Vegetarian Nutrition

Vegetarianism is a diet that includes predominantly plant-based foods. While vegetarian individuals consume plant foods, they consume little or no animal foods such as meat, poultry, fish, eggs, milk, cheese, yoghurt.

Vegetarian diet is preferred for different reasons. The most basic reason is the grain-based diet of the society. In addition, milk and eggs are easily accessible, meat is consumed in a short time after slaughtering, and meat is an expensive food source. In recent years, cardiovascular diseases, hypertension, diabetes, cancer, etc. Vegetarian diet is chosen in order to prevent chronic diseases.

A vegetarian diet differs in limitations in food types. These;
1. Vegan diet: No food of animal origin is consumed. The diet consists of cereals, vegetables and fruits, and legumes. The number of people who follow a vegan diet all over the world is very small. There are also subgroups of vegans.
2. Lacto-vegetarian diet: Along with plant foods, milk and dairy products from animal-derived foods are consumed.
3. Lowland vegetarian diet: Along with plant foods, eggs are also included in the diet. In addition, meat and milk are not consumed.
4. Lacto-ova vegetarian diet: Consumes milk and eggs. It is the most common vegetarian diet today.
5. Polo vegetarian diet: No red meat is consumed in this diet. In addition to plant foods, only poultry such as chicken and turkey are consumed as animal products.
6. Pesko vegetarian diet: Red meat is not consumed in this diet either. In addition to plant foods, only fish varieties and mussels are consumed as animal products.
7. Semi-vegetarian diet: Red meat is not consumed in this diet either. A limited amount of chicken and fish is consumed. Semi-vegetarians consume eggs, milk and derivatives as much as they want.

EVALUATION OF VEGETARIAN DIETS IN TERMS OF NUTRITIONAL CONTENT AND NUTRITION

The nutritional value of a vegetarian diet varies according to the variety of nutrients in the food. If a vegetarian diet is poorly planned, it causes some nutritional deficiencies. An individual on a vegetarian diet may also choose an eating style that includes high-fat and low-fiber foods throughout the day. For this reason, in order to provide nutrient diversity during the day, the foods in the consumed food groups should be chosen correctly (Table 1). The easiest way to do this is to increase the nutritional diversity of the diet during the day. It is easiest and most accurate to benefit from food groups to provide food diversity. At each meal, at least one of the foods in each different food group should be consumed. Vegetarian diets include high complex carbohydrates, low saturated fat, cholesterol and high unsaturated fat, fiber types and phytochemicals, as they mainly contain plant-based foods. Since vegetarian individuals consume mostly unpurified grain products or foods with fiber sources in their diets, whole grain products, unpurified grains, vegetables and fruits should be preferred among carbohydrate foods. While the complex carbohydrates in the structure of these foods allow blood sugar to rise more regularly, the risk of chronic diseases such as obesity, diabetes, cardiovascular diseases and bowel cancer is reduced by consuming fiber types. When choosing foods from the grain group, vegetarian individuals should pay attention to the amount of servings recommended to be consumed at least per day. In whole grain products; Consumption of whole wheat bread, bulgur, breakfast cereals, pasta, brown rice and other whole wheat products should be preferred. Vegetarian individuals should also meet approximately 50-60% of their daily energy from carbohydrates (Table 2).

In addition to the amount of carbohydrates consumed, the type of carbohydrate is also important. The major problem in the diet of many vegetarians is that their diets do not contain enough or quality protein. Lacto-ova, lacto, polo and pesco vegetarians do not have a big problem with protein when they consume enough milk and dairy products, eggs, except meat. However, vegans who do not consume any animal products may have problems, and vegans may consume soybeans instead of meat. Meat equivalents (poultry, fish, milk and dairy products, eggs); It is a good source of protein, fat, cholesterol, iron, zinc and B group vitamins. Vegetarians who consume lean meat and skinless chicken will consume products that are low in fat and cholesterol. Pesco-vegetarians should prefer fish with higher unsaturated fatty acids (omega-3), such as salmon, mackerel, haddock, catfish, which contain less saturated fat and cholesterol, to shellfish.
 Vegetarian diets are mostly plant-based. Vegetarian individuals can synthesize body proteins when they consume enough energy from plant foods such as legumes, oil seeds, seeds, grains, vegetables and fruits, as well as adequate energy intake throughout the day. Legumes and oilseeds, on the other hand, are a good source of protein and contain low total fat and saturated fat, while they do not contain cholesterol. Vegetarians, especially vegans, who do not consume any food of animal origin, can meet the nutrient requirements of this group by consuming legumes and oilseeds as a meat alternative. The important thing is to provide a variety of foods containing essential amino acids in vegetarian diets. While essential amino acids are found in appropriate amounts in foods of animal origin, they are limited in some plant sources. For this reason, especially vegans should meet essential amino acids by providing a variety of plant-based foods in their meals. If vegetarian individuals eat some plant foods by mixing them, they will make up for this deficiency and provide the protein balance of their diets. For example; When they eat bulgur or rice with dried beans cooked without meat, they balance the essential amino acids and take them into their bodies. The daily protein requirement of vegetarians, as in healthy adults, is 1 gram per kilogram of body weight. For example; The daily protein requirement of a vegetarian individual weighing 58 kg is 58×1=58 g. In other words, approximately 15-20% of the daily energy intake should be met from proteins.

The diets of vegetarians, especially vegans, contain less omega-3 fatty acids than non-vegetarians. Pesco-vegetarians or semi-vegetarians who only consume fish in their diets consume enough omega-3 fatty acids. The diets of vegans are low in fish containing omega-3 and high in vegetable oils containing omega-6. Disruption of the balance between these fats can cause some problems in brain development, vision and central nervous system during the growth period. It increases the risk of cardiovascular and inflammatory diseases in adulthood. Therefore, attention should be paid to the n-6/n-3 ratio. Unless restrictions are made due to a health problem in vegetarian individuals, a maximum of 25-30% of daily energy should be provided from fats (Table 2). The daily total fat content of the diet; 1/3 from saturated fatty acids (such as butter), 1/3 from polyunsaturated fatty acids (sunflower, corn germ, flaxseed, soft bowl margarine, etc.), 1/3 from monounsaturated fatty acids (olive oil, hazelnut oil etc.) should be provided. The daily consumption of dietary cholesterol should not be more than 300 mg.
Depending on the type of vegetarianism, there is insufficient intake of some vitamins and minerals. Each food contains different vitamins and minerals in its composition. Although they are found in very small amounts in foods, they have very important functions. Individuals with a vegetarian diet should be exposed to regular sunlight like individuals with a normal diet. Babies and children with dark skin, elderly, home-bound, closed-to-wear vegetarian individuals and especially vegans should pay attention to getting enough vitamin D. The biggest problem encountered in vegans is riboflavin (vitamin B2) and vitamin B12 deficiency. Those who follow a vegan diet for a long time may develop health problems (anemia, anemia, irreversible nerve damage) due to vitamin B12 deficiency. For this reason, the diet of vegans should be controlled by a dietitian in terms of vitamin B12. Vitamin B12 is especially important for the elderly with vegetarian diets, pregnant and lactating mothers, and infants and children. Adequate amounts and appropriate types of dietary fats should be consumed for the intake and use of fat-soluble vitamins A, D, E and K, and for the production of certain hormones that enable the body to function.

Vegetarian individuals should make their food choices carefully. Vegetarian individuals consuming milk and its products meet their calcium needs with daily consumption of milk, cheese and yogurt. If vegan individuals do not consume enough milk and its products, they should consume foods from other food groups that contain good sources of calcium. When vegetarian individuals consume enough calcium, they also have a low risk for brittle bone diseases and osteoporosis. Vegans should consume plenty of green leafy vegetables, nuts and seeds, legumes, whole grain products for important minerals such as iron, zinc and calcium. The most practical way to choose calcium-rich foods other than milk and its products is that each portion of food selected contains approximately 100-150 mg of calcium. Dietary planning may be necessary to get the recommended amount of calcium-containing foods during the day. The lacto-ova vegetarian diet and semi-vegetarian diet, in which meat is limited, plant foods, milk and dairy products and eggs are included, are generally adequate and balanced. This diet may be deficient in iron only for women of childbearing age who are prone to anemia, and for children and teenagers. There may be a risk of iron deficiency in vegetarian individuals if they do not have a balanced diet. The use of iron taken from vegetables and grains by the body is less than the iron in meat. Since iron is absorbed more strongly when consumed with foods containing vitamin C, vegetarian individuals should consume legumes, green leafy vegetables, dried fruits, molasses, eggs and nuts, which are good sources of iron. However, a food rich in vitamin C should be consumed at every meal. Foods rich in vitamin C are; citrus fruits or their juices, broccoli, tomatoes, green peppers. Tea or coffee consumed with meals reduces the absorption of iron and zinc so that iron absorption is not damaged. It is helpful to drink beverages such as tea and coffee 1 hour before or 2 hours after a meal. Lacto-ova vegetarians get enough zinc by consuming milk, cheese, yogurt and eggs. Vegetarian individuals who do not have red meat, poultry, or seafood in their diet may be deficient in zinc. Because the fiber content of the vegan diet is high, some minerals such as iron, zinc and calcium, which are necessary for growth and health, have low usefulness rates for the body. The fluid requirement of vegetarian individuals is not different from non-vegetarians.

FEATURES OF NUTRITION IN VEGETARIAN INDIVIDUALS WITH SPECIAL CONDITIONS

There may be individuals of different ages, pregnant, lactating, athletes and growth periods (infancy, childhood and adolescence) who prefer vegetarian nutrition. There are important points to be considered in the nutrition of each of these individuals who have a vegetarian diet.

Nutrition of infants of vegetarian mothers;
Vegetarian mothers should take care to feed their babies with their own milk. The content of the milk of vegetarian mothers is similar to the milk of non-vegetarian mothers and does not have the same nutritional value as any other food. If babies cannot be breastfed up to 6 months, or if breast milk is stopped early, then commercial infant formulas can be applied. Baby foods, animal milks and soy milk can never replace breast milk. Because the nutritional values ​​of these foods are not found in appropriate proportions and are not similar to breast milk. In this period, help from a dietitian or physician should be sought in order to meet the increasing needs of the baby and to provide adequate and balanced nutrition.

Nutrition of vegetarian children;
The growth and development of children on a lacto-ova vegetarian diet are similar to the growth and development of non-vegetarian children. If the daily food intake of children with very strict vegetarian eating habits is not well planned, growth retardation can be seen. Vegan children have slightly higher protein needs than non-vegetarians. If these children provide sufficient energy and a variety of plant-based foods in their daily diets, no problems will be seen. The daily protein intake of vegetarian children other than vegans is lower compared to non-vegetarian children. However, the amount of protein they consume can meet the recommended daily intake for children when they eat a balanced diet. While especially vitamin B12 deficiency is observed in children on a vegetarian diet, calcium deficiency is added to this in vegan children. In addition, attention should be paid to the intake of iron and zinc nutrients. In order for children to meet these nutrients, care should be taken to ensure that they can consume milk and its products, eggs, vegetables and fruits, hard-shelled fruits, oilseeds, soy and other legumes, and whole wheat products. If these children cannot benefit from sunlight enough, care should be taken in terms of vitamin D deficiency.

Vegetarian adolescent nutrition;
Vegetarian children and adolescents need adequate nutrient diversity and energy to grow and develop just like non-vegetarians. Care should be taken to ensure the growth of vegetarian-fed adolescents and to meet their high nutritional needs. Lacto-ova vegetarians usually get enough nutrients from the foods they choose. However, adolescents who choose a vegan diet should pay attention to the consumption of calcium, iron, B12 and vitamin D.

Nutrition of vegetarian pregnant and lactating;
Vegetarian mothers' need for energy and nutrients during pregnancy and lactation are the same as non-vegetarian mothers. However, vegetarian diet has both positive and negative effects on pregnancy. Consumption of high fiber fiber in vegetarian diet prevents constipation, which is common during pregnancy. Vegetable-based foods consumed by vegetarians contain folic acid, which is beneficial for the development of the baby's nervous system. Even if vegetarians usually consume more folic acid than non-vegetarians, they can consult an expert about whether to take a folate supplement. It is easy for lacto-vegetarians to get enough calcium during pregnancy and lactation. It is appropriate to add one or two more portions from the milk group to this. It is appropriate to consume adequate amounts of vitamin B12 sources, which adversely affect the health of the mother and the baby in its deficiency.

Nutrition of the vegetarian elderly;
The food consumption of vegetarian elders is not much different from non-vegetarian elders. While the energy needs of the vegetarian elderly decrease, their needs for calcium, vitamin D, vitamin B6 and vitamin B12 increase. Care should be taken to consume foods containing these nutrients and to benefit from adequate sunlight. In addition, the use of flaxseed, canola oil and soy products in the diets of elderly vegetarians, when fish and seafood are not available, provides omega-3 fats.

Nutrition of vegetarian athletes;
The energy and nutrient needs of vegetarian athletes should be regulated by taking into account the type of vegetarianism they prefer and their exercise status. The energy needs of vegetarian athletes differ even among individuals of the same age, gender and sport. Athletes who eat vegetarian type have a diet high in fiber and low in energy because they consume mostly plant-based foods. Consumption of high-fiber foods increases the satiety of vegetarian athletes, while foods such as legumes cause discomfort to the athlete due to their high gas-forming properties. In addition, it replenishes muscle glycogen stores in greater amounts than other nutrients. For this reason, foods that have been purified and whose starch content has increased, but whose content is subsequently enriched with vitamins and minerals (enriched breads, pasta, etc.), fresh fruit juices sweetened with molasses or sugar, peeled fruits and vegetables should be consumed, and consumption of energy and nutrient-dense, low-fiber foods should be preferred.