What is a Vegetarian

There are several versions of the vegetarian diet. According to the Mayo Clinic website there are three main categories of vegetarians: vegan, lacto-vegetarian, and lacto-ovo vegetarian (http://www.mayoclinic.com/health/vegetarian-diet/HQ01596). The strictest form of vegetarianism is vegan, where no animal products are consumed at all, including all meat, eggs, cheese, and milk. The lacto-vegetarians exclude all meat and eggs but include dairy products like milk, cheese, and yogurt. The third type is lacto-ovo vegetarians, and they still exclude all meats but do allow milk products and eggs. A semi-vegetarian consumes primarily a plant based diet but does eat some meat, fish, poultry, eggs, and cheese in small amounts.

According to Koebnick et al. (2005) there is another form of vegetarianism called the raw food diet where food is consumed predominantly or exclusively as uncooked and unprocessed raw food. The primary foods in this form of diet are fruits, nuts, seeds, sprouted grains, and beans. The health benefits of each of these diets will be discussed in more detail later on.

Why Become a Vegetarian

There are many reasons why one chooses to practice a vegetarian diet. For some it is for religious reasons, for some it is because they feel that they are standing up for animal rights, like PETA, and for others it is purely to gain the health benefits that a vegetarian diet can provide. This paper will primarily address the health benefits of vegetarian diet and only briefly touch on the other reasons for choosing not to consume animal products.

Struempler (1990) explains that there are seven reasons one might choose to be a vegetarian: religion, ecology, ethics, economics, food preference, personal convictions, and health. Trappist Monks, Seventh Day Adventists, and Hindus have a long history of vegetarianism. These groups tend to believe that vegetarian diets can purify the body. The ecology group feels that the growing of crops to feed livestock is not a sustainable and jeopardizes the ability to feed the people of the world. Ethics comes into play because of compassionate living and oppose the act of killing. A vegetarian diet is economically beneficial because meat usually costs more that fruits, vegetables, and grains. Some people are vegetarians simply because of food preference, they just don’t like meat. The last two, personal convictions and health, both focus on the increased quality of life and lower risk of chronic diseases and health conditions.

Seventh-day Adventists

According to the Seventh-day Adventists website (http://www.sdada.org/position.htm) they have practiced a vegetarian lifestyle for 130 years. The claim to practice a vegetarian lifestyle because of their belief in the holistic nature of humankind and that whatever they eat or drink should preserve the health of their mind, body, and spirit. Their website claims that since 1954 there have been over 250 articles published about their lifestyle and health.

According to the information posted on their website, Seventh-day Adventists (SDAs) have 50% less risk of heart disease, certain types of cancers, strokes, and diabetes. They also claim that SDAs men live an average of 8 years longer and SDAs women live an average of 7 years longer, compared to men and women who eat meat. They do claim that special attention needs to be given to intake of protein, iron, zinc, calcium, Vitamin B 12, and protein. These issues will be addressed in more detail later.

Benefits of Vegetarian Diet

There are many health benefits associated with eating a vegetarian diet. One of the biggest health benefits of eating a vegetarian based diet is the fact that more nutrient rich foods are consumed. A vegetarian diet usually includes more fiber, less calories, and less saturated fat than non-vegetarian diets. Pharmaceutical companies make millions of dollars by selling cholesterol lowering medications to Americans and they even mention diet and exercise in their advertisements as a way to lower your cholesterol. These companies know the statistics that were mentioned above and they realize that it is much easier for someone to take a pill than to change their lifestyle.

White and Frank (1994) claim that vegetarians usually have lower weight, lower total serum cholesterol levels, and lower blood pressures than omnivores. Vegetarians also tend to have lower mortality than the population at large, due mostly to lower death rates from ischemic heart disease and certain cancers. Vegetarians also have not to suffer from nutritional deficiencies even among strict vegetarians.

Vegetarian Diet as a Medical Treatment

The Gerson Institute developed an entire treatment regimen using a strict vegetarian diet to treat a variety of health problems. According to their website, their therapies have been used to treat cancer, diabetes, heart disease, and arthritis (www.gerson.org). Their brochure states that their treatment consists of diet, juices, detoxification, medications and supplements, and rest. I will elaborate on the diet and juices portion of their treatment. According to their brochure, the diet consists of three vegetarian meals per day, 10 to 13 glasses of fresh made juice per day, and snacking on fresh fruits and vegetables throughout the day. The daily diet consists of nearly 20 pounds of fresh, organic fruits and vegetables and most of that is consumed by drinking one glass of juice per hour throughout the day. By using this regimen, they claim to be boost the “body’s own immune system and other defenses to heal cancer, arthritis, heart disease and allergies, as well as many other chronic conditions” (Gerson Brochure 2009).

A raw food vegetarian diet was used to treat fibromyalgia. A report by Donaldson, Speight, and Loomis (2001) found that a raw vegetarian diet was successful in helping fibromyalgia patients. Fibromyalgia is a painful disease that is often accompanied by unrestorative sleep patterns, fatigue, headaches, irritable bowel and bladder syndrome, stiffness, anxiety, and depression. The study consisted of 30 fibromyalgia patients who consumed a raw diet of fruits, salads, carrot juice, tubers, grain products, nuts, seeds, and a dehydrated barley grass juice (2001).

Treatment effectiveness was determined by analyzing the results of fibromyalgia impact questionnaire (FIQ), quality of life (QOL) surveys, food frequency questionnaires (FFQ), and the SF-36 short form health survey. The SF-36 has been widely used to record how a person perceives his or her own health status. These questionnaires were completed by the patients at 0, 2, 4, and 7 months. The results of these surveys were analyzed by repeated measures of analysis of variance. The FIQ results showed a significant trend for improvement in all categories. The QOL scores revealed significant improvements, with the largest impact seen in active recreation, health, socializing, and participating in organizations. The SF-36 results revealed that after 7 months of intervention that 4 of the 8 heath categories no longer showed a statistically different score than the norms. There were significant improvements in general health, vitality, role emotional and mental health (Donaldson et al., 2001).

Meat Intake and Mortality

Sinha, Cross, Graubard, Leitzmann, and Schatzkin (2009) conducted a 10 year study on the relationship between meat intake and mortality. They looked at the eating habits of the cohort from 1995 to 2005. They saw a connection between red meat and processed meat consumption and an increased risk in total mortality, cancer, and cardio vascular disease. The study showed an inverse correlation in total mortality risk and cancer mortality with the consumption of white meat; however, there was a light increase in risk for cardio vascular disease. This data shows that consuming less of all types of meat can have a positive impact on cardiovascular disease and that consumption of red and processed meats increase total mortality risk and cancer.

article_em.htm).

Protein Intake and Vegetarians

Protein is needed for good health. Meat products are not the only way to get protein in your diet. The Loma Linda University website explains that proteins can either be complete or incomplete (http://lomalindahealth.org/health-library/a-z-health-guide/1/002465.htm). Complete proteins contain the necessary amounts of essential amino acids required for good health, whereas incomplete proteins contain only some of the necessary amino acids. They go on to explain that you do not need to eat animal products to get the essential proteins in your diet but you do have to combine incomplete proteins like milk and cereal, bread and peanut better, or rice and beans. By combining two or more incomplete proteins you are able to get the necessary amino acids your body needs without consuming meat.

Vegetarian Information

Vegetarian diet information is neither a secret nor is it hard to find. The CDC, The American Heart Association, The American Dietetic Association, and The Mayo Clinic all have detailed information on vegetarian diets and the health benefits they can provide. A Google search for the term “vegetarian diet” provides over 2,360,000 results. So why do Americans choose to live a lifestyle that can potentially harm them? Some argue that the fruits and vegetable are either not available or they are too expensive. In an article by Springen (2007) claims that rural Americans live too far from grocery stores and often shop at the local convenience store, where health food choices are simply not available and if they are available, they are too expensive (http://www.newsweek.com/2007/12/10/junk-food-county.html).

Unfortunately American fast food is cheap and readily available. The busy lifestyle of many Americans often leads to poor eating habits. It is a lot easier to go through the drive through and get a bag full of cheeseburgers and French fries than it is to stop at the grocery store a buy healthy, nutritious food that you will have to go home and prepare and then have to dirty kitchen to clean up. One could argue that it is cheaper to eat fast food than it is to eat a vegetarian diet, but the cost of poor heath is much higher. In a 2008 report published by Mayo Clinic Health Solutions, they state that obesity related claims accounted for 2.8% of health care costs. This might not seem like much, bit 2.8% of the $2 trillion that the U.S. spends on health care is a lot of money. The report also states that for every one point increase in BMI (body mass index) that medical costs increase by $119.70 and medication costs go up by $82.60 (http://ohp.nasa.gov/disciplines/hpromo/pdf/The_True_Cost_of_Poor_Health.pdf).

Lifestyle and Health

America has seen an increase in lifestyle diseases such as obesity, diabetes mellitus, hyperlipidaemia, hypertension, coronary artery disease and cancer. There is considerable epidemiological evidence suggesting that a vegetarian lifestyle is associated with a lower risk for these diseases (http://qjmed.oxfordjournals.org/content/92/9/531.long). In an article by White and Frank (1994) they claim that vegetarians tend to have lower weight, total serum cholesterol levels, and blood pressures than omnivores. Vegetarians have lower mortality than the population at large, attributable primarily to lower death rates from ischemic heart disease and certain cancers.

There is a diet and lifestyle known as the Mediterranean diet. This diet is explained on Mayo Clinic’s website (http://www.mayoclinic.com/health/mediterranean-diet/CL00011) as a heart-healthy way of eating. This form of diet includes plentiful amounts of fruits and vegetables, fish, whole grains, and healthy fats and oils like those in salmon and olive oil. According to the website, research has shown that the Mediterranean diet reduces the risk of cardiovascular disease, cancer, Parkinson’s disease, and Alzheimer’s disease. If you will notice by the image below, this diet limits the amount of red meat and sweets and encourages fruits, vegetables, and whole grains.

The Traditional American Diet

The traditional American diet includes very small amounts of fresh fruits and vegetables. Let’s consider some statistics from the CDC and particularly from the BRFSS report. The 2009 Prevalence and Trends data indicate that only 23.5% of Americans are consuming the recommended 5 or more servings of fruits and vegetables per day (http://apps.nccd.cdc.gov/BRFSS/list.asp?cat=FV&yr=2009&qkey=4415&state=All). When you add the static that 73.1% of Americans are either overweight or obese and that only 29% of Americans are getting 20 minutes or more of exercise three or more days a week, it is little wonder why we spend so much money on health care in this country.

Vegetarian Diet vs. Traditional American Diet

The average American eats too many calories, too much sodium, and too many grams of fat. Consider these examples from Men’s Health Magazine: a McDonald’s meal consisting of Chicken Selects® Premium Breast Strips (5 pc) with Creamy Ranch Sauce with Large French Fries, and Large Coke has 1,670 calories, 87 grams of fat (13 g saturated fat), and 2,370 mg sodium (http://eatthis.menshealth.com/content/worst-fast-food-meals-america?article=14&page=1). According to the calorie calculator available at www.mayoclinic.com, a 40 year old male that is 5 foot 11 inches tall, weighs 188 pounds, and is somewhat active should have a daily intake of 2,450 calories. The McDonald’s meal mentioned above would consist of more than 68% of their daily caloric intake. The recommended daily intake of sodium is 1,500mg to 2,300 mg and the recommended fat intake is 44 to 78 grams (www.mayo.com). Comparing this data with the McDonald’s meal listed above, one would consume their entire daily amount of sodium and fat in this one meal. Now, if that same person stops by Starbucks for a 16 ounce Toffee Mocha Frappuccino, they would consume another 450 calories, 290 mg of sodium, and 13 grams of fat (http://www.starbucks.com). Now the daily fat count is up to 100 grams, sodium goes up to 2,660 mg, and total calories are at 2,120. This is only one meal and one frappuccino. If that same person was to go to Chili’s for supper and order a Smokehouse Bacon Triple Cheese Big Mouth Burger with Jalapeno Ranch Dressing, they would add another 1,901 calories, 138 grams of fat (47 g saturated), 4,201 mg sodium (http://eatthis.menshealth.com/content/worst-burgers-america-2009?article=9&page=1). Now the totals are 4,021 calories, 6,681mg of sodium, and 238 grams of fat. If this same person happens to have breakfast at Bob Evans and ordered the Stacked and Stuffed Caramel Banana Pecan Hotcakes, they would consume another 1,543 calories, 77 grams of fat (26 g saturated; 9 g trans), and another 2,259 mg sodium. Now the daily totals are 5,564 calories, 315 grams of fat, and 8,940 mg of sodium. Even salads are not as healthy as one would assume. The Chevy's Fresh Mex Tostada Grande Salad with Chicken contains 1,551 calories, 94 grams fat (37 g saturated), and 2,840 mg sodium. With nutritional data like these, it is no wonder that 73% of Americans are either overweight or obese.

Now, let’s look at the calories, sodium, and fat content of a vegetarian diet. According to Food Calorie Calculator on WebMD, a slice of whole wheat bread has only 69 calories, 132 mg of sodium, and 1 gram of fat. One cup of fresh strawberries has only 49 calories, zero fat, and 2 mg of sodium. A medium banana has only 105 calories, zero fat, and 1 mg of sodium. One large fresh apple has only 116 calories, zero fat, and 2 mg of sodium. A 5 inch head of bibb lettuce contains only 21 calories, zero fat, and 8 mg of sodium (http://www.webmd.com/diet/healthtool-food-calorie-counter). Also, according to Diet Bites website, a 16 ounce serving or orange juice has about 210 calories and a 16 ounce serving of black coffee has about 4 calories. As you can see, a vegetarian diet consists of much fewer calories (http://www.dietbites.com/Calories-Simple-Foods/).

The Food Pyramid

No matter what type of diet you practice, eating more fruits and vegetable is essential to good health. The history of the Food Guide Pyramid began in 1894 (Scott, 2010). At this time, vitamins and minerals had not even been discovered; however, the importance of eating healthy was evident. According to Scott, President Franklin D. Roosevelt organized a National Nutritional Conference in 1941 to help American make healthy eating choices. It was during this time that separate food groups were created and daily intake recommendations were being made. The USDA continues to update and make changes to the Food Pyramid and their latest version is called My Food Pyramid and allows you to create a recommended diet based on your individual needs and goals.

The Harvard School of Public Health has developed a Health Eating Pyramid. As you can see from there pyramid listed below, the food recommendations are very close to the vegetarian pyramid except for the addition of fish, poultry, and eggs. The Harvard pyramid adds red meat to the top section, which is the use sparingly section.

Source: http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/pyramid-full-story/index.html

Vegetarian Food Pyramid

As you can see from the vegetarian food pyramid below, the top of the pyramid does not include any meats or dairy products. These items are replaced by legumes, nuts and other protein containing foods. The top section of the pyramid is labeled fats. According to the Mayo Clinic website, these fats should be consumed from healthy fats like those found in olive oil, peanut oil, vegetable oil, and omega-3 fatty acids found in flaxseed, flax oil, and walnuts (http://www.mayoclinic.com/health/fat/NU00262).

Source: http://www.mayoclinic.com/health/vegetarian-diet/HQ01596

Eat Fruits and Vegetables

So, why don’t Americans eat more fruits and vegetables? Magee (2007) states that there are 9 excuses that people use for net eating fruits and vegetables. These excuses are as follows: 1. It’s not convenient to eat fruits and vegetables.

2. I don’t like to fruits and vegetables.

3. I am out of the habit of eating fruits and vegetables.

4. I’m not motivated to eat fruits and vegetables.

5. I don’t know how to serve fruits and vegetables to my family.

6. I eat out a lot.

7. Fresh produce spoils before I can eat it.

8. Other snacks are more convenient.

9. Fruits and vegetable cost too much.

Magee recommends several ways to overcome these arguments and add more fruit and vegetables to your diet. Make fruits and vegetable more convenient by keeping fresh and dried fruit available and by going to restaurants that offer salads and vegetarian menu items. Try eating a variety of different fruits and vegetables, add fruits and vegetables to foods that you like, serve a green salad with your meal, and include a fruit salad as part of your meal. Increase your motivation by understanding the added health benefits that come from consuming more fruits and vegetables. If you eat out a lot, try ordering a salad or a fruit cup with your meal. To control the costs of fruits and vegetables, you should try to buy locally grown produce and fruits and vegetables that are in season. Canned or frozen fruits and vegetable are readily available and will not spoil as quickly as fresh fruits and vegetables do.

Negative Health Impacts of Vegetarian Diet

There are some possible negative health aspects of consuming a strict vegetarian diet. It is very important to plan your meals to be sure that you are getting the essential nutrients and calories that your body needs. According to the Position of the American Dietetic Association: Vegetarian Diets, vegetarians tend to have lower intakes of vitamin B-12, vitamin D, calcium, zinc, and n-3 fatty acids (July 2009). Struempler (1990) published a paper on vegetarian diets that claimed vegetarians were at risk of being deficient in protein, vitamin B12, total calories, calcium, riboflavin, iron, and vitamin D. Fontana, Shew, Holloszy, and Villareal (2005) cite a study that evaluated people who consumed a strict raw vegetarian diet and found an connection with low bone mass. The study followed 18 individuals who consumed a strict raw food vegetarian diet and they found “significantly lower BMC and BMD at the lumbar spine and hip sites compared with age- and sex-matched individuals eating a typical American diet” (Fontana et al., 2005). BMC stands for Bone mineral content and BMD stands for bone mineral density and are measurements of one’s bone density. The report claims that the decrease in bone mass is due to the low calorie and low protein intake associated with a raw food vegetarian diet.

In an article by Craig (2009) the health effects of a vegetarian diet were analyzed. A strict vegan is at a slight risk of being deficient in n-3 polyunsaturated fats, vitamin D, iron, vitamin B-12, and zinc. The risk of these deficiencies is not significant in partial vegetarians that consume fish, eggs, and sea vegetables (2009). They suggest that for vegans to get the necessary nutrients they should be sure to eat fortified foods and/or take vitamin supplements. The article confirms the benefits of reduced BMI, lower serum cholesterol, lower blood pressure, and lower risk of cardiovascular disease. According the Mayo Clinic website, “If you're generally healthy and eat a wide variety of foods, including fruits, vegetables, whole grains, legumes, low-fat dairy products, lean meats and fish, you likely don't need dietary supplements” (http://www.mayoclinic.com/health/supplements/NU00198/NSECTIONGROUP=2). However, they do recommend that a vegetarian who eats a limited variety of foods should take a multivitamin to compensate for the lack of vitamins and minerals in their diet.

Conclusion

For those that practice a less stringent vegetarian diet there are few, if any, negative health concerns. The American Dietetic report states that “It is the position of the American Dietetic Association that appropriately planned vegetarian diets, including total vegetarian or vegan diets, are healthful, nutritionally adequate, and may provide health benefits in the prevention and treatment of certain diseases” (2009). White and Frank (1994) claim that “the balance of the data suggests that vegetarianism likely improves individual as well as societal health” and state “our review of the data suggests that people, particularly those at high risk for cardiovascular disease and cancer, should be encouraged to consume increasingly vegetarian diets” (p. 470).

Going back to the Struempler (1990) report, a vegetarian can get the nutrients that they need by making sure to eat the right foods. Eating meat is not the only way to get protein. Nuts, beans, peas, and whole grains all contain significant amounts of protein. Complete proteins are only found in meat sources, but vegetable proteins can be combined to achieve complete protein consumption. For example, by combining rice and black eyed peas or lima beans and corn, one would consume all necessary protein components. Iron can be obtained by eating dark green leafy vegetables, dried fruits, and legumes. Vitamin B12 can be obtained by eating fortified foods or taking a vitamin supplement. Vitamin D can be obtained by consuming egg yolks or by drinking vitamin fortified milk; however, strict vegetarians would probably need to take a vitamin supplement. Calcium and Riboflavin can be obtained from dark green leafy vegetables, legumes, enriched breads, and whole grains.

A vegetarian lifestyle can be a healthy way of life as long as a variety of foods are eaten. As mentioned earlier, even if a person is a strict vegetarian, as long as they eat a wide variety of foods and take a vitamin supplement that includes B12, Vitamin D, calcium, and zinc, there are more health benefits than risks. Vegetarians have lower risk of cancer, stroke, obesity, cardiovascular disease, lower cholesterol, and diabetes. A vegetarian diet can also result in lower overall cost of food. There are many reasons to choose to practice a vegetarian lifestyle, no matter the reason that one chooses, it seems that there are many health benefits to practicing a vegetarian lifestyle.

References

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Koebnick, C., Garcia, A., Dagnelie, P., Strassner, C., Lindemans, J., Katz, J., Leitzmann, C., and Hoffmann, I. (2005). Human nutrition and metabolism. Long-Term consumption of a raw food diet is associated with favorable serum LDL cholesterol and triglycerides but also with elevated plasma homocysteine and low serum HDL cholesterol in humans. The Journal of Nutrition. Retrieved from http://jn.nutrition.org/content/135/10/2372.full.pdf+html.

Loma Linda University Medical Center. (n.d.). Vegetarianism. Retrieved from http://lomalindahealth.org/health-library/a-z-health-guide/1/002465.htm.

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