How ought to vegetarians and non-vegetarians with diabetes handle protein and vitamin B 12 deficiency

A 65-year-old frail man with diabetes and weak muscular tissues requested me, “Doc, ought to I swap over to vegetarian diets in my situation as I’m a non-vegetarian? Folks say vegetarian diets are higher for me.” One other affected person of mine, a 56-year-old lady with diabetes, deranged kidney capabilities and a household historical past of colon most cancers requested, “Since I’m a vegetarian, ought to I swap over to non-vegetarian diets in my situation?” So, I’ve determined to reply each their questions.

What are the varied kinds of vegetarian diets?

There may be an growing reputation of vegetarian diets in international locations, that are predominantly non-vegetarian. The explanations are endorsement by celebrities and protecting sentiments for animals. Vegetarian diets, though lumped beneath a single identify, are heterogenous.

Lacto-vegetarian diets: These exclude meat, fish, poultry and eggs in addition to meals that include them and embody dairy merchandise (milk, cheese, yogurt and butter).

Ovo-vegetarian diets: Eggs are allowed however exclude meat, poultry, seafood and dairy merchandise.

Lacto-ovo vegetarian diets: Enable dairy merchandise and eggs and exclude meat, fish and poultry.

Lastly, vegan diets exclude meat, poultry, fish, eggs and dairy merchandise — and meals that include these merchandise.

Most Indians are lacto-ovo vegetarians. The essence and goodness of vegetarian diets are in consumption of crops, nuts, legumes and fruits.

A plant-based vegetarian weight loss plan is sweet and has a number of advantages. It decreases the chance of coronary heart illness, lowers blood ldl cholesterol and weight. As well as, intestinal illnesses (diverticulitis), kidney stones, cataracts and probably some cancers are additionally decrease in vegetarian/vegan diets. Curiously, these diets don’t lower the chance of stroke, and will even improve it. Even short-term (as much as three months) use of vegan diets might lower blood sugar ranges in a affected person with diabetes. Then why do many vegetarian Indians have diabetes, coronary heart and liver illness?

Simply taking a “vegetarian weight loss plan” just isn’t ok. Elements should be balanced and must be conducive to metabolism. There are two main flaws in Indian vegetarian diets. First, there’s a excessive consumption of refined carbohydrates (rice, naan, and so forth), in main meals. This majorly upsets all metabolic parts (sugar, triglycerides) post-meal. Second, the excessive consumption of saturated fats/trans fat (ghee, butter, excessive fats milk, coconut oil, oils derived from palm, partially hydrogenated vegetable oils), which get thickly layered in liver and arteries, stop clean functioning of cells and blood circulation, and even block it. Moreover different issues (see under), these two points alone can result in diabetes, coronary heart and liver illness.

ALSO READ | Vegetarians, these meals will assist meet your protein necessities

What are the downsides of vegetarian diets and what can we do about them?


Vegetarians are in need of high-quality protein, particularly if they don’t take eggs and dairy merchandise. (Supply: Freepik) Vegetarians are in need of high-quality protein, particularly if they don’t take eggs and dairy merchandise. (Supply: Freepik)

A number of deficiencies might happen due to extended consumption of vegetarian diets. These embody that of vitamin B12, which is primarily obtained from non-vegetarian diets. Its deficiency may cause nerve harm, which can be prevalent in diabetes. So, sufferers with diabetes who’re vegetarians, ought to get their B12 ranges checked, if potential. If they’re low, or they’re on a drug known as Metformin, then supplementation with this vitamin is warranted.

There’s a risk of deficiency of iron, zinc, calcium (particularly in those that don’t take dairy), and Omega-3 fatty acids (primarily derived from fish). The latter are important for nerves and blood triglycerides. To some extent, these micro-nutrients will be supplemented through the use of canola and soy oils in cooking, and walnuts, floor flaxseed and soybeans, however the physique wants extra. Some sources of iron embody beans and darkish leafy inexperienced greens, peas, lentils, enriched cereals and dried fruits. Nonetheless, iron absorption from plant sources is inefficient. For higher absorption of iron, meals wealthy in vitamin C are wanted. This contains citrus fruits like oranges, cruciferous greens like cabbage and broccoli and tomatoes. These are to be taken on the time that iron-containing meals are being eaten. Zinc is crucial for survival of cells and builds immunity. Like iron, it’s poorly absorbed from vegetarian diets. Consumption of cheese, complete grains, soy merchandise, legumes, and nuts may enhance zinc standing within the physique. Vegans could also be prone to iodine deficiency and will even develop goitre. Iodine may very well be obtained from iodised salt and from dairy, eggs, and a few yoghurt. Lastly, due to the absence of dairy in vegan/related diets, their followers are liable to weakening of bone and fractures.

Importantly, vegetarians are brief of top quality protein, particularly if they don’t take eggs and dairy merchandise. In lots of Indians, whose muscular tissues are weak (sarcopenia), this additional causes low muscle capabilities and likewise impacts bones. In chosen people, particularly aged vegetarians whose meals consumption is low, protein supplementation is required. Good sources of protein embody soybeans, lentils, cowpeas, peanuts, almonds, Bengal gram, flax seeds, oats, pumpkin seeds and so forth.


So, my reply to the 65-year-old man with diabetes and weak muscular tissues is that he mustn’t quit non-vegetarian diets as a result of these are good sources of protein. On prime of it, he may add good vegetarian sources of protein. These would profit his muscular tissues and bones. Second, I instructed my 56-year-old lady affected person to proceed along with her vegetarian weight loss plan and regulate protein consumption (with the assistance of a nutritionist) in keeping with her kidney capabilities. I mentioned that she ought to keep away from non-vegetarian meals, particularly crimson meat, which has been linked to colon most cancers.

A balanced vegetarian weight loss plan will do wonders to the well being and metabolism offered it doesn’t include a grimy bag of refined carbs and saturated fat, and care is taken to keep away from potential deficiencies of nutritional vitamins and minerals.

(Dr Misra is Padma Shree Awardee and writer of the ebook “Diabetes with Delight.”)

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