Embracing a New Diet: Vegetarianism

For as long as I can remember, I have disliked meat.  I believe it started with my sensitive gag reflex as a child.  I could hardly chew and swallow pork chops, pineapple, or anything else that didn’t go down easily. In high school I became best friends with a girl who didn’t eat meat.  It seemed like a really cool lifestyle, so I joined ranks with her.  Instead of eating meat, we consumed french fries, fruit punch, and snack cakes.  This became our definition of vegetarianism. Then, during my junior year of high school, my doctor informed me that my chronic low blood sugars might be improved by more protein consumption, so I forced myself back into the life of a carnivore, not knowing then that protein consumption didn’t have to equal a slab of meat at every meal. 

Now, after eleven more years of an ongoing distaste for meat, I am embracing the gradual process of becoming a vegetarian again. But this time, I realize that I need answers before I make such a big change.  Some of my concerns include my diabetes (is it safe for someone with my disease to eliminate a food group?), my vitamin and mineral intake (can I get the nutrients I need from proteins other than meat?), and my options (holidays? dining out? family meal planning?).

I decided to take my concerns and questions to my diabetes go-to medical professional, Ms. Michelle Preston.  Michelle is a certified diabetes educator (CDE) and registered dietitian (RD) at the Diabetes Institute at Christian North East Hospital in St. Louis, Missouri.  Her answers deepened my understanding of a vegetarian lifestyle. 


Rachel:   Please define vegetarianism.

Michelle:    There are several types.   Lacto ovo vegetarians do not eat meat, fish, or poultry, but do eat eggs and products made with eggs in them, yogurt, cheese, milk, and ice creams.  Lacto vegetarians do not eat meat, fish, poultry or eggs, but include dairy products in their diet. They will eat milk, ice cream that does not include eggs, yogurt, and cheese, but they avoid ice cream, baked goods, pancakes, and veggie burgers that contain eggs. Vegans do not eat any fish, meat, poultry, eggs, dairy products, or foods that contain any of these ingredients. They also do not use any non-food items that contain products from animals, including wool from sheep, leather, and silk. Vegans often do not eat honey because bees may be killed while harvesting it.

Rachel:   What are people’s motivations to embrace a meatless diet?

Michelle:  People often become vegetarian for one reason, be it health, religion, or animal rights, and later adopt some of the other reasons as well.

Rachel:  What essential nutrients does meat provide?

Michelle:  Meat, chicken, pork, and fish provide a source of complete proteins, meaning that they contain all the essential amino acids that our bodies need.  Meat is also a major contributor of zinc and vitamin B12, vitamin B6, iron, and niacin, all nutrients that are often lacking in a vegan diet.  These vitamins are essential for metabolism, formation of antibodies and red blood cells, nerve function, taste and smell, and proper healing.

Rachel:  In what ways can a vegetarian make sure to get the nutrition that is lacking without meat consumption?

Michelle:  Consume an adequate amount of protein from a variety of sources: soy, beans, nuts, protein powders, eggs, and/or dairy products. Most people need 0.4 grams of protein per pound of body weight. I also recommend taking a multivitamin daily as “insurance” in case some vitamins and minerals are missed from day to day.  A supplement, however, should never be the main source of nutrition. Food comes first.  There are also many products that are fortified with B vitamins, calcium, viitamin D, and iron.  Iron absorption is increased markedly by eating foods containing vitamin C along with foods containing iron: or example, a small orange with whole grain cereal fortified with iron.  Too much for your brain to handle?  That’s what registered dietitians are for!

Rachel:  Can a person with diabetes safely be a vegetarian?

Michelle:  Absolutely. The same guidelines apply for non-vegans.  Moderate carbohydrate foods: fruit, milk, grains, and starchy vegetables.

Rachel:  What are the benefits of a vegetarian diet?

Michelle:  The results of an evidence-based review showed that a vegetarian diet is associated with a lower risk of death from ischemic heart disease. Vegetarians also appear to have lower low-density lipoprotein cholesterol levels, lower blood pressure, and lower rates of hypertension and type 2 diabetes than non-vegetarians. Furthermore, vegetarians tend to have a lower body mass index and lower overall cancer rates. Features of a vegetarian diet that may reduce risk of chronic disease include lower intakes of saturated fat and cholesterol and higher intakes of fruits, vegetables, whole grains, nuts, soy products, fiber, and phytochemicals.

Rachel:  How can a person embrace a vegetarian diet when other members of her household do not? 

Michelle:  It may be a challenge, but vegetarian meals can often “look” like they contain meat if you use the right products.  My “guiltless vegetarian lasagna” was a hit in my family, and no one knew it contained  textured vegetable protein instead of meat. On the other hand, I do know that some families require two separate meals to be prepared.  Dietitian Diane Dyer has experience with this.  Visit her website (www.cancerrd.com) for more information and recipes.

Rachel:  As you know, I have a fifteen-month-old daughter.  Is a vegetarian diet safe for children?  What about children with diabetes?

Michelle:  It can be safe as long as their diet is monitored.  Feeding Vegan Kids by Reed Mangels, PhD, RD, is an extremely helpful book for parents.

Rachel:   Do vegetarians have a lot of food options?  What are some of them?

Michelle:  Yes.  There are so many products on the market today for vegetarians!  I found a helpful list at  http://www.vrg.org.

Try substituting beans for animal protein in all of your favorite dishes. For example, make black bean burgers instead of hamburgers and bean enchiladas instead of traditional enchiladas. Even try mixing cannellini beans into your pasta or using kidney beans in place of meat in your favorite sloppy joe recipe.

Meat substitutes
Many meat substitutes are available at most major grocery stores. It’s not just veggie burgers anymore! Try meatless ribs, sausage, chicken wings, franks, and bacon or soy crumbles to replace ground beef.

Hearty vegetables
Try using heartier vegetables, such as Portobello mushrooms and eggplant, to create filling, healthy meals. Use these vegetables to replace meat in your favorite dishes, such as lasagna.

Tofu picks up the flavor of any ingredient with which it is mixed. If you mix it into a stir-fry, it will pick up the flavor of the soy sauce, and if you mix it into a fruit smoothie, it will pick up the flavor of the fruit. This versatile ingredient adds protein to any dish. You can even use soft tofu to create a vegetable dip for a fast and easy snack.

Textured vegetable protein (TVP)

Textured vegetable protein is my favorite! It is a meat substitute, made from soy flour, that is used in many frozen and canned vegetarian products found in health food stores and other retail locations. TVP is also available as a stand-alone product and can be substituted for ground beef in many recipes.

Grilled vegetables
Grill vegetables and top with cheese to make a fast and easy sandwich. It is especially tasty to brush the vegetables with a little olive oil and balsamic vinegar before grilling. As an alternative, make marinated shish kebabs for a quick meal.

Enjoy split pea soup, lentil soup, or meatless chili, paired with whole-grain bread for a satisfying meal.

Ethnic foods
Experiment with different ethnic food dishes. For example, many traditional Middle Eastern, Asian, South Indian, and Mexican dishes are vegetarian.

Try a variety of flavored oils, vinegars, cooking wines, fruit and vegetable juices, herbs, and spices to liven up vegetable-based dishes.

If you are trying to avoid cow’s milk, consume calcium-fortified soy milk, orange juice, breakfast cereals, bread, or other products to make up for the loss of calcium in your diet. In addition, include the following calcium-rich foods (one cup cooked or two cups raw): Bok choy, broccoli, collards, Chinese cabbage, kale, mustard greens, or okra.

Nut butters
Use peanut, almond, and cashew butters to add a touch of sweetness, “staying power,” and nutrition to oatmeal, stir-fries, smoothies, etc.

Rachel:  On a social level, how can vegetarians defend their choice to not eat meat?  (As you know, people with diabetes are already scrutinized for their eating habits).   Is being a vegetarian as taboo as it used to be?

Michelle:   No one should feel required to explain why they choose not to eat a certain food. It is a personal choice. If someone doesn’t like okra, no one protests because okra is not a commonly liked vegetable.  Many people enjoy meat, however, so they have a harder time understanding why someone else doesn’t want to eat it. Identifying yourself as a vegetarian is not taboo at all.  It is much more widely accepted today.

Rachel:  What health dangers should vegetarians be aware of in regard to their diet?

Michelle:  Inadequate protein intake and vitamin deficiencies.  

Rachel:  Any other words of advice?

Michelle:  If you are thinking about becoming a vegetarian or are one already, make an appointment with a registered dietitian to ensure that you are getting adequate nutrition.


Since my interview with Michelle a few weeks ago, I have embraced a lacto ovo vegetarian diet with the exception of the occasional taste of seafood.   I can’t see myself giving up eggs, cheese, or my beloved ice cream any time soon, so the lacto ovo route worked best for me.   My blood sugars have remained stable, and I’m enjoying preparing and eating new, meatless recipes.   


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