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Healthy or Hogwash? The Pros and Cons of a Vegetarian Diet

Vegetarian woman holding a muffin and an apple
April 28, 2014 (Updated: August 16, 2018)
Lily Moran

Are you mystified by nutrition news? Confused about what to eat and what to avoid?

If so, you’re like most of my patients – intelligent people who just need a little guidance navigating through an intimidating number of diets, eating plans, and confusing nutrition news.

So today, I’d like to take a look at a question that my patients often ask – what do I think of a vegetarian diet?

I wish I could give a thumbs up or down to questions like these, but the truth is — it’s complicated. Being a vegetarian might seem simple: Don’t eat meat, right? Not so fast. There are a number of different types of vegetarian diets, including, but not limited to:

  • Vegan (no animal products whatsoever, including eggs, dairy, or even honey!)
  • Lacto-vegetarian (eats dairy, but no eggs, meat, poultry, or fish);
  • Lacto-ovo-vegetarian (eats eggs and dairy products, but no meat, poultry, or fish);
  • Pescatarian (eats fish, possibly eggs and dairy, but no meat or poultry);
  • Semi-vegetarian (rarely eats meat, poultry, or fish).

Why Go Vegetarian?

Traditionally, people choose vegetarian diets either because they are concerned about fat in their diet or animal cruelty. Often these days, patients are having second thoughts about: the health of food animals, since the majority are fed unhealthy GMO grains, antibiotics, and growth hormones; food safety, because serious outbreaks of food poisoning often originate in meat; and whether meat belongs in a healthy diet at all, given cholesterol concerns and recent studies linking red meat with cancer.

These are all valid concerns. For some people, a vegetarian diet puts those worries to rest. If you don’t eat meat, you don’t have to wonder about how your food was raised or what bacteria or other toxins are lurking in your hot dog.

Furthermore, there is a substantial amount of research establishing the health benefits of a vegetarian diet.

  • A report published in the prestigious Journal of the American Medical Association Internal Medicine looked at results of a vegetarian diet on more than 73,000 men and women who belong to the Seventh-day Adventist Church, which advocates vegetarianism. The findings showed that, when compared to non-vegetarians, the vegetarians were less likely to die from heart, kidney, or endocrine diseases, as well as other causes;
  • A survey of nearly 70,000 men and women in California found that those who ate a vegetarian diet were least likely to be diagnosed with cancer. In addition, a vegan diet appeared to protect women from cancer of all types, but especially female-specific cancers.
  • Recent research published in the American Journal of Clinical Nutrition found a clear link between a plant-based diet and a reduced risk of breast cancer in a study of more than 90,000 women;
  • A vegetarian diet reduced inflammation of the intestines and resulted in an improved ratio of beneficial gut bacteria, according to a clinical trial in Korea. These improvements translate into less risk of metabolic diseases, such as pre-diabetes.

Add to this list the fact that eating a strict vegan diet has been shown to result in dramatic health improvements in several studies. Researchers have demonstrated, for example, that it’s possible to reverse serious conditions like cardiovascular disease and diabetes by giving up all meat and animal products. Even so, with such a limited menu, the vegan diet is not for everyone.

For people going meatless, I strongly recommend supplementing with vitamin B12 and three grams daily of omega-3 essential fatty acids. These two key nutrients are very difficult to obtain if you’re not eating meat or fish.

In addition, you’ll need to find sources of protein to replace meat. You’ve got choices: fermented, organic soy; nuts; plant-based, vegan cheeses; beans; protein powders; and don’t forget vegetables like peas, broccoli, and spinach. Your total daily protein intake should fall between 10 and 35 percent of your daily calories, according to the prestigious Institute of Medicine’s Food and Nutrition Board. Women should aim for at least 46 grams daily, while men should get a minimum of 56 grams of protein each day.

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 But Where Are the Vegetables?

Here’s the problem: Often, when I look through a vegan patient’s food journal, I find a glaring omission – lots of pasta, rice, chips, and grains. But where are the vegetables?

Typically, these are the patients who are having difficulties losing weight or complain of getting sleepy in the afternoon. No wonder! They’re loading up on simple, high glycemic index carbohydrates – refined grains like white flour, rice, potatoes — which elevate insulin, cause blood sugar problems, and pack on the pounds. Just as importantly, these “pastatarians” are missing out on the incredible array of health-promoting phytochemicals in vegetables and fruit. These thousands of substances perform a wide range of vital health functions.

How Vegetarians Go Wrong  

My patient Brad is a good example of what happens when someone gives up meat but forgets the veggies! Brad was worried about following in the footsteps of his father and older brother, both of whom had developed both cardiovascular heart disease and diabetes in their 40s.

So in his mid-30s, Brad read a magazine article about the health benefits of being a vegetarian and decided he could live without meat if it meant lower cholesterol, triglycerides, and blood sugar.

Brad’s idea of being a vegetarian meant lots of grilled cheese sandwiches, cheesy lasagna, exotic ice creams, and other starchy or sugary foods. About four months into his new diet, Brad came to see me because he wasn’t getting the results he wanted.

“I had a routine physical for work, and the results came back showing my cholesterol at 240 and triglycerides at 300 and A1c at 6.4%,” he said. “My blood sugar is way up, nearly diabetic. And, instead of losing weight, I’m gaining – seven pounds in the last couple of months. The scale just keeps creeping up and I have no idea why or what I’m doing wrong.”

After Brad described a typical day’s meals to me, I explained the problem. All those starches from pasta and bread, plus Brad’s tendency to overdo it with cheese and other dairy products, were ruining his health. I described how to plan meals by starting with vegetables. So in addition to a side salad of mixed greens, cucumber, and avocado, Brad could fill his dinner plate with stir-fried orange broccoli, sautéed cabbage and mushrooms, and a half-cup of black bean stew, instead of a bowl full. Portion sizes matter, people, even for vegetarians!

Months later, I ran into Brad at a hockey game. He was not only thinner, but he reported that a recent blood test showed his cholesterol was well below 200, his triglycerides were 150 and his blood sugar (A1c) had fallen to 5.5%. “I feel great, too,” he added. “Lots of energy, especially now that I don’t have to worry about my health so much anymore.”

In spite of the success stories, I have many patients who can’t imagine a life without meat. They enjoy eating it, and are willing to accept the possible risks. And that’s OK as long as it is really eaten in moderation. It’s up to each individual to choose the diet that works best for him or her. If you do decide to go meatless, remember to eat lots of vegetables and fruits, and avoid the starches and fat.

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