DEAR DR. BLONZ: I go to the gym regularly, but have been having problems with cramped muscles in my shoulder that have been slow to heal. Some friends tell me that it is not healing correctly because I do not eat red meat. Could this be true? Is there anything I should supplement my diet with because I do not eat red meat? -- S.T., San Jose, Calif.
DEAR S.T.: Good nutrition is good nutrition whether you eat red meat or not. You did not mention whether you consume other animal products, but even if not, there should be no problems with a balanced diet. If you are a vegetarian, however, there are a few nutrients you need to pay attention to, including protein, vitamin B-12, calcium, iron, zinc and vitamin D.
Of these, protein is the least likely to be a problem. Amino acids are the building blocks of protein, and of the 20 different amino acids, our body can manufacture all but nine. These nine, referred to as the essential amino acids (EAAs), need to be supplied in our diet. Most foods contain some amino acids. Animal proteins, such as meat, poultry, fish, eggs and dairy are considered "complete" proteins because they contain all nine EAAs.
Except for soybeans, vegetable proteins such as grains and legumes are incomplete proteins because they lack one or more of the EAAs. But people who eat a vegetarian diet, or even a vegan diet (no animal products), can easily meet their daily protein requirements by combining different foods so that sufficient amounts of all the EAAs are consumed during the day.
One nutrient that may be a potential problem is vitamin B-12. Needed for red blood cells and nerve tissue, vitamin B-12 is only found in bacteria and animal foods. Vegetarians can use specially fermented soy products, such as tempeh or miso, as a dietary source of B-12; another option is to rely on foods fortified with it.
If you consume dairy products, you shouldn't have any problems with calcium. Otherwise, you will have to rely on calcium-rich foods like broccoli; dark green leafy vegetables, such as kale and turnip greens; calcium-set tofu; calcium-fortified soy milk and orange juice; almonds; figs and some legumes.
Red meat is an excellent source of iron, but it can be found dark green leafy vegetables, legumes, raisins and prunes. Iron absorption is facilitated by acidic foods, such as citrus juices and vitamin C. Zinc, which can also be in short supply without red meat, can be found in nuts, seeds, whole grains and legumes.
Vitamin D, needed for calcium absorption and bone formation, is another nutrient that's not widely available in vegetarian cuisine. Besides food sources such as fish and vitamin D-fortified milk products, the body produces this nutrient upon exposure to direct sunlight. Again, the alternative is to rely on a fortified food or a supplement.
A supplement can be a convenient alternative for any of the above nutrients.
In your question, however, you mention a muscle problem that is not healing. I would encourage you to consider a consultation with a physical therapist. While such a practitioner will not solve any dietary deficiencies, he or she can help you with specific exercises to help strengthen the affected muscle.
Send questions to: "On Nutrition," Ed Blonz, c/o Universal Uclick, 1130 Walnut St., Kansas City, MO, 64106. Send email inquiries to firstname.lastname@example.org. Due to the volume of mail, personal replies cannot be provided.