Dear HEALTHbeat subscriber,

Do you know the signs and symptoms of a heart attack? Most of us know to seek help for chest discomfort lasting more than a few minutes, shortness of breath, and/or pain or discomfort in other parts of the upper body and abdomen. But these symptoms may occur for reasons other than a heart attack. Even medical professionals can find it difficult to rule in—or rule out—the diagnosis of a heart attack. That’s why a group of national organizations recently updated the clinical definition of heart attack, in the hopes of improving timely diagnosis and treatment. Also in this issue, Dr. Harvey Simon, editor of the Harvard Men’s Health Watch, discusses vegetarian diets.

Wishing you good health,


Nancy Ferrari
Managing Editor
Harvard Health Publications
HEALTHbeat@hms.harvard.edu

Q: Following the lead of our 12-year-old daughter, my wife has become a vegetarian. She says she’s willing to continue serving meat and chicken, but I sense that she’d rather not. What can you tell me about the safety of a vegetarian diet?

A. Most people who choose vegetarian diets are motivated by their personal philosophies, ethical beliefs, or religious convictions. But health certainly is a factor, and if a vegetarian eating plan is constructed properly, it can be an asset to health.

Vegetarians come in many stripes. Some avoid all animal products, others allow eggs and dairy products, while some also accept fish.

Without eating any animal products, strict vegetarians may lack certain nutrients. Vitamin B₁₂, for example, is naturally present only in animal foods — but since it’s added to fortified grains and cereals, vegetarians who consume these products can get enough. Iron is another potential problem, at least for menstruating women. The body is much less efficient at absorbing iron from vegetable sources than from red meat. Fortunately, inexpensive B₁₂ and iron supplements are available over the counter for people who need them.

Animal protein provides the protein building blocks that best meet the needs of the human animal. But even strict vegetarians can get the proper mix of amino acids and proteins if they eat a variety of protein-rich plants, such as beans.

One of the best things about a vegetarian diet is that it’s likely to be low in nutrients that contribute to disease. The list includes cholesterol, saturated fat, and sodium. At the same time, fruits and vegetables provide healthful amounts of vitamins and potassium, while nuts and olive oil offer “good” omega-3 polyunsaturates and monounsaturated fats. Fish are particularly desirable for their omega-3s and proteins.

A 2006 study confirms the benefits of vegetarian eating. Scientists compared 35 healthy vegetarians with 35 equally healthy nonvegetarians. None of the volunteers used medications and none were smokers or drinkers. On average, the vegetarians were leaner, had lower blood pressure, and had better cholesterol and blood sugar levels. The vegetarians also had better cardiac function and vascular reactivity. To make vegetarian diets healthful, meal plans should include non- or low-fat dairy products, whole grains, and olive oil and other healthy fats.

This Question and Answer first appeared in the May 2009 Harvard Men’s Health Watch, available at www.health.harvard.edu/mens.