Getting the vegan diet right

The simplest definition of vegetarianism is a diet that is free of meat and fish. But the eating habits of vegetarians cover a wide spectrum. At one end are lacto-ovo vegetarians who avoid meat but eat eggs and milk products, and at the other end are vegans, who forgo all animal-based products, milk, milk products and honey included.

The term “vegan” was coined in England in 1944 by Donald Watson, co-founder of the British Vegan Society, to mean “non-dairy vegetarian”. Singer Paul McCartney and actor Alec Baldwin promote the cause and regard a flesh-free diet not only as a more healthful, but as a more ethical, way to live. Without going into the question of ethics, being a vegan in India or a vegetarian with dairy allergies is fraught with challenges, since the vegetarian diet in India relies heavily on cow or buffalo milk and milk products. Here’s a guide to eating vegan in India, its health benefits, and how it can help you lose weight. 

Why choose to be a vegan?

Most doctors will agree that a low-fat diet high in fruits, vegetables and nuts is a boon to health. There is also widespread acknowledgment that reducing or eliminating red meat from the diet cuts the risk of heart disease. A plant-based diet can also improve the health of people with type 2 diabetes, improve overall glycaemic levels (a calculation of the effect of different foods on blood glucose levels) and control lipid levels. A diet based on fruits and vegetables, which are low in calories, will help maintain weight.

Albert Einstein once wrote, “Nothing will benefit human health and increase chances for survival of life on Earth as much as the evolution to a vegetarian diet.” Though Einstein’s words remain as true today as when he penned them in 1930, we now know that there are more than a few concerns for those who choose to go vegan. Let’s look at some of these health concerns and how we can circumvent them.

Anaemia

One of the main concerns for those switching to a vegan diet is anaemia. The most common type, iron-deficiency anaemia, occurs when a person isn’t getting enough iron in the diet; the symptoms include fatigue, weakness and dizziness. Since meat, eggs, poultry, fish and dairy products are the primary dietary sources for iron, vegans need to make sure they get enough from alternative sources. 

Iron is essential for the production of haemoglobin and women, especially pregnant women, need to get enough of it. A balanced vegetarian diet with plenty of green leafy vegetables such as spinach, dried fruits such as apricots, raisins and prunes, and tofu (which is soy-based) will provide enough iron for most people. If you’re concerned you’re not getting enough, ask your doctor to perform a simple test to check the iron content in your blood. Vitamin C intake with meals increases iron absorption, so include some orange juice with meals or have your iron capsule with a capsule of vitamin C. Calcium reduces iron absorption, so don’t take iron and calcium capsules together.

Protein deficiency

Protein is essential for the growth and maintenance of cells. Although protein is abundant in meats, it is also present in vegan sources like peas, nuts, lentils and soy products such as tofu and tempeh. Build meals around low-fat, protein-rich foods such as lentils, beans and quinoa, and substitute meat and dairy products with soy substitutes like tofu, tempeh and seitan (also called “wheat meat”), available at speciality food stores. 

It is a myth that vegans cannot get enough protein—you just need to know how to combine the foods properly. For example, beans are high in an amino acid called lysine, but low in sulphur-rich amino acids. Amino acids are the building blocks of proteins, which are made up of 20 amino acids, 11 of which are manufactured by the body and nine that can be obtained only through food. Lysine is an essential amino acid—so food combinations become vital to get the maximum benefit of proteins.

Eating a meal of black beans/chana (Bengal gram)/rajma (kidney beans) and rice is one way to get a balanced set of proteins as well as carbohydrates.

Osteoporosis

Osteoporosis occurs when the body does not form enough new bone over time. Adults require about 1,200mg per day (on an average) of calcium. Major dietary sources include milk, cheese and yogurt, but vegans can find it in green, leafy vegetables such as spinach or collard greens and in soy products such as soy milk and tofu. I do prescribe calcium supplements with a combination of vitamin D (required for the body to absorb calcium from foods) to most patients though, especially vegans.

Vitamin B-12 deficiency

This is a deficiency seen commonly in vegans. Vitamin B-12 is essential for brain and nervous-system functioning. It is most commonly found in animal and dairy products such as eggs and milk, so this is a serious concern for vegans. Fortunately, nowadays, many foods are fortified with B-12, including many breakfast cereals, soy milk and nutritional yeast. It is also commonly available as a supplement. Deficiencies in B-12 and omega 3 (also often seen in vegans, since the major source of omega 3 is fish oil), in turn, are linked with higher blood levels of an amino acid called homocysteine, and with decreased levels of HDL cholesterol, the good cholesterol. While high homocysteine levels are an established risk factor for heart disease, higher HDL levels protect the heart. Try and include seaweed (also a good source of omega 3) and greens for vitamin B-12. I would advise vegans to take a supplement of B-12.

For a boost in omega-3 fatty acids, try plant sources such as flaxseed, walnut, pumpkin seeds and soy, canola oils and soybean oils.

Some Substitutes

These items work to provide the health benefits of meats and dairy.

• For protein: Pulses and beans , soy products like tofu and tempeh, nuts and nut butters like peanut butter.

• For iron: Fortified breakfast cereals, soy-based foods, dried prunes and apricots, nuts, beans, legumes, wholewheat bread, and baked potatoes.

• For calcium: Soy products, legumes, almonds, sesame tahini, calcium-fortified orange juice, and dark, leafy vegetables.

• For zinc: Soybean, fortified breakfast cereals, nuts, breads, mushrooms and peas. Wheatgerm (the embryo of the wheat plant) and pumpkin seeds.

• For vitamin B-12: Soy-based beverages, some fortified breakfast cereals.

• For riboflavin: Almonds, fortified cereals, mushrooms, and soy milk.

Vishakha Shivdasani is a Mumbai-based medical doctor with a fellowship in nutrition. She specializes in controlling diabetes, cholesterol and obesity. 

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