Chapter 16 Risk Management for Drugs and Biologics in the United States Chapter 16RISK MAnAgEMEnT FOR DRugS AnD bIOLOgICS In THE unITED STATES Arcoxia, Vioxx, Acomplia, Zelnorm, and Tysabri; Aranesp, Procrit, Avandia, and Lucentis —all of these prominent drugs, and others, have been in the news often over the past year.1 The concerns raised about them illustrate the unprecedented combined focus on both drug safety and costs, not only by the Food and Drug Administration (FDA), but also by Congress and the Centers for Medicare and Medicaid Services (CMS).
the whys and hows of a healthier diet four food groups useful tips for beginning a delicious low-fat, Powerful tools for Health vegetarian menu is a powerful and pleasurable way to achieve good health. AThe vegetarian eating pattern is based on a wide variety of foods that are satisfying, delicious, and healthful.
Vegetarians avoid meat, fish, and poultry. Those who include dairy products and eggs in their diets are called lacto-ovo vegetarians. Vegans (pure vegetarians) eat no Inside this Kit meat, fish, poultry, eggs, or dairy products. While there is a considerable advantage the whys and hows to a lacto-ovo vegetarian pattern, vegan diets are the healthiest of all, reducing risk of a broad range of health concerns. Vegetarian Foods .2The Protein Myth .4 Vegetarians have much lower cholesterol levels than meat-eaters, and heart disease is less common in vegetarians. The reasons are not hard to find. Vegetarian meals Plant-Based Diets .6 are typically low in saturated fat and usually contain little or no cholesterol. Since What about Milk? . 7 cholesterol is found only in animal products such as meat, dairy, and eggs, vegans consume a cholesterol-free diet. The type of protein in a vegetarian diet may be another important advantage. Many a Healthy Weight .10 studies show that replacing animal protein with plant protein lowers blood cholesterol levels—even if the amount and type of fat in the diet stays the same. Those studies Vegetarian Diets show that a low-fat, vegetarian diet has a clear advantage over other diets. for Pregnancy . 11Vegetarian Diets lower blood pressure for Children . 12 An impressive number of studies, dating back to the early 1920s, show that veg- etarians have lower blood pressure than non-vegetarians. In fact, some studies have new four food groups shown that adding meat to a vegetarian diet raises blood pressure levels rapidly and significantly. The effects of a vegetarian diet occur in addition to the benefits of reduc- ing the sodium content of the diet. When patients with high blood pressure begin a tips for vegetarian diets vegetarian diet, many are able to eliminate the need for medication.
The 3-Step Way to controlling diabetes The latest studies on diabetes show that a vegetarian diet high in complex carbo- hydrates and fiber (which are found only in plant foods) and low in fat is the best dietary prescription for controlling diabetes. A diet based on vegetables, legumes, fruits, and whole grains, which is also low in fat and sugar, can lower blood sugar levels Cooking without Eggs .5 and often reduce or even eliminate the need for medication. Since individuals with Dairy-Free Dining . 7 diabetes are at high risk for heart disease, avoiding fat and cholesterol is important, The Veganizer .10 and a vegetarian diet is the best way to do that. cancer prevention for Children . 13 A vegetarian diet helps prevent cancer. Studies of vegetarians show that death rates from cancer are only about one-half to three-quarters of those of the general Recipes for Health .14 Breast cancer rates are dramatically lower in countries where diets are typically 2 VegetaRian StaRteR Kit
plant-based. When people from those white blood cells, called "natural killer and iron. Green leafy vegetables, beans, countries adopt a Western, meat-based cells," which are able to seek out and de- lentils, tofu, and nuts are excellent sources diet, their rates of breast cancer soar. Veg- stroy cancer cells.
of calcium, as are enriched soymilk and etarians also have significantly lower rates fortified juices.
of colon cancer than meat-eaters. Colon the calcium connection Vitamin D is normally made in the cancer is more closely associated with Vegetarians are less likely to form either body when sun shines on the skin. People meat consumption than any other dietary kidney stones or gallstones. In addition, who are dark-skinned or live at northern vegetarians may also be at lower risk for latitudes have some difficulty producing Why do vegetarian diets help protect osteoporosis because they eat little or no vitamin D year-round. Vitamin D can against cancer? First, they are lower in animal protein. A high intake of animal easily be obtained from fortified foods. fat and higher in fiber than meat-based Some sources are commercial breakfast diets. But other factors are important, protein encourages the loss of calcium cereals, soymilk, other supplemental too. Plants contain other cancer-fighting from the bones. Replacing animal prod- products, and multivitamins. substances called phytochemicals. For ex- ucts with plant foods reduces the amount ample, vegetarians usually consume more of calcium lost. This may help to explain Regular intake of vitamin B12 is impor- of the plant pigments beta-carotene and why people who live in countries where tant. Good sources include all common lycopene. This might help to explain why the diet is typically plant-based have little multiple vitamins (including vegetarian they have less lung and prostate cancer. osteoporosis, even when calcium intake vitamins), fortified cereals, some brands Also, some studies have suggested that di- is lower than that in dairy-consuming of nutritional yeast, and fortified soymilk. ets that avoid dairy products may reduce countries.
It is especially important for pregnant the risk of prostate and ovarian cancer. women and breast-feeding mothers to get Some of the anti-cancer aspects of a planning vegetarian diets enough vitamin B12. When reading food vegetarian diet cannot yet be explained. It's easy to plan vegetarian diets that labels, look for the word cyanocobalamin For example, researchers are not quite meet all your nutrient needs. Grains, in the ingredient list. This is the form of sure why vegetarians have more of certain beans, and vegetables are rich in protein vitamin B12 that is best absorbed.
the three-Step Way to go Vegetarian First, think of three vegetarian meals that you al-
Third, check out some veg-
If you are making the switch ready enjoy. Common ones are tofu and vegetable etarian cookbooks from the to a vegetarian diet for its health stir-fry, vegetable stew, or pasta primavera. library and experiment with benefits, you'll be pleased to find the recipes for a week or that there is a wonderful addition- Second, think of three reci-
so until you find three new al benefit to vegetarian eating: it's pes that you prepare regularly recipes that are delicious and a delicious and fun way to explore that can easily be adapted to easy to make. Just like that, new foods. A vegetarian meal can a vegetarian menu. For exam- with minimal changes to your be as familiar as spaghetti with ple, a favorite chili recipe can menus, you will have nine marinara sauce, as comforting as be made with all of the same vegetarian dinners. a bowl of rich, potato soup, or ingredients; just replace the as exotic as Gril ed Polenta with meat with beans or textur- Portabella Mushrooms (see recipe ized vegetable protein. Enjoy on page 15).
After that, coming up bean burritos (using canned The switch to a vegetarian diet with vegetarian options vegetarian refried beans) in- is easier than you might think. for breakfast and lunch stead of beef burritos, veggie Most people, whether vegetar- is easy. Try muffins with burgers instead of hamburg- ians or meat-eaters, typical y use fruit spread, cholesterol- ers, and gril ed eggplant and a limited variety of recipes; the free French toast, or cereal roasted red peppers instead of average family eats only eight or for breakfasts. Sandwiches gril ed chicken in sandwiches. nine different dinners repeatedly. with spreads like hummus Many soups, stews, and cas- You can use a simple, three-step or white bean pâté with seroles also can be made into method to come up with nine lemon and garlic, pasta vegetarian dishes with a few vegetarian dinner menus that you salads, or dinner leftovers enjoy and can prepare easily. make great lunches.
The Protein Mythpoof!
n the past, some people believed one could never get too much protein. In the early 1900s, Americans were told to Ieat well over 100 grams of protein a day. And as recently as the 1950s, health-conscious people were encouraged to boost their protein intake. Today, some diet books encourage high protein intake for weight loss, although Americans tend to take in twice the amount of protein they need already. And while in- dividuals following such a diet have sometimes had short-term success in losing weight, they are often unaware of the health risks associated with a high-protein diet. Excess protein has been linked with osteoporosis, kidney disease, calcium stones in the urinary tract, and some cancers. the building blocks of life People build muscle and other body proteins from amino acids, which come from the proteins they eat. A varied diet of beans, lentils, grains, and vegetables contains all of the essential amino acids. It was once thought that various plant foods had the protein you consume, it is important to eat enough calories to be eaten together to get their full protein value, but current to meet your energy needs.
research suggests this is not the case. Many nutrition authori- ties, including the American Dietetic Association, believe pro- the trouble with too much protein tein needs can easily be met by consuming a variety of plant The average American diet contains meat and dairy products. protein sources over an entire day. To get the best benefit from As a result, it is often too high in protein. This can lead to a Tips for making the switch to a vegetarian diet • Convenience foods cut cooking time. Supermarkets and natural • International restaurants are the best bets for finding vegetarian foods stores stock a huge array of instant soups and main-dish food when dining out. Italian, Chinese, Mexican, Thai, Japanese, and vegetarian convenience items. Many canned soups, such as min- Indian restaurants all offer a wide variety of vegetarian dishes.
estrone, black bean, or vegetable, are vegetarian. Flavored rice or • Texturized vegetable protein (TVP) is fat-free, has a texture like other grain mixes, like curried rice or tabouli salad, can be stretched ground beef, and is wonderful in tacos, chili, and sloppy joes. Look into an entrée with a can of beans. Visit the frozen food section for it in the bulk food section of the grocery store. for international y inspired vegetarian frozen entrées such as corn • Summer barbecues are healthy and fun with meatless hot dogs and and bean enchiladas, lentil curry, or vegetarian pad thai. Or try burgers. Or, for a real change of pace, grill thick slices of marinated vegetarian baked beans, refried beans, sloppy joe sauce, and meat- vegetables like eggplant, zucchini, or tomatoes.
less spaghetti sauce from the canned goods isle.
• Check out ethnic groceries for special vegetarian foods. Middle-East- • Ask for it! Even restaurants that don't offer vegetarian entrées ern delis offer stuffed grape leaves, falafel, and eggplant spreads. can usual y whip up a meatless pasta or vegetable plate if you ask. Italian markets are a wonderful place to find hearty homemade If attending a catered affair, catch the waiter before you are served breads, sun-dried tomatoes, and fresh pasta. Indian and Asian and ask him or her to remove the chicken breast from your plate markets offer many vegetarian delicacies, also.
and slip on an extra baked potato. Most airlines offer vegetarian • The simplest dishes are often the most satisfying. Brown rice, meals if you ask in advance; or you can always bring a meal on gently seasoned with herbs and lemon and sprinkled with chopped board with you.
nuts or sunflower seeds, is a perfect dish. • Order your next pizza without cheese but with a mountain of • When traveling, pack plenty of vegetarian snacks like instant soups, vegetable toppings.
fresh fruit, raw vegetables, trail mix, granola bars, and homemade • Find vegetarian cookbooks at your local library or bookstore and oatmeal cookies. Fill a cooler with sandwiches and individual con-have fun experimenting with new foods and recipes.
tainers of juice and soymilk.
4 VegetaRian StaRteR Kit
number of serious health problems: normal through their kidneys. Worth • Kidney Disease: When people eat too noting, countries with lower-protein diets
much protein, they take in more nitrogen have lower rates of osteoporosis and hip than they need. This places a strain on fractures. the kidneys, which must expel the extra Increased calcium excretion increases nitrogen through urine. People with risk for kidney stones. Researchers in kidney disease are encouraged to eat England found that when people added low-protein diets. Such a diet reduces the about 5 ounces of fish (about 34 grams Many people choose not to use eggs excess levels of nitrogen and can also help of protein) to a normal diet, the risk of in their diet. About 70 percent of the prevent kidney disease.
forming urinary tract stones increased calories in eggs are from fat, and a big portion of that fat is saturated. They • Cancer: Although fat is the dietary by as much as 250 percent.
are also loaded with cholesterol—about substance most often singled out for For a long time it was thought that 213 mil igrams for an average-sized egg. increasing cancer risk, protein also plays athletes needed much more protein than Because egg shel s are fragile and po- a role. Populations who eat meat regularly other people. The truth is that athletes, rous and conditions on egg farms are are at increased risk for colon cancer, and even those who strength-train, need only crowded, eggs are the perfect host for researchers believe that the fat, protein, slightly more protein, which is easily salmonella—the bacteria that is the natural carcinogens, and absence of fiber obtained in the larger servings athletes leading cause of food poisoning in this in meat all play roles. The 1997 report of require for their higher caloric intake. the World Cancer Research Fund and Vegetarian diets are great for athletes. Eggs are often used in baked prod- American Institute for Cancer Research, To consume a diet that contains enough, ucts because of their binding and leav- Food, Nutrition, and the Prevention of but not too much, protein, simply replace ening properties. But smart cooks have Cancer, noted that meaty, high-protein animal products with grains, vegetables, found good substitutes for eggs. Try diets were linked with some types of legumes (peas, beans, and lentils), and one of the fol owing the next time you fruits. As long as one is eating a vari- prepare a recipe that cal s for eggs: • Osteoporosis and Kidney Stones: ety of plant foods in sufficient quantity
• If a recipe calls for just one or two Diets that are rich in animal protein cause to maintain one's weight, the body gets eggs, you can often skip them. Add a people to excrete more calcium than plenty of protein.
couple of extra tablespoons of water for each egg eliminated to balance out the moisture content of the product.
• Eggless egg replacers are available in many natural food stores. These are different from reduced-cholesterol egg products, which do contain eggs. Egg replacers are egg-free and are usually in 3 oatmeal pancakes with 1 cup oatmeal with cinnamon and a powdered form. Replace eggs in bak- applesauce topping, calcium- raisins, ½ cup fortified soymilk, ing with a mixture of the powdered egg fortified orange juice, fresh fruit 1 slice toast with 1 tablespoon replacer and water according to package almond butter, ½ grapefruit Bean burritos: black beans in corn • Use 1 heaping tablespoon of soy flour tortillas, topped with chopped let- Whole wheat pita stuffed or cornstarch plus 2 tablespoons of tuce, tomatoes, and salsa, spinach with hummus (see recipe on water to replace each egg in a baked salad with tahini-lemon dressing page 14), sliced tomatoes, and lettuce, carrot sticks • Use 1 ounce of mashed tofu in place Chinese stir-fry over brown rice: • In muffins and cookies, half of a tofu chunks, broccoli, pea pods, 1 cup baked beans , baked mashed banana can be used instead water chestnuts, and Chinese cab- sweet potato, 1 cup steamed of an egg, although it will change the bage (bok choy), cantaloupe chunks col ard greens drizzled with flavor of the recipe somewhat.
drizzled with fresh lime juice lemon juice, baked apple • For vegetarian loaves and burgers, use any of the fol owing to bind ingre- Banana soymilk shake dients together: tomato paste, mashed potato, moistened bread crumbs, or rolled oats.
Many people avoid milk because reducing calcium loss it contains saturated fat, A number of factors affect calcium loss Calcium in Foods
cholesterol, allergenic proteins, from the body: lactose sugar, and frequent traces of • Diets that are high in protein cause contamination, or simply because they more calcium to be lost through the don't feel well after consuming dairy products. Milk is also linked to type 1 urine. Protein from animal products is Broccoli, 1/2 cup, boiled . . . . 31 (juvenile-onset) diabetes and other serious much more likely to cause calcium loss Brussels sprouts, 1/2 cup, boiled. . 28 conditions. Happily, there are many other than protein from plant foods. Butternut squash, 1/2 cup, baked . . 42 good sources of calcium. • Diets high in sodium increase calcium Carrots, 2 medium, raw . . . . 40 Keeping your bones strong depends losses in the urine.
Cauliflower, 1/2 cup, boiled . . . 10 more on preventing the loss of calcium • Caffeine increases the rate at which Col ards, 1/2 cup, boiled . . . .133 from your body than on boosting your calcium is lost through urine. Kale, 1/2 cup, boiled . . . . . 47 • Smoking increases the loss of calcium Sweet potato, 1/2 cup, baked . . . 38 Some cultures consume few or no from the body.
dairy products and typically ingest fewer A number of factors increase bone than 500 milligrams of calcium per day. building in the body: Black turtle beans, 1/2 cup, boiled . 51 However, these people generally have Chickpeas, 1/2 cup, boiled . . . 40 low rates of osteoporosis. Many scientists • Exercise is one of the most important Great Northern beans, 1/2 cup, boiled 60 believe that exercise and other factors factors in maintaining bone health.
Kidney beans, 1/2 cup, boiled . . 31 have more to do with osteoporosis than • Exposure to sunlight allows the body Lentils, 1/2 cup, boiled . . . 19 calcium intake does.
to make the bone-building hormone Navy beans, 1/2 cup, boiled . . 63 Pinto beans, 1/2 cup, boiled . . 40 calcium in the body • Eating a plentiful amount of fruits and Soybeans, 1/2 cup, boiled . . . 88 Almost all of the calcium in the vegetables helps to keep calcium in bone.
Soymilk, 1 cup, calcium-fortified . 368 body is in the bones. There is a tiny • Consuming calcium from plant-based Tofu, raw, firm, 1⁄2 cup . . . 253 amount in the bloodstream, which is sources, especially green vegetables and Vegetarian baked beans, 1/2 cup . 43 responsible for important functions such beans, provides one of the building blocks White beans, 1/2 cup, boiled . . . 81 as muscle contraction, maintenance of for bone building.
the heartbeat, and transmission of nerve sources of calcium We regularly lose calcium from our Exercise and a diet moderate in Rice milk, 1 cup, enriched . . . 300* bloodstream through urine, sweat, and protein will help to protect your bones. Wheat bread, 1 slice . . . . . 26 feces. It is renewed with calcium from People who eat plant-based diets and Whole wheat flour, 1 cup . . . . 41 bone or from the diet. are active probably have lower calcium Bones are constantly broken down and made anew. Up until the age of 30 or needs. However, it is still important to eat Dried figs, 1/2 cup figs . . . . . . 121 so, we build more bone than we lose. calcium-rich foods every day. Navel orange, 1 medium . . . . . . 60 Later, the bones tend to break down more The "Calcium in Foods" chart on the Orange juice, 1/2 cup calcium-fortified 150* than build up. The loss of too much bone left side of this page gives the amount of calcium can lead to fragile bones or calcium found in some excellent plant * package information sources. A quick glance shows how Source: U.S. Department of Agriculture, How rapidly calcium is lost depends, in easy it is to meet calcium needs. The Agricultural Research Service. 2004. USDA part, on the kind and amount of protein sample menus on page 5 each provide National Nutrient Database for Standard Reference, Release 17. Nutrient Data Laboratory you eat, as well as other diet and lifestyle approximately 1,000 milligrams of Web site, http://www.nal.usda.gov/fnic/foodcomp 6 VegetaRian StaRteR Kit
What about Milk?
• Calcium: Green leafy vegetables, such as kale, are better than milk as
calcium sources. • Fat Content*: Dairy products—other than skim varieties—are high in
fat, as a percentage of total calories.
• Iron-Deficiency: Milk is very low in iron. To get the U.S. Recommended
Dietary Allowance of 11 milligrams of iron, an infant would have to ideas for Delicious drink more than 22 quarts of milk each day. Milk also causes blood loss from the intestinal tract, depleting the body's iron. • Diabetes: In a study of 142 children with diabetes, 100 percent had high
If you are curious whether dairy foods levels of an antibody to a cow's milk protein. It is believed that these are contributing to your al ergies, skin antibodies may destroy the insulin-producing cells of the pancreas. problems, asthma, stomach upset, gas, • Contaminants: Milk is frequently contaminated with antibiotics and
diarrhea, or constipation, or you'd like excess vitamin D. In one study of 42 milk samples tested, only 12 to see how your body feels when it is percent were within the expected range of vitamin D content. Of ten dairy-free, just give it a try for three samples of infant formula, seven had more than twice the vitamin D weeks. It takes about three weeks to content reported on the label, and one had more than four times the break or create a habit. And in that short time, many people experience major benefits, such as a drop in blood • Lactose: Three out of four people from around the world, including an
cholesterol levels, weight loss, relief estimated 25 percent of individuals in the United States, are unable to from al ergies, asthma, indigestion, or digest the milk sugar lactose, which then causes diarrhea and gas. The chronic stomach problems. Here are lactose sugar, when it is digested, releases galactose, a simple sugar that some simple ideas to get you started: is linked to ovarian cancer and cataracts.
• Allergies: Milk is one of the most common causes of food allergy. Often
Top your oats or cold cereal with forti- the symptoms are subtle and may not be attributed to milk for some fied rice or almond milk.
Make smoothies with enriched vanil a • Colic: Milk proteins can cause colic, a digestive upset that bothers one
soymilk or drink an ice cold glass of in five infants. Milk-drinking mothers can also pass cow's milk proteins your favorite soymilk with your meal to their breast-feeding infants. "Leave off the cheese, please." Order your entrée or salad with no cheese. Many dishes can be easily made cheese- *Fat content of dairy products
free. Ask for guacamole, rice, or extra based on percentage of calories from fat salsa in your burrito or on your tostada instead of the cheese. Put more veg-etables on a dinner salad or add some Butter: 100% fat beans, nuts, or baked tofu chunks in-stead of cheese.
Most recipes calling for milk can be Cheddar cheese: 74% fat made with soymilk instead. If it's a soup or other savory dish, be sure to purchase plain soymilk for cooking.
Whole milk: 49% fat Make creamy dips and desserts using silken tofu in place of sour cream or "2%" milk: 35% fat cream cheese.
(it is 2% fat only by weight.) Sprinkle nutritional yeast on popcorn or pasta for a cheesy flavor instead of parmesan.
the Power Plate featuring the New Four Food groups* 3 or more servings a day+
2 or more servings a day+
Fruits are rich in fiber, vitamin C, and beta- Legumes, which is another name for beans, carotene. Be sure to include at least one serving peas, and lentils, are all good sources of fiber, each day of fruits that are high in vitamin protein, iron, calcium, zinc, and B vitamins. C—citrus fruits, melons, and strawberries are This group also includes chickpeas, baked and all good choices. Choose whole fruit over fruit refried beans, soymilk, tempeh, and tofu.
juices, which do not contain very much fiber. Serving size: ½ cup cooked beans • 4 ounces
Serving size: 1 medium piece of fruit • ½ cup
tofu or tempeh • 8 ounces soymilk cooked fruit • 4 ounces juice Many of us grew up with the USDA's old Basic Four food provides excellent sources of the nutrients once only associated groups, first introduced in 1956. The passage of time has with meat and dairy products—namely, protein and calcium. seen an increase in our knowledge about the importance of In 1991, PCRM developed the New Four Food Groups, which fiber, the health risks of cholesterol and fats, and the disease- formed the basis for the 2009 launch of the Power Plate. This no- preventive power of many nutrients found exclusively in plant- cholesterol, low-fat plan supplies all of an average adult's daily nu- based foods. We also have discovered that the plant kingdom tritional requirements, including substantial amounts of fiber. In 8 VegetaRian StaRteR Kit
*Be sure to include a good source of vitamin B12, such as fortified cereals or vitamin supplements.
5 or more servings a day+
4 or more servings a day+
This group includes bread, rice, pasta, hot or cold Vegetables are packed with nutrients; they cereal, corn, mil et, barley, bulgur, buckwheat provide vitamin C, beta-carotene, riboflavin, groats, and tortil as. Build each of your meals iron, calcium, fiber, and other nutrients. Dark around a hearty grain dish—grains are rich in green leafy vegetables such as broccoli, collards, fiber and other complex carbohydrates, as well kale, mustard and turnip greens, chicory, or as protein, B vitamins, and zinc.
bok choy are especial y good sources of these important nutrients. Dark yellow and orange Serving size: ½ cup hot cereal • 1 ounce dry
vegetables such as carrots, winter squash, sweet cereal • 1 slice bread potatoes, and pumpkin provide extra beta-carotene. Include generous portions of a variety of vegetables in your diet.
Serving size: 1 cup raw vegetables • ½ cup
+ Serving numbers are suggestions only. Eat a variety of plant foods throughout the day.
2011, the USDA revised its recommendations with MyPlate, a plan stroke—have a dramatically lower incidence among people that reduces the prominence of animal products and vegetable consuming primarily plant-based diets. Weight problems—a fats. But because regular consumption of such foods—even in contributor to a host of health problems—can also be brought lower quantities—poses serious health risks, PCRM recommends under control by following the Power Plate recommendations.
instead the Power Plate, based on the New Four Food Groups.
Try the Power Plate and discover a healthier way to live! Learn The major killers of Americans—heart disease, cancer, and more at www.ThePowerPlate.org.
Achieving and Maintaining a Healthy Weight
Of the many ways to lose weight, The old myth was that pasta, bread, po- have almost the same number of calo- one stands out as by far the most tatoes, and rice are fattening. Not true. In ries per gram, foods that are high in pro- healthful. When you build your fact, carbohydrate-rich foods are perfect tein—particularly animal products—are meals from a generous array of vegetables, for permanent weight control. Carbohy- also usually high in fat. Even "lean" cuts fruits, whole grains, and beans—that is, drates contain fewer than half the calories of meat have much more fat than a healthy healthy vegetarian choices—weight loss is of fat, which means that replacing fatty body needs. And animal products always remarkably easy. And along with it come foods with complex carbohydrates auto- lack fiber. Fiber helps make foods more major improvements in cholesterol, blood matically cuts calories. But calories are satisfying without adding many calories, pressure, blood sugar, and many other only part of the story.
and it is only found in foods from plants.
aspects of health. The message is simple: The body treats carbohydrates different- Exercise helps, too. Aerobic exercise Cut out the foods that are high in fat and ly than fat calories. The difference comes speeds up the breakdown of fat and makes devoid of fiber, and increase the foods from how the body stores the energy of sure that muscle is not lost. Toning exer- that are low in fat and full of fiber. This different food types. It is very inefficient cises and weight-lifting help firm muscles low-fat, vegan diet approach is safe and for the body to store the energy of carbo- and increase muscle mass. The trick is to easy—once you get the hang of it. hydrates as body fat. When your body tries find activities that you enjoy and that fit Changing eating habits is the corner- to turn carbohydrate into fat, it wastes 23 your lifestyle. Walking is a good way to stone of achieving and maintaining a percent of the calories of the carbohydrate. start. You can do it anywhere at just about healthy weight permanently. There is no But fat is easily converted into body fat. any time.
way to "lose 20 pounds in two short weeks" Only 3 percent of the calories in fat are The best weight control program is and make it last. Very-low-calorie diets or burned in the process of conversion and a high-complex carbohydrate, low-fat, low-carbohydrate, high-protein diets may storage. It is the type of food that affects vegetarian diet complemented by regu- cause major health problems and are very body fat the most.
lar exercise. This is the best choice for a difficult to maintain for the long term.
Although protein and carbohydrates healthier, longer, happier life.
if your regular meal is: try this meal instead: The Veganizer* st Donut, coffee with cream, banana
Cinnamon raisin toast with jam; coffee with non-fat, non-dairy creamer; banana See how to change your regular Cereal with milk, orange juice, strawberries Cereal with non-fat soy- or rice milk, orange juice, strawberries meals into low-fat vegan meals. Scrambled eggs, home fries, Scrambled low-fat tofu, oven-roasted potatoes, English English muffin, sausage, hot tea muffin, Gimme Lean™ fat-free sausage, hot tea Seasoned tofu and sweet potato burrito with lettuce, tomato, Chicken burrito, rice, refried beans and onion (hold the cheese); rice; vegetarian black beans Turkey sandwich with lettuce, tomato, Sandwich with hummus or black bean spread, lettuce, and and mayo; yogurt; potato chips tomato; applesauce; fat-free chips or crackers Chicken noodle soup, bread, green Vegetable soup or minestrone, bread, green salad salad with Russian dressing with fat-free dressing or vinegar Chicken fajita, rice, refried beans, piña colada Vegetable fajita (no oil), rice, vegetarian black beans, margarita Vegetarian tofu soup, stir-fried Chinese vegetables (hold Hot and sour soup, beef and broccoli, rice the oil), broccoli with garlic sauce, lots of rice Broiled salmon, boiled new potatoes Broiled portabel a mushrooms, boiled new potatoes with *Note: veganizer machine not included.
with parmesan cheese, asparagus with hol andaise basil and black pepper, asparagus with orange sauce 10 VegetaRian StaRteR Kit
Vegetarian Diets for Pregnancy
During pregnancy your need the second and third trimesters. to 30 minutes of direct sunlight on your for nutrients increases. For ex- • See your healthcare provider regularly. hands and face two to three times weekly.
ample, you will require more If you do not get regular sunlight, vita- calcium, more protein, and more folic • Limit empty calories found in highly min D is also available in multiple vita- acid, although your calorie needs increase processed foods and sweets. Make your mins and in fortified foods. Many brands only modestly. It is important to eat foods calories count! of ready-to-eat cereals and soy and rice that are rich in nutrients, but not high in nutrients milks are fortified with vitamin D. fat or sugar or excessive in calories.
Vegetarian diets, based on nutritious To make certain that you are getting 12: Vitamin B12 is not found
in most plant foods. To get enough of whole foods, are healthful choices for adequate nutrition, pay particular atten- this important nutrient, be certain to in- pregnant women.
tion to these nutrients: clude vitamin B12-fortified foods in your Calcium: All of the new four food groups daily routine. These foods include many
good health during include foods that are rich in calcium. Be breakfast cereals, some meat substitute certain to include plenty of calcium-rich products, some brands of soymilk, and foods in your diet. These include tofu, • Begin a healthful diet before you be- Vegetarian Support Formula nutritional dark green leafy vegetables, bok choy, come pregnant. Your body's store of nu- yeast. Be certain to check the ingredi- broccoli, beans, figs, sunflower seeds, trients supports the early growth and ent label for cyanocobalamin, the most tahini, almond butter, calcium-fortified development of your baby.
soymilk (try Silk or Vitasoy brands or absorbable form of vitamin B12. Seaweed and products like tempeh are generally • Maintain a steady rate of weight gain. others that use whole organic soybeans), Aim for about three to four pounds total and calcium-fortified cereals and juices.
not reliable sources of vitamin B12. Vita- during the first trimester and then about Vitamin D: The normal source of vitamin min B12 is also in all standard multivita-
three to four pounds each month during D is sunlight. You'll want to get at least 20 mins and in vegetarian supplements.
Iron: Iron is abundant in plant-based
if your regular meal is: try this meal instead: diets. Beans, dark green vegetables, dried fruits, blackstrap molasses, nuts and seeds, and whole grain or fortified Donut, coffee with cream, banana Cinnamon raisin toast with jam; coffee with non-fat, non-dairy creamer; banana breads and cereals all contain plenty of Cereal with milk, orange juice, strawberries Cereal with non-fat soy- or rice milk, orange juice, strawberries iron. However, women in the second half of pregnancy sometimes need to take a Scrambled eggs, home fries, Scrambled low-fat tofu, oven-roasted potatoes, English supplement regardless of the type of diet English muffin, sausage, hot tea muffin, Gimme Lean™ fat-free sausage, hot tea they follow. Your healthcare provider will Seasoned tofu and sweet potato burrito with lettuce, tomato, discuss iron supplements with you.
Chicken burrito, rice, refried beans and onion (hold the cheese); rice; vegetarian black beans A word about protein. Protein needs
increase by about 30 percent during preg- Turkey sandwich with lettuce, tomato, Sandwich with hummus or black bean spread, lettuce, and nancy. While there may be concern over and mayo; yogurt; potato chips tomato; applesauce; fat-free chips or crackers whether protein intake is adequate at Chicken noodle soup, bread, green Vegetable soup or minestrone, bread, green salad such an important time, most vegetarian salad with Russian dressing with fat-free dressing or vinegar women eat more than enough protein to meet their needs during pregnancy. With ample consumption of protein-rich foods such as legumes, nuts, seeds, vegetables, and whole grains, protein needs can easily be met during pregnancy.
Chicken fajita, rice, refried beans, piña colada Vegetable fajita (no oil), rice, vegetarian black beans, margarita Vegetarian tofu soup, stir-fried Chinese vegetables (hold Hot and sour soup, beef and broccoli, rice The guidelines for breastfeeding moth- the oil), broccoli with garlic sauce, lots of rice ers are similar to those for pregnant Broiled salmon, boiled new potatoes Broiled portabel a mushrooms, boiled new potatoes with women. Milk production requires more with parmesan cheese, asparagus with hol andaise basil and black pepper, asparagus with orange sauce calories, so you will need to boost your food intake a little bit.
ages 1 to 4 years Breakfast: Oatmeal with applesauce,
calcium-fortified orange juice
Lunch: Hummus (see recipe) on crack-
ers, banana, soymilk, carrot sticks
Dinner: Corn, mashed sweet potatoes,
steamed kale, soymilk
Right from the Start
Snacks: Peach, Cheerios, soymilk
ages 5 to 6 years ating habits are set in early childhood. Vegetar- Breakfast: Whole grain cereal with
ian diets give your child the chance to learn to banana and soymilk, orange wedges enjoy a variety of wonderful, nutritious foods. They Lunch: Missing Egg Sandwich (see
provide excellent nutrition for all stages of childhood, recipe), apple juice, carrot sticks, oat- from birth through adolescence.
Dinner: Baked beans with soy "hot
The best food for newborns is breast-milk, and dog" pieces, baked potato, spinach, the longer your baby is breast-fed, the better. If your soymilk, fruit salad baby is not being breast-fed, soy formulas are a good Snacks: Trail mix, graham crackers,
alternative and are widely available. Do not use com- mercial soymilk for infants. Babies have special needs and require a soy formula that is developed especially ages 7 to 12 years for those needs.
Infants do not need any nourishment other than Breakfast: Strawberry-banana smooth-
breast milk or soy formula for the first half year of ie, toast with almond butter, calcium- life, and they should continue to receive breast milk fortified orange juice or formula at least throughout their first 12 months. Lunch: Hearty Chili Mac (see recipe),
Breast-fed infants also need about two hours a week green salad, bread of sun exposure to make vitamin D—a great motiva- Dinner: Steamed broccoli with nutri-
tor for Mom to get back into a walking routine. Some tional yeast, steamed carrots, oven fries, infants, especially those who are dark-skinned or Berry Cobbler (see recipe), soymilk who live in cloudy climates, may not make adequate amounts of vitamin D. In these cases, vitamin D Snacks: Popcorn, figs, soy "ice
supplements may be necessary. Vegetarian women who are breast-feeding should also be certain to include good sources of vitamin ages 13 to 19 years B12 in their diets, as intake can affect levels in breast milk. Foods fortified with cyanocobalamin, the active Breakfast: Bagel with apple butter,
banana, calcium-fortified orange juice
form of vitamin B12, can provide adequate amounts of this nutrient. A multivitamin may also be taken Lunch: Bean burrito with lettuce, to-
as directed by your doctor. Breast milk or infant mato, and guacamole, rice, baked tor- formula should be used for at least the first year of til a chips, and salsa your baby's life.
Dinner: Braised broccoli, carrots, yel-
At about 5 to 6 months of age, or when baby's low squash, and mushrooms, spaghetti weight has doubled, other foods can be added to the with marinara sauce, cucumber salad, diet. Pediatricians often recommend starting with an iron-fortified cereal because, at about 4 to 6 months, Snacks: Hummus (see recipe) and baby
infants' iron stores, which are naturally high at birth, carrots, fruit smoothie, Luna or Clif begin to decrease. Add one simple new food at a time, at one- to two-week intervals. The following guidelines provide a flexible plan for 12 VegetaRian StaRteR Kit
adding foods to your baby's diet.
ing teens to make lower-fat selections Legumes, nuts, Seeds, when eating out will help to steer them and non-Dairy Milks away from dining pitfalls that often cause • Introduce iron-fortified infant cereal. weight gain and health problems for ado- • Legumes include any cooked bean such Try rice cereal first, mixed with a little lescents.
as pinto, kidney, lentils, split peas, navy breast milk or soy formula, since it is the Caloric needs vary from child to child. beans, and chickpeas, as well as soy prod- least likely to cause allergies. Then, offer The following guidelines are general ones. ucts such as tofu, veggie burgers, soy "hot oat or barley cereals. Most pediatricians dogs" or sandwich slices, and tempeh.
recommend holding off on introducing • One serving of legumes equals 1/2 cup wheat until the child is at least 8 months of beans, tofu, or other item (unless an old, as it tends to be more allergenic.
amount is specified).
• Non-dairy milks include breast milk and soy formula for infants and toddlers, • Introduce vegetables. They should be and rice-, soy-, and other vegetable-based thoroughly cooked and mashed. Potatoes, milks for children at least 1 year of age. green beans, carrots, and peas are all good Choose fortified soymilk, such as West- soy Plus, Enriched VitaSoy, or Edensoy, • Introduce fruits. Try mashed bananas, • Whole grains include breads, hot and whenever possible, or use other fortified avocados, strained peaches, or apple- cold cereals, pasta, cooked grains such as vegetable-based milks. rice and barley, and crackers.
• One serving of non-dairy milk equals • Introduce breads. By 8 months of age, • One serving equals 1/2 cup of pasta, 1 cup.
most babies can eat crackers, bread, and grains, or cooked cereal, 3/4 to 1 cup of • Nuts include whole or chopped nuts, nut ready-to-eat cereal, 1/2 bun or bagel, or 1 butters, whole seeds, and seed butters.
• Introduce protein-rich foods. Also, by slice of bread.
• One to two servings of nuts may be about 8 months, infants can begin to eat included in a healthy diet, but they are higher protein foods like tofu or beans Vegetables optional. One serving of nuts or nut but- that have been cooked well and mashed.
• "Dark green vegetables" include broc- ters equals 1 tablespoon.
coli, kale, spinach, collards, turnip, mus- children and teens tard and beet greens, bok choy, and Swiss Fruits Children have a high calorie and nu- chard.
• Fruits include all fruits, fresh or frozen, trient need but their stomachs are small. • "Other vegetables" refers to all other raw or cooked, and fruit juices.
Offer your child frequent snacks.
vegetables, fresh or frozen, raw or cooked. • One serving equals 1/2 cup cooked Teenagers often have high-energy needs • One serving of vegetables equals 1/2 cup fruit, 1/2 cup fruit juice, 1/4 cup dried and busy schedules. Keeping delicious, cooked or 1 cup raw (unless an amount is fruit, or 1 piece of fruit (unless an amount healthy snack choices on hand and guid- specified).
Daily Meal Planning for Children and teens 1- to 4-Year-Olds
5- to 6-Year-Olds
7- to 12-Year-Olds
13- to 19-Year-Olds
2 to 4 tbsp dark green 1/4 cup dark green 1 serving dark green 1-2 servings dark green 1/4 to 1/2 cup other 1/4 to 1/2 cup other 3 servings other vegetables 3 servings other vegetables 1/4 to 1/2 cup legumes 1/2 to 1 cup legumes 2 servings legumes 3 servings legumes 3 servings breastmilk, 3 servings soymilk or other 3 servings soymilk or other 2 to 3 servings soymilk or formula, or non-dairy milk other non-dairy milk 3/4 to 1 and 1/2 cups be sure to include a source of vitamin b12, such as any typical children's multivitamin or vitamin-fortified cereals or soymilk.
Recipes for Health
2 green onions, finely chopped cups of cleaned spinach leaves to the pot 1 tablespoon reduced-fat soy mayonnaise right before serving.
2 tablespoons pickle relish NUtRitioN iNfoRmAtioN peR SeRviNg: 78 1 teaspoon stone ground mustard cALoRieS, 4 g pRoteiN, 16 g cARbohyDRAte, 0 g fAt, 150 mg SoDiUm, 0 mg choLeSteRoL ¼ teaspoon cumin¼ teaspoon turmeric Spinach Salad
¼ teaspoon garlic powder or granules8 slices whole wheat bread with Fruit Flavors
Makes 16 3-inch pancakes A favorite from PCRM's cooking classes, The mellow flavor of buckwheat com- Combine the mashed tofu with green on- this recipe is chock full of cancer-fighting bines with the cornmeal to make a light, ions, mayonnaise, pickle relish, mustard, delicious pancake. Serve these satisfying cumin, turmeric, and garlic powder or 10 ounces chopped spinach, washed pancakes with fruit preserves, applesauce, granules. Mix thoroughly. Spread on whole 1 cup berries, grapes, or 10 or maple syrup.
wheat bread and garnish with lettuce and strawberries, chopped tomato slices.
½ cup buckwheat flour 1 10-ounce can mandarin or NUtRitioN iNfoRmAtioN peR SANDWich: 197 cALoRieS, 10 g pRoteiN, 29 g cARbohyDRAte, clementine oranges, or grapefruit ½ teaspoon baking powder 4 g fAt, 271 mg SoDiUm, 0 mg choLeSteRoL sections, drained and rinsed ¼ teaspoon baking soda ¼ cup sunflower seeds Lentil Barley Soup
¼ cup chopped Brazil nuts 1 ½ tablespoons maple syrup Serves 6 to 8 ¼ cup fat-free raspberry vinaigrette 1 tablespoon vinegar This hearty soup is easy to prepare and Toss ingredients together and serve.
1-1 ¼ cups soy- or rice milk cooks in a single pot.
Fresh fruit, fruit preserves, NUtRitioN iNfoRmAtioN (1/6 of Recipe): 111 cALoRieS, 3.9 gm pRoteiN, 10.5 gm cARbohyDRAte, syrup for serving 1 cup lentils, rinsed 7 gm fAt, 60 mg SoDiUm, 0 mg choLeSteRoL ½ cup hul ed or pearled barley Stir the buckwheat flour, cornmeal, baking 6 cups water or vegetable stock powder, and baking soda together in a mix- ing bowl. In a separate bowl mash the ba- Makes about 2 cups nana and mix it with the maple syrup, vin- 2 garlic cloves, minced or crushed A very versatile food: use hummus as a egar, and 1 cup of milk. Combine the liquid 2 carrots, sliced sandwich filling, a dip, or spread on a and dry ingredients and stir just enough to 2 stalks celery, sliced tortilla and top with lettuce and salsa remove any lumps. The batter should be ½ teaspoon oregano and roll up.
pourable; if it seems too thick, add the re- ½ teaspoon ground cumin maining milk. Preheat a non-stick skil et or ¼ teaspoon black pepper 1 can garbanzo beans, drain and griddle and mist it lightly with a vegetable ¼ teaspoon red pepper flakes reserve liquid, rinse beans oil spray. Pour small amounts of the batter ½-1 teaspoon salt 2 tablespoons tahini (sesame butter) onto the heated surface and cook until ¼ cup lemon juice Place all ingredients except salt into a large the tops bubble. Turn with a spatula and 3 scal ions, chopped pot and bring to a simmer. Cover and cook, cook the second side until golden brown. 1 tablespoon garlic, chopped stirring occasionally, until the lentils are (Stir the batter each time before pouring.) tender, about 1 hour. Add salt to taste. Serve immediately.
Note: For an added nutrient boost add 3 NUtRitioN iNfoRmAtioN peR pANcAke: 43 ½ teaspoon black pepper cALoRieS, 1 g pRoteiN, 9 g cARbohyDRAte, 0.2 Optional: ½ cup roasted red peppers g fAt, 32 mg SoDiUm, 0 mg choLeSteRoL Put all ingredients in food processor and Missing Egg Sandwich
process until smooth. Add reserved bean Makes about 4 sandwiches liquid for a smoother consistency. Spread on whole-wheat pita bread, or serve as a Delicious, lower fat, and cholesterol-free dip for vegetables.
alternative to traditional egg salad.
NUtRitioN iNfoRmAtioN peR 2 tAbLeSpooN SeRviNg: ½ pound firm tofu, mashed 44 cALoRieS, 2 gm pRoteiN, 6 gm cARbohyDRAte, 1.5 gm fAt, 29 mg SoDiUm, 0 mg choLeSteRoL 14 VegetaRian StaRteR Kit
Easy Bean Salad
(at least 2 hours). To gril , cut into wedges, Note: Textured vegetable protein is made brush or spray lightly with olive oil, and from soybeans and is low in fat and high in cook over medium-hot coals until nicely protein. Look for it in natural food stores So simple and delicious, you won't browned. Clean the mushrooms and cut and the bulk section of supermarkets.
off the stems. Prepare the marinade by NUtRitioN iNfoRmAtioN peR SeRviNg: 275 stirring the remaining ingredients together cALoRieS, 14 g pRoteiN, 52 g cARbohyDRAte, 1 1 15-ounce can kidney beans g fAt, 549 mg SoDiUm, 0 mg choLeSteRoL in a large bowl. Place mushrooms top side 1 15-ounce can pinto beans down in the marinade and let stand 10 to 1 15-ounce can black-eyed peas 15 minutes. Grill bottom side down over 1 10-ounce frozen package medium hot coals about 5 minutes. Turn Fordhook lima beans and pour some of the marinade into each 1 cup frozen corn of the cavities. Grill until mushrooms can 1 large red bell pepper, diced be pierced with a skewer, about 5 minutes ½ medium onion, diced longer. Serve with gril ed polenta. Garnish with roasted red pepper strips, if desired.
1 teaspoon pepper Note: The polenta may be broiled in the ½ cup low-fat Italian salad dressing oven instead of gril ed.
Toss all ingredients together. Serve cold or NUtRitioN iNfoRmAtioN peR SeRviNg: 141 at room temperature. May be covered and cALoRieS, 4 g pRoteiN, 20 g cARbohyDRAte, 3 g fAt, 308 mg SoDiUm, 0 mg choLeSteRoL Easier to make and much lower in fat than stored in the refrigerator for several days.
fruit pie. For a real treat, top the hot cob-bler with a spoonful of non-dairy frozen NUtRitioN iNfoRmAtioN peR SeRviNg: 176 Chili Mac
cALoRieS, 9.7 gm pRoteiN, 31 gm cARbohyDRAte, 2.2 gm fAt, 508 mg SoDiUm, 0 mg choLeSteRoL 5-6 cups fresh or frozen berries Kids of all ages love this simple meal.
8 ounces pasta spirals or macaroni raspberries, or a mixture of these) 3 tablespoons wholewheat pastry flour 2-3 cloves of garlic, minced ¼ cup sugar or other sweetener 1 small bell pepper, diced 1 cup wholewheat pastry flour ¾ cup textured vegetable protein 2 tablespoons sugar or other sweetener 1 15-ounce can crushed tomatoes 1 ½ teaspoons baking soda 1 15-ounce can kidney Grilled Polenta with
beans, including liquid 2 tablespoons vegetable oil 1 15-ounce can corn, including liquid ½ cup non-fat soymilk or rice milk 1 tablespoon chili powder Preheat oven to 400°F. Spread the berries in a 9 x 9-inch baking dish and mix them Grilling or oven-roasting vegetables is so Cook the pasta in boiling water until it is with 3 tablespoons of flour and ¼ cup of easy and brings out their best flavors. tender. Drain and rinse it under hot water, sugar. In a separate bowl, mix 1 cup of ½ cup polenta (coarsely then set it aside. Heat ½ cup of water in a flour and 2 tablespoons of sugar with the large pot, then add the chopped onion and baking powder and salt. Add the oil and 1 15-ounce can vegetable broth garlic. Cook until the onion is soft, about mix it with a fork or your fingers until the or 2 cups vegetable stock 3 minutes. Add the bell pepper, textured mixture resembles coarse corn meal. Add vegetable protein, crushed tomatoes, kid- the soymilk or rice milk and stir to mix. 4 large portabella mushrooms ney beans, corn, spices, and an additional Spread the mixture over the berries (don't 1 tablespoon olive oil ½ cup water. Stir to mix, then simmer over worry if they're not completely covered), 2 tablespoons soy sauce medium heat, stirring occasional y, for 20 then bake until golden brown, about 25 minutes. 2 tablespoons balsamic vinegar minutes. Add the cooked pasta and check the seasonings. Add more chili powder if 2 tablespoons red wine or water NUtRitioN iNfoRmAtioN peR SeRviNg: 166 a spicier dish is desired.
cALoRieS, 3 g pRoteiN, 32 g cARbohyDRAte, 3 2 garlic cloves, crushed g fAt, 67 mg SoDiUm, 0 mg choLeSteRoL 1 roasted red pepper, cut into thin strips for garnish (optional) More Recipes
Combine the polenta, vegetable broth, and ½ cup of water in a saucepan. Bring to a For more delicious recipes simmer and cook, stirring frequently, until please visit PCRM's website at very thick, 15 to 20 minutes. Pour into a 9 x 9-inch baking dish and chill completely 5100 Wisconsin Ave., NW • Suite 400 Washington, DC 20016 Resources for Better Health Through Plant-Based Nutrition Books from PCRM president neal D. Barnard, M.D.
Resources from Food for Life/the Cancer Project Power Foods for the Brain: An Effective 3-Step Plan The Cancer Survivor's Guide to Protect Your Mind and Strengthen Your Memory Find out how foods fight cancer and the advantages of In Power Foods for the Brain, Dr. Barnard has gathered the a high-fiber, low-fat, dairy- and meat-free diet. Includes most important research and studies to deliver a program updates from the latest research, special prostate and that can boost brain health, reducing the risk of Alzheim- breast cancer sections, tips for making the dietary er's disease, stroke, and other less serious malfunctions, transition, and more than 130 recipes. including low energy, poor sleep patterns, irritability, and Eating Right for Cancer Survival DVD 21-Day Weight Loss Kickstart: Boost Metabolism, This video is designed to work hand-in-hand with the companion The Cancer Lower Cholesterol, and Dramatically Improve Your Health Survivor's Guide. Together they'll point you toward simple, everyday choices Dr. Barnard's latest book expands on PCRM's popular that can cause major changes in your health and well being.
Kickstart program and forms the basis for his PBS pro- gram, "Kickstart Your Health." You'll get fast results: drop pounds, lower cholesterol and blood pressure, improve blood sugar, and more. NutritionMD.org Food for Life 90-Day Journal: Kickstart to a Healthier Lifestyle An online handbook of nutrition guidelines for hundreds of diseases, reviewed Use this colorful, portable spiral notebook to make the by 75 clinical experts, and the home of the Meal Planner, which provides meal benefits of a plant-based diet part of your regular lifestyle. ideas, recipes, and shopping lists.
You keep a daily of record of fiber intake and physical activ-ity. Includes a seven-day sample menu, recipes, nutritional guidance, and plenty of inspiration. 144 pgs, $12.00 Find additional resources and explore the work of the Physicians Committee for Responsible Medicine at PCRM's main website.
Dr. Neal Barnard's Program for Reversing Diabetes Rather than just compensating for malfunctioning insulin like other treatment plans, Dr. Barnard's program helps The place to send people with diabetes for nutrition education including repair how the body uses insulin.
lectures, cooking demonstrations, an online video support group, and much Order books and DVDs through the PCRM Marketplace. Visit www.PCRM.org/shop or call 800-695-2241.
THE VEGETARIAN STARTER KIT is published by the Physicians Committee for Responsible Medicine, 5100 Wisconsin Ave., N.W., Suite 400, Washington, DC 20016, (202) 686-2210. PCRM consists of approximately 6,000 physicians and 100,000 lay members. PCRM promotes nutrition, preventive medicine, ethical research practices, and compassionate medical policy. Readers are welcome to reproduce articles from this publication for personal or educational use without additional permission. Material should not be reproduced for resale without prior arrangement with PCRM. PCRM, 2005.
Note to the Reader: This booklet does not take the place of individualized medical care or advice. If you are overweight, have any health problems, or are on medication,
you should consult with your doctor before making any changes in your diet or exercise routines. A diet change can alter your need for medication. For example, indi-
viduals with diabetes, high blood pressure, or high cholesterol levels often need less medication when they improve their diets. With any dietary change, it is important
to ensure complete nutrition. Be sure to include a source of vitamin B12 in your routine, which could include any common multivitamin, fortified soymilk or cereals, or
a vitamin B12 supplement containing five micrograms of B12 or more per day.
16 VegetaRian StaRteR Kit
Printed on recycled paper 13152-NTR • 20130717
Division of Community and Public Health Section: Appendices Subsection: Table of Contents APPENDICES Sample Forms (click on link in each title) 4.01 Missouri Department of Health and Senior Services Tuberculosis Case Management Manual Division of Community and Public Health Section: Appendices