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While the benefits of eating green are plentiful, it is vital to also understand its nuances to mitigate the risks of sarcopenia.

THE RISE IN VEGETARIAN ALTERNATIVES TO LOCAL FAVOURITES, such as bak kwa and chicken rice, underscores Singapore’s growing taste for plant-based diets. Data from abillion¹, a Singapore-based app that tracks vegan food and cruelty-free products, provides evidence of this shift, showing a doubling in vegan dishes served at local restaurants between 2019 and 2020.

This upward trend resonates with an expanding demographic of residents embracing vegetarian and vegan lifestyles. While both champion plant-based nourishments, they derive from distinct dietary philosophies. Vegetarians, while refraining from meat, poultry and fish, may still consume dairy or eggs. Vegans, on the other hand, remain resolute, only focusing on plant-based ingredients and shunning all animal derivatives.

The motivations for such dietary choices are multifaceted, ranging from sustainability concerns to animal welfare. Notably, health is also an influential motivator. Research² suggests that a vegetarian lifestyle could substantially lower cancer risks by as much as 14 per cent.

Mr Gerard Wong, Senior Dietitian, Parkway Cancer Centre, associates this to the overall benefits of a plant-based diet: “A lower intake of saturated fat and cholesterol can play a role in reducing the risk of certain cancers. It can also lower heart disease risk.” But he cautions against an over-reliance on processed plant-based foods, which are often loaded with sodium and other preservatives. “These may not be as beneficial as you would expect,” he says. “Not every green-labelled food is golden for your health.”

FUELLING RESILENCE

Plant-based diets may aid in cancer prevention, but how do they fare for those already dealing with cancer? Along with cancer, many patients face sarcopenia, a condition characterised by muscle decline. Prolonged periods of inactivity brought on by cancer, along with ageing, can trigger this muscle loss.

However, sarcopenia is not just an inconvenient by-product of cancer. If overlooked, it can adversely affect outcomes of cancer patients, from reduced tolerance to treatment to heightened risk of complications such as infection and impaired immunity.

Sarcopenia is often treated with resistance exercises and dietary changes, particularly increasing one’s protein intake. For the average adult, the recommended dietary allowance for protein is 0.8g of protein per kg of body weight every day. That means someone who weighs 60kg will require about 48g of protein every day, while someone who weighs 70kg will need 56g of protein. “This number goes up for patients with sarcopenia,” says Mr Wong. “To address sarcopenia, we should aim for anything between 1g and 1.2g of protein per kg of body weight per day.”

Contrary to popular belief, people can also get protein from non-animal sources. “When we think of protein, it is mostly animal products we turn to — meat, chicken, fish,” says Mr Wong. “But there is protein in tofu and nuts as well. Many carbohydrate-rich foods, like rice and bread, are also good sources of protein.”

However, people on plant-based diets may have to consume larger amounts to match protein from meat sources. For example, 50g of fish can provide 10g of protein. To equal that amount, a vegetarian would have to eat 120g of tofu.

Animal and plant proteins are not formulated the same way either. “In general, plant proteins are less complete than animal proteins. Those on plant-based diets need to combine different types of plant proteins to get their essential nutrients,” advises Mr Wong. He recommends using a simple formula to map out your protein intake:

Group 1 + Group 2A or 2B or 2C = Complete protein Intake

Group 1 Baked beans, lentils, soya beans, chickpeas, split peas
Group 2A: Rice, pasta, bread
Group 2B: Almonds, walnuts, cashews
Group 2C: Pumpkin seeds, sesame seeds, sunflower seeds

MUSCLE MATTERS

While adequate protein intake is fundamental, it alone cannot ward off sarcopenia. Patients should also engage in strength training to help build and retain muscle. “Weight-bearing exercises are important for the maintenance of muscle mass,” says Mr Wong. “Together with a protein-rich diet, they can help reduce functional decline and the loss of independence that is commonly seen in ageing adults.”

A sample protein meal plan

“In general, plant proteins are less complete than animal proteins. Those on plant-based diets need to combine different types of plant proteins to get their essential nutrients.”

Mr Gerard Wong, Senior Dietitian, Allied Health, Parkway Cancer Centre

¹ https://www.channelnewsasia.com/singapore/vegan-plant-based-food-growing-market-2899661
² https://www.ndph.ox.ac.uk/news/new-study-finds-lower-risks-of-cancer-for-vegetarians-pescatarians-and-low-meat-eaters