V is for Vegan/Vegetarian

Jolene Wolf, MPH, RD, LD, CDE

Clinical Dietitian
Mary Greeley Medical Center
Vegetarian Diets Continue to Increase in
Popularity
 3% of Americans are full-time vegetarians
 37% say they always or sometimes eat vegetarian when dining out
 20% are likely to look for a restaurant which serves some vegetarian items
What is a vegetarian diet?

 Lacto-vegetarian – excludes meat, fish, poultry, eggs; includes dairy

 Ovo-vegetarian – excludes meat, fish, poultry, dairy; includes eggs
 Lacto-ovo vegetarian–excludes meat, fish, poultry;includes dairy, eggs
 Pescatarian – excludes meat, poultry, dairy, eggs; includes fish
 Vegan – excludes meat, poultry, fish, eggs, dairy, honey

 Flexitarian – a semivegetarian diet; primarily plant-based but includes animal products on

occasion or in small amounts
Why choose a vegetarian diet?

 Health benefits
 Weight loss
 Religious/moral/ethical reasons
 Environmental motivation
Health Benefits

 Top reason for choosing vegetarian

 Heart health
 Healthier plant-based foods=25% lower chance of heart disease
 Unhealthy plant foods=32% higher chance of heart disease
 Diabetes
 Healthy plant foods diet=34% decreased risk of diabetes
 Less healthy plant food diet=16% higher risk of diabetes

Eating more healthy plant foods while NOT cutting out meat still has benefits for heart health and for
avoiding diabetes.
“Twinkie” Vegetarian

 Vegan/vegetarian diets are NOT automatically healthy

 Limit refined carbs
 Emphasize whole grains, whole fruits/vegetables and nuts
Weight Loss

 Vegetarian diets don’t automatically result in weight loss

 Tend to be lower in calories and higher in fiber=feel full on less cals
 Replacing meat with cheese and nuts could even increase calories
 Many vegetarians avoid alcohol, caffeine, & tobacco and exercise regularly-helps control
weight
Cancer Risk

 Processed meat
 How you cook your meat
 AICR promotes a plant based diet
 Phytochemicals
 Pooled data from 2 Oxford studies showed fish eaters had a lower risk of certain cancers
than vegetarians
 Studies comparing caner rates in vegetarians and nonvegetarians have shown inconsistent
results
Other Vegetarian Health Factors

 Study in JAMA suggests a vegetarian diet may be just as effective as statin drugs in
lowering cholesterol
 Was low fat
 Included soy, nuts, margarines with plant sterols, high fiber grains, plenty of fruits and vegetables
Are there downsides to vegetarian diets?

 Mood problems?
 No cause and effect link to mental problems and vegetarian diets
 Hair loss?
 Meat contains protein, iron, vitamin B and zinc-all important for hair growth
How to Follow a Vegetarian Diet

 Choose a variety of healthy plant-based foods

 Whole fruits and vegetables
 Legumes and nuts
 Whole grains
 Cut back on less healthy choices
 Sugar sweetened beverages
 Fruit juices
 Refined grains
Healthy Vegetarian Eating Pattern
(servings for a 2000 cal/day diet)
Vegetables 2-1/2 cups a day
Dark green 1-1/2 cups a week
Red and orange 5-1/2 cups a week
Legumes 1-1/2 cups a week
Starchy 5 cups a week
Other 4 cups a week
Grains 6-1/2 ounces a day

Whole grains >3-1/2 ounces a day

Refined grains <3 ounces a day

Protein foods 3-1/2 ounces a day
Eggs 3 ounces a week
Legumes 6 cups a week
Soy products 7 ounces a week
Nuts and seeds 8 ounces a week
Fruits 2 cups a day
Dairy 3 cups a day
Added sugars, solid fats, added refined No more than 290 calories a day (15% of
starches total calories)
Oils 27 grams a day
Challenging Nutrients

 The more restrictive the diet, the more challenging to get all the nutrients needed
 Vegan diets eliminate natural food sources of B12
 Vegan diets eliminate dairy which contains calcium
 Pay special attention to the following nutrients:
 Calcium, vitamin D
 Vitamin B-12
 Protein
 Omega-3 fatty acids
 Iron, zinc, iodine
Calcium and Vitamin D

 Calcium helps build/maintain strong teeth and bones

 Milk and dairy foods are highest in calcium
 Dark green vegetables are good plant sources
 Calcium-enriched and fortified products are other options
 Vitamin D also plays a role in bone health
 Vitamin D is added to cow’s milk, some brands of soy and rice milk, and some cereals and
margarines
 Check food labels
 Low fortified food intake and limited sun exposure=may need plant derived vitamin D
supplement
Vitamin B-12

 Necessary to produce red blood cells and prevent anemia

 Found almost exclusively in animal products
 May go undetected because high folate masks deficiency till severe problems occur
 Vegans should consider:
 B-12 supplements
 Enriched cereals
 Fortified soy products
Protein

 Helps maintain healthy skin, bones, muscles, organs

 Eggs and dairy are good sources
 Plant foods provide sufficient protein if you eat a variety through day
 Soy products and meat substitutes
 Legumes
 Lentils
 Nuts
 Seeds
 Whole grains
Omega-3 Fatty Acids

 Important for heart health

 Diets low in fish and eggs are low in active forms of Omega-3 Fas
 Canola and soy oils, walnuts, ground flaxseed, soybeans are good sources of essential Fas
 Conversion of plant-based Omega-3 is inefficient
 Vegans should consider fortified products, supplements, or both
Iron

 Iron is a crucial component of RBCs

 Sources include legumes, lentils, enriched cereals, whole grains, dark leafy greens, dried
fruits
 Not as easily absorbed from plant sources
 Recommended intake for vegetarians almost double that of non-vegetarians
 To aid absorption, eat foods rich in vitamin C at the same time
 Strawberries, citrus, tomatoes, cabbage and broccoli
Zinc

 Essential component of many enzymes

 Plays a role in cell division
 And formation of proteins
 Not as easily absorbed from plant sources
 Cheese is a good option if you eat dairy
 Plant sources include whole grains, soy, legumes, nuts, wheat germ
Iodine

 Component in thyroid hormones

 Help regulate metabolism, growth and function of key organs
 Vegans may not get enough
 May be at risk of deficiency and goiter
 Foods such as soybeans, cruciferous vegetables and sweet potatoes may promote a goiter
 ¼ teaspoon of iodized salt per day provides a significant amount of iodine
Common Questions

 Do I have to start over totally?

 Will changes cost me more?
 Will this take more time?
 Why do I have to do this?
Tips for Introducing Vegetarian Food Into
Institutions
 Easiest way to meet needs of different categories of customers is to offer vegan menu
items
 Start with minor changes to existing menu
 Changes should be easy to implement
 Begin with changes that do not involve excessive staff time/training or equipment purchases
 Cost of new menu items should be equal to or less than existing
 Potential cost savings of vegetarian options can be a selling point to administrators
Simple Modifications to an Existing Menu

 Examine the existing menu

 Are there already vegetarian items?
 Baked potatoes
 Salads
 Breads
 Soup (no chicken or beef broth)
 Mac and cheese/meatless lasagna/pizza
 Indicate by a special marking on the menu, an info card at POS, or by posting a separate
vegetarian menu
Simple Modifications to an Existing Menu

 Make a vegetarian soup a daily menu item

 Offer a meatless prepared salad (bean or grain) every day
 Consider adding a salad bar
 Offer cooked pasta or a baked potato every day
 If a selection of hot entrees is offered each day, make one of them meatless
 Have nondairy milks available
 Keep a good supply of fresh fruit available at all times
Simple Modification of Existing Recipes

 Many soups can be made vegetarian by changing from meat-based stock to a vegetable
stock.
 Replace meat stock with vegetable stock in pilaf, other grain dishes, sauces
 Lasagna can be prepared with a meatless sauce with vegetable subs
 When preparing spaghetti or pasta sauce, prepare part w/o meat
 Use vegetable oil instead of animal fat for frying/sautéing
 Prepare or purchase baked goods with vegetable instead of animal fat
Simple Modifications of Existing Recipes

 Prepare or purchase yeast breads without eggs or dairy

 Milk can be replaced with soy milk, rice milk, or with water in most recipes
 Buttermilk can be replaced with soured soy milk or rice milk (use 1 cup soy milk plus 1
Tbsp of vinegar)
 Crumbled tofu can be substituted for cottage cheese or ricotta cheese in recipes
 Offer vegetarian beans, chili beans, refried beans w/o lard
Simple Modifications of Existing Recipes

 Over 60 varieties of nonmeat burger patties exist to sub for hamburgers

 Vegetarian hot dogs are also available
 To produce a chewier, meatier tofu, freeze it for 3 days, thaw, squeeze out water, and
crumble
 Add bulgur to the beans in tacos, chili, etc. if you want less beans
 See handout for more tips
Typical Entrees with Vegetarian Alternatives

 Chicken fajitas/Tofu fajitas (use Lawry’s Fajita Seasoning)

 Beef or chicken tacos/Bean or Bean and Nut-Seed tacos
 Spaghetti with meat sauce/Spaghetti with marinara sauce
 Lean beef or chicken patty on bun/ADM Burger patties (dry mix)
 Chicken gyros with Tzatziki sauce in pita/ADM taco filling in pita with sauce
 Ground beef or turkey lasagna/lasagna with meatless sauce
 Stromboli sandwich with turkey, ham, mozzarella/Vegetable Stromboli sandwich with
mozzarella, sliced tomato, sliced black olives
 Beef and cheese egg rolls/La Choy vegetable egg rolls with almonds (these are vegan)
Breakfast Substitutions

 Eggs – scrambled tofu

 Crumble tofu, add spices, turmeric or curry for color
 Pancakes
 Use soy milk or water in place of dairy milk
 If you eliminate eggs, increase the baking powder and add lemon jc or vinegar
 French Toast – blend soy milk and banana to use as dipping batter
 Cold Cereal
 Hot Cereal
Breakfast Substitutions

 Polenta – Fry on a griddle, serve with applesauce

 Juices
 Bread
 Be sure ingredients don’t list animal fat
 If catering to vegans, no eggs, whey, casein or other dairy products
 Bagels – serve with jam or bananas instead of cream cheese
 Fresh fruit
Quantity Recipes

 Vegan in Volume by Nancy Berkhoff

https://
www.vrg.org/catalog/index.php?main_page=product_info&cPat
h=1&products_id=10
Fast, Lower Budget Vegan Menu Items

 Three-Bean Tamale Pie

Alternate three types of cooked beans with salsa, top with prepared vegan cornbread mix, and
bake. Optionally, substitute mashed potatoes for the cornbread.
Chili Sauté

 Add chopped bell peppers, onions, and garlic to three or four bean chili and sauté or bake.
Serve over steamed rice, vegetarian cornbread, or mashed potatoes.
Veggie Shepherd’s Pie

 Top vegetable stew – a mix of carrots, celery, onions, and mushrooms or mixed vegetables
combined with cooked beans – with prepared mashed potatoes and bake.
Pasta Bake

 Combine cooked pasta with tomato sauce, chopped tomatoes, and diced mushrooms.
Season with ground basil and oregano and bake.
Lentil Stew

 Combine cooked lentils with cooked, quartered steamed potatoes; cooked carrot slices;
diced celery; and chopped tomatoes. Season with pepper and dill, and simmer until ready
to serve.
Veggie-Size

 Serve veggie burgers topped with vegetarian chili and chopped veggies. Serve on a
hamburger bun or toasted bread.
Burrito Wrap

 Fill a large tortilla with mashed beans, sliced chilies, chopped tomatoes or salsa, and sliced
onions. Heat in the oven or microwave and serve hot.
References

 Mayoclinic.org
 Webmd.com
 Vrg.org
 Eatright.org
 Health.Harvard.edu
 MD Anderson Cancer Center
 Dietary Guidelines for Americans