October 10, 2014Kristine Birge MS, RD1 Bariatric Nutritionist Bariatric and Metabolic Interdisciplinary (BMI) Clinic 900 Blake Wilbur Drive W0048 Palo

April 11, 2023 Kristine Birge MS, RD 1

Bariatric Nutritionist

Bariatric and Metabolic Interdisciplinary (BMI) Clinic900 Blake Wilbur Drive W0048Palo Alto, CA 94304kbirge@stanfordmed. org

To schedule an appointment call: 650 736-5800

Many Cultures Consume Vegan Diets

MIDDLE EAST (Israel, Lebanon)

Ingredients: Chickpeas, tahini (sesame paste), cracked wheat, olives, tomatoes, eggplant, yogurt, flatbreads, fresh fruits (apricots, dates), parsley

Well-known dishes: Hummus (chickpea dip) baba ghanouj (eggplant dip), tabouleh (cracked wheat and parsley salad)

NORTHERN AFRICA (Morocco, Egypt)

Ingredients: Chickpeas, lentils, nuts, carrots, pumpkins and other squashes, rice, fava beans, dried fruits, sweet spices, flatbreads, mint

Well-known dishes: Couscous, tagine (vegetable stew)—Morocco; foul (fava beans with red lentils), koshary (macaroni with rice and lentils)—Egypt

ASIA

Japan: Tofu, Edamame, and Tahini or Sesame Paste

Indonesia: Tempeh

India: Lentils, Dahl


Why Do People Choose to Consume a Vegan Diet?

Religious

Ethical

Health

Environmental concerns for the planet

Love of animals and animal welfare

Economical

Because of chemicals and hormones in meat

Don't like the taste of meat

To lose weight

To reduce hunger and famine worldwide


Top 10 Best Countries to be Vegetarian

Canada: There is a large vegetarian culture in Canada, especially in big cities. Toronto is the most diverse city in the world.

Israel: Because Israeli restaurants and supermarkets will often abide by Kosher laws, pork and shellfish are not served, and prepared food usually will not combine milk and meat. Falafel and hummus are available everywhere, and cucumbers and hummus are served with every meal.

Hong Kong: Inspired by British culture, Hong Kong has many vegetarian options, that are not only Chinese food, but often Indian or Western inspired.

United States: Especially around big cities like New York, San Francisco or Chicago, the US has many vegetarians. It is more difficult to eat out in the South, but supermarkets will have an abundance of options.

Thailand: Vegetarianism is accepted in Thailand, and many traditional Thai dishes with rice and noodles are meat-free and loaded with a wide range of fresh veggies. Many vegetable dishes are made with fish sauce, but you can request to have it excluded. There is even a Phuket Vegetarian Festival!

Taiwan: Taiwan does offer vegetarian options, but it is difficult to navigate your options without knowing the language.

United Kingdom: This is one of the most advanced vegetarian cultures in the world, with veggie-friendly food available in almost every town. Most restaurants have vegetarian options, and vegetarian food in supermarkets is often clearly labeled. The UK isn’t exactly known for its amazing native food, so there are often great vegetarian Indian dishes available in restaurants. Pubs often serve veggie burgers.

Vietnam: Though many of the vegetable dishes are made with fish sauce, there are ways around it. Their delicious Pho noodle dishes taste just as great without meat.

Malaysia: There is a vegetarian culture in Malaysia, and their food is inspired by Chinese, Indian and European influence. There are many delicious vegetarian curry and noodle dishes, and it is not difficult to find suitable restaurants.

India: India has the highest number of vegetarians in the world, making up 20-40% of the population. Food in supermarkets has special labels for the vegetarian selections, and almost all restaurants offer the option.

Types of Vegetarian DietsLacto-Ovo Vegetarian: does not eat meat, fish or fowl. Eats dairy and egg products. Most popular.

Ovo Vegetarian: does not eat meat, fish, fowl or dairy products. Eats egg products.

Lacto Vegetarian: does not eat meat, fish, fowl or eggs. Eats dairy products.

Vegan: does not eat any animal products including meat, fish, fowl, eggs, dairy, honey, etc. Most vegans do not use any animal products such as silk, leather, wool, etc. as well.


Possible Health Benefits of Vegetarian Diets

Cardiovascular

Hypertension

Cancer

Diabetes

Obesity

Kidney disease/ renal stones

Gallstones

Diverticular disease


Nutrition Considerations for Vegetarians

Protein

Vitamin B12

Vitamin D

Calcium

Iron

Vitamin A/ Beta carotene

Diet is low in fat

Diet is low in refined sugar

Daily calorie intake is appropriate for achieving and maintaining a healthy weight you can live with.

It is very important to choose your food wisely & take your vitamin & mineral supplements.


Nutrition Considerations for Vegetarian Protein Intake:

Quality of plant protein varies.

Soy protein can meet protein needs as effectively as animal protein.

Wheat protein alone may be 50% less usable than animal protein.

Assortment of plant foods throughout day provides all essential amino acids.

Recommendations for protein intake are at least:46 grams per day for women56 grams per day for men

If you are very tall or weigh significantly more than your recommended weight, protein intake should be higher:

60 grams per day for women80 grams per day for men


Tofu 4 ounces provides: 100-120 calories

9-10 grams protein

High in easily digestible protein

low in fat

a good source of IronB vitaminsTofu made with calcium sulfate provides up to 20% of average daily calcium requirement


Delicious Ways to Prepare Tofu:

Barbecue-Flavored Tofu and Onion Skillet

Tofu Eggless “Egg Salad” for Sandwiches or Pitas

Asian Noodles with Napa Cabbage, Mushrooms, and Tofu

Tofu and Potato Hash Browns

Baked Tofu Teriyaki

Tofu Scramble with Jalapeño and Cilantro

Gently Curried Tofu Burgers

Summer Tofu Skillet with Tomatoes and Bell Peppers April 11, 2023 Kristine Birge MS, RD 10

Tempeh2 ounces provides: 110 calories

10 grams protein

Tempeh, a traditional Indonesian food, is made of cooked and coagulated soybeans.

Sold in cellophane-wrapped packages.

It’s even higher in protein than tofu.

Tempeh is also quite versatile, but has a more distinct flavor and a dense, chewy texture.

Though somewhat of an acquired taste, once you do, you’ll be a fan for life.


Cooking Suggestions

Tempeh may be crumbled and used as a ground meat substitute.

Diced and sautéed, it can be tossed into grain, noodle or vegetable dishes.

Mash it with vegan mayonnaise, add some finely diced celery and minced scallion, and use as a sandwich spread or wrap filling .

Tempeh may also be sliced and sautéed like cutlets, and served with a barbecue sauce .


Delicious Ways to Prepare Tempeh

Though it might be argued that tempeh is not quite as versatile as tofu, there are many tempting ways to use it.

Tijuana Tempeh

Tempeh Teriyaki

Tangy Tempeh with Portobello Mushrooms

Japanese Noodles with Tempeh and Vegetables

Tempeh, Kale, and Sweet Potato Skillet

Hearty Breakfast Skillet


Cooked Beans, Legumes & Lentils ½ cup provides: 110-120 calories

7-8 grams protein

Black beans

Navy beans

Kidney beans

Red beans

Pinto beans

Lima beans

Cannellini beans

Garbanzo beans (chickpeas)

Butter beans

Fava beans (broadbeans)

Not jelly beans!

Edamame (green soybeans)

Split peas

Black eyed peas

Green peas (1 cup= ½ cup cooked dried beans and legumes)

Lentils


Beans & Legumes

CANNED BEANSCan be high in sodiumDrain and rinse the canned beans well before using them to reduce the sodium.Many people prefer canned chickpeas to home-cooked, which take an inordinately long time to become tender, and are not as tasty.

HOMECOOKED BEANSPreparation time for cooking beans is minimal, though the beans themselves take their sweet time to cook. It’s worth cooking your own if you need a large quantity for dishes like black bean soup or red beans and rice.You can also control the amount of salt and seasonings that go in.

April 11, 2023 Kristine Birge MS, RD

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Edamame: fresh soybeans shelled, ½ cup: 100 calories

8 grams protein

A delicious, hearty, protein- and fiber-rich snack that is fun to eat.

Chock-full of disease-fighting phytosterols (a plant compound that can lower cholesterol, among other things).

Look for fresh edamame at your local farmer’s market, or check the frozen vegetable case in the supermarket.

Most kids love them.


Hummus: 4 ounces provide: 200 calories

4 grams protein

Hummus is a dip or spread made from cooked, mashed chickpeas, blended with tahini, olive oil, lemon juice, salt and garlic.

It is popular throughout the Middle East.

Make your own lower calorie version of hummus, minimizing the amount of oil and tahini used.


Falafel:.6 ounce patty provides: 60 calories

2 grams protein

First made in Egypt and then moved to other countries in the Middle East.

A falafel is a deep-fried ball or patty made from ground chickpeas, fava beans, or both.

Falafel is usually served in a pita, which acts as a pocket, or wrapped in a flatbread.

The falafel balls are topped with salads, pickled vegetables, hot sauce, and drizzled with tahini-based sauces.

Falafel balls may also be eaten alone as a snack


Cooking Beans & Legumes

There are several ways to cook beans: Conventional soaking and cookingPressure cookingSlow crockpot cooking

Cooking time is determined by several factors, includingSimmering temperatureSoaking timeSizeFreshness of the beansThe altitude at which you live.

Every cup of dry beans yields about 2 l/2 cups cooked.

April 11, 2023 Kristine Birge MS, RD

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Cooking Lentils

Lentils need no pre-soaking and cook much more quickly than other dried legumes.

Simply pick over to remove debris or shriveled lentils, rinse, and drain.

Cover with water or broth and boil for 2 to 3 minutes (to aid in digestion).

Reduce heat and simmer until tender. Depending on the variety and age, cooking time may take anywhere from 10 minutes to 1 hour.

Salt added to the cooking water will toughen the lentils. Add salt once the lentils are completely cooked.

Acidic ingredients such as wine or tomatoes can lengthen cooking time. You may wish to add these ingredients after the lentils have become tender.

Older lentils will take longer to cook because they have lost more moisture. Do not mix newly-purchased lentils with old ones. They will cook unevenly.

Kristine Birge MS, RD

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Beans, Legumes & Lentils

Beans and legumes are nutritional powerhouses rich in protein and fibervery low in fatGood source of B vitamins Good source of iron

Look for delicious high-protein bean recipes for

Stews and Chilis

Main Dishes

Salads


Nuts (1 ounce)

Almonds : 24 nuts

Cashews: 18 medium nuts

Macadamia: 12 nuts

Pecans: 15 halves

Pistachios: 47 nuts

English Walnuts: 14 halves

Peanuts : 35 pieces

Regular

Reduced fat

Peanut Butter: 1 Tablespoon (.5 oz)

Calories Protein (g)

170 5.5

160 4.5

200 2.5

190 5

160 5.5

180 4

160 7

130 6

105 4


SeedsSunflower Seeds

Kernels dry roasted: ¼ cup

In shell: 1.75 oz. package

Pumpkin Seeds

Whole roasted: 85 seeds

Kernels dry roasted: 1 oz. (142 seeds)

Sesame Seeds: ¼ cup

Pine Nuts: 1 oz. (167 seeds)

Calories Protein (g)

190 6

155 7

125 5

150 7

210 6

190 4


Nuts and Seeds

Full of nutrients

They bring rich, earthy flavor to the palate

High in mono- and polyunsaturated fats

They provide a feeling of satiety when small amounts are added to the diet.

A “little bit goes a long way”

Eaten in these small quantities, nuts can provide a healthful alternative to foods high in saturated fats and cholesterol.

Consider incorporating nuts intosalads soups vegetable stir-frycasseroles


Tahini or Sesame Paste: 1 ounce provides: 200 calories

6 grams protein

Tahini or sesame paste, is a paste of ground sesame seeds used in cooking. North African, Greek, Turkish and West Asian tahini is made of hulled, lightly roasted seeds.

Sesame paste is an ingredient in some Chinese, Korean, and Japanese dishes.

Tahini is a major component of hummus (chickpeas with tahini).


Quinoa ½ cup cooked: 110 calories

4 grams protein

Quinoa has more and higher quality protein than any other grain aside from amaranth.

It’s also rich in minerals, B-vitamins, and vitamin E.

Quinoa cooks in a mere 15 minutes, and its fluffy texture and nutty flavor and aroma make it extremely versatile.

Use it as a bed of grain for bean or vegetable dishes in place of rice.

Use it to make pilafs with nuts and dried fruits.

It’s great for stuffing vegetables.

Make tabbouleh-style salads with it. Add diced crisp vegetables, fresh tomatoes, and minced herbs. Toasted pine nuts add a delicious touch.

Just use it simply, as a nutrition-boosting side dish.


Tips for Cooking Quinoa

Rinse the quinoa in a very fine sieve.

Combine with water in a 2 to 1 ratio in a small saucepan (2 cups water to 1 cup quinoa).

Add a salt-free vegan bouillon cube for added flavor, if you’d like.

Bring to a rapid simmer, then lower the heat and cover. Simmer gently until the water is absorbed, about 15 minutes.


Amaranth ¼ cup seeds or flour provides:

180 calories7 grams protein

Since 1975 amaranth has been gaining support in the U.S. and is now grown in Colorado, Illinois, Nebraska, and other states, but is still not a mainstream food.

Amaranth seed is high in protein. It is high in fiber and contains calcium, iron, potassium, phosphorus, and vitamins A and C.

Using amaranth in combination with wheat, corn or brown rice results in a complete protein as high in food value as fish, red meat or poultry.


How to Use Amaranth

Amaranth is found in many natural food stores and the flour is often used in baked goods.

Amaranth can be cooked as a cereal, ground into flour, popped like popcorn, sprouted, or toasted.

The seeds can be cooked with other whole grains, added to stir-fry or to soups and stews as a nutrient dense thickening agent.

Amaranth flour is used in making pastas and baked goods. It must be mixed with other flours for baking yeast breads, as it contains no gluten.

Sprouting the seeds will increase the level of some of the nutrients and the sprouts can be used on sandwiches and in salads, or just to munch on.


Tips for Cooking Amaranth

Amaranth flavor is mild, sweet, nutty, and malt like, with a variance in flavor according to the variety being used.

To cook amaranth boil 1 cup seeds in 2-1/2 cups liquid such as water or half water and half stock or apple juice until seeds are tender, about 18 to 20 minutes.

Adding some fresh herbs or gingerroot to the cooking liquid can add interesting flavors or mix with beans for a main dish.

For a breakfast cereal increase the cooking liquid to 3 cups and sweeten with Stevia, honey or brown rice syrup and add raisins, dried fruit, allspice and some nuts.

Amaranth has a "sticky" texture that contrasts with the fluffier texture of most grains and care should be taken not to overcook it as it can become "gummy."

Amaranth keeps best if stored in a tightly sealed container, such as a glass jar, in the refrigerator. This will protect the fatty acids it contains from becoming rancid. The seeds should be used within 3 to 6 months.


Seitan½ cup: 120 calories

24 grams protein

A traditional Asian food used as a meat substitute.

You may have encountered seitan in dishes like “Buddhist’s Delight” in Chinese restaurants.

Dense and chewy, this product of cooked wheat gluten is almost pure protein.

Seitan is not gluten free.

Store-bought seitan usually comes in 8-ounce packages or 16-ounce tubs.


Seitan½ cup: 120 calories

24 grams protein

Seitan’s “meaty” texture lends itself to numerous preparations.

It’s great as: a substitute for beef chunks in stewsstir-friesSaladsWrapsfajitas kebabs


Seitan Recipes:

Homemade Seitan

Seitan and Broccoli Stir-Fry

Hearty Seitan Salad

Seitan “Meat and Potatoes” Stew

Seitan “Peppersteak”

Sweet-and-Sour Seitan and Vegetables

Seitan and Polenta Skillet with Fresh Greens


Adapt Your Recipes to Go Vegetarian

Check bookstore, magazine racks or go online to recipes.

You can adapt almost any recipe for vegetarian-style eating.

Substitute cooked or canned beans for meat in casseroles, stews, soups and chili.

For grilling, cube and skewer firm tofu and vegetables.

On pizza, hot sandwiches, sloppy joes and other dishes that typically call for meat, use soy-protein patties, bacon or sausages.

Prepare pasta sauces, pizza, soups and stews as always, but skip the meat. Add more chopped vegetables and beans instead.


Tips for Vegetarians

Build meals around protein sources that are naturally low in fat, such as beans, lentils, and rice.

Don’t overload meals with high-fat cheeses to replace the meat.

Calcium-fortified soy-based beverages can provide calcium in amounts similar to milk. They are usually low in fat and do not contain cholesterol.

Many Asian and Indian restaurants offer a varied selection of vegetarian dishes.



http://www.vegetariannutrition.org/food-pyramid.pdf

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October 10, 2014Kristine Birge MS, RD1 Bariatric Nutritionist Bariatric and Metabolic Interdisciplinary (BMI) Clinic 900 Blake Wilbur Drive W0048 Palo