Your vegetarian questions answered

[Guest guest]

Nutritionist and 'Today' contributor Dr. Madelyn Fernstrom digs deeper, answering your mail on the pros and cons of plant-based eating NBC VIDEO • Tips on proper nutrition for vegetariansOct. 16: "Today" show host Matt Lauer talks with "Today" contributor Dr. Madelyn Fernstrom about how to get proper nutrition if you are a vegetarian and how to make sure your growing vegetarian kids get all the nutrients they need. Today show By Madelyn Fernstrom, Ph.D., CNS “Today” contributor Today show Updated: 11:30 a.m. ET Oct. 16, 2006 Madelyn Fernstrom, Ph.D., CNS 'Today' show contributor • Profile • E-mail I was thrilled and very surprised to see so much interest in my column on vegetarian diets. Many people shy away from this topic, but not this group of readers — the mailbag was full of opinions, suggestions, and personal experiences. I am delighted that so many people are putting such thought into developing and sustaining healthy eating habits. The letters ranged from those who recently gave up red meat to vegans who have been following this way of eating for years. There were also many people who wanted to share knowledgeable and informative commentary on the topic. A lively and important issue, I am certain we will revisit it in the future. In the meantime, here are answers to some of the questions we received: Dear Dr.

Fernstrom: My 20-year-old daughter has been a vegan for years, living mostly on spinach and soy. She recently developed a blood clot in her leg and has been put on blood thinners. She cannot consume vitamin K, which is found in dark green vegetables, since it interferes with the medication. She doesn’t eat meat, fish, or eggs, and also has anemia. She looks tired, is forgetful, and is under a lot of stress. What can I do to help her?—Linda from Bronx, N.Y. Dear Linda: It is important during times of illness to be open to including a greater variety of foods in your diet to support the body's needs. People taking prescription medications should also understand the balance between their dietary restrictions and ways to maintain healthful eating. In your daughter's case it's

clear that her nutritional needs are not being met, so a visit to your family doctor is a must to determine her nutritional status. She should also take a daily multivitamin mineral supplement of 100 percent RDA, since it's key to getting a range of nutrients. This dose might be increased with your doctor’s recommendations. While dark green vegetables like spinach, kale, and broccoli are out for now, your daughter can still eat lots of other colorful vegetables – go for yellow, green, and red ones – and fruit, particularly dried fruits. Make sure she's not eating any other foods she should avoid while taking her medications (a topic I addressed in a previous column, http://msnbc.msn.com/id/14785552/). To add more protein, soy protein is a solid choice, but make sure she is eating sufficient servings. Determine daily grams by taking your child’s weight and dividing it in half; that number is the approximate amount of grams of

protein she'll need in a day. (If she’s 120 pounds, she’ll need 60g of protein daily.) Aim for seven to nine servings of fruits and vegetables per day. If she eats dairy products (or is willing to add them back into her diet), they are also a great source of protein and contain calcium. Dear Dr. Fernstrom: Legumes (like soy) are a good source of protein, but beans are also a good source of protein and fiber. Beans and rice have been a staple for me and should be mentioned as an important source of these nutrients.—Jonetta from Tulsa, Okla. Dear Jonetta: It's important to eat a variety of protein sources to meet your complete protein needs, but we now know the "old" thinking that specific protein sources must be consumed together is not true. It has been shown that as long as different protein

sources are consumed, it is not biologically necessary to eat them together in one meal (formerly called "complementary proteins") to make them complete. Proteins can be eaten at different times and still be utilized equally as well — it all balances out. So, beans are a great source of fiber and protein, but only need to be eaten with rice if you like this combination, not because adding these proteins together is better for your health. That said, in general it is a good idea to choose different plant proteins to mix it up for your taste buds and to ensure that your amino acid (the building blocks of protein) needs are met. Why? Unlike concentrated animal proteins, which are complete, many plant-based proteins do not, when consumed alone, have a complete pattern of amino acids. Dear Dr. Fernstrom: After being a vegan for years, I recently returned to eating all foods and gained a lot of

weight back as a result. My portions were already too large with the vegan diet. What are appropriate portion sizes?—Dario from Chicago, Ill. Dear Dario: While a vegetarian diet offers many health benefits, even the most healthful calories will be stored as fat if too many are consumed. Because many plant-based foods (especially fruits and vegetables) have a high fiber and water content, a plant-based eater can often consume a greater amount of food for fewer calories. As you broaden what you eat, though, be sure to read food labels and measure your portions to determine the calories per serving. Also, be mindful of the amount of fat used in cooking and monitor your intake of dairy products, which can be higher in fat and calories. It's best to aim for non-fat and low-fat versions of these dairy products. Finally, some high-calorie, healthy foods, such as nuts, are good for you, but

it's easy to consume hundreds of extra calories if you’re not careful. Dear Dr. Fernstrom: What about diabetics? Can they adopt a vegetarian lifestyle? What is the best form and are there special concerns?—Alan from Kerrville, Texas Dear Alan: Diabetics can certainly benefit from a vegetarian eating plan. The ovo-lacto vegetarian diet, which includes eggs and low-fat dairy products, will give you the greatest flexibility. While it is important to monitor your total carbohydrate intake, due to blood sugar concerns, moderate amounts of fiber-rich starches, vegetables, and fruits are all good choices. To offset the limitations of carbohydrates that most diabetics face, consuming a large variety of lean proteins and heart-healthy fats are key for a successful eating plan. The best idea, though, is to visit a

nutritionist who can lay out a personalized diet for you that will both maximize plant-based foods and manage your blood sugar. However, be sure to check with your doctor before making any changes in your diet. The best monitor of how this new eating plan is working for you will be your blood sugar measurements paired with your eating changes. Dr. Fernstrom’s Bottom Line: A plant-based diet can be a healthful one if a variety of foods, which have been minimally processed, are consumed. Restrictive vegetarian diets put the eater at a greater risk of nutritional deficiencies, ranging from not getting enough protein to calcium to iron. With a little planning, though, this is a healthy alternative for many people. A daily vitamin/mineral supplement containing 100 percent RDA is important, as well as calcium, iron, and B-12 sources, particularly for growing teens. If you have any medical

illnesses or are taking medications, address this with your doctor before making any dietary changes. Whether your diet is a plant- or animal-based one, it should be enhanced with a 20- to 30-minute daily walk. Madelyn Fernstrom, Ph.D., CNS, is the founder and director of the University of Pittsburgh Medical Center’s Weight Management Center. An associate professor of psychiatry, epidemiology, and surgery at the University of Pittsburgh School of Medicine, Fernstrom is also a board-certified nutrition specialist from the American College of Nutrition.Peter H

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