Going vegetarian or vegan can have many health benefits, but these diets also come with risks if they aren’t properly balanced. Kimberly Gudzune, M.D., M.P.H., a specialist in internal and obesity medicine in the Johns Hopkins Healthful Eating, Activity and Weight Program, explains how to get the key vitamins and nutrients you need if you go meatless or plant-based.

What Are the Health Benefits of a Plant-Based Diet?

Many people choose a vegetarian (no meat) or vegan (no animal products) diet for its health benefits.

“Some people may have heart disease or high cholesterol and they’ve heard these diets can help manage those conditions,” says Gudzune. “You can definitely improve your cholesterol levels, particularly lowering your LDL [low-density lipoprotein] cholesterol. It’s often called the ‘bad cholesterol’ because it can adhere to the walls of your arteries, which may increase your risk of heart disease.” 

People with underlying coronary artery disease might combine a vegan or vegetarian diet with other treatment approaches like stress management and physical activity. These diets can also help with weight loss if people follow them in a calorie-reduced format.

But like any diet, it’s all about balance. A balanced vegetarian or vegan diet means getting all the essential vitamins, minerals and nutrients from a wide range of sources.

What Are the Risks of an Unbalanced Vegetarian or Vegan Diet?

“A vegetarian or vegan diet is very different from the way a lot of Americans grow up eating,” says Gudzune. “This can be a really big, sudden change. If you normally eat processed, fatty foods and suddenly cut these out, a lot of people don’t know what to eat. They’re not sure how to plan meals or select foods that are nutritionally balanced for their body.”

Since vegetarians don’t eat meat, they’re at risk of missing out on protein and vitamin B12. Vegans, who don’t eat any animal products, follow an even more restrictive diet. Without eggs and dairy in their diet, vegans need to keep an eye on their calcium and vitamin D intake as well as protein and vitamin B12.

It's important to keep in mind that these diets aren’t just about excluding certain foods. They’re also about adding other foods, such as fruits, vegetables and whole grains. “Someone might cut out meat and animal products, but then they begin to rely on quick carbohydrates and processed foods like bagels and macaroni and cheese,” says Gudzune. “That’s not a healthy vegan or vegetarian diet.”

How to Get the Necessary Vitamins and Nutrients as a Vegetarian or Vegan

If you’re a vegetarian or vegan, make sure you:

• Avoid foods that are high in sodium, added sugars and fats. Vegan and vegetarian products such as “faux meats” can be very processed and loaded with salt. Read nutrition labels carefully and check out the sodium, saturated fat and added sugar content. For many people, limiting their total sodium intake to no more than 2,300 milligrams (mgs) per day can help prevent or manage high blood pressure. The American Heart Association (AHA) recommends that men limit their intake of added sugar to no more than 9 teaspoons (36 grams) daily and women limit it to no more than 6 teaspoons (25 grams) daily. Similarly, the AHA recommends that only 5% of your daily calories come from saturated fats.
• Choose high protein foods. Vegetarian protein sources include eggs and dairy products like yogurt and cottage cheese. Great vegan protein sources include legumes (beans, lentils and peas), seeds and nuts. Learn about protein-packed meatless meals. If you have certain health conditions like a history of breast cancer or kidney disease, talk to your doctor about which protein sources are right for you.
• Don’t eat too many carbohydrates. It’s easy to load up on bread when you cut out meat. But too many refined carbs can lead to weight gain, blood sugar swings and other health issues. Instead, opt for whole grains such as oatmeal, brown rice or quinoa.
• Get enough vitamin B12. “Very low vitamin B12 can cause anemia, especially in people who are following a vegan diet,” warns Gudzune. Taking a vitamin that contains B12 may be an easy way to avoid a deficiency.
• Meet your calcium requirements. Your calcium needs depend on your age, gender and family history of conditions like osteoporosis. Dairy products are rich in calcium. If you’re vegan, calcium can be found in veggies such as cooked kale or collard greens. You can also take a calcium supplement that contains vitamin D, which helps with calcium absorption.
• Opt for vitamin D-fortified foods. In addition to getting small amounts of safe sun exposure, which helps your body make vitamin D, vegans can choose foods like orange juice, cereal or plant-based milks that are fortified with vitamin D.
• Consider an appointment with a registered dietician. A transition to a vegetarian or vegan diet can be challenging. If you have any doubts or questions, Gudzune recommends talking with a registered dietician to learn how to meet all nutritional and health needs.

How Can I Start a Healthy Vegetarian or Vegan Diet?

If you’re thinking about going vegan or vegetarian, it’s a good idea to make a nutrition plan with a physician or a registered dietitian. It’s especially important if you have preexisting health conditions such as diabetes, heart disease, obesity or a gastrointestinal disorder. The provider can also tell you which vitamins and supplements to take. Nutritional requirements vary based on age, gender and health risks, so don’t hesitate to contact a professional for dietary guidance.

Gudzune also suggests:

• Finding support. Connect with other vegans or vegetarians to exchange recipes and healthy eating tips. Stay in close communication with your dietitian.
• Starting slowly. Remove one meat or animal product from your diet each week. Replace it with a fruit, vegetable, whole grain or plant-based protein.
• Staying practical. Make a meal plan that fits your schedule and budget. Skip the weeknight takeout and try to do meal preparation on weekends.