It’s estimated there are now over 3 million vegetarians in the UK, who avoid eating meat or fish, and around half a million vegans, who exclude any form of animal products from their diet, including meat, fish, dairy and eggs. Numbers have risen dramatically over the past decade, and more and more people are embracing a plant-based diet.
If you’re thinking about going vegetarian or vegan, or you’ve been following such a diet for some time, it’s clear from research that there can be some real health benefits to following a plant-based diet (1); however, the choices within this diet are crucial, and you need to do your research to make sure you give your body all the nutrients it needs. It’s not enough to simply cut out the meat, fish, eggs, or dairy and hope for the best. In fact, if you don’t replace the nutrients in those foods with suitable plant alternatives, you could be putting your health at risk.
I’ve seen many vegetarians or vegans in my clinic who simply rely on cheese or a few nuts or seeds sprinkled over their meals to replace the animal products, without proper thought to creating a balanced meal. Being a “cheese on toast” vegetarian or a vegan who relies on artificial meat products is certainly not a healthy way to go. Yet with a little planning, knowledge and commitment, you can create a very healthy diet focused around plant foods.
One of the problems is that there’s so much information out there about how to follow a non-meat diet, and it can be confusing at times to navigate! So in this article I’ll be focusing on three key areas – protein, essential fats and three of the most important vitamins and minerals you need to be aware of.
Can I get enough protein on a vegetarian or vegan diet?
You certainly can get enough protein on a plant-based diet, and in fact there are a number of vegan and vegetarian endurance athletes and power sportsmen & women who are competing at the top of their game. Clearly, you can thrive on a meat-free diet, but this takes planning and understanding of the different foods you need to incorporate in your diet, especially when it comes to protein.
Protein is a macronutrient needed for so many functions in the body, forming the basic material for all living cells. We need it for healing and repair, blood sugar control and neurotransmitter balance. Protein is made up of amino acids, and there are eight essential amino acids which we have to eat in our diet, because the body simply cannot make them from other amino acids.
Most plant-based foods are considered incomplete proteins because they are low in one or more of these essential amino acids, which affects how much of the protein the body can absorb. Animal proteins on the other hand are complete proteins, because they contain good levels of all the essential amino acids. Yet there are a few complete plant-based proteins as well, which any vegetarian or vegan should be looking to include regularly in their diet. These include quinoa, buckwheat, amaranth and soya. If you’ve never used these proteins before, here are some ideas:
- Quinoa: a really nutty grain, that’s packed with protein, fibre, iron, magnesium and manganese. It’s so healthy that NASA are looking to grow it for space missions! It’s a great alternative to rice – just add half a cup of quinoa per person to 1 cup of boiling water and allow to simmer for about 12 minutes. Take off the heat, put on a lid and let it steam for about 5 minutes. Add lots of fresh mint, coriander, pumpkin seeds and grated vegetables to turn it into tabbouleh. Quinoa is also really nice as a flour, which can be used to add extra protein to baking. You’ll also find lots of cereals, snack bars and crackers containing quinoa; you can also find quinoa flakes to add to porridge.
- Buckwheat: a great gluten-free flour for making blini (small pancakes), the grain (known as buckwheat groats) is also delicious boiled up and used to stuff vegetables and then baked. Also really yummy for breakfast made into a pudding, either by soaking and cooking the groats or the flakes.
- Amaranth: a tiny circular grain that has a nutty flavour – delicious toasted and sprinkled onto salad or made into a breakfast pudding.
- Soya: if you’re using soya products, go as natural as you can, avoiding the regular use of highly processed soya milk and other similar products. However tofu is a great addition to any vegetarian or vegan diet – marinate firm tofu in some chilli, garlic, ginger, sesame oil and soya sauce and stir fry, or use silken tofu for smoothies and desserts.
What other plant proteins can I use?
When the vegetarian movement began to take root in the ‘sixties, it was thought that we needed to eat complete proteins or combine different protein foods at the same meal, to prevent limited essential amino acid from affecting absorption; however, we now know that the body has an amino acid storage pool, meaning we simply need to eat a broad variety of plant proteins across the day (2). So if you’re relying on the same protein source all the time, you may be deficient in some of the essential amino acids. Just a few nuts and you may not be getting enough of the essential amino acid lysine, or if you’re only eating beans and vegetables, you may need more methionine.
Choose a variety of different plant proteins throughout the day, to ensure your body can use and absorb all of the wonderful foods you give it. Here are some to include:
- Beans and pulses: from kidney beans to blackeyed peas, chickpeas to edamame beans, you can use either tinned or dried soaked pulses to add protein to your meals. Great combined with some brown rice or other grain for a complete protein meal.
- Nuts and seeds: as well as being rich in essential vitamins, minerals and fats, nuts and seeds are packed with protein. Throw onto salads, soups, stir fries and breakfasts for a nutritious crunch.
- Wholegrains: we tend to think of grains as our carbohydrate source, but brown rice, quinoa, buckwheat, rye and whole wheat are rich in protein as well. Always choose wholegrains rather than the white variety for extra protein, fibre and essential vitamins and minerals.
- Vegetables: many vegetables are also rich in protein, particularly sweetcorn, avocado, peas, beansprouts, broccoli and asparagus.
Getting enough essential omega-3 fats
Oily fish is one of our main sources of polyunsaturated omega-3 essential fats, which means that if you’re vegetarian or vegan then you need to find your omega-3 fats elsewhere. This is possible, but it does take some planning and consideration to ensure your body can make the best use of the fats you provide.
There are many plant-based sources of omega-3 fats, particularly seeds such as flax or chia seeds, however you need to include a very nutrient-dense diet alongside the seeds, to ensure your body can transform these plant-based omega-3 fats into anti-inflammatory chemicals. This is because plant-based omega-3 fats are short chain, and have to be converted into the longer chain fatty acids which we find in oily fish. These longer chain fats are then converted into chemicals known as prostaglandins, which help to keep our hearts and cardiovascular system healthy, support hormone balance and help to support mental health (3). The conversion from short chain to long chain is a delicate one, and requires good levels of B6, zinc and magnesium, as well as healthy blood sugar control (i.e. avoiding a diet high in white refined grains and sugar).
Sources of plant-based omega-3 fats
Alpha linolenic acid (ALA) is the most common plant-based source of omega-3 essential fat, which is found in flaxseed (also known as linseed), chia seeds and soya, as well as small amounts in other nuts and seeds, and dark green leafy vegetables. Vegetarians and vegans should include a daily source of omega-3 rich seeds; an easy way to do this is to add a tablespoon of ground or soaked flaxseed to your cereal, porridge, soup or salads daily. Chia seeds are also rich in ALA, which are great for making breakfast puddings and desserts. If you’re looking to supplement with omega-3 fats, then echium seed oil is a really good option because it’s longer chain than ALA, meaning it’s got less conversion to go through before reaching the longer chain essential fats.
3 key essential nutrients
Of course, there are many nutrients you need to be aware of when following a vegetarian or vegan diet, but here I’ve focused on 3 of the most common nutrient deficiencies for those on a plant-based diet.
Vitamin B12 is not naturally found in a vegan diet and needs to be either supplemented or consumed in fortified foods. If you do not get enough vitamin B12, you’re leaving yourself open to risk of serious health complications. Long-term low intake of vitamin B12 can lead to neurological damage.
For vegetarians, you’ll find Vitamin B12 in dairy and eggs, with milk providing a very good source of bioavailable vitamin B12 (4). For vegans you’ll need to look for fortified foods such as non-dairy milks, cereals, meat replacements and yeast powders – but do check the labels to see which has B12 added. Most adults should be looking for around 5 to 10mcg per day from their food to prevent deficiency (4).
You can also consider a vitamin B12 supplement – the amount you need depends on your current B12 status, and it may be worth asking your GP to check your B12 levels before you start to supplement. Chewable or sub-lingual supplements are the best option, because they tend to be better absorbed. There is no upper tolerable limit of B12, and you can safely take 500 to 1000mcg every day or couple of days, as we only absorb a very small amount of the vitamin B12 present.
There are many plant foods which are rich in iron. These include dark green leafy vegetables, nuts, seeds, lentils, soya beans, whole wheat, oats, blackstrap molasses, dried apricots, parsley, dark or raw cocoa powder or dark chocolate. There is a lot of debate as to whether the iron from plant foods is as well absorbed as the iron from meat and fish, known as heme iron. Whilst the jury is still out, what you do need to be aware of is that the absorption of non-heme plant-based iron can be affected by phytates, which are commonly high on a plant-based diet (5). Phytates are found in wholegrains, legumes, nuts, seeds and some vegetables and can bind minerals and make them less absorbable. There are a number of ways of helping to release iron from plant-based foods, and these include:
- Fermentation – any food which goes through a fermentation process may help to break down phytates and release the minerals for absorption. This includes sourdough breads, fermented soya such as tempeh and miso, sauerkraut and kimchi.
- Toasting – by toasting nuts and seeds, this can help to break down phytates and release minerals.
- Sprouting and soaking of nuts and seeds may also help to break down phytates.
- Adding vitamin C to your meals can also help to boost the amount of iron that your body can absorb – so whenever you eat foods rich in iron, also include foods rich in vitamin C at the same meal – e.g. berries, red pepper, green leafy vegetables, kiwis.
We also know that the tannins in tea and coffee can bind minerals, particularly iron, so moderate your tea and coffee intake and avoid drinking it with iron-rich meals (6).
For vegans, excluding dairy does remove a valuable calcium source from your diet, so you’ll need to be mindful of ensuring you’re getting enough calcium from elsewhere. Calcium is a vital mineral for your bone health, as well as muscle relaxation and nerve cell transmission.
There are in fact many great sources of plant-based calcium, and these include tofu, oranges, fortified non-dairy milks, chickpeas, sesame seeds, tahini, parsley, blackstrap molasses, dark green leafy vegetables, dried figs and sweet potato. Aim to include at least 5 servings of calcium-rich foods each day and ensure you’re getting enough vitamin D, as your body cannot absorb enough calcium without it.
- Orlich MJ et al., (2013)Vegetarian Dietary Patterns and Mortality in Adventist Health Study, JAMA Internal Medicine. Published online June 3 2013
- Craig WJ et al., (2009) Position of the American Dietetic Association: vegetarian diets, Journal America Dietetic Association, 109 (7): 1266-82.
- Siriwardhana N et al., (2012) Health benefits of n-3 polyunsaturated fatty acids: eicosapentaenoic acid and docosahexaenoic acid, Adv Food Nutr Res.65:211-22.
- Vogiatzoglou A et al., (2009) Dietary sources of vitamin B-12 and their association with plasma vitamin B-12 concentrations in the general population: the Hordaland Homocysteine Study, The American Journal of Clinical Nutrition 89no. 4 1078-1087
- Hurrell RF et al., (1992) Soy protein, phytate, and iron absorption in humans Am J Clin Nutr.56(3):573-8.