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| Vegetarian Nutrition |
For many one of the largest obstacles to becoming vegetarian (or vegan) is a fear of getting inadequate
amounts of protein (and to a lesser extent, calcium, iron and B-12). In general, we would do well to have a
greater fear of getting too much of a good thing. With the possible exception of pregnant women and
impoverished individuals, western adults (and some children) tend to suffer from excess nutrition--not
malnutrition. For instance, most everyone in this country consumes too much protein--even vegetarians!
Let's look at the nutritional fears. The materials below are exerts from "Position of The American Dietetic
Association: Vegetarian diets" published in the Journal of the ADA, Nov. 1993, Vol. 93, Number 11. It should be
noted that the ADA is one of the most conservative and respected dietary organizations in the world. Medical
and dietary policy is greatly influenced by ADA positions (although meat industry money often has a greater
influence). The ADA report is widely considered to be the most authoritative document on vegetarian nutrition.
Protein
Plant sources of protein alone can provide adequate amounts of the essential and nonessential amino acids,
assuming that dietary protein sources from plants are reasonably varied and that caloric intake is sufficient to
meet energy needs. Whole grains, legumes, vegetables, seeds, and nuts all contain essential and nonessential
amino acids. Conscious combining of these foods within a given meal, as the complementary protein dictum
suggests, is unnecessary. Additionally, soy protein has been shown to be nutritionally equivalent in protein value
to proteins of animal origin and, thus, can serve as the sole source of protein intake if desired.
Although most vegetarian diets meet or exceed the Recommended Dietary Allowances for protein, they often
provide less protein than nonvegetarian diets. This lower protein intake may be associated with better calcium
retention in vegetarians and improved kidney function in individuals with prior kidney damage. Further, lower
protein intakes may result in a lower fat intake with its inherent advantages, because foods high in protein are
frequently high in fat also. Reduced consumption of meat and animal protein has also been associated with
decreased colon cancer in some, but not all, studies of omnivores.
Calcium
Certain plant constituents appear to inhibit the absorption of dietary calcium, but within the context of the total
diet, this effect does not appear to be significant. Calcium from low-oxalate vegetable greens, such as kale, has
been shown to be absorbed as well or better than calcium from cow's milk. Calcium deficiency in vegetarians is
rare, and there is little evidence to show that calcium intakes below the Recommended Dietary Allowance cause
major health problems in the vegetarian population. The relatively high US recommendations for calcium intake,
compared with those for populations consuming a more plant based diet, are designed to compensate for the
calciuric effect of high intakes of animal protein, which are customary in the United States. Studies have shown
that vegetarians, on the other hand, absorb and retain more calcium from foods than do nonvegetarians.
Iron
Vegetarians are not at greater risk of iron deficiency than nonvegetarians, but Western vegetarians generally
have better iron status than those in developing countries. Western vegetarians generally have an adequate
intake of iron from plant products. They also consume greater amounts of ascorbic acid, an important enhancer of
nonheme iron absorption.
B-12
A vegetarian diet that includes animal products such as milk and milk products is unlikely to be deficient in vitamin
B-12. Vegans should include a reliable source [of vitamin B-12] in their diets. Cyanocobalamin, the form of vitamin
B-12 that is physiologically active for human beings, is available from vitamin supplements or fortified foods such
as some commercial breakfast cereals, soy beverages, some brands of nutritional yeast, and other products.
In Western countries where sanitary practices are better than in developing countries where people receive B-12
from microbes and organisms on the surfaces of unwashed fruits or vegetables, the risk of vitamin B-12
deficiency for vegans may be greater. Lack of intrinsic factor in the stomach, rather than diet is the most common
cause of vitamin B-12 deficiency.
Other considerations
A vitamin D supplement may be indicated for vegans if exposure to sunlight is limited. Western vegetarians
usually have satisfactory zinc status. Good plant sources include grains, nuts and legumes.
Infants, children, and adolescents who consume well-planned vegetarian diets can generally meet all of their
nutritional requirements for growth. Calcium, iron, and zinc intakes may deserve special attention, although
intakes are usually adequate when reasonable variety and adequate energy are consumed. Well-planned
vegetarian diets can be adequate for pregnant and lactating women. Vegetarians and nonvegetarians alike are
generally advised to take iron and folic acid supplements during pregnancy, although vegetarians frequently
have greater intakes of those nutrients than do nonvegetarians. For infants, children, adolescents, pregnant
women and lactating women, the ADA generally reiterates the previous information, adds the concern of
sufficient caloric intake for vegan infants and weaning children, and extends sunlight/vitamin D concerns to
certain nonvegetarians as well.
How does the common concern about malnutrition compare to the risk or over-nutrition? Let's use some common
sense by asking: How many people do we know who have died from or suffered from any type of malnutrition?
How many friends, loved ones and acquaintances have we lost from heart disease, stroke, cancer and diabetes?
It's no contest. Again, quoting the ADA: A considerable body of scientific data suggests positive relationships
between vegetarian diets and risk reduction for several chronic degenerative diseases and conditions, including
obesity, coronary artery disease, hypertension, diabetes mellitus, and some types of cancer.
Vegetarians' high intake of complex carbohydrates, which are often relatively high in fiber content, improves
carbohydrate metabolism and may lower basal blood glucose levels. Animal products are devoid of fiber. Fiber
has been shown to be important in the prevention and treatment of certain conditions and diseases.
Vegetarians have lower rates of hypertension and non-insulin-dependent diabetes mellitus than do
nonvegetarians. Vegetarians may be at lower risk for non-insulin-dependent diabetes because they are leaner
than nonvegetarians. Vegetarians, especially vegans, often have weights that are closer to desirable weights
than do nonvegetarians.
Vegetarian diets that are low in animal products are typically lower than nonvegetarian diets in total fat,
saturated fat, and cholesterol, factors associated with reduced risk of coronary artery disease and some forms of
cancer. Dietary differences, especially in vegans, may produce physiologic changes that may inhibit the causal
chain for colon cancer. Lung cancer rates are lower in vegetarians, chiefly because they usually do not smoke,
but possibly also because of diet. Research suggests that vegetarians are also at decreased risk for breast
cancer.
Mortality from coronary artery disease is lower in vegetarians than in nonvegetarians. . . . Studies of vegetarians
indicate that they often have lower mortality rates from several chronic degenerative diseases than do
nonvegetarians.
Vegetarian diets are very safe, have real benefits, and generally require very little planning for maximum health.
In contrast, diets that include meat must include careful, extremely complex planning to reduce the risks of the
most prevalent diseases. Next an overview of essential vitamins, minerals and their source:
Vitamin A: Yellow fruit and vegetables, carrots, peppers, all dairy products including margarine, green leafy
vegetables, dried apricots. Essential for night vision, healthy skin, and growth of bones.
Vitamin B1 (Thiamin): Fortified breakfast cereals, yeast extract, pulses, nuts, wholemeal rice/pasta/bread.
Essential for metabolism of carbohydrates for energy.
Vitamin B2 (Riboflavin): Fortified products, yeast extracts, mushrooms. Helps convert fats, carbohydrates and
proteins into energy.
Vitamin B3 (Niacin): Fortified products, yeast extract, peanuts, wholemeal bread and pasta and brown rice.
Essential for energy production, healthy skin and the nervous system.
Vitamin B6: Breakfast cereals, potatoes, nuts, pulses, avocados, pears. Helps convert protein into energy.
Vitamin B12: Fortified soya milk, fortified nutritional yeast and some breakfast cereals. Essential for red blood
cell formation, growth and a healthy nervous system.
Vitamin C: Citrus fruit and juice, blackcurrants, most green vegetables, potatoes, tomatoes. Essential for healthy
bones, teeth, skin and gums; growth, wound healing, energy production and resistance to infection.
Vitamin D: Appropriate levels of sunlight, fortified soya or rice milk and most dry cereals. Essential for healthy
bones and teeth and for calcium absorption.
Calcium: Calcium-fortified soya and rice milks; orange juice; tofu; dark green leafy vegetables; dried figs; chick
peas. Contributes to strong bones and teeth. Important for blood clotting and muscle contraction.
Calories and fat: Avocados, nuts, seeds, dried fruit and soya products can provide concentrated levels of
calories. Saturated fats nearly always come from animal products. Polyunsaturated fats usually come from plant
sources. Cholesterol is not present in plant foods.
Copper: Wholegrain cereals, wholemeal bread and pasta, dried fruit, pulses, nuts and seeds. Essential for the
functioning of enzymes and nerves.
Fibre: Popcorn, fresh fruit, raw vegetables, nuts, whole grain breads and cereal, fruits and vegetables with
edible skins.
Folic Acid: Potatoes and most vegetables and fruits. Folic acid exists naturally in foods and body tissues in the
form of folates. Folates are members of the B vitamin group.
Iodine: Essential for functioning of thyroid hormones and development of babies in the womb.
Iron: Whole or enriched grains, iron-fortified cereals, green leafy vegetables and dried fruits, bran flakes, chick
peas, spinach, dried fruit, dates, millet, pumpkin seeds, molasses. Essential for transporting oxygenated blood
around the body.
Magnesium: Nuts, seeds, pulses, cheese, yoghurt, wholemeal bread and pasta. Essential for functioning of
muscle, nervous system and enzymes. Helps control calcium balance.
Phosphorus: Wholegrain cereal including wholemeal bread and pasta, brown rice, seeds, nuts and pulses.
Essential for strengthening bones; important for maintaining body's chemical balance.
Protein: Protein needs can be met by eating a variety of plant foods and having an adequate intake of calories.
Foods high in protein include vegetables, grains, soya products, nuts, and dairy products. Grains such as rice,
pasta, breads and cereals provide the same protein.
Potassium: Fruit and fruit juice, potatoes and vegetables. Essential for maintaining sodium balance, functioning
of muscles and nerves.
Selenium: Green and brown lentils, bread, brazil and cashew nuts. Essential for functioning of red blood cells.
Sodium: Salt, yeast extract, cereal products, milk and milk products, salty foods. Essential for maintaining water
balance and the functioning of muscles and nerves.
Zinc: Vegetables, seeds, whole grain products, wheat-germ, nuts, chick peas, pumpkin seed. Essential for
building muscle and for the functioning of enzymes.
Special Notes on Iron:
By Winston Miller
Personal Experience
I should start by saying that I have been a vegan (I do not consume animal products) for approximately 16 years
and a vegetarian for 26. From a personal aspect, I can say that, my iron has been in the "normal" range every
time I have had it tested. Except that is, before I was a vegetarian: Then, I was anemic and required medication.
In more recent years I recall a nurse exclaiming "Boy, you got a lot of iron in your blood." My last iron test
showed it to be right smack in the middle of normal. I have stopped spending money on such tests. I used to
request such tests just to be on the safe side, but would now do so only if I were advised by a physician to do
so (or won the lottery and had nothing better to do with my money). Having said this, I really don't put much
stock in examples--I like major studies.
Surprising Medical Evidence
On the other hand, I AM worried about HIGH levels of iron. There is even some evidence that so- called "normal"
levels of stored iron strongly indicate an increased risk of heart attack. Reported in the 1992 issue of the AHA
journal, Circulation, a study conducted by Jukka T. Salonen, M.D., Ph.D et. al. followed 1,931 men for an average
of 3 years. Every 1% increase in serum ferritin indicated a 4% increase in heart attack risk. Jerome L. Sullivan,
M.D., Ph.D., Director of Clinical Laboratories at the Veterans Affairs Medical Center in Charleston, S.C., whose
comments were published with the study in Circulation, feels that stored iron may be a better risk indicator than
diabetes, cholesterol or blood pressure. This may explain why menstruating women have lower heart disease
risk.
An important question is how should "normal" levels be set. One obvious answer is to get away from the idea
(and unfortunate term) of "normal" and think in terms of "healthiest" or "optimal." Many nutrients appear to have
an extremely wide range of healthy blood levels and/or intake levels; ranges for other nutrients appear to be
more narrow. So, it's important not to fall into the trap of worrying too much about getting "enough." In the
Western diet, we must also worry about getting too much.
It occurs to me that what is optimum in one respect may not be optimum in another. That is, it may be that a
"safe" level of iron with respect to various ailments attributed to low levels, may be an "unsafe" level with
respect to heart disease and other problems. (It may be impossible to be optimally safe in every respect
simultaneously.) In any activity in which we set targets, be they nutritional or otherwise, we recognize that there
are usually competing concerns that must be balanced.
However, I wouldn't stop eating high-iron foods like collards, kale, broccoli (and other dark greens), beans,
seeds and whole grains just yet--some dispute the findings about iron. It may be that iron doesn't help cause
heart attacks; something in common to "normal" iron levels and heart attacks may be causing both. It is also
possible that the study is flawed. In any event, it appears that not everyone has signed on yet to the study's
conclusions.
My hunch, is that recommended intakes will eventually be modified downward--at least for men. However, if
additional studies confirm that "normal" levels of iron are dangerous, you can bet that special interests will try to
block any changes. If I have learned anything in my little bit of volunteer experience in Washington D.C., it is that
things that seem like only an obscure scientific matter (in which you would think no special interest would be
concerned about) can quickly become a political matter subject to almost unbearable special interest pressures.
These special interest pressures (and influences) are not supposed to reach scientific decision makers, but they
do (in the most interesting and intricate ways).
It should be noted that there is another concern about excess iron: hemochromatosis (a genetic disorder, in
which iron levels are greatly elevated). Hemochromatosis affects only one in every 200 to 500 Americans.
(Concerns about arthritis, premature wrinkling, and promotion of free-radicals have also been raised.)
Competing Risks--Real and Imagined
Again, the question seems to be one of competing risks:
*First, we must determine what the risks are. (The iron study should be a significant concern but should be
considered unverified. Therefore, the stated risks of the study must be measured against critical analysis and
downgraded according to any merits of such analysis.)
Next, we must weigh the risks (which vary by age, sex and other status) according to the seriousness of each
risk. The seriousness of the effects of "too-low" iron levels (and the frequency at which these levels produce the
effects) must be weighed against the seriousness of the (yet to be verified) effects associated with "normal"
levels (and the frequency at which these levels produce heart disease--or other problems). I can't claim that this
is reducible to some neat equation, but I believe the concept to be valid. It is not enough to say that "iron
deficiency is a common problem" (as one professional has reported) unless we document the risks associated
with the majority of cases falling into the "iron deficient" category. Again, "iron deficiency" should not be
determined by norms. (By the way, I don't claim that "iron deficiency" status has, in fact, been determined by
norms. However, I am suspicious that norms played a large role based on the poor history of nutritional
standards determination. I would be pleasantly surprised if this were not the case and you can be sure that the
meat industry had an input in the process.)
Now we turn to another concern of competing risks:
Suppose that there was no heart disease risk associated with "normal" levels of iron. And suppose that having
levels of iron slightly below "normal" levels was definitely risky. What is the risk that a vegetarian diet will
actually cause a "deficiency"--that is, an iron level below so-called "normal"? For that question, I would like to
refer the reader to my article, "Authoritative Vegetarian Facts" (published by the East Tennessee Vegetarian
Society. In short, the answer is none.
(Important note: According to the American Dietetic Association, "Vegetarians and nonvegetarians alike are
generally advised to take iron and folic acid supplements during pregnancy, although vegetarians frequently
have greater intakes of those nutrients than do nonvegetarians." Iron is also an issue for small
children--vegetarian and nonvegetarian.)
The meat industry likes to point out that part of the iron found in animal products is in the form of heme iron and
that this type of iron is absorbed better. However, vitamin C (which is consumed in large quantities in vegetarian
diets) can increase absorption of non-heme iron manyfold. Besides, all of the theoretical arguments in the world
cannot change the health statistics of vegetarians--according to the American Dietetic Association, "vegetarians
are not at greater risk or iron deficiency than nonvegetarians."
Again, any increased risk of "deficiency," if it did actually exist (it doesn't), would have to be weighed against the
real risks associated with nonvegetarian diets. Yet, in conversations about vegetarian diets, I often feel like I'm
debating smoking and the other party says "but if you don't smoke, your lungs won't get the same amount of
exercise!" We must keep things in perspective. Although I don't claim that the vegetarian issue is necessarily as
clear-cut as smoking, and I recognize that the analogy is limited, I do feel that people are much more upset by
"unusual" risks than the ones we have grown to accept. By virtue of being common, common killers have become
less frightening. So, we have the situation where people feel that heart attacks and cancer just kind of happen
("you're gonna die sooner or later anyway") but are so very concerned about protein, iron etc. Folks don't stop
to ask:
*What are the chances of suffering from a particular affliction? (For instance I have never heard of a Western
vegetarian or vegan that had a protein deficiency--but so many nonvegetarians are so worried about it.)
*What are the consequences of suffering from an affliction if it did somehow occur? (Do people usually die of iron
or protein "deficiencies"? Do "deficient" individuals tend to live long, normal lives?)
*Does the alleged "deficiency" tend to have early symptoms that can alert one to lessen it's effects (or, in some
cases, allow complete reversal) or is it more like cancer or heart disease in which it's often too late? For example,
do people usually drop dead of iron "deficiency" or do they usually get some kind of warning. And to any extent
that irreversible damage CAN occur, how often and to what extent DOES it actually occur. The scare stories might
look a bit silly when you take a look at this from a statistical vantage.
So, it is clear that the risks alleged by some to be associated with vegetarian diets appear small (or nonexistent)
when placed beside the serious risks associated with nonvegetarian diets.
Practical Considerations
Of course, it is often stated that you can avoid harmful levels of substances without becoming a vegetarian. On
the other hand, I would counter that you can consume everything you need without eating meat. Even if you
have to take a supplement, it appears that a vegetarian diet is safer and more practical--it is relatively easy to
supplement a vegetarian meal, but much more difficult to somehow remove the undesirable components found in
meat. For instance, the vegan diet is a zero-cholesterol diet. Cholesterol consumption is next to impossible to
avoid with diets that include meat. (Note: Your body can manufacture all the cholesterol you need.)
In practical terms, a Western vegan diet (and to a lesser extent, a lacto-ovo vegetarian diet) tends to be low in
fat and high in fiber. A nonvegetarian Western diet tends to be high in fat and low in fiber.
The Bottom Line
In summary, it boils down to this: Nonvegetarians are dying (in large numbers) of cancer, heart disease,
diabetes mellitus and stroke. Vegetarians are dying in lesser numbers of such diseases, do not tend to die (or
even suffer) from protein deficiencies, iron deficiencies or other alleged ailments, and tend to enjoy better health.
As a footnote to this article my son Gaura Gopal (18) plays Rugby for the Katikati school team, plays soccer for
the school team, plays cricket for the school team, and runs long distance in inter-school competitions, and has
finished in the top three or four on several occasions. Recently he was giving blood as he voluntarily likes to do,
and the doctors commented on how high his iron count was. He puts this down to Marmite he's been having on
his toast for the last so many years..... anyway, just something of interest thought to share with you. He's a life
long lacto-vegetarian, having never eaten meat, fish or eggs in his life.
amounts of protein (and to a lesser extent, calcium, iron and B-12). In general, we would do well to have a
greater fear of getting too much of a good thing. With the possible exception of pregnant women and
impoverished individuals, western adults (and some children) tend to suffer from excess nutrition--not
malnutrition. For instance, most everyone in this country consumes too much protein--even vegetarians!
Let's look at the nutritional fears. The materials below are exerts from "Position of The American Dietetic
Association: Vegetarian diets" published in the Journal of the ADA, Nov. 1993, Vol. 93, Number 11. It should be
noted that the ADA is one of the most conservative and respected dietary organizations in the world. Medical
and dietary policy is greatly influenced by ADA positions (although meat industry money often has a greater
influence). The ADA report is widely considered to be the most authoritative document on vegetarian nutrition.
Protein
Plant sources of protein alone can provide adequate amounts of the essential and nonessential amino acids,
assuming that dietary protein sources from plants are reasonably varied and that caloric intake is sufficient to
meet energy needs. Whole grains, legumes, vegetables, seeds, and nuts all contain essential and nonessential
amino acids. Conscious combining of these foods within a given meal, as the complementary protein dictum
suggests, is unnecessary. Additionally, soy protein has been shown to be nutritionally equivalent in protein value
to proteins of animal origin and, thus, can serve as the sole source of protein intake if desired.
Although most vegetarian diets meet or exceed the Recommended Dietary Allowances for protein, they often
provide less protein than nonvegetarian diets. This lower protein intake may be associated with better calcium
retention in vegetarians and improved kidney function in individuals with prior kidney damage. Further, lower
protein intakes may result in a lower fat intake with its inherent advantages, because foods high in protein are
frequently high in fat also. Reduced consumption of meat and animal protein has also been associated with
decreased colon cancer in some, but not all, studies of omnivores.
Calcium
Certain plant constituents appear to inhibit the absorption of dietary calcium, but within the context of the total
diet, this effect does not appear to be significant. Calcium from low-oxalate vegetable greens, such as kale, has
been shown to be absorbed as well or better than calcium from cow's milk. Calcium deficiency in vegetarians is
rare, and there is little evidence to show that calcium intakes below the Recommended Dietary Allowance cause
major health problems in the vegetarian population. The relatively high US recommendations for calcium intake,
compared with those for populations consuming a more plant based diet, are designed to compensate for the
calciuric effect of high intakes of animal protein, which are customary in the United States. Studies have shown
that vegetarians, on the other hand, absorb and retain more calcium from foods than do nonvegetarians.
Iron
Vegetarians are not at greater risk of iron deficiency than nonvegetarians, but Western vegetarians generally
have better iron status than those in developing countries. Western vegetarians generally have an adequate
intake of iron from plant products. They also consume greater amounts of ascorbic acid, an important enhancer of
nonheme iron absorption.
B-12
A vegetarian diet that includes animal products such as milk and milk products is unlikely to be deficient in vitamin
B-12. Vegans should include a reliable source [of vitamin B-12] in their diets. Cyanocobalamin, the form of vitamin
B-12 that is physiologically active for human beings, is available from vitamin supplements or fortified foods such
as some commercial breakfast cereals, soy beverages, some brands of nutritional yeast, and other products.
In Western countries where sanitary practices are better than in developing countries where people receive B-12
from microbes and organisms on the surfaces of unwashed fruits or vegetables, the risk of vitamin B-12
deficiency for vegans may be greater. Lack of intrinsic factor in the stomach, rather than diet is the most common
cause of vitamin B-12 deficiency.
Other considerations
A vitamin D supplement may be indicated for vegans if exposure to sunlight is limited. Western vegetarians
usually have satisfactory zinc status. Good plant sources include grains, nuts and legumes.
Infants, children, and adolescents who consume well-planned vegetarian diets can generally meet all of their
nutritional requirements for growth. Calcium, iron, and zinc intakes may deserve special attention, although
intakes are usually adequate when reasonable variety and adequate energy are consumed. Well-planned
vegetarian diets can be adequate for pregnant and lactating women. Vegetarians and nonvegetarians alike are
generally advised to take iron and folic acid supplements during pregnancy, although vegetarians frequently
have greater intakes of those nutrients than do nonvegetarians. For infants, children, adolescents, pregnant
women and lactating women, the ADA generally reiterates the previous information, adds the concern of
sufficient caloric intake for vegan infants and weaning children, and extends sunlight/vitamin D concerns to
certain nonvegetarians as well.
How does the common concern about malnutrition compare to the risk or over-nutrition? Let's use some common
sense by asking: How many people do we know who have died from or suffered from any type of malnutrition?
How many friends, loved ones and acquaintances have we lost from heart disease, stroke, cancer and diabetes?
It's no contest. Again, quoting the ADA: A considerable body of scientific data suggests positive relationships
between vegetarian diets and risk reduction for several chronic degenerative diseases and conditions, including
obesity, coronary artery disease, hypertension, diabetes mellitus, and some types of cancer.
Vegetarians' high intake of complex carbohydrates, which are often relatively high in fiber content, improves
carbohydrate metabolism and may lower basal blood glucose levels. Animal products are devoid of fiber. Fiber
has been shown to be important in the prevention and treatment of certain conditions and diseases.
Vegetarians have lower rates of hypertension and non-insulin-dependent diabetes mellitus than do
nonvegetarians. Vegetarians may be at lower risk for non-insulin-dependent diabetes because they are leaner
than nonvegetarians. Vegetarians, especially vegans, often have weights that are closer to desirable weights
than do nonvegetarians.
Vegetarian diets that are low in animal products are typically lower than nonvegetarian diets in total fat,
saturated fat, and cholesterol, factors associated with reduced risk of coronary artery disease and some forms of
cancer. Dietary differences, especially in vegans, may produce physiologic changes that may inhibit the causal
chain for colon cancer. Lung cancer rates are lower in vegetarians, chiefly because they usually do not smoke,
but possibly also because of diet. Research suggests that vegetarians are also at decreased risk for breast
cancer.
Mortality from coronary artery disease is lower in vegetarians than in nonvegetarians. . . . Studies of vegetarians
indicate that they often have lower mortality rates from several chronic degenerative diseases than do
nonvegetarians.
Vegetarian diets are very safe, have real benefits, and generally require very little planning for maximum health.
In contrast, diets that include meat must include careful, extremely complex planning to reduce the risks of the
most prevalent diseases. Next an overview of essential vitamins, minerals and their source:
Vitamin A: Yellow fruit and vegetables, carrots, peppers, all dairy products including margarine, green leafy
vegetables, dried apricots. Essential for night vision, healthy skin, and growth of bones.
Vitamin B1 (Thiamin): Fortified breakfast cereals, yeast extract, pulses, nuts, wholemeal rice/pasta/bread.
Essential for metabolism of carbohydrates for energy.
Vitamin B2 (Riboflavin): Fortified products, yeast extracts, mushrooms. Helps convert fats, carbohydrates and
proteins into energy.
Vitamin B3 (Niacin): Fortified products, yeast extract, peanuts, wholemeal bread and pasta and brown rice.
Essential for energy production, healthy skin and the nervous system.
Vitamin B6: Breakfast cereals, potatoes, nuts, pulses, avocados, pears. Helps convert protein into energy.
Vitamin B12: Fortified soya milk, fortified nutritional yeast and some breakfast cereals. Essential for red blood
cell formation, growth and a healthy nervous system.
Vitamin C: Citrus fruit and juice, blackcurrants, most green vegetables, potatoes, tomatoes. Essential for healthy
bones, teeth, skin and gums; growth, wound healing, energy production and resistance to infection.
Vitamin D: Appropriate levels of sunlight, fortified soya or rice milk and most dry cereals. Essential for healthy
bones and teeth and for calcium absorption.
Calcium: Calcium-fortified soya and rice milks; orange juice; tofu; dark green leafy vegetables; dried figs; chick
peas. Contributes to strong bones and teeth. Important for blood clotting and muscle contraction.
Calories and fat: Avocados, nuts, seeds, dried fruit and soya products can provide concentrated levels of
calories. Saturated fats nearly always come from animal products. Polyunsaturated fats usually come from plant
sources. Cholesterol is not present in plant foods.
Copper: Wholegrain cereals, wholemeal bread and pasta, dried fruit, pulses, nuts and seeds. Essential for the
functioning of enzymes and nerves.
Fibre: Popcorn, fresh fruit, raw vegetables, nuts, whole grain breads and cereal, fruits and vegetables with
edible skins.
Folic Acid: Potatoes and most vegetables and fruits. Folic acid exists naturally in foods and body tissues in the
form of folates. Folates are members of the B vitamin group.
Iodine: Essential for functioning of thyroid hormones and development of babies in the womb.
Iron: Whole or enriched grains, iron-fortified cereals, green leafy vegetables and dried fruits, bran flakes, chick
peas, spinach, dried fruit, dates, millet, pumpkin seeds, molasses. Essential for transporting oxygenated blood
around the body.
Magnesium: Nuts, seeds, pulses, cheese, yoghurt, wholemeal bread and pasta. Essential for functioning of
muscle, nervous system and enzymes. Helps control calcium balance.
Phosphorus: Wholegrain cereal including wholemeal bread and pasta, brown rice, seeds, nuts and pulses.
Essential for strengthening bones; important for maintaining body's chemical balance.
Protein: Protein needs can be met by eating a variety of plant foods and having an adequate intake of calories.
Foods high in protein include vegetables, grains, soya products, nuts, and dairy products. Grains such as rice,
pasta, breads and cereals provide the same protein.
Potassium: Fruit and fruit juice, potatoes and vegetables. Essential for maintaining sodium balance, functioning
of muscles and nerves.
Selenium: Green and brown lentils, bread, brazil and cashew nuts. Essential for functioning of red blood cells.
Sodium: Salt, yeast extract, cereal products, milk and milk products, salty foods. Essential for maintaining water
balance and the functioning of muscles and nerves.
Zinc: Vegetables, seeds, whole grain products, wheat-germ, nuts, chick peas, pumpkin seed. Essential for
building muscle and for the functioning of enzymes.
Special Notes on Iron:
By Winston Miller
Personal Experience
I should start by saying that I have been a vegan (I do not consume animal products) for approximately 16 years
and a vegetarian for 26. From a personal aspect, I can say that, my iron has been in the "normal" range every
time I have had it tested. Except that is, before I was a vegetarian: Then, I was anemic and required medication.
In more recent years I recall a nurse exclaiming "Boy, you got a lot of iron in your blood." My last iron test
showed it to be right smack in the middle of normal. I have stopped spending money on such tests. I used to
request such tests just to be on the safe side, but would now do so only if I were advised by a physician to do
so (or won the lottery and had nothing better to do with my money). Having said this, I really don't put much
stock in examples--I like major studies.
Surprising Medical Evidence
On the other hand, I AM worried about HIGH levels of iron. There is even some evidence that so- called "normal"
levels of stored iron strongly indicate an increased risk of heart attack. Reported in the 1992 issue of the AHA
journal, Circulation, a study conducted by Jukka T. Salonen, M.D., Ph.D et. al. followed 1,931 men for an average
of 3 years. Every 1% increase in serum ferritin indicated a 4% increase in heart attack risk. Jerome L. Sullivan,
M.D., Ph.D., Director of Clinical Laboratories at the Veterans Affairs Medical Center in Charleston, S.C., whose
comments were published with the study in Circulation, feels that stored iron may be a better risk indicator than
diabetes, cholesterol or blood pressure. This may explain why menstruating women have lower heart disease
risk.
An important question is how should "normal" levels be set. One obvious answer is to get away from the idea
(and unfortunate term) of "normal" and think in terms of "healthiest" or "optimal." Many nutrients appear to have
an extremely wide range of healthy blood levels and/or intake levels; ranges for other nutrients appear to be
more narrow. So, it's important not to fall into the trap of worrying too much about getting "enough." In the
Western diet, we must also worry about getting too much.
It occurs to me that what is optimum in one respect may not be optimum in another. That is, it may be that a
"safe" level of iron with respect to various ailments attributed to low levels, may be an "unsafe" level with
respect to heart disease and other problems. (It may be impossible to be optimally safe in every respect
simultaneously.) In any activity in which we set targets, be they nutritional or otherwise, we recognize that there
are usually competing concerns that must be balanced.
However, I wouldn't stop eating high-iron foods like collards, kale, broccoli (and other dark greens), beans,
seeds and whole grains just yet--some dispute the findings about iron. It may be that iron doesn't help cause
heart attacks; something in common to "normal" iron levels and heart attacks may be causing both. It is also
possible that the study is flawed. In any event, it appears that not everyone has signed on yet to the study's
conclusions.
My hunch, is that recommended intakes will eventually be modified downward--at least for men. However, if
additional studies confirm that "normal" levels of iron are dangerous, you can bet that special interests will try to
block any changes. If I have learned anything in my little bit of volunteer experience in Washington D.C., it is that
things that seem like only an obscure scientific matter (in which you would think no special interest would be
concerned about) can quickly become a political matter subject to almost unbearable special interest pressures.
These special interest pressures (and influences) are not supposed to reach scientific decision makers, but they
do (in the most interesting and intricate ways).
It should be noted that there is another concern about excess iron: hemochromatosis (a genetic disorder, in
which iron levels are greatly elevated). Hemochromatosis affects only one in every 200 to 500 Americans.
(Concerns about arthritis, premature wrinkling, and promotion of free-radicals have also been raised.)
Competing Risks--Real and Imagined
Again, the question seems to be one of competing risks:
*First, we must determine what the risks are. (The iron study should be a significant concern but should be
considered unverified. Therefore, the stated risks of the study must be measured against critical analysis and
downgraded according to any merits of such analysis.)
Next, we must weigh the risks (which vary by age, sex and other status) according to the seriousness of each
risk. The seriousness of the effects of "too-low" iron levels (and the frequency at which these levels produce the
effects) must be weighed against the seriousness of the (yet to be verified) effects associated with "normal"
levels (and the frequency at which these levels produce heart disease--or other problems). I can't claim that this
is reducible to some neat equation, but I believe the concept to be valid. It is not enough to say that "iron
deficiency is a common problem" (as one professional has reported) unless we document the risks associated
with the majority of cases falling into the "iron deficient" category. Again, "iron deficiency" should not be
determined by norms. (By the way, I don't claim that "iron deficiency" status has, in fact, been determined by
norms. However, I am suspicious that norms played a large role based on the poor history of nutritional
standards determination. I would be pleasantly surprised if this were not the case and you can be sure that the
meat industry had an input in the process.)
Now we turn to another concern of competing risks:
Suppose that there was no heart disease risk associated with "normal" levels of iron. And suppose that having
levels of iron slightly below "normal" levels was definitely risky. What is the risk that a vegetarian diet will
actually cause a "deficiency"--that is, an iron level below so-called "normal"? For that question, I would like to
refer the reader to my article, "Authoritative Vegetarian Facts" (published by the East Tennessee Vegetarian
Society. In short, the answer is none.
(Important note: According to the American Dietetic Association, "Vegetarians and nonvegetarians alike are
generally advised to take iron and folic acid supplements during pregnancy, although vegetarians frequently
have greater intakes of those nutrients than do nonvegetarians." Iron is also an issue for small
children--vegetarian and nonvegetarian.)
The meat industry likes to point out that part of the iron found in animal products is in the form of heme iron and
that this type of iron is absorbed better. However, vitamin C (which is consumed in large quantities in vegetarian
diets) can increase absorption of non-heme iron manyfold. Besides, all of the theoretical arguments in the world
cannot change the health statistics of vegetarians--according to the American Dietetic Association, "vegetarians
are not at greater risk or iron deficiency than nonvegetarians."
Again, any increased risk of "deficiency," if it did actually exist (it doesn't), would have to be weighed against the
real risks associated with nonvegetarian diets. Yet, in conversations about vegetarian diets, I often feel like I'm
debating smoking and the other party says "but if you don't smoke, your lungs won't get the same amount of
exercise!" We must keep things in perspective. Although I don't claim that the vegetarian issue is necessarily as
clear-cut as smoking, and I recognize that the analogy is limited, I do feel that people are much more upset by
"unusual" risks than the ones we have grown to accept. By virtue of being common, common killers have become
less frightening. So, we have the situation where people feel that heart attacks and cancer just kind of happen
("you're gonna die sooner or later anyway") but are so very concerned about protein, iron etc. Folks don't stop
to ask:
*What are the chances of suffering from a particular affliction? (For instance I have never heard of a Western
vegetarian or vegan that had a protein deficiency--but so many nonvegetarians are so worried about it.)
*What are the consequences of suffering from an affliction if it did somehow occur? (Do people usually die of iron
or protein "deficiencies"? Do "deficient" individuals tend to live long, normal lives?)
*Does the alleged "deficiency" tend to have early symptoms that can alert one to lessen it's effects (or, in some
cases, allow complete reversal) or is it more like cancer or heart disease in which it's often too late? For example,
do people usually drop dead of iron "deficiency" or do they usually get some kind of warning. And to any extent
that irreversible damage CAN occur, how often and to what extent DOES it actually occur. The scare stories might
look a bit silly when you take a look at this from a statistical vantage.
So, it is clear that the risks alleged by some to be associated with vegetarian diets appear small (or nonexistent)
when placed beside the serious risks associated with nonvegetarian diets.
Practical Considerations
Of course, it is often stated that you can avoid harmful levels of substances without becoming a vegetarian. On
the other hand, I would counter that you can consume everything you need without eating meat. Even if you
have to take a supplement, it appears that a vegetarian diet is safer and more practical--it is relatively easy to
supplement a vegetarian meal, but much more difficult to somehow remove the undesirable components found in
meat. For instance, the vegan diet is a zero-cholesterol diet. Cholesterol consumption is next to impossible to
avoid with diets that include meat. (Note: Your body can manufacture all the cholesterol you need.)
In practical terms, a Western vegan diet (and to a lesser extent, a lacto-ovo vegetarian diet) tends to be low in
fat and high in fiber. A nonvegetarian Western diet tends to be high in fat and low in fiber.
The Bottom Line
In summary, it boils down to this: Nonvegetarians are dying (in large numbers) of cancer, heart disease,
diabetes mellitus and stroke. Vegetarians are dying in lesser numbers of such diseases, do not tend to die (or
even suffer) from protein deficiencies, iron deficiencies or other alleged ailments, and tend to enjoy better health.
As a footnote to this article my son Gaura Gopal (18) plays Rugby for the Katikati school team, plays soccer for
the school team, plays cricket for the school team, and runs long distance in inter-school competitions, and has
finished in the top three or four on several occasions. Recently he was giving blood as he voluntarily likes to do,
and the doctors commented on how high his iron count was. He puts this down to Marmite he's been having on
his toast for the last so many years..... anyway, just something of interest thought to share with you. He's a life
long lacto-vegetarian, having never eaten meat, fish or eggs in his life.
