Vegetarian and vegan diets for ostomates

10 May, 2021

Consultant Dietitian Sophie Medlin has written some fantastic advise for vegetarian and vegan ostomates (and those looking to include more plants in their diet).

It’s national vegetarian week in the UK so it’s a great time to talk about plant-based diets! Most people won’t be surprised to hear that the number of people following vegetarian and vegan diets has risen by 40% in recent years. Adding more plants (fruit, vegetables, whole-grains, pulses/beans, nuts and seeds) is ideal for our overall health but can be challenging when you live with a stoma.

It’s also important to recognise that there is a significantly higher risk of nutritional deficiencies on vegan and vegetarian diets. This is because there are certain nutrients that we can’t get from plants or that are only available in much lower quantities. In particular, plant based eaters need to be more careful not to become deficient in vitamin B12, vitamin D, zinc, iron and omega-3 fatty acids.

There is an added complexity for vegetarians and vegans living with an ileostomy as the same nutrients that are lacking on a vegan diet are also more likely to be deficient.

Research tells us that 17% of people with an ileostomy have iron deficiency anaemia, 31% of the ileostomy population are deficient in vitamin B12, 13% of the ileostomy population are vitamin D deficient and 8% of the ileostomy population are zinc deficient. Unfortunately, this work hasn’t been done for people living with a urostomy or colostomy.

This means that vegetarian or vegan people living with an ileostomy can be deficient in these nutrients because of their stoma lowers absorption AND because their diet contains less which is double the risk.

That doesn’t mean that anyone with a stoma can’t or shouldn’t follow a plant based diet, it just means that more time and energy will need to be put into planning and supplementing the diet appropriately.

Similarly, many people living with a stoma may struggle to increase their plant based foods in their diet due to the fibre content disrupting stoma function. As always, this does not mean we shouldn’t be trying to increase these foods regardless of whether we choose to cut out animal products.

Some tips for including more plant based foods in your diet include:

• Blending beans and pulses into dips (hummus) and pastes for added plant based protein.
• Ensuring you have at least two vegetables with lunch and your evening meal and a portion of fruit in the day.
• If you struggle with veg, try vegetable juices, smoothies or soups as an alternative.

As vegetarian and vegan products have become more available, it is a great time to experiment with some of the red meat alternatives, particularly if you have had bowel cancer in the past. Choosing soya or Quorn mince in place of beef mince will be a healthier option. Unfortunately, ‘vegan’ doesn’t always mean healthy so we still need to be careful of highly processed vegan foods.

Overall, if you’re not vegetarian or vegan, remember, more plants in our diets is always a good thing so consider this week a nudge to have a think about where you can get more in! If you are on a plant based diet and you live with a stoma, be aware of those deficiencies and ask your stoma team or GP to screen your bloods for deficiencies. There are some great plant based supplements on offer to top up your diet and some excellent resources from the Vegan and Vegetarian Society to help you to plan an optimal plant based diet.

If you have any queries about vegetarian or vegan diets, supplements or anything relating to your digestion check out our World Digestive Day webinar on 29th May: https://www.colostomyuk.org/get-involved/world-digestive-day-webinar/