Vegan & Vegetarian Athletes: Special Considerations

Vegan and Vegetarian Athletes:  Special Considerations

Fit For Life Physical Therapy

Rebecca Youngs, MS, RD, LD

Vegan and vegetarian diets have become more and more popular for a variety of reasons including ethical issues highlighted via social media and the idea that a vegan or vegetarian diet is healthier than a diet that includes meat.  Vegan and vegetarian diets may be practiced for other reasons including religious preferences.  A vegetarian diet is defined as a diet excluding poultry, meat, and seafood.  Some vegetarians may consume dairy and eggs.  A vegan diet eliminates all animal products including meat, poultry, seafood, dairy and eggs.  Vegan and vegetarian athletes have all of the same nutritional needs as athletes who consume animal products, but due to eliminating food groups, there are a few nutrients that vegan and vegetarian athletes need to focus on and may consider supplementing.  Daily amounts needed of the below items will differ from athlete to athlete based on age, gender, dietary intake, and health history.  Working with an appropriate healthcare provider is the best way to determine if an athlete needs further supplementation.

Protein

Protein is critical to help repair muscles after activity, carry out a variety of metabolic functions, and stimulate proper growth and development.  Vegan and vegetarian athletes require the same amount of protein as athletes who are not vegan or vegetarian.  Most individuals think of animal products like meat, poultry, and fish as main sources of protein, but there are a variety of plant based options.  To achieve proper muscle protein synthesis, or the generation of new muscle, a variety of amino acids must be present in the diet, but the most important is leucine.  Eating a wide variety of protein rich plant based sources is the best way to ensure all of the necessary amino acids for growth, including leucine, are consumed.  Vegan or vegetarian protein powders can be used if an athlete is struggling to meet protein needs by food alone, but they are encouraged to try to meet protein needs through the diet first.  If using a plant based protein powder, look for brands that have a variety of plant based protein sources included (pea protein, soy protein, brown rice protein, hemp protein etc.) to achieve the best amino acid ratio and distribution.  Soy products are high in leucine, so soy based protein shakes or snacks should be considered after a workout or game.  Daily protein needs will differ based on the goals of the athlete.

Vegan and Vegetarian Sources:

• Tempeh and tofu: ½ cup ? 7 grams
• Soybeans (edamame): ½ cup ? 6 grams
• Quinoa: 1 cup ? 8 grams
• Fortified cereals: 1 cup ? 8-12 grams
• Beans, lentils: ½ cup ? 8-9 grams 
• Nuts: 1 oz. ? 6 grams
• Plant based yogurt; milk: 1 cup: 6-8 grams.
• Soy protein powder: 1 scoop ? 20-30 grams

Vitamin B12

Vitamin B12 is essential for the formation of red blood cells, and it helps convert our food to energy. B12 deficiency can lead to symptoms of anemia such as lethargy, paleness, a tingly pins and needles sensation, and a swollen tongue.  It is found in fish, shellfish, eggs, dairy, and poultry.  It can also be found in non-animal based sources such as nutritional yeast, fortified grains and cereals, and tofu.  Nutritional yeast is one of the best sources of B12!  It has a cheesy flavor that can be added to soups, rice, or salads.  Many vegan athletes may need to take a B12 supplement depending on how much nutritional yeast, fortified cereals, or fortified grains they consume, and if they are able to consume them in consistent amounts to meet B12 needs.  Consult with a dietitian before starting a B12 supplement to determine appropriate management. 

Vegan and Vegetarian Sources:

• Nutritional yeast: 2 Tbsp. ? 15 mcg
• Fortified cereal: ½-1 cup ? 18-20 mcg.
• Tempeh: 3 oz. ? 2.4 mcg
• Tofu: 3.5 oz. ? 1.4-2.4 mcg

Iron

Iron is necessary to transport oxygen to red blood cells that are used by exercising muscles.  Iron is needed to build endurance, aerobic capacity, and to promote energy metabolism.  It is one of the most common nutrient deficiencies among athletes, specifically endurance athletes.  Iron can be lost through sweat and through the red blood cell destruction that naturally comes from running and striking our feet on the ground.  Athletes with a history of frequent NSAID use or calorie restriction may have a higher risk for iron deficiency as well as females due to menstruation.  Signs and symptoms of low iron include tiredness, brittle nails, fogginess, bruising with ease, difficulty keeping up in a workout, coldness and frequent chills, and light headedness.  Vegan and vegetarian athletes may have a harder time meeting iron needs since the most bioavailable, or most easily used source of iron for our body comes from animal products.  This is called heme iron.  Non-heme iron is iron that comes from non-animal based sources and can still be used in the body, but it is less readily absorbed.  Consuming non-heme iron foods paired with Vitamin C rich foods like peppers, oranges, strawberries, kiwi, and dried fruit, can aid in this absorption of non-heme iron.  Avoid consuming coffee or tea with iron rich foods since it can inhibit absorption and refrain from taking calcium and iron supplements at the same time since they compete with each other for absorption. 

Iron levels should be assessed if there is suspicion or symptoms of iron deficiency. A blood panel for iron assessment in an athlete should include ferritin, hemoglobin, hematocrit, total iron binding capacity, and transferrin.  Talk to your doctor to see if all of these biomarkers are assessed in a regular iron panel.  Testing “iron” itself will not show the full picture of iron stores in the body.  Early signs of iron deficiency can be reversed through diet, but a supplement may be needed.  Vegan and vegetarian athletes should ensure they are getting adequate sources of iron in their diet and could consider multivitamins as a preventative measure.  Iron deficiency and iron overload, or high iron, can have similar symptoms, so working with a sports dietitian before supplementation is needed due to differing needs of athletes, a spectrum of iron deficiency symptoms, proper iron level assessment and appropriate selection of supplements. 

Vegan and Vegetarian Sources:

• Dark leafy greens: 1 cup cooked ? 2.5-6 mg
• Fortified cereals: 5-12 mg
• Oatmeal: 1 cup cooked ? 3 mg
• Beans: ½ cup ? 4-6mg
• Tofu: 6 oz. ? 3.5 mg
• Soybeans: 1 cup ? 8 mg
• Dried fruits, nuts: 1 oz. ? 1-1.5mg

Vitamin D 

Vitamin D is necessary for bone health and hormone functioning.  It also plays a role in maintaining a strong immune system.  Most individuals are low in vitamin D due to decreased sunlight exposure, especially in the fall and winter months, and it can be difficult to consume adequate calories to reach necessary vitamin D needs from diet alone, but vegan athletes may be at higher risk due to elimination of dairy products.  Vitamin D is often found in milk, yogurt, cheese, egg yolks, fatty fish like salmon, and fortified cereals and juices.  Vegan athletes should look for plant based dairy alternatives like soy milk, soy based yogurt, and fortified grains to meet vitamin D needs.  Athletes with a history of fractures or stress reactions should consider supplementing with vitamin D.  Work with a sports dietitian to determine if vitamin D supplementation is needed. 

Vegan and Vegetarian Sources:

• Fortified orange juice: 1 cup ? 320 IU
• Fortified cereal: 1 cup ? 300-550 IU
• Soy milk: 1 cup ? 120 IU
• Plant based yogurt: ½ cup ? 50-150 IU.
• Mushrooms (exposed to UV light): 1 cup ? 400-600 IU

Registered & Licensed Dietitian Rebecca Youngs is an avid marathoner, loves to work out, and has specialized her practice in gastrointestinal health, as well as sports nutrition and fueling athletes of all levels. She is available for individual consultations at Fit For Life Physical Therapy or through zoom video conference.

Fit For Life Physical Therapy cares for people of all activity levels - to help prevent, recover from, or rehabilitate sports & orthopedic injuries.  We are proud to move people every day.

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