Do you hear people, whether living with diabetes or not, say they eat a “raw” diet or define their eating style as vegan, vegetarian, or pescatarian? Do you wonder what these terms mean and what foods these eating plans include and exclude? Wonder no more! Here are simple explanations about these increasingly popular plant-based eating styles, from the most to the least restrictive. Remember that not all eating plans are for everyone; check with your health care professional before changing your meal plan to ensure that it will work for you.
Raw: The goal of a raw food diet is to eat foods close to their natural state – uncooked or unprocessed. Food preparation methods include straining, blending, juicing, and dehydrating, along with plenty of chopping. Foods are never heated to above 115 degrees Fahrenheit. Followers may combine their “raw” eating style with vegan. A raw diet is not necessarily vegetarian, some followers do eat unprocessed and uncooked meats, seafood, eggs, and raw, unpasteurized dairy foods.
Foods included: Vegetables, fruits, nuts, whole grains, seeds, beans, herbs, and sprouts.
Foods excluded: Any cooked and processed foods, alcohol, caffeine, refined sugars, fats, and oils.
Vegetarian: “Vegetarian” covers a broad swath of eating styles, from vegan, which is the most restrictive, to lacto-ovo vegetarian, which is the least restrictive. All vegetarians make fruits, vegetables, nuts, seeds, beans, and whole grains their mainstays. The following are the food groups included and excluded by different categories of vegetarians:
- Vegan: Doesn’t eat any animal-origin foods including meat, poultry, seafood, eggs, and dairy.
- Lacto-Vegetarian: Doesn’t eat animal-origin foods including meat, poultry, seafood and eggs. Does eat dairy foods.
- Ovo-Vegetarian: Doesn’t eat animal-origin foods including meat, poultry, seafood, and dairy. Does eat eggs.
- Lacto-Ovo Vegetarian: Doesn’t eat animal-origin foods including meat, poultry, and seafood. Does eat eggs and dairy foods.
Pescatarian: The only difference between pescatarians and lacto-ovo vegetarians is the addition of seafood to their diet. Pescatarians might also call themselves semi-vegetarian or flexitarian. They may limit red meats and poultry due to their saturated fat content and include fish for a convenient source of omega-3 fats.
Foods included: All foods eaten by lacto-ovo vegetarians, plus seafood.
Foods excluded: Animal-origin foods including meat and poultry.
Mediterranean: While there isn’t one specific Mediterranean meal plan, the eating pattern includes mainly fruits, vegetables, whole grains, fish, nuts, beans, olive oil, herbs, and spices. Poultry, eggs, cheese, and yogurt are used in moderation, and meats and sweets are saved for special occasions.
Flexitarian: The term “flexitarian” is used to define an eating plan focusing mainly on eating fruits, vegetables, nuts, seeds, beans, and whole grains, but doesn’t exclude small amounts of lean red meats, poultry, seafood, eggs, and low-fat dairy foods. People might use the term semi-vegetarian to describe this eating pattern, which means they mainly eat like a lacto-ovo vegetarian, but they’re not opposed to splurging on red meat or fried chicken on occasion.
Let’s step back and ask, what’s common in all of these eating plans? An accent on fruits, vegetables, beans, whole grains, and nuts. Several plans include lean sources of protein, seafood, and eggs. All suggest you lighten up on or exclude red meats and poultry, and encourage excluding refined starches, refined sugars, heavy use of fats, fatty or processed foods, and meats. As a dietitian, I consider these healthy choices!
Do you wonder if any of these meal plans are healthy for people living with diabetes? A few recommendations from the American Diabetes Association’s Standards of Medical Care for Diabetes – 2013 offer guidance. In essence, the guidelines say that the mix of calories from the three main sources of calories – carbohydrate, protein, and fat – may be adjusted to meet your metabolic goals (glucose, lipid, and blood pressure levels) and your individual food and eating style preferences. Another recommendation: reduce saturated fat to less than seven percent of calories and keep trans fats to a minimum. So, the answer is yes, in general, these eating plans can work for those living with diabetes.
“With a plant-based diet – whether vegan, vegetarian, or flexitarian, you’ll eat more heart-healthy nutrients, fiber, potassium, calcium, and magnesium, and lighten up on foods with saturated or trans fats – red and processed meats and high-fat dairy foods” says Sharon Palmer, RD and author of The Plant-Powered Diet.
None of these eating plans per se assure that you eat healthfully. You still need to make healthy food choices, prepare foods healthfully, and eat just enough calories to meet your nutrition needs and weight goal. Remember that just saying you’re a vegetarian or pescatarian, yet eating lots of cheese, fried fish, and potato chips doesn’t measure up to healthy eating.
As you look into these eating styles and listen to others talk about how they eat, you may begin to realize that people create their own unique eating style that is comfortable and realistic for them to follow within the challenges of daily life. I recommend you do the same based on your personal nutrition, health, weight, and diabetes goals.
Hope Warshaw, MMSc, RD, CDE*, is the author of several best-selling books published by the American Diabetes Association, including Diabetes Meal Planning Made Easy and Guide to Healthy Restaurant Eating. She’s a frequent contributor to Diabetic Living magazine. Warshaw is a paid contributor for The DX. All opinions contained in this article reflect those of the contributor, and not of Sanofi US, its employees, agencies, or affiliates.
*“Certified Diabetes Educator” and “CDE” are certification marks owned and registered by the National Certification Board for Diabetes Educators (NCBDE). NCBDE is not affiliated in any way with Sanofi US. NCBDE does not sponsor or endorse any diabetes-related products or services.
© 2013 The DX: The Diabetes Experience