The aim of this article is to empower vegetarians and vegans with information to increase their quality of life and, quite importantly, to increase their confidence in the choice of diet that they have chosen. In my experience this can be of particular importance when dealing with orthodox practitioners, and also natural therapists to some extent (especially when issues such as the blood type diet, iron deficiency, or protein intake are concerned).

So arm yourself with the following knowledge and become confident in your choice to follow a vegetarian or vegan diet. You might find that you will have to be the educator if you ever have to visit a Doctor’s office, or another health care practitioner (in my experience even naturopaths and chiropractors). This knowledge may be beneficial to other vegetarians who visit your health care provider in the future.

Consider the following quote: “It is the position of the American Dietetic Association and Dietitians of Canada that appropriately planned vegetarian diets are healthful, nutritionally adequate, and provide health benefits in the prevention and treatment of certain diseases”. (J Am Diet Assoc. 2003; 103:748-765). To further prove this, the information below has been compiled based on nutrient concerns that I’ve often heard raised amongst health care practitioners arguing against plant-based diets.

Protein

Protein is considered to be the basic structure of all living things that we know of. We require protein for its amino acids (there are eight amino acids that the adult body doesn’t make, and therefore needs to have supplied). Many people actually consider plant protein to be far more superior to that of animal protein. One reason for this is that plant-based protein lacks the saturated fat that meat contains. Another reason is because it is believed that relying on plants for protein avoids excessive intakes of nitrogen with may be damaging to bone and kidney health.

We need protein for different reasons such as to make body tissues; enzymes; & protein hormones, and to make antibodies and immune system molecules.
Many people mistakenly believe that if you don’t eat meat you won’t get enough protein. The recommended daily intake of protein is 0.5 - 1g per 1kg of body weight daily. Many educated people believe that this figure may actually be less for vegetarians. This figure also varies between individuals and different lifestyles.
It is very easy to eat adequate amounts of protein. Examples of foods that offer generous amounts of protein include tofu, beans (soy beans, mung beans, baked beans, barlotti beans, navy beans, kidney beans), lentils, nuts (cashews, brazil nuts, almonds, peanuts), chick peas, seeds (sunflower seeds, pumpkin seeds, etc.), tempeh, whole grains (quinoa, whole wheat, rye, amaranth, oats millet, barley, buckwheat), brown rice etc.
The once widely held notion of protein combining has (thankfully) become a thing of the Past. Frances Moore Lappe introduced the idea of protein combining in the '70s in her book entitled “Diet for a Small Planet”. The book highlighted the issue of food scarcity and guided people on the path to choose the best diet for their bodies and for our planet.
The guidelines included the theory of combining foods to get the most balanced amount of amino acids in each meal. However in her 10th anniversary revised edition of her book she renounced the protein combining ideal and apologized for giving people the impression that a plant-based diet was in any way inferior to a carnivorous diet.
The American Dietetic Association agrees. In 1193 they released a paper entitled “Position of the American Dietetic Association: Vegetarian Diets (1993)” in which they stated, “Plant sources of protein alone can provide adequate amounts of the essential and nonessential amino adds, 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.”
Thus, it is plain to see that diets based solely on plant foods easily supply the recommended amounts of all the amino acids, and protein combining at each meal is unnecessary. I highlight that food combining is not necessary because I have found it to be a common belief amongst many natural health care providers.

Learn to LOSE WEIGHT the natural way

Iron

Iron is an important mineral for the body. It forms an essential part of haemoglobin (the oxygen carrying part of the blood), assists in energy and stamina levels, prevents iron-deficiency anaemia, and has a role to play in the immune system’s resistance to infections. Iron is particularly important to menstruating women.

The recommended daily intake of iron is approximately 7mg for adult men and 12-16mg for women (of course this varies with factors such as gestation).For vegetarians and vegans it is helpful to know how to maximise iron absorption, especially due to the lowered iron content of many plant foods due to inorganic methods of farming and food processing.

There are two types of iron – haeme iron and non-haeme iron. The form of haem iron is found in meat. A benefit of haeme iron is that it is more efficiently absorbed than non-haeme iron. A disadvantage of haeme iron is that it continues to be stored in the body even if iron stores are already high. As with all things in excess, excessive iron can be a problem just as much as iron deficiency.

The other form - non-haeme iron - appears in plants. Non-haeme iron is generally not as readily absorbed as haeme iron. However studies show that the amount of iron absorption is often proportional to the amount of iron already in an individual’s body. The theory is that if the body’s iron levels are low, the body scavenges the non-haeme iron. Alternatively, if iron levels are satisfactory, the body won’t absorb so much. (This absorption is affected by other dietary factors discussed further on.) So, the absorption of haeme iron appears to decline as iron stores rise in the body, thus preventing very high iron stores on a plant based diet.

Plant sources of iron include spirulina, blackstrap molasses (organic is best), nuts, broccoli, brewers yeast, watercress, celeriac, apricots, dates, kelp, wheat bran and wholemeal bread, lentils and red, blue, purple and black foods such as eggplant, berries and red cabbage.

Bear in mind that organic produce contains far more iron. Consider the iron content of the following vegetables bought from the supermarket as opposed to organic farmers: (measurements are made in mg/kg. From the Nutritional study undertaken by Organic Retailers and Growers Association of Australia 1999. Analysis performed by Australian Government Analytical Labs)

	Supermarket	Organic
Beans	0.6	5
Tomatoes	0.5	5
Capsicum	0.5	5
Silverbeet	1.4	9.4

 

As you can see the difference in the amount of iron is quite significant! This amount is incredibly different with many other nutrients including calcium, potassium, magnesium and zinc for example.

There are many ways in which the absorption of iron is enhanced. In particular, vitamin c and other organic acids such as citric acid, malic acid, tartaric acid, and lactic acid (all found in fruits) all dramatically increase the absorption of non-haeme iron. Hence, fruit and vegetables play a vital role in iron absorption from plant foods and offer other co-factors required to strengthen red blood cells and assist iron in its roles within the body.

There are certain foods and food components that lower iron absorption. This includes certain polyphenols (including tannins). The polyphenols that affect iron absorption can be found in teas (black and oolong and green tea to a much lesser extent), coffee, wines (mainly red wines), chocolate and the herbs guarana and yerba mate. It has been recommended that people drink only limited or no tea and coffee each day to avoid excessive interference with iron absorption.

Some alternatives to tea and coffee can include dandelion tea, rooibos tea, Echo, organic de-caffeinated coffee (water extraction method) and other herbal teas (peppermint, chamomile, ginger, lemon balm etc) and other coffee substitutes.

Furthermore, it is important to remember that caffeine can be found in significant amounts in certain soft drinks.

Phytates can also have an inhibitory affect on iron. Phytates or phytic acid can be found in large quantities in unrefined seeds. They can also be found in grains and legumes. It has been pointed out that humans have the enzyme phytase which breaks down phytic acid in plant foods. For those still concerned though, methods to overcome phytate content can include fermentation, germination and soaking to release the natural phytases from cereal grains or flours which degrade the phytic acid.

Certain proteins are also thought to decrease iron absorption. These include cow milk proteins, egg proteins and soy milk proteins. However, research has been done that indicates that marginally iron deficient individuals will absorb the iron from soy beans. This takes us back to the notion of the body scavenging iron if in need.

The good news is that in a varied plant-based diet with fruit and vegetables being consumed at most meals, absorption enhancers can greatly neutralize the effects of inhibitors. This means that good overall absorption can be maintained and iron stores settle at a healthful level.

Please don’t feel disillusioned if iron levels fall! We live in a society that largely sells inorganic products, encourages stress and encourages poor eating habits and digestion in addition to placing a massive stress on the body through pollution! Hence, one may need to take an iron supplement (a blood test is the best way to confirm this). I have seen many non-vegetarian women who have benefited significantly from iron supplementation also.

When taking an iron supplement, many people find an organic form best (this is stated on labels as being an “iron amino acid chelate”, “ferrous phosphate”, or “ferrous lactate” for example). In nature phosphate seems to be a natural regulator of iron absorption (in balanced doses). These organic forms of iron favour the formation of ferritin, an iron-containing protein that functions in the storage of iron. This means that the iron stores better within the body when using organic forms of iron.

Some organic forms that offer maximum absorption include Spirulina, Ferro Force, Floradix and Floravital. Spirulina is available in tablets, capsules and powder. Other tablet forms of iron include Thompsons Iron, Ethical Nutrients Iron Plus and Nutrimedicine’s iron formula.

Inorganic forms of iron such as ferrous sulphate may cause problems such as constipation, nausea and vomiting. Sometimes it causes diarrhea. It may also encourage a deficiency of vitamins E, A, C, beta-carotene and increase a need for oxygen, vitamin B5, and essential fatty acids. It may also interfere with zinc absorption. In excess this form of iron may poison the mucosal cells by binding to cytoplasmic protein and disrupting cell metabolism.

When taking an iron supplement be sure to take it a few hours away from drinking any tea or coffee and/or taking calcium supplements.

Calcium

The main function of calcium is structural – it assists in bone health and strength. We also require calcium for strengthening teeth, normal communication amongst nerve cells, muscle contraction, blood clotting, and proper parathyroid function. Hence, due to its varied roles within the body it is important to maintain optimal calcium balance within the body. Unfortunately many members of society still think that dairy foods are the sole and best form of calcium. As we will soon discover, this simply isn’t the case!
The following foods all contain calcium: broccoli, fortified plant milks, kale, blackstrap molasses, collards, almonds, figs, apples, cabbage, bok choy, kidney beans, chick peas, papaya, brown rice, beetroot, amaranth, oats, rye, soy beans, watercress, sesame seeds, quinoa, kelp, alfalfa, prunes, , eggplant, fennel, lentils, olives, dates, whole wheat, mung beans, okra and dairy products (from cows, goat etc). Organic forms of these foods contain more calcium than inorganic forms.

Tofu can also be a source of calcium if it is made using calcium chloride or calcium sulphate, and also if the sodium content is relatively low.

Many of these foods further contain nutrients such as magnesium, silica, boron, potassium and vitamin K which can assist in calcium absorption and utilization!

The concept that sodium interferes with calcium absorption is only half true. There are two types of sodium – organic and inorganic. Most people consume inorganic sodium from table salt (sodium chloride). However, it can not be used by the body because the sodium and chloride are held together by ionic bonds. It is this form of salt that studies have shown to increase blood pressure and contribute to other health problems. Much of today’s foods are high in sodium chloride.

Inorganic sodium can interfere with calcium absorption when the body doesn’t have organic sodium available for use as a buffer to acids. If this occurs the body tends to use calcium in place of the organic sodium. Sodium chloride may not be used as a buffer because it isn’t organic. (Sodium chloride can actually cause an increase in acidity which can further deplete calcium).

The other type of sodium (derived from plants) is organic. This form of salt is covalently bonded, meaning that the bonds are easily broken down and the sodium is readily used. The body can use this form of sodium because it has been chelated to a protein molecule. This occurs as the salt passes through the plant kingdom. Hence this form of sodium can be found in fruits and vegetables in abundance.

The moral is to watch the sodium and salt content of foods in order to keep inorganic sodium to a minimum. You can do this by reading labels and checking the salt or sodium content (especially on some canned foods), getting out of the habit of adding salt to meals, eat less fast-foods and when dining at restaurants ask that salt not be added in your meal. Also increase intake of fruit and vegetables.

If you still crave that salty flavour seaweed and sea vegetables taste great (quite salty!) and are high in minerals additional to organic sodium! Because of the high iodine content of sea vegetables, they are best avoided by people with hyperthyroid and Graves Disease.

Lifestyle factors are important. Getting enough sunlight provides Vitamin D which assists calcium absorption and utilisation! Vitamin D works in the intestines to increase calcium absorption, on the bones to increase calcium re-sorption and on the kidney to reduce calcium loss in the urine. It may also be found in sunflower seeds and mushrooms to some extent.

To ensure adequate “intake” of this vitamin it is important to get regular sunlight. At least fifteen minutes per day is advisable (perhaps more in winter). In summer it may be best to avoid the sun between the times when the sun is at its strongest (generally an hour to two hours before and after midday). Despite the winter cold, this may mean an extended trip to the clothesline, eating lunch outdoors when at work, etc. Furthermore, tanning beds offer no assurance of vitamin D as they may not provide enough UVB wavelengths needed to generate vitamin D.

Certain other factors may inhibit absorption of vitamin D from the sun. These include sunscreens of an SPF rating of 8 or higher, mineral oil on the body (e.g. baby oil), and certain medications such as sedatives and tranquilisers. For ladies this may influence the type of make-up worm in winter months (check if there is an SPF factor in foundations). And if people are taking these medications and are concerned, a chat with their health professional will assist in this area.

I highlight the need for vitamin D from sunshine because most forms of supplemental D in Australia are in the form of vitamin D3 (cholecalciferol). In his book Plant Based Nutrition and Health, Stephen Walsh PhD explains that “cholecalciferol is the form generated by the action of sunlight on skin and is commercially produced by exposing wool or skins obtained from slaughterhouses to radiation, or by a more complex synthesis from cholesterol. In all cases the raw material for vitamin D3 production is derived from animals”. (pg 105)

Obviously it would be a personal choice as to whether or not one wishes to consume vitamin D3 in supplemental form. For some the thought of vitamin D being synthesized on animal skin or animal cholesterol, or lanolin from sheep wool may be acceptable (as the animals aren’t killed for their skin in particular), while for others it may not be acceptable. The best thing would be to ring companies if you wish to take a supplement containing vitamin D to find out the method they use and whether or not you feel comfortable taking the supplement.

The balance of protein in the body will also influence calcium absorption. Too high and too low protein can both be bad. If low, this may reduce the rate of repair of bone and muscle. In this instance increased protein may be beneficial for calcium absorption. Alternatively, very high protein intake tends towards calcium loss. Hence, the protein information earlier will assist in promoting a protein balance in the diet.

And once again I will be mentioning caffeine (my apologies to any coffee lovers!). Caffeine actually encourages the kidneys to lose calcium in the urine. As mentioned earlier, caffeine can come in many forms such as coffee, black tea, green tea, softdrinks, “energy” drinks, chocolate etc. So it may be beneficial to avoid these more often (see under iron for a list of tea and coffee alternatives!).

Softdrinks in particular may severely affect calcium absorption. This is not merely because of the high caffeine content in some! They also generally contain excessive amounts of sugar and contain a high phosphoric acid content. Both of these things can affect calcium absorption.

The ratio of calcium to phosphorus in the body is ideally 2:1. When phosphorus is consumed within other foods, the food contains other nutrients as well. Hence the phosphorus is absorbed normally. The problem with softdrinks may well lie in the fact that the phosphoric acid is being consumed without any calcium. This extra phosphorus can bind with calcium and prevent it from being absorbed within the body.

It is also worth mentioning another calcium inhibitor here – Aluminium. This substance can be found in inconspicuous places within our society such as antacids, deodorants, salt, tap water (aluminium sulfate), flour (as a bleaching agent), foil, baking powder, cookware, and some cheeses (used as an emulsifier). Aluminium can bind with calcium and preventing it from use in the body. (It may also interfere with folic acid, potassium, copper and phosphorus content in the body).

It is difficult to avoid consuming aluminium altogether in today’s society. So here are some hints for minimizing aluminium consumption. For those suffering from heartburn there are natural supplements that may be used as an alternative to antacids. These can include products like slippery elm, Fruitin (made by Wagner), and other supplements on the market (especially cleansing programs which may deal with the root of the problem). It is best to check with a health professional for further details.

For those who think they may benefit from taking a calcium supplement, remember it is best taken at night, and away from softdrinks, caffeine-containing beverages and iron supplements. Generally speaking dolomite is not the ideal source of calcium. An ideal calcium supplement will come with other nutrients such as magnesium, silica, boron, potassium etc. Swisse make a good Calcium supplement.

Finally I would like to highlight that dairy products are not necessary for healthy calcium levels within the body! Many studies have also come to this conclusion. For example, the Harvard Nurses’ Health Study, which followed more than 75,000 women for 12 years, showed no protective effect of increased milk consumption on fracture risk. In fact, increased intake of calcium from dairy products was associated with a higher fracture risk. An Australian study showed the same results, while other studies also found no protective effect of dairy calcium on bone (see references for these and other study results).

But why is this? Some reasons that have been put forward include: dairy milk is high in protein which may affect the calcium absorption; it has a calcium to magnesium ratio that doesn’t suit our body’s; doesn’t contain other minerals such as silica, boron etc. that assist in calcium absorption (and if it does, only minor amounts); and the rate of calcium to phosphorus is imbalanced (1.3:1 as compared to human milk being 2.3:1).

For those of you who enjoy drinking dairy milk it would be healthier for both yourself and the dairy cows to opt for biodynamic products, or if this option is unavailable to look for organic products. Jalna makes a tasty biodynamic yoghurt.

(Please note that there is no affiliation between the writer of this article and any brand names mentioned. The brand names are simply listed as examples).

Author:
Eve Adam ND BHSc
(Naturopath)