Diet Planning Guide: Vegan and Vegetarian Diets

Author: Riley Thornton, RDN

Registered Dietitian and Wellness Specialist, Employee Wellness Department, University of Alabama at Birmingham.

Citation: Thornton R. Diet planning guide: vegan and vegetarian diets [Published online April 29, 2019]. Nutrition411.

People who follow vegetarian, vegan, and similar plant-based diets have decreased risks of certain health conditions, including cardiovascular disease, type 2 diabetes, hypertension, certain types of cancer, and obesity. For this reason, incorporating plant-based foods into the diet can generally be very beneficial for patients.

Although plant-based diets can be healthful and nutritionally adequate throughout the lifespan, it is important for dietitians to get a full picture of patients’ medical history and eating behaviors to ensure there are no underlying vitamin, mineral, or protein deficiencies that need to be addressed.

Dietitians whose patients adhere to these diets should ensure their patients are consuming adequate amounts of proteins through a variety of different foods each day to meet the body’s amino acid needs. Foods containing soy, along with a number of other fortified foods, are great sources of plant-based protein and should be incorporated in the diet when possible.

In addition, vitamins and minerals that are found in low amounts in plant-based foods, such as vitamin B12, vitamin D, calcium, iron, zinc, iodine, and some omega-3 fatty acids, should be appropriately taken into account. In some cases, especially in the context of vegan diets, patients may need to take supplements.

A strict vegan or vegetarian diet is not necessarily warranted for any particular subgroup of patients, but it can be beneficial to promote plant-based eating patterns like those in vegan and vegetarian diets in the general population. It is up to the dietitian to determine what is best for each patient and ensure that a patient’s diet adequately meet their nutritional needs.

Patients with irritable bowel syndrome or celiac disease, among other conditions, who follow vegan or vegetarian diets would especially benefit from counseling on their food choices. In these contexts, it is important to ensure that patients are obtaining sufficient amounts of daily vitamins, minerals, and nutrients without disrupting or creating any additional symptoms.

As the Academy of Nutrition and Dietetics has stated in their position paper on vegan and vegetarian diets, these types of diets can be nutritionally adequate when planned appropriately with the aid of a dietitian. I would recommend dietitians to look to this position paper for guidance on the benefits of plant-based diets and how to properly incorporate them into a patient’s daily eating patterns.¹

Diet Planning Guide: Vegan and Vegetarian Options

Below are some options that may benefit patients who opt for vegan, vegetarian, or similar plant-based diets. Again, dietitians should consider a patient’s full medical history before creating a diet plan that is right for them.

Foods to Encourage:

Legumes: Try cooked dried beans, peas, peanuts/peanut butter, lentils, tofu, soymilk, or edamame.

• Legumes can be a great source of protein and zinc for vegetarians and vegans. Vegans in particular should consider incorporating even more legumes in their diet to ensure they are meeting all of their amino acid needs throughout the day.

Dark leafy greens: Try kale, mustard greens, broccoli, or collards.

• These cruciferous vegetables contain calcium, with some having better absorption rates than cow’s milk.

Healthy fats: Encourage canola oil, walnuts, and flaxseed. Supplementing to meet DHA and EPA needs may be considered.

Vitamin/Mineral Sources to Consider:

Iron/Vitamin C: To ensure adequate iron absorption, ensure your patients are also consuming vitamin C at most to all meals. Encourage fruits such as oranges, strawberries, or vegetables such as broccoli, peppers or tomatoes.

Vitamin B12: This vitamin is especially important to consider for vegans. Some fortified foods include non-dairy milks, meat substitutes, and breakfast cereals.

• Supplement when needed: Vegans especially will need to consider vitamin B12 supplementation if fortified food intake is not meeting their needs. Depending on a patient’s current intake, dietitians should encourage incorporating a daily B12 supplement. Vegetarians should be screened for B12 deficiency and consider daily or weekly supplementation.

In summary, legumes, non-dairy milks (or other products), whole grains, a variety of fruits and vegetables (often dark leafy greens), nuts, seeds, and healthy vegetable oils should be incorporated daily into a vegan or vegetarian’s eating pattern.

This is not a full list of all considerations, but a few to be mindful of. Talking with your patients and understanding their full eating pattern and medical history will guide your recommendations for meeting all of their nutritional needs.

Additionally, for dietitians working with vegetarian/vegan populations, the Vegetarian Nutrition Practice Group of the Academy of Nutrition and Dietetics is a great resource with recommendations, best-practice and evidence to help guide your patients.²

References:

1. Position of the Academy of Nutrition and Dietetics: vegetarian diets. J Am Acad Nutr Diet. 2016;116(12). doi:10.1016/j.jand.2016.09.025.

2. Vegetarian nutrition. A dietetic practice group of the Academy of Nutrition and Dietetics. https://vndpg.org/. Accessed on April 26, 2019.