Healthy Eating

Vegetarianism

Some people choose to follow a vegetarian diet, which means they eat mostly plant-based foods (grains, fruits, vegetables, legumes, nuts, and seeds). For more information, see the topic Vegetarian Diets.

There are several different forms of vegetarian diets:

• Vegans, or total vegetarians, eat only plant foods. They do not eat red meat, poultry, fish, milk products, eggs, or other foods that come from animals, such as honey and gelatin.
• Lacto-vegetarians include milk products—such as milk, cheese, and yogurt—in their diet.
• Lacto-ovo vegetarians include milk products and eggs in their diets.
• Semi-vegetarians may include poultry and fish in their diets, but they do not eat red meat.

If properly planned, vegetarian diets are healthy and can provide all the nutrients a person needs. As a group, vegetarians have:⁶

• Lower cholesterollevels.
• Lower BMIs (body mass index).
• Less risk of dying from coronary artery disease (CAD).
• Less risk of getting high blood pressure.
• Less risk of getting prostate or colorectal cancer.
• Less risk of getting type 2 diabetes.

When considering a vegetarian diet, many people are concerned that they will not get enough protein. This nutrient is made of building blocks called amino acids. Although the human body can make some of these amino acids, nine of them (the essential amino acids) must be obtained from food. Soy foods and animal sources of protein (milk, eggs, meat, poultry, fish, and seafood) contain all the essential amino acids in the amounts our bodies need.

Most plant foods contain the essential amino acids in varying amounts, so vegetarians need to eat a variety of plant foods to make sure they get enough of all nine essential amino acids. For example, legumes (cooked dried beans, dried peas, and lentils) are low in sulfur-containing amino acids (such as methionine), but they are high in another amino acid called lysine. Grains are just the opposite. So if you eat both foods during the course of a day, you can get all the essential amino acids your body needs.

When the amino acids from two or more foods add up to make a complete protein, those foods are called “complementary proteins.” Examples of complementary proteins are:

• Beans and tortillas.
• Black beans and rice.
• Chili and corn bread.
• Pita bread with hummus (ground garbanzo beans and sesame seed paste).

You do not need to consciously combine these foods at every meal. Eating them throughout the course of a day will provide your body with adequate protein.

Protein is not the only nutrient of concern in a vegetarian diet. Vegetarians also need to make sure they are getting the following nutrients:

• Vitamin B12. Vitamin B12 is found only in foods from animal sources, such as milk, eggs, and meat. Vegans either need to eat foods fortified with vitamin B12 (such as fortified soy milk) or take a supplement that contains vitamin B12.
• Iron. Vegetarian iron sources include cooked dry beans, leafy green vegetables, and iron-fortified grain products. Iron from plant foods is not absorbed as well as iron from meats, so it is important for vegetarians to regularly eat iron-rich foods. Eating foods that contain vitamin C will improve the absorption of iron from a meal.
• Calcium. Vegetarians who do not use milk or milk products need to get calcium from other sources. Soy milk and orange juice fortified with calcium are good sources. Other nonmilk sources of calcium include seeds, nuts, and certain green vegetables.
• Zinc. Zinc from plant foods is poorly absorbed, so it is important for vegetarians to get enough zinc. Good sources of zinc include leavened whole grains (such as whole wheat bread), legumes (beans and lentils), soy foods, and vegetables.
• Vitamin D. Vegetarians who do not use milk or milk products may not get enough vitamin D. But soy milk is often fortified with vitamin D, as are some cereals. Your body can also make vitamin D when exposed to sunlight on a regular basis. Supplements may be needed if you don't consume a source of vitamin D and don't get adequate sunlight.

As a vegetarian, you can still use MyPyramid . Use the following guidelines:

• In the meat and meat substitutes group, use the following as a substitute for 1 oz (28 g) of meat:
  • ¼ cup cooked dry beans, peas, or lentils
  • 1 egg or 2 egg whites
  • ½ oz (1 Tbsp) nuts or seeds
  • ¼ cup tofu or tempeh
  • 1 Tbsp peanut butter
• In the milk and milk products group, use the serving sizes listed in MyPyramid. If you do not use milk, use soy milk fortified with calcium, vitamin D, and vitamin B12. Count 1 cup (8 fl oz) as one serving. Fortified soy cheese or soy yogurt also may be used.

Eat according to the pyramid for the other food groups. Use whole grains as much as possible, and eat at least 1 cup of dark green vegetables each day to help meet your iron needs.

You can fit a vegetarian diet into the dietary guidelines quite easily:

• Eat a variety of foods. Include whole grains and a wide variety of vegetables and fruits. Use soy products, legumes, nuts, and seeds to replace meat and, if desired, dairy products and eggs.
• Choose plenty of grain products, vegetables, and fruits. Use foods closest to their natural state, fresh and unprocessed, and minimize your intake of heavily processed foods.
• Choose foods moderate in fat and low in saturated fat, trans fat, and cholesterol. If you eat animal foods, such as dairy products, choose lower-fat versions of these foods. Try not to use these foods as your main sources of protein, because they may replace plant sources of protein in your diet—such as legumes, nuts, and seeds—which contribute the iron you need.
• Do not restrict dietary fat in children younger than 2 years old. For older children, include some foods that are higher in unsaturated fats (such as nuts, seeds, nut and seed butters, avocado, and vegetable oils, and milk products and eggs, if desired) to help meet their nutrient and energy needs.
• Choose beverages and foods that limit your sugar intake. Minimize your intake of highly sweetened and heavily processed foods.

Vegans need to include a source of vitamin B12 (fortified foods or a supplement) in their diets. They also need to include a source of vitamin D if their exposure to sunlight is limited. People who live in the northern half of the United States do not get enough sun exposure during the winter months.

If you are raising an infant or child to eat a vegetarian diet, consider the following:

• Infants who are consuming only breast milk should have supplements of iron after the age of 4 to 6 months. (This is not necessary if you add iron-fortified infant cereal to the child's diet at this age.)
• If your child does not get much sun exposure, add a food source or a supplement of vitamin D to the child's diet. Most doctors suggest daily vitamin D supplements for children and teens, starting by age 2 months. Talk with your doctor about how much and what sources of vitamin D are right for your child.
• Breast-fed infants of vegan mothers need vitamin B12 supplements if the mother's diet is not fortified.⁶

Organic foods

Organic meat, poultry, eggs, and dairy products come from animals that eat organically grown feed, and they are not given antibiotics or growth hormones. Organic food is produced without using most conventional pesticides, genetic engineering, or radiation, and its production emphasizes using renewable resources and conserving soil and water.

Organic foods are not free of pesticide residues, but they do contain smaller amounts than found in foods that are not organic. Organic foods are an alternative source of foods for those who are concerned about pesticides in foods.

The U.S. Department of Agriculture (USDA) sets guidelines for the production of organic foods and for when the organic-food label can be used.

There is debate over whether organic foods are more nutritious than conventionally produced food, and the USDA makes no claims that organic foods are safer or more nutritious.

For more information, see the topic Organic Foods.

Vitamin and mineral supplements

Certain groups of people need to pay attention to specific nutrients, including:

• Infants and children, who may need supplements such as iron, vitamin D, and fluoride.
• Girls and women, who may need iron, folic acid, and calcium supplements, for example.
• People who are recovering from an accident or an illness, have a chronic disease, or are unable to eat a variety of foods. People with these problems may need a dietary supplement to help meet their nutrition needs.
• People older than 50. Because people older than 50 tend to have trouble absorbing enough vitamin B12, calcium, and vitamin D, it is recommended that they take a supplement or eat more of the foods that contain these nutrients.

Dietary supplements can't make up for poor eating habits. They don't contain all the vitamins, minerals, antioxidants, and phytochemicals found in food. For most healthy people, a balanced diet can provide all the nutrients needed for good health, and supplements are not necessary. Ask a registered dietitian or other health professional whether you need to take vitamin or mineral supplements.

For more information on vitamin and mineral supplements, see the topic Choosing a Vitamin and Mineral Supplement.

Special diets

Conditions for which nutrition plays an important part in treatment include:

• High cholesterol.
• Diabetes.
• Heart failure.
• Coronary artery disease.
• Kidney disease.
• Ulcerative colitis.
• Cystic fibrosis.
• Hypertension (high blood pressure).
• Osteoporosis.
• Food allergies.
• Food intolerances (including lactose intolerance).
• Celiac sprue/gluten intolerance.
• Cancer.

You may get more information about diets for these conditions by contacting a registered dietitian in your area.

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