alive Editorial
We live in a world of plenty. But we often have to make critical choices when it comes to the foods we eat, especially when we’re following a special diet. We run the risk of nutritional gaps with many of these diets. Find out how you can plug these nutritional imbalances before they cause problems.
We’re lucky enough to live in a world full of choices. But, whether we follow particular dietary practices by choice or by necessity, we can all use a little help from time to time to fill those inevitable nutritional gaps.
Restrictions imposed by some diets can sometimes cause nutrient imbalances, but with awareness and some careful planning, along with supplementation, we can avoid problems that can happen because of nutrient deficiencies or depletions.
We’ll look at just a few of the many types of special diets that prescribe avoidance of particular foods and the nutrients that may need some special attention. For each nutrient that may pose a challenge with your diet, you’ll find specific signs and symptoms that may suggest a deficiency. We’ll also provide you with some suggestions about how to plug the gap and how much of each of these nutrients you should aim for each day.
If you’re planning to follow a special diet, consider consulting first with a health care practitioner who can help advise you about how to avoid potential nutrient deficiencies and monitor you as needed.
Did you know?
8 percent of Canadians identify as being vegetarian.
Vegetarian diets
What does it mean?
Vegetarians generally avoid meat in their diets. There are different variations of a vegetarian diet, including ovo vegetarians who include eggs but not dairy products, lacto vegetarians who include dairy products and not eggs, and ovo-lacto vegetarians who include animal/dairy products like eggs, milk, and honey.
What you might be missing
A properly balanced vegetarian diet is associated with benefits, like increased antioxidant intake and reduced risk of cardiovascular disease. But an unbalanced one can lead to deficiencies in several nutrients, especially vitamin B12, protein, and iron.
Nutrient |
Signs of deficiency |
Foods to eat |
Supplement |
| vitamin B12 | anemia; fatigue; weakness; constipation; loss of appetite; weight loss; numbness and tingling in the hands and feet; difficulty maintaining balance; depression; confusion; dementia; poor memory; soreness of the mouth or tongue | B12-fortified cereals; fortified soy products; nutritional yeast; eggs and dairy (ovo-lacto) | 1,000 mcg twice weekly, or a lower dose daily as part of a B complex |
| iron | paleness; fatigue; reduced ability to exercise; frequent infections; brittle nails; decreased appetite; irritability; sore tongue or throat; thinning hair/hair loss | iron-fortified breads and cereals; beans and lentils; tofu; dried fruits; spinach and other dark green leafy vegetables | 8–45 mg per day; more for documented deficiency and anemia |
| protein | fatigue; poor healing; decreased immune function; swelling; muscle wasting; pale, dry, or flaking skin; hair breakage and loss | tempeh; tofu; beans and lentils; nuts; seeds; quinoa; bulgur; spinach; broccoli; dairy and eggs (ovo-lacto) | 46 g/day for women; 56 g/day for men; try powdered protein supplements like whey protein isolates |
| zinc | loss of appetite; mental lethargy | nuts; seeds; beans; lentils; vegetable oils; whole grains; tofu; tahini; eggs and dairy (ovo-lacto) | 8–40 mg/day for women; 11–40 mg/day for men |
| fatty acids | fatigue; dry skin/mouth/eyes/hair; poor wound healing; depression | nuts; seeds; beans; whole grains; squash | at least 1.1 g/day for women; 1.6 g/day for men; try omega-3-rich vegetable oils |
| calcium | bone density loss; muscle spasms or cramps; weak, brittle nails; numbness or tingling in hands, feet, face; confusion; memory loss | green leafy vegetables; beans; almonds; tofu; tahini; dairy products (lacto) | 1,000–2,500 mg/day |
| vitamin D | muscle pain and weakness; bone pain; increased risk of certain cancers and autoimmune diseases; immune dysfunction | fortified dairy products (lacto); grains; eggs (ovo); fortified soy/rice/almond beverages | 600–4,000 IU per day |
Did you know?
Nearly 12 million Canadians are either already vegetarian or are eating less meat.
Vegan diets
What does it mean?
Vegans eliminate all animal products from their diets, including dairy, eggs, and honey. Vegans often make choices beyond diet, including with their clothing and cleaning products, to protect animals and the environment.
What you might be missing
Some researchers have found B12 to be deficient in more than half of vegans assessed (not surprising since obtaining enough vitamin B12 from a vegan diet is almost impossible). Other possible challenges for vegans are protein and calcium.
Nutrient |
Signs of deficiency |
Foods to eat |
Supplement |
| vitamin B12 | anemia; fatigue; weakness; constipation; loss of appetite; weight loss; numbness and tingling in hands and feet; difficulty maintaining balance, depression; confusion; soreness of mouth or tongue | B12-fortified cereals; fortified soy products; nutritional yeast | 1,000 mcg twice weekly, or a lower dose daily as part of a B complex |
| iron | paleness; fatigue; reduced ability to exercise; frequent infections; brittle nails; decreased appetite; irritability; sore tongue or throat; thinning hair/hair loss | iron-fortified breads and cereals; beans and lentils; tofu; dried fruits; spinach and other dark green leafy vegetables | 8–45 mg per day; more for documented deficiency and anemia |
| protein | fatigue; poor healing; decreased immune function; swelling; muscle wasting; pale, dry, or flaking skin; hair breakage and loss | tempeh; tofu; beans and lentils; nuts; seeds; quinoa; bulgur; spinach; broccoli | 46 g/day for women; 56 g/day for men; try powdered protein supplements like pea protein or soy protein powders |
| zinc | loss of appetite; mental lethargy | nuts; seeds; beans; lentils; vegetable oils; whole grains; tofu; tahini | 8–40 mg/day for women; 11–40 mg/day for men |
| fatty acids | fatigue; dry skin/mouth/eyes/hair; poor wound healing; depression | nuts; seeds; beans; whole grains; squash | at least 1.1 g/day for women; 1.6 g/day for men; try omega-3-rich vegetable oils |
| calcium | bone density loss; muscle spasms or cramps; weak, brittle nails; numbness or tingling in hands, feet, face; confusion; memory loss | green leafy vegetables; beans; almonds; tofu; tahini | 1,000–2,500 mg/day |
| vitamin D | muscle pain and weakness; bone pain; increased risk of certain cancers and autoimmune diseases; immune dysfunction | grains; fortified soy/rice/almond beverages | 600–4,000 IU per day |
Did you know?
A healthy vegan diet has many health benefits including lower rates of obesity, heart disease, high blood pressure, high blood cholesterol, type 2 diabetes, and certain types of cancer.
Gluten-free diets
What does it mean?
Celiac disease is an immune reaction to gluten, a component of many grain products, which impairs the intestine’s ability to absorb nutrients. Strict adherence to a gluten-free diet can eliminate many of the nutritional deficiencies in celiac disease and improve nutritional status.
What you might be missing
Gluten-free diets still run the risk of nutrient deficiencies because of ongoing malabsorption and/or lack of adequate variety in the diet. Whole grains are a good source of fibre, magnesium, and B vitamins, so these nutrients need to be replaced by other foods or through use of appropriate supplements.
Nutrient |
Signs of deficiency |
Foods to eat |
Supplement |
| fibre | constipation; increased cholesterol levels; weight gain; blood sugar fluctuations; nausea; fatigue; weakness | fruit; vegetables; quinoa; non-gluten grains (rice, corn, millet, buckwheat, teff, gluten-free oats); nuts; beans | 21 g/day for women; 38 g/day for men; fibre supplements may be helpful |
| magnesium | loss of appetite; nausea; vomiting; fatigue; weakness; numbness; tingling; muscle cramps; abnormal heart rhythms | dark green leafy greens; nuts; seeds; beans; lentils; milk; yogurt; brown rice; salmon; halibut; chicken | 320 mg/day for women; 420 mg/day for men |
| B vitamins | anemia; fatigue; weakness; constipation; loss of appetite; weight loss; numbness, tingling in hands, feet; balance problems; depression; confusion; soreness in mouth, tongue | non-gluten grains (rice, corn, millet, buckwheat, teff, gluten-free oats); dairy products; nuts; seeds; dark green leafy vegetables; beans; lentils | B complex, particularly folic acid: at least 0.8 mg; B12: at least 0.5 mg); and B6: at least 3 mg |
| folic acid | anemia; poor healing; fatigue; weakness; mouth sores; irritability; pale skin; shortness of breath | leafy greens; citrus; bananas; melons; eggs; beans; poultry; shellfish | 400–1,000 UL/day |
| iron | paleness; fatigue; reduced ability to exercise; frequent infections; brittle nails; decreased appetite; irritability; sore tongue or throat; thinning hair/hair loss | beans and lentils; tofu; dried fruits; spinach and other dark green leafy vegetables | 8–45 mg per day; more for documented deficiency and anemia |
| calcium | bone density loss; muscle spasms or cramps; weak, brittle nails; numbness or tingling in hands, feet, face; confusion; memory loss | green leafy vegetables; beans; almonds; tofu; tahini; milk products; seafood | 1,000–2,500 mg/day |
| vitamin D | muscle pain and weakness; bone pain; increased risk of certain cancers and autoimmune diseases; immune dysfunction | fortified dairy products; fortified soy/rice/almond beverages; oily fish | 600–4,000 IU per day |
Did you know?
6 percent of Canadians are gluten sensitive and more than 7 million Canadians avoid gluten for other reasons.
Athletes’ diets
What does it mean?
Thanks to reams of research, we know that athletes and highly active people have even more reason to pay attention to their diets. High performance demands can drain body systems if they’re not adequately topped up.
Nutrient |
Signs of deficiency |
Foods to eat |
Supplement |
| calories | weight loss; fatigue; reduced performance; slower metabolism; | increase intake of healthy, nutrient-rich foods | organic meal replacement bars: 300–400 calories, at least 5 g protein, at least 3 g fibre, vitamins, and minerals |
| hydration | weakness; fatigue; loss of performance; thirst; dizziness; muscle cramps | fluids and hydrating foods (strawberries, oranges, cantaloupe, cucumber, peppers, etc.) | hydrate before, during, and after endurance activities; aim for about 16 oz (500 mL) fluid for every lb (0.5 kg) lost during exercise |
| carbohydrates | constipation; weakness; nausea; headache; mental and physical fatigue; inability to continue endurance activity | whole grains; vegetables; honey; dried fruits | intake of 6–10 g/kg of body weight/day; choose products (gels, drinks, or powders) that are 6–8 percent carbohydrates |
| protein | fatigue; poor healing; decreased immune function; swelling; muscle wasting; pale, dry, or flaking skin; hair breakage and loss | fish; poultry; meat; dairy; eggs; beans; nuts/nut butters; seeds; soy/soy beverages | minimum 0.80 g/kg body weight/day; 46 g/day for women; 56 g/day for men; try powdered protein supplements (whey protein isolates) |
| electrolytes | dizziness; weakness; fatigue; muscle cramps | mineral-rich foods (nuts; seeds; leafy greens; bananas) | electrolyte replacement mix or beverage |
| iron | paleness; fatigue; reduced ability to exercise; frequent infections; brittle nails; decreased appetite; irritability; sore tongue or throat; thinning hair/hair loss | meat; poultry; iron-fortified breads, cereals; beans, lentils; tofu; dried fruits; spinach and other dark green leafy vegetables | 8–45 mg per day; more for documented deficiency and anemia |
| fatty acids | fatigue; dry skin/mouth/eyes/hair; poor wound healing; depression | mostly unsaturated fatty acids derived from foods such as nuts, seeds, beans, and fish | at least 1.1 g/day for women; 1.6 g/day for men; essential fatty acid supplements (fish oils, flax oils) or combinations of plant oils |
| magnesium | fatigue; muscle pain; restlessness; anxiety; sleep problems; abnormal heart rate | dark green leafy greens; nuts; seeds; beans; lentils; milk; yogurt; brown rice; salmon; halibut; chicken | 320 mg/day for women; 420 mg/day for men |
| B vitamins | anemia; fatigue; weakness; constipation; loss of appetite; weight loss; numbness, tingling in hands, feet; balance problems; depression; confusion; soreness in mouth, tongue | whole grains; dairy products; nuts; seeds; dark green leafy vegetables; beans; lentils | B-complex supplement daily |
| Calcium | bone density loss; muscle spasms, cramps; weak, brittle nails; numbness, tingling in hands, feet, face; confusion; memory loss | green leafy vegetables; beans; almonds; tofu; tahini; dairy products; fish and seafood | 1,000–2,500 mg/day |
Did you know?
Athletes can run the risk of low levels in several nutrients like iron, potassium, calcium, and B vitamins and also need to pay special attention to calorie, carb, and protein intake as well as hydration.
Lactose-free diets
What does it mean?
Lactose is a sugar in milk and milk products that causes problems for people whose bodies don’t have enough lactase, an enzyme needed to digest lactose. Lactose-intolerant people can experience symptoms like gas, bloating, diarrhea, and other gastrointestinal upset after eating lactose-containing foods.
What you might be missing
Although all nutrients available in milk products can be easily sourced from other foods, if you avoid lactose, special attention should be paid to calcium and vitamin D sources.
Nutrient |
Signs of deficiency |
Foods to eat |
Supplement |
| calcium | bone density loss, muscle spasms | green leafy vegetables; almonds; tofu; tahini; sardines/salmon with bones | 1,000–2,500 mg/day |
| vitamin D | muscle pain and weakness; bone pain; increased risk of certain cancers and autoimmune diseases; immune dysfunction | fortified soy/rice/almond beverages; oily fish; egg yolks | 600–4,000 IU per day |
| vitamin B12 | anemia; fatigue; weakness; constipation; loss of appetite; weight loss; numbness and tingling in hands and feet; difficulty maintaining balance; depression; confusion; soreness of mouth or tongue | B12-fortified cereals; fortified soy products; coconut/rice/oat/almond milk; nutritional yeast; meat; poultry; fish and seafood | 1,000 mcg twice weekly, or a lower dose daily as part of a B complex |
Did you know?
About 1 in 6 Canadians reported being lactose intolerant (in a recent study).
When to suspect lactose intolerance
People vary in their response to lactose, depending upon the degree of their intolerance, but also upon how much lactose is in the foods you eat.
Common symptoms of lactose intolerance include
- bloating
- gas
- cramping
- nausea
- diarrhea
- weight loss (mostly in children)
What to look for on the label
Lactose isn’t just confined to milk and milk products. Lactose can be lurking in foods you may not suspect—so it’s important to check the label information for ingredients that might be masquerading under a different name. Here are just a few ingredients to watch out for.
- milk solids
- whey
- lactose
- curds
- cheese flavour
- malted milk
- non-fat milk solids
- buttermilk
- cream
- non-fat milk powder
Michelle von Hahn
Alexa Everett
Laura Bolt
Gail Johnson