People choose to stay on a vegetarian diet for various reasons. Since there is a growing interest and increasing awareness of animal welfare as well as environmental concerns, more people are choosing to reduce or avoid consumption of animal products.

"There are many different types of vegetarianism, hence it is important to understand their differences before switching to a vegetarian diet. Therefore, read as much as you can about vegetarianism, try out recipes and experiment cooking using different ingredients, equip yourself and learn about healthy alternatives of animal products," says Ms Joey Ho, Dietitian ​from the Department of Nutrition and Dietetics at KK Women's and Children's Hospital (KKH), a member of the SingHealth​ group.

Types of vegetarian

The following explains the key differences of vegetarianism:

  • Vegan
    This diet includes fruits, vegetables, beans, grains, seeds and nuts. All animal protein sources including meat, fish, poultry, eggs and dairy products are excluded from the diet.

  • Lacto-vegetarian
    This diet includes dairy products (e.g. milk cheese, yoghurt etc.) in addition to the foods allowed in a vegan diet.

  • Lacto-ovo-vegetarian
    This diet allows dairy products and eggs in addition to foods listed in a vegan diet.

  • Pesco-vegetarian
    This diet includes fish in addition to the foods listed in the lacto-ovo-vegetarian diet.

In view of the elimination of certain food groups in different types of vegetarian diets, there are certain nutritional deficiencies you need to be mindful of (this is addressed below).

Tips to help you make the switch to a vegetarian diet

Dietitians had the following tips for women who are planning to switch to a vegetarian diet:

  1. Decide what kind of vegetarian you want to be
    Pesco-vegetarian, lacto-vegetarian, lacto-ovo-vegetarian or vegan (see descriptions below). Read as much as you can about vegetarianism – books, online resources. Educate yourself on nutrition and learn about healthy substitutes for animal products.

  2. Start by first eliminating red meat.
    After a few days or weeks, eliminate white meat and then fish. Initially you may still have cravings for meat but eventually they will fade. Remember to replace meat with beans and bean products, pulses, nuts and seeds.

  3. Invest in a vegetarian cookbook.
    When cooking, experiment with different vegetables and fruits. You may wish to experiment with different ethnic cuisines too.

Avoid these common nutritional deficiencies when sticking to a vegetarian diet

  • Calcium

  • Calcium is important regardless of age. It is one of the key minerals that help to maintain bone health. Throughout life, especially during childhood and teenage years, the rate of bone formation is faster than bone loss, peak bone mass will be achieved around 20 years of age. After achieving peak bone mass, bone loss will begin to speed up, which causes your bones becoming weaker over time. Therefore, it is important to get enough calcium in your diet in order to slow down the loss of calcium from bones and reduce the risk of osteoporosis in later in life. Besides, women are more prone to osteoporosis after menopause due to the reduced estrogen levels, as estrogen plays an important role in protecting bones. 

    Lacto- and lacto-ovo-vegetarians can obtain calcium from dairy products, such as yoghurt, cheese and milk. Vegans are encouraged to seek non-dairy source of calcium, such as soybean products including tofu and taukwa, dark green leafy vegetables, nuts and dried figs. Fortified food products such as high calcium soymilk, nuts’ milk (e.g. enriched calcium almond milk) and juices are also widely available in the market.

    Vitamin D is also essential to enhance the absorption of calcium. In general, sensible sun exposure of 10 to 15 minutes daily will be adequate to meet the requirement. Other than relying on sunlight for vitamin D, consumption of oily fishes (e.g. salmon, tuna, mackerel etc.), egg yolks, processed cheeses, mushrooms, milk and fortified soymilk are also good dietary sources of vitamin D.

  • Iron

  • Inadequate iron intake may lead to reduced production of red blood cells and lead to a condition commonly known as iron deficiency anemia. There are two types of iron found in our food sources – heme and non-heme iron. Heme iron can be obtained from animal meat sources, including beef, mutton and livers. For vegetarian sources, non-heme iron is commonly found in beans and legumes (e.g. red beans, baked beans, lentils), dark green leafy vegetables, dried fruits (e.g. raisins, apricots, prunes), malted drinks and iron-fortified cereals.

    To enhance the absorption of non-heme iron, it is recommended to include vitamin C-rich foods, such as fresh fruit or juice with or after main meals. Also, coffee and tea should be taken one to two hours apart from main meals as they contain tannins and polyphenols that tend to inhibit iron absorption.​​

  • Vitamin B12

  • Besides iron, vitamin B12 is required for the formation of red blood cells. Vitamin B12 is also vital in supporting neurological functions and synthesising DNA. It is mainly found in meat, dairy products and eggs, and it is not present in plant foods.

    For vegetarians, taking fortified products such as soymilk and breakfast cereals can be good sources of vitamin B12. Nutritional yeast powder or flakes used in bread and beer production also contain vitamin B12 which can be added to most foods and provide a savoury and cheesy flavour. In the form of dietary supplement, the absorption depends on the existing amount of intrinsic factor (a type of protein secreted by stomach cells) in the body as it is required to bring vitamin B12 to the intestines to be absorbed.

    If required, individuals diagnosed with vitamin B12 deficiency are commonly treated with vitamin B12 injections.

Can I be a vegetarian if I’m pregnant or breastfeeding?

Nutritional guidelines for pregnant women who are vegetarian are the same as that of women who are non-vegetarian. All pregnant women need additional calories, iron, calcium, folate, zinc, protein and essential fatty acids like DHA. It’s important to eat a varied and balanced diet in pregnancy to provide enough nutrients for the foetus and for your own health.

Vegetarian and vegan new mums and mums-to-be need to pay special attention to their intake of calcium, vitamin D, iron and vitamin B12.

Ref: L20​​