In this lesson, you will learn about the vegetarian and vegan diets. These diets are plant-based. Meat, from any animal, is excluded. Further, the vegan Way Of Eating (WOE) excludes all animal products (e.g., dairy and eggs). These WOEs can be excellent for chronic pain if well-managed. However, they can also be harmful if healthy choices are not made.

So, what’s the differences between a vegetarian and a vegan? Vegetarians do not eat meat; however, they may still eat animal products like dairy and eggs. Vegans eat an entirely plant-based diet. This means they don’t eat anything that comes from an animal (e.g., meat, dairy, eggs). There are other forms of vegetarianism that do include some meat. For example, pescatarians will eat fish and sometimes chicken, but not red meat.

Why Go Plant-Based?

There are several reasons why plant-based diets have such a huge following. People avoid eating meat to protect animals, the environment, and themselves. Let’s discuss that!

Currently, the increasing population has put a lot of pressure on food production. This has led to factory farming, especially in the United States. Factory farming involves raising large masses of livestock in small spaces. It often involves cruel livestock practices as animals are crammed in tiny cages, overfed, and pumped with hormones and antibiotics.

Not to mention, keeping large amounts of livestock (especially cattle) is rough on the environment. Cattle release methane gas which greatly contributes to climate change. Also, agriculture has been the cause of several water contamination cases. These have caused deadly E. coli outbreaks and have decimated marine life in surrounding lakes/rivers. This is only scratching the surface of issues related to factory farming.

For these reasons, people often cut out meat to prevent animal cruelty and further environmental damage. However, there is another added benefit. The plant-based diet has been tied to significant health benefits. Some of which are reduced inflammation and improved pain.

Adopting a plant-based diet has been shown to decrease inflammation. This is because plants are rich in antioxidants, fiber, vitamins, and minerals. Additionally, plants can supply all essential macronutrients when eaten in the right balance. In fact, meat is not as necessary as one may think.

Vegetarian and Vegan Diets for Chronic Pain

A systematic review looking at the effect of plant-based diets on rheumatoid arthritis (RA) found some promising results. Vegetarian and vegan diets improved RA symptoms for several reasons. Similar improvements may be seen for other chronic pain conditions, too.

First, RA symptoms are known to be more extreme in people who have higher BMIs. Vegetarian and vegan diets can promote weight loss and lower cholesterol. After becoming vegetarian, the decrease in BMI and cholesterol that the subjects in the systematic review experienced led to improved RA symptoms. This effect was even stronger for those who became vegan.

Second, RA is characterized by inflammation. As you know, inflammation causes pain. Diets that are high in processed meats and saturated fat produce high inflammatory factors, like C-reactive protein (CRP). When people in one study became vegan for 3-weeks, their CRP levels decreased by a third! This was due to the anti-inflammatory nature of a plant-based diet (e.g., due to high fiber and antioxidant intake).

Third, RA is affected by your gut flora (the bacteria in your intestines). Without healthy, biodiverse gut flora, toxins from your food can enter your bloodstream more effectively. These toxins can worsen inflammation. Some good bacteria in your gut thrive when dietary fiber is present. Vegetarian and vegan diets are high in dietary fiber. Thus, eating more plants can improve your gut flora, and better protect you from inflammation-causing toxins.

Choosing Plants

Although vegetarian and vegan diets are thought to be healthy, there are some less healthy options to avoid. It’s easy to eat a diet that is full of pasta and cheese and call it vegetarian. However, this type of diet will not reap the same benefits as previously discussed.

When adopting a plant-based diet, you still need to make healthy choices. Choose whole grains, fruits, vegetables, nuts, healthy oils, and legumes. Avoid refined carbs like white rice, pasta, white bread, and fruit juices. These are high in sugar. Additionally, some plant-based foods are highly processed. For example, soy-based meat alternatives may have trans-fats, added sodium, and preservatives.

A well-balanced plant-based meal may look like the following:

• A quarter (25%) of the meal is whole grains (e.g., whole-wheat bread, brown rice, quinoa, etc.).
• A quarter (25%) is a healthy protein source like beans and/or nuts.
• Half of the meal (50%) should be vegetables and fruits. This proportion should be about 75% veggies, 25% fruits.

Choose colorful fruits and veggies that are chock full of vitamins and minerals. The fat source in these meals should be healthy oils like olive oil. Aim for monounsaturated fats rather than saturated or trans-fats. You can use these oils in cooking or as a dressing.

An important issue to keep in mind is that it may be difficult to get enough protein. Ensure that you are including plant-based proteins in your meal. You can get protein from beans, nuts, quinoa, tofu, soymilk, and most whole grains. If you are worried about getting enough protein, there are vegan protein powders that you can buy. You can mix them into smoothies, oatmeal, and plant-based milks.

Transitioning to Plant-Based

If you’ve been eating meat your whole life, it may be hard to consider giving up meat. This may be even harder if you’re going vegan. Many people transition to vegetarianism first, then they become vegan.

Although it might be a challenge, you can absolutely do it! Below are some gradual steps to reducing your meat intake. You can take it at whatever pace you want.

Begin by making a list of vegetarian dishes you already love to eat. Start eating these dishes more often. Further, stop eating any meat dishes that you don’t eat very often. For example, don’t go out of your way to eat pork chops if this isn’t something you eat regularly.

It is difficult to transition all at once. It’s okay to start by reducing the amount of meat you’re eating while increasing plant-foods. Try shifting the balance of the meal. Instead of a large portion of meat, have a small one, and increase the portion of plant-based foods in that dish. For example, if you’re going to have steak and potatoes, choose a smaller piece of steak. Then, add more veggies to the dish.

You might have a hard time giving up your favorites. You’re more likely to give up if you make drastic changes all at once. Don’t cut out these favorites at the beginning. Rather, eat them less frequently. This will give you a chance to find new plant-based favorites.

You’re less likely to fold if you’re well prepared. Keep your kitchen stocked with healthy plant-based foods. Stop re-stocking animal products when you go grocery shopping. Choose plant-based alternatives and try new things.

Another excellent way to embrace the vegetarian and vegan diets is to connect with others. You probably have some plant-based friends. Ask them for meal ideas or restaurant suggestions. You can even join a vegetarian/vegan community online. You’re more likely to stick with it if you have support from others.

Once you’ve made the transition, you’ll crave meat and animal products less often. You’ll begin to feel better and reap the benefits of this lifestyle.

Example Meals

In this section, you will see some examples of dishes that are vegetarian and vegan. We’ll analyze two in detail but include more for you to consider.

Vegetarian 

This recipe, Black Bean Quinoa Burgers, comes from A Sweet Spoonful, a food blog focused on healthy, wholesome recipes.

The dish features black beans, a yogurt dressing and whole grain buns. Black beans are high in protein. They are also a source of complex carbs, fiber, vitamins, minerals and antioxidants. Whole grain buns also provide complex carbs and fiber. Yogurt is excellent source of calcium, proteins, and probiotics.

The dairy and mayonnaise in this recipe make it vegetarian rather than vegan. However, it can be made vegan easily with some substitutions. Also, you can pile veggies onto your plate to add more vitamins and minerals.

Other example meals are Stuffed Butternut Squash with Quinoa (BBC GoodFood), Mushroom Baked Eggs with Squished Tomatoes (BBC GoodFood), and Farmers Market Veggie Enchiladas (Feasting at Home).

Vegan

This recipe, 5-Minute Easy Vegan Tacos, comes from Happy Kitchen. This recipe is special because it provides several healthy pick-and-choose options. Elena lists vegan options for the protein, toppings, and garnishes. The rest is up to you to choose.

She suggests making the tacos with whole wheat tortillas. Then, you can choose a protein. She includes simple ideas like black beans or tempeh. However, she also provides links to recipes for other vegan taco meat substitutes made from tofu, nuts, or beans. For the toppings, she suggests a wide range of different vegetables. Finally, for the garnishes, you can choose herbs, citrus, onions, hot sauce, and vegan cheese.

Any combination of these options come with healthy fats, whole grains, vitamins, minerals, and antioxidants. The best part is that you can make it personalized to what you like!

Other example dishes are Vegan Pumpkin Spice Oatmeal (It Doesn’t Taste like Chicken), Hummus Avocado Toast (Where You Get Your Protein), and Vegan Chilli (BBC GoodFood).

Other example plant-based meals can be found online.

Check out this resource

Cutting out major parts of your diet can be hard. Having a plan to cut back or cut out foods/ingredients can help with the process. For this reason, we’ve included a Cutting Out Foods Plan worksheet. This can be used for people transitioning to vegetarianism or cutting out any kind of food/ingredient.

Reflect 

Do you have any favorite Vegetarian or Vegan recipes? Are you strictly vegetarian or vegan? If so, what made you decide to cut out meat? Have you personally found this diet to be helpful to your pain and well being?

If not, would you ever consider reducing the amount of meat you eat regularly? What is a realistic goal for eating less meat (e.g. meatless Mondays)?

To continue to the next lesson, take the next quiz

References

Alwarith, J., Kahleova, H., Rembert, E., Yonas, W., Dort, S., Calcagno, M., Burgess, N., Crosby, L., & Barnard, N. D. (2019). Nutrition interventions in rheumatoid arthritis: The potential use of plant-based diets. A review. Frontiers in Nutrition, 6. doi: 10.3389/fnut.2019.00141

Arnarson, A. (2019, May 14). Kidney Beans 101: Nutrition Facts and Health Benefits. Healthline. https://www.healthline.com/nutrition/foods/kidney-beans

Desmazery, B. (n.d.). Vegan Chilli. BBC GoodFood. https://www.bbcgoodfood.com/recipes/vegan-chilli

Fountaine, S. (2019, September 25). Farmers Market Veggies Enchiladas. Feasting At Home. https://www.feastingathome.com/vegetarian-enchiladas/

Good Food Team. (n.d.). Mushroom baked eggs with squished tomatoes. BBC GoodFood. https://www.bbcgoodfood.com/recipes/mushroom-baked-eggs-squished-tomatoes

Harvard Medical School. (2020, January 29). The right plant-based diet for you. Harvard Health Publishing. https://www.health.harvard.edu/staying-healthy/the-right-plant-based-diet-for-you

Hire. C. (n.d.). Stuffed Butternut Squash with Quinoa. BBC GoodFood. https://www.bbcgoodfood.com/recipes/stuffed-butternut-squash-quinoa

Kris-Etherton, P.M. (1999). Monounsaturated Fatty Acids and Risk of Cardiovascular Disease. Circulation, 100(11), 1253-1358. doi: 10.1161/01.CIR.100.11.1253

Luna, M. (2016, June 4). Hummus and Avocado Toast. Where You Get your Protein. https://www.whereyougetyourprotein.com/hummus-avocado-toast/

McQuillan, S. (2020, February 3). Got Pain? Here’s What to Eat to Help You Feel Better. Practical Pain Management. https://www.practicalpainmanagement.com/patient/resource-centers/chronic-pain-management-guide/got-pain-here-what-eat-help-you-feel-better

Morgan-Bathke, M. & Jensen, M. (2018, October 3). The Vegetarian Diet and Chronic Inflammation. The FASEB Journal, 31(S1), 964. doi: 10.1096/fasebj.31.1_supplement.964.19

Petre, A. (2016, August 16). The 17 Best Protein Sources for Vegans and Vegetarians. Healthline. https://www.healthline.com/nutrition/protein-for-vegans-vegetarians

Ros, E. (2010). Health Benefits of Nut Consumption. Nutrients, 2(7), 652-682. doi: 10.3390/nu2070652

Ruscigno, M. (n.d.). Transitioning to a plant-based diet. 7Day Vegan. https://7dayvegan.com/transition/

Szeliga, E. (2019, May 19). 5-Minute Easy Vegan Tacos. Happy Kitchen. https://happykitchen.rocks/5-minute-easy-vegan-tacos/

Towery, P., Guffey, J. S., Doerflein, C., Stroup, K., Saucedo, S., & Taylor, J. (2018). Chronic musculoskeletal pain and function improve with a plant-based diet. Complementary Therapies in Medicine, 40, 64-69. doi: 10.1016/j.ctim.2018.08.001

Turnbull, S. (2016, October 5). Vegan Pumpkin Spice Oatmeal. It Doesn’t Taste Like Chicken. https://itdoesnttastelikechicken.com/vegan-pumpkin-spice-oatmeal/#wprm-recipe-container-11170

Van der Zee, B. (2017, October 4). Why factory farming is not just gruel- but also a threat to all life on the planet. The Guardian. https://www.theguardian.com/environment/2017/oct/04/factory-farming-destructive-wasteful-cruel-says-philip-lymbery-farmageddon-author

Whitten, R. & Kemper, M. (2017, January 23). Learning Vegan: A Natural Strategy Against Chronic Pain. Mayfield Brain & Spinal Column. https://mayfieldclinicblog.com/?p=4823

Whole Grain Goodness. (n.d.). Spicy Bean Burgers Recipe. https://wholegraingoodness.com/recipes/spicy-bean-burgers-recipe/