Vegetarianism and Diabetes: Do the Two Mix? (Part 3)

By Amy Campbell | November 6, 2006 10:51 am

Over the past couple of weeks, we’ve been taking a closer look at vegetarian eating. The purpose of these entries hasn’t necessarily been to persuade you to convert, but to show you the benefits of eating a plant-based diet—if not every day, then at least a few days a week. As we wrap up with the final part of our series, we’ll take a closer look at a few of the nutrition considerations that come with vegetarianism.

Remember that vegetarian eating can lower the risk of heart disease, high blood pressure, and certain types of cancer. Vegetarians tend to have a lower body-mass index (BMI) and may have lower rates of osteoporosis, gout, and kidney stones. But before you take the plunge, consider meeting with a dietitian to help you plan a strategy. And be sure to think about the following nutrients, some of which can be lacking in a vegetarian diet if it isn’t carefully planned out.


Carbohydrate. Plant-based diets are higher in carbohydrate than more traditional diets. While some of this carbohydrate comes from dietary fiber, the fact is that if you adopt a vegetarian diet, you’ll probably end up eating more carbohydrate (from grains and legumes, for example) than you normally do. This, in turn, may cause a rise in blood glucose levels. Be sure to monitor your blood glucose levels and count your carbohydrate grams carefully. If you take insulin, you can typically subtract out the fiber from your total carbohydrate intake. And remember to fit physical activity into your diabetes management plan, which can help counteract higher blood glucose levels.

Protein. Most people in the United States get more than enough protein, so it’s highly unlikely that you won’t get enough following a vegetarian diet. A balanced vegetarian meal plan will include protein from legumes (such as chickpeas, lentils, and black beans), nuts, seeds, some grains, and soy-based foods like tofu, soy burgers, soy hot dogs, and soy milk. And if you include milk and eggs in your eating plan, you’ll get plenty of protein.

Vitamin B12. Vegetarian diets can be low in vitamin B12, a vitamin found primarily in animal foods. Enriched cereals and fortified vegetarian foods may contain vitamin B12, but it’s not a bad idea to take a multivitamin supplement as a safeguard.

Vitamin D. Foods are typically low in vitamin D unless they are fortified. Milk, some cereals, and some brands of soy milk are fortified with vitamin D. Your body makes vitamin D when you go out into the sunshine, although several factors (including a person’s location and the season) affect how much can be produced. Again, taking a multivitamin supplement that contains vitamin D is a good idea.

Iron. Most high-iron foods are animal foods. However, iron is available from legumes, enriched cereals, whole grains, dried fruit, and dark green, leafy vegetables. Because vitamin C helps the body absorb iron, eat foods that are a good source of vitamin C, such as citrus fruits, strawberries, and tomatoes, along with high-iron foods. Don’t take iron supplements unless your health-care provider advises you to do so.

Calcium. While milk and yogurt are prime sources of calcium, you can get calcium from green vegetables, legumes, tofu, and fortified orange juice or soy milk. Women need a little more calcium than men, so if you think you’re not getting enough from food, you may need to take a calcium supplement.

Finally, if you’re scratching your head wondering what you’d be eating on a vegetarian meal plan, rest assured that there are plenty of choices. Stir-fry dishes, vegetarian chili, bean enchiladas, and even macaroni and cheese are just a sampling of possibilities. Enjoy! And for more information on vegetarianism, check out the Vegetarian Resource Group’s Web site,

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Amy Campbell: Amy Campbell is the author of Staying Healthy with Diabetes: Nutrition and Meal Planning and a frequent contributor to Diabetes Self-Management and Diabetes & You. She has co-authored several books, including the The Joslin Guide to Diabetes and the American Diabetes Association’s 16 Myths of a “Diabetic Diet,” for which she received a Will Solimene Award of Excellence in Medical Communication and a National Health Information Award in 2000. Amy also developed menus for Fit Not Fat at Forty Plus and co-authored Eat Carbs, Lose Weight with fitness expert Denise Austin.

Amy earned a bachelor’s degree in nutrition from Simmons College and a master’s degree in nutrition education from Boston University. In addition to being a Registered Dietitian, she is a Certified Diabetes Educator and a member of the American Dietetic Association, the American Diabetes Association, and the American Association of Diabetes Educators. Amy was formerly a Diabetes and Nutrition Educator at Joslin Diabetes Center, where she was responsible for the development, implementation, and evaluation of disease management programs, including clinical guideline and educational material development, and the development, testing, and implementation of disease management applications. She is currently the Director of Clinical Education Content Development and Training at Good Measures. Amy has developed and conducted training sessions for various disease and case management programs and is a frequent presenter at disease management events.

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