. Semi-vegetarians are
often people who are making a transition to a vegetarian diet.
- Lacto-ovo vegetarian: Eats milk, dairy products and
eggs but not meat, fish or poultry.
- Lacto-vegetarian: Eats milk and other dairy products
but not meat, fish, poultry or eggs.
- Pescetarian: Eats a diet of fruits, vegetables, grains,
legumes and includes fish. They may or may not eat eggs and dairy
- Vegan: Do not eat any animal products (meat, fish,
poultry, eggs or dairy foods). A vegan eats only plant-based foods.
- Raw Vegan: Eats only plant foods; including
vegetables, fruit, nuts and seeds, legumes (dried beans, peas, and lentils),
and sprouted grains. The majority of the food is uncooked varying from 75% to
100%.
Can people with diabetes follow a vegetarian or plant-based diet?
Research shows the many benefits of omega-3 fatty acids. They may reduce the
risk for cardiovascular disease, improve cognitive function and vision, and act
as an anti-inflammatory agent in the body. The primary sources of omega-3 fatty
acids in the diet are fish, organ meats, and DHA-enriched foods such as eggs.
Based on these food sources, vegetarians may not get enough omega-3 fatty acids
in their diet. Adding some plant-based omega-3 rich foods can help the
vegetarian meets their needs.
What are the health benefits?
There are many reasons why people choose to follow a
vegetarian or a plant-based diet, including financial reasons, ethical,
environmental concerns and religious beliefs. Some people make the change for
health reasons, as well. Vegetarian and plant-based eating may help reduce the
risk of:
- Cancer
- Diabetes
- Heart disease
- High blood pressure
- Kidney disease
- Obesity
Yes. They can be higher in carbohydrates and lower in
protein than meat-based diets, so glucose levels may be affected. As a result,
your healthcare provider may need to change the amount or type of your diabetes
medicine. Anyone interested in changing to vegetarian or plant-based eating, including people with
diabetes, should work with a dietitian to make sure they are meeting their
nutritional needs.
Is vegetarian/plant-based eating nutritionally adequate?
A well-planned vegetarian/plant-based diet can be healthful
and nutritionally adequate. Keep in mind that the more restricted the diet, the
greater the chance of a nutritional deficiency. Below are some considerations.
Protein:
Vegetarian/plant-based diet(s) can provide an adequate
amount of protein as long as you eat a variety of foods and consume adequate
protein sources. Protein is made up of amino acids, nine of which are called
essential amino acids. Animal foods contain all of the essential amino acids,
whereas plant foods are missing one or two. However, if you eat a variety of
plant foods, you will get all nine essential amino acids.
Sources of Plant Protein:
Legumes (Pulses)
Legumes include dry beans, peas, and lentils. They are an
excellent food to extend or replace meat. Legumes are low cost, high in
nutritive value, and contribute iron, B vitamins, and fiber to your diet. They
are not a complete protein, because they do not contain all of the essential
amino acids the body needs. When combined with a variety of other plant-based
foods throughout the week, legumes can become valuable protein sources in your
diet. Legumes may be purchased dry or canned. Dry legumes tend to be less
expensive
Dry Beans: Rich in protein, iron, calcium, phosphorus
and potassium. There are many varieties of dry beans including black beans,
garbanzo beans (also called chickpeas), kidney beans, lima beans, navy beans
and pinto beans.
Dry Peas: Good sources of protein, iron, potassium and
thiamin. They are green or yellow and can be purchased split or whole.
Lentils: They are rich in protein, iron, potassium,
calcium and phosphorus. They are small disc-shaped legumes; they can be brown,
yellow or red.
Soy Products: Soy products include tofu, soymilk,
tempeh and other products. They are derived from soybeans, a rich source of
plant-based protein. Protein in soybeans contains as much complete protein as
meat and are a good source of B vitamins and essential fatty acids, including
some omega-3s. Soy foods are typically low in unhealthy fats (saturated/trans)
and are cholesterol-free. They also contain isoflavones which may help lower
the risk of some chronic diseases.
Soybean: A legume, which is an excellent, inexpensive
source of protein and iron. Soybeans can be eaten in their whole form and, but
are also used to make a number of vegetarian substitutions for meat, dairy, and
eggs.
Soy cheese: A cheese-like product made from soybeans.
They come in a variety of flavors such as parmesan, mozzarella and cheddar. Not
all soy cheeses are vegan; some contain the milk protein casein.
Soymilk: A milk-like product made from soybeans, with a
similar amount of protein and less fat than cow’s milk. Not all soymilks are
vegan as some contain the milk protein casein. Fortified soymilks have calcium
and vitamin D added.
Tempeh: Made from fermented soybeans and other grains,
tempeh is a replacement for meat.
Textured Soy Protein (TSP): Commonly used as a
substitute for ground beef; TSP is derived from soy flour.
Tofu: Made from curdled soymilk and pressed into
blocks. It can be used as a replacement for meat, eggs and cheese and can be
eaten fresh or cooked in many different ways. Tofu is an excellent source of
protein. Types and suggestions of how to use tofu:
- Extra-firm tofu: frying, roasting, grilling or marinating
- Firm tofu: stir-frying, boiling or use as a filling
- Soft tofu: pureeing
- Silken tofu: pureeing, simmering, egg substitution, used in
vegan desserts and smoothies
Nuts and Seeds:
Nuts and seeds are some of the best plant sources of
protein. They are rich in fiber, folic acid, potassium, antioxidants (vitamin E
and selenium) and phytochemicals as well. Nuts are high in monounsaturated and
polyunsaturated fatty acids, including omega 3 fatty acids. Because nuts and
seeds are high in fat, portions should be limited.
- Tree nuts: Includes almonds, Brazil nuts, cashews,
hazelnuts, macadamias, pecans, pine nuts, pistachios and walnuts.
- Seeds: Includes pumpkin, sesame, sunflower, chia and
flaxseed.
- Nut Butters: Peanut butter is the most popular but
other nuts and seeds make butter: sunflower, almond, cashew, hazelnut and soy.
Omega-3 Fatty Acids
Sources of Omega-3 foods:
- Flaxseed
- Chia seeds
- Hemp seeds
- Walnuts
- Canola oil
- Soy
- Some soymilks and breakfast bars
Iron:
Plant foods contain a different form of iron than animal
foods, called non-heme iron. Non-heme iron is not as well absorbed as heme
iron. Non-heme iron will be better absorbed if eaten along with foods that
contain vitamin C, or by cooking foods in cast-iron pots and pans. The daily
recommendation for iron intake is 1.8 times higher for vegetarians than those
who eat meat. For most vegetarians, an iron supplement is recommended to help
meet iron requirements.
Sources of iron:
- Bran flakes cereal Pumpkin seeds Instant oatmeal Dried
beans/peas Fortified cereals Tofu
- Sea vegetables Textured vegetable protein
Sources of vitamin C:- Cantaloupe
- Strawberries
- Honeydew melon
- Broccoli
- Citrus fruits
- Green peppers
- Kiwi
- Tomatoes
- Papaya
- Brussels sprouts
Zinc:
As with iron, zinc is a mineral that is present in plant
foods but better absorbed from animal sources. As a result, some vegetarians
can have lower concentrations of zinc than non-vegetarian diets. Most
vegetarians still have levels within the normal range. True zinc deficiencies
are rare in Western civilizations. Including foods rich in zinc can help the
vegetarian maintain adequate levels of zinc in their body. Like iron, zinc can
be better absorbed when eaten in combination with vitamin C-rich foods. (See
list above)
Sources of Zinc:
Vitamin B-12:
Vitamin B-12 is found mainly in animal foods. Some plant
foods contain vitamin B-12, but not in a usable form. A lacto-ovo or
lacto-vegetarian diet will provide adequate amounts of vitamin B-12. Certain
foods are fortified with vitamin B-12, such as some breakfast cereals, soymilk
and meat substitutes. If you are a vegan, you must either make sure you eat
these fortified foods, or take a B-12 supplement.
Sources of Vitamin B-12:
- Fortified cereals
- Eggs
- Brewer’s yeast Milk and milk products
- Fortified meat substitutes
- Fortified soy milk
Calcium:
A lacto-ovo vegetarian diet generally is adequate in
calcium. A vegan diet tends to provide lower amounts of calcium, although, with
careful planning, a vegan diet can supply enough calcium. Your dietitian may
recommend a calcium supplement if you can’t meet your calcium needs through
food sources.
Note: Calcium decreases the absorption of iron. If taking
supplemental calcium or iron, take them at separate times of the day.
Sources of calcium:
- Milk and milk products
- Legumes
- Fortified soy milk
- Collard greens
- Tofu (made with calcium)
- Turnip greens
- Fortified orange juice
- Kale
Vitamin D:
Vegan diets may be low in vitamin D, since cow’s milk is the
most common source of this vitamin. However, if you follow a vegan diet, you
can get enough vitamin D from fortified cereals and fortified milk
alternatives. Unprotected exposure to sunlight (hands and arms) for 15-20
minutes a day can also supply adequate vitamin D. Some people may need a
vitamin D supplement. Your dietitian may recommend supplemental vitamin D if
your diet is deficient and/or your vitamin D level is low.
Sources of vitamin D:
- Fortified cereals
- Fortified soy milk
- Milk
- Sunlight
Getting started with vegetarian/plant-based meal planning
Choose a variety of foods, including whole grains,
vegetables, fruits, legumes, nuts, seeds, and, if desired, dairy products and
eggs.
Try gradually decreasing the amount of animal protein to
allow time to adjust to a vegetarian/plant-based diet.
Substitute soy products (tofu, meat substitutes) and legumes
for meat, poultry and fish.
If you use milk products and eggs, choose lower-fat versions
of these foods, such as skim or 1% milk and yogurt, and egg whites or egg
substitutes.
If you are following a vegan diet, be sure to include a
regular source of vitamin B-12 in your diet along with a source of vitamin D if
sun exposure is limited. Supplements are often required to meet nutrient needs.
Use fats sparingly; choose unsaturated fats, such as olive,
canola and peanut oils, nuts and seeds, instead of saturated fats, such as
butter, margarine and cream cheese.
Limit your intake of high-fat foods, such as cheeses, whole
milk, nuts, seeds, avocados and oils, especially if you are trying to lose
weight.
Be sure to count the carbohydrates in foods – many
vegetarian diets can be very high in carbohydrates. Keep your carbohydrate
intake consistent and read food labels carefully for their carbohydrate
content.
It is important to monitor your glucose regularly if you are
changing to a vegetarian diet/plant-based diet. Your diabetes medication or
insulin dose may need to be adjusted, especially if you are eating more
carbohydrates than before.
Vegetarian meal ideas
Below are some meal ideas to help get you started? Again, be
sure to include a variety of foods in your eating plan.
- Breakfast: Whole-grain cereal and skim/1% fat or milk
alternatives; whole-grain toast; bagels; English muffins; pancakes and waffles;
fruit; eggs and egg substitutes; nonfat Greek yogurt; regular/low-fat cheeses;
peanut and nut butter; tofu “cream cheese”; vegetarian/plant-based proteins
“bacon” and “sausage”.
- Lunch/Supper: grilled cheese sandwich; hummus and
vegetable sandwich; peanut butter and jelly sandwich; minestrone, bean, split
pea and lentil soups; vegetable pizza; rice and beans; bean and vegetable
burritos bowls; macaroni and cheese; vegetarian lasagna; stir-fry vegetables
and tofu; “veggie/plant-based” burgers; vegetarian-style chili
Note: Many vegetarian and planted-based frozen products are
not necessarily healthy choices. Some of the products can be high in calories
and fat. Always read the nutrition facts to make sure the item is appropriate
for your goals.
Resources:
The Vegetarian Resource Group - https://www.vrg.org/
Eating Vegetarian - https://www.nutrition.gov/topics/basic-nutrition/eating-vegetarian
Vegetarian Times - https://www.vegetariantimes.com
Mark Bittman - https://www.markbittman.com/
PBS, Jazzy Vegetarian Cooking Show - http://www.pbs.org/food/shows/jazzy-vegetarian/
Forks over Knives - https://www.forksoverknives.com/
The Plant-Based Network - https://plantbasednetwork.com
Although this content is reviewed by Joslin Diabetes
Center healthcare professionals, it is not intended to replace the medical
advice of your doctor or healthcare provider. Please consult your healthcare
provider for advice about a specific medical condition.
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Have a great week, everyone, and thank you for your support!
Blessed be… and happy cooking!
Chef Michael R
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