Vegetarianism

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Vegetarian — Vitamin B-12 deficient?

Dear Animal Lover,

Vitamin B12 is important in the formation of nerve cells and red blood cells. Natural food sources of the vitamin are found primarily in meat and other animal products, which mean those who stick with a plant-based diet have to find their source elsewhere. Though there are some foods that your friend may want to add to her/his diet, vitamin supplements may also be something to consider. However, because of the serious symptoms and long-term risks involved with B12 deficiency, consulting with a health care provider and/or a registered dietitian may help as well.

Contrary to popular belief that B12 deficiency takes many years to develop, it actually may only take a matter of two to four years to become symptomatic. A recent meta-analysis found that the prevalence rate of B12 deficiency among non-pregnant young adults who followed a vegetarian diet (lacto- or lacto-ovo) was at about 32 percent and among vegans, ( those who eschew all animal products: meat, eggs, dairy, honey, leather, silk, etc.) prevalence was at 43 percent. Symptoms of B12 deficiency include anemia, fatigue, weakness, constipation, loss of appetite, and weight loss. Long-term effects may be neurological changes such as numbness and tingling in the hands and feet. Additional signs of B12 deficiency include difficulty in maintaining balance, depression, confusion, dementia, poor memory, and soreness of the mouth or tongue. But be advised that these can also be symptoms of many different ailments, so having a blood test from a doctor like your friend did can help with diagnosis.

The recommended daily allowance (RDA) of B12 for adults is 2.4 micrograms (µg) and there are actually two forms of B12, active (which the body can actually use) and inactive (a.k.a.,pseudovitamin B12). Now, for the good news: Both vegetarians and vegans have various options for obtaining sufficient amounts of vitamin B12. Some varieties of mushrooms, green and purple nori (seaweed), and some fermented foods like sauerkraut and tempeh (fermented soy beans) are recognized as plant-based sources active B12. Fortified foods like some cereals, soy products, or meat substitutes are options for both vegans and vegetarians. Milk, yogurt, and eggs are rich in vitamin B12 and may also be added to a vegetarian diet. And while it is possible to get sufficient amounts of the vitamin from these sources, many vegans and vegetarians don’t seem to eat enough of these products. As such, it might be a good idea to look into vitamin supplements that contain B12. Due to the low absorption rate of the vitamin through supplements, taking a 250 microgram (µg) dose is recommended. Seeking out the guidance of a registered dietitian may prove helpful for your friend to identify where B12–rich sources can be added in her/his diet.

Happy healthy eating!

Alice

For more information or to make an appointment, check out these recommended resources:

Medical Services (Morningside)

Student Health Services (CUMC)


Becoming a vegetarian — Columbia Health resources?

Dear Future Veggie,

Yes, absolutely! Columbia Health has lots of resources for you as you prepare to make the switch. When planning out a healthy vegetarian diet, it is certainly helpful to have some guidance. Get Balanced! Columbia University's Guide for Healthier Eating provides a ton of great information on making healthy food choices as a vegetarian or vegan. Columbia students can also meet with a registered dietitian through Columbia Health. Before meeting with a professional, it may be helpful to do some background research. Check out the related questions below for a plethora of useful information!

It's a great idea to plan consciously when switching over to a vegetarian diet. Not eating meat can offer many health benefits, as well as addressing environmental and ethical concerns. However, people who make the change without learning about proper nutrition can very easily become deficient in certain nutrients, experience undesired weight gain or loss, and fall into the famous trap of becoming a "pasta" vegetarian who lives on carbs and sweets and not much else.

Have you thought about to what degree of vegetarianism you will pledge? There are many variations on the vegetarian diet, including: lacto-ovo, vegetarians who avoid all meat but eat milk and eggs; pescatarians, who eat fish, and do not eat other types of meat; vegans, who avoid all animal products including milk, eggs, and even honey (produced by bees); raw foodists, who eat only raw fruits, veggies, sprouted nuts and grains; and even fruititarians, who only eat fruits, nuts, and seeds. Wherever you fall on the vegetarian spectrum, here are some general tips on converting to a vegetarian diet:

  • Plan to incorporate into your diet a wide variety of whole grains, fruits, vegetables, legumes, nuts, seeds, vegetable oils, and of course leave room for some decadent delights (think: vegan triple chocolate cake).
  • Ensure that you are eating adequate amounts of non-meat proteins, necessary for long-term sustained energy, and to repair and replace worn-out body cells. High protein veggie foods include beans, nuts (including peanuts and almonds), and milk.
  • Vitamins B-12 and D, calcium, iron, and zinc are other nutrients important to pay attention to, as they are abundantly found in meat, but not as easy to find in plant foods. Some strategizing with a nutritionist or educating yourself about vegetarian sources for these nutrients will help you make sure you're getting enough of these important nutrients.
  • Because vegetarian diets are often high in fiber, remember to drink lots of water to ensure all that roughage is moving through and out of your system efficiently. Six to eight glasses per day is the general recommendation.

When planning a vegetarian diet, it is important to take into consideration a number of variables, such as body size, activity level, health status, and food preferences. But standing behind your ethical beliefs with the food you take in and the industries you support is an admirable and worthwhile undertaking. With the right guidance, education, and support, you could enjoy great health, a happy and clean conscience, and the joy of being an inspiration and teacher for others who wish to join you!

Alice

Vegetarian — Hair loss?

Dear Where's my hair?

You can expect to normally lose between 100-200 strands of hair each day. If your hair is coming out by the handfuls however, you do have cause to worry and should see a physician for a complete medical workup. A large loss of hair can indicate more serious bodily malfunctions. Stress can also be implicated as a cause of hair loss, and if things have been extra stressful for you lately, you might want to see a counselor to help you reduce your stress levels.

If your hair loss is more moderate, you are right that your nutrition and diet have a lot to do with it. Zinc is an important mineral for your hair, and a deficiency would probably show up as excessive hair loss, lack of sheen, and difficulty with control. The Recommended Dietary Allowance (RDA) for zinc in adult men is 11 mg, and for adult women the RDA is 8 mg. A  zinc supplement might help you here, but consult your health provider before starting one. Zinc is found naturally in beans, seeds and nuts, legumes, milk, and wheat bran and germ. Also, in terms of your vegetarianism, you might very well be taking in insufficient levels of vitamin B-12. This is somewhat common among vegetarians, and the results of a deficiency include dandruff, scaling, and hair loss. Most of the naturally occurring B-12 is in animal products, but can also be found in nutritional yeast and sometimes in fermented soy products (i.e. tempeh). For adult women, the RDA for B-12 is 2.4 mcg. For adult men, the RDA is 2.4 mcg. Read Vegetarian — B-12 deficient for more information on vegetarians and B-12 deficiencies.

If updates to your eating plan don't seem to help, perhaps a visit with your health care provider is the next step.  S/he can run some tests to check for a number of other possible options. If you are a Columbia student, you may consider a visit with a Registered Dietitian. Never fear, hope is not lost.  Happy eating and a speedy solution to your concerns.

Alice

How to stop being a vegetarian/start eating meat?

Dear J,

Rejoining the ranks of the omnivorous need not mean you make major shifts in your current vegetarian diet, assuming that your current diet is reasonably well-balanced and contains plenty of fruits, vegetables, and whole grains. Most recommendations about transitioning from a vegetarian diet to one that includes meat suggest slowly adding in easy-to-digest, lean meats, while continuing to eat vegetarian staples.

Fish is an excellent first step. Fish, especially salmon, trout, herring, and sardines (in general, cold-water fish with small bones) is a great source of protein as well as omega-3 fatty acids, and fish isn't as hard for the body to break down and digest as more dense, fattier meats. Choosing the right fish has become trickier as concerns about mercury levels (a toxin), overfishing of wild stocks, and aqua-farming practices increase. Check out the Monterrey Bay Aquarium's Seafood Watch program to learn more about sustainable and healthy choices for getting your fish fix.

Lean meats, such as poultry (white meat and skinless are the leanest poultry choices), lean cuts of beef and pork, and ground meats with the least percentage of fat, are also good sources of protein and iron. These should be at least 90 percent lean. Again, when adding poultry and meats back into your diet, you may want to consider issues of sustainability when buying. Some issues to consider include whether the animals were free-range, raised without hormones or antibiotics, or grass-fed.

Like any meat-eater, you may want to use caution when considering processed meats like ham, sausage, hot dogs, and packaged lunch meats, as they're often loaded with preservatives and sodium. However, if you find a trustworthy brand or deli, these are a convenient and easy way to incorporate meat into your diet once your body has had a while to get used to the leaner meats. Turkey, roast beef, and low-fat varieties of luncheon meats tend to have less fat than bologna or salami. With the addition of meat to your diet comes increased cholesterol and saturated fat. Fatty or red meats, egg yolks, and full-fat dairy are high in both cholesterol and saturated fat. Everyone, not just those transitioning from vegetarianism, should be mindful of how much cholesterol and saturated fat they're consuming.

Finally, just because you are adding meat to your diet, remember that your vegetarian favorites like grains, beans, nuts, seeds, fruits, and vegetables are still an important part of your eating plan. These are all important sources of vitamins, minerals, fibers, proteins, and enzymes. You mentioned that you were a lacto-ovo vegetarian, which means you have been eating eggs and dairy. These animal products are great sources of protein and other nutrients and can be included in your diet along with everything else.

The USDA considers fish, meat, legumes, and beans to be in the same food group. The recommended daily amount one should eat from this group depends on age, sex, and level of physical activity; however, typically a serving from the protein group is 3 to 4 ounces. As you can see, meat doesn't need to be eaten in huge portions to meet your protein requirements and, you don't need to eat it every day. Making the change to an omnivorous diet slowly, with continued use of the vegetarian foods you were accustomed to eating, can help avoid shocking your system with a sudden onslaught of new foods.

Columbia students who would like more nutrition guidance can make an appointment with a Registered Dietician by calling Medical Services (Morningside campus) or the Student Health Center (CUMC campus). Enjoy the vast array of new options you have in meal planning and restaurant choices, and don't forget to eat your vegetables, even in the midst of meat-eating bliss!

Alice

Fish-less omega-3 fatty acids

Dear Reader,

Yes, there certainly are! Good sources include:

  • Canola and olive oils.
  • Walnuts.
  • Ground flaxseed.
  • Tofu.
  • Leafy green veggies.

There are three main types of omega-3s. Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are mainly found in fish, whereas alpha-linolenic acid (ALA) is found elsewhere. Good sources of ALA include vegetable oils (such as soybean or canola), nuts (especially walnuts), flax seeds and flaxseed oil, and leafy vegetables (like kale, spinach, and Brussels sprouts). You could try adding some walnuts and flaxseed into your oatmeal, yogurt, or smoothie, and use vegetable oil for cooking or in a salad dressing to top off a leafy veggie. Try using canola oil to make a vegetable stir fry with tofu. Tahini, which is made with sesame seeds, is a great source of omega-3s and can be used to make sauces and dips, such as hummus. For more information about nutrition, check out the Get Balanced Guide to Healthier Eating as well as the Alice! Health Promotion Nutrition Initiatives.

Omega-3s fatty acids are polyunsaturated fatty acids that your body needs for numerous body functions, such as controlling blood clotting and normal brain function. Omega-3s have been shown to help prevent heart disease and possibly stroke, may help control lupus, eczema, and rheumatoid arthritis due to anti-inflammatory properties, and could be protective against certain types of cancer and other conditions.

There is some debate on whether sources of ALA carry the same benefits as fish sources of EPA and DHA. The body converts ALA into EPA and DHA, but not everyone’s body does this well. If you’re not averse to making an exception to your vegetarianism for fish oil, you can consider taking a fish oil supplement and might want to speak with your health provider or a nutritionist before doing so. For questions about your specific individual nutritional needs, Columbia students can make an appointment with Medical Services on the Morningside Campus or Student Health at the Medical Center to speak with a healthcare provider or nutritionist.

Happy eating!

Alice

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