Diabetes Meal Planning and Nutrition For Dummies
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There is an impressive body of evidence demonstrating the effectiveness of a vegetarian diet in weight management, A1C improvement, increased insulin sensitivity, and cardiovascular health indicators. But, can you really get adequate nutrition from plants?

According to the Academy of Nutrition and Dietetics, “appropriately planned vegetarian diets, including total vegetarian or vegan diets, are healthful, nutritionally adequate, and may provide health benefits in the prevention and treatment of certain diseases.”

Defining a vegetarian depends to some extent upon whom you ask. A pollo-pescetarian vegetarian, for instance, eats poultry and seafood.

Many people around the world, however, fall under more accepted variations of vegetarianism, and it’s reasonable to address the question of diabetes management as it applies to a couple of different views on plant-based eating.

The truth is that most people could stand to lean more toward vegetarian to add more vegetables and to cut down on red meat. But, there’s one surprising nutrient most Americans could use a little more of, and getting enough of this from plants while managing blood glucose levels takes a little thought.

One challenge of a plant-based diet is finding nutrients, including protein, to replace what’s lost when giving up meat and other animal products.

Adopting the ovo-lacto view

Movie credits often run the disclaimer, “no animals were harmed during the making of this film.” Ovo-lacto vegetarians take a similar view, and include eggs and dairy products into their primarily plant-based diet because no animals are harmed in the making of those foods.

Adding eggs and dairy provides additional options for dietary protein, the best dietary source of calcium from dairy and better access to vitamin B12 (more on that next). But, it isn’t that these nutrients aren’t available from plant foods.

Eating protein is all about getting the amino acids. Protein is built from amino acids, and your body uses about 20 different amino acids to build everything it needs for good health. Of the 20, a specific 9 are called essential amino acids because your body cannot produce them from scratch — these must be in your diet.

Protein is readily available from plants like beans, nuts and seeds, and grains, but whereas most animal sources of protein include all nine essential amino acids, single sources of plant protein are often missing a few. In practice, that simply means that vegetarians should eat a wide variety of protein foods.

Adding eggs and dairy, however, does provide a couple of one-stop shops for essential amino acids, but soy protein is of equal quality. All in all, concerns about inadequate protein in a vegetarian diet are irrelevant as long as a variety of foods are included and adequate protein consumption is a focus.

Adequate calcium is only slightly more a concern in a vegetarian diet. Calcium is available in dark greens like collards or kale, green soy beans (edamame) and soy, and sesame seeds, to name a few, but calcium in plants may not be as available for absorption as calcium in dairy or fish. And, dairy is the richest source of calcium.

Consuming dairy products as part of a plant-based diet, therefore, adds some distinct benefit. In the big picture, eggs and dairy in the diets of ovo-lacto vegetarians may be valuable if only by adding more variety.

To be sure you get enough calcium in your diet, you need to have enough vitamin D, which promotes the uptake of calcium in your intestine. The best source of vitamin D is definitely sunlight, but there is a fear of overexposure to sunlight, which might lead to skin cancer or possibly malignant melanoma.

And there are many places far from the equator where the sun comes in at such an angle in the winter that you get little or no vitamin D from sun exposure. You can get some vitamin D from food, especially from milk and fatty fish like salmon, but the easiest source is a little gel capsule, which is cheap and available in any drugstore.

If you are concerned that you are not getting enough vitamin D, ask your doctor to perform a blood test for your level.

Being vegan

The word vegan describes a person who eats only foods from plants, or in some cases avoids, using any animal products at all, like leather or silk. With respect to diet, you have already seen how plants can provide well-balanced nutrition.

Plants are a primary source of carbohydrates in any diet, plant protein is sufficient when the diet is varied, and plant fats are, for the most part, healthy unsaturated fats. There’s one nutrient that vegetarians, and especially vegans, cannot get in a plant-based diet, and that is vitamin B12.

Eggs and dairy products do contain vitamin B12, but there are no reliable sources of this essential vitamin from plants. Vitamin B12 has some very important responsibilities, including brain and nervous system function, and a deficiency of this vitamin can lead to severe neurological damage.

Vegans must either consume vitamin B12 fortified foods or take a vitamin supplement. Breakfast cereals are commonly fortified with vitamin B12 and provide a convenient source for vegans. Soy and nut milks are often fortified, as are meat substitutes, and vegans must look for this nutrient on nutrition labels. Products targeted to vegetarians and vegans are certain to list this essential fact on the nutrition label.

A vegetarian or vegan diet can be completely consistent with diabetes, especially when nonstarchy vegetables are liberally included. The heart benefits to this eating strategy are clear, and as long as you remember that carbohydrates are found in fruits, grains, legumes (beans), and starchy vegetables, you can manage your health and your diabetes quite nicely.

About This Article

This article is from the book:

About the book authors:

Toby Smithson, RDN, CDE, has managed her own diabetes for more than 40 years, and founded DiabetesEveryDay.com to share her insights into diabetes self-management. Alan Rubin, MD, is the author of several successful diabetes books, including Diabetes For Dummies and Diabetes Cookbook For Dummies.

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