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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.



Protein

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.



Carbohydrate

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).



Fat

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,

Ashley



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