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Healthy You

Vegan, Vegetarian, Pescatarian, Flexitarian and Macrobiotic Diets – What’s the Difference?

Wednesday, June 26, 2019 4:30 PM

By: Lauren McRae

What exactly is the difference between a vegan and a vegetarian? How about a pescatarian and a flexitarian? Macrobiotic may be a new dietary term to you as well. We asked Vanessa Lennie, MS, RDN, LDN, Oncology Nutrition to give us a breakdown of what’s included and not included in each of these diets.

Difference Between Diets


This diet eliminates meat, fish, poultry, eggs and dairy products, as well as other animal-derived products, such as honey. On this diet you are also restricted from rennet, gelatin, collagen and other types of animal protein; stocks or fats derived from animals.

Veganism also goes a little further than just dietary decisions. Strict vegans also extend their choices to any product that directly or indirectly involves the human use of animals. These products include leather goods, wool, silk, beeswax, cosmetics tested on animals, latex products that contain casein (which comes from milk proteins), and certain soaps and candles derived from animal fats.


Vegetarians abstain from the consumption of all animal flesh products, like red meat, fish and poultry. This may also include the abstention of by-products of animals processed for food. Apart from the health benefits of possibly reducing your risk of chronic diseases, it’s also adopted for ethical or environmental reasons.

There are several sub-types of vegetarians:

Lacto-ovo-vegetarian diet: Eliminates meat, fish and poultry but allows eggs and dairy products. 
Lacto-vegetarian diet: Eliminates meat, fish, poultry and eggs but allows dairy products. 
Ovo-vegetarian diet: Eliminates meat, fish, poultry and dairy products but allows eggs.

Some vegetarians also apply some of the vegan principles to their lifestyle, by avoiding goods involved in animal testing or created with animal-like leather goods.


This diet abstains from eating all meat and animal flesh (like red meat and poultry) with the exception of fish. A pescatarian is someone who maintains a vegetarian diet with the addition of fish and other seafood like shrimp, mussels, salmon, crabs and lobster.

However, a pescatarian is not considered a vegetarian—the diets are separate from each other. A vegetarian diet excludes all animals.

Pescatarians are allowed beans and legumes like tofu and tempeh, vegetables, grains, fruits and dairy products. One benefit of this diet is the moderate consumption of fish or fish oils, which are high in Omega-3 fatty acids, a necessary part of one’s diet.


This includes people who eat mostly vegetarian but occasionally eat meat which includes red meat, poultry, seafood and fish. Also referred to as a semi-vegetarian, when they do choose to meat, it’s sometimes free-range or organic animal products. There is no firm definition as to how much meat you should eat during the week, whether it’s once a day, once a week or occasionally, this diet is up to the individual person. 


Popularized by the Japanese, the Macrobiotic diet isn’t just about eating certain foods, it’s also about achieving balance in your life through food choices. Macrobiotic dieters are encouraged to eat regularly, chew their food thoughtfully, listen to their bodies, be active and maintain a positive mental outlook.

Macrobiotic eaters can have whole grains, vegetables and beans. About 40-60 percent of the diet should be organically-grown whole grains, like brown rice, barley, millet, oats and corn. 20 to 30 percent of the diet should be vegetables (with a high emphasis on Asian vegetables like daikon and bok choy, and sea vegetables, like seaweed, nori and agar). 5 to 10 percent of the diet is dedicated to beans and legumes, like tofu and tempeh.

You can have fresh fish and seafood, locally-grown fruit, pickles and nuts. Rice syrup is one of the sweeteners you can have occasionally.

Macrobiotic eaters do not eat dairy, eggs, poultry, red meat, refined sugars along with tropical fruits, fruit juice and certain vegetables like asparagus, eggplant, spinach, tomatoes and zucchini. Also, anything spicy is strongly discouraged along with strong alcoholic beverages, soda, coffee and anything refined, processed or chemically-preserved.

This diet even goes as far as to determine which kind of kitchenware to use. Cooking utensils should be made from certain materials such as wood or glass, while some materials like plastic, copper and non-stick coatings should be avoided.

Final Thought: 

One thing that all of these dietary patterns have in common is this: choose whole foods and foods with minimal processing and little added sugar and fat. A plate that regularly contains fried foods, sweets and other highly processed foods with added sugar and fat isn’t healthy.

To determine which diet is right for you, contact a registered dietitian nutritionist to help you navigate the pros and cons of each while meeting the needs for your body and lifestyle!