Assessing and Meeting the Nutritional Needs of Vegan Clients

Healing from an eating disorder while on a vegan diet can be particularly difficult in the initial stages of recovery. Vegan diets are inherently more restrictive, and when intertwined with an eating disorder, the amount of food that one feels comfortable eating or has access to may be minimal. This makes it even harder to meet one’s nutritional requirements and caloric needs. Hence, many people who consume certain vegetarian or vegan diets will need specific nutritional guidance and additional supplementation of essential nutrients.

Nutrients that may be of particular concern for vegans are:

• Protein: Some good plant sources of protein are tofu and other soy products, seeds, legumes (peas, beans, and lentils), nuts and nut butters, meat alternatives, and grains (like quinoa and wild rice). Lacto-ovo-vegetarians, lacto-vegetarians, and ovo-vegetarians can usually get enough protein from consuming eggs and/or dairy products.

• Iron: Iron from plants (called non-heme iron) is not absorbed as easily as that found in animal products (called heme iron), which can be a concern for vegetarians, particularly for menstruating women. Iron is also better absorbed when taken with foods rich in vitamin C (like broccoli, citrus fruits, and tomatoes). Some good plant-based sources of iron are leafy green vegetables (like spinach), soy products (like soy milk, tofu, and tempeh), seeds, nuts and nut butters, fortified breads and cereals, whole grains, legumes (peas, beans, and lentils), and dried fruits (like raisins, dried apricots, and dried figs).

• Omega-3 fatty acids: Plant-based sources of omega-3 fatty acids include flaxseed and flaxseed oil, soy products (like tofu, soy milk, and soybean oil), walnuts, chia seeds, and canola oil. Vegetarians often have lower levels of omega-3 fatty acids DHA and EPA because the main source of these is fish. Lacto-ovo-vegetarians and ovo-vegetarians may have better levels of these if they eat eggs that are rich in omega-3s.

• Zinc: Just like iron, plant-based sources of zinc are not absorbed as easily as animal sources. Some good sources of zinc for vegetarians are soy products, whole grains, seeds, nuts and nut butters, legumes (peas, beans, and lentils), and fortified cereals and bread. Lacto-ovo-vegetarians and lacto-vegetarians can obtain enough zinc from dairy products like cheese, milk, and yogurt.

Because they have more food restrictions, vegans should also make sure that they’re receiving enough vitamin D, calcium, and vitamin B12.

• Vitamin D: Vitamin D is crucial for bone health. The best source of this vitamin is sun exposure, particularly during summer and spring, since the human body naturally creates vitamin D when we expose our skin to sunlight. A limited number of foods contain vitamin D naturally (e.g., eggs), but some foods are fortified with it, such as cereals and breads, dairy products (like milk and yogurt), plant-based milks (like almond milk and soy milk), and orange juice. 

• Calcium: Together with Vitamin D, calcium is essential for bone health; however, milk and dairy products are its leading sources. For vegans, plant-based sources of calcium are leafy green vegetables (like kale, cabbage, bok choy, and collard greens), calcium-enriched tofu, broccoli, almonds and almond butter, and calcium-fortified products like cereals, breads, and orange juice.

• Vitamin B12: Lastly, vitamin B12 is mainly found in animal foods (including eggs and dairy products). However, there are sources of vitamin B12 for vegans, such as fortified cereals and breads, as well as fortified soy products like tofu and soy milk. Vitamin B12 supplements are also available and often recommended to vegans, but it’s best to consult your healthcare provider and/or dietitian to confirm.

Medical Monitoring of Vegan Clients

When treating vegan clients, our medical team and dietary team will work closely together to ensure that your nutritional needs are being met. All ‘Ai Pono clients receive:

• A comprehensive medical evaluation upon admission
• 24/7 nursing support
• Lab monitoring to ensure that signs of malnutrition are identified and addressed
• Additional nutritional supplementation as needed
• 1x weekly individual session with a Registered Dietitian and 2x weekly Nutrition Groups
• Ability to participate in meal and snack outings in the local community
• Customized meal planning based on your own nutritional needs
• Therapeutic support at and around the table
• Process groups that allow space for clients to explore the complex relationships between food and feelings