Vegetarians avoid meat and fish but most are happy to eat dairy products and eggs. Vegans avoid all animal products, including meat, fish, dairy products, eggs and honey.

Another term crept into the language some years ago – ‘flexitarian’. It was formally recorded in the Oxford English Dictionary in 2014 and describes a diet that emphasises plant foods, includes modest amounts of dairy products, eggs and fish with meat making only an occasional appearance.

A flexitarian diet appeals for several reasons. There’s plenty of evidence for the health benefits. It also fits with the increasing body of evidence on sustainable food choices that finds we need to be careful about the amounts and types of meats, seafood and other animal products we grow, export and consume.

It also fits with my philosophy that we certainly need to look at how much of particular foods we consume, but less doesn’t have to mean none. Like most nutritionists, I’m concerned about the amount of sugar and unhealthy fat the average Australian consumes, but eating less sugar or fat doesn’t mean we can never enjoy, say, a slice of birthday cake or a few fried chips. On all counts, a flexitarian diet seems like a winner to me.

Health benefits

Several years ago, a paper examining flexitarian diets identified 25 studies showing evidence of benefits for body weight, blood pressure, various markers of metabolic health (including lower blood glucose and insulin levels) and a reduced risk of type 2 diabetes. New studies also show we’re likely to have a much healthier microbiome with a diet dominated by healthy plant foods. (I discussed this in the Kangaroo Valley Voice in June 2023).

The key to success with any diet, including those that emphasise plant foods, is to make healthy choices. Plant-based highly processed breakfast cereals, sweet drinks, biscuits, most desserts and snack foods won’t cut it in the health stakes. The basis of a healthy diet is wholegrains, nuts, seeds, legumes (beans and peas), vegetables and fruit. Fish and seafood add some bonus nutrients.

Health risks?

Meat is a food rich in many nutrients, and some people worry that less meat will lead to problems getting enough protein or iron. Concerns about protein are easily solved. It’s not difficult to get enough protein from legumes, nuts, seeds and wholegrain products. Adding some milk, yoghurt, cheese and eggs makes it even easier.

Proteins are made up of amino acids. Some of these are ‘essential amino acids’, as they can’t be made in the body and must be supplied from the diet. Although many plant foods contain plenty of protein, most don’t contain all the essential amino acids. Quinoa and soy beans are exceptions. Years ago, we used to recommend specific combinations of plant foods that would provide the full complement of these essential amino acids. For example, grains lack one of the essential amino acids that is well supplied by nuts and legumes, so a peanut butter sandwich made with wholegrain bread is a source of ‘complete’ protein. Rice and beans provide another example. Or hummus made from tahini and chick peas. Or pasta and peas.

However, some years ago, biochemists found that plant foods don’t have to be combined in the same meal to provide all the essential amino acids. Simply eating some kind of legume, wholegrains, nuts and seeds over the course of a day can easily provide all the essential amino acids.

However, those who follow a vegan diet need to be aware that young children who are no longer breast-fed need dairy substitutes that have equivalent protein and calcium to animal milks. Rice, oat, almond and some other dairy-milk substitutes do not provide adequate protein for young children. Calcium levels may also be low if using a dairy substitute without adequate added calcium. Check the label on all non-dairy milk substitutes and look for at least 120mg/100 mL. Most soy drinks fit this, and some also have other added vitamins.

Iron also causes some concern, especially in areas where a good food supply is unavailable. In countries like Australia, vegetarians who eat a varied and healthy diet are not at any greater risk of iron deficiency anaemia than non-vegetarians. Iron levels may be lower in those who avoid red meat, but the levels are usually still within the recommended range. Iron is not something where more is better and very high levels can increase the risk of several serious health problems.

One nutrient that is lacking in a vegan diet is vitamin B12. Although small amounts of vitamin B12 may be made within the body, the vitamin is found only in animal foods. Those who avoid all meat, fish and eggs need a supplement of this important vitamin.

Putting it into practice

On days when no flesh, fowl or fish are consumed, it’s important to include legumes as well as making nuts, seeds and wholegrains part of every day’s meals.

Check out the variety of legumes available. Some beans have long preparation times whereas most lentils and some beans can be prepared quickly. Canned legumes are a good choice. Most varieties have no artificial additives and most are available without added salt. Canned chick peas and various lentils and beans are quick and easy and can be used in hummus, soups, or made into felafel or burgers. They can also be used in salads or tossed with spices and baked into a deliciously healthy snack food.

Check the freezer section of the supermarket for edamame – young green soy beans that can be used in many dishes or brushed with a little olive oil and baked as another healthy and highly nutritious snack food.

Unless you have an allergy to them, nuts and seeds (sesame, sunflower, pepitas, chia) should have a regular place in most people’s daily diet. (As a side note, recent research has found a reduction of around 80% in nut allergies when babies are given appropriate nut products at around six months of age. Care is needed in families where allergies are common, but introducing nuts at this time seems to train the baby’s developing immune system to see these foods as ‘friendly’ rather than a threat.)

Also include a range of wholegrains which may include oats and other wholegrain cereals and breads, amaranth, barley, buckwheat, bulgur (cracked or steamed wheat), farro, brown, red and black rice, millet, popcorn and quinoa (not strictly a grain but with similar nutritional benefits).

Take home message

Whether you choose to include meat or not, it’s wise to include a variety of healthy plant foods. The flexitarian diet with its emphasis on more legumes, wholegrains, nuts, seeds, fruit and vegetables and modest quantities of animal foods makes a lot of sense.

Dr Rosemary Stanton OAM