The popularity of plant-based diets has grown tremendously in recent years, due in part to claims of numerous health and environmental benefits. Clients who are interested in adopting a plant-based diet face several considerations. You can help clients determine whether these types of diets will be sustainable for them, understand their unique nutritional needs, and adjust their eating patterns in a healthful way.
“Plant-based diet” is a broad term that can include several dietary patterns. Following a vegan diet means zero animal products are consumed, while a vegetarian diet excludes meat and fish but includes dairy and/or eggs. Flexitarians are primarily vegetarians who occasionally eat animal-based foods. “Plant-based” also has been used to describe plant-forward diets that focus on plant foods but still include animal proteins regularly. For the purposes of this blog, plant-based will include vegan, vegetarian, and flexitarian diets.
Discussing the benefits of plant-based diets is the first step in helping clients decide whether one of these eating patterns is right for them. An increased consumption of plant based foods helps decrease the risk of heart disease, stroke, obesity, hypertension, high cholesterol, type 2 diabetes, and some cancers. These benefits are linked to plant-based diets’ lower saturated fat and higher fiber and phytochemical content, which lower cholesterol and improve glucose control. Consumption of red meat, especially processed red meat, has been associated with greater mortality risk, whereas plant proteins have been associated with lower blood pressure and LDL cholesterol, and greater insulin sensitivity. Furthermore, a study in the Journal of the American Heart Association reported a 16% lower risk of CVD, 31% to 32% lower risk of CVD-related mortality, and 18% to 25% lower risk of all-cause mortality among those in the highest quintile of a plant-based diet index compared with those in the lowest quintile.
Despite these benefits, there are potential nutrient concerns clients need to be aware of. Plant-based diets often provide necessary nutrients from whole foods, but stricter versions such as vegan diets may require supplementation with certain vitamins and minerals. Common nutrients of concern include protein, iron, zinc, and vitamin B12.
Protein: A common misconception about plant-based diets is that they lack high-quality, “complete” protein that contains all essential amino acids, but it’s unnecessary to consume a complete protein at every meal or snack. Tofu and quinoa are complete proteins by themselves, while other plant foods can be combined throughout the day to obtain all amino acids. For example, nuts as a midmorning snack and brown rice for dinner become a complete protein. Appropriate calorie intake and a varied diet will help clients meet their protein needs.
Iron: Adequate iron intake is possible with a vegetarian diet, but iron from plant sources has lower bioavailability than that from meat sources. Phytates and polyphenols, commonly found in plant foods, inhibit iron absorption, while vitamin C and citric acid help to improve absorption. Clients can combine iron rich foods with foods rich in vitamin C to enhance iron absorption. For example, they can add spinach to a strawberry smoothie or make a quinoa salad with fresh tomatoes for lunch.
Zinc: Most vegetarians in the United States have adequate zinc status, but older adults, children, and pregnant and lactating women have a high risk of deficiency. That said, vegetarians and vegans should be mindful of their zinc intake; as with iron, phytates in some plant foods inhibit absorption, so a higher level of zinc than the Recommended Dietary Allowance may be necessary. Plant-based sources of zinc include fortified cereals, pumpkin seeds, chickpeas, and oats. Clients also can increase zinc absorption by sprouting grains, beans, and seeds and consuming leavened grain products such as whole grain bread.
Vitamin B12: Vitamin B12 isn’t found in plants, so clients should be aware of supplementation methods and signs of deficiency. Clients may have a deficiency even though they feel healthy; this can cause detrimental health problems in the long term, such as stroke, bone loss, and cognitive issues. Supplements and/or fortified foods are essential to prevent vitamin B12 deficiencies among individuals consuming plant-based diets.
Help clients focus on a diet rich in whole plant foods. There are plenty of processed and less healthful plant-based products on the market that seem like healthful alternatives to animal foods, but these can be high in saturated fat and sodium and have little nutritional value.
Transitioning to a plant-based diet may be intimidating for clients, but the following tips can help ease the process.
First, remind them that plant-based meals don’t tend to look like the standard American plate with a separate protein, starch, and vegetable. Mixed meals are easy ways to incorporate a large variety of plant foods and nutrients into meals. Examples include a stir-fry with tofu, vegetables, and brown rice and minestrone soup with pasta, beans, and vegetables.
Second, help clients find recipe inspiration and challenge them to transform familiar meat-based meals into plant-based meals. Some examples include the following:
- Replace the beef in Bolognese sauce with any type of mushroom and serve with spaghetti.
- Grill or pan fry a plant-based burger made from black beans and quinoa.
Hundreds more recipe ideas are available online through blogs or Pinterest. Here are some links to get clients started:
- Vegetarian Meal Ideas: Academy of Nutrition and Dietetics
- Budget-Friendly Vegetarian Recipes: Food Network
- Vegetarian Versions of Meat Dishes: Brit + Co
Educating clients on the benefits of a plant-based diet and preparing them for potential pitfalls will help them form the foundation for a healthful and sustainable plant-based eating pattern.
— Cate Herrmans is currently completing her dietetic internship at Florida State University. She’s also working towards a master’s degree in exercise physiology, sports nutrition. Upon graduation, she hopes to begin working with professional or collegiate athletes.