Thoughts on vegetarian/ vegan diet

**LibraSunCNM, BSN, MSN, CNM** · Feb 20, 2019

There's nothing wrong with a vegan/vegetarian diet if you're educated about it and find adequate protein sources. Sure, some vegans are holier-than-thou, but most aren't. I've never understood some meat-eaters' utter disdain for vegetarians and find it equally obnoxious as a condescending vegetarian. If it doesn't affect your life personally, what do you care what someone else chooses to do with their diet? I could never give up meat or dairy but I'm in awe of people who can and who enjoy/find health benefits in that lifestyle.

As far as educating patients about nutrition as a nurse, I see no reason why you'd need to refer to a dietician unless you're truly at a loss about what they're asking. Nutrition was a pre-requisite for my nursing program and I assume most competent nurses can have at least a basic conversation about it.

Orca, ADN, ASN, RN · Feb 20, 2019

21 hours ago, Sour Lemon said:
I can't think of any medical condition where a vegetarian diet is specifically called for.

It's a personal preference. I have also read studies that say that vegetable protein does not have the same nutritional quality as animal protein, and that pure vegetarians and vegans are often protein deprived.

"nursy", RN · Feb 20, 2019

I have been a vegan for 8 years and in great health. I have NEVER had any inclination to preach to anybody about diet issues. Long before I became vegan, it was obvious to me that people are extremely set in their ways when it comes to diet, and unless someone has a real desire to change, you can preach till the cows come home, but they are not going to change. For people who are curious and want information about veganism from a healthy perspective, there are several books and web sites written by prominent cardiologists who use a vegan diet as a means to reverse heart disease.

FullGlass, BSN, MSN, NP · Feb 20, 2019

My clinic actually fired an NP who would not stop proselytizing patients about the vegan diet. She claimed a vegan diet would cure everything from obesity to GERD, often with bad results for the poor patients. One of her nuggets was chiding breast feeding mothers and instructing them to put their infants on a vegan diet! She also made non-vegan patients feel very bad. Given this is a rural area with lots of ranches and a large Hispanic population, it was also extremely annoying to many patients. She was repeatedly warned to stop doing this, but ignored the warnings. She also endlessly lectured the clinic staff about the wonders of her vegan diet and the horrors of eating any animal-based products, including cheese and eggs. There were other factors involved in her dismissal, but this was one of the major factors.

My advice is that if a patient is interested in a vegetarian diet, and especially if they are interested in a vegan diet, refer them to a dietitian. These diets require considerably more effort to obtain all needed nutrients and are also not suitable for everyone. I would restrict patient advice to CDC, American Heart Association, American Diabetes Association recommendations.

pixierose, BSN, RN · Feb 20, 2019

I’m a vegetarian. Even by eliminating meat, etc from your diet, you can still eat incredibly poorly (i.e., substituting unhealthy carbs, processed foods).

As a nurse, I feel we can provide nutritional advice based on well established guidelines. And if it’s more self limiting, I’ll refer to the RD and educate further based on that.

buttercup9, ASN, BSN, MSN · Feb 20, 2019

A person can absolutely be healthy on a vegan or vegetarian diet. Vegans need to take a B12 supplement and possibly a calcium supplement. There are A LOT of protein options available that don't include animals. I have been a vegetarian for over 20 years and have never had a problem. Whole grains and legumes have a lot of protein, nuts & seeds. Lacto-ovo vegetarians can eat eggs, cheese and yogurt, all of which have high levels of protein. Since I became a vegetarian, the "fake meat" industry has improved dramatically!

There have been plenty of studies linking vegetarian diets to positive health benefits.

Melina, Vesanto, MS, RD, Craig, Winston, PhD, MPH, RD, & Levin, Susan, MS, RD, CSSD. (2016). Position of the academy of nutrition and dietetics: Vegetarian diets. Journal of the Academy of Nutrition and Dietetics, 116(12), 1970-1980. doi:10.1016/j.jand.2016.09.025

Parker, H. W., & Vadiveloo, M. K. (2019). Diet quality of vegetarian diets compared with nonvegetarian diets: A systematic review. Nutrition Reviews, doi:10.1093/nutrit/nuy067

I agree that proselytizing is not only annoying but inappropriate. I don't think it is helpful to try to convert people to a non meat diet, but I do think it is important to encourage people to eat more vegetables, less processed food and no sugary drinks.

If you are uncomfortable talking to someone about a vegetarian diet, then be honest and just tell them you don't know enough about it. If you have enough patients asking you about it, then perhaps educate yourself on healthy ways to be a vegetarian or vegan. It isn't as hard as you think it is.

buttercup9, ASN, BSN, MSN · Feb 20, 2019

4 minutes ago, pixierose said:
I’m a vegetarian. Even by eliminating meat, etc from your diet, you can still eat incredibly poorly (i.e., substituting unhealthy carbs, processed foods).
As a nurse, I feel we can provide nutritional advice based on well established guidelines. And if it’s more self limiting, I’ll refer to the RD and educate further based on that.

You are so right about still eating poorly. When I became a complete vegetarian in college (only ate chicken until I was 19) and having to eat in the dining hall, I couldn't afford the expensive salad bar and ate cheap mashed potatoes and stuffing. I gained 10 lbs and was in a food coma every night after dinner. I eventually got my act together and ate better but it took a while.

ch105 · Feb 21, 2019

Tried pescatarian, vegetarian, & vegan due to a bit of a guilty conscience to contributing to world hunger, climate change, deforestation, global warming, ocean degradation, & animal cruelty but I couldn't stick with either. I still have cut down substantially on animal products but I was just raised eating all that junk so it's TOUGH. It's definitely much healthier. My family & I did the blood work after being one month vegan & the results were impressive. Diabetes, high cholesterol, & breast cancer run in the family so I stick with a lot of plant products as meat is carcinogenic here. I admire those people but I couldn't stick to it. Many docs are going vegan.. esp CV. Try to see what they would recommend. Don't let those healthy-lifestyle-hating people influence your perception of it either. Unfortunately, our society has gone from telling people to "eat their veggies" to talking down on those who do. You'll really hear more from the pescatarian/vegetarian/vegan haters than them themselves. My daughter is one but you would never know if it weren't for the big smack talkers that our unhealthy family can be at times.

ch105 · Feb 21, 2019

3 hours ago, buttercup9 said:
You are so right about still eating poorly. When I became a complete vegetarian in college (only ate chicken until I was 19) and having to eat in the dining hall, I couldn't afford the expensive salad bar and ate cheap mashed potatoes and stuffing. I gained 10 lbs and was in a food coma every night after dinner. I eventually got my act together and ate better but it took a while.

This is accurate. It is extremely rare to be unhealthy as a vegan or pescatarian though I do know SEVERAL overweight vegetarians. My daughter would just come home after school & just eat Daiya mac n' cheeze if it weren't for me cooking healthier alternatives. She's in college & is currently living off of taco bell & carl's jr beyond burgers yet still thin. I'm sure here sodium is not looking that great though.

guest52816 · Feb 21, 2019

My first question is why is the patient interested in a vegan or vegetarian diet?

Do they have cardiovascular disease?

If so, I would refer them to the DASH diet. Dr. Dean Ornish is preferred, but can be hard to follow, unless highly motivated.

Are they trying to lose weight?

Vegetarian or vegan, doesn't guarentee weight loss.

Are they concerned about the killing of animals, or climate change?

Before we can offer suggestions, we need to know what is drawing the patient to a particular diet.

I have been vegetarian for over 25 years.

It isn't religion for me. I am not religious.

But it is a lifestyle I chose after watching my father die of CHF, at age 56.

Before I could advise anyone else, I would need to know their motivation.

Wuzzie · Feb 21, 2019

On 2/19/2019 at 2:46 PM, bs76247 said:
I am curious about what advice I should give to a patient about a vegetarian or vegan diet for lifestyle adjustments. I have seen many benefits for patients overall health but I wanted to see if others had and opinion. Thanks

Answer questions about it? Certainly. Suggest and advocate for it? Hard Pass. Not my place.

Divine-LPN,BSN · Feb 21, 2019

Hello, this post grabbed my attention since I am a vegetarian. To be more specific, I am a lacto-vegetarian. As far as what you should advise your patient - if he/she is still in your care,- I think that you should stick to the Plan of Care at your facility. Although you may have your suggestions/preferences, professionalism must be at the forefront of nursing care. I hope that this helps...

Sincerely,

Divine-LPN,BSN