Let ’Em Eat Lettuce

Athletes who chose a vegetarian diet can be healthful and successful. But they may need some help in making sure their greens, beans, nuts, and grains are nutritionally balanced.

By Leslie Bonci

Leslie Bonci, MPH, RD, is Director of Sports Nutrition at the University of Pittsburgh Medical Center and serves as a consultant to the Pittsburgh Steelers, Pitt athletics, and several area high schools.

Training & Conditioning, 13.3, April 2003, http://www.momentummedia.com/articles/tc/tc1303/lettuce.htm

Can an athlete be a vegetarian and also successful in his or her sport? The answer is a resounding yes. However, even more than the typical athlete’s diet, a vegetarian athlete’s diet needs to be well planned to provide the necessary nutrients for health as well as for performance.

In helping vegetarian athletes, the first step is to be both knowledgeable and respectful of their choice. This will not only help avoid misconceptions, it will go a long way towards persuading a vegetarian to take your advice.

To start, it is important to understand why some athletes choose to become vegetarians. The most common reasons are:

Ethical: They don’t believe in killing animals for human consumption and/or feel the treatment of animals bred for consumption is inhumane.

Health: They feel a vegetarian diet will have short and/or long-term health benefits.

Taste: They may not like the taste of meat or may simply find other foods more appealing.
Performance enhancement: They may have found that switching to a vegetarian diet has helped their performance.

Religious beliefs: Some Jewish and Muslim athletes may choose to keep kosher/halal, which means they only eat certain types of animal meat and only if it is butchered in a particular way. If this meat is not served in the college cafeteria or available at local supermarkets, they may end up eating a vegetarian diet. In addition, Seventh-Day Adventists and many Hindus and Buddhists don’t eat meat.

But there may be other reasons, too. Some may be living with friends who are vegetarians, and others may simply want to experiment with not eating meat to see how it affects their health and performance. Of course, some of today’s student-athletes come from vegetarian households and eating meat is simply not their norm.

By asking why the athlete has chosen to consume a vegetarian diet, you’ll have insight into helping him or her optimize that diet. An athlete who is a vegetarian for ethical or religious reasons will often need different suggestions than an athlete who is a vegetarian for health reasons. It’s important not to assume that the lifelong vegetarian does not need some assistance. If he or she is entering a much more rigorous training program than experienced in high school, his or her former diet may no longer be sufficient.

The other important piece of information you’ll need to find out is what type of vegetarian the athlete is. It is important to understand that vegetarianism is not “one size fits all.” The following are the major categories:

Semi-vegetarian: includes some but not all animal products, such as poultry, seafood, eggs, milk, and milk products.

Lacto-ovo-vegetarian: includes eggs, milk, and milk products, but excludes meat or seafood.

Lacto-vegetarian: includes milk and milk products but no eggs, meat or seafood.

Ovo-vegetarian: includes eggs as the only animal protein source.

Vegan: includes beans, grains and vegetables but excludes all animal products including eggs, milk, milk products, and, in some instances, honey.

Fruitarian: includes only nuts and fruit.

Macrobiotic: includes a balance of beans, grains and vegetables, with occasional fruit, seeds, dairy, seafood, poultry and meat, prepared only certain ways.

After understanding the why and what of a vegetarian athlete’s choices, ask if they have thought through how their nutrient needs will be met. I have worked with athletes who want to be vegetarians, but don’t like beans, nuts, seeds, or even most vegetables! Getting the nutrients one needs is not that difficult, but certain strategies must be in place.

PROTEIN NEEDS
Some athletes are dissuaded from becoming vegetarians because they have been told they will not be able to fulfill their protein needs. This is far from the truth, and is another reason why educating athletes is so important.

The amount of protein that athletes need depends on their athletic endeavors, age, and weight. Here are some daily guidelines:

Competitive athlete: 0.6-0.9 grams of protein per pound of body weight.

Building mass: 0.7-0.9 grams protein per pound of body weight.

Growing athlete: 0.9-1.0 grams protein per pound of body weight.

Athlete desiring weight loss: 0.7-1.0 grams protein per pound of body weight.

For example, a 130-pound athlete would need 78-117 grams of protein per day.

Protein is found in ALL foods except fruits, sweets, and oils. There are several excellent sources of plant-based protein, but oftentimes it is necessary to eat larger quantities of these foods to get the same amount of protein as is found in animal protein sources. The best sources of plant-based protein include soy foods, nuts, nut butters, seeds, and dried beans. (Table One, below, lists the protein content of foods commonly chosen by vegetarian athletes.)

Vegetarians are sometimes confused by the concept of combining different types of proteins in a single meal to get a full set of amino acids. A generation ago, vegetarians were told to eat lentils with rice or oatmeal with nuts in order to meet those needs. But more recent studies have shown that this is not necessary, because although most plant proteins do not contain all of the essential amino acids, the body can synthesize new proteins over a 24-hour period. An athlete who has oatmeal for breakfast, a handful of nuts mid-morning, lentil soup for lunch, and pasta for dinner will meet protein requirements over the course of the day. This gives the student-athlete a little more leeway and flexibility with meal planning.

OTHER NUTRIENTS
Aside from proteins, it is important for vegetarian athletes to meet their needs for vitamins and minerals. Here are some suggestions:

Vitamin D is found in milk, egg yolks, and fortified cereals, and is made naturally by the body when exposed to sunlight.

Iron in found in iron-fortified cereals, spinach, whole grain breads, blackstrap molasses, and dried beans. (Eat these foods with a vitamin C source, such as citrus fruit or juice, to improve absorption.)

Zinc is found in whole grain breads and cereals, nuts, seeds, and legumes.

Vitamin B12 is found in many fortified cereals and soy milks, and some meat-analog products, although the source in some may be from animals, a consideration for vegetarians. A common non-animal source is nutritional yeast, a powder with a slightly salty, cheese-like flavor and aroma that can be added to many dishes, and which makes a good alternative to butter when sprinkled on hot popcorn. Certain fermented foods, such as miso and tempeh, may also contain B12, although the amount can vary widely with exactly how these products are prepared.

Calcium is found in dairy foods, calcium-fortified juices or soy products, cereals, or supplements. Spinach, kale, and broccoli are good plant sources. Strive for 1300 mg/day.

Magnesium is found in whole grains, nuts, and chocolate.

Fiber is found in fruits, vegetables, whole grain breads, cereals, nuts, dried beans, and brown rice.

Nuts and nut butters are an excellent way of ingesting both protein and fat as well as magnesium and fiber. Fortified foods can be very helpful, and a multivitamin-mineral supplement, with B12, may be warranted for some athletes.

PROBLEM SOLVING
Although a vegetarian diet can be quite healthy, and indeed may be healthier than a meat-based diet, food choices must be careful and appropriate. The vegetarian who eliminates animal protein without substitutions will see a negative effect on health and performance.

A vegetarian diet doesn’t necessarily promote weight loss, but it is not uncommon. The athlete who loses too much weight is eating too few calories and is not fulfilling their protein, carbohydrate, or fat requirements. They may have simply eliminated meat from their plate without adding anything. Or they may be eating too many fruits and vegetables and not enough dried beans and nuts. This is a cause for concern, not only because of the effect on performance, but for its effect on the health and well-being of the athlete.

In some cases, switching to a vegetarian diet can actually cause weight gain. Athletes who are gaining weight may be overcompensating for their diet by eating too many fat-containing foods such as dairy products, nuts, and nut butters. While these are excellent sources of nutrients, they also contain a lot of calories.
If vegetarian athletes complain of weight loss or gain, ask them to complete a three-day food record, so you can get an idea of their current eating behavior. Compare it to the daily goals listed in Table Two (below) to spot potential problems.

Of course, many athletes are not going to come ask for help if they are losing weight. For athletes who are ovo-vegetarian fruitarian, macrobiotic, or vegan, it’s important to keep a look out for possible nutrition-related problems, including the following:

• Fatigue beyond that expected.
• Decreases in strength, speed, and stamina.
• Poor wound healing.
• Increased incidence of stress fractures.
• Rapid weight fluctuations.
• Gastrointestinal distress.

ON THE ROAD
Team travel can be a challenge for vegetarians, especially when food choices are limited. Athletic trainers can help by suggesting that pregame meals include a vegetarian entree that is nutritious and acceptable to the vegetarian athlete or athletes. (See Table Three, below, for suggestions.)

Athletic trainers can also educate these athletes on how to make good choices, and can ask coaches to check that restaurants have a range of options. Most restaurants do have vegetarian dishes such as:

• Veggie hoagies
• Baked potatoes
• Salads
• Veggie burgers (among national chains, Burger King has one)
• Pizza (for the vegan, no cheese)
• Bean burritos
• Rice and beans
• Corn
• Veggie stir-fry
• Bagels
• Pasta
• Cereals
• Pancakes

It is also a good idea to have the athlete bring some protein-containing snacks such as peanut butter, trail mix, roasted soybeans, and soy milk. Packaged vegetarian soups just require hot water, and instant hot cereals are also very easy to pack. If choices are very limited, there are several sports bars that can provide protein to ensure that needs are met. If there are no acceptable food choices, another option is to bring along a protein powder.

ARMED WITH INFO
Whether an athlete is a longtime vegetarian or just learning about becoming one, take the time to talk with them and give them as many resources as possible. Table One can educate them on what foods to search out at the cafeteria or grocery store, while Table Two can serve as a daily guideline. Table Three can be helpful to athletes who lives off campus (or for the cafeteria staff). Finally, the resources box, below, can help them with further questions.

Learning to make new food choices can easily create nutritional deficiencies in your student-athletes. By steering them in the right direction, you can help your vegetarian athletes make safe, healthy choices.


Sidebar: RESOURCES
There are many excellent resources for you as well as to provide to your athletes. Here are some of the best:

BOOKS:

Dorfman, L. The Vegetarian Sports Nutrition Guide. Wiley, 2000.

Kleiner S., Kester K. The Be Healthier, Feel Stronger Vegetarian Cookbook. Macmillan, 1997.

Havala S. The Vegetarian Food Guide and Nutrition Counter. Berkeley Books, 1997.

WEBSITES

The American Dietetic Association: www.eatright.org

Vegetarian Resource Group: www.vrg.org

The Veggie Sports Association: www.veggie.org



TABLE ONE: High-Protein Choices
The following table lists the protein content (in grams) of foods commonly chosen by vegetarian athletes.

FOOD - PROTEIN
Egg, 1 large - 7
Egg whites, 2 - 7
Milk, 1 cup - 8
Cottage cheese, 1/2 cup - 13
Dried beans, 1/2 cup - 7
Tofu, 3 oz. piece - 6
Yogurt, 8 oz. - 10
Cheese, 1 oz. slice - 7
Soy cheese, 1 oz. slice - 7
Pasta, 1 cup cooked - 6
Textured vegetable
protein,1/4 cup - 12
Soy veggie burger - 7-10
1/4 cup nuts or seeds - 7
3 TBsp peanut butter - 7
1/2 cup rice - 3
1 slice of bread - 2-3



TABLE TWO: Daily Goals
In developing an eating plan for vegetarian athletes, the following daily goals should be used as a template.

MILK AND MILK ALTERNATIVES
These will provide protein and calcium, as well as Vitamins A and D (milk), carbohydrates and potassium (yogurt), and fiber (tofu, nuts, nut butters). Strive for 6-8 servings.
1/2 cup milk, yogurt, or fortified soy milk
1 oz. cheese
1/2 cup cottage cheese
1/4 cup tofu
1/4 cup almonds
3 TBsp sesame butter or almond butter

MEAT SUBSTITUTES
Dry beans, nuts, seeds, eggs, and meat substitutes are excellent sources of protein, as well as minerals such as calcium (soy products if fortified), magnesium (nuts and nut butters), and iron (dried beans). Strive for 2-3 servings.
1 cup cooked dry beans, lentils, or peas
2 cups soy milk
1/2 cup tofu
2 oz. veggie meat
2 oz. soy cheese
2 eggs or 4 egg whites
1/4 cup nuts or seeds
3 TBsp peanut butter

VEGETABLE GROUP
These foods are excellent sources of fiber, vitamins (especially C and folate), potassium, and phytonutrients such as lutein, carotene, and zeaxanthin. Strive for 3-4 servings.
1/2 cup cooked or chopped raw vegetables
1/2 cup tomato sauce
1 cup raw, leafy vegetables
3/4 cup vegetable juice

FRUIT GROUP
Fruits are a great source of carbohydrate, Vitamin C, potassium, and fluid. Strive for 2-4 servings.
3/4 cup juice
1/4 cup dried fruit
1/2 cup chopped, raw fruit
1/2 cup canned fruit
1 piece of fruit

BREAD, CEREAL, RICE, PASTA GROUP
These foods provide necessary carbohydrates for exercise and are great sources of fiber, vitamins, and minerals, especially in fortified products. Strive for 6-11 servings.
1 slice bread
1/2 bagel, English muffin, or bun
1 oz. ready-to-eat cereal
1/2 cup cooked cereal
1/2 cup pasta or rice

OMEGA-3 FATTY ACID FOOD SOURCES
Omega-3 fatty acids provide long-term health benefits. Strive for 1-2 servings.
3 TBsp walnuts
4 tsp canola or soybean oil
1 TBsp ground flaxseed



TABLE THREE: Vegetarian Entrees
For athletes who prepare their own food, there are many quick and easy-to-prepare vegetarian dishes. The following list can also be helpful to whoever is preparing pregame meals.

Oatmeal with walnuts, raisins, and soy or cow’s milk
Lentil soup with rice or pasta added
Vegetarian refried or black beans in corn tortillas
Peanut butter sandwich
Chili with textured vegetable protein (TVP), tomato sauce, and kidney beans
Veggie burgers
Stir fry with vegetables and dried beans over rice
Pizza with cheese or soy cheese
Pasta with vegetables, olive oil
Pasta with marinara sauce and TVP
Cheese ravioli
Cheese-filled manicotti
A vegetable omelet
Rice and beans
Hummus in pita bread, with feta cheese for additional protein
A bowl of vegetarian vegetable soup and a bagel with melted cheese or soy cheese