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What Constitutes a Healthy Vegetarian Diet?

The saying goes, “You are what you eat.”

Does that make Fruitarians fruity, Breatharians airy and Vegetarians nuts?

Photo credit: Vanessa Lewis Photography

More importantly, do vegetarians actually eat nuts? Or do they carry the veggie label only to make for an awkward dinner quest? Has vegetarianism become yet another unhealthy eating phenomenon?

Traditionally eating was, and still remains, a means to survival. Everything we ingest has an effect on our health. What we eat determines the quality of our blood, which in turn affects our cells, tissues, organs, and the workings of our minds. Healthy food has the potential to strengthen our physical bodies and positively influence our mood.

Only recently has the emphasis shifted from food as a means of survival to specific dietary needs and performance demands. Food needs to provide adequate energy for completing daily tasks, building blocks, for growth and development and micronutrients such as vitamins and minerals, for optimal function of the body’s complex, internal pathways.

It is therefore important to include a variety of foods that complement all areas within its chemical makeup. By limiting a diet to exclude certain types of food (driven by strong emotive, moral or ethical grounds) it is imperative to include alternatives in order to maintain a healthy balance.

What could be lacking in the diet when animal products are excluded?


Protein, needed for growth and development, is made up of small building blocks (amino acids) of which there are a total of twenty. Eight of these amino acids are called essential, which means that they are not made in the human body, but that they are required in order to maintain optimal functioning of the internal pathways.

Individuals who choose to exclude meat and other animal products from their diet should be made aware that they are choosing to eliminate a source of easily accessible protein. Without replacing animal sources of protein with vegetarian alternatives, the body will still be supplied with sources of energy (in order to perform daily tasks or even more energy requiring activities such as sport) but left without the ability to adequately stimulate growth and development, support the immune system or have the nutrients required to promote optimal detoxification by the liver.
Phase two of the liver detoxification process is dependant on sulphur-containing amino acids such as taurine and cysteine for optimal function. Without the availability of these molecules, successful elimination of toxins may be hindered, which may result in the re-uptake and circulation of toxic molecules or the deposit thereof in the adipose tissue. The inability to excrete unwanted waste products potentially creates an added stress on the body.
Even though plant based foods contain protein, it is not as complete as in the case of animal products, which means that they do not contain all eight essential amino acids. In order to gain optimal health benefits, protein containing plant based products, should ideally be eaten in combination with whole grain products to ensure all eight essential amino acids are included. Even though tofu is considered the most complete vegetable protein, it provides sub-optimal levels of the amino acids, methionine and cystine, and should ideally be combined with complementary protein sources like Brazil nuts, seeds or cereal grains.

Complete protein alternatives:

Soya products such as tofu and soya milk; or
combine beans/chickpeas/lentils with:
brown/wild rice, nuts, seeds, corn, wheat, millet, oats, spelt, rye grain, amaranth or quinoa.

Vitamin B12

Vitamin B12 is necessary for healthy blood cell formation and rapidly growing tissues. An inadequate supply could lead to pernicious anaemia (a condition in which there are not enough red blood cells due to the body’s inability to absorb vitamin B12 from food) and neurological disorders.

The presence of vitamin B12 has not been conclusively established in plant based foods. However, vitamin B12 is stored in the body for up to 5 years and can be recycled throughout that period of time which suggests that daily ingestion is not necessarily required. Fortified foods have been made available and should ideally be included regularly in order to replenish depleted stores of vitamin B12 especially for strict vegetarians.

Vitamin B12 fortified food: marmite and breakfast cereals
or shiitake mushrooms

Essential Fatty Acids.

Essential Fatty Acids (EFA’s) are made up of the ‘good’ fats that our bodies need in order to perform specific functions in targeted areas within the body, such as cell membrane structure and permeability.

Fats are essential in the diet to provide:
a concentrated source of energy,
regulation of cardiac cells1,
an insulating layer under the skin,
structural components in the body,
functional constituents of many metabolic processes,
a vehicle for intake and absorption of fat-soluble vitamins (Vitamins A, D, E & K),
an important contributor to flavour and palatability of foods.

EFA’s are so called because they can not be manufactured by the body, but must be present within the foods that are consumed. There are two types of EFA’s namely, Omega 3 (linolenic acid) and Omega 6 (linoleic acid). For optimal functioning, a ratio of 1:5 should ideally not be exceeded. The modern day, western diet tends to include more Omega 6. These EFA’s are converted within the body, in a healthy state, in order to become more specific within their action on specific target areas. These converted EFA’s play a vital role in normal brain development, communication, skin health, arterial health and vision.

Fish, a rich source of Omega 3, have the ability to perform the conversion, meaning their consumption provides EFA’s in an already converted state. When individuals choose to eliminate fish from their diet, an excellent source of converted EFA’s is absent. This necessitates the regular inclusion of alternative sources of Omega 3 rich foods (which will now be in a pre-converted state), in order for the ratio between the two EFA’s to be balanced.

Omega 3 foods
Canola oil
Soybean oil
Flax seeds
Hemp seeds
Pumpkin seeds
Sea vegetables
Leafy green vegetables

Omega 6 foods
Corn oil
Sesame oil
Safflower oil
Sunflower oil
Cottonseed oil


The many functions of iron in the body include transport of oxygen (without which we can not survive) to the lungs and other relevant tissues, the energy production process and aiding certain internal pathways in their specific functions.

Iron is an integral part of haemoglobin (the substance in red blood cells that carries oxygen around the body). Red blood cells die off roughly every 120 days and need to be replaced. A regular supply of bio-available iron is essential for adequate red blood cell formation. Sub-optimal levels of iron can lead to the development of anaemia, a condition in which there are not sufficient amounts of red blood cells in the blood to transport oxygen, causing tiredness and paleness.

Menstruating women are potentially at greater risk of anaemia due to the regular monthly blood loss cycle. Adolescent girls should be particularly vigilant to ensure an adequate supply of iron as the immature physiology is still in the process of growth and development.

Dietary sources of iron include: cereals, pulses, beans, fruit and vegetables. Meat, fish, poultry and ascorbic acid (found in fruit and vegetables) all enhance the absorption of iron. Elimination of meat, fish and poultry in the diet, should be counteracted, by increasing vitamin C rich fruits and vegetables in order to enhance the absorption of iron from dietary sources.

Citrus fruits with nuts
(such as oranges and almonds)
Stir fried tofu with broccoli
or shredded bok choy and cashew nuts
Beans and tomato sauce.

So what constitutes a healthy vegetarian diet?

The health benefits of a diet rich in vegetables and fruit are well publicised. Ideally this would be the basis of all diets and in particular for vegetarians. Conditions that benefit from consumption of a variety of these natural occurring produce include:

Decreased risk of heart disease [3];
Lowered blood pressure [4];
Lowered cholesterol [7];
Lowered risk of stroke [6];
Lowered risk of age related degenerative eye conditions [5];
Digestive irregularities [2].

A healthy diet has its roots in a variety of nutritious food choices. Along with an adequate supply of protein, energy giving food in the form of carbohydrates and fats (depending on the individual physical activity level), the emphasis should be on including a variety of unrefined, unprocessed, natural foods within a chosen diet.

An adequate, regular supply of natural water should also be included. Water is considered an essential nutrient as we cannot manufacture it in the body and therefore need to consume it from exogenous sources to satisfy our various metabolic demands. Our bodies constitute approximately 60% water, which plays a major role in a myriad of metabolic functions including digestion, absorption and transport. Inadequate water supply can compromise many cell functions including metabolic waste excretion by the kidneys, electrolyte imbalances, skin elasticity and the regulation of body temperature. In fact humans cannot survive beyond about 10 days without water.

As long as food, which has been chosen to be eliminated from a traditional diet, is substituted with healthy alternatives, there should be no reason why any chosen diet could not support optimal health.

It’s not just what you avoid, it’s what you eat that counts.

1. Reiffel JA, McDonald A. Antiarrhythmic effects of omega-3 fatty acids. Am J Cardiol. 2006 Aug 21;98(4A):50i-60i. Epub 2006 May 26
2. Lembo A, Camilleri M. Chronic constipation. N Engl J Med. 2003; 349:1360–68.
3. HC, Joshipura KJ, Jiang R, et al. Fruit and vegetable intake and risk of major chronic disease. J Natl Cancer Inst. 2004; 96:1577–84.
4. Appel LJ, Moore TJ, Obarzanek E, et al. A clinical trial of the effects of dietary patterns on blood pressure. DASH Collaborative Research Group. N Engl J Med. 1997; 336:1117–24.
5. Sommerburg O, Keunen JE, Bird AC, van Kuijk FJ. Fruits and vegetables that are sources for lutein and zeaxanthin: the macular pigment in human eyes. Br J Ophthalmol. 1998; 82:907–10.
6. He FJ, Nowson CA, MacGregor GA. Fruit and vegetable consumption and stroke: meta-analysis of cohort studies. Lancet. 2006; 367:320–26.(2)Hung
7. Appel LJ, Sacks FM, Carey VJ, et al. Effects of protein, monounsaturated fat, and carbohydrate intake on blood pressure and serum lipids: results of the OmniHeart randomized trial. JAMA. 2005; 294:2455–64.

This article was published in Positive Health On-line Magazine in July 2009.

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