ADVANCED DIPLOMA IN PRINCIPLES OF NUTRITION

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Biomedicine and Nutrition Course Educators: Thomas

1 ADVANCED DIPLOMA IN PRINCIPLES OF NUTRITION BY AMANDA BRODERICK BSc ANutR BSC HONS Sports Biomedicine and Nutrition Course Educators: Thomas Woods, William BY AMANDA BRODERICK LESSON: 8

2 Special Diets Semester : Lesson 8 Vegetarian and Raw Food Diets Course Educator: Amanda Broderick Course Educator B.A. amandabroderick@shawacademy.com

3 Lesson 5 Learning Outcomes What are the different plant based diets Are vegetarian diets always healthy? Nutritional implications for vegetarian and vegan diets Raw food diet

4 Vegetarian and Veganism

5 Vegetarian and Veganism Increasing in popularity More common in females than males More common in those aged years More of a way of life than a diet: Most have never smoked 50% have university degrees Reflects a lifestyle

Vegetarians/ Vegans Different Types Lacto-Vegetarians- eat dairy foods but exclude meat, fish, poultry and eggs as well as foods that contain them Lacto-ovo vegetarians- eat dairy

6 Vegetarians/ Vegans Different Types Lacto-Vegetarians- eat dairy foods but exclude meat, fish, poultry and eggs as well as foods that contain them Lacto-ovo vegetarians- eat dairy products and eggs but exclude meat, fish or poultry Ovo-vegetarians- eat eggs but avoid all other foods including dairy Vegans- avoid all animal products and animal byproducts e.g. honey, fur

7 Common Types of Vegetarian Diets Type Piscatarian Demi- or semivegetarian Lactovegetarian Lacto-ovovegetarian Ovo-vegetarian Vegan Fruitarian Macrobiotic Characteristics Occasionally eats meat, poultry and fish Eats fish and possibly other seafood but excludes red meat and poultry Excludes all meat, fish, shellfish, eggs and ingredients derived from them e.g. gelatine, rennet. Eats dairy products Includes eggs but avoids dairy products, meat, poultry, fish and other seafood Includes eggs but avoids dairy products, meat, poultry, fish and other seafood Excludes all animal flesh and products, derived ingredients and additives. Avoids animal products not only in their diet but also in every aspect of their life A type of vegan diet which consists mainly of raw fruit, vegetables, nuts, seeds, sprouted pulses and grains. Usually consists only of foods which do not kill the plant of origin Based on the Chinese philosophy of yin and yang. Aims to balance foods which contain qualities of these two opposing but complementary forces of nature. Has 10 levels, which become increasingly restrictive. Lower levels are most varied and may contain meat or fish if wild/hunted. The highest level consists of whole grains and limited fluids.

Case Study- Are All Vegetarians Healthy? Unhealthy meal pattern: 7am- wake up 7.30-9.00 am- No breakfast- rushing 11.30-12.00pm- Danish and full fat latte 1.00-2.30pm- No lunch 3.

8 Case Study- Are All Vegetarians Healthy? Unhealthy meal pattern: 7am- wake up am- No breakfast- rushing pm- Danish and full fat latte pm- No lunch pm- Crisps, chocolate bar and coke pm- none, traveling home from work, eating cheese sandwiches on the train home pm- chocolate and crisps whilst watching TV Skipping meals causes dips in energy levels Tired, no energy Making poor food choices as no energy Diet higher in fatty, high calorie foods Overall eating more fat and calories than if eating regularly Lacking essential nutrients

Nutritional Considerations of Vegetarian Diets Several health advantages: Higher intake of complex carbohydrates High intake of fibre, fruit and veg High in antioxidants High in micronutrients -

9 Nutritional Considerations of Vegetarian Diets Several health advantages: Higher intake of complex carbohydrates High intake of fibre, fruit and veg High in antioxidants High in micronutrients - folate, boron, magnesium, carotenoids, phytochemicals; isoflavones and sterols Low intake of saturated fat Low intake of sulphur containing amino acids, protective against bones Can be restrictive- insufficient B12, calcium, iron, protein, omega-3 fats, zinc and occasionally riboflavin Need to be planned so that they are nutritionally adequate

Nutritional Implications of Vegetarian Diets Energy; generally similar intake to non-vegetarians Vegans tend to be lower in energy than non-vegans EPIC oxford study showed that vegetarians tend to

10 Nutritional Implications of Vegetarian Diets Energy; generally similar intake to non-vegetarians Vegans tend to be lower in energy than non-vegans EPIC oxford study showed that vegetarians tend to have lower BMI than omnivores Infants and children, diet may be too bulky Important to include energy dense food, e.g. nuts, nut spreads, pulses, dried fruit, soya cheese, vegetable oils Children can follow vegetarian/vegan diet if it is balanced

Protein Concerns that plant foods are lower

variety of plant foods A variety of plant

11 Protein Concerns that plant foods are lower in protein content and protein quality Possible to obtain protein from plant foods Important to eat adequate energy Eat a wide variety of plant foods A variety of plant foods consumed daily can provide all essential amino acids

12 Plant Based Diets and Protein Protein: Essential amino acids can t be made by the body so needed from food Sources: dairy products, eggs Can be found in plant foods e.g. quinoa Can also be obtained by combining protein foods e.g. hummus with whole wheat pita A well-balanced plant based diet provides adequate amounts of essential amino acids and prevents protein deficiency

$Plant Based Diets and Protein Soybeans and foods made from soybeans- good sources of protein May help lower levels of LDL cholesterol in the blood Reduce the risk of hip fractures and some cancers$

13 Plant Based Diets and Protein Soybeans and foods made from soybeans- good sources of protein May help lower levels of LDL cholesterol in the blood Reduce the risk of hip fractures and some cancers Overly processed, soy-based meat substitutes are often high in isolated soy proteins and other ingredients that may not be as healthy as less processed soy products (i.e., tofu, tempeh, and soy milk)

14 Plant Base Protein Sources FOOD AMOUNT PROTEIN PROTEIN (gm) (gm/100 cal) Tempeh 1 cup Soybeans, cooked 1 cup Seitan 3 ounces Lentils, cooked 1 cup Black beans, cooked 1 cup Kidney beans, cooked 1 cup Chickpeas, cooked 1 cup Pinto beans, cooked 1 cup Lima beans, cooked 1 cup Black-eyed peas, cooked 1 cup Veggie burger 1 patty Veggie baked beans 1 cup Tofu, firm 4 ounces Tofu, regular 4 ounces Bagel 1 med. (3.5 oz) Quinoa, cooked 1 cup Peas, cooked 1 cup Textured Vegetable Protein (TVP), cooked 1/2 cup Peanut butter 2 Tbsp Veggie dog 1 link Spaghetti, cooked 1 cup Almonds 1/4 cup Soy milk, commercial, plain Whole wheat bread 1 cup slices Almond butter 2 Tbsp Soy yogurt, plain 8 ounces Bulgur, cooked 1 cup Sunflower seeds 1/4 cup Cashews 1/4 cup Spinach, cooked 1 cup Broccoli, cooked 1 cup 4 6.7

Fat Concern re high percentage of n-6 polyunsaturated fatty acids- high consumption of oils rich in linoleic acid A high ratio of linoleic acid (18:2 n-6)

absent from vegetarian diets Recommended intake for linoleic acid (n-6) in USA (17g/day for men) and 12g/day for women Recommended intake of

15 Fat Concern re high percentage of n-6 polyunsaturated fatty acids- high consumption of oils rich in linoleic acid A high ratio of linoleic acid (18:2 n-6) to alphalinolenic acid (18:3 n-3)- may inhibit production of EPA and DHA, important role in development of brain and retinal tissue EPA and DHA can be absent from vegetarian diets Recommended intake for linoleic acid (n-6) in USA (17g/day for men) and 12g/day for women Recommended intake of alpha-linolenic (n-3) acid is 1.6g/day for men and 1.1g/day for women Recommended to use soya, rapeseed or corn oil to reduce n-6 fatty acids and increase n-3 fatty acids

16 Fat

essential fatty acids may manifest as skin, hair and nail abnormalities Vegans likely to be deficient in omega-3 fats (n-3 fats) Sources of n-3

17 Fatty acids humans must ingest for good health Bodies do not synthesise them 2 essential fatty acids: Linoleic acid (an omega-6 fatty acid) Alpha-linolenic acid (an omega-3 fatty acid) Conditionally essential: Palitoleic acid Lauric acid Famm-linolenic acid Fatty Acids Deficiency in essential fatty acids may manifest as skin, hair and nail abnormalities Vegans likely to be deficient in omega-3 fats (n-3 fats) Sources of n-3 fatty acids- linseed, hempseed, walnuts, and walnut oil, sweet potatoes, soya beans, pumpkin seeds, green leafy vegetables, wild fruit and berries

18 Dietary Guidelines to Achieve optimal EFA intake in vegetarians The diet should be based on a wide variety of plant foods Most dietary fat should be obtained from whole foods such as nuts, seeds, avocados, olives and soya foods Fats and oils should be rich in monounsaturated fats; n-3-rich oils can also be used but should not be heated Only moderate use of n-6-rich oils is recommended Intake of processed foods and deep-fried foods rich in trans and n-6 fatty acids should be limited Intake of foods rich in saturated fat should be reduced Plant-based sources of n-3 fatty acids should be included in the diet on a daily basis Use of a direct source of DHA should be considered

Carbohydrate Huge contributor to a vegetarian diet Fibre: Structural fibre- celluloses and ligninsinsoluble e.g. wheat bran Gel-forming fibres- pectins, gums and mucilages- soluble e.

19 Carbohydrate Huge contributor to a vegetarian diet Fibre: Structural fibre- celluloses and ligninsinsoluble e.g. wheat bran Gel-forming fibres- pectins, gums and mucilages- soluble e.g. beans, peas, barley and flaxseeds Fibrous foods, sources of phytic acid and oxalic acids, react with minerals such as iron, zinc and calcium in food reducing bioavailability

compensate for any losses incurred Some mineral bound by fibre, eventually freed by action of

20 Carbohydrate Populations who eat high fibre diets which are nutritionally balanced do not appear to have a compromised mineral status Most high fibre foods provide sufficient minerals to compensate for any losses incurred Some mineral bound by fibre, eventually freed by action of bacteria in large bowel Eating a wide variety of whole plant foods will not result in excessive intakes of fibre

21 How much fibre is in food? Bowl of porridge 3g 2 Weetabix 3g Bowl of cornflakes 0.5g 1 slice of wholegrain bread 2g 1 piece of fruit 2g 1 serving of vegetables (3 dessertspoons) 2g 1 dessertspoon milled seeds 3-4g 1 tablespoon sunflower seeds 3g 1 baked potato (eaten with the skin) 3g Aim for 25g women 38g men fibre daily 6g/100g- good source of fibre 3g/100g- source of fibre 1 bowl of All-Bran Original 11g ½ tin of chickpeas 10g ½ tin baked beans 7.5g ½ tin kidney beans 10g 1 tablespoon dried lentils 1.5g 1 serving of brown rice 2g 1 serving of white rice 0.5g 1 serving of brown pasta 2g 1 tablespoon nuts 1.5g 3 dried prunes 1.5g

Vitamins Vegetarians usually achieve adequate intake of vitamins Vegans may have low intakes of Vitamin B12, riboflavin and vitamin D Vitamin D: 10ug/day vitamin D advised for young children,

22 Vitamins Vegetarians usually achieve adequate intake of vitamins Vegans may have low intakes of Vitamin B12, riboflavin and vitamin D Vitamin D: 10ug/day vitamin D advised for young children, pregnant women of Asian origin and elderly people who are institutionalised Asians who are vegetarian- may need vitamin D supplementation Several reports of rickets in children on Rastafarian and macrobiotic diets, and some Asian children

23 Vitamins High phytates of these diets may be the problem Cholecalciferol (vitamin D3) is obtained from fish oil and lanolin Ergocalciferol (vitamin D2)- made from yeastacceptable form to vegans Vitamin D2 only 60% as effective as vitamin D3 in increasing serum vitamin D levels

Vitamin B12 Unique among vitamins Synthesised by bacteria, fungi and certain algae Accumulated from microbial action in animals Lacto-ovo-vegetarians- dairy and eggs source of B12 Plant foods - not

25 Vitamin B12 Unique among vitamins Synthesised by bacteria, fungi and certain algae Accumulated from microbial action in animals Lacto-ovo-vegetarians- dairy and eggs source of B12 Plant foods - not a good source unless fortified Inactive vitamin B12 - found in spirulina, nori, tempeh and miso- may compete with the active form for uptake Must seek alternative sources or take a dietary supplement

Vitamin B12 Deficiency Usually result of reduced absorption and/or lack of vitamin B12 in diet Vitamin B12 deficiency is often masked by folate

26 Vitamin B12 Deficiency Usually result of reduced absorption and/or lack of vitamin B12 in diet Vitamin B12 deficiency is often masked by folate intake Deficiency only spotted when neurological symptoms present Be careful in babies breastfed by vegan mothers, often low B12 levels in breast milk

Riboflavin Dairy products and meat are major sources of riboflavin for many Vegans have lower intakes than omnivores Satisfactory levels in

27 Riboflavin Dairy products and meat are major sources of riboflavin for many Vegans have lower intakes than omnivores Satisfactory levels in vegetarian women Lacto-ovo vegetarians generally have little difficulty meeting the RNI for riboflavin Generous use of wholegrains can contribute riboflavin

28 Riboflavin

Vitamin A Preformed vitamin A (active form) is found in animal foods Vegans obtain all their vitamin A from conversion of dietary carotenoids, particularly B- carotene Bioavailability

29 Vitamin A Preformed vitamin A (active form) is found in animal foods Vegans obtain all their vitamin A from conversion of dietary carotenoids, particularly B- carotene Bioavailability of B-carotene from foods is variable Daily vitamin A requirements can be met by: 50g carrots 100g sweet potatoes or dried apricots 200g dark green leafy vegetables such as spinach or kale

30 Minerals and trace elements Intakes are similar to that of omnivores Exceptions - iodine, calcium (vegans only) and possibly selenium Take extra care with iron and zinc - low bioavailability from plant-based diets

31 Iron Iron intake mostly in the form of non-haem iron In those with low iron stores, most nonhaem iron is absorbed due to up-regulation Vitamin C aids absorption Phytates, oxalates, tannins and other polyphenols - inhibit absorption

32 Iron Vegans and vegetarians should be advised to: Include plant sources of iron daily, e.g. pulses, fortified cereals, wholegrain breads and cereals Include vitamin C rich foods with meals Minimise the intake of mineral absorption inhibitors such as tannins at times when ironcontaining foods are consumed. It is important to remember that vegetarian and vegan diets are by nature higher in both vitamin C and phytates and so advice needs to be tailored individually, especially in at-risk groups.

Sunflower seeds(35g) Pumpkin seeds (20g) Wholemeal bread (75g) Brown bread (90g) White bread (125g) Wheatgerm (25g) Fortified Breakfast cereals

33 Vegetarian Sources of Iron Iron (amount providing approximately 2 mg Iron) Soya flour (30g) Tempeh (70g) Soya, haricot, pinto, kidney beans, lentils, chickpeas (70-100g) peas, split peas ( g) Peanuts, pecans, brazil nuts, peanut butter (80-100g) almonds, hazlenuts (60g) Pine nuts, cashew (35g) Sunflower seeds(35g) Pumpkin seeds (20g) Wholemeal bread (75g) Brown bread (90g) White bread (125g) Wheatgerm (25g) Fortified Breakfast cereals (10-50g) Dried figs, dried apricots, raisins (50g)Prunes (70g) Watercress, kale (90-105g) spinach (125g) kombu, wakame, nori (15g) Black treacle (20g) Eggs (100g)

Calcium Generally have adequate levels of calcium Vegans who exclude milk and dairy products may have lower intakes Lower fat intake of vegetarians may aid calcium bioavailability Oxalates or

34 Calcium Generally have adequate levels of calcium Vegans who exclude milk and dairy products may have lower intakes Lower fat intake of vegetarians may aid calcium bioavailability Oxalates or phytates - inhibit bioavailability o e.g. spinach or swiss chard - not good sources Lower protein and higher alkalinity of vegan diets - improve the conservation of calcium compared with meat containing diets

Calcium Increased intestinal rate of absorption, provided vitamin D is adequate Studies found equal or matched bone density in vegetarians compared with matched omnivores Postmenopausal vegan women,

35 Calcium Increased intestinal rate of absorption, provided vitamin D is adequate Studies found equal or matched bone density in vegetarians compared with matched omnivores Postmenopausal vegan women, lower spinal bone mineral density Low-oxalate green vegetables (e.g. broccoli, kale, okra) should be encouraged in the vegan diet Vegetarian and vegan women should be encouraged to avoid being underweight

36 Vegetarian Sources of Calcium Amount providing approx. 100mg Calcium Tofu made with calcium chloride or sulphate (25g) Soya cheese (25g) Fortified soya milk (70-120ml) Soya, kidney, haricot beans( g) Almonds (40g) brazil nuts (60g) hazelnut (70g) White/brown bread (100g) Wholemeal bread (185g) Dried figs (40g) Spinach, watercress, kale (70g), spring greens (130g) Kombu, wakame, nori (15-25g), black treacle (20g) Milk (75-90ml) Hard cheeses (20g) Yoghurt (50-70g)

37 Iodine Lower iodine than omnivores Vegans more at risk- milk is a good source of iodine Excessive intake has been found in vegans who eat seaweed Low iodine, increased thyroid stimulating hormone (TSH) levels Seaweed or supplements

Selenium Antioxidant Conflicting reports; some say vegetarian diets lower in selenium, others say it is adequate Sources: Brazil nuts, other nuts, seeds, soya beans, mushrooms, grains and bananas are

38 Selenium Antioxidant Conflicting reports; some say vegetarian diets lower in selenium, others say it is adequate Sources: Brazil nuts, other nuts, seeds, soya beans, mushrooms, grains and bananas are all vegan sources of selenium Other studies have shown that the selenium intake of vegetarians is significantly lower and may be of concern Selenium supplementation should be considered for vegetarians and vegans

Zinc Intake higher or similar to that of omnivores Children and infants have higher requirements Richest sources - animal foods Bioavailability from plant foods is low -

39 Zinc Intake higher or similar to that of omnivores Children and infants have higher requirements Richest sources - animal foods Bioavailability from plant foods is low - phytates inhibit zinc absorption Food preparation, e.g. sprouting or soaking may enhance absorption Effects of marginally low intakes of zinc are unknown Supplements may be necessary

40 Vegetarian Sources of Zinc Amount providing approx. 1mg Zinc Soya flour, miso (30g) Soya cheese, tempeh (55g) Chickpeas, split peas, lentils (70-85g) Haricot, pinto, soya beans, peas (100g) Almonds, peanuts (30g) Walnuts (40g) Cashews (20g) Pumpkin, sunflower seeds (20g) Wheat germ (5g) Wholemeal bread (55g) Brown rice (140g) Fortified breakfast cereals (50g) Watercress (140g) Kombu (15g) Cocoa powder (15g) Hard cheeses (30-50g) Eggs (75g)

41 Dairy/fish Vegetable Protein eggs, milk, cheese, yoghurt beans, lentils, chickpeas, tofu, quorn, soya, nuts, quinoa Iron Vegetarian and Vegan Dietary Considerations Vitamin C Dried beans and peas, lentils, fortified breakfast cereal, dark green leafy veg Strawberries, oranges, tomatoes, citrus fruits, cabbage and broccoli Calcium milk, cheese, yoghurt Dark green veg, fortified breads, nuts, peas, lentils, tofu and dried fruit Vitamin D (sunlight) oily fish, eggs, dairy foods Fortified breakfast cereal Vitamin B12 Omega 3 Fatty acids eggs, yeast extract, soya milks and yoghurts, textured vegetable protein and fortified breakfast cereals. canola oil, walnuts, soy oil, ground flaxseeds and soy beans

42 Sources Vitamin D, B12 and Riboflavin Vitamin Vitamin D Vitamin B12 Riboflavin Source Exposure to gentle sunlight Fortified soya milk Fortified breakfast cereals Fortified soya cheeses and yoghurts Fortified vegan margarines e.g. vitaquell, tomor, granrose Vitamin supplements Fortified yeast extract/vegetable stock e.g. marmite, vegemite Fortified soya milk Fortified rice milk Fortified textured soya protein Fortified breakfast cereals Vitamin supplements Yeast extract Fortified breakfast cereals Fortified soya milk Wheat germ (0.7mg/100g) Almonds (0.8mg/100g) Tempeh (0.5mg/100g) Soya beans (0.3mg/100g) Pumpkin, sunflower, sesame seeds, tahini (0.2mg/100g) Mushrooms (0.3mg/100g) Seaweeds (kombu 0.3mg/100g; nori 1.3mg/100g) Avocado (0.2mg/100g) Dried apricots, prunes (0.2mg/100g) Carob flour (0.5mg/100g)

Dietary Considerations Pregnancy in Groups Well planned vegan/vegetarian diets adequate for mother and baby Low birth weight has been reported when the diet is deficient The increased requirement for

43 Dietary Considerations Pregnancy in Groups Well planned vegan/vegetarian diets adequate for mother and baby Low birth weight has been reported when the diet is deficient The increased requirement for protein, vitamins A and C, thiamine, riboflavin and folate can be met easily by a varied vegetarian diet Vegans may have more difficulty in achieving adequate riboflavin intake and particular attention must be paid by both vegans and vegetarians to ensuring adequate vitamin B12 intake

Dietary Considerations in Groups A daily 400ug of folic acid supplement is also advised Vitamin D supplement, may be needed where exposure to sunlight

44 Dietary Considerations in Groups A daily 400ug of folic acid supplement is also advised Vitamin D supplement, may be needed where exposure to sunlight is limited Ensure obtaining adequate calcium Iron and iodine supplements may be necessary Intake may be affected by appetite changes or morning sickness

Essential fatty acids and pregnancy Long-chain polyunsaturated fatty acids (PUFA) such as docosahexanoic acid (DHA), eicosapentaenoic acid (EPA) and arachidonic acid (AA) which is important for

45 Essential fatty acids and pregnancy Long-chain polyunsaturated fatty acids (PUFA) such as docosahexanoic acid (DHA), eicosapentaenoic acid (EPA) and arachidonic acid (AA) which is important for foetal development Conversion of alpha-linoleic (omega-3) acid to AA is efficient Conversion of alpha linolenic acid to EPA and DHA is only 5-10% and 2-5% respectively Vegetarians consume minimal amounts of EPA and negligible amounts of DHA

Essential fatty acids and pregnancy Vegans consume negligible amounts of both The developing foetus obtains long-chain PUFA from the maternal supply Infants of vegan mothers were found to have

46 Essential fatty acids and pregnancy Vegans consume negligible amounts of both The developing foetus obtains long-chain PUFA from the maternal supply Infants of vegan mothers were found to have <30% of the EPA and DHA of infants whose mothers ate meat It has also been suggested that pregnant and lactating women should take a 300mg/day supplement of DHA starting from the second trimester.

vegetarian foods Same attention to calcium and riboflavin

47 Lactating Women Risk of deficiency of: Vitamin B12 Vitamin D Calcium DHA Increased needs should be met using nutritious vegetarian foods Same attention to calcium and riboflavin should be taken, as in pregnancy, to prevent deficiency in breastfed infants

Infants and Children Well-planned and balanced diet can meet nutritional requirements of infants and children Very restrictive macrobiotic diets

48 Infants and Children Well-planned and balanced diet can meet nutritional requirements of infants and children Very restrictive macrobiotic diets are not recommended as they are generally low in energy, high in fibre resulting in inadequate energy intake and reduced nutrient bioavailability

Infants and Children Vitamin B12 deficiency may occur if breast milk has a low concentration of vitamin B12 Vegan mums should eat B12 rich foods or take supplements If not

49 Infants and Children Vitamin B12 deficiency may occur if breast milk has a low concentration of vitamin B12 Vegan mums should eat B12 rich foods or take supplements If not breastfeeding, medical advice should be sought when choosing a formula alternative As with all infants, cow s milk and cartons of soya milk, sheep or goat s milk are not suitable for infant feeding

Children From 1 year, whole cow s milk can be introduced to replace breast milk or infant milk in vegetarian children Recommended that non-breastfed vegan children remain on soya-based infant milk

50 Children From 1 year, whole cow s milk can be introduced to replace breast milk or infant milk in vegetarian children Recommended that non-breastfed vegan children remain on soya-based infant milk until 2 years of age, at which time it is appropriate to change to fortified soya milk Growth failure and malnutrition are not common Growth rate can be slower than in omnivorous children up to the age of 5 years

Adolescents Popular time to adopt vegetarian diet Important nutritional considerations in this age group are: Iron: this is particularly relevant in adolescent females.

51 Adolescents Popular time to adopt vegetarian diet Important nutritional considerations in this age group are: Iron: this is particularly relevant in adolescent females. As dietary intake is mainly non-haem iron, higher intakes may be required to compensate for poor bioavailability. Adequate vitamin C should also be included in the diet to assist the absorption of non-haem iron

52 Adolescents Calcium and vitamin D: These are important through adolescence as this is a period of rapid bone growth. Adequate intakes should be maintained to achieve maximum bone density and reduce the risk of osteoporosis Eating disorders: Although it is by no means the case that every young person who changes to a vegetarian diet will go on to develop an eating disorder, there is evidence that the conversion to a vegetarian diet can be used to camouflage an existing eating disorder

supplementation, is recommended for people over 65 years of age Absorption of micronutrients especially vitamin

53 Basic diet principles the same as for omnivores Care must be taken to ensure that the intake of protein, vitamin D, B6 and B12, iron and zinc is sufficient Vitamin D: Intake of 10ug of vitamin D daily, via diet and /or supplementation, is recommended for people over 65 years of age Absorption of micronutrients especially vitamin B12 is reduced and regular consumption of vitamin B12 rich foods is important Benefits: Leaner Regular bowels Elderly People

amennorhoea - low energy intake is likely the cause Well-planned

54 Athletes No evidence vegetarian athletes can t meet nutritional requirements Concern vegetarian athletes are at increased risk of amennorhoea - low energy intake is likely the cause Well-planned diets can meet nutritional needs of both recreational and elite athletes

Plant Based Diets Considerations Healthy, plant-based diet requires planning, reading labels and discipline Include a variety of fruits and vegetables including: Beans, legumes, seeds, nuts and whole

55 Plant Based Diets Considerations Healthy, plant-based diet requires planning, reading labels and discipline Include a variety of fruits and vegetables including: Beans, legumes, seeds, nuts and whole grains Avoid or limit animal products, added fats, oils and refined, processed carbohydrates Most suitable for those with obesity, Type 2 diabetes, high blood pressure, lipid disorders, CVD Benefits will be relative to the level of adherence to diet plan

56 In Conclusion There are many types of plant based diets They are not always healthy Care needs to be taken to ensure that they are nutritionally complete especially in at risk groups such as pregnant women, infants, children and the elderly

57 Next Steps Try attend all of the sessions live and see your knowledge grow Practical lesson 8 will continue on this subject Recordings are uploaded within 24 hours of the completion of each live session Further reading links are available if you wish to learn more

58 To expand upon the subjects covered in todays lesson: Further Learning Basic nutrition- Diploma in Nutrition Weight loss- Ultimate weight Loss Programme

Advanced Course Resources Free Short Videos Topical Items that Pop Up Frequently Easy way of communicating that free content is available without

59 Advanced Course Resources Free Short Videos Topical Items that Pop Up Frequently Easy way of communicating that free content is available without spamming you!!!! Facebook: Before we begin let us gauge your experience level

60 Contact us anytime on: UK: +44 (0)

61 Further Reading 1) Food Allergies- 2) Organic Vs non-organic- 3) Benefits of Fruit and Vegetables- 4) Alkaline diet- 5) Raw food Diet: ) Vegetarian info- Manual of Dietetics, 4 th edition, by Briony Thomas and Jacki Bishop

Healthy Eating Guidelines for Vegans

Healthy Eating Guidelines for Vegans A vegan diet includes grains, vegetables, fruit, legumes (dried beans, peas and lentils), seeds and nuts. It excludes meat, fish, poultry, dairy and eggs and products