Should You Be A Vegetarian? Answers from nutrition science.

1. Should You Be A Vegetarian?Answers from nutrition science. Trulie Ankerberg-Nobis, M.S., R.D. truliea@gmail.com

2. My personal story

3. My personal story

4. The Historical Four Food Groups • MEAT • MILK • BREAD • FRUITS & VEGETABLES • Developed from industry pressures: FoodPolitics.com

5. The NEW Four Food Groupsdeveloped by PCRM • LEGUMES • GRAINS • VEGETABLES • FRUIT

6. Nutritional Adequacy of Vegan Diets “…appropriately planned vegetarian diets are healthful, nutritionally adequate, and provide health benefits in the prevention and treatment of certain diseases. Well-planned vegan and other types of vegetarian diets are appropriate for all stages of the life cycle, including during pregnancy, lactation, infancy, childhood, and adolescence.” “Position of the American Dietetic Association and Dietitians of Canada: Vegetarian Diets,” Journal of the American Dietetic Association, June 2003

7. The Power of Plant Foods • Fruits and vegetables –reduced risk for cardiovascular disease, cancers, and other chronic diseases (such as macular degeneration and cataracts). • Legumes - sources of protein, fiber, and a variety of micronutrients and phytochemicals that may protect against disease.

8. The Power of Plant Foods • Nuts - lower risk for heart disease and lower mortality rates. • Whole-grains - reduced risk for heart disease, diabetes, high blood pressure, and stomach and colon cancers.

9. Heart Disease: #1 Killer • Framingham Heart Study • 150 mg/dl cholesterol • 1% incr in cholesterol; 2% incr in risk • Ornish Heart Study • Can reverse disease with low fat veg diet, stress reduction and exercise • Dangerous foods: saturated fats and cholesterol, trans fats • Major sources: animal foods and processed foods • Highest source of saturated fat in American diet: dairy products • Only animal foods have cholesterol

10. Cancer: #2 Killer • ESTIMATED PERCENTAGES OF CANCER DUE TO SELECTED FACTORS* • Diet 35-60% • Tobacco 30% • Alcohol 3% • Radiation 3% • Air and Water Pollution 1-5% • Medications 2% • * These figures are rough estimates based on data from: Cancer Rates and Risks, National Cancer Institute (Washington, DC: 1985), and R. Doll and R. Peto, Journal of the National Cancer Institute, 1981, 66(6):1191-1308. Other factors may also play a role in certain forms of cancer and are not included in this table. Categories may overlap. For example, both tobacco and alcohol contribute to esophageal cancer.

11. Cancer and diet • Foods rich in fat and oils affect digestive cancers and sex-hormone cancers • E.g. colon, rectum, prostate, breast • The difference between a low-fat vegetarian diet and an omnivorous one = 1500 g fat/month. • Protective dietary components • Fibers from whole grains and colon and rectum cancers • Fiber helps to rid the body of excess hormones protecting against prostate and breast cancer • There is no fiber in any animal product • Plant nutrients: Beta-carotene, vitamin C

12. Vegetarians and disease “Vegetarian diets offer a number of nutritional benefits, including lower levels of saturated fat, cholesterol and animal protein,as well as higher levels of carbohydrates, fiber, magnesium, potassium, folate, and antioxidants such as vitamin C and E and phytochemicals. Vegetarians have been reported to have lower body mass indices than nonvegetarians as well as lower rates of death from ischemic heart disease;… also lower blood cholesterol levels; lower blood pressure; lower rates of hypertension, type 2 diabetes, and prostate and colon cancer.” • Position of the American Dietetic Association and Dietitians of Canada: Vegetarian Diets,” Journal of the American Dietetic Association, June 2003

13. What about getting enough protein? • Plants = the source of all protein on earth! • Cows did not eat other cows for protein! • Green vegetables • There are nine essential amino acids we need to obtain from the foods we eat • As long as you're meeting your energy needs and eating a varied diet, you'll get enough protein

14. Protein Sources • Beans • Whole Grains • Veggie Burgers • Nuts/ Nut Butters • Tofu/ Tempeh • Soy Milk

15. But isn’t fish healthy? • Although fatty fish, compared to red meat, has been associated with less cardiovascular risk, fish and shellfish often contain mercury and other environmental toxins • Affects central nervous system, cardiovascular health, reproduction, immune function and are possibly carcinogenic • Other nutritional problems • Contribute to already high intakes of animal protein • High protein diets associated with increased risk for kidney problems, osteoporosis and complications with diabetes • Contribute to saturated fat and cholesterol intake

16. Safer N-3 fatty acid sources • Flax seed and flaxseed oil • Walnuts • Soybeans, tofu, and soybean oil • Canola oil • Leafy greens and other vegetables • Beans • Whole grains

17. But isn’t milk important for health? • Milk is species specific- For example, Dogs don't drink goat's milk • Many people don’t drink milk because they are lactose intolerant. • 70% of world’s population • Lactose intolerance is a natural process that occurs after an infant stops breast-feeding

18. Plant sources contain: Fiber Phytochemicals Vitamin K Salicylic acid Plant protein Cow’s milk contains: Nothing from plant column Saturated fat Cholesterol Animal protein Lactose Hormones Contaminants Plant Calcium Vs. Cow’s Milk Calcium

19. “Where will I get my calcium from?” • Plant foods are good sources of calcium • Absorption rate of calcium from plants compared with cow’s milk • Green vegetables 52-64% • Cow’s milk 32%

20. Mg Calcium in 100 Calories of:

21. Recommendations for Bone Health • Get some physical activity! • Achieve positive calcium balance by avoiding calcium depleters • animal protein • high sodium foods • caffeine • refined sugars • excessive vitamin A supplements • Meet other nutrient needs: protein, potassium, vitamins D, K, and C, magnesium, boron • High intake fruits and vegetables

22. Vitamin B12 • Only found in animal products • It’s present in the soil, so we used to be able to get B12 from vegetables that were unwashed

23. Where Vegans Should Be Cautious • Ensure an adequate intake of Vitamin B12 and Omega 3 fatty acids • Other nutrients that can be low: Vitamin D, some minerals • Make whole plant foods the staples of your diet • Not french fries, fried foods, processed foods, sugary foods • Don’t smoke, get some exercise, keep health body weight

24. Vitamin B12 • What can vegans do since they don’t eat animal products? • Fortified soymilks and breakfast cereals. • Multi-Vitamin • Recommended intake: 2 mcg/ day

25. But isn’t a diet with fortified foods unnatural and not optimal? • Most people do not consume a “natural” diet • Times change so new foods with fortified nutrients are created • E.g. vitamin D and living near the equator • Fortified foods and supplements allow for more people to meet all their nutrient needs • We should remember the rest of world when making diet choices

26. Where omnivores should be cautious • Study found that omnivores are often deficient in 7 nutrients • Calcium, iodine, vitamin C, vitamin E, fiber, folate, and magnesium • Most people do not consume enough fruits and vegetables • Most consumed vegetable in US: potatoes as french fries or chips; ketchup as a vegetable – the least nutritious • Study found that vegetarian teens’ diets contained more nutrients than omnivores

27. So what should a vegan diet look like?Often, much like an omnivorous diet!

28. BREAKFAST #1 • 1 cup oatmeal with cinnamon and raisins and 1/2 cup fortified soymilk • 1 slice toast with 1 tablespoon almond butter and jam • 1/2 grapefruit

29. BREAKFAST #2 • 3 oatmeal pancakes with applesauce topping • 1 glass of calcium-fortified orange juice • Fresh fruit

30. BREAKFAST #3 • Raisin Bran with soymilk and sliced banana • Toast with peanut butter and jam • Orange juice

31. LUNCH #1 • Whole wheat pita stuffed with hummus, sliced tomatoes, and lettuce • Carrot sticks • Fresh Fruit • Pretzels

32. LUNCH #2 • Bean burritos: black beans in corn tortillas, topped with chopped lettuce, tomatoes, and salsa • Spinach salad with tahini-lemon dressing • Fresh Fruit • Fortified juice or soymilk

33. LUNCH #3 • Salad of mixed greens with assorted vegetables, ½ cup beans, croutons, and low-fat salad dressing • Whole grain bagel • Fresh fruit

34. DINNER #1 • Steamed vegetables and cannelini beans over pasta with marinara sauce • 1 cup steamed collard greens drizzled with lemon juice • Baked apple

35. DINNER #2 • Chinese stir-fry over brown rice: tofu chunks, broccoli, pea pods, water chestnuts, and Chinese cabbage (bok choy) • Cantaloupe chunks drizzled with fresh lime juice • Fortified juice or rice milk

36. DINNER #3 • Veggie chili over Baked sweet potato • Side salad • ½ cup sorbet • Fortified juice

37. HEALTHY SNACKS • Banana soymilk shake (Fresh Samantha for example) • Fresh or dried fruit • Popcorn • Granola Bars • Nuts • Carrots/ Celery and hummus

38. Making the switch!www.TryVeg.com is helpful

39. Choosing the approach: Gradual or Cold- Tofu? • Overnight Approach: • works best when you've done your research, • are surrounded by support, • are free from other major life distractions.

40. Choosing the approach: Gradual or Cold- Tofu? • Gradual Approach: eating habits are more likely to stick. • Begin by • learning some basic vegetarian nutrition, • grocery shopping and stocking your kitchen with veg. staples, • learning about meal planning and new recipes • “Support” network: like minded friends and relatives; becoming part of a community with these interests

41. Choosing the approach: Gradual or Cold- Tofu? • Begin by cutting out the meat: • Try having meatless meals two to three times a week. • Begin with favorites such as spaghetti with tomato sauce, vegetarian pizza, bean burritos, etc. • Try some veggie convenience foods: • Veggie dogs, garden burgers, hummus and pita bread, bean dip with veggies

42. Avoid the Coke and French fries Trap • Be Careful! Be Healthy! • None of us are immune to junk food!!

43. Stocking the Vegetarian Pantry • Look at the vegetarian foods you already have and the vegetarian meals you usually eat. • You probably already eat many vegetarian or vegan meals, or meals that could easily be made vegetarian.

44. Food Group Bread, grains, cereals Product Whole grain mixes: pancakes, baking mixes Bulk grains: rice, barley, pasta, oats Whole grain breakfast cereals Breads, rolls, muffins, bagels, English muffins, tortillas Frozen waffles and low-fat muffins Stocking the Vegetarian Pantry

45. Food Group Legumes Product Bean or lentil soup Black bean burritos or tacos Canned beans and Vegetarian baked beans  Tofu Stocking the Vegetarian Pantry

46. Food Group Fruits and Vegetables Meat substitutes Dairy Substitutes Product All kinds and all varieties Veggie burger patties Veggie sausage Soy milks Soy cheeses Stocking the Vegetarian Pantry

47. Food Group Convenience foods Product Morningstar Farms Stuffed Sandwiches Mock Chicken patties Frozen veggie pizza Soup in a cup Stocking the Vegetarian Pantry

48. 1. Soymilk 2. Powdered vegetarian egg replacer 3. Vegetarian burger patties and hot dogs 4. Whole grain breakfast cereals 5. Tempeh and Tofu 6. Canned beans 7. Frozen entrees 8. Hummus and Peanut Butter 9. Instant soups 10. Tomato sauce Top 10 Vegetarian Convenience Foods

49. For more information • Online: • The Physicians Committee for Responsible Medicine (PCRM): http://www.pcrm.org

50. Summary of nutrition science;For more information see: • Online: • The Physicians Committee for Responsible Medicine (PCRM): http://www.pcrm.org • The Cancer Project: http://www.cancerproject.org/ • www.TryVeg.com • www.TryVegetarian.com