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In affluent countries, where heart disease and cancer claim many lives, people who eat well-planned vegetarian diets often have lower risks of chronic diseases, and a lower risk of dying from all causes, than people whose diets center on meat.¹ Should everyone consider using a vegetarian eating pattern, then? If so, is it enough to simply omit meat, or is more demanded of the vegetarian diet planner? What positive contributions do animal products make to the diet? ms.) This Controversy looks at these issues and ends with some practical advice for the vegetarian diet planner. A vegetarian lifestyle may be im- mediately associated with a particular cultural, religious, political, or other belief system, but there are many reasons why people might choose it, as Table C6-2 makes clear. Vegetari- ans are categorized not by motivation but by the foods they choose to eat. Distinctions among vegetarian diets Can an eating pattern without animal products supply the needed nutrients? *Reference notes are found in Appendix F Compare the advantages and disadvantages of the vegetarian diet and the meat eater's diet. Pa/Stubas.com are useful academically, but they do not represent uncrossable lines. Some people use meat or broth as a condiment or seasoning for vegeta- ble or grain dishes. Some people eat meat only once a week and use plant protein foods the rest of the time. Others rely mostly on milk products and eggs for protein but will eat fish, too, and so forth. To force people into the categories of "vegetarians" and "meat eaters" leaves out all those with in-between eating styles (aptly named flexitarian by the press) that have much to recommend them. Positive Health Aspects of Vegetarian Diets Today, nutrition authorities state with confidence that a well-chosen vegetarian diet can meet nutrient needs while supporting health superbly. Although much evidence supports this choice, such evidence is not easily obtained. It would be easy if vegetarians differed from others only in the absence of meat, but they often have increased intakes of whole grains, legumes, nuts, fruits, and vegetables as well. Such eating patterns are rich contributors of carbohydrates, fiber, vitamins, minerals, and phytochemicals that also correlate with low disease risks. For example, in one study, as servings of fruit and vegetables increased from less than one to more than five per day, overall risk of death decreased by 36 percent, risk from cancers decreased by 25 percent, and risk from heart disease decreased by 20 percent, regardless of meat consumption. Table C6-1 Terms Used to Describe Vegetarian Diets Some of the terms below are in common usage, but others are useful only to researchers. . fruitarian includes only raw or dried fruits, seeds, and nuts in the diet. lacto-ovo vegetarian includes dairy products, eggs, vegetables, grains, legumes, fruits, and nuts; excludes flesh and seafood. ▪ lacto-vegetarian includes dairy products, vegetables, grains, legumes, fruits, and nuts, excludes flesh, seafood, and eggs. macrobiotic diet a vegan diet composed mostly of whole grains, beans, and certain vegetables: taken to extremes, macrobiotic diets can compromise nutrient status. * ovo-vegetarian includes eggs. vegetables, grains, legumes, fruits, and nuts, excludes flesh, seafood, and milk products. partial vegetarian a term sometimes used to mean an eating style that includes seafood, poultry, eggs, dairy products, vegetables, grains, legumes, fruits, and nuts, excludes or strictly limits certain meats, such as red meats. Also called flexitarian vegan includes only food from plant sources: vegetables, grains, legumes, fruits, seeds, and nuts; also called strict vegetarian. * vegetarian includes plant-based foods and eliminates some or all animal-derived foods. ontents C6-2 Reasons for Choosing Eating Styles Why Some People Are Vegetarians Health concerns. Vegetarian diets are often high in whole grains, fruits, vegetables, and legumes and often low in saturated fats, diet characteristics associated with good health. * Moral objections. Some believe that animals should not be killed for food; others object to use of any animal products, such as milk, cheese, eggs, or honey, or to use of items made from leather, wool, feathers, or silk. Humane treatment of animals. Many people object to inhumane treatment of livestock and food-producing animals. Environmental concerns. Producing meat protein requires a much greater input of resources than does an equal amount of vegetable protein. • Weight-control efforts. Some people mistakenly believe that simply eliminating meat will produce weight loss (it doesn't if high-calorie vegetarian foods and treats are consumed in excess of the daily energy need). * Cover-Up. Some adolescents may hide an eating disorder under the guise of being "vegetarian" (Chapter 9 takes up the issues of weight-loss dieting and eating disorders). Also, many vegetarians live a healthy lifestyle: they avoid tobacco, use alcohol in moderation, if at all, and are more physically active than other adults. When researchers take into account people's lifestyle on disease development, the evidence still often weighs in favor of vegetarian eating patterns, as the next sections make clear. Defense against Obesity Among both men and women and across many ethnic groups, vegetarians more often maintain a healthier body weight than nonvegetarians. The converse is also true: meat consumption correlates with increased energy intake and increased obesity. The reason for this is not clear but may reflect that many vegetarians make health a high priority. Why Some People Eat Meat ■ Convenience. Some people find that a hamburger or chicken salad sandwich makes a convenient lunch. Sources: C. Letzmann, Vegetarian nutrition Past, present, future, American Journal of Clinical Nutrition 100 (2014): 4965-5025, A. M. Bardone-Cone. The inter relationships between vegetarianism and eating disorders among females, Journal of the Academy of Nutrition and Dietetics 112 (2012) 12-47-1262 Defense against Heart and Artery Disease Vegetarians die less often from heart disease and related illnesses than do meat-eating people, although not all . Nutrients. Some people rely on animal products for the energy and key nutrients they supply. • Taste. Others enjoy the taste of roasted chicken, barbecued ribs, or a grilled steak. . Familiarity. Some people wouldn't know what to eat without meat; they are accustomed to seeing it on the plate. Weight-control efforts. Some people believe that eating meat instead of whole grains, fruits and vegetables, and legumes speeds weight loss (it doesn't). When consumed in sufficient quantity, soy foods, such as this roasted tofu, may improve the health of the heart. Course of the thi indicators of heart health are consistently improved in vegetarians. When vegetarians choose the unsaturated fats of soybeans, seeds, avocados, nuts, olives, and vegetable oils and shun the saturated fats of cheese, sour cream, butter, shortening, and other sources, their risks of heart disease are reduced. If their diet also contains nuts and legumes, as most vegetarian diets do, then LDL choles- terol typically falls, and heart benefits compound. Defense against High Blood Pressure Vegetarians tend to have lower blood pressure and lower rates of hypertension than average. Often, vegetarians maintain a healthy body weight, and appropriate body weight helps to maintain healthy blood pressure. So does eating enough fiber, fruit, vegetables, low-fat milk products, and soy protein, often amply supplied by a vegetarian diet. The mineral sodium promotes high blood pressure, but vegetarian diets are not always low-sodium diets. Other lifestyle factors such as not smoking. moderating alcohol intake, and being physically active all work together to keep blood pressure normal. Defense against Cancer Questions about diet and cancers are not easily answered, but the World Health Organization has concluded that high intakes of red meats, such as beef, goat, lamb, pork, veal, and non-bird game meat, are likely to raise the risk of colon and rectal cancers. The group also lists processed meats, such as lunchmeats and hot dogs, among human carcinogens and concludes that eating about two ounces daily increases colon and rectal cancer risks by 18 percent. In a study of over 60,000 people in the United Kingdom, those who ate fish or vegetables but not red meats had the lowest overall cancer rates-a finding that agrees with many other studies. Accounting for smoking, exercise, and other lifestyle factors, the overall cancer risk (compared to meat eaters) was: . 19 percent lower in vegans, - 12 percent lower in fish eaters, and - 11 percent lower in lacto-ovo vegetarians. Other researchers, however, report no difference in cancer risks between meat eaters and vegetarians. Such conflicts may stem partly from wide variations in eating patterns within groups-some meat eaters also love legumes, fish, and vegetables and eat them often, while some vegetarians may base their diets on fried foods, refined grains, cheeses, sweets, and daily alcohol (see Controversy 3). Such factors may influence cancer risks. More details about diet and cancer appear in Chapter 11. Other Health Benefits In addition to obesity, heart disease, high blood pressure, and cancer, vegetarian eating patterns may help prevent cataracts, diabetes, diverticular disease, gallstones, high blood pressure, and osteoporosis. However, these effects may arise more from what vegetarians include in their diet-abundant fruit, legumes, vegetables, and whole grains than from omission of meat. Table C6-3 spells out some arguments for and against eliminating meat from the diet. Positive Health Aspects of the Meat Eater's Diet With prudent choices, both meat eaters and lacto-ovo vegetarians can rely on their diets to support health during critical times of life. In contrast, a vegan eating pattern poses challenges. Protein is critical for building new tissues during growth, for fighting illnesses, for building bone during youth, and for maintaining bone and muscle in old age. While protein from plant sources can meet most people's needs. very young children and very elderly people with small appetites may not consume enough legumes, whole grains, or nuts to supply the protein they need. This 5-ounce steak provides almost all of the meat recommended for an entire day's intake in a 2.000 calorie diet. The chapter made clear that protein from meat, fish, milk, and eggs is the clear winner in tests of digestibility and availability to the body, with soy protein a close second. Also, animal-derived foods provide abundant iron, zinc, vitamin D, calcium, and vitamin B needed by everyone but particularly by pregnant women, infants, children, adolescents, and the elderly (details about these needs appear in later chapters). Iron and zinc are less readily absorbed from vegan sources, such as grains and legumes, than from meat, but iron and zinc from sup- plements or fortified foods can help prevent deficiencies. Vegans must also find and regularly consume alternate sources of vitamin D, calcium, vitamin B., and the omega-3 fatty acids EPA and DHA In Pregnancy and Infancy Women who eat seafood, eggs, or milk products can be sure of receiving enough energy, vitamin B₁, vitamin D, calcium, iron, and zinc, as well as protein, to support pregnancy and breastfeeding. A woman following a well-planned lacto-ovo vegetarian eating pattern can also relax in the knowledge that she is superbly supplied with energy and all necessary nutrients. A vegan woman who doesn't meet her nutrient needs, however, may enter pregnancy too thin and with scant nutrient stores to draw on as the nutrient demands of the fetus grow larger. Of particular concern is vitamin B₁ a vitamin abundant in foods of animal origin but absent from vegetables. Obtaining enough vitamin B₁, poses a challenge to vegans of all ages, who often test low in the vitamin." For pregnant and lactating women, obtain- ing vitamin B₁ is critical to prevent serious deficiency-related disorders in infants who do not receive sufficient vitamin B¹ In Childhood Children who eat eggs, milk, and fish receive abundant protein, iron, zinc, vitamin D, calcium, and vitamin B such foods are reliable, convenient sources of nutrients needed for growth, Likewise, children eating well-planned lacto-ovo vegetarian diets receive Som.com/ci for the general meat-eating population. Also, vegan children who rely on whole grains and vegetables for the minerals iron and zinc receive them, but in less absorbable forms, so a supplement or fortified foods may be needed. Other nutrients of concern for vegan children include vitamin B, vitamin D, vitamin C, Planning a and calcium. In Adolescence The healthiest vegetarian adolescents choose balanced diets that are heavy in fruits and vegetables but light on the sweets, fast foods, and salty snacks that tempt the teenage palate. These healthy vegetarian teens often meet the goals of the Dietary Guidelines for Americans- a rare accomplishment in the United States. Other teens, however, adopt poorly planned vegetarian eating patterns that provide too little energy and too few nutrients for health. Omissions of protein, calcium, and vitamin D, for example, lead to weak bone development at precisely the time when bones must develop strength to protect bone health through later life. If a vegetarian child or teen refuses sound dietary advice, a registered dietitian nutri- tionist can help to identify problems, dispense appropriate guidance, and put unwarranted parental worries to rest. stories of cures attributed to restrictive eating plans, such as macrobiotic diets. However, such diets often severely limit food selections and can fail to deliver the energy and nutrients needed for recovery. In Aging and in Illness For elderly people with diminished appetites or impaired digestion, too little dietary protein compromises both bone and muscle strength, leading to bone fractures and infirmity. Providing frequent meals with high-quality protein, such as low-fat cheese, fish, or soft- cooked ground poultry or meat, may reduce these risks." Vegetarians, and particularly vegans, may be at greater risk for weakened bones and fractures than nonvegetarians." People battling life-threatening diseases may encounter testimonial Vegetarian Diet Eating a nutritious vegetarian diet requires more than just omitting certain foods and food groups any eating pattern that omits key foods omits essential nutrients. Grains, fruits, and vegetables are naturally abundant in the vegetarian's diet and provide adequate amounts of the nutrients of plant foods: carbohydrate, fiber, thiamin, folate, and vitamins B, C, A, and E. Nutrients in animal-derived foods may be of concern, however-particularly zinc, along with protein, iron, calcium, vitamin B₁, vitamin D, and omega-3 fatty acids, Table C6-4 (p. 237) presents vegetarian sources for these nutrients. Choosing within the Food Groups When selecting from the Vegetables and Fruits groups, vegetarians should emphasize sources of calcium and iron. Green leafy vegetables provide both calcium and iron. Similarly, dried fruits deserve special notice in the Fruits group because they can deliver more iron than other fruits. The Protein Foods group emphasizes legumes, soy products, nuts, and seeds. The Dietary Guidelines encourage the use of vegetable oils, nuts, and seeds rich in unsaturated fats and omega-3 fatty acids. To ensure adequate nutrient intakes, vegans need to select fortified foods or use supplements daily. Milk Products and Protein Foods It takes a little planning to ensure adequate intakes from a variety of vegetarian foods in the Milk and Milk Products group and the Protein Foods group. Figure C6-1 (p. 238) turns a spotlight on these food groups, and Appendix E provides the USDA Healthy Vegetarian Eating Pattern in full for many calorie levels. The USDA Eating Pattern also specifies weekly amounts that vegetarians should obtain from the Protein Foods subgroups. Note that the Milk and Milk Products group features fortified soy milk and yogurt for vegans. Protein-rich soy products are often fortified and match many of the nutrients of milk products. Other "milk" beverages and yogurts, based on almonds, coconuts, hemp, oats, or rice, generally lack protein and other nutrients. Smart shoppers compare the nutrients of substitutes with those of milk and dairy foods before choosing. Convenience Foods Prepared frozen or packaged vegetarian foods make food preparation quick and easy-just be sure to scrutinize each label's Nutrition Facts panel when choosing among them. Some products constitute a nutritional bargain, such as vegetarian "hot dogs" or "veggie burgers. Made of soy, these foods look and taste like the original meat product but contain much less fat and saturated fat. Some brands may be high in sodium or added sugars, however (read the labels). Soybeans in other forms, such as plain tofu (bean curd), edamame (cooked green soybeans, pronounced ed-eh-MAH- may), or soy flour, offer protein with fewer additives. Among snack foods, banana or vegetable chips, often sold as "healthy" foods, are no bargain: a quarter cup of banana chips fried in saturated coconut oil provides 150 calories with 7 grams of saturated fat (a big hamburger has 8 grams). A plain banana has 100 calories and practically no fat. Look for freeze- dried fruit and vegetable "chips"-they Table C6-4 Vegetarian Sources of Key Nutrients NUTRIENTS PROTEIN Whole grains IRON ZINC CALCIUM VITAMIN B VITAMIN D OMEGA-3 FATTY ACIDS Grains Fortified cereals, enriched and whole grains Fortified cereals, whole grains Fortified cereals Fortified cereals Fortified cereals Vegetables Dark green, leafy vegetables (spinach, turnip greens) Dark green, leafy vegetables (bok choy, broccoli, collard greens, kale, mustard greens, turnip greens, watercress) Marine algae and their oils Fruits FOOD GROUPS Dried fruits (apricats. prunes, raisins) Fortified juices, figs Legumes and Other Protein- Rich Foods Legumes. seeds, nuts, soy products (tempeh, tofu, veggie burg- ers); eggs (for ovo-vegetarians) Legumes (black- eyed peas, kidney beans, lentils), soy products Legumes (garbanzo beans, kidney beans, navy beans), nuts. seeds (pumpkin seeds) Fortified soy products, nuts (almonds), seeds (sesame seeds) Eags (for ovo-vegetarians); fortified soy products Chia seeds, flax- seed, walnuts, soybeans, forti fied margarine, fortified eggs (for ovo-vegetarians) Milk or Soy Milk Milk, cheese, yogurt (for lacto-vegetarians); soy milk, soy yogurt, soy cheeses Milk, cheese, yogurt (for lacto-vegetarians); soy milk, soy yogurt, soy cheeses Milk, cheese, yogurt (for lacto-vegetarians); fortified soy milk, fortified soy yogurt, fortified soy cheese Milk, cheese, yogurt (for lacto-vegetarians); fortified soy milk, fortified soy yogurt, fortified soy cheese Milk, cheese, yogurt (for lacto-vegetarians); fortified soy milk, fortified soy yogurt, fortified soy cheese Oils Algae oil, flaxseed oil, walnut oil, soybean oil "Many plant proteins lack certain essential amino acids or contain them in insufficient amounts for human health. A variety of daily plant protein sources, such as grains and legumes, can meet protein needs when energy intake is sufficient *Fortification sources of EPA and DHA may be fish all or marine algae oil; read the ingredients list on the label < Figure C6-1 Filling the Vegetarian MyPlate Each day, in a 2,000-calorie diet, both vegans and lacto-ovo vegetarians require 3 cups of Milk and Milk Product equivalents and 5% ounces of Protein Foods. (For details and for other calorie levels, see Appendix E.) Fruits Vegetable Grains Protein Dairy Choose MyPlate.gov 1 oz Protein Foods Equivalent Amounts For vegans Bears, peas, and lentils, cooked Seeds, nuts Nut butters Soy products (totu, tempah, textured Ас Voz 1 tbs Ac vegetable protein) Veggie burgers 1 burger Additional option for ovo-vegetarians Eggo 1 099 Equivalent Amounts Milk and Milk Products For vegans • Calcium and vitamin D fortified beverages (soy milk, orange juice. and others) Tofu (calcium sot) ½¢ Calcium-fortified soy yogurt 10 Additional options for lacto-vegetarians Low-fat milk Low-fat cheese Low-fat yogurt 10 10 1/ oz 10 have no added fats, but the freeze- ble of Contents cess creates a pleasing crunch and preserves most nutrients. Conclusion This comparison has shown that both a meat-eater's diet and a vegetarian's diet are best approached scientifically. If you are just beginning to study nutrition, consider adopting the attitude that the choice to make is not whether to be a meat eater or a vegetarian but where along the spectrum to locate yourself. Your preferences should be honored with these caveats: that you plan your own diet and the diets of those in your care to be adequate, balanced, controlled in calories, and varied and that you limit intakes of foods high in sodium, solid fats, and added sugars. Whatever your eating style or reasons for choosing it, choose carefully: the foods that you eat regularly make an impact on your health. Critical Thinking 1. Becoming a vegan takes a strong commitment and significant education to know how to combine foods and in what quantities to meet nutrient requirements. Most of us will not choose to become vegetarians, but many of us would benefit from a diet of less meat. Identify ways you could alter your diet so that you eat less meat. 2. Identify two critical periods of life that demand high nutrient intakes, and defend the use of a vegetarian diet during those times. Discuss specific nutrient challenges and solutions for both life stages. In affluent countries, where heart disease and cancer claim many lives, people who eat well-planned vegetarian diets often have lower risks of chronic diseases, and a lower risk of dying from all causes, than people whose diets center on meat.¹ Should everyone consider using a vegetarian eating pattern, then? If so, is it enough to simply omit meat, or is more demanded of the vegetarian diet planner? What positive contributions do animal products make to the diet? ms.) This Controversy looks at these issues and ends with some practical advice for the vegetarian diet planner. A vegetarian lifestyle may be im- mediately associated with a particular cultural, religious, political, or other belief system, but there are many reasons why people might choose it, as Table C6-2 makes clear. Vegetari- ans are categorized not by motivation but by the foods they choose to eat. Distinctions among vegetarian diets Can an eating pattern without animal products supply the needed nutrients? *Reference notes are found in Appendix F Compare the advantages and disadvantages of the vegetarian diet and the meat eater's diet. Pa/Stubas.com are useful academically, but they do not represent uncrossable lines. Some people use meat or broth as a condiment or seasoning for vegeta- ble or grain dishes. Some people eat meat only once a week and use plant protein foods the rest of the time. Others rely mostly on milk products and eggs for protein but will eat fish, too, and so forth. To force people into the categories of "vegetarians" and "meat eaters" leaves out all those with in-between eating styles (aptly named flexitarian by the press) that have much to recommend them. Positive Health Aspects of Vegetarian Diets Today, nutrition authorities state with confidence that a well-chosen vegetarian diet can meet nutrient needs while supporting health superbly. Although much evidence supports this choice, such evidence is not easily obtained. It would be easy if vegetarians differed from others only in the absence of meat, but they often have increased intakes of whole grains, legumes, nuts, fruits, and vegetables as well. Such eating patterns are rich contributors of carbohydrates, fiber, vitamins, minerals, and phytochemicals that also correlate with low disease risks. For example, in one study, as servings of fruit and vegetables increased from less than one to more than five per day, overall risk of death decreased by 36 percent, risk from cancers decreased by 25 percent, and risk from heart disease decreased by 20 percent, regardless of meat consumption. Table C6-1 Terms Used to Describe Vegetarian Diets Some of the terms below are in common usage, but others are useful only to researchers. . fruitarian includes only raw or dried fruits, seeds, and nuts in the diet. lacto-ovo vegetarian includes dairy products, eggs, vegetables, grains, legumes, fruits, and nuts; excludes flesh and seafood. ▪ lacto-vegetarian includes dairy products, vegetables, grains, legumes, fruits, and nuts, excludes flesh, seafood, and eggs. macrobiotic diet a vegan diet composed mostly of whole grains, beans, and certain vegetables: taken to extremes, macrobiotic diets can compromise nutrient status. * ovo-vegetarian includes eggs. vegetables, grains, legumes, fruits, and nuts, excludes flesh, seafood, and milk products. partial vegetarian a term sometimes used to mean an eating style that includes seafood, poultry, eggs, dairy products, vegetables, grains, legumes, fruits, and nuts, excludes or strictly limits certain meats, such as red meats. Also called flexitarian vegan includes only food from plant sources: vegetables, grains, legumes, fruits, seeds, and nuts; also called strict vegetarian. * vegetarian includes plant-based foods and eliminates some or all animal-derived foods. ontents C6-2 Reasons for Choosing Eating Styles Why Some People Are Vegetarians Health concerns. Vegetarian diets are often high in whole grains, fruits, vegetables, and legumes and often low in saturated fats, diet characteristics associated with good health. * Moral objections. Some believe that animals should not be killed for food; others object to use of any animal products, such as milk, cheese, eggs, or honey, or to use of items made from leather, wool, feathers, or silk. Humane treatment of animals. Many people object to inhumane treatment of livestock and food-producing animals. Environmental concerns. Producing meat protein requires a much greater input of resources than does an equal amount of vegetable protein. • Weight-control efforts. Some people mistakenly believe that simply eliminating meat will produce weight loss (it doesn't if high-calorie vegetarian foods and treats are consumed in excess of the daily energy need). * Cover-Up. Some adolescents may hide an eating disorder under the guise of being "vegetarian" (Chapter 9 takes up the issues of weight-loss dieting and eating disorders). Also, many vegetarians live a healthy lifestyle: they avoid tobacco, use alcohol in moderation, if at all, and are more physically active than other adults. When researchers take into account people's lifestyle on disease development, the evidence still often weighs in favor of vegetarian eating patterns, as the next sections make clear. Defense against Obesity Among both men and women and across many ethnic groups, vegetarians more often maintain a healthier body weight than nonvegetarians. The converse is also true: meat consumption correlates with increased energy intake and increased obesity. The reason for this is not clear but may reflect that many vegetarians make health a high priority. Why Some People Eat Meat ■ Convenience. Some people find that a hamburger or chicken salad sandwich makes a convenient lunch. Sources: C. Letzmann, Vegetarian nutrition Past, present, future, American Journal of Clinical Nutrition 100 (2014): 4965-5025, A. M. Bardone-Cone. The inter relationships between vegetarianism and eating disorders among females, Journal of the Academy of Nutrition and Dietetics 112 (2012) 12-47-1262 Defense against Heart and Artery Disease Vegetarians die less often from heart disease and related illnesses than do meat-eating people, although not all . Nutrients. Some people rely on animal products for the energy and key nutrients they supply. • Taste. Others enjoy the taste of roasted chicken, barbecued ribs, or a grilled steak. . Familiarity. Some people wouldn't know what to eat without meat; they are accustomed to seeing it on the plate. Weight-control efforts. Some people believe that eating meat instead of whole grains, fruits and vegetables, and legumes speeds weight loss (it doesn't). When consumed in sufficient quantity, soy foods, such as this roasted tofu, may improve the health of the heart. Course of the thi indicators of heart health are consistently improved in vegetarians. When vegetarians choose the unsaturated fats of soybeans, seeds, avocados, nuts, olives, and vegetable oils and shun the saturated fats of cheese, sour cream, butter, shortening, and other sources, their risks of heart disease are reduced. If their diet also contains nuts and legumes, as most vegetarian diets do, then LDL choles- terol typically falls, and heart benefits compound. Defense against High Blood Pressure Vegetarians tend to have lower blood pressure and lower rates of hypertension than average. Often, vegetarians maintain a healthy body weight, and appropriate body weight helps to maintain healthy blood pressure. So does eating enough fiber, fruit, vegetables, low-fat milk products, and soy protein, often amply supplied by a vegetarian diet. The mineral sodium promotes high blood pressure, but vegetarian diets are not always low-sodium diets. Other lifestyle factors such as not smoking. moderating alcohol intake, and being physically active all work together to keep blood pressure normal. Defense against Cancer Questions about diet and cancers are not easily answered, but the World Health Organization has concluded that high intakes of red meats, such as beef, goat, lamb, pork, veal, and non-bird game meat, are likely to raise the risk of colon and rectal cancers. The group also lists processed meats, such as lunchmeats and hot dogs, among human carcinogens and concludes that eating about two ounces daily increases colon and rectal cancer risks by 18 percent. In a study of over 60,000 people in the United Kingdom, those who ate fish or vegetables but not red meats had the lowest overall cancer rates-a finding that agrees with many other studies. Accounting for smoking, exercise, and other lifestyle factors, the overall cancer risk (compared to meat eaters) was: . 19 percent lower in vegans, - 12 percent lower in fish eaters, and - 11 percent lower in lacto-ovo vegetarians. Other researchers, however, report no difference in cancer risks between meat eaters and vegetarians. Such conflicts may stem partly from wide variations in eating patterns within groups-some meat eaters also love legumes, fish, and vegetables and eat them often, while some vegetarians may base their diets on fried foods, refined grains, cheeses, sweets, and daily alcohol (see Controversy 3). Such factors may influence cancer risks. More details about diet and cancer appear in Chapter 11. Other Health Benefits In addition to obesity, heart disease, high blood pressure, and cancer, vegetarian eating patterns may help prevent cataracts, diabetes, diverticular disease, gallstones, high blood pressure, and osteoporosis. However, these effects may arise more from what vegetarians include in their diet-abundant fruit, legumes, vegetables, and whole grains than from omission of meat. Table C6-3 spells out some arguments for and against eliminating meat from the diet. Positive Health Aspects of the Meat Eater's Diet With prudent choices, both meat eaters and lacto-ovo vegetarians can rely on their diets to support health during critical times of life. In contrast, a vegan eating pattern poses challenges. Protein is critical for building new tissues during growth, for fighting illnesses, for building bone during youth, and for maintaining bone and muscle in old age. While protein from plant sources can meet most people's needs. very young children and very elderly people with small appetites may not consume enough legumes, whole grains, or nuts to supply the protein they need. This 5-ounce steak provides almost all of the meat recommended for an entire day's intake in a 2.000 calorie diet. The chapter made clear that protein from meat, fish, milk, and eggs is the clear winner in tests of digestibility and availability to the body, with soy protein a close second. Also, animal-derived foods provide abundant iron, zinc, vitamin D, calcium, and vitamin B needed by everyone but particularly by pregnant women, infants, children, adolescents, and the elderly (details about these needs appear in later chapters). Iron and zinc are less readily absorbed from vegan sources, such as grains and legumes, than from meat, but iron and zinc from sup- plements or fortified foods can help prevent deficiencies. Vegans must also find and regularly consume alternate sources of vitamin D, calcium, vitamin B., and the omega-3 fatty acids EPA and DHA In Pregnancy and Infancy Women who eat seafood, eggs, or milk products can be sure of receiving enough energy, vitamin B₁, vitamin D, calcium, iron, and zinc, as well as protein, to support pregnancy and breastfeeding. A woman following a well-planned lacto-ovo vegetarian eating pattern can also relax in the knowledge that she is superbly supplied with energy and all necessary nutrients. A vegan woman who doesn't meet her nutrient needs, however, may enter pregnancy too thin and with scant nutrient stores to draw on as the nutrient demands of the fetus grow larger. Of particular concern is vitamin B₁ a vitamin abundant in foods of animal origin but absent from vegetables. Obtaining enough vitamin B₁, poses a challenge to vegans of all ages, who often test low in the vitamin." For pregnant and lactating women, obtain- ing vitamin B₁ is critical to prevent serious deficiency-related disorders in infants who do not receive sufficient vitamin B¹ In Childhood Children who eat eggs, milk, and fish receive abundant protein, iron, zinc, vitamin D, calcium, and vitamin B such foods are reliable, convenient sources of nutrients needed for growth, Likewise, children eating well-planned lacto-ovo vegetarian diets receive Som.com/ci for the general meat-eating population. Also, vegan children who rely on whole grains and vegetables for the minerals iron and zinc receive them, but in less absorbable forms, so a supplement or fortified foods may be needed. Other nutrients of concern for vegan children include vitamin B, vitamin D, vitamin C, Planning a and calcium. In Adolescence The healthiest vegetarian adolescents choose balanced diets that are heavy in fruits and vegetables but light on the sweets, fast foods, and salty snacks that tempt the teenage palate. These healthy vegetarian teens often meet the goals of the Dietary Guidelines for Americans- a rare accomplishment in the United States. Other teens, however, adopt poorly planned vegetarian eating patterns that provide too little energy and too few nutrients for health. Omissions of protein, calcium, and vitamin D, for example, lead to weak bone development at precisely the time when bones must develop strength to protect bone health through later life. If a vegetarian child or teen refuses sound dietary advice, a registered dietitian nutri- tionist can help to identify problems, dispense appropriate guidance, and put unwarranted parental worries to rest. stories of cures attributed to restrictive eating plans, such as macrobiotic diets. However, such diets often severely limit food selections and can fail to deliver the energy and nutrients needed for recovery. In Aging and in Illness For elderly people with diminished appetites or impaired digestion, too little dietary protein compromises both bone and muscle strength, leading to bone fractures and infirmity. Providing frequent meals with high-quality protein, such as low-fat cheese, fish, or soft- cooked ground poultry or meat, may reduce these risks." Vegetarians, and particularly vegans, may be at greater risk for weakened bones and fractures than nonvegetarians." People battling life-threatening diseases may encounter testimonial Vegetarian Diet Eating a nutritious vegetarian diet requires more than just omitting certain foods and food groups any eating pattern that omits key foods omits essential nutrients. Grains, fruits, and vegetables are naturally abundant in the vegetarian's diet and provide adequate amounts of the nutrients of plant foods: carbohydrate, fiber, thiamin, folate, and vitamins B, C, A, and E. Nutrients in animal-derived foods may be of concern, however-particularly zinc, along with protein, iron, calcium, vitamin B₁, vitamin D, and omega-3 fatty acids, Table C6-4 (p. 237) presents vegetarian sources for these nutrients. Choosing within the Food Groups When selecting from the Vegetables and Fruits groups, vegetarians should emphasize sources of calcium and iron. Green leafy vegetables provide both calcium and iron. Similarly, dried fruits deserve special notice in the Fruits group because they can deliver more iron than other fruits. The Protein Foods group emphasizes legumes, soy products, nuts, and seeds. The Dietary Guidelines encourage the use of vegetable oils, nuts, and seeds rich in unsaturated fats and omega-3 fatty acids. To ensure adequate nutrient intakes, vegans need to select fortified foods or use supplements daily. Milk Products and Protein Foods It takes a little planning to ensure adequate intakes from a variety of vegetarian foods in the Milk and Milk Products group and the Protein Foods group. Figure C6-1 (p. 238) turns a spotlight on these food groups, and Appendix E provides the USDA Healthy Vegetarian Eating Pattern in full for many calorie levels. The USDA Eating Pattern also specifies weekly amounts that vegetarians should obtain from the Protein Foods subgroups. Note that the Milk and Milk Products group features fortified soy milk and yogurt for vegans. Protein-rich soy products are often fortified and match many of the nutrients of milk products. Other "milk" beverages and yogurts, based on almonds, coconuts, hemp, oats, or rice, generally lack protein and other nutrients. Smart shoppers compare the nutrients of substitutes with those of milk and dairy foods before choosing. Convenience Foods Prepared frozen or packaged vegetarian foods make food preparation quick and easy-just be sure to scrutinize each label's Nutrition Facts panel when choosing among them. Some products constitute a nutritional bargain, such as vegetarian "hot dogs" or "veggie burgers. Made of soy, these foods look and taste like the original meat product but contain much less fat and saturated fat. Some brands may be high in sodium or added sugars, however (read the labels). Soybeans in other forms, such as plain tofu (bean curd), edamame (cooked green soybeans, pronounced ed-eh-MAH- may), or soy flour, offer protein with fewer additives. Among snack foods, banana or vegetable chips, often sold as "healthy" foods, are no bargain: a quarter cup of banana chips fried in saturated coconut oil provides 150 calories with 7 grams of saturated fat (a big hamburger has 8 grams). A plain banana has 100 calories and practically no fat. Look for freeze- dried fruit and vegetable "chips"-they Table C6-4 Vegetarian Sources of Key Nutrients NUTRIENTS PROTEIN Whole grains IRON ZINC CALCIUM VITAMIN B VITAMIN D OMEGA-3 FATTY ACIDS Grains Fortified cereals, enriched and whole grains Fortified cereals, whole grains Fortified cereals Fortified cereals Fortified cereals Vegetables Dark green, leafy vegetables (spinach, turnip greens) Dark green, leafy vegetables (bok choy, broccoli, collard greens, kale, mustard greens, turnip greens, watercress) Marine algae and their oils Fruits FOOD GROUPS Dried fruits (apricats. prunes, raisins) Fortified juices, figs Legumes and Other Protein- Rich Foods Legumes. seeds, nuts, soy products (tempeh, tofu, veggie burg- ers); eggs (for ovo-vegetarians) Legumes (black- eyed peas, kidney beans, lentils), soy products Legumes (garbanzo beans, kidney beans, navy beans), nuts. seeds (pumpkin seeds) Fortified soy products, nuts (almonds), seeds (sesame seeds) Eags (for ovo-vegetarians); fortified soy products Chia seeds, flax- seed, walnuts, soybeans, forti fied margarine, fortified eggs (for ovo-vegetarians) Milk or Soy Milk Milk, cheese, yogurt (for lacto-vegetarians); soy milk, soy yogurt, soy cheeses Milk, cheese, yogurt (for lacto-vegetarians); soy milk, soy yogurt, soy cheeses Milk, cheese, yogurt (for lacto-vegetarians); fortified soy milk, fortified soy yogurt, fortified soy cheese Milk, cheese, yogurt (for lacto-vegetarians); fortified soy milk, fortified soy yogurt, fortified soy cheese Milk, cheese, yogurt (for lacto-vegetarians); fortified soy milk, fortified soy yogurt, fortified soy cheese Oils Algae oil, flaxseed oil, walnut oil, soybean oil "Many plant proteins lack certain essential amino acids or contain them in insufficient amounts for human health. A variety of daily plant protein sources, such as grains and legumes, can meet protein needs when energy intake is sufficient *Fortification sources of EPA and DHA may be fish all or marine algae oil; read the ingredients list on the label < Figure C6-1 Filling the Vegetarian MyPlate Each day, in a 2,000-calorie diet, both vegans and lacto-ovo vegetarians require 3 cups of Milk and Milk Product equivalents and 5% ounces of Protein Foods. (For details and for other calorie levels, see Appendix E.) Fruits Vegetable Grains Protein Dairy Choose MyPlate.gov 1 oz Protein Foods Equivalent Amounts For vegans Bears, peas, and lentils, cooked Seeds, nuts Nut butters Soy products (totu, tempah, textured Ас Voz 1 tbs Ac vegetable protein) Veggie burgers 1 burger Additional option for ovo-vegetarians Eggo 1 099 Equivalent Amounts Milk and Milk Products For vegans • Calcium and vitamin D fortified beverages (soy milk, orange juice. and others) Tofu (calcium sot) ½¢ Calcium-fortified soy yogurt 10 Additional options for lacto-vegetarians Low-fat milk Low-fat cheese Low-fat yogurt 10 10 1/ oz 10 have no added fats, but the freeze- ble of Contents cess creates a pleasing crunch and preserves most nutrients. Conclusion This comparison has shown that both a meat-eater's diet and a vegetarian's diet are best approached scientifically. If you are just beginning to study nutrition, consider adopting the attitude that the choice to make is not whether to be a meat eater or a vegetarian but where along the spectrum to locate yourself. Your preferences should be honored with these caveats: that you plan your own diet and the diets of those in your care to be adequate, balanced, controlled in calories, and varied and that you limit intakes of foods high in sodium, solid fats, and added sugars. Whatever your eating style or reasons for choosing it, choose carefully: the foods that you eat regularly make an impact on your health. Critical Thinking 1. Becoming a vegan takes a strong commitment and significant education to know how to combine foods and in what quantities to meet nutrient requirements. Most of us will not choose to become vegetarians, but many of us would benefit from a diet of less meat. Identify ways you could alter your diet so that you eat less meat. 2. Identify two critical periods of life that demand high nutrient intakes, and defend the use of a vegetarian diet during those times. Discuss specific nutrient challenges and solutions for both life stages.
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A Concise Introduction to Logic
ISBN: 978-1305958098
13th edition
Authors: Patrick J. Hurley, Lori Watson
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