One of my postoperative patients is on a vegan diet. What is the difference between vegetarian and vegan diets?-HM, NJ

Emily Jang and Bridget Parsh, EdD, CNS, RN, respond-An increasing number of people have been moving toward vegetarian-type diets for health or environmental reasons.1 In the US, almost 6% of people claim to be vegetarian, and 3% claim to be vegan.2 Some local legislatures require hospitals and long-term-care facilities to offer plant-based food options.3 Although more people are adhering to plant-based diets, healthcare professionals often lack knowledge about vegetarianism.1,4 This lack of knowledge can impact healthcare and patients' access to evidence-based resources.4

Vegetarian diets consist of reduced or eliminated intake of animal products, mainly consisting of fruits, vegetables, grains, nuts, and legumes.5

Prefixes further categorize some vegetarian diet subtypes. A lacto-vegetarian diet includes milk and milk products; an ovo-vegetarian diet includes eggs; and a lacto-ovo vegetarian diet includes milk, milk products, and eggs.6,7 A pesco-vegetarian diet includes fish in addition to milk products and eggs. A semivegetarian diet includes minimal amounts of meat or meat products.8

A vegan diet is a more restrictive type of vegetarian diet. It consists solely of consuming plant products and excludes any products from animals such as milk, eggs, and honey.6,7

Nutritional deficits

People who adhere to a vegan diet are more at risk for nutritional deficiencies in fatty acids, proteins, vitamins, and minerals including vitamin B12, vitamin D, iodine, calcium, zinc, and iron.7 However, people adhering to vegan diets can obtain sufficient nutrients by following comprehensive diet plans that may include mushrooms, dried seaweed, sauerkraut, and fermented soybeans.7,9

Nursing considerations

Unfortunately, patients frequently receive the wrong diet or diet tray. For example, in a 5-year study in Pennsylvania hospitals, 285 dietary errors were noted with 63.5% being food delivered that the patient was allergic to, 17.5% receiving the incorrect diet, and 15.1% receiving another patient's tray.10 Ensuring the correct diet by checking two unique patient identifiers, using the bedside whiteboard to communicate diet, and matching food allergies with dietary ingredients, is essential to patient safety and satisfaction.10

Educate and empower

Patients need to eat healthily both in the hospital and in their day-to-day lives.1 Many do not have a proper understanding of what constitutes a healthy diet, so it is crucial to educate patients on how to receive the appropriate nutrition.11 For instance, nurses can educate patients about the health effects of whole foods and the use of MyPlate to help guide their meals.12

Ask patients about their dietary preferences. If you are unsure about whether a pharmaceutical or nutraceutical product is vegan or vegetarian, consult a pharmacist or registered dietitian for additional assistance.13,14

Promote healing

Nurses should also consider what is needed to promote patient healing, such as additional proteins and vitamins A, E, and C.15 For example, postsurgery patients require additional calories, nutrients, and proteins to meet the body's demands and heal damaged tissue.16 For vegan patients, this means possible zinc supplementation and additional citrus fruits, tomatoes, and broccoli.17,18

Dietary guidelines

All patients should follow the Dietary Guidelines for Americans.12 These guidelines are evidence-based practice recommendations to promote healthy diets and prevent diseases.12 Also, patients can refer to MyPlate, a resource on making healthy diet choices that allows patients to picture how a meal should look: half comprised of fruits and vegetables and the other half of grains and proteins, along with dairy product such as cheese, milk, yogurt, or fortified soy.19 For non-dairy consumers, suggestions such as juice or tofu with added calcium are given.

Nurses, together with registered dietitians, can empower patients to make their own diet decisions and encourage healthier food choices.

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