Going the vegetarian route?

Many people think that being a vegetarian means healthier eating, but does it really? Different eating patterns are found to exist amongst vegetarians, where not only meat is excluded. A vegetarian excludes any meat, poultry or seafood; a lacto-ovo vegetarian includes dairy products and eggs; a lacto-vegetarian only includes dairy products and a vegan includes solely grains, vegetables, fruits, legumes, nuts and seeds. A lacto-ovo vegetarian who consumes full cream dairy products and a considerable number of eggs weekly actually takes in a substantial amount of unhealthy saturated (animal) fat, compared to someone who eats small quantities of lean red meat. Also, if fast foods are still consumed, trans as well as saturated fats will be found in the diet, which then puts one at risk of a high cholesterol and other health problems. It is only when followed along the lines of healthy eating principles that any diet is deemed ‘healthier’, but if you still decide to take the vegetarian route, keep the following in mind:


Plant proteins are poor quality proteins (short in certain amino acids) but can meet your daily requirements. Sources of proteins for vegetarians include soya and soya products (soya milk, mince, yoghurt and tofu), cereals (wheat, oats and rice), legumes (beans, lentils and peas) as well as eggs and dairy products (milk, cheese and yoghurt) – taken according to the type of vegetarian eating pattern being followed. If milk and dairy products as well as eggs are not being eaten on a daily basis, remember to include soya products and a variety of the other protein sources so that if one food is deficient in a particular amino acid, another food source can make up for it. In this way, you also ensure that you take in sufficient amounts of dietary zinc (also sprinkle pumpkin seeds over salads or roasted mixed vegetables as a garnish for that little bit extra). Infants and children are still growing so will need more daily protein than adults, ensuring also that their energy needs are met.

Some great protein combinations include beans in a tomato relish mixed with rice; whole wheat pasta with peas, almonds and a suitable, tasty sauce; whole wheat toast with peanut butter spread or a bean soup/salad with whole wheat crackers on the side.

Essential fatty acids

Diets not including fish or eggs are low in some essential fatty acids which are important for heart health. Consult a health professional about taking a supplement if you are concerned but also make sure that you include alternative sources on a daily basis, such as flaxseed (see recipe) and canola oil. Walnuts are also a great source - have a small handful as a snack or crush them up and sprinkle them over salads or pasta dishes.

Recipe: Berry Flax Smoothie
½ cup fresh/frozen strawberries; ½ fresh, peeled banana; 1 cup fat free cow’s milk OR soya milk (according to preference); 1-2 tbsp flax seeds/1 tsp flaxseed oil; handful ice cubes - blend until at smooth consistency


The recommended intake of iron for vegetarians is almost twice as much as for non-vegetarians so make sure you include good sources every day. These include dark green, leafy vegetables, wholegrain cereals and flours, legumes and some dried fruits. However, the iron found in these plant foods is non-heme iron, which is not readily absorbed by the body. This requires that certain measures be taken into account to heighten the absorption process: ensure that you do not drink excessive amounts of tea, coffee or cocoa in combination with iron-rich foods and soak grains and legumes in water prior to cooking.

Additionally, vitamin C and other organic acids (found in fruits and vegetables) with most meals will also enhance the absorption of iron into the body – squeeze fresh lemon juice over salads, include peppers and diced pineapple in stir fries and fresh strawberries in desserts.


Calcium has many important functions in the body, especially in bone strength. A diet including plenty of dairy products, fish (assuming the bones are eaten), nuts and grains should also include fruits and vegetables rich in potassium and magnesium (e.g. green, leafy vegetables and bananas) to ensure that calcium is not lost from the body. The main sources of calcium in vegetarians are dairy products, greens (e.g. broccoli) and products fortified with calcium such as fruit juice, soya/rice milk and breakfast cereals. Sesame seeds, almonds and dried beans also contain calcium but it is not well absorbed in the body. Remember that certain foods may reduce the amount of calcium absorbed - following guidelines as for iron can help to prevent this.

Vitamin D

Vitamin D also plays an important role in bone health. Generally an exposure to 5-30 minutes of sun at least twice weekly to the face, arms, back or the legs (without sunscreen) is sufficient. If, as a vegetarian, you do not get this exposure, you need to ensure you consume foods fortified with vitamin D, like cow’s milk, some brands of soya/rice milk and some margarines and breakfast cereals. A supplement is recommended if these needs are not met.

Vitamin B-12

The vitamin B-12 status of some vegetarians may be less than adequate as a result of not regularly consuming reliable sources such as dairy products, eggs and meat. Vegetarians should include foods fortified with vitamin B-12 (soy/ rice beverages, some breakfast cereals and meat analogs) or include dairy products and eggs on a daily basis if possible. Even though the daily recommendation is small, a vitamin B12 deficiency can lead to anaemia and nerve damage, so if needs are not met, a daily vitamin B-12 supplement is essential.

A B-12 deficiency may go undetected so it is useful to recognize the symptoms - be aware of paleness of skin, shortness of breath, fatigue, headaches or nausea.

Overall, ensure that you choose from a variety of foods every day, which include whole grains, different vegetables and fruits, legumes, nuts, seeds and, if desired, dairy products and eggs. Remember that if dairy is consumed, lower fat varieties are always best and any foods high in fat, sugar or salt should be used sparingly. It may seem as though you are following very healthful eating patterns, however, a poorly planned and unbalanced vegetarian diet can result in lower intakes of essential nutrients. Hence it is important that, if you make the decision to adopt a vegetarian eating pattern, you follow basic healthy nutritional guidelines and, if necessary, consult a registered dietitian.

Written by Lauren Pietersen, Registered Dietitian, the Heart and Stroke Foundation South Africa

For more heart smart information, please contact the Heart Mark Diet Line on 0860 223 222 or email heart@heartfoundation.co.za