Thoughts on vegetarian/ vegan diet

Nurses General Nursing

Published

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

Vegans have lower BMI's; less than 10% are obese, and they have a 60% less chance of developing type 2 diabetes....Just as a weight a control mechanism it should be encouraged.

But a vegan diet does more than keep people thinner. It stops coronary artery disease from progressing and in some patients can reverse narrowing and improve blood flow of the coronary vessels. This has been proven with before and after cath lab and CT imaging. Vegans also have lower blood pressure. Reducing obesity, diabetes, and blood pressure reduces stroke risk and peripheral artery disease.

Other benefits include a healthier gut microbiome, less diverticular disease and less constipation.

A lot to consider, but looking at the epidemic of obesity and diabetes that is ravaging this country, the disability and death rates of CVA, and that heart disease is our #1 killer, medical schools are remiss for not teaching that a low fat whole foods plant based diet is what people should be following.

Now, obviously you can be vegan drinking beer and eating butterscotch candies. I am talking about mindful eating of healthy food with sufficient calories.

All that being said, since I work in a revolving door MICU, much of what we do is procedures and pills, patch work and acute symptom management. When patients can take po we send them what looks like what you'd eat if you had a frozen dinner from the grocery store in 1972, except probably even less palatable. ? When dietary conversations arise at work I do try to encourage my patients to decrease saturated fat, especially saturated animal fat, and to eat more nutrient dense, high fiber plant based foods. If they've never eaten fruits or vegetables and can't stand the taste or texture we talk about finding smoothies they like, maybe pureed bean and vegetable soups, or how to sneak in a little extra nutrition in their spaghetti sauce and pasta, for example, by adding vegetables and finding spices they enjoy. I also encourage markedly decreasing processed foods, watching their salt, and choosing whole grain options vs. highly refined foods. This kind of discussion is pretty rare, though, maybe a few sentences about it a few times a month, if that.

Tragically health care does an absolutely *horrible* job in preventing disease through healthy eating. There are a few glimmers of hope though; there are more cardiologists getting on board, and there is a little more interest in "lifestyle" medicine (which generally includes promotion of a lower fat WFPB diet) amongst internal medicine, pediatric, and family practice docs. Also, Medicare has approved reimbursement for The Ornish Reversal Program, which is an intensive cardiac rehab program that solely focuses on diet and lifestyle changes, and Kaiser Permanente is now working with physicians to encourage plant based eating.

I am sure most of us would rather no diagnosis vs "early" detection of illness. We need to start promoting health. Once doctors get paid for patients getting healthy, that's when we will see real primary prevention being taught and practiced.

Just my two cents. Don't want to start a war. ?

4 Votes
Specializes in oncology, MS/tele/stepdown.

I think educating patients on diet is important, but I do think if they are asking for specific information for specific dietary changes, RD should be involved. People can be healthy as vegetarians and vegans, so there's no reason to discourage it, but they aren't lifestyles for everyone. I certainly wouldn't preach about it.

I was a vegetarian for almost 7 years starting in middle school. I gained a lot of weight and needed a lot of supplements when I followed up with my doctor because I didn't replace my meat protein with plant protein. I made the decision without any real information about how to do it properly. Eventually I figured it out, no harm done. I eat meat now and have no interest in giving it up again, much to my husband's relief.

4 Votes

Ain't nobody got time for that. If the provider did not order a dietary consult, get the order.

7 Votes
2 hours ago, BedsideNurse said:

Vegans have lower BMI's; less than 10% are obese, and they have a 60% less chance of developing type 2 diabetes....Just as a weight a control mechanism it should be encouraged.

But a vegan diet does more than keep people thinner. It stops coronary artery disease from progressing and in some patients can reverse narrowing and improve blood flow of the coronary vessels. This has been proven with before and after cath lab and CT imaging. Vegans also have lower blood pressure. Reducing obesity, diabetes, and blood pressure reduces stroke risk and peripheral artery disease.

Other benefits include a healthier gut microbiome, less diverticular disease and less constipation.

A lot to consider, but looking at the epidemic of obesity and diabetes that is ravaging this country, the disability and death rates of CVA, and that heart disease is our #1 killer, medical schools are remiss for not teaching that a low fat whole foods plant based diet is what people should be following.

Now, obviously you can be vegan drinking beer and eating butterscotch candies. I am talking about mindful eating of healthy food with sufficient calories.

All that being said, since I work in a revolving door MICU, much of what we do is procedures and pills, patch work and acute symptom management. When patients can take po we send them what looks like what you'd eat if you had a frozen dinner from the grocery store in 1972, except probably even less palatable. ? When dietary conversations arise at work I do try to encourage my patients to decrease saturated fat, especially saturated animal fat, and to eat more nutrient dense, high fiber plant based foods. If they've never eaten fruits or vegetables and can't stand the taste or texture we talk about finding smoothies they like, maybe pureed bean and vegetable soups, or how to sneak in a little extra nutrition in their spaghetti sauce and pasta, for example, by adding vegetables and finding spices they enjoy. I also encourage markedly decreasing processed foods, watching their salt, and choosing whole grain options vs. highly refined foods. This kind of discussion is pretty rare, though, maybe a few sentences about it a few times a month, if that.

Tragically health care does an absolutely *horrible* job in preventing disease through healthy eating. There are a few glimmers of hope though; there are more cardiologists getting on board, and there is a little more interest in "lifestyle" medicine (which generally includes promotion of a lower fat WFPB diet) amongst internal medicine, pediatric, and family practice docs. Also, Medicare has approved reimbursement for The Ornish Reversal Program, which is an intensive cardiac rehab program that solely focuses on diet and lifestyle changes, and Kaiser Permanente is now working with physicians to encourage plant based eating.

I am sure most of us would rather no diagnosis vs "early" detection of illness. We need to start promoting health. Once doctors get paid for patients getting healthy, that's when we will see real primary prevention being taught and practiced.

Just my two cents. Don't want to start a war. ?

Found the vegan.

4 Votes

I am a vegetarian and vegan off and on. I am older and have to keep up with much younger people and so I experiment. I find somehow I can work a 12 hour shift with more energy if I eat vegan in the morning. Something like rice and lentils with tofu. I eat whatever I can find later on, but I would have thought that eating eggs and steak in the morning would provide longer energy but I seem to do best with the vegan breakfast .

I am careful with advice for patients but I really see a lot of the hospital prepared food as not looking terribly healthy.

One thing I do know is that super extra amounts of B12 is necessary and calcium also when eating vegan. I showed up with osteopenia a few years ago and also large red blood cells. I have improved these problems with supplements. On the other hand, I am thin, strong, and have no heart disease or diabetes. Just my own personal experience .

2 Votes
Specializes in ER.

I strongly believe we are honor bound to teach, or remind, patients of the benefits of a healthy lifestyle including a proper diet, sensible exercise, and adequate sleep. These are the foundation of good health. Many patients could eliminate most of their medications with better lifestyle choices. I "preach" lifestyle all day every day. I look them in the eye and say it with passion because their life may well depend on getting the basics right. They know I care and appreciate the effort.

As I stated in my first post here, not eating meat does not make a person healthy. I feel no need to preach a vegetarian lifestyle. I never start the argument, but I will gladly defend myself when I'm teased about my choice to eat a big bag of fresh greens and carrots and a garden burger. ("That's not food. That's what FOOD eats.")

4 Votes

No, offering nutritional advice is not out a nurses scope of practice. It is our responsibility as long as we are not prescribing a dietary regimen. If we tried to prescribe then we would be practicing medicine without a license.

It is disturbing to me how much nurses are giving their practices away because they do not understand their scope of practice. This happens regularly because we avoid the work it takes to know the laws in the states where we practice and by not knowing our scopes of practice.

Unfortunately, in my humble opinion, we don't have enough time in school learning about what our scope actually covers. Its left up to us to learn the intricacies of our legal practice. How many of us come out of nursing school believing that nurses are a medical profession? That thought process is frightening. What makes nursing different?

The specialty practice is in large part what covers people when they are educating patients. It is up to nurses to define their practice, not the physicians and not the CEO, CFO etc. They don't know. They know their job, not ours.

1 Votes

May I suggest anyone that has a problem with vegetarian or vegan diets look at the science. LifeStyle Medicine would argue the point. Plant-based nutrition reverses diabetes type 2 and cardiac disease.

1 Votes
On 2/19/2019 at 6:26 PM, brownbook said:

I have toooo much respect for Registered Dietitians to presume I could give appropriate dietary advice.

A BS at an accredited university, or entry level Masters Degree.. Completed an ACEND accredited supervised practice program, typically a 6 - 12 month program, passed a national examination by the Commission on Dietetic Registration.

I don't presume the average bedside nurse with 4 - 8 patients has the knowledge or time to advise patients.

I guess if you had one on one time as a public health nurse or some other areas of nursing it would be appropriate.

I have overheard some wacky ideas from co-workers about diet advise to each other. To say nothing of the original poster wanting to give advise to patients about a vegan diet, or a co-worker of mine telling patients coffee was bad for them.

Thank you! I have a BS in Dietetics and have basically spent a good portion of my life correcting bad "nutrition" advice. Didactic students take courses that teach the chemistry behind micro and macronutrient absorption, so they really understand that there is no one-size-fits-all dietary advice. They also take a bunch of food science classes in order to really understand food at the molecular level.

A NP once told me that plain, decaf herbal tea did not count towards my total daily water intake. I smiled and said "okay." I hope nurses don't routinely give unfounded nutrition advice. I certainly don't plan to once I'm an RN.

1 Votes
Specializes in Psych, Addictions, SOL (Student of Life).
6 hours ago, Thefourofus said:

May I suggest anyone that has a problem with vegetarian or vegan diets look at the science. LifeStyle Medicine would argue the point. Plant-based nutrition reverses diabetes type 2 and cardiac disease.

Not arguing the merits of a vegan lifestyle but I am wary of anything that makes such broad claims. For instance no diet in the world is going to cure type 1 diabetes where the body makes no insulin. and the term cardiac disease covers a lot of ground including congenital defects. If we are looking at diseases that are the result of unhealthy lifestyle choices I would tend to agree with you except that carbohydrate centric diets are never recommended for diabetics.

Perhaps it would be better to state your claim as in some cases a plant based diet has been shown to reverse some cases of diabetes and heart disease. I did a quick search for evidence based research in my online college library and there are very few evidence based peer reviewed studies to support such a claim. But the website for lifestyle medicine does seem to be pretty slick and aimed at separating people from their money.

Hppy

6 Votes
Specializes in Maternal Child Health, GYN.

Teaching patients about diet is not out of the scope of nursing practice. Nutrition is a part of the curriculum in nursing school. Why would that be taught if it was out of the scope of practice for an RN to teach patients about their diet? We practice in a diverse culture and some patients are vegans or vegetarians. A nurse should be able to provide dietary information to the patient according to what's needed.

2 Votes
2 hours ago, MyCall2Nsg said:

Teaching patients about diet is not out of the scope of nursing practice. Nutrition is a part of the curriculum in nursing school. Why would that be taught if it was out of the scope of practice for an RN to teach patients about their diet? We practice in a diverse culture and some patients are vegans or vegetarians. A nurse should be able to provide dietary information to the patient according to what's needed.

Because we are given a rudimentary class in nutrition and are by no means experts in that arena. It would be folly for us to take this on when there ARE experts readily available. Furthermore it is not our place to suggest particular diets beyond general recommendations because WE believe they are healthier. This was the premise in the original post. Vegan/vegetarianism requires a great deal of knowledge to safely follow and the requirements vary patient to patient. I don’t believe a Google search is an acceptable substitute for the knowledge of an educated and registered dietician. It is utter hubris to think otherwise.

4 Votes
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