More and more people are going vegetarian in recent years, thanks to year-round availability of fresh produce, more meatless dining options, and a growing culinary influence of cultures with largely plant-based diets. But is it healthy? Read on to learn the risks and benefits of a vegetarian diet, and how to make sure you’re eating enough nutrients for optimal health.
Vegetarian Diet Risks and Disadvantages
Vegetarian diets vary widely from person to person. And just like meat-containing ones, they can be healthy or unhealthy. But there are some specific areas of concern, including bone health–namely, the risk of hip fracture.
Bone and Muscle Health Risks
BMC Medicine conducted a study to see if eating vegetarian correlates with getting a hip fracture. The researchers looked at middle-aged women and found that the ones who ate vegetarian had a higher chance (33% more) of getting a hip fracture compared to those who ate meat sometimes, those who ate fish but no meat, and those who ate meat often. This study is one of the only ones that used hospital records to confirm hip fractures in vegetarians and omnivores (those who eat all food groups, including meat).
According to the study lead author, James Webster, from the School of Food Science and Nutrition at the University of Leeds, “Our study highlights potential concerns regarding risk of hip fracture in women who have a vegetarian diet. However, it is not warning people to abandon vegetarian diets. As with any diet, it is important to understand personal circumstances and what nutrients are needed for a balanced healthy lifestyle.”
Vegetarian diets often have lower intakes of nutrients that are linked with bone and muscle health. The nutrients of concern in vegetarian diets include:
- Vitamin B12
- Vitamin D
- Omega-3 fatty acids
Low consumption of these nutrients can lead to lower bone mineral density and muscle mass, which can make you more susceptible to hip fracture risk. This makes it especially important to better understand factors driving the increased risk in vegetarians, whether it be particular nutrient deficiencies or weight management, so that we can help people to make healthy choices.
Although a vegetarian diet can meet current recommendations for all nutrients, supplements and fortified foods, such as soy or almond milk, soy or coconut yogurts, and calcium-set tofu, can be helpful to avoid nutrient deficiency.
Vegetarian diets are typically low in saturated fat and cholesterol and high in dietary fiber and the many healthy phytochemicals found in fruits, vegetables, whole-grains, legumes, nuts, and various soy products. And while studies have shown the many health benefits of vegetarian diets, merely removing animal products from your diet doesn’t automatically ensure good health.
As with any eating plan, it’s important to know some basic nutritional information.
Risk of Low Body Mass Index (BMI)
The BMC Medicine research team found that the average BMI among vegetarians was slightly lower than the average among the “regular” meat eaters. Previous studies have shown that lower BMI can indicate people are underweight, which can mean poorer bone and muscle health, and higher risk of hip fracture.
“This study is just part of the wider picture of diet and healthy bones and muscles in older age,” said study co-author, Dr Darren Greenwood, a biostatistician in the School of Medicine at Leeds.
Further research is needed to confirm whether low BMI is the cause of higher hip fracture risk in vegetarians, whether men have the same risk, and to identify the true reasons for different outcomes in vegetarians and meat-eaters.
Vegetarian Diet Disadvantages: Key Nutrients to Look Out For
Vegetarian diets are often lacking in the following nutrients, so be sure you’re eating a wide variety of foods to get the fuel your body needs.
Vitamin B12 deficiency is especially common in vegans (those who eat no animal products whatsoever), but also for ovo-lacto vegetarians. No matter what kind of plant-based diet you’re following, make sure you’re getting enough vitamin B12 by:
- Eating fortified foods two or three times a day to get at least three micrograms (mcg or µg) of B12 each day
- OR Taking one B12 supplement daily, providing at least 10 micrograms
- OR Taking a weekly B12 supplement, providing at least 2000 micrograms.
Omega-3 fatty acids
Omega-3 fatty acids are conventionally sourced from fish. But they’re readily available in a wide variety of plant-based foods, such as:
- Chia seeds
- Hemp seeds
- Green leafy vegetables (although in smaller amounts)
- Beans (also in smaller amounts)
Vitamin D is extremely important for good bone health. Our bodies make vitamin D when we’re exposed to sunlight, and it’s found in red meat, such as beef and lamb.
To make sure you’re getting enough vitamin D, it’s a good idea to spend some time outdoors every day without sunscreen–just not too much. And during the winter months, take a vitamin D supplement or eat vitamin D-fortified foods like soy, rice, or almond milk, orange juice, or fortified, whole-grain cereals.
Proteins are a primary nutrient in meat and are the building blocks of the body. So they’re an extremely important part of our diet. A balanced diet should include a daily intake of around 0.8 grams of protein for every two pounds of body weight.
There are many protein-rich foods for vegetarians, rivaling the protein content of meat products. Great options include:
- Peanut butter
- Nuts and seeds, such as almonds, cashews, and sunflower seeds
- Legumes like black beans, garbanzo beans (chickpeas), kidney beans, pintos, and lentils
- Brown rice
- Seitan (a wheat-based meat substitute)
- Soybeans and soy products, such as tofu and soy milk
- Textured vegetable protein
Another major vegetarian diet disadvantage is low iron content. Not getting enough iron can result in anemia, which can show up as fatigue, headaches, restless legs syndrome (RLS), heart problems, and even pregnancy problems.
Make sure you’re getting enough iron by eating foods that contain substantial amounts of this vital nutrient, such as:
- Legumes, such as lentils, soybeans, tofu, tempeh, and lima beans
- Grains like quinoa, fortified cereals, brown rice, and oatmeal
- Nuts and seeds, such as pumpkin, squash, pine, pistachio, sunflower, cashews, and unhulled sesame
- Vegetables like swiss chard, collard greens, and even tomato sauce
- Other sources like blackstrap molasses and prune juice
Calcium is an important nutrient to consider when on a vegetarian or vegan diet because of its benefits for bone health. Although there’s some calcium in plant-based foods, it may be difficult to eat and absorb enough for optimal nutrition.
Eat plenty of cholesterol-free, calcium-rich foods like:
- Calcium-fortified orange juice
- Great northern beans
- Greens like kale, collard greens, and mustard greens
- Beans, such as black, kidney, navy, and pinto beans
- Sesame seeds
- Soybeans, soy milk, and tofu
- Textured vegetable protein
Benefits of Vegetarian Diets
While some studies have found that vegetarians have lower bone density, other studies have shown contradictory results. One research team tracked the bone health of individuals who had been consuming a lacto-ovo vegetarian diet (a diet consisting of vegetables, eggs, and dairy, but no meat or fish) for at least 20 years. This study found that, by the time the participants reached 80 years old, they had lost less bone mineral than those of the same age who followed a non-vegetarian diet.
Vegetarian diets have also been shown to aid weight loss, improve cholesterol, and reduce the risk of certain cancers. Switching to a plant-based diet from a typical omnivorous one may also reduce your risk of developing diabetes by 53%, according to some studies. And those who switch to a vegetarian diet to lose weight could ditch 4.5 more pounds over an 18-week period than omnivores, on average.
So a plant-based diet can be extremely healthy. But it depends on the foods you eat.
More Research Needed as Vegetarian Diets Boom in Popularity
Adopting a vegetarian diet is more popular than ever before. The plant-based food market reached record levels in 2020 and increased another 6.2% in 2021, bringing the total market value to an all-time high of $7.4 billion.
Dr. Neal Barnard, a doctor and teacher at George Washington University School of Medicine, thinks this is due to COVID-19 lockdowns, when many people were stuck at home and eating more. Because of this, many people gained weight–and then decided to make a change. “They were looking to get healthy,” Barnard says. “In addition, they had time to read and look at health information, which they might have been neglecting before.”
There’s also a worldwide movement happening, in which people are trying to eat less meat and other animal products. The motive is to fight climate change and ensure better treatment of animals. With this giant boom in plant-based eating, understanding hip fracture and other vegetarian diet risks has become increasingly important.
Hip fracture is a global health issue with high economic impacts. It can cost you your independence, reduce your quality of life, and increase the risk of other health issues, including blood clots, pneumonia, further loss of muscle mass, increased risk of falls and injuries, and even death.
So even though more research is needed to establish the correlation between vegetarian diets and hip fracture–among other health issues–if you’re going plant-based, do so with care. Eat a wide variety of healthy foods, and practice regular strength-training to increase bone density and muscle mass.
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