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Vegetarian nutrition nutritional generalities of vegetarian diets - nutrition vegetarian
One of the most prestigious associations of dietitian-nutritionists in the world, the American Dietetic Association, stated in 1997, and reaffirmed in 20021 that scientific evidence shows that a vegetarian diet reduces the risk of numerous chronic degenerative diseases such as obesity, coronary heart disease, hypertension, diabetes and some cancers. In 2000, the New Zealand Dietetic Association joined the American Dietetic Association and adopted the same position on vegetarian diets and health2.
So, if the vegetarian diet has a clear health advantage3,4,5 , why is vegetarian nutrition viewed by Spanish health personnel, on most occasions, from the point of view of possible deficiencies? A glance at the doctoral theses published in Spain on vegetarianism gives us an idea of how little vegetarianism is rooted in the world of Spanish doctors: from 1976 to date, only 7 doctoral theses have been carried out in Spain on some aspect of vegetarianism. Of these seven, one deals with "Spanish medical naturism and the naturist-vegetarian movement "6 and another with "Intracultural diversity of dietary behavior: the case of vegetarians in present-day urban Catalonia "7, that is, we are left with 5 theses that have evaluated aspects related to nutrition and vegetarianism, in all of them the nutritional advantage went hand in hand with the vegetarian option8,9,10,11,12. However, the idea that prevails in the great majority of our health personnel is to relate a vegetarian diet with a poor, unbalanced, and unvaried diet, which clashes with studies that indicate that vegetarians often have lower morbidity and mortality rates for various chronic degenerative diseases than non-vegetarians13,14,15.
All diets or ways of eating need to be well planned to be nutritionally adequate, and vegetarian diets are no exception. Well-planned vegetarian and vegan diets are appropriate for pregnancy, lactation, infancy1, as well as for sports performance16,17, with the athlete Carl Lewis [vegan] being a clear example18. However, for reasons of space, this article will only briefly discuss some of the most important aspects of the vegetarian diet of a typical adult, leaving the nutritional aspects of other stages of life for later articles.
Protein is needed mainly for the maintenance of our body tissues [muscles, bones, blood cells and other body cells]. Although vegetarian diets have a lower amount of protein than omnivorous diets, and although the protein needs of a vegetarian may be somewhat higher due to the lower quality of some vegetable proteins, the protein intake of both ovo-lacto-vegetarians and vegans seems to be sufficient for health19,20. The available evidence does not support different protein recommendations for non-vegetarians and vegetarians, if the latter consume a mixture of vegetable proteins in their diet21, which is the case for most vegetarians1.
So >is it impossible for a vegetarian to "fall short" of protein? No, it is not impossible, and he could lose muscle mass or decrease his immunity if this were to happen.
To avoid this it is important to:
B12 deficiency is often associated with a vegan diet that is not supplemented with this vitamin. But it is not only strict vegetarians who are at risk of vitamin B12 deficiency. Studies suggest that all types of vegetarian diets [especially in the case of pregnant or lactating women], should include foods fortified with this vitamin, or take vitamin B12 supplements. In theory, milk and eggs could be sufficient, however, if they are not consumed in sufficient quantity, the needs are not covered. Thus, both the B12 levels of ovo-lacto-vegetarians and their dietary intake are often below what is recommended1,22,23. >Does this indicate that the vegetarian diet is unnatural? No, it indicates that we have moved away from the earth, since the earth is the main source of this vitamin, thus, if we lived 300 years ago, our nails, as well as all the food we ate, would have enough B12, but today's hygiene, as well as the massive use of chemicals in agriculture, cause a clear decrease in our intake of this vitamin. Cows have B12 in their muscles because they eat grass and pull up soil debris that contains B12-producing microorganisms [the same ones that produce the B12 in supplements or fortified foods]. They eat those microorganisms that produce it and then it goes into their muscles and liver. But the cow did not manufacture it, it is B12 of bacterial origin24.
For the avoidance of doubt, as Stephen Walsh stated at the last International Vegetarian Congress25, none of the following foods contain B12 usable by our body: tempeh, nori or spirulina algae, Klamath Lake algae, raw food or dirty food. Brenda Davis and Vesanto Melina, two experts in vegetarianism from the American Dietetic Association, go further, and also exclude alfalfa, spinach, mushrooms, arame, wasake and kombu algae, nuts, legumes and fermented soy-derived foods such as tamari or miso, as well as tempeh26. The same opinion is expressed in various sources consulted27,28,29. In the aforementioned document of the last International Vegetarian Congress, it is stated that a weekly supplement containing 2000 micrograms of vitamin B12 [to be chewed] covers the needs. It doesn't seem so difficult, does it?
Recently, the Institute of Medicine in the United States has recommended that all adults over 50 years of age [whether vegetarian or not] should take B12 supplements or foods fortified with this vitamin to cover their needs30.
As stated by the American Dietetic Association, the rates of iron deficiency anemia [iron deficiency anemia] in vegetarians are similar to those of the rest of the population1, but the fact is that the rates of anemia in the population are very high: iron deficiency anemia is possibly the most frequent nutritional deficiency in our country31. To increase the utilization of iron from vegetables, the best strategy [in addition to excluding "junk" foods again] is to take foods rich in vitamin C with the main meals32, that is, to include citrus fruits [oranges, tangerines] or a salad that includes, for example, red or green bell pepper and tomato, or to include cauliflower or broccoli in the meal, which are foods rich in vitamin C33.
Vegetarians and non-vegetarians, according to the World Health Organization34, should take iodized salt [or iodine supplements] to prevent so-called Iodine Deficiency Diseases [IDD]35. One of the nutritional objectives for the Spanish population is that adults should ingest an average of 150 micrograms of iodine per day, according to the Consensus reached by the Spanish Society of Community Nutrition in October 2000, with the sponsorship of the World Health Organization36. 36 These figures are estimated at 90 mcg for children aged 6 years, and 120 mcg for children aged 7 to 10 years37.
The calcium intake of ovo-lacto-vegetarians is comparable or higher than that of non-vegetarians38,39. However, the calcium intake of vegans is generally lower than that of ovo-lacto-vegetarians and non-vegetarians40. The recommendations of the best experts in vegetarian nutrition are that vegans should strive to achieve their recommended intake from food or supplements1,41,42,43 , which in Spanish adults is 800 mg/day44 , which is easy to achieve if foods such as nuts, whole grains, green leafy vegetables, cruciferous vegetables, legumes, oranges are regularly included in the diet and "junk foods" are excluded. It should not be forgotten that calcium-enriched soy shakes and fruit juices are available on the market.
In the next issue we will discuss the most important aspects of the following nutrients [in relation to vegetarian diets]: vitamin D, zinc and omega-3 fatty acids.
