Eating a Vegetarian Diet. Not As Healthy As You May Believe.

You hear vegetarian and what comes to mind? A nutritious, disease preventing, high fiber diet? Wholesome meals full of whole grains, nuts and seeds, fruits and vegetables, chock full of vitamins and minerals? Slim and fit individuals living a healthy lifestyle, carefully meeting their nutritional needs?

If only it were so! Perhaps in its ideal form this diet is filled with all the protein, healthy fats and unprocessed carbohydrate you might need to stay healthy. It also provides a full range of antioxidants, including flavonoids, found in color-rich fruits and vegetables, as well as in nuts. These compounds are linked with prevention of many cancers, heart disease and aging related conditions. And if you include three low fat dairy servings per day, the model vegetarian diet satisfies the DASH diet for hypertension. This fruit and vegetable filled diet, together with the mineral-rich low fat dairy has been shown in studies to significantly improve blood pressure as effectively as medication.

But in practice, that’s just not how it is. Twenty-five years of counseling clients has shown me how real people live as vegetarians. And it’s not pretty. Here’s a look at what really happens to many vegetarians. Check out these pitfalls to healthy vegetarianism to be sure to avoid.

Vegetarians may set too many unnecessary rules.

Instead of eating the healthy diet described above, they may limit their fats, failing to meet their needs for essential fatty acids. Reduced fat soy milk or lower fat avocado—are they really necessary? Why choose such items?

Being fat phobic, they may omit valuable food sources such as nuts and nut butters, such as peanut butter and almond butter, eggs and even avocado. As a result of this extra layer of rules, it may be challenging to maintain their weight in a healthy range. With their limited selection, they also exclude valuable sources of protein-rich foods.

These vegetarians typically are not yet diagnosable as eating disordered. For them, vegetarianism is simply another way to limit their intake in a socially acceptable way. Vegetarianism is healthy, right?

They have no interest in exploring unfamiliar vegetarian food choices.

And so they limit their intake to vegetarian meals such as pasta, grilled cheese, and pizza, for instance. Now don’t get me wrong. There’s no problem with including these foods, as part of a balanced diet. But vegetarian choices tend to be limited, particularly when eating out. And if you don’t include much variety, the calorie density of your diet can become quite high. This becomes more exaggerated when you don’t care for many fruits and vegetables. And so your entrée portion needs to be larger to feel satisfied. Typically, these individuals end up gaining weight unexpectedly, in spite of their good intentions to eat a “healthy” vegetarian diet. As a result, they are left with a less than balanced diet and are struggling with their weight.

They are cooking challenged or have little time for food preparation.

As a result, they rely on mostly processed foods, generally quite high in sodium. Take a look at the labels on the canned beans or refried beans. Explore the sodium levels of the many soy-based and Quorn brand processed vegetarian products. To achieve the equivalent of three ounces of animal protein (a deck of cards size), you’d consume approximately 1200 mgs of sodium, from this single protein alternative, in a reasonable portion. If you are choosing vegetarianism for the prevention of heart disease, you may want to rethink this choice. If you have high blood pressure, the current recommendation is for a total of 1500 mgs. per day! You’d be better off allowing for lean protein sources such as white meat poultry, or fish, for the pescetarians.

If your nutrient needs are high (if you are still growing, quite active, very tall, pregnant or nursing, or underweight), vegetarianism can be challenging.  

A healthy vegetarian diet, high in whole grains, fruits, vegetables and legumes is high volume, high fiber with low caloric-density. As a result, it can be very filling. If you are someone with a high calorie requirement (like those described above), it takes more effort to meet your needs, while still feeling physically comfortable. It is certainly achievable, but requires a higher intake of fats and a bit more planning. Otherwise, you’ll frequently feel full and have a difficult time consuming all that your body requires.

Oh no! My daughter has decided to become a vegetarian!

Mrs. Katz called me earlier this week, seemingly alarmed, given the tone of her voice on the phone. She just discovered that her daughter has been limiting her eating to vegetarian choices for the past 3 weeks. Rebecca was well known to me from more than a year of regular visits for her eating disorder. Last time I saw her, 6 weeks ago, she had been doing great. She had been maintaining her weight in a health range, without symptoms, and appeared quite relaxed and comfortable about the changes she had made. She was allowing herself a full range of foods, including items formally considered junk foods. And she achieved all this while competing on her high school swim team. For many, many, months now, I could say she had fully recovered.

Mrs. Katz had good reason to contact me. News of her daughter’s becoming vegetarian needed to be explored, to ensure it was not a slip into more eating disordered thinking and behavior.

When I met with Rebecca today, here’s what I concluded. That Mrs. Katz has no need for concern. That while a vegetarian diet could red flag unnecessary dietary restriction, for Rebecca I felt assured that limiting her intake was not the goal (or likely to result from her new found vegetarian identity). Yes, she would have to be mindful to maximize her iron intake, as well as her protein, calcium and Vitamin D, nutrients which often fall short when eating vegetarian. Not being a vegan, B12 deficiency was not going to be an issue. She was eating a varied diet providing enough calories to adequately fuel her body. And her weight continued to be maintained in a healthy range for her height. So it was easy to reassure Mrs. Katz.

Just because some vegetarians may be restrictive eaters, that’s not to say that you can’t be a healthy vegetarian and successfully meet your nutritional needs.

If you’re motivated to be a healthy vegetarian consider the following:

•     A balanced vegetarian diet requires planning. Actually, you can say the same thing for balanced eating of any type. But it is easier to throw a steak on the grill than to cook rice and dry beans.
•     Take advantage of vegetarian resources. Explore the many vegetarian cookbooks and websites for easy, delicious recipes. (Check out some of my favorites on this blog—lentil stew, lentil soup, vegetarian chili and corn bread, granola to name a few. As for cookbooks, my old favorites are Mollie Katzen’s updated Moosewood and The Enchanted Broccoli Forest, as well as the Vegetarian Epicure by Anna Thomas.
•     Eating out? Consider Indian resturants, and other Asian cuisines (offering tofu based vegetable filled dishes), which typically offer a large selection of vegetarian options.
•     Cook soups, stews, and casseroles and freeze them in small batches to provide quick and convenient vegetarian meals.

Being vegetarian clearly has its merits. It makes us more mindful of where our food comes from and its impact on the environment. (For true enlightenment, check out the movie Food, Inc. with Michael Pollan or his books including The Omnivore’s Dilemma). But choosing vegetarianism means not just being morally responsible. It requires being responsible for meeting your body’s needs. And that is equally important.

Do you have a favorite vegetarian cookbook or website? Have a thought to share on this post as a vegetarian or a soon-to-be vegetarian? Please share! I’d love to hear from you.

Spring Cleaning for Your Thoughts. Ridding Yourself of Diets and Disorder.

I’ve never been a compulsive cleaner, and I know better than to say I wish I were. Many of my patients past and present struggle with this urge, which is not particularly pleasant. But I do tend to get into a bit of extra cleaning in this season.

In preparation for the Passover festival, those who observe are obligated to do some serious physical cleaning, throughout the house, and even of the car. The goal? To get rid of the residual leavening—you know, the crumbs—from eating while driving, eating in your bedroom and TV room, as well as the kitchen. Even if you appropriately and mindfully eat solely in the kitchen, no corner is to be left uncleaned, in this Passover preparation. Even closets, if they might contain some food remnants, and blankets, need to be dealt with.

But the deeper meaning of this preparation comes as I am mindlessly vacuuming out my minivan, a task last completed a full year ago. It’s a mess, and I must say I actually looked forward to this cleaning like I look forward to my daily Matzo Brai, a kind of French toast equivalent made with matzo. There’s something so pleasing about making things happen. You vacuum, and things look and feel better—immediately. Ah, if only changing our behaviors were this easy!

But what struck me most is the feeling as I tossed out the old wrappers and coffee cups, the used tissues and pre-GPS printed directions scattered on the dirty car mats. It felt good to get rid of things, useless things. Clearing out my physical trash and cleaning house, so to speak, somehow orients me, grounds me. Sound weird? Perhaps. But there have been plenty of studies about how our physical environment influences how we feel, and vice versa. It’s a scary thought, if you saw the inside of my van!

So I got to thinking about clearing out the internal crap. What chametz, or undesirable leaven, do I need to vacuum out of me? The answer isn’t a quick one. But I’ve decided to start with adding a filter, a cheese cloth of sorts. I’m working on more mindfully, and sensitively, letting out some of my less-than-thoughtful reactions to people and situations.

And what does this have to do with me, you ask? It seems that we would all benefit from examining which thoughts and beliefs we live by, or more specifically, eat by, and which are best sent on their way.

Do you hold on to crumbs of old diets, labeling foods good versus bad? Do you live by the clock, trying desperately to extend the interval to prevent eating until so many hours, all the while denying your hunger? Do you hold on to the crumbs of belief that you don’t deserve to eat well, to feel well, to indulge in foods you enjoy?

Regardless of religion, whether you follow one or not, we could all use a bit of spring cleaning, to sweep out the chametz. And to destroy those messages we replay that keep us stuck in unhealthy patterns.

Happy holidays to all.

A Slave to Diet Deprivation?

Pastry from French Memories, Sharon, MA

I just bought and ate a delicious Napoleon pastry—cream layered with flaky dough—and loved every bite. But was I hungry? No. Stressed? No. Mindlessly triggered by its appearance? No. I sought out a parking spot to purchase it at a favorite local French bakery and made a bee-line for the display, comforted that one remained. This was not the result of a fresh, enticing baked good on the kitchen counter luring me to eat it.

Being one to overanalyze things, I can tell you why I ate it. Deprivation. No, I’m not embarking on some weight loss diet (no need to panic) nor have I become diabetic, necessitating a controlled carb plan. This is anticipatory deprivation, knowing that I will soon be without the foods I love and cherish—if only for a week.

Just 8 more days!

Tonight starts the festival of Passover, which I observe. From a food perspective it is potentially a holiday of deprivation. That is, unless you are a lover of gluten-free style, bad-tasting baked goods. We give up a wide array of foods to help us remember, to feel as if we each personally experience that which our ancestors lived through as slaves in Egypt. Whether we believe the story as myth or historic truth, we follow these dietary rules quite rigidly.

We avoid anything leavened, for our hasty departure from Egypt left no time for our bread to rise. And so a week without is what follows. But it doesn’t stop here. There’s a very long list of foods to be avoided which includes most of my favorite starches—rice, pasta, legumes and of course, bread and most baked goods worth eating.

Friday I was food shopping and already feeling deprived. I found myself wanting to stock up, even hoard, the soon-to-be-forbidden starches. I recalled the many patients who reported binging the night before their first visit to the nutritionist’s office, fully expecting it would be their last supper, so to speak. And yes, they were pleasantly surprised by my message! And the many stories I hear from those who get anxious thinking about running out of food—not because of money—but because someone, perhaps even themselves, might restrict them from eating sometime soon. Trauma from a history of past diet experiences, perhaps. So now I really get it.

I do love these coconut macaroons! NOTHING like the canned ones in the market!

The remedy for my patients and for those of you still struggling with such deprivation is permission. Permission to eat whenever you need to, regardless of who you are with. Permission to eat whatever you feel like, in amounts appropriate for your body. Permission to eat any time you need to—yes, even at 11 pm, if you’re hungry.

Grandma Bea's sponge cake. Guaranteed to raise
your cholesterol level after only 8 days!

As for me? I had to remind myself of all that I love to eat that I can give myself permission to have. That includes the obvious fruits, vegetables, nuts, and all. And, my favorite baked goods, acceptable for Passover. So last night I baked 4 dozen coconut macaroons, 2 dozen almond ones, and a moist sponge cake. I packaged them up and removed them from the kitchen counter.

And I plan to enjoy them whenever I am hungry, to satisfy my need. On the positive side, at least I didn’t have to sacrifice use of my Kitchen Aid mixer and Cuisinart, although I don’t think the slaves had the benefit of these either.

Yummy almond macaroons.

Passover observant or not, these baked goods are delicious and so easy to prepare. The macaroons are high in sugar, but quite satisfying, requiring only a small dose to hit the spot. And perfect for those with celiac or others following a gluten-free diet.

If you are a follower and would like the recipe, please email me.

Enjoy!