Consumer

Covid-19, the smart shopping for vegetarians and vegans

April 6, 2020

Covid-19 containment measures introduced everywhere impose severe restrictions on leaving home, as seen. Purchases of essential goods, under quarantine, should be made weekly to minimize the risk of coronavirus transmission.

Smart shopping for vegetarian and vegan consumers – in line with the recommendations of SINU (Italian Society of Human Nutrition), EFSA(European Food Safety Authority) and scientific literature – in the following scheme.

Vegetarian and vegan smart shopping

The weekly expenditure pattern to follow was developed by us (Suardi) following the ‘VEG plate’ model, with a total energy intake of about 2000 kcal/day. Based on the Reference Intake Levels of Nutrients and Energy (LARNs) recommended by the Italian Society of Human Nutrition (SINU). (1)

– The vegetarian diet is shown in the full table,

– The vegan diet is derived from only the foods displayed on a white background. Exclusion of the food categories shown on a blue background (milk and yogurt, eggs and cheese) postulates replacement of the respective portions with as many of ‘plant-based protein sources‘ or legumes and grains in mix.

Vegetarian and vegan diet, general directions

SINU-the Italian Society of Human Nutrition-initiated a Working Group on Vegetarian Diet in 2012. Paper 5.6.19 shows how vegetarian and vegan diets, in general, can provide adequate nutritional intakes in all age groups. (2) And it provides a wealth of information on how to ensure that these diets are balanced and complete with respect to daily nutrient and micronutrient requirements (LARNs).

Indeed, the Mediterranean diet lends itself to healthy and nutritionally adequate veg choices. One just has to draw on the wide variety of foods that are characteristic of tradition and territory. Whole grains and legumes, fresh seasonal vegetables and fruits, nuts and seeds, and extra virgin olive oil.

Salt must always be kept in check, in veg as well as omnivore diets. Remembering that its excess consumption–in comparison with the maximum daily threshold of 5 g, indicated by the WHO–is associated with the onset of cardiovascular disease, still the leading cause of premature mortality globally. Beware especially of snacks (or finger foods) and vegetarian and vegan convenience foods.

The focus of nutritionists is on some key nutrients-protein, omega-3 fatty acids, vitamin B12, calcium and vitamin D, iron-that may be deficient in some diets based on eating only plant-based foods.

Protein and Omega 3

Proteins-the ‘building blocks of cells’ of the human body-are the first nutrient to dwell on. They are found in every tissue of the body and have numerous functions. In addition to structural and transport (of oxygen and lipids, vitamins and other micronutrients, through the blood) there are those that are protective against infection (immunoglobulins) and regulatory, including of the immune system. They consist of more than 20 basic elements called amino acids, 9 of which-the so-called essential amino acids-must be introduced through the diet because the body is unable to synthesize them.

A scientific study from the University of Cambridge, published in the British Journal of Nutrition, shows that the bio-availability of plant proteins is lower than that of animal proteins. The researchers therefore suggest that vegetarians-and vegans in particular-have a slightly higher protein intake (5-10%) than suggested for the general population. (3)

Omega-3 fatty acids are also essential for maintaining good health, preventing cardiovascular disease and inflammation, and strengthening the immune system. It is important to ensure adequate intake of them, as they too are not synthesized by the body and must come from food. Also from plant sources, such as nuts, flaxseeds, chia and hemp seeds, and seaweed. An average serving of nuts and seeds of about 30 g fulfills the daily requirement. (12)

Vitamin B12

Vitamin B12 has the main function of maintaining healthy nerve cells, supporting proper brain function, and contributing to DNA and RNA production.

In synergy with other B vitamins, B12 also fulfills other tasks. Such as contributing to red blood cell production, along with folic acid (B9).

Low levels of vitamin B12 can cause fatigue, nervousness, dizziness, numbness and tingling in fingers and toes. Severe deficiencies can lead in the long term to memory or mobility loss, walking problems. A blood test can allow levels to be measured and appropriate supplementation to be made if necessary.

Vegans are at risk of deficiency because the primary dietary sources of vitamin B12 are animal products (shellfish and fatty fish, liver, meat, milk and yogurt, eggs). The only significant plant source-beyond certified vegan dietary supplements-is brewer’s yeast, which can also be taken in tablet form. This was followed by microalgae and water lentils(duckweed). (4) Some studies have indicated how vitamin B12 absorption is often less than 50%. (5) In fact, the average uptake is estimated by EFSA(European Food Safety Authority) to be 40 percent. This compares with a recommended daily intake of 4 μg/day (6.7).

Iron

Iron is essential for transporting oxygen into tissues, through red blood cells. It intervenes in numerous vital processes and contributes to immune function, among other things. Its bio-availability, however, is low-estimated at 18%, on average, in omnivorous diets-and is reduced to 10% in veg diets (8,9,10). Therefore, the researchers recommend that vegetarians and vegans get almost twice as much iron as recommended for the general population (+80%). Most importantly, to promote absorption, they recommend:

– Combine iron-rich foods with foods rich in ascorbic acid (vitamin C. E.g., peppers, arugula, kiwi, oranges, lemons, red cabbage),

– prepare foods in ways (milling, soaking and sprouting grains and legumes, sourdoughing bread) that decrease the content of phytic acid, a potent chelator of iron (and also zinc and calcium).

Check blood iron levels periodically and where appropriate arrange for supplementation.

Calcium and vitamin D

Calcium contributes to the formation and maintenance of bones, teeth, and cartilage. It is essential to the function of muscles, nerves and the central nervous system. In addition to blood coagulation. Vegetarians and vegans should take care to ensure adequate calcium intake by regular intake of:

– vegetables (broccoli, cabbage, kale),

– oranges,

– waters naturally rich in calcium(avoiding the use of ‘softeners’ for drinking water). The bioavailability of calcium in mineral waters is even equal to or higher than that of milk, (10)

– Soy and soy products. Calcium chloride and calcium sulfate, used to make tofu, are found to have bioavailability comparable to that of cow’s milk, (11)

– sesame, almonds.

Vitamin D, in turn, plays an essential role in reducing oxidative stress and inflammation but also in strengthening the immune system. And its periodic check by blood test is important, given its widespread deficiency in southern European populations, including Italy. Please refer to the previous article to consult its properties, the importance of daily exposure to direct light to promote its absorption, and food sources. These include mushrooms in the vegetable kingdom, eggs butter and milk for vegetarians.

Smart spending for omnivores and over-65s

To households that include omnivorous and over-65 consumers, we also point out previous articles on:

– Smart spending and Mediterranean diet for omnivorous consumers,

– Strengthen the immune system through diet,

– Over-65, nutritional recommendations.

Dario Dongo and Carlotta Suardi

Notes

(1) SINU. (2014).
Intake levels of Reference of Nutrients and Energy- IV Revision.
. Italian Society Of Human Nutrition

(2) Amit M.
Vegetarian diets in children and adolescents
. Paediatr Child Health 2010; 15: 303-14

(3) Gilani GS, Wu XC, Cockell KA. Impact of antinutritional factors in food proteins on the digestibility of protein and the bioavailability of amino acids and on protein quality. Br J Nutr 2012; 108 Suppl 2: S315-S332. doi:10.1017/S0007114512002371

(4) Minnamari Edelmann et al. Riboflavin, niacin, folate and vitamin B12 in commercial microalgae powders. Journal of Food Composition and Analysis 2019, Vol 82. https://doi.org/10.1016/j.jfca.2019.05.009

(5) Doets EL, In ‘t Veld PH, Szczecinska A, Dhonukshe-Rutten RA, Cavelaars AE et al. Systematic review on daily vitamin B12 losses and bioavailability for deriving recommendations on vitamin B12 intake with the factorial approach. Ann Nutr Metab 2013; 62: 311-22. Ann Nutr Metab. 2013;62(4):311-322. doi:10.1159/000346968

(6) EFSA.
Scientific Opinion on Dietary Reference Values for Cobalamin (Vitamin B12).
. EFSA Journal 2015; 13: 4150. doi: 10.2903/j.efsa.2015.4150

(7) EFSA. (2017).
Dietary Reference Values for nutrients
. doi: 10.2903/sp.efsa.2017.e15121

(8) Hunt. JR.
Bioavailability of iron, zinc, and other trace minerals from vegetarian diets.
. Am J Clin Nutr 2003; 78: 633S-9S. doi:10.1093/ajcn/78.3.633S

(9) Lönnerdal B.
Soybean ferritin: implications for iron status of vegetarians.
. Am J Clin Nutr 2009; 89: 1680S-5S. doi:10.3945/ajcn.2009.26736W

(10) Heaney RP.
Absorbability and utility of calcium in mineral waters.
. Am J Clin Nutr 2006; 84: 371-4. doi:10.1093/ajcn/84.1.371

(11) Weaver CM, Heaney RP, Connor L, Martin BR, Smith DL, Nielsen S.
Bioavailability of Calcium from Tofu as Compared with Milk in Premenopausal Women (a work funded by Indiana Value Added).
Journal of Food Science 2016, Vol 67 Issue 8. https://doi.org/10.1111/j.1365-2621.2002.tb08873.x

(12) Roman VB, Ribas BL, Ngo J, Gurinovic M, Novakovic R, Cavelaars A et al.
Projected prevalence of inadequate nutrient intakes in Europe.
. Ann Nutr Metab 2011; 59: 84-95. doi:10.1159/000332762