Vegan – a Path to Better Health?

Every vegetarian and vegan I know strongly defends their choice to abstain from eating meat and meat byproducts. And, with good reason, they obviously chose this lifestyle because they believe doing so will improve their health. Here’s the rundown on the pluses and minuses of becoming a vegan:

Benefits:
Higher intake of fiber, folic acid, vitamins C & E, potassium, magnesium and many phytochemicals (plant based healthy compounds).
Less saturated fat and cholesterol (beneficial? For some, possibly)
Vegans tend to be thinner, have lower total cholesterol and lower blood pressure reducing their risk of heart disease.
In general, vegetarians typically have lower rates of cardiovascular disease, obesity, type 2 diabetes and some types of cancer.

Drawbacks:
Vegan diets increase the risk of some nutrient deficiencies including vitamins B-12 and D, calcium, omega 3 fatty acids.
Iron and zinc status may be compromised because of the limited bioavailability of these minerals in a vegan diet (compounds in grains, seeds and legumes as well as some other foods and beverages interfere with the absorption of iron and zinc).

Recommendations
Consume B-12 fortified foods such as rice and soy milk and breakfast cereals (check out the Nutrition Facts panel).

Consume calcium-fortified plant foods such as breakfast cereals, fortified beverages, in addition to natural sources such as green leafy vegetables, tofu and tahini.

Consume vitamin D fortified foods.

Eat omega 3 rich vegetarian foods (which contain the omega 3 fat ALA) including flaxseeds, walnuts, canola oil, soy products, hemp seed beverages. Also, consider taking EPA and DHA supplements or eating foods and consuming beverages fortified with these two omega 3 fatty acids.

Click here for references.

Vegetarian? Make Sure You Eat these Key Nutrients!

Vegetarianism is a healthy way of life for many. Some research shows vegetarians live longer, are leaner and their diets include more fiber and disease fighting antioxidants. There are four main categories of vegetarians and a fourth one for those who just don’t want to go all the way: Flexitarians. Here’s a brief description of all of these categories in descending order of how completely they follow a vegetarian diet in addition to what nutrients they need to be especially cognizant of consuming:

Flexitarian – a Flexitarian is someone who is a semi-Vegetarian. They choose vegetarian meals the majority of the time but sometimes fit in poultry or turkey. Most Flexitarians avoid red meat completely. Flexitarians are not really considered vegetarians but, their diet still consists mainly of plant-based foods. For more information, check out this book on the Flexitarian diet.


Pesco-vegetarian – this diet includes fish, eggs and dairy but excludes all meat and poultry. The main nutrient of concern for a pesco-vegetarian is iron. However, if you eat fish, opt for oysters and clams for your heme iron (the most well absorbed type of iron).

Lacto-ovo vegetarian – this person excludes meat, fish and poultry but eats eggs and dairy products. With good planning (and by including eggs and dairy) the lacto-over vegetarian can easily meet most of their nutrient needs (though they may fall short on iron, copper and zinc).

Lacto-vegetarian – meat, poultry, fish and eggs are excluded but milk and milk products (butter, cheese, yogurt) are allowed.

Vegan – this is the most strict type of vegetarian. Vegans exclude all animal flesh as well as eggs and dairy.

The top vegetarian sources of commonly missing nutrients:

Iron – vegetarians who avoid fish need about twice the amount of iron as non-vegetarians. Why? Vegetarian source of iron (non-heme iron) are poorly absorbed so you need more. Choose from fortified cereals, instant oatmeal, soybeans, lentils, beans (kidney, navy, lima, pinto), tofu, spinach, and black-eyed peas. Consume your iron rich foods with a source of vitamin C such as tomatoes and citrus fruits to enhance the absorption of non-iron. You can also cook in an iron skillet (add foods rich in vitamin C to your skillet meal).

Iodine – this forgotten nutrient is found in iodized salt. If you avoid salt, eat kelp.

Calcium & Vitamin D – dairy is your best bet. If you avoid dairy, choose calcium and vitamin D fortified soy or rice milk. Vitamin D insufficiency and deficiency is emerging as a huge issue in all people, vegetarian or not.

Vitamin B 12 – is found in animal flesh and animal products. Therefore, vegans are very likely to fall short on this crucial vitamin and should therefore focus on consuming fortified cereals (check for B12) and fortified tofu or, talk to your physician about taking a supplement.

Zinc – is found mostly in some types of seafood and meat. For vegans, opt for fortified breakfast cereals, cashews, almonds, kidney beans and peas.

Copper – sesame seeds, cashews, crimini mushrooms, cooked soybeans, cooked barley, sunflower seeds, cooked tempeh, garbanzo beans, navy beans.

Omega-3 fats – are mainly found in fatty fish. If you avoid fish, opt for walnuts, soybean oil, flaxseeds, hemp seeds, dark green leafy vegetables and canola oil. These contain the omega-3 fatty acid alpha linolenic acid.

In general, the more you cut out of your diet, the more diligent you must be to ensure an adequate nutrient intake. It can be done, though sometimes not through food alone and therefore supplements are necessary. Vegans, in particular, should consider supplementing with a B complex (which includes B12), iodine rich foods, vitamin D and calcium or consider a multivitamin which will help make up for dietary shortfalls.

What's the Point of a Raw Food Diet?

Every once in a while I pick up US Magazine, People or a similar publication while waiting in line at the grocery store (I know I know, I’m the only person around who isn't glued to facebook mobile). And, I always turn to the sensational (i.e. crazy) stories about how stars got their celebrity bodies. What they report about their diet is pure entertainment for me. Like the actress who said she didn't eat carbohydrates and then listed her daily diet which consisted of, among other things.....fruits and vegetables - both of which are otherwise known as forms of... *gasp* carbohydrate!

But when it came to Raw Food Diets, I pretty much ignored the stories. And then one day, while doing something random (probably driving) I sat there thinking and thinking trying to figure out why someone would take the deep plunge into a raw food diet.

Here are some of the benefits as I see it:
• Enzymes - that doesn't really jive though as our body has the enzymes it needs to break down food during digestion. Next...
• No Acrylamides. Acrylamides are formed during high temperature cooking and may be carcinogenic (cancer-causing) in high doses.
• No heterocyclic amines, carcinogenic compounds formed by cooking meat at high temperatures.
• Loads of fresh fruits and vegetables
• Little prep time

Drawbacks:
• Boring!
• Where’s the protein? If you can load up on fish (including oysters), you’ll get the protein and minerals you are missing if you cut out meat and poultry (zinc, iron, copper). If you don’t eat fish, good luck with many missing nutrients since fortified cereal is… cooked! PS, you need that fish for EPA and DHA (omega 3s) too so, enjoy your sushi!
• No dairy (and therefore little to no calcium or vitamin D – unless you want to eat 10 cups of leafy greens a day to get your calcium and bake in the sun for your vitamin D).

The raw food diet has some perks but some serious drawbacks as well. If a person is doing it solely for health reasons I think it should be a short-term thing. Otherwise, I just don't see the point of living without ever eating a nice chocolate dessert.

It's Time for a Diet Overhaul

You’ve heard about shopping the perimeter of the store. And by now you probably also know that creating a list and sticking to it (regardless of what is on sale) will help you save money by preventing you from buying food you either won’t use or probably shouldn’t be eating. But, have you ever considered taking a close look at your diet and considering if you need a overhaul? Here are some keys to a healthy diet as well as some food groups you should include in your diet (or supplement somehow).

1) Variety – eating a variety of foods increase the likelihood that you will obtain a wide variety of nutrients (vitamin, minerals) and antioxidants.

2) Consider the staples:

a. Dairy – got milk? Or yogurt or cheese? If not, try a calcium fortified soy milk, cheese or yogurt or, consider
supplementing with calcium + D (D especially in the winter in states north of Atlanta, GA).

b. Fruit – are loaded in vitamins, minerals and antioxidants to keep you healthy and functioning in tip-top shape. Most
adults need 2 cups of fruits per day. If you aren’t getting that now, consider adding fresh or frozen fruit to your dishes.

c. Vegetables – like fruit, vegetables pack a nutrient-rich punch. Think variety and different methods of cooking and
preparation. You can choose salads or opt for steamed veggies. Top your pizza with veggies or load your sandwiches,
soups and stews to get the recommended 2.5 cups per day.

*There really is no substitute for not eating fruits and vegetables. So, find ones you enjoy eating and load up (you can eat
more than the recommendations, especially for vegetables).

d. Lean meats & poultry – are your best bet for iron, zinc and ……How much you need really depends on what your
individual needs are but, every single adult should aim for 25-30 grams of protein per meal (yes, that includes
breakfast).

e. Fatty fish – salmon, mackerel, herring, halibut, sardines and anchovies are packed with EPA and DHA, the two fatty acids
that are best for preventing certain risk factors for cardiovascular disease as well as potentially decreasing the risk for
depression in some individuals – notably women and the elderly). How much do you need? I use the American Heart
Association’s recommendations: eat at least
two 3.5 ounce servings of fatty fish every week (after all, cardiovascular disease is the number one cause of death
in men and women in the U.S. as well as many other countries). If you don’t consume fatty fish, add walnuts, flaxseeds
and flaxseed oil to your diet or, talk to your physician about omega 3 supplements.

When you add any of these foods that are missing to your diet, you will force out some of the not so healthy foods that you are eating while adding a variety of nutrients you need for optimal health.

Common Nutrition Pitfalls for Women

In general, there are some patterns I frequently seen in the dietary choices made by men and women. Men typically opt for more meat and starchy carbohydrates (as well as beer) while women tend to have more fruits, vegetables and sweets in their diet. Athlete or not athlete, I help each person balance out their dietary choices while figuring out how to get what they need given their current lifestyle (fast food only, they cook, can’t boil water, tight food budget etc.). With pre-menopausal women, I can scan their diets in just a few minutes and find out that >90% are missing one or more of the following categories: dairy, red meat, fruits or vegetables or fatty fish. Some supplement while the others have no idea just what they are missing out on. So, we do a little dietary juggling to find out if they will or will not eat those foods (those who will just add food make my job easier!). But for women (or men) who avoid any of these categories, we have to find a way to get calcium, vitamin D, magnesium (all from dairy), iron and zinc (red meat) and omega 3 fatty acids (fatty fish).

Got Milk?
The next best thing to dairy is calcium and vitamin D fortified soy milk (yes I know greens contain calcium but you’d have to eat more greens to meet your calcium needs than I have ever seen in the thousands of diet records I’ve looked at). Otherwise, it is important to supplement (it is especially important to supplement with vitamin D in the winter time if you live north of Atlanta, GA).

Where's the Beef?
Red Meat is the absolute best source of dietary iron. If you hate it or watch your food budget, opt for the runner's up: dark turkey and chicken. Plant based sources aren’t absorbed as well but you can maximize your absorption of vegetarian sources of iron if you eat them with vitamin C rich foods and without foods rich in compounds that bind iron. Zinc – oysters, beef and crab are your best bet. If you shun any of these foods, choose a cereal fortified with zinc (it should contain at least 25% of the DV).

Stock the Pond with Fatty Fish
If you avoid fatty fish, opt for walnuts, flaxseeds, flaxseed oil and omega 3 rich soy oil. All of these contain ALA, not EPA and DHA (the two fatty acids with the most research behind them for preventing cardiovascular disease, decreasing depression in some populations and fighting inflammation – and possibly helping athletes return to competition sooner after concusions). But, consuming foods rich in ALA is better than consuming little to no omega 3s at all!

Whatever you do, look for the missing gaps in your diet and fill those with the right foods, the next best choices or, dietary supplements.

Micronutrient Smackdown: The Best Time to Take Your Vitamins and Minerals

When I meet with people for nutrition coaching, I always ask about their medicine and supplement intake in addition to what they are eating. Why? Because I can quickly spot gaps in their diet and want to be sure they are filling those gaps with supplements. Especially if they don't plan on adding food sources of the missing nutrients in the near future. And, I want to be certain they are taking their supplements the right way because many people were never told by their physician (or the supplement bottle doesn’t mention this) how to take a particular mineral.

You see, like sorority girls, minerals are finicky. There are many forms for each one (calcium carbonate, calcium citrate, calcium phosphate for example) and some just don’t like each other (calcium interferes with iron absorption) or certain medications (calcium decreases the absorption of some antibiotics) and others have formed a team and help one another (magnesium and calcium for example). So, how do you know what to take when? Here’s a quick rundown of some of the common ones people need and how to take them:

Multivitamin – take with food and preferably food with a little fat (to enhance the absorption of fat soluble vitamins you need fat in your gut).

Calcium – take up to 600 mg at a time. If your physician told you to take 1,200 total mg/day, take them in two separate doses of 600 mg, spaced apart. Your body only absorbs up to 500-600 mg at a time.

Calcium carbonate – take with food to enhance absorption.
Calcium citrate can be taken at any time of the day.

Magnesium – no single pill multivitamin contains 100% of your magnesium needs per day (it is a very big mineral) and according to population based data, many people don’t consume enough magnesium through their food intake. Diuretics and antibiotics can contribute to magnesium depletion. Magnesium can decrease the absorption of tetracycline (an antibiotic); so take it at a different time of the day. Many antacids and laxatives contain magnesium –be careful consuming these due to the potential for elevated blood magnesium levels. Enteric coating of magnesium supplements can decrease their absorption.

Iron – there are two types of supplements.
Non-heme iron is the most popular (all over the counter kinds of iron unless it says it contains heme iron) and should be taken with vitamin C rich foods, a heme iron source (meat) and not taken close in proximity to calcium containing foods or supplements. In addition, it’s best not to take this with leafy greens or bread as each has compounds that decrease the absorption of non-heme iron.

Heme iron – easy, take anytime of the day. You don’t need to worry about what you take it with or without.

Zinc – taking an iron supplement with large quantities of iron may decrease zinc absorption. According to NIH, taking iron between meals will help (see note above about iron). High intakes of iron can impair absorption of copper.

Potassium – found in very minor amounts in multivitamins. Don’t take extra potassium unless your physician tells you to do so. Having too much or too little potassium can be very serious.

Given that so minerals are picky and like to be treated a certain way, you are probably wondering why you should even bother taking a multivitamin mineral supplement. However, I do believe in multis and take one myself and I supplement with minerals as needed. After all, I try to eat a wide variety of foods but, I realize that there are probably vitamins and minerals I am missing out on.

Nutrition Confessions from a Dietitian

After writing my post the other day, I feel like I have a few nutrition confessions to make. These have weighed on me for some time because people have this perceived notion of dietitians even though we all have different specialties, different food likes and dislikes and very different food habits. So, here goes....my nutrition confessions revealed....

1) I'm a little afraid to try new foods. I am convinced this is a genetic trait as my mom still tells stories about how, at age 4, I picked bacon apart because I hated the "white stuff" and when I was a little older I sat at the table for hours because I wasn't about to put one single pea in my mouth. I've gotten better as an adult but even then, I struggle with the noted sliminess of oysters and mystery food like Cajun Boudin.

2) I don't like red meat. It was my freshman year of college and I had hit a record for fast food joints and all-you-can-eat buffets while on road trips with my college soccer and softball teams. One day after a particularly bad road trip where I didn't play and we lost, I decided, in a rather defiant mood, that I was done with red meat. That McDonald's hamburger was my last. I never liked the taste of red meat, the smell of steak reminds me of an ex-boyfriend whose table manners are trumped by 3 year olds and, I can find my protein, iron, zinc, creatine and B vitamins elsewhere.

3) I am not a foodie. *Gasp* I know, I've heard it before. I'm not totally sure what a foodie is but I imagine it to be the person who thinks about food throughout the day, reads cookbooks for entertainment and can't wait for their next gourmet meal. And, that isn't me. I am, however, fascinated with food as medicine and how food can fuel better performance, mentally and physically. And, I do enjoy the taste of various dishes. But, if you take me to a foreign country, you are more likely to find me wandering around taking in the sights then sitting at a restaurant for hours.

And, despite not being a foodie, I can cook just about anything (and will even cook red meat) and I'm one heck of a baker (or at least I like to think so) because my mom taught all of us how to cook when we were young and by 11 I had free range of the kitchen. Like a chemist in action I'd mix together ingredients, pop them in the oven and wait eagerly for my parents approval of my concoction. As a young teenager I made cinnamon swirl bread from scratch, multi-layered cakes, and infamous fat free muffins that had the consistency of a doorstop. And apparently, I passed my creativity on to my 5 year old niece who helped herself to the cabinets last night and found a strawberry cereal bar which she topped with cake icing and sprinkles. Absolutely brilliant! That's one I never thought of as a child but I see a future baker in the making....

4) I don't care what people eat. Okay, I care if you are a client or family member. But, unlike a dietitian friend of mine who slapped my wrist when I reached for dessert or my uncle who flipped out when I salted my food in front of him, I'm not going to shame you, comment or even pay attention. Eat whatever you'd like. Just don't make silly comments like "oh this is going straight to my hips" or (as overheard in a restaurant) "I really want your corn muffins but I'm trying to avoid carbohydrates, but they are really good, but..." or "I'm eating salad for a week straight after today". Please, for the sake of the people you are dining with, leave your shame and guilt behind and enjoy what you are eating.

So there you have it, I've confessed all of my dietitian sins. I'll cook or bake whatever you'd like but might not try a dish you made (don't be offended) and don't expect me to pay attention or comment on what you are eating. I'm off duty when I'm dining out :)