Although most vegetarian diets meet or exceed the Recommended Dietary Allowances13 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.
Plant carbohydrates are usually accompanied by liberal amounts of dietary fiber. This is in
contrast to animal products, which are devoid of fiber. Fiber has been shown to be important in
the prevention and treatment of certain conditions and diseases.
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.
Adequate iron nutriture depends on both the amount of dietary iron consumed and the amount
absorbed. Inhibitors and enhancers affect the absorption of nonheme iron, the form of iron found
in plants. However, inhibitors and enhancers can offset each other when a variety of foods is
consumed. 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. In contrast,
vegetarians in developing countries rely on food staples that are low in iron; consume less
ascorbic acid; and consume more tea, which contains tannin, an inhibitor of iron absorption.
The Recommended Dietary Allowance13 for vitamin B12 is minute. Vitamin B12 is produced by
microorganisms present in the guts or gastrointestinal tracts of animals and human beings, as well
as in dirt on the surface of unwashed plants. Vitamin B12 is found in all animal products; hence,
a pattern that includes animal products such as milk Bacteria produce vitamin B12 in the human
gut, but it appears to be produced beyond the ileum, the site of vitamin B12 absorption in the
intestine14.
Lack of intrinsic factor in the stomach, rather than diet, however, is he most common cause of
vitamin B12 deficiency. Atrophic gastritis, with the consequent bacterial overgrowth of the upper
gut, may also contribute to vitamin B12 deficiency, especially in the elderly. Plants provide no
vitamin B12. In countries where sanitation is poor, vegans may derive vitamin B12 from foods that
are contaminated with microbes, organisms that produce the vitamin, such as on the surfaces of
unwashed fruits or vegetables. In Western countries, however, where sanitary practices are better,
the risk of vitamin B12 deficiency may be far greater.
Vegans should include a reliable source of the vitamin in their diets. Spirulina, seaweed, tempeh,
and other fermented foods are not reliable sources of vitamin B12. As much as 80% to 94% of
the so-called vitamin B12 in these foods, as measured by microbiological assay, may be inactive
analogs. Cyanocobalamin, the form of vitamin B12 that is physiologically active for human
beings, is available from vitamin fortified foods such as some commercial breakfast cereals, soy
beverages, some brands of nutritional yeast, and other products.
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 milk15. Calcium deficiency in vegetarians is rare, and there is little evidence to show
that calcium intakes below the Dietary Allowance13 cause major health problems in the
vegetarian population. The relatively high US recommendations for calcium intake, compared
with those for populations consuming a more basic 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 nonvegetarians16,17.
Zinc is necessary for proper growth and development. Good plant sources include grains, nuts
and legumes. Western vegetarians usually have satisfactory zinc status18.
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 desired12.(table 1 here)
| ©American Dietetic Association Used with permission |
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