The vegetarian diet composed of "organically grown" foods comes the closest to following the general nutritional guidelines recommended throughout this book. A high-fiber, high-complex-carbohydrate, nutrient-rich diet composed mainly of whole grains, legumes, vegetables, fruits, nuts, and seeds will provide all the nutrients we need. Whether vegetarian or not, this should be the basic foundation of all health-oriented diets. It is also more alkaline and higher in most vitamins and minerals than any other type of diet. Only small amounts of milk products, eggs, or various animal fleshes might be added to the vegetarian diet to make it easier to obtain the necessary calcium, iron, and B12.

Protein is always the big topic of discussion when it comes to vegetarianism. Eating complementary proteins, such as grains or seeds with legumes, or eggs or dairy foods with any of the vegetable proteins, is the usual suggestion for obtaining adequate protein. This is because each specific vegetable protein is low in one or two of the essential amino acids so that when eaten alone it does not provide equivalent levels of all the essential amino acids required to build our tissue proteins. When we eat some legumes, which are high in lysine and isoleucine and low in tryptophan and methionine, with grains, which have the opposite strengths and weaknesses, we obtain all of our essential amino acids in more equal levels. If the digestion of proteins and the assimilation of amino acids and peptides is normal, then a minimum daily requirement of protein should be in the range of 40–50 grams (about 1H–2 ounces).

Several noted authors have recently suggested that we do not need to be as concerned about complementary proteins as was previously thought. Frances LappŽ, who proposed the idea of complementing proteins in Diet for a Small Planet, now suggests that our body can find the needed amino acids when any plant protein food has been eaten over the day. Though I have felt that this might be true, I have not seen any conclusive research, which might be hard to conduct, about this issue. On the other hand, it would seem that when there is any malnutrition and subsequent deficiency or low body stores of certain nutrients, in this case amino acids, it would be more difficult to manufacture necessary body proteins from consistent meals containing incomplete proteins eaten over several days. In that situation, or when food intake analyses or blood tests suggest inadequate protein intake or assimilation, we then must focus more on protein consumption and, possibly, digestion. Otherwise, a balanced vegetarian diet should pose no concerns about adequacy of protein intake.

Given the current knowledge and an attitude of "better safe than sorry," I still suggest combining vegetable proteins at meals or at least in the same day to create a complete profile of essential amino acids. Protein deficiency, though much rarer than most people fear, can cause some problems. With a more stressful lifestyle or a high level of athletic activity, protein needs may be increased, and thus, more high-protein foods are required. Fatigue is a common problem in vegetarians with low-protein diets. Weight loss and low body weights are also more likely with this type of diet. Another concern I have is that amino acids and proteins are very important to the immune system. I commonly see lower white (and red) blood cell counts in vegetarians, likely due to not having all the cell-building nutrients available, particularly protein. If the immune system is weakened by a low nutrient availability, especially in combination with high stresses, infectious disease is much more likely. In the digestive analyses of my patients I also see a higher amount of parasites and intestinal yeast overgrowth present in the vegetarians. This may be due to the lower protein and higher sweet diet which appears more common with inadequate protein intake—more vegetable-based foods are higher in carbohydrates and sweet flavors, plus many vegetarians crave sweet foods. It may also result from a more alkaline system, which supports growth of parasites and yeasts, or low immunity. In most of these cases, I recommend a higher-protein, wholesome food diet. I may even suggest the additional L-amino acids to ensure that all are present for immune functions, though most amino acid formulas are not "vegetarian derived."