Nutrition Diploma Assignment 14: Vegetarian Diet and Health Outcomes

This assignment from a Nutrition Diploma program provides a detailed overview of vegetarian diets. It explores the definition and types of vegetarianism, including vegan, lacto-vegetarian, ovo-lacto vegetarian, and semi-vegetarian diets. The assignment delves into the nutritional aspects, specifically focusing on vitamin B12 and its importance, as well as the role of fats (saturated, monounsaturated, and polyunsaturated) and iron in vegetarian diets. It also highlights the health benefits associated with vegetarian diets, such as improved heart health, obesity management, and potential benefits for skin conditions and cataract prevention. The document also includes a list of vegetarian food sources and a discussion on the importance of iron intake for vegetarians. This assignment offers a comprehensive understanding of the nutritional aspects and health implications of vegetarian diets.

Running head- NUTRITION DIPLOMA
Assignment 14
Name of the Student
Name of the University
Author Note

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Answer 1
A vegetarian abstains from consumption of flesh, meat, seafood, poultry and other animals.
Vegetarians generally abstain from consuming any by-products of animal slaughter. The
vegetarian diet became popular in the England during the early part of the 19th century. The
Vegetarian Society was founded during that time and had religious associations. The conversion
to vegetarian diet has been ever increasing since then. A vegetarian lives on a diet that consists of
pulses, grains, nuts, seeds, legumes, fruits, vegetables, fungi, and other non-animal food
products. They also focus on consumption of dairy products. Research evidences suggest that
vegan diet confers several advantages to the health outcomes of people who follow them and
also helps in eliminating the incidence of several potentially fatal diseases. These diets provide
adequate nutrition to the concerned person and prevent ill health. Several nutritional deficiencies
can lead to the occurrence of ill health outcomes1.
The vegetarian diets contain low amounts of saturated fats. They are rich in fiber and contain
several phytochemicals that work together in preventing cancer. Furthermore, they also help in
reducing heart diseases. Food derived from animal sources act as rich source of saturated fats and
adds cholesterol to the body. The presence of fibers in vegan diet helps in lowering cholesterol
1 Shridhar, Krithiga, Preet Kaur Dhillon, Liza Bowen, Sanjay Kinra, Ankalmadugu Venkatsubbareddy Bharathi,
Dorairaj Prabhakaran, Kolli Srinath Reddy, Shah Ebrahim, and Indian Migration Study Group. "The association
between a vegetarian diet and cardiovascular disease (CVD) risk factors in India: the Indian Migration Study." PloS
one 9, no. 10 (2014): e110586.

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levels. These low fat and high fiber diet also lower blood pressure2. The four types of vegetarian
diets followed by vegans are mentioned below-
 Vegan- This diet is followed by people who abstain from consumption of animal
products and are associated with a philosophy that rejects commodity status of all
animals. They do not consume any animal derived substances. Vegan diets help in
reducing the risk of chronic diseases. They exclude eggs, dairy products as well as honey
from their diet. They only eat vegetables and fruits3.
 Lacto vegetarian- This kind of diet includes vegetables, dairy products such as, cheese,
milk, butter, yoghurt, ghee, kefir and cream. This diet excludes eggs. They do not
consume seafood, fish or fowl. The concept of following a lacto-vegetarian diet is
popular among countries that follow Eastern religious traditions. It is focused on non-
violence towards any form of animal life. However, the primary difference between
vegans and lacto-vegetarian lies in the fact that core vegans avoid dairy products owing
to their belief that production of dairy food causes suffering or premature death of the
animals4.
2 Pilis, Wiesław, Krzysztof Stec, Michał Zych, and Anna Pilis. "Health benefits and risk associated with adopting a
vegetarian diet." Roczniki Państwowego Zakładu Higieny 65, no. 1 (2014).
3 Zimmer, Jasmin, Bettina Lange, Julia-Stefanie Frick, Helene Sauer, Kurt Zimmermann, Andreas Schwiertz,
Kerstin Rusch, Sibylle Klosterhalfen, and Paul Enck. "A vegan or vegetarian diet substantially alters the human
colonic faecal microbiota." European journal of clinical nutrition 66, no. 1 (2012): 53-60.
4 De Filippis, Francesca, Lucia Vannini, Antonietta La Storia, Luca Laghi, Paola Piombino, Giuseppina Stellato,
Diana I. Serrazanetti et al. "The same microbiota and a potentially discriminant metabolome in the saliva of
omnivore, ovo-lacto-vegetarian and vegan individuals." PLoS One 9, no. 11 (2014): e112373.

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 Ovo-lacto vegetarian- These vegetarians do not consume meat. However, they consume
some animal products such as, dairy and eggs. They abstain from consumption of fish
and seafood. A typical ovo-lacto vegetarian diet includes vegetables, fruits, nuts, grains,
herbs, seeds, fungi, roots, cheese, milk, kefir, yoghurt and eggs. Ovo-lacto vegetarians are
more commonly found in the Western world5.
 Semi-vegetarian- This diet is based primary based on plant products with occasional
inclusion of flesh and meat. This diet is also known as flexitarian diet. These people
cannot be called a strict vegetarian, however, they have cut down the amount of meat
consumption, and generally abstain from having red meat. Their diet includes eggs, fish,
fruits, vegetables, dairy products and poultry6.
Answer 2
Vitamin B12 is also known as cobalamine and plays an essential role in controlling the
normal brain functioning. It is generally involved in controlling the metabolism of all cells of the
human body. This water soluble vitamin occurs naturally in some food items and is also
available in the form of dietary supplements. Owing to the presence of the mineral cobalt, it is
often referred to as cobalamine. The two forms of vitamin B12 that are active in human
5 Ha, Vanessa, and Russell J. de Souza. "“Fleshing out” the benefits of adopting a vegetarian diet." (2015): e002654.
6 Dinu, Monica, Rosanna Abbate, Gian Franco Gensini, Alessandro Casini, and Francesco Sofi. "Vegetarian, vegan
diets and multiple health outcomes: a systematic review with meta-analysis of observational studies." Critical
reviews in food science and nutrition 57, no. 17 (2017): 3640-3649.

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metabolism are 5-deoxyadenosylcobalamine and methylcobalamine7. It also assists in the
formation of red blood cells and synthesis of DNA. Vitamin B12 is one of the most essential
components of a vegetarian diet and also plays an essential role in maintaining the medullary
sheath that surrounds the nerve fibers. Vitamers are chemical compounds present in vitamin B12
that have pharmacological activity.
Lack of vitamin B12 in the diet results in irreversible damage to the nervous system and
leads to the occurrence of several deficiency disorders. Levels of vitamin B12 lower than the
normal values cause lethargy, fatigue, memory loss, headache, breathlessness, and pale skin
among the elderly8. Deficiency diseases occur due to low intake of vitamin B12 along with
intestinal disorders, malabsorption and effect of certain medications. Vegetarians likely suffer
from such deficiency disorders due to the lack of this vitamin in plant sources. Infants, born to
vegetarian mothers are always at an increased risk of suffering from such disorders. Elderly
population with limited intake of animal products and meat are also vulnerable to such
deficiencies9. The estimated average requirements are 2.0μg/day and the recommended dietary
7 Watanabe, Fumio, Yukinori Yabuta, Tomohiro Bito, and Fei Teng. "Vitamin B12-containing plant food sources
for vegetarians." Nutrients 6, no. 5 (2014): 1861-1873.
8 Dangour, Alan D., Elizabeth Allen, Robert Clarke, Diana Elbourne, Astrid E. Fletcher, Louise Letley, Marcus
Richards, Ken Whyte, Ricardo Uauy, and Kerry Mills. "Effects of vitamin B-12 supplementation on neurologic and
cognitive function in older people: a randomized controlled trial." The American journal of clinical nutrition 102,
no. 3 (2015): 639-647.
9 Pawlak, Roman, Scott James Parrott, Sudha Raj, Diana Cullum-Dugan, and Debbie Lucus. "How prevalent is
vitamin B12 deficiency among vegetarians?." Nutrition reviews 71, no. 2 (2013): 110-117.

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allowances are 2.4 μg/day, as advised by the U.S. Institute of Medicine (IOM). The adequate
level for infants is considered to be around 0.4–0.5 μg/day.
Sources of vitamin B12- It is principally found in animal sources such as, milk, meat,
eggs and liver. This vitamin is stored in the liver and muscle of animals. Bioavailability of
vitamin B12 is 40-60% from fowl, fish and meat, compared to <9% from eggs. The major animal
sources that contain significant amount of vitamin B12 are organ meats, lamb, turkey, beef,
mackerel, clams, fish eggs, and crab meat.
It is also found among prokaryotes such as archaea and other bacteria. Gut bacteria
present in animals and humans synthesize this vitamin. However, human beings are not able to
absorb it due to the large distance between the small intestine and the colon. The fortified foiods
consumed by vegans also contain high amounts of this vitamin, such as, soy products, cereals,
nutritional yeast and energy bars. Vitamin B12 supplements are available in the form of pills and
are used for enriching foods such as, pasta and bread10. Certain species of mushroom, tempeh
and algae are also considered to be rich sources of vitamin B12, although, they have not been
tested in human trials. The human body stores vitamin B12 for as long as five years and it gets
reabsorbed after secretion in the bile. The inability of the human body to absorb adequate
vitamins also results in pernicious anaemia, neurological damage and can even be fatal.
Answer 3
A vegetarian diet is associated with an increased consumption of folic acid, fibers, vitamin E,
vitamin B, unsaturated fats, magnesium and several phytochemicals. Several studies have shown
10 Stabler, Sally P. "Vitamin B12 deficiency." New England Journal of Medicine 368, no. 2 (2013): 149-160.

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that possible avoidance of fish, meat, and eggs from the diet increases protection against cardio-
metabolic risk factors such as, type 2 diabetes, cancer, obesity and mortality11. It also increases
protection against cardiovascular disease. Different benefits of a vegetarian diet are mentioned
below:
 Supports heart health- vegetarian foods help in reducing inflammation, that is the primary
factor responsible for cardiovascular disorders. These foods also provide huge amounts of
dietary fiber. A high fiber diet provides increased protection against diabetes, high
cholesterol and heart diseases12. Studies proved that an increased intake of plant based
diet that is rich in vegetables, substantially lowers the risk of developing coronary heart
disease13.
 Manages obesity- vegetarian diets prove extremely beneficial in reducing high rates of
obesity, high body mass index BMI, increased blood pressure, high levels of cholesterol
11 Chuang, Shao-Yuan, Tina HT Chiu, Chun-Yi Lee, Ting-Ting Liu, Chwen Keng Tsao, Chao A. Hsiung, and Yen-
Feng Chiu. "Vegetarian diet reduces the risk of hypertension independent of abdominal obesity and inflammation: a
prospective study." Journal of hypertension 34, no. 11 (2016): 2164-2171.
12 Tonstad, S., K. Stewart, K. Oda, M. Batech, R. P. Herring, and G. E. Fraser. "Vegetarian diets and incidence of
diabetes in the Adventist Health Study-2." Nutrition, Metabolism and Cardiovascular Diseases 23, no. 4 (2013):
292-299.
13 Rosi, Alice, Pedro Mena, Nicoletta Pellegrini, Silvia Turroni, Erasmo Neviani, Ilario Ferrocino, Raffaella Di
Cagno et al. "Environmental impact of omnivorous, ovo-lacto-vegetarian, and vegan diet." Scientific Reports 7, no.
1 (2017): 6105.

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and triglycerides14. Obesity management can be attributed to the fact that plant sources
contain less calories and help in filling the stomach. This in turn, prevents overeating.
Thus, vegetarian diets are associated with lowered obesity risks and low BMI status15.
 Improve psoriasis- The skin disease, psoriasis causes redness and irritation of the skin.
Plant based diet exerts an autoimmune and inflammatory effect and help to treat the skin
disorder16. This anti-inflammatory property arises due to the antioxidant effects of
vegetables and fruits17.
 Reduces development of cataract- Research studies have shown that meat eaters are more
likely to suffer from cataracts than vegans. Adding vegetables and fruits to the diet
creates lowest possible risks of developing from cataracts. The higher intake of vitamin C
14 Bennett, Wendy L., and Lawrence J. Appel. "Vegetarian Diets for Weight Loss: How Strong is the Evidence?."
(2016): 9-10.
15 Li, Duo. "Effect of the vegetarian diet on non‐communicable diseases." Journal of the Science of Food and
Agriculture 94, no. 2 (2014): 169-173.
16 Afifi, Ladan, Melissa J. Danesh, Kristina M. Lee, Kevin Beroukhim, Benjamin Farahnik, Richard S. Ahn, Di Yan
et al. "Dietary Behaviors in Psoriasis: Patient-Reported Outcomes from a US National Survey." Dermatology and
Therapy (2017): 1-16.
17 Marsh, Kate, Carol Zeuschner, and Angela Saunders. "Health implications of a vegetarian diet: A
review." American Journal of Lifestyle Medicine 6, no. 3 (2012): 250-267.

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and E from plant sources significantly lowers the chances of the lens appearing cloudy.
Thus, vision is not blurred18.
Answer 4
6 types of vegetarian foods are listed below:
 Fruits and vegetables like spinach, broccoli, bell papers, tomatoes, cabbage, apple,
grapes, pear, banana, oranges, beet roots, brussel sprouts and carrots, among many
others.
 Whole grains that include oatmeal, bulgur, quinoa, popcorn, rice, wheat, barley,
millets.
 Soy foods such as, tofu, tempeh, and soybeans that are rich sources of plant proteins.
 Seed sprouts, beans, lentils, split peas, kidney beans, garbanzo beans and other
legumes.
 Dairy products such as milk, cheese, cottage cheese, butter, mayonnaise, whey, curd,
yoghurt, butter milk and clotted cream.
 Seeds, nuts, peanuts, dried fruits, pecans and walnuts19.
Answer 5
18 Ghanavati, Matin, Maryam Behrooz, Bahram Rashidkhani, Damoon Ashtray-Larky, Seyed Davood Zameni, and
Meysam Alipour. "Healthy eating index in patients with cataract: A case-control study." Iranian Red Crescent
medical journal 17, no. 10 (2015).
19 Appleby, Paul N., and Timothy J. Key. "The long-term health of vegetarians and vegans." Proceedings of the
Nutrition Society75, no. 3 (2016): 287-293.

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The three types of fat are present in all food products are given below:
 Saturated fats- These fats are generally solid at room temperature. These types of fat are
associated with an increase in bad cholesterol level (LDL cholesterol). They also
contribute to a reduction in good cholesterol level (HDL cholesterol). Owing to this
property, the intake of saturated fats is restricted to less than 10% calories. Their limit is
around 25 g/day for men and 20 g/day for women20. The principle sources of this fat are
lard, butter, milk, cream, cheese, fatty meat, processed meat, chicken skin, ice-cream,
palm oil, coconut oil, ghee, deep fried foods, baked food items such as, pies, pastries,
biscuits and cakes, and margarine. They are often associated with increased health risks.
 Monounsaturated fats- These fats also exist in liquid form at room temperatures. They are
considered as an excellent choice for the heart owing to their action on lowering LDL
cholesterol and maintaining the levels of good or HDL cholesterol in the body21. They are
most commonly found in avocados, olive oil, canola oil, nuts such as, pecans, almonds
and hazelnuts, pumpkin and sesame seeds and rapeseed oil.
 Polyunsaturated fats- They tend to remain in liquid form at room temperatures and help
to reduce the levels of LDL cholesterol. However, in the process, the levels of good or
HDL cholesterol also gets lowered. These fats are generally categorized into 2 groups
namely, omega-6 and omega-3. Omega-3 helps in reducing inflammation and results in
20 Malhotra, Aseem. "Saturated fat is not the major issue." BMj347 (2013): f6340.
21 Root, Martin M., and Hannah R. Dawson. "DASH-like diets high in protein or monounsaturated fats improve
metabolic syndrome and calculated vascular risk." Int. J. Vitam. Nutr. Res 83, no. 4 (2013): 224-231.

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cognitive improvement22. These polyunsaturated fats are found in sunflower oil, flaxseed
oil and seeds, maize oil, pumpkin and sesame seeds, pine nuts, walnuts, brazil nuts,
safflower oil and soybean oil or soya spread.
Answer 6
Iron is an essential nutrient because it is the central component of hemoglobin that
distributes oxygen in the body tissues. This iron exists in 2 forms, heme and non heme iron.
Heme iron is principally found in poultry, fish and meat. Non-heme iron forms an essential
constituent of other animal tissues and plants. A vegetarian diet contains non-heme iron.
Therefore, vegans should include such foods in their diet that will promote absorption of iron23.
The primary function is therefore related to transport of oxygen in the bloodstream. Upon
inhalation, oxygen combines with the hemoglobin to form oxyhemoglobin that is distributed to
each and every cell in the body through circulation. It is also required for the production of red
blood cells by a process known as hematopoesis24.
22 Hulbert, Anthony J., Megan A. Kelly, and Sarah K. Abbott. "Polyunsaturated fats, membrane lipids and animal
longevity." Journal of Comparative Physiology B 184, no. 2 (2014): 149-166.
23 Menal-Puey, Susana, and Iva Marques-Lopes. "Development of a Food Guide for the Vegetarians of
Spain." Journal of the Academy of Nutrition and Dietetics 117, no. 10 (2017): 1509-1516.
24 Domellöf, Magnus, Christian Braegger, Cristina Campoy, Virginie Colomb, Tamas Decsi, Mary Fewtrell, Iva
Hojsak et al. "Iron requirements of infants and toddlers." Journal of pediatric gastroenterology and nutrition 58, no.
1 (2014): 119-129.

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Iron helps in converting blood glucose to energy. This metabolic energy facilitates
functioning of the muscles during any kind of strenuous activity such as, exercise25.
Furthermore, iron also helps in the production of several enzymes that assist in the
synthesis of new cells, hormones, amino acids and other neurotransmitters. These enzymes
require iron in the form of a cofactor and most of the enzymes are involved in the process of
oxidative phosphorylation. Therefore, in order to increase dietary iron intake, vegetarians should
consume soybeans, lentils, tofu, black beans, turnip, potato, spinach, blackstrap molasses and
chickpeas owing to their property of being rich iron sources. Insufficient intake of iron can lead
to its deficiency, most commonly in women and young children26. Low iron levels result in
anemia and the deficiency symptoms include rapid heartbeat, fatigue, and shortness of breath
while performing physical activity.
Answer 7
All soya products are derived from soybeans that are a widely present legume, native to Asia.
The edible bean has numerous benefits and is a significant and cheap source of protein, when
compared to other animal food sources. These soybeans are rich in significant amounts of dietary
minerals, phytic acids, and vitamin B. There are several soya products that are consumed by
vegetarians. The most consumed soya products are listed below:
25 Abbaspour, Nazanin, Richard Hurrell, and Roya Kelishadi. "Review on iron and its importance for human
health." Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences 19,
no. 2 (2014): 164.
26 Camaschella, Clara. "Iron-deficiency anemia." New England Journal of Medicine 372, no. 19 (2015): 1832-1843.