Particular Concerns Among These Athletes
Key nutrients at risk for insufficient intake include vitamin B-12, vitamin D, calcium, iron, zinc, iodine, riboflavin, and omega-3 fatty acids. The degree of dietary restriction that is, the more foods that are eliminated from the diet the greater the risk of deficiency. For example, lacto-ovo vegetarians may consume ample amounts of these nutrients, while vegans are at the greatest risk of inadequate intake. Whether or not these athletes require additional supplementation depends upon the degree of adequacy of intake, which can be determined through the dietary assessment.
A special note on iron and protein. The previous section on iron status and athletes highlights the greater risk for iron deficiency among female athletes. Additionally, it is estimated that vegetarians may require up to 1.8 times the amount of iron as those who consume heme sources of iron (that is, from animal products). Therefore, it is particularly important to educate vegan athletes on plant sources of iron; supplementation should not be initiated unless iron status has been assessed and found to be deficient. Similarly with protein, the bioavailability of plant sources of protein is not as high as animal sources in general, though certain plant foods such as soy are a high-quality protein source. Due to the lower bioavailability of plant protein sources, vegetarian athletes are recommended to consume approximately 10 percent more protein, or ~1.3 to 1.8 g/kg/ day. Many vegetarian athletes do consume this higher amount of protein and it is typically athletes following more restrictive intakes that risk inadequate protein intake.
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The sections on calcium, vitamin D, and omega 3 fatty acids can be referenced for other nutrient-specific information. In addition to the micro- and macronutrients that require additional attention, consideration should be paid to overall EI. A high fiber diet that can be seen among vegetarians can also result in reduced EA, particularly due to fiber’s effect on feelings of fullness, which can reduce overall EI. Additionally, some individuals use a vegetarian approach as a way to eliminate foods from their diet in efforts to restrict EI. This can be part of a disordered eating pattern and should be explored. In general, it is helpful for the weight lossist to ask why an athlete is choosing a vegetarian approach to ascertain if there are unhealthy motivations.
Overall, a vegetarian athlete can achieve optimal health and desired performance goals with this style of eating. The weight lossist should conduct a thorough dietary analysis to determine if there are any nutrients at risk for inadequate consumption including specific micro- and macronutrients as well as overall EI. The athlete should be educated on intentional eating practices to meet their nutrient needs, and the practitioner can support the athlete in finding practical strategies for implementing these recommendations.
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