What are Common Nutrition Issues for Plant-Based Diets?

How do you eat a healthy plant-based diet? What nutrients are a concern for vegetarian and vegan diets? Are there certain foods you should avoid while eating an optimal diet? I get so many questions on how to eat vegan and vegetarian. I’m answering your top nutrition issues for plant-based diets. 

Plant-based eating may be a more mainstream lifestyle choice today, but it still comes with a variety of concerns. With more than half of Americans open to eating more plant-based foods, there are more and more questions about this eating style. This interest has prompted a flood of plant-based products; the global vegan food market reached $15.4 billion in 2020. There are plant-based alternatives in just about every section of the supermarket: produce, deli foods, prepared foods, canned foods, frozen foods, bakery, and even the meat counter. And plant-based foods, such as dairy and meat alternatives, can have vastly different nutritional contents. Additionally, it’s vital to be in tune with non-evidence-based information on plant-based diets making rounds on the Internet. Case in point: The claim that “dirt on carrots provides enough vitamin B12 to meet your needs” (the answer is “no” it doesn’t!). So how can you choose plant-based foods and supplements that help meet your nutritional needs for optimal health?

Research shows that well-planned plant-based diets, including vegetarian and vegan, offer many health benefits, and may even reduce environmental footprint associated with diet, but there are several key nutrition issues to consider. It’s tough to stay on top of relevant nutrition information, which includes research on plant-based diets and health outcomes and new products hitting the market. It’s a good idea if you are new to a plant-based lifestyle to see a registered dietitian familiar with plant-based diets to evaluate your nutritional status and create an individualized meal plan that meets your needs. One source of evidence-based information, as well as a list of plant-based dietitian experts in locations around the country, may be found at the Academy of Nutrition and Dietetics Vegetarian Nutrition Dietetic Practice Group (VNDPG). 

I asked top plant-based registered dietitian nutritionists to weigh in on some of the most common issues they see among their plant-based clients. 

Common Nutrition Issues and Concerns for Plant-Based Eating

1. Balancing the Plate. People often lack knowledge on how to create a balanced, nutritious plant-based meal. “With people who are new to transitioning to a plant-based diet, I find that the issue I discuss most is the balance of the plate and increasing variety of foods. I have seen a lot of clients that do not understand how to put together a meal without the center of the plate being the meat portion,” says Parul Kharod, MS, RD, LD, clinical dietitian and past chair VNDPG. 

2. Getting Enough B12. While most vegans know about the importance of vitamin B12, fewer understand the complicated absorption pathway and higher amounts needed in supplementation, says Alex Caspero, MA, RD of Delish Knowledge. She states, “B12 relies on a protein called intrinsic factor to aid in absorption; because of this, small amounts of B12 are able to bind to intrinsic factor at one time. For those consuming animal products or fortified foods often, the small amounts of B12 present in these foods are absorbed at a higher percentage. However, when you consume B12 in a single large dose, like a supplement, then you need much higher doses for absorption. Multivitamins that contain only the RDA of B12 are usually not enough for vegans. I prefer to go with the European Food Safety Authority recommendations of 100 mcg/day from a single B12 supplement.” 

3. Meeting Iodine Needs. Iodine is an issue of possible concern on plant-based diets, according to Caspero. While plants do contain some iodine, the largest dietary sources are dairy foods, seafood and eggs. Seaweed also contains iodine, but the amount varies greatly and depending on which type of seaweed is consumed, the upper limit for iodine can quickly be reached. Caspero adds, “I like to call iodine a ‘goldilocks’ nutrient because you don’t want too much or too little, you need an amount that’s just right. Because of this, I recommend that my vegan clients supplement with 1/2 the RDA of iodine—150 mcg per day—or use an iodized salt in cooking.”

4. Avoiding Grains and Pulses. There may be misconceptions that you should restrict pulses and grains (instead, pile on whole grains and pulses!). Kharod reports that people may think they can get enough fiber from vegetables alone. “If the diet is lacking in whole grains or beans because people may not be familiar or comfortable with incorporating them in their daily routine, then low fiber intake may be an issue,” says Kharod. 

5. Eating More Frequently. Switching to a more plant-based diet can mean a decrease in calorically-dense foods, says Jordan. “You may need to eat more often to meet their needs, such as three moderate meals and some small meals and/or snacks,” she adds. 

6. Increased Fiber. Another issue is GI discomfort related to rapid increases of fiber in the diet when moving from a Western-style diet to a plant-based diet. “I usually recommend slowly adding in plants, and starting with more fruits and vegetables before adding lots of pulses and whole grains. I recommend one meatless meal at a time to ease into the transition. I also discuss the ‘how’ of eating, such as slowing down, chewing food more thoroughly, sipping water, sitting up after eating, and light movement to support digestion,” says Alison Jordan, MMN, RDN, LMNT, CLC, CDCES, founder of Thinkgreenwell-being.com.

7. Getting Omega–3s. While plant foods provide short-chain omega-3 fatty acids in the form of ALA, the conversion to long-chain omega-3 fatty acids may be minimal. Jordan suggests that her vegan clients supplement with a third-party tested algae-based EPA and DHA supplement to support adequate essential fatty acid needs. 

8. Choosing the Right Plant–Based Milk. With dozens of options available in many supermarkets, consumers may have a hard time making the best choice of plant-based milk, says Sherene Chou, MS, RDN, past chair of VNDPG. Chou adds, “I always ask what each person is using the milk for. For a milk equivalent, soy milk and pea milk are the best choices based on protein and fat content. While other milks have different flavor profiles and can be used in smoothies, cooking, or otherwise. Many plant-based milks are fortified with vitamin D, calcium, B12, and other micronutrients that can be a good and easy way to help bridge any gaps.” 

For other blogs on meeting nutrients on plant-based diets, check out the following: 

Meeting Your Nutrient Needs on a Vegan Diet
How to Get Vitamin B12 on a Vegan Diet
How to Get Vegan Calcium Sources

References:

1. Global Vegan Food Market (2017-2027). EMR. Accessed on 9/29/22 here: https://www.expertmarketresearch.com/reports/vegan-food-market.
2. Climate Change and the American Diet. Earth Day Network. Accessed on 9/29/22 here: https://www.earthday.org/foodprintsreport/