Key Nutrients for Vegetarians

by Dr. Stephen Sinatra
Filed Under: Food and Nutrition, General Health, Heart Health
Last Reviewed 02/06/2014

A vegetarian diet is healthier than the typical American diet in many ways. It’s low in saturated fat, high in fiber, and contains antioxidants and a score of phytonutrients that may help reduce the risk of many serious diseases.

However, if you’re one of the millions who follow a vegetarian diet—or are considering a change in that direction—it’s important to know that there is much more to being a vegetarian than simply excluding meat, fish, and fowl. This is especially true for strict vegetarians, or vegans—vegetarians who avoid using any products from animals (including dairy and eggs in their diet, and supplements from animal sources).

Virtually every vegetarian I’ve examined has been deficient in nutrients commonly found in animal products. These deficiencies include protein, omega-3 essential fatty acids, vitamin B12, and carnitine (along with a few others).

Vegetarians must be sure to get the critical nutrients that are contained in the foods that they have excluded from their diet—which means finding other food sources or supplements. So here’s how you can make up the deficit and avoid health problems related to the deficiencies.

Be Proactive in Getting Your Protein

The first of the nutrients that is deficient in most vegetarian diets is probably the easiest to address from plant sources. Good vegetarian sources for protein include tofu, nuts, and quinoa—a grain that grows in the Andes.

In fact, quinoa is the only vegetable source I know that contains a balanced set of the essential amino acids. It’s also high in fiber, phosphorus, magnesium, and iron. I use it instead of rice when I fix stir fry—which, of course, is great with extra-firm tofu in place of pork, chicken, shrimp, or other forms of meat.

For a tougher texture, slice your extra-firm tofu and freeze it for a few days. Then let it thaw. Squeeze all the water from each thawed slice and you will have tofu that has an even firmer texture—but with all the protein and other nutrients that tofu is famous for.

Get Your Critical Fatty Acids

In addition to protein, vegans need to be sure to get their omega-3 fatty acids—something most Americans don’t get enough of even if they’re not vegetarians. The best source for the important omega-3s known as EPA and DHA is cold-water fish such as salmon, sardines, and tuna.

EPA plays an important part in cardiovascular health, and DHA is one of the most abundant fats in the brain. It’s vital for optimal brain function, including mood and memory. If you’re a vegan, which means you won’t eat fish or take a fish oil supplement, you’ll need to get these omega-3s from other sources.

Flaxseed oil is the richest source of alpha-linolenic acid (ALA), the essential omega-3 that is found in plant sources. However, you should also make sure your diet contains plenty of green leafy vegetables—such as spinach and mustard greens. Additionally, wheat germ, walnuts, and tofu also contain ALA in varying amounts.

One excellent way of getting high amounts of ALA is by eating a salad that includes spinach and mustard greens sprinkled with wheat germ and walnuts and topped with a vinaigrette dressing made with flaxseed oil. It’s a delicious way to get your ALA, fiber, and a host of other important phytonutrients.

Most people are able to convert ALA into EPA and DHA. However, your body’s ability to make the conversion may decline as you age. Even if your body’s conversion ability is running at peak efficiency, you’ll probably only be able to use about 18 percent of the ALA you take in.

If you eat fish or take a fish oil supplement, it’s still a good idea to add ALA to your diet. A recent Harvard study concluded that ALA may help improve cardiovascular health through various biological mechanisms—including platelet function, inflammation reduction, endothelial cell activity, and arrhythmia control.

Don’t Be B12 Deficient

Additionally, vegetarians must consider their need for vitamin B12. The natural sources for this key member of the family of B vitamins are meat and dairy, which means vegans are often deficient in this crucial nutrient that helps maintain nervous system function and normal homocysteine levels while also helping to prevent pernicious anemia.

There aren’t any plant sources for vitamin B12, so vegetarians must take a supplement to get what they need. The good news here is that supplemental B12 is vegan friendly. It’s a synthetic form called cyanocobalamin.

Keep in mind that it’s important to have a wide array of B vitamins and to not just supplement with one of them. So your best bet is a high-quality multinutrient that not only gives you 200 mcg of B12 per day but that also gives you a wide range of other B vitamins—such as 20 mg of thiamine (B1), 20 mg of riboflavin (B2), 40 mg of niacin (B3), 40 mg of B6, and 800 mcg of folic acid or folate (B9).

There are other B vitamins, but the important thing to keep in mind is that a quality multinutrient will provide you with a full range of the members of the vitamin B family.

Keep Keen on Carnitine

As the name indicates, carnitine comes from meat (carni being Latin for flesh or meat). Lamb and mutton are the best sources for this nutrient that crosses into the mitochondria (the powerhouse of the cells). Carnitine helps do at least three things for your body: turn fat into energy, deliver and balance oxygen supplies, and prevent the production of some toxins.

As with B12, if you don’t get your carnitine from meat, you’ll have to get it from a supplement. Although the body can produce its own carnitine if it has the proper enzymes and co-enzymes, studies have indicated that vegetarians aren’t able to make adequate amounts on their own—which is why supplemental carnitine is essential.

Even meat eaters should look to a full-spectrum carnitine supplement. Again, the good news for vegans is that the carnitine used in supplements is synthetic.

Remember CoQ10, Taurine, and Alpha Lipoic Acid

Everyone should supplement with coenzyme Q10 (CoQ10), but vegetarians need to be even more vigilant. Over the years that I’ve been measuring blood levels for this critical nutrient, I’ve found low levels in some of my vegetarian patients who don’t take a CoQ10 supplement.

Two other nutrients that vegetarians are usually low in are taurine and alpha lipoic acid. As with B12 and carnitine, it’s important to get synthetic forms of these nutrients in a supplement if you’re not consuming organic meat and dairy. Be aware, though, that the gelatin used for most supplement capsules will have an animal source, so vegans will need to look for supplements that use “veggie caps.”

There you have it. Adopting a vegetarian diet can be a healthy move, but you have to play it smart. Your best efforts may backfire unless you make sure you get the critical nutrients you need from other sources.

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