Keeping Healthy on a Vegetarian Diet

When you are a vegetarian, you will be well accustomed to being asked “but where do you get your protein?”. Fortunately, it is not all that difficult to consume sufficient protein on a vegetarian diet. However, protein is not the whole story, and vegetarians must also ensure they are getting all of the vitamins and minerals that they need to keep healthy and thrive.

Vegetarians should strive to eat a good variety of protein-rich foods to ensure the right balance of amino acids. Amino acids are the building blocks of protein. Your body needs 20 different amino acids to function properly, 9 of which - the “essential” amino acids - can only be obtained from food. Whilst plant foods do contain all 20 amino acids, the proportion of these amino acids is less optimal than in animal proteins. As a result, to get sufficient protein from plant-based sources, it is very important to eat as wide a range as possible of protein-rich foods, including legumes, pulses, nuts, and grains. Quinoa and edamame get a special mention for their optimal protein content. And of course, dairy and eggs are fantastic sources of protein.

However, in my clinical experience I have found that vitamin and mineral deficiencies are more of an issue for vegetarians than protein deficiency. The following are particularly significant:

• Vitamin B12: this is found in dairy foods and eggs, but on a purely plant-based diet will almost certainly need to be supplemented. Vitamin B12 is important for nerve and brain function, and a deficiency may lead to fatigue, headaches and even depression.
• Vitamin D: most of us in the Northern Hemisphere have low vitamin D levels, and vegetarians may be particularly vulnerable as the best food sources are in animal proteins. Vitamin D is important for the immune system, and supplementation is highly recommended.
• Iron: fortunately, iron can be found in plant foods such as leafy green vegetables, beans and seeds, which should all be included in a vegetarian diet. Iron is important for the production of red blood cells, which are required to transport oxygen around the body. Insufficient levels of iron can cause a condition called anaemia, which leads to tiredness and lack of energy.
• Zinc: this mineral is very important for the immune system, but it can be difficult for non-meat and fish eaters to get enough through diet. Vegetarians should eat plenty of chickpeas, cashew nuts, pumpkin seeds and avocado, along with dairy products if possible.

Where insufficient levels of these nutrients are being obtained through diet, it may be necessary to supplement. For children who struggle with tablets, all of these can be purchased in spray or droplet form.

My next point may sound obvious, but it is important for vegetarians to actually eat vegetables! In my practice, I sometimes come across vegetarians who I would actually qualify as “carbetarians”. Remember to “eat the rainbow” and include all colours of produce, as this will help to ensure that you get the full range of vitamins, minerals and antioxidants that your body needs. Stock your kitchen with as wide a range of fruit and vegetables as possible.

Finally, try to limit processed and ultra-processed foods. Not all vegetarian food is healthy, and some substitution and convenience products can be very high in sugar and unhealthy fats, and low in nutrients and fibre. Of course the occasional treat will not be harmful, but overall a diet rich in whole foods and low in processed foods is more likely to keep you healthy.