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Plant-based Nutrition Pt1 - Addressing macronutrients deficiency

Plant-based diets (generally including less animal-food and focusing more on whole foods - similar to vegetarian or vegan diets) is becoming more visible and is a growing area of interest in the promotion of physical and environmental health (1,2).

Observational data show that vegetarians tend to have better cardiovascular outcomes compared to those consuming omnivorous diets, including:

- reduced risk of morbidity and mortality from ischemic heart disease (3-5)

- reduced incidence of cancers, particularly among vegans (5)

- decreased risk of developing Type 2 Diabetes (6,7)

- decreased risk of developing metabolic syndrome (MetS) (8,9)

- lower all-cause mortality (10,11)

These positive health outcomes likely relate to:

- lower body mass index [BMI] (12)

- lower glucose levels (5)

- lower systolic and diastolic blood pressure (13,14)

- lower total and low-density lipoprotein cholesterol (15,16)

- lower triglycerides (17)

- lower levels of uric acid and high-sensitivity C-reactive protein (18)

- higher levels of plasma ascorbic acid observed among vegetarians (18)

However, plant-based diets that are poorly constructed might predispose individuals to macronutrients - protein, n-3 and micronutrient - vitamin B12 and vitamin D; iron, zinc, calcium, iodine deficiencies (19-22). Thus, this article addresses how we can better nourish our bodies with adequate macronutrients in a plant-based diet.


The quality and quantity of protein intake is essential for the optimisation of health in a plant-based diet (23). The recommended protein intake for most non-active adults is 0.8 g/kg−1.0/kg per bodyweight per day (24,25). It is also important to note that protein intake requirements should be tailored to reflect training-goal requirements as well (24-26).

The role of protein serves as a substrate for exercise performance and a catalyst for exercise adaption. Protein also aids with muscle recovery, adaption and anabolism after exercise by creating a positive balance between Muscle Protein Breakdown [MPB] and Muscle Protein Synthesis [MPS], this reaction is known as Net Protein Balance [NPB] (27-29). The picture below better illustrate this reaction. Vice versa, when the body is placed under hypo-caloric conditions, a negative energy balance adaptive mechanism causes the body to preserve Fat Free Mass [FFM] (30,31).

It is commonly mistaken that amino acid intake may be inadequate in plant-based diet. This claim that plant-based diet may be "missing" specific amino acids is evidently false. All plant foods contain all 20 amino acids, including the 9 indispensable amino acids (32). Rather than "missing" amino acids, a more accurate description would be that the amino acid distribution profile is less optimal in plant foods compared to animal foods. For example, lysine contains a much lower protein proportions in grains optimal for human needs as compared to proportions found in animal products. This would predispose plant-based eaters to have inadequate lysine if a high proportion of their protein source comes from cereals only, which contains limited amount of lysine as required. However, by replacing animal protein with a mix of protein-rich plant foods such as legumes, nuts and seeds could produce no risk of an insufficient intake of protein, including amino acids such as lysine.

Therefore, a plant-based diet can still achieve significant amounts of total protein when the diet is constructed well from a high intake of a variety of whole foods such as vegetables, legumes, grains, nut and seeds (33). Foods such as grains, legumes, nuts and seeds are recommend to ensure adequate BCAA are consumed to support recovery and adaption from training. Examples of high-protein vegan-friendly foods can be found in illustration below:

Plant-based Protein Supplements

Commercially available plant-based protein supplements include soy (& soy isolate), pea, rice, hemp and composite/blended protein products (34-37). Supplemental protein might be of interest for individuals whom may find achieving sufficient protein difficult or inconvenient via whole foods. Even though it remains debatable that the differential rates of protein digestibility impacts amino acid availability, it is still possible to achieve sufficient amino acid absorption in a plant-based diet. Comparison of the digestibility between plant and animal protein sources are only a few percent, with pea protein isolate, soy protein isolate and wheat flour [89-92%], similar to those found in eggs [91%], meat [90-94%] and milk protein [95%] (38). Thus, this body of evidence so far does not show a difference large enough to result in a risk of insufficient amino acid absorption for plant-based diet. Additionally, emerging data is beginning to support the efficacy of plant-based protein powders at improving recovery from training (39).

Overall, plant-based eater should aim to consume the recommended protein intake of 0.8g/kg per bodyweight per day, comprising a range of whole foods including legumes, grains, vegetables, nuts and seeds and fruits to maintain protein adequacy.


Achieving an adequate carbohydrate intake is relatively straightforward in plant-based diets as it tends to be usually higher in carbohydrates, fibre, vegetables, fruits, antioxidants and phytochemicals (40). Grains, legumes, beans, root vegetables and fruits are staples to meet carbohydrate requirements satisfactorily. However, do note that although these foods mentioned are nutritious, they are rich sources of fibre and a high-fibre diet can also cause gastric distress in some cases (41-43).


Plant-based diets are typically lower in total and saturated fat. This produces a health benefit with reductions in heart disease, hypertension, cholesterol, type 2 diabetes and cancer (44). Attention should be paid to the quality and quantity of fat consumed. Limiting linoleic acid consumption (an n-6 fatty acid), found in sunflower, corn and safflower oils while consuming adequate fat from avocados, oil, nuts and seeds (50) within the recommended values of 0.5–1.5 g ∙ kg ∙ day−1 (or 30% of daily caloric intake). It is recommended that food sources of n-3 ALA, such as flax seeds, walnuts and chia seeds might offer broader health-related benefits (45-47). Combining whole-food sources rich in ALA might optimise n-3 fatty acid intake, improving overall health in plant-based diets (48,49).

Overall, through a strategic management of food choices, with attention being paid to achieve recommended energy, macro and micronutrients, a plant-based diet can achieve the needs of most individual satisfactorily. Plant-based diets does not have to just be salads, they can be wholesome, nourishing and satisfying too! If you're interested to know more on how to personalise your nutrition and improve your health, do reach out to us here!

With love,



  1. Mintel Food and Drink Trends 2017. [(accessed on 27 November 2018)]; Available online:

  2. Mintel Global Food and Drink Trends 2018. [(accessed on 27 November 2018)];2018 Available online:

  3. Szeto Y., Kwok T.C., Benzie I.F. Effects of a long-term vegetarian diet on biomarkers of antioxidant status and cardiovascular disease risk. Nutrition. 2004;20:863–866. doi: 10.1016/j.nut.2004.06.006.

  4. Kwok C.S., Umar S., Myint P.K., Mamas M.A., Loke Y.K. Vegetarian diet, Seventh Day Adventists and risk of cardiovascular mortality: A systematic review and meta-analysis. Int. J. Cardiol. 2014;176:680–686. doi: 10.1016/j.ijcard.2014.07.080.

  5. Dinu M., Abbate R., Gensini G.F., Casini A., Sofi F. Vegetarian, vegan diets and multiple health outcomes: A systematic review with meta-analysis of observational studies. Crit. Rev. Food Sci. Nutr. 2017;57:3640–3649. doi: 10.1080/10408398.2016.1138447.

  6. Tonstad S., Stewart K., Oda K., Batech M., Herring R., Fraser G. Vegetarian diets and incidence of diabetes in the Adventist Health Study-2. Nutrition. Metab. Cardiovasc. Dis. 2013;23:292–299. doi: 10.1016/j.numecd.2011.07.004.

  7. Satija A., Bhupathiraju S.N., Rimm E.B., Spiegelman D., Chiuve S.E., Borgi L., Willett W.C., Manson J.E., Sun Q., Hu F.B. Plant-based dietary patterns and incidence of type 2 diabetes in US men and women: Results from three prospective cohort studies. PLoS Med. 2016;13:e1002039. doi: 10.1371/journal.pmed.1002039.

  8. Turner-McGrievy G., Harris M. Key elements of plant-based diets associated with reduced risk of metabolic syndrome. Curr. Diabetes Rep. 2014;14:1–9. doi: 10.1007/s11892-014-0524-y.

  9. Sabaté J., Wien M. A perspective on vegetarian dietary patterns and risk of metabolic syndrome. Br. J. Nutr. 2015;113:S136–S143. doi: 10.1017/S0007114514004139.

  10. Soret S., Mejia A., Batech M., Jaceldo-Siegl K., Harwatt H., Sabaté J. Climate change mitigation and health effects of varied dietary patterns in real-life settings throughout North America. Am. J. Clin. Nutr. 2014;100:490S–495S. doi: 10.3945/ajcn.113.071589.

  11. Orlich M.J., Singh P.N., Sabaté J., Jaceldo-Siegl K., Fan J., Knutsen S., Beeson W.L., Fraser G.E. Vegetarian dietary patterns and mortality in Adventist Health Study 2. JAMA Intern. Med. 2013;173:1230–1238. doi: 10.1001/jamainternmed.2013.6473.

  12. Burkert N.T., Muckenhuber J., Großschädl F., Rásky E., Freidl W. Nutrition and health–the association between eating behavior and various health parameters: A matched sample study. PLoS ONE. 2014;9:e88278. doi: 10.1371/journal.pone.0088278.

  13. Pettersen B.J., Anousheh R., Fan J., Jaceldo-Siegl K., Fraser G.E. Vegetarian diets and blood pressure among white subjects: Results from the Adventist Health Study-2 (AHS-2) Public Health Nutr. 2012;15:1909–1916. doi: 10.1017/S1368980011003454.

  14. Yokoyama Y., Nishimura K., Barnard N.D., Takegami M., Watanabe M., Sekikawa A., Okamura T., Miyamoto Y. Vegetarian diets and blood pressure: A meta-analysis. JAMA Intern. Med. 2014;174:577–587. doi: 10.1001/jamainternmed.2013.14547.

  15. Ferdowsian H.R., Barnard N.D. Effects of plant-based diets on plasma lipids. Am. J. Cardiol. 2009;104:947–956. doi: 10.1016/j.amjcard.2009.05.032.

  16. Wang F., Zheng J., Yang B., Jiang J., Fu Y., Li D. Effects of vegetarian diets on blood lipids: A systematic review and meta-analysis of randomized controlled trials. J. Am. Heart Assoc. 2015;4:e002408. doi: 10.1161/JAHA.115.002408.

  17. De Biase S.G., Fernandes S.F.C., Gianini R.J., Duarte J.L.G. Vegetarian diet and cholesterol and triglycerides levels. Arq. Bras. Cardiol. 2007;88:35–39. doi: 10.1590/S0066-782X2007000100006.

  18. Szeto Y., Kwok T.C., Benzie I.F. Effects of a long-term vegetarian diet on biomarkers of antioxidant status and cardiovascular disease risk. Nutrition. 2004;20:863–866. doi: 10.1016/j.nut.2004.06.006.

  19. Appleby PN, Key TJ. The long-term health of vegetarians and vegans. Proc Nutr Soc. 2016;75:287–293. doi: 10.1017/S0029665115004334.

  20. Marsh K, Zeuschner C, Saunders A. Health implications of a vegetarian diet: a review. Am J Life Med. 2012;6:250–267. doi: 10.1177/1559827611425762.

  21. Clarys P, Deliens T, Huybrechts I, Deriemaeker P, Vanaelst B, De Keyzer W, et al. Comparison of nutritional quality of the vegan, vegetarian, semi-vegetarian, pesco-vegetarian and omnivorous diet. Nutrients. 2014;6(3):1318–1332. doi: 10.3390/nu6031318.

  22. Craig WJ. Health effects of vegan diets. Am J Clin Nutr. 2009;89(5):1627S–1633S. doi: 10.3945/ajcn.2009.26736N.

  23. Phillips SM. The impact of protein quality on the promotion of resistance exercise- induced changes in muscle mass. Nutr Metab. 2016;13(1)

  24. Slater G, Phillips SM. Nutrition guidelines for strength sports: sprinting, weightlifting, throwing events, and bodybuilding. J Sports Sci. 2011;29:S67–S77. doi: 10.1080/02640414.2011.574722.

  25. Stellingwerff T, Maughan RJ, Burke LM. Nutrition for power sports. Middle-distance running, track cycling, rowing, canoeing/kayaking, and swimming. J Sports Sci. 2011;29:S79–S89. doi: 10.1080/02640414.2011.589469.

  26. Phillips SM. Protein requirements and supplementation in strength sports. Nutrition. 2004;20(7):689–695. doi: 10.1016/j.nut.2004.04.009.

  27. Tipton KD, Wolfe RR. Protein and amino acids for athletes. J Sports Sci. 2004;22(1):65–79. doi: 10.1080/0264041031000140554.

  28. Antonio J, Peacock C, Ellerbroek A, Fromhoff B, Silver T. The effects of consuming a high protein diet (4.4 g/kg/d) on body composition in resistance-trained individuals. J Int Soc Sports Nutr. 2014;11

  29. Helms E, Aragon A, Fitschen P. Evidence-based recommendations for natural bodybuilding contest preparation: nutrition and supplementation. J Int Soc Sports Nutr. 2014;11(1):1. doi: 10.1186/1550-2783-11-20.

  30. Phillips S, Van Loon LC. Dietary protein for athletes: from requirements to optimum adaptation. J Sports Sci. 2011;29:29–38. doi: 10.1080/02640414.2011.619204.

  31. Hartman J, Moore D, Phillips S. Resistance training reduces whole-body protein turnover and improves net protein retention in untrained young males. App Phys, Nutr Metab. 2006;31(5):557–564. doi: 10.1139/h06-031.

  32. Phillips S, Van Loon LC. Dietary protein for athletes: from requirements to optimum adaptation. J Sports Sci. 2011;29:29–38. doi: 10.1080/02640414.2011.619204.

  33. Camilleri G.M., Verger E.O., Huneau J.F., Carpentier F., Dubuisson C., Mariotti F. Plant and animal protein intakes are differently associated with nutrient adequacy of the diet of