How many times has someone asked you how you can get enough protein on a vegan or vegetarian diet?

We’ve just published the 5th edition of Simply Vegan and updated the nutrition section, including Protein in the Vegan Diet. The section includes helpful charts showing how much protein is found in common foods vegetarians/vegans eat, which you can see here: http://www.vrg.org/nutrition/protein.php

Click here to purchase the updated edition of Simply Vegan

A reader asked about nutritional yeast for a twelve month old boy.

If a child’s diet is nutritionally adequate or supplements are being used to insure intakes at the RDA level for age, nutritional yeast is not especially needed. Some families choose to use Vegetarian Support Formula nutritional yeast as a source of vitamin B12. I am not aware of any need to avoid this product for a healthy 1-year old. The RDA for vitamin B12 for a 1-3 year old is 0.9 mcg/day. Approximately 2 heaping
tablespoons of Large Flake Vegetarian Support Formula (VSF) nutritional yeast or 1.5 heaping tablespoons of Mini Flake provides 8 mcg of vitamin B12. (http://lesaffre-yeast.com/red-star/vsf.html). By my calculations, about 3/4 teaspoon of Large Flake VSF or 1/2 teaspoon of Mini Flake VSF would provide close to 0.9 mcg of vitamin B12, which is the 1-3 year old RDA for vitamin B12.

The contents of this posting and our other publications, including the Vegetarian Journal, are not intended to provide personal medical advice. Medical advice should be obtained from a qualified health professional. We often depend on product and ingredient information from company statements. It is impossible to be 100% sure about a statement, info can change, people have different views, and mistakes can be made. Please use your best judgment about whether a product is suitable for you. To be sure, do further research or confirmation on your own.

You can find more archives of the Dr. Don Show here: http://bullheadurgentcare.com/archives/index.html, including the April 25, 2012 show, in which Dr. Mangels spoke about vegetarian diets in infants, and the March 6, 2012 show, in which Dr. Mangels discussed pregnancy, lactation and vegetarian diets.

For more information on vegan pregnancy, see:

• The Everything Vegan Pregnancy Book by Reed Mangels, RD, PhD
• Vegan Nutrition in Pregnancy and Childhood

Iron is another nutrient that new vegans and vegetarians are often concerned about. Fortunately, there are many excellent plant sources of iron. Our recently-updated article, Iron in the Vegan Diet, contains a list of the iron content of selected vegan foods, a comparison of iron sources, and some sample menus that provide more than the daily recommended amount of iron.

Iron in the Vegan Diet is excerpted from the newly released 5th Edition of Simply Vegan. For a limited time, we’re offering 50% off the cover price when you order 5 copies from our online bookstore. For more information about vegan nutrition, visit the Nutrition section of our website.

The Vegetarian Resource Group relies upon the generosity of our supporters. Please donate so we can continue to provide vital nutrition information like this.

Thanks to VRG volunteer Alan Polster for converting this update into HTML!

While you may not hear it as often as the ubiquitous protein question, nevertheless, calcium and dairy products are inextricably linked in the minds of most people. Fortunately, there are a wide variety of calcium rich foods that don’t come from a cow. VRG’s newly-updated article Calcium in the Vegan Diet contains a list of vegan sources of calcium, as well as sample menus that provide more than the recommended 1,000 mg per day.

Calcium in the Vegan Diet is excerpted from the newly released 5th Edition of Simply Vegan. For a limited time, we’re offering 50% off the cover price when you order 5 copies from our online bookstore. For more information about vegan nutrition, visit the Nutrition section of our website.

The Vegetarian Resource Group relies upon the generosity of our supporters. Please Donate so we can continue to provide vital nutrition information like this.

Thanks to VRG volunteer Alan Polster for converting this update into HTML!

For more information on WIC, see:

• http://www.vrg.org/journal/vj2008issue3/scientific_update.htm
• http://www.fns.usda.gov/wic/

I’ve recently gotten some questions about the use of folic acid supplements prior to and during pregnancy. Folic acid is one form of folate, an essential vitamin. Folic acid is the form of folate that is used in supplements and fortified foods because it is the form that is most stable. It is added to enriched grain products including breads, pasta, and breakfast cereals. There are several forms of folate that are found naturally in foods; these are called “food folates.” Foods that are naturally high in folate include green leafy vegetables, dried beans, and oranges.

The Centers for Disease Control (CDC) urges women to take 400 micrograms of folic acid every day, starting at least one month before getting pregnant and continuing during pregnancy, to help prevent major birth defects of the baby’s brain and spine (1). They specifically call for use of folic acid from fortified foods and/or supplements, in addition to getting folate from foods.

The first few weeks of pregnancy are important times for the development of the fetus’ brain and spinal cord. Taking folic acid in the period from about 1 month before to 6 weeks after conception is associated with reduced risk of having a baby with a neural tube defect. Neural tube defects include spina bifida, anencephaly, and other serious birth defects. Folic acid is also associated with reduced risk of cleft lip/palate (2).

You may be wondering if you can just get the folate you need for pregnancy from foods. Somewhat surprisingly, no studies have been published that look at food folate and the prevention of neural tube defects. All of the studies that have been done looking at neural tube defects have compared women who used folic acid supplements or foods fortified with folic acid to women who did not use these products. In these studies, women who used folic acid had a 35% to over 70% lower risk of having a baby with a neural tube defect.

It’s unfortunate that food folate studies have not been done but, at this point, there may be ethical questions about doing such studies since folic acid has shown such impressive effects in terms of risk reduction.

Numerous factors affect how well humans absorb food folate. These include genetics and race/ethnicity (3). Folic acid is not affected as much by these variations in absorption. This may be another reason why folic acid supplements are recommended before and during pregnancy in addition to getting folate from foods.

Because of the significant impact of folic acid, specifically on the reduction of the risk of having a child with a serious birth defect, and the lack of evidence for similar benefits of food folate, I would not personally be comfortable with telling someone contemplating pregnancy to avoid folic acid supplements or fortified foods at the recommended levels. That said, food sources of folate also contain many other important nutrients. These foods including dried beans and green leafy vegetables should be a part of everyone’s diet.

Some websites raise concern about health risks of using folic acid. Many of these concerns do not apply for the short-term used of folic acid just before and during pregnancy. For example, one study is pointed to as suggesting a higher risk of breast cancer with use of folic acid (4). This study was conducted in postmenopausal women, not in women who took folic acid only around the time of pregnancy, so is not really relevant to this discussion.

Similarly, a report of higher risk of colon cancer (5) found no increased risk in those taking supplements for up to 3 years.

One study which found a correlation between use of folic acid in pregnancy and breast cancer (6) had some subjects taking more than 10 times as much folic acid as is recommended. The number of subjects in this study was small and the researchers themselves comment that their results could be due simply to chance. No other study has replicated the findings of this study.

Some websites raise the issue of whether or not children whose mothers take folic acid in pregnancy have a higher risk of asthma. There have been 4 studies of the relation between supplemental folic acid in pregnancy and childhood asthma. Two found statistically significant associations between childhood asthma and late (but not early) pregnancy maternal folic acid exposure. Another found a statistically significant association between childhood wheeze and early (but not late) pregnancy maternal folic acid exposure. A fourth study found little association between maternal dietary folate in pregnancy and infantile wheeze. (7) One group of researchers commented, “We would remind women that respiratory risks from late pregnancy folic acid are unproven, but that even if they are real, the absolute increase in risk to an individual child would be fairly small. Hypothetically, if the relative risk increase of asthma from standard dose late pregnancy folic acid was 10–20% (consistent with the Australian and English studies), and assuming an Australian childhood asthma prevalence of 20%, a pregnant woman taking folic acid in late pregnancy would increase her child’s risk of asthma by 2–4%. Couching the statistics in these terms may help patients make an informed decision (7).”

Bottom line (my opinion): We don’t have enough information to recommend food folate in place of folic acid to reduce risk of neural tube defects. Based on what we know now, the benefits of folic acid supplements prior to conception and during pregnancy outweigh the risks.

References
1. Centers for Disease Control. Facts About Folic Acid. http://www.cdc.gov/ncbddd/folicacid/about.html
2. Wilcox AJ, Lie RT, Solvoll K, et al. Folic acid supplements and the risk of facial clefts: A national population-based control study BMJ, 2007 Mar 3;334(7591):464.
3. Caudill MA. Folate bioavailability: implications for establishing dietary recommendations and optimizing status. Am J Clin Nutr. 2010 May;91(5):1455S-1460S.
4. Stolzenberg-Solomon RZ et al. Folate intake, alcohol use, and postmenopausal breast cancer risk in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Am J Clin Nutr. 2006 Apr;83(4):895-904.
5. Fife J et al. Folic acid supplementation and colorectal cancer risk; a meta-analysis. Colorectal Dis. 2011 Feb;13(2):132-7.
6. Charles D et al. Taking folate in pregnancy and risk of maternal breast cancer. BMJ 2004;329:1375;6.
7. Sharland E, Montgomery B, Granell R. Folic acid in pregnancy – is there a link with childhood asthma or wheeze? Aust Fam Physician. 2011 Jun;40(6):421-4.

For fifteen years, what I put in my body has been all-important. Hyperawareness of my intake and output continues as a daily priority. My choice to go vegan occurred just over two years ago in April of 2010, but my diagnosis with type 1 diabetes mellitus, commonly known as juvenile diabetes, happened in August of 1997.

While I used to administer upwards of five shots of insulin via syringe each day, in 2007 I transitioned to the insulin pump. Instead of time-dependent injections, I now deliver rapid-acting insulin continuously through a catheter to manage my blood glucose level. Need to clear up the medical jargon? Find explanations and definitions of diabetic terminology on the American Diabetes Association or Medline Plus websites.

So – what is diabetes?

Diabetes is a disorder of metabolism— the way the body uses digested food for growth and energy. Most of the food people eat is broken down into glucose…the main source of fuel for the body.
After digestion, glucose passes into the bloodstream, where it is used by cells for growth and energy. For glucose to get into cells, insulin must be present. Insulin is a hormone produced by the pancreas, a large gland behind the stomach. (National Institute of Diabetes and Digestive and Kidney Diseases).

When I eat, unlike non-diabetics, my pancreas cannot give proper insulin doses. Glucose does not move to cells from my blood as my pancreas sends out too little insulin. The result? I need to self-administer different amounts of insulin depending on my personal food intake, activity level and current blood glucose level.

Considering that people with diabetes have trouble using food for growth and energy, the omnivore-vegan transition might initially intimidate. Personally, the journey towards veganism brought both challenge and triumph. My childhood consisted of avid milk drinking. A cup of cow’s milk equates roughly to one slice of bread or one small fruit in carbohydrate content. I turned to milk whenever I needed a quick, easy snack that supplied carbohydrate and also included calcium and protein. When my go-to blood sugar stabilizer, cow’s milk, fell out of the picture, I found that along with plant-based milks like soy milk, many fast-acting carbohydrates like apple juice, bread, crackers and glucose tablets still fit the vegan tab. When I became vegan, I noticed that my blood sugars were lower on average, and reduced my basal rate (the continuous drip of insulin) to compensate. Lower blood sugars presented several potentially serious risks, but with proper management, I kept my levels largely within my personal target range. My A1C (an indicator of how well my blood sugar was controlled within the past couple months) dropped more than half a point, a sign of effective control.

Energy plays a central role in both diabetic and vegan lifestyles. Challenge came in managing carbohydrate intake while choosing foods for their protein content. Meeting with a registered dietitian revealed the importance of adequate protein to maintain strength as well as hair and nail health. With a relatively active lifestyle (I was a competitive cheerleader in high school and I dance at college), my dietitian and I decided to select for protein to help me gain muscle mass. Meals like pancakes and cottage cheese, while high in both carbohydrates and protein, contain dairy and eggs. Protein-rich vegan combinations like tofu, broccoli and almonds provide lower carb content. My personal remedy? Include carb sources like oatmeal, brown rice and bagels with other typically protein-rich/low-carb foods. That’s not to say pancakes disappear in a vegan meal plan. I love using bananas or flax seed and water as egg replacers in pancake mixes. Come breakfast time, water and nut or plant-based milks ensure that my pancakes retain their fluffy texture.

Being a vegan diabetic, I know that I need to eat more before physical activity. This past winter, I skied for the first time. While I was far from Olympic caliber, learning technique took a lot out of me. As my friends refueled with dairy products and meat-based protein, I made sure to pack along my favorite soy protein powder (Whole Foods Soy Protein Powder in Natural Vanilla flavor) and consume my fair share of peanut butter and lentil soup. However, even with meal planning, I experienced late-night blood sugar drop, or post exercise hypoglycemia. My body responded to changing stress levels and stores of glycogen with a drop in blood glucose level. Everyone’s reaction to exercise varies, which is why I check my blood glucose level before, during and after physical activity and pack snacks in case of low blood sugar. I found instant oatmeal and apples to be quick and easy fast-acting foods. My best advice, simple and overused: prepare and plan ahead.

If the vegan shift brought tremendous change, then the college-vegan-diabetic transition created a trifecta of new and unexpected (yet manageable!) challenges. At Northwestern University, I balance picking up my own prescriptions with buying additional groceries and navigating the dining hall options. Lucky for me, Northwestern won Most Vegan-Friendly College from PETA2 for the second year in a row. Oven roasted herb potatoes and hummus flatbread plates? As both a vegan and a diabetic, I can’t complain! For me, NU’s on-line weekly menus provide invaluable planning information. I access menus at my favorite dining halls, being sure to fill any nutritional holes with a quick run to Walgreens, Whole Foods or my dorm room.

As freshman year wraps up and I enter my 16th year with diabetes and embark on vegan year three, I can say sincerely that I enjoy myself in health and life at large. Bottom line: use experience to your advantage and have fun! As a diabetic, I’m used to knowing my body. This made the switch easier; I adhered to the already familiar routine of monitoring how what I eat makes me feel. My advice? Dive in full force. Know your body; explore the make up of your food. Be innovative with low blood sugar snacks (might I suggest “vegan cookie dough?” Instant oatmeal, peanut/nut/sunflower seed butter, bananas, and – if you’re up for it – raisins). All changes present risk, but for me, keeping confidence up and reflecting over my convictions allow me to lead a “vegabetic” lifestyle with ferocity.

Questions about monitoring carb intake, planning meals, finding recipes or “free foods” (those low enough in calories and carbs that they are considered “free”)? Many solutions and resources can be found in VRG’s Vegan Menu for People with Diabetes (containing a carb exchange/equivalency table and daily menu pattern, also available in Spanish) and the Physician’s Committee for Responsible Medicine guide to going vegan with diabetes. You can also find general information about nutrition for people with diabetes on the American Diabetes Association “Food & Fitness” page.

As stated in Vegetarian Journal 2003 Issue 2 in “Vegan Menu for People with Diabetes:” “Every person who has diabetes has his or her own individual energy and nutrient needs, so please consult your health care professional to make sure our suggestions will work for you.”

This is not personal medical advice. This article stems from personal experience and things that I individually find helpful. Consult your healthcare professional for personal suggestions and/or medical advice.

Written by Aileen McGraw during her internship with The Vegetarian Resource Group

Veg Babies with Reed Mangels

You can find more archives of the Dr. Don Show here: http://bullheadurgentcare.com/archives/index.html, including the March 6 show, in which Dr. Mangels discussed pregnancy, lactation and vegetarian diets.

For more information on vegan pregnancy, see:

• The Everything Vegan Pregnancy Book by Reed Mangels, RD, PhD
• Vegan Nutrition in Pregnancy and Childhood

By Christine Kasum Sexton

The short answer is yes. Protein deficiency, as well as lack of exercise, can contribute to age-related muscle loss. Vegan diets are no more likely to be protein deficient than are non-vegan diets. As you age, however, you likely require fewer calories in your diet, so it is important to make sure that the foods you eat are nutrient-dense and protein-rich.

Age-related muscle loss is extremely common. After the age of 50, most people lose about 1-2% of their muscle per year^1,2. Rates of muscle loss in aging are higher in men than in women^3,4. The name given to this loss of muscle that occurs with aging is sarcopenia. Sarcopenia can significantly impact quality of life by decreasing mobility and increasing risk of falls.

Some research has suggested that slightly higher protein intake, coupled with resistance training, can lead to improved muscle mass in older men⁵. The evidence suggests that an appropriate range of protein intake for older vegans is between 0.36 and 0.57 grams per pound of body weight per day. Using this range, a 65 year old vegan man who weighs 180 pounds would need between 65 and 103 grams of protein per day. You can definitely get this range of protein while following a vegan diet. Choose foods that are good sources of protein such as soybeans, quinoa, lentils, black beans, kidney beans, tempeh, seitan, and textured vegetable protein products such as vegetable burgers and vegetable sausage. Limit empty sources of calories such as soda and “junk” foods like chips or sweets. Some research has also suggested that sarcopenia may be slowed by consuming some protein with each meal (rather than carbohydrates at one meal, and protein at another, for example)⁶.

Lack of regular exercise is a significant factor contributing to age-related muscle loss. Men and women who are less physically active have less muscle mass, and are more likely to experience falls. Resistance training has been clearly shown to lead to increases in both muscle strength and muscle mass. The term resistance training refers to types of exercise that work to increase muscle strength and endurance through repetition of exercises using weights, weight machines, or resistance bands. No other intervention has proven to be as effective at reversing age-related muscle loss as resistance training. The U.S. Department of Health & Human Services recommends that older adults perform muscle-strengthening activities at least 2 days each week. When resistance training is used, they recommend one set of 8 to 12 repetitions of each exercise. For maximum effectiveness, exercises should be done that involve all of the major muscle groups.

The sample menu below shows how easy it can be for a vegan to obtain a healthy amount of protein. This menu provides approximately 2000 calories and 92 grams of protein.

Breakfast:
Oatmeal made with soymilk and raisins
2 links of veggie sausage
Coffee

Morning snack:
Orange

Lunch:
Vegan black bean burrito on whole wheat tortilla with avocado, soy cheese, and tomato
Carrot sticks
Apple
Water

Afternoon snack:
Almonds
Strawberry soy yogurt

Dinner:
Stir-fry with mixed vegetables, tofu, and brown rice
Soy milk

References

1. Hughes VA, Frontera WR, Roubenoff R, Evans WJ, Singh MA. Longitudinal changes in body composition in older men and women: role of body weight change and physical activity. Am J Clin Nutr. 2002;76(2):473-81.

2. Sehl ME, Yates FE. Kinetics of human aging: I. Rates of senescence between ages 30 and 70 years in healthy people. J Gerontol A Biol Sci Med Sci. 2001;56(5):B198-208.

3. Gallagher D, Ruts E, Visser M, Heshka S, Baumgartner RN, Wang J, Pierson RN, Pi-Sunyer FX, Heymsfield SB. Weight stability masks sarcopenia in elderly men and women. Amer J of Physio – Endocr & Metab. 2000;279(2):E366-E375.

4. Roubenoff R. Sarcopenia: a major modifiable cause of frailty in the elderly. J Nutr Health Aging. 2000;4(3):140-2.

5. Haub MD, Wells AM, Tarnopolsky MA, Campbell WW. Effect of protein source on resistive-training-induced changes in body composition and muscle size in older men. Am J Clin Nutr. 2002; 76(3): 511–517.

6. Paddon-Jones D, Rasmussen BB. Dietary protein recommendations and the prevention of sarcopenia. Curr Opin Clin Nutr Metab Care. 2009; 12(1): 86–90.

For more nutrition information, see http://www.vrg.org/nutrition/

The contents of this website and our other publications, including Vegetarian Journal, are not intended to provide personal medical advice. Medical advice should be obtained from a qualified health professional. We often depend on product and ingredient information from company statements. It is impossible to be 100% sure about a statement, info can change, people have different views, and mistakes can be made. Please use your best judgment about whether a product is suitable for you. To be sure, do further research or confirmation on your own.