Meeting your clients’ nutritional needs on a vegan diet

If your nutrition client follows a vegan diet, it’s important that you create a well-balanced meal plan that meets all of their needs. Here’s how you can nutritionally support your client with nutrients such as iron, vitamin B12, zinc, iodine, calcium, and omega-3 fatty acids.

Plant-based diets have gone mainstream, and for good reason! Growing research shows that plants contribute to a long and healthy life, as plant-based diets have been associated with a lower risk of heart disease, certain types of cancer, and type 2 diabetes. Moreover, people are flocking towards plants for various ethical and environmental reasons, making vegan diets a mainstream sensation. When done right, this eating style has a multitude of health benefits, but despite your best efforts, a diet based exclusively on plant foods can still fall short on important nutrients.?

As a nutrition professional, you can help your vegan clients meet their nutritional needs through a well-curated meal plan. But what nutrients should you focus on, why are they important, and how do these play a role in your clients’ overall health? Before we dive into these nutrients of concern, let’s first understand what a vegan diet is and any health benefits associated with it.

What is a vegan diet?

A vegan diet is a dietary approach that is based on eating foods sourced primarily from plants such as fruits, vegetables, nuts, seeds, whole grains, legumes, and beans. Animal products such as meat, eggs, and dairy are stricken from this eating style.?

Health benefits of a vegan diet

Plant-based diets have been touted as the creme de la creme when it comes to health benefits. Here are some ways that vegan diets reign supreme.

• Reduced risk of heart disease. Studies have shown that those who follow a plant-based diet have a 75% reduced chance of developing high blood pressure, and a 43% less chance of dying from heart disease [1,2].?
• Aid with weight management. Those who eat a plant-based diet have been found to have lower BMIs than their omnivore counterparts [3].?
• Lower blood sugar levels. Vegans have a lower risk of developing type 2 diabetes and tend to have lower blood sugar levels than nonvegans [4].?
• Protect against certain cancers. Legumes, fruits, and vegetables have cancer-protective benefits, which may explain why vegans have a 15% lower risk of developing or dying from cancer [5].?

Nutrients of concern

While vegan diets have many health benefits, your client could still fall short on nutrients such as vitamin B12, iron, vitamin D, calcium, iodine, or zinc [6,7,8]. Let’s take a closer look at these important nutrients, and how you, as a nutrition professional, can use them in a meal plan to meet your client’s nutritional needs.

Tip: learn more about how to help your clients overcome nutrient deficiencies with this article.

Iron?

Iron is found in the hemoglobin of red blood cells, and is essential for transporting oxygen throughout the body. Since it aids in cellular function, immunity, DNA synthesis, and neurological development, an iron deficiency can lead to weakness, anemia, GI distress, and impaired cognitive function [9].

Heme and non-heme iron are two forms of iron found within foods; the former comes from meat sources, while the latter is found in plants and iron-fortified foods [9]. However, non-heme iron has only 5-12% bioavailability, and since compounds found in grains, beans and cereals further diminish this absorption, those who follow a vegan diet are more at risk for iron deficiency [9].?

The RDA for iron varies greatly depending on gender and age. Here is the daily recommended intake for adults [9]:

• Men and non-menstruating women: 8 mg
• Menstruating women (<18 and 19-50 years old): 15 mg and 18 mg, respectively
• Pregnant women: 27 mg
• Lactating women (19-50 years old): 9 mg
• Men and women who follow a vegan diet: 1.8 times the recommended RDA due to reduced bioavailability?

You can help your client meet their iron needs through supplementation or dietary sources such as grains, legumes, leafy greens, tofu, and enriched cereals.

Vitamin B12

Vitamin B12 has many important functions, as it’s necessary for DNA synthesis, red blood cell formation, and function of the central nervous system. Deficiency may result in serious complications, such as megaloblastic anemia, weight loss, memory loss and disorientation [10]. Since unfortified plant foods don’t provide significant levels of vitamin B12, it’s recommended that all vegans be screened for deficiency.?

Here is the daily recommended intake for vitamin B12 [10]:

• Older children and adults: 2.4 mcg/day
• Pregnant and breastfeeding women: 2.6 and 2.8 mcg/day, respectively
• Vegan adults: up to 250 mcg/day (this is due to B12’s poor absorption rate and a high risk of deficiency) [11]

You can help your client meet their vitamin B12 needs through supplementation or dietary sources such as nutritional yeasts, fortified breakfast cereals, tempeh, and plant-based milks.

Iodine?

Iodine is an essential mineral necessary for thyroid hormone production, protein synthesis, and metabolic function [12]. Unfortunately, one-third of the world has an iodine deficiency, with symptoms including hypothyroidism, goiter, unexpected weight gain, fatigue, weakness, hair loss, and/or dry skin. Those who are at the highest risk include pregnant women, vegetarians, vegans, and those who live in countries where there is little iodine in the soil.?

Here is the daily recommended intake for iodine [12]:

• Adults: 150 mcg
• Pregnant women: 220 mcg
• Lactating women: 290 mcg

You can help your client meet their iodine needs through supplementation or dietary sources such as sea vegetables and iodized salt.?

Calcium?

Calcium plays a vital role in bone health, blood clotting, hormone secretion, and muscle function [13]. When there is a lack of dietary consumption, your body takes calcium out of the bone to maintain calcium homeostasis, which can lead to weak bones and osteoporosis over time.

Here is the daily recommended intake for calcium[13]:

• Adult men (19-70 years old) and adult women (19-50 years old): 1,000 mg
• Men and women over 70 and 50 years old, respectfully: 1200 mg

You can help your client meet their calcium needs through supplementation or dietary sources such as calcium-fortified foods (plant-based milks, orange juice, and tofu), leafy greens, broccoli, butternut squash, beans, and almonds.

Zinc

From immune function to metabolism and DNA structure, zinc is an important mineral needed for overall health. As such, a deficiency can lead to hair loss, delayed wound healing, and developmental problems, as well as negatively affect the reproductive and central nervous systems? [14].?

Research suggests that vegans may have slightly lower zinc levels due to a decreased bioavailability from the presence of inhibitors in plant sources [14].

Here is the daily recommended intake for zinc [15,16]:

• Adults: 8–11 mg
• Pregnant women: 11–12 mg
• Lactating women: 12–13 mg?
• Vegans: <1.5 times the RDA?

You can help your client meet their zinc needs through supplementation or dietary sources? such as whole grains, soy, beans, nuts, and seeds.

Omega-3 fatty acids

This polyunsaturated fat is important for hormone production, brain health, immunity, and blood clotting, and cardiovascular health [17]. There are three common types of omega-3’s –ALA, EPA, and DHA– with the former being found in most plant foods. However, research shows that vegans have up to 50% lower concentrations of EPA and DHA compared to their omnivorous counterparts, and while ALA can convert to EPA and DHA, the rate is low. As such, vegans are at a higher risk of omega-3 deficiency, which has been associated with depression, heart disease, arthritis, and various cancers [17,18].

While there is no current recommendation for EPA and DHA, experts tend to agree that 250 - 300 mg per day is sufficient [17].?

You can help your client meet their omega-3 needs through supplementation or dietary sources such as soybeans, flax seeds, walnuts, and hemp seeds.

Summary

If your nutrition client follows a vegan diet, it’s important that you create a meal plan that fills in any nutritional gaps. Iron, vitamin B12, zinc, iodine, calcium, and omega-3 fatty acids are some of the most important nutrients to focus on, so by including certain foods, you can create a well-curated meal plan to help your vegan clients meet their nutritional needs.?

References

1. Le, L. T., & Sabaté, J. (2014). Beyond meatless, the health effects of vegan diets: findings from the Adventist cohorts. Nutrients, 6(6), 2131–2147. https://doi.org/10.3390/nu6062131?
2. Alexander, S., Ostfeld, R. J., Allen, K., & Williams, K. A. (2017). A plant-based diet and hypertension. Journal of geriatric cardiology : JGC, 14(5), 327–330. https://doi.org/10.11909/j.issn.1671-5411.2017.05.014?
3. Turner-McGrievy, G., Mandes, T., & Crimarco, A. (2017). A plant-based diet for overweight and obesity prevention and treatment. Journal of geriatric cardiology : JGC, 14(5), 369–374. https://doi.org/10.11909/j.issn.1671-5411.2017.05.002?
4. McMacken, M., & Shah, S. (2017). A plant-based diet for the prevention and treatment of type 2 diabetes. Journal of geriatric cardiology : JGC, 14(5), 342–354. https://doi.org/10.11909/j.issn.1671-5411.2017.05.009?
5. Dinu, M., Abbate, R., Gensini, G. F., Casini, A., & Sofi, F. (2017). Vegetarian, vegan diets and multiple health outcomes: A systematic review with meta-analysis of observational studies. Critical reviews in food science and nutrition, 57(17), 3640–3649. https://doi.org/10.1080/10408398.2016.1138447?
6. Weikert, C., Trefflich, I., Menzel, J., Obeid, R., Longree, A., Dierkes, J., Meyer, K., Herter-Aeberli, I., Mai, K., Stangl, G. I., Müller, S. M., Schwerdtle, T., Lampen, A., & Abraham, K. (2020). Vitamin and Mineral Status in a Vegan Diet. Deutsches Arzteblatt international, 117(35-36), 575–582. https://doi.org/10.3238/arztebl.2020.0575?
7. Nebl, J., Schuchardt, J. P., Wasserfurth, P., Haufe, S., Eigendorf, J., Tegtbur, U., & Hahn, A. (2019). Characterization, dietary habits and nutritional intake of omnivorous, lacto-ovo vegetarian and vegan runners - a pilot study. BMC nutrition, 5, 51. https://doi.org/10.1186/s40795-019-0313-8?
8. Bakaloudi, D. R., Halloran, A., Rippin, H. L., Oikonomidou, A. C., Dardavesis, T. I., Williams, J., Wickramasinghe, K., Breda, J., & Chourdakis, M. (2021). Intake and adequacy of the vegan diet. A systematic review of the evidence. Clinical nutrition (Edinburgh, Scotland), 40(5), 3503–3521. https://doi.org/10.1016/j.clnu.2020.11.035?
9. U.S. Department of Health and Human Services. (n.d.). Office of dietary supplements - iron. NIH Office of Dietary Supplements. Retrieved January 28, 2022, from https://ods.od.nih.gov/factsheets/iron-healthprofessional/.??
10. ?U.S. Department of Health and Human Services. (n.d.). Office of dietary supplements - vitamin B12. NIH Office of Dietary Supplements. Retrieved January 28, 2022, from https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional/.??
11. https://www.todaysdietitian.com/newarchives/0418p38.shtml
12. U.S. Department of Health and Human Services. (n.d.). Office of dietary supplements - iodine. NIH Office of Dietary Supplements. Retrieved January 28, 2022, from https://ods.od.nih.gov/factsheets/Iodine-HealthProfessional/.?
13. U.S. Department of Health and Human Services. (n.d.). Office of dietary supplements - calcium. NIH Office of Dietary Supplements. Retrieved January 28, 2022, from https://ods.od.nih.gov/factsheets/Calcium-HealthProfessional/.??
14. Roohani, N., Hurrell, R., Kelishadi, R., & Schulin, R. (2013). Zinc and its importance for human health: An integrative review. Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences, 18(2), 144–157.?
15. U.S. Department of Health and Human Services. (n.d.). Office of dietary supplements - zinc. NIH Office of Dietary Supplements. Retrieved January 31, 2022, from https://ods.od.nih.gov/factsheets/Zinc-HealthProfessional/?
16. National Academy Press. (2001). Dri: Dietary reference intakes for vitamin A, vitamin K, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc. https://www.nap.edu/read/10026/chapter/14?
17. U.S. Department of Health and Human Services. (n.d.). Office of dietary supplements - omega-3 fatty acids. NIH Office of Dietary Supplements. Retrieved January 31, 2022, from https://ods.od.nih.gov/factsheets/Omega3FattyAcids-HealthProfessional/???
18. Saunders, A. V., Davis, B. C., & Garg, M. L. (2013). Omega-3 polyunsaturated fatty acids and vegetarian diets. The Medical journal of Australia, 199(S4), S22–S26. https://doi.org/10.5694/mja11.11507?