Center for Human Nutrition

Medical Nutrition Syllabus

Guide to Healthy Diet and Lifestyle

Exercise Guidelines

Managing Obesity

Exercise Prescription

Medicine and Surgery Nutrition Assessment Checklist

Pediatric Nutrition Assessment Checklist

Adolescent Nutrition Assessment Checklist
Syllabus Menu: | Dietary Assessment | Weight Assessment | Dietary Recommendations | Nutritional Deficiencies | Nutrition During Lifecyle | Nutrition in Pathological Conditions | Vegetarianism | [Popular Diets | References |


Types of Vegetarian Diets


  • Most vegetarians fall into this category.
  • Includes dairy products and eggs, but no animal flesh (meat, poultry, and fish).
  • A subset of this group also avoids eggs, and they are called lacto-vegetarians. Those that avoid dairy products, but not eggs, are called ovo-vegetarians.
  • If a lacto-ovo vegetarian consumes a variety of whole foods, then there is little concern about nutrient deficiencies.
  • One cause for concern is an over-reliance on cheese, milk, and eggs. If a patient is counseled on other ways of fulfilling protein and calcium requirements and making good use of nonfat dairy foods, they can limit consumption of fattier dairy foods and eggs.
  • Lacto-ovo vegetarians exhibit low rates of cancer, heart disease, obesity, diabetes and hypertension.


  • Many ethical vegetarians chose this pattern of eating.
  • They avoid all animal products: meat, fish, poultry, dairy, and eggs. Foods that involve animal processing may also be avoided. These include honey, sugar, vinegar, wine, and beer.
  • The nutrient of concern in vegan diets is B12, which is found only in foods of animal origin. All vegans need to identify a source of B12 in their diets. Vegans who do not eat fortified foods should probably use a supplement
  • Vegan diets are also low in vitamin D, especially if they do not get enough sun exposure. Many breakfast foods and soymilk are fortified with vitamin D.
  • Calcium deficiencies may be common among vegans. This can be alleviated if they consume calcium-fortified soymilks or orange juice.
  • Zinc is lacking in many vegan diets. Also, bioavailability is poorer in plant foods than in animal foods. Vegans should be careful to get enough zinc in their diets or take a supplement to fulfill their daily requirements


  • Macrobiotic philosophy is linked to Buddhism and to the ancient Chinese principles of yin and yan. The lifestyle focuses on the principles of balance and harmony with nature and the universe. They believe that their diet is the healthiest way of eating.
  • The diet makes extensive use of rice, sea vegetable and Asian condiments, such as tamari, miso, and umeboshi plum. Also consumed are root vegetables, such as daikon and lotus root. The diet is 50-60% grains. Foods that are avoided are vegetables of the nightshade family (potatoes, tomatoes, eggplant, and peppers), tropical fruits, and processed sweeteners.

Foods consumed should be in season and locally produced. Climate and geography dictate the make-up of the macrobiotic diet to an extent.

Vegetarian Food Pyramid (See page 33)

Grains (6-11 servings)

  • Consuming bread is a good way to fulfill this requirement. Bread requires no preparation and is usually well liked. Whole grain bread should be encouraged over refined bread.
  • Grains should be the "center of the plate" meaning that meals should be based on grain.
  • Many ethnic foods contain a healthy amount of grains.
  • A simple way of preparing grains is by cooking them in vegetable broth, or by using apple juice as part of the cooking liquid. Also, tossing grains with herbs, chopped dried fruits, or nuts is a good idea.
  • Breakfast is a good opportunity for vegetarians to consume more grains, since foods such as cereals, breads, pancakes, muffins, bagels, pancakes, and French toast contain many grains. Whole grain cereals should be suggested, along with ready-to-eat cereals fortified in B12 and D.
  • Lunch foods with high grain contents include sandwiches, cold pasta or rice salads, and soups with pasta, rice, or barley.
  • Snacks can also be a good way of getting grains into the diet. Popcorn, bread, muffins, graham crackers, oatmeal cookies, bagels, and pretzels are good choices.

Vegetables (3-5 servings)

  • Vegetarians may find it difficult to include 3-5 servings of vegetables per day.
  • Green leafy vegetables, such as kale, collards, and mustard, turnip, and dandelion greens, are especially valuable in providing a wide variety of nutrients, particularly calcium. They can also be torn into small pieces and added to tomato-based dishes, stews or vegetable soups.
  • A serving of raw vegetables per day is a good way to increase vegetable intake (i.e., a salad or raw carrot sticks).
  • Vegetables can be flavored with salad dressing, nonfat salad dressing, flavored mustards, herb vinegars, or Parmesan cheese.
  • Sea vegetables are rich in many minerals and make a good addition to any meal. They are most common in Asian diets. Recipes for vegetarian sushi can be found in Asian cookbooks.

Vegetarian Food Pyramid

Legumes (2-3 servings)

  • Legumes play an important role in the vegetarian diet.
  • Canned beans are a good choice for those who do not have the time to prepare long-cooking foods. Using a pressure cooker can also shorten cooking time.
  • If flatulence and discomfort from beans is a problem, vegetarians can consume less gas producing legumes, like lentils or split peas. Over-the-counter products like Beano can reduce gas production.
  • Chili, baked beans, black-eyed peas, kidney beans, lima beans, pinto beans and lentil soup is a good way to introduce legumes into the diet. Beans can also be added to salads and vegetable soups. Ethnic foods like hummus and pasta fagioli are also good choices.
  • Vegetarians should explore different ways in preparing legumes. Well-cooked beans can be pureed with olive oil and herbs to create sandwich spreads. Beans can also be blended into dip.
  • Soy foods such as tofu, textured soy protein, and soymilk are good alternatives.
  • There are several meat analogues that are made out of soy protein or gluten (wheat protein). Many of them appear very similar to popular meat products, like hamburgers, chicken patties and hot dogs. Many of these products are high in protein, as well as fortified with nutrients like vitamin B12.

Fruits (2-4 servings)

  • Fruits are well liked and therefore it is not difficult for vegetarians to get their daily servings of fruits. Dried, fresh, canned and frozen fruits are all good sources.
  • Fruit juice is a good way for children to consume fruits. However, it is better that adults get their fruit from whole fruit sources.
  • Stewed, or cooked and mashed fruits are an excellent option for older people and children who cannot chew well.
  • Fruits contribute vitamins A and C, and some B vitamins and minerals. Dried fruits can contribute significant iron.

Milks (2-3 servings)

  • Nutritious diets can be planned without the use of cow’s milk.
  • Vegans and macrobiotic vegetarians do not consume dairy products. Also, some lacto-ovo vegetarians choose to use milk substitutes.
  • Many vegetarians choose to consume vegetable milks, like soymilk (protein-rich), rice milk, or almond milk. These milks can be used in much the same way as regular cow milk. They can be used in cereals, consumed as a beverage, used in baked goods, cream soups or sauces. Many soymilks and rice milks are fortified with calcium, vitamin D and/or vitamin B12.

Nuts and Seeds (1 serving)

  • May be included in legume food group.
  • Includes all nuts and seeds, including nut butters such as peanut butter and almond butter. It also includes tahini, which is sesame seed butter.
  • Nuts and seeds provide protein, fiber, iron, calcium, and trace minerals.
  • Compared with most legumes, nuts and seeds are high in fat, and therefore need to be limited.
  • Nuts and seeds are especially important in the diets of vegan children.

Fats, Oils and Sweets (eat sparingly)

  • Included in the food guide as an option for adults, and are an important contributor of calories in children.
  • Fats usually include vegetable oils, mayonnaise, salad dressings, margarine butter, soy or cream cheese, and sour cream.
  • Fats can contribute vitamin E and essential fatty acids, but should be limited in the adult diet.
  • Sweets are optional and do not contribute to good health.

Where to get nutrients in vegetarian food:

  • Protein - Vegetables, grains, nuts, seeds, legumes, lentils, milk, cheese, eggs, tofu, soy milk
  • Iron - Vegetables, grains, cereals, legumes, greens, nuts, seeds, dried fruits
  • Calcium - Cheese, yogurt, dark green vegetables, tofu, enriched dairy and soy products
  • Zinc - Grains, nuts, legumes, wheat germ
  • Vitamin B12 - Milk, yogurt, cheese, supplements (especially if vegan)
  • Vitamin D - Sunlight, D-fortified milk or soy milk, supplements