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Dietary intake and nutritional status of young vegans and omnivores in Sweden
Abstract
Background: Adolescents sometimes become vegetarian for ethical rather than health reasons. This may result in health problems caused by lack of interest in and knowledge of nutrition.
Objective: We compared the dietary intake and nutritional status of young Swedish vegans and omnivores.
Design: The dietary intakes of 30 vegans (15 males and 15 females; mean age: 17.5 ± 1.0 y) and 30 sex-, age-, and height-matched omnivores were assessed with the use of a diet-history interview and validated by the doubly labeled water method and by measuring nitrogen, sodium, and potassium excretion in urine. Iron status and serum vitamin B-12 and folate concentrations were measured in blood samples.
Results: The diet-history method underestimated energy intake by 13% and potassium intake by 7% compared with the doubly labeled water method and 24-h urine excretion, respectively. Reported dietary nitrogen and sodium intakes agreed with the 24-h urinary excretion measure. Vegans had higher intakes of vegetables, legumes, and dietary supplements and lower intakes of cake and cookies and candy and chocolate than did omnivores. Vegans had dietary intakes lower than the average requirements of riboflavin, vitamin B-12, vitamin D, calcium, and selenium. Intakes of calcium and selenium remained low even with the inclusion of dietary supplements. There was no significant difference in the prevalence of low iron status among vegans (20%) and omnivores (23%). Two vegans with low intakes of vitamin B-12 had low serum concentrations.
Conclusion: The dietary habits of the vegans varied considerably and did not comply with the average requirements for some essential nutrients.
... Compared to an omnivorous diet, the vegan diet is characterized by a higher intake of dietary fiber, but a lower overall fat intake, in particular less cholesterol and saturated fatty acids. Micronutrients such as vitamin C, folic acid, and copper are consumed more [5][6][7][8][9][10][11]. However, limiting food choices can lead to inadequate intake of some nutrients, such as vitamin D, B 2 , B 12 , calcium, iron, iodine, and zinc [7,8,[10][11][12]. ...
... Micronutrients such as vitamin C, folic acid, and copper are consumed more [5][6][7][8][9][10][11]. However, limiting food choices can lead to inadequate intake of some nutrients, such as vitamin D, B 2 , B 12 , calcium, iron, iodine, and zinc [7,8,[10][11][12]. Also, selenium might not be sufficiently supplied by a vegan diet [7,8,11]. ...
... Therefore, it is very difficult to use standard nutritional survey data to estimate selenium intake because, particularly for plant-based foods, there are large differences in selenium concentrations depending on the geographical region in which they have been grown [15,27,28]. Subject to this, it has been described that due to the lower selenium content in a vegan diet compared to an omnivorous diet, many vegans do not reach the daily intake of 70 and 60 µg for men and women, respectively, recommended by the German Nutrition Society [7,8,10,31]. Since serum selenium concentrations reflect dietary selenium intake, vegans demonstrate lower levels compared to individuals following other dietary patterns, indicating a poorer selenium status [6,[32][33][34]. ...
Purpose
A vegan diet is associated with health benefits but may also lead to inadequate intake of essential nutrients. Due to the lower selenium content in plant-based compared to animal-based foods, many vegans do not reach the recommended selenium intake in Europe. The only plant-based food with high selenium content is the Brazil nut, even though there is also a high variability. Therefore, we investigated the effectiveness of Brazil nut butter compared to a dietary supplement as selenium source to improve the selenium status of vegans and omnivores.
Methods
44 vegans and 42 omnivores were randomly assigned to one of three intervention groups, either receiving placebo or consuming additional 55 µg of selenium daily as Brazil nut butter or supplement for two weeks. Serum selenium concentrations, glutathione peroxidase 3 (GPX3), and selenoprotein P (SELENOP) were measured at baseline and after intervention. Additionally, dietary selenium intake was estimated using a five-day dietary protocol.
Results
The estimated selenium intake was significantly lower in vegans compared to omnivores and correlated with all three selenium biomarkers. Independent of the dietary pattern (vegan or omnivore), Brazil nut butter as well as supplement significantly increased serum selenium and SELENOP concentrations, while there were no changes in the placebo groups. Both interventions were equally effective in increasing selenium levels, but the upregulation of SELENOP was more pronounced in vegans than in omnivores.
Conclusion
Brazil nuts are a plant-based source of selenium suitable for vegans and omnivores to improve their selenium status when consumed once in a while.
Trial registration number and date of registration
Clinical trials registration number: NCT05814874, April 18 2023.
... Despite numerous of systematic reviews pointing out that the nutrient adequacy of plant-based diets depends on the type and quantity of food groups consumed, and currently, there is very limited knowledge on the food group intake among young people who adhere to plant-based diets [16][17][18]33]. In the most recent systematic review among children and adolescents comparing plant-based diets to omnivores [17], six out of 33 studies had subjects in the age range of 16-18 years [34][35][36][37][38][39], in which only three of them examined food group intake [34,35,39], and the remaining three examined iron status. The limited number of studies available among youth who follow different types of plant-based diets highlights the need for more studies. ...
... Despite numerous of systematic reviews pointing out that the nutrient adequacy of plant-based diets depends on the type and quantity of food groups consumed, and currently, there is very limited knowledge on the food group intake among young people who adhere to plant-based diets [16][17][18]33]. In the most recent systematic review among children and adolescents comparing plant-based diets to omnivores [17], six out of 33 studies had subjects in the age range of 16-18 years [34][35][36][37][38][39], in which only three of them examined food group intake [34,35,39], and the remaining three examined iron status. The limited number of studies available among youth who follow different types of plant-based diets highlights the need for more studies. ...
... One of the studies that examined food group intake was published in 2002 by Larsson et al, among Swedish vegans and omnivores in the age range 16-20 years (vegans n = 30, omnivores n = 30) [35]. Similar to our findings, the study found the highest consumption of vegetables and legumes among vegans compared to omnivores. ...
Background
Knowledge about the diet quality among youth who follow different types of plant-based diets is essential to understand whether support is required to ensure a well-planned diet that meets their nutritional needs. This study aimed to investigate how food groups, macronutrient intake, and objective blood measures varied between Norwegian youth following different plant-based diets compared to omnivorous diet.
Methods
Cross-sectional design, with healthy 16-to-24-year-olds (n = 165) recruited from the Agder area in Norway, following a vegan, lacto-ovo-vegetarian, pescatarian, flexitarian or omnivore diet. Participants completed an electronic questionnaire, a dietary screener, 24-hour dietary recalls and provided dried blood samples for analysis of carotenoids and fatty acids.
Results
Vegans reported the highest mean intake (g/d, g/MJ) of vegetables, legumes, nuts and seeds and substitutes to dairy and meat (compared to all, p<0.001), fruit and berries (compared to omnivores, p = 0.004 and pescatarians, p = 0.007), and vegetable oil (compared to omnivores, p<0.001, pescatarians, p = 0.003 and flexitarians, p = 0.004) and vegetable products (compared to omnivores, p = 0.007). No difference was found between groups in mean intake (g/d, g/MJ) of any of the confectionary foods or sweet pastries, beverages (sugar-sweetened, non-sugary, alcoholic), or salted snacks, neither in g/MJ of convenience foods. The energy percentage (E%) of protein, carbohydrates and total fat were within the Nordic Nutrition Recommendations 2023 across groups. However, all groups, except vegans, exceeded the E% for saturated fatty acids. All groups exceeded recommendations for added and free sugar. Furthermore, all groups consumed <25g/d of dietary fibre, except vegans and pescatarians. For omega-3, lacto-ovo-vegetarians had intakes below recommendations. Blood marker of total carotenoids did not differ between groups, neither did the reported mean intake (g/MJ) of carotenoid-rich foods. Vegans showed the lowest blood level of palmitic acid compared to all (p<0.001), but highest level of linoleic acid (compared to flexitarians, p = 0.022, and omnivores, p<0.001). The lowest blood levels of eicosapentaenoic acid and docosahexaenoic acid were found in vegans and lacto-ovo-vegetarians.
Conclusions
Our findings suggest that all groups had risk of dietary shortcomings. However, vegans consumed the most favorable diet. All groups should increase their consumption of vegetables, fruits and berries, and reduce their total sugar intake.
... Three studies reported on niacin intake in children or adolescents from Finland, Sweden, and the UK [26,27,39], two of which assessed intake from foods alone. In all studies, niacin intake across dietary patterns was well above the EAR of the respective age and gender groups. ...
... In all studies, niacin intake across dietary patterns was well above the EAR of the respective age and gender groups. Out of two studies that compared niacin intake from foods between dietary patterns, one found significantly lower intake in vegans compared to meat eaters [39]; the other found no significant difference in the intake of vegan and vegetarian children and adolescents compared to meat eaters [27]. Two studies that included intake from foods and supplements found similar [27] or significantly lower niacin intake [26] in vegetarians but a significantly higher niacin intake in vegans compared to meat eaters [27]. ...
... Two studies reported on the prevalence of zinc intake below the DRV among young and school-age children in the UK and Ghana, with no significant differences between dietary patterns [23,26]. Most (i.e., 8/9) studies also found no significant difference in zinc intake from foods alone or from foods and supplements between dietary patterns, except for one study among Swedish adolescents that showed a significantly lower zinc intake from foods in vegans compared to meat eaters [39]. ...
Health authorities increasingly recommend sustainable and healthy diets rich in plant foods and with moderate amounts of animal foods. However, there are concerns about whether such diets can meet all nutrient requirements, especially in children and adolescents, who have relatively high nutrient needs for growth and development. Therefore, we aimed to evaluate the nutrient intake and status of children and adolescents (2–18 y) consuming plant-based (i.e., vegetarian and vegan) diets compared to those of meat-eating children following a systematic literature review of studies published between 2000 and 2022. Mean intake and status data of nutrients were calculated across studies and benchmarked to dietary reference values and cut-off values for nutrient deficiencies. A total of 30 studies were included (15 in children 2–5 y, 24 in children 6–12 y, and 11 in adolescents 13–18 y). In all diets, there were risks of inadequate intakes of vitamin D and calcium. Children consuming meat had a risk of inadequate folate and vitamin E intake; and mean fiber, SAFA, and PUFA intakes were not in line with the recommendations. Children consuming plant-based diets risked inadequate vitamin B12, iron, and zinc intakes. In contrast to vegans, vegetarian children may not meet the recommended intakes of fiber, SAFA, and possibly PUFA, but their mean intakes were more favorable than in meat-eating children. Although the data are limited and need further validation, our findings indicate that there are risks of nutritional inadequacies in all diet groups. Therefore, increasing consumption of a variety of plant-based foods, in combination with food fortification and supplementation where needed, is recommended for children and adolescents to have sustainable and nutritionally adequate diets.
... However, the impact of cooking (heating and leaching) and processing on the available vitamin content should not be neglected [34]. Compared to intakes of these vitamins in omnivorous children, those in vegetarians and vegans have been shown either identical or even higher in most studies, especially in vegans [35][36][37][38][39][40][41][42][43][44][45][46][47][48][49]. Lower intake of vitamin B2 has been reported in children following a macrobiotic diet compared to omnivores [35]. ...
... On the other hand, the dietary intake of vitamin D is very limited and can only come from infant's and young child's formulas and to a lesser extent from some fatty fishes or even less from some mushrooms [50][51][52][53][54]. Compared to the intake in omnivorous children, no study found a difference in vegetarian children [45][46][47], but one found a lower intake in vegan children [41]. ...
... The reported intakes of vitamin B12 in children are depicted in Figure 1. The more the diet restricts ASF intake and the longer the compliance with this restriction, the lower the intake [35,36,[39][40][41]43,[46][47][48][49]74,75]. a vegetarian mother [68]. ...
Vegetarian diets have gained in popularity worldwide and therefore an increasing number of children may be exposed to the resulting nutritional consequences. Among them, the risk of micronutrient shortfall is particularly of concern. This narrative review aims to assess and discuss the relevance of micronutrient deficiency risk based on the available data. It mainly draws attention to iron, zinc, iodine, and vitamins B12 and D intake. Diets that are more restrictive in animal source foods, such as vegan diets, have a greater likelihood of nutritional deficiencies. However, the actual risk of micronutrient deficiency in vegetarian children is relatively difficult to assert based on the limitations of evidence due to the lack of well-designed studies. The risk of vitamin B12 deficiency must be considered in newborns from vegan or macrobiotic mothers and children with the most restrictive diet, as well as the risk of iron, zinc, and iodine deficiency, possibly by performing the appropriate tests. A lacto-ovo-vegetarian diet exposes a low risk if it uses a very varied diet with a sufficient intake of dairy products. Vegan and macrobiotic diets should be avoided during pregnancy and childhood. There is a need for education and nutrition guidance and the need for supplementation should be assessed individually.
... A higher intake of vitamin C in vegans could also potentially increase the low bioavailability of nonheme iron found in plant-based foods 29 . Similar to the previous findings 27,29,38,45 , vegans in our study had higher intakes of magnesium, which is attributed to increased consumption of vegetables and fruits. Magnesium bioavailability is also affected by factors such as phytic acid and oxalate and should be considered when planning a vegan diet 29 . ...
... However, vegans exhibited a significantly lower margarine consumption in our research while Elorinne et al. 26 reported a statistically higher margarine consumption in their study. In accordance with the results of previous studies 26, 38 , vegans (both men and women) showed statistically higher consumption of vegetables and fruits compared with omnivores. Refined cereals have lower dietary fiber, iron, and vitamin B groups compared to whole grains 16 . ...
... In our study, consumption of refined grains and white bread was lower in vegans than omnivores. Similar to the previous studies 6,27,38,46 , we observed significantly lower consumption of sugars, jams, and chocolate among vegans compared with omnivores. ...
Background: Veganism is gaining more interest in Turkey, however, there is limited data on the nutritional intake of Turkish vegans. Aims: This cross-sectional online study aimed to evaluate the nutritional intake of Turkish vegans and compare their macro and micronutrient intake with Turkish omnivores. Subjects and Methods: This cross-sectional online study was conducted in İstanbul from October 2019, until December 2019. 108 Turkish adult vegans and 108 omnivores completed a sociodemographic questionnaire and a 3-day dietary recall online. The energy, macro-, and micronutrient intake were evaluated from the dietary recall via the dietary analysis program BEBIS 8.1, using the Turkish Food composition database. The dietary intake was compared to the Turkey Dietary Guideline. The Healthy Eating Index 2015 (HEI – 2015) was calculated as a diet quality indicator. Statistical analyses were performed with SPSS version 22.0. Results: Mean protein intake was 66.16 ± 21.69 g in vegan women and 74.87 ± 21.90 g was in omnivorous women (p < 0.05), and 75.53 ± 29.09 g in vegan men and 88.89 ± 28.48 g in omnivorous men (p > 0.05). Both male and female vegans had significantly higher dietary intakes of thiamine, vitamin C, iron, magnesium, potassium, and copper; with significantly lower intakes of riboflavin, vitamin B12, vitamin D, calcium, iodine, phosphorus, zinc compared to omnivores of both sexes. Vitamin B12, riboflavin and calcium intakes were below the recommendations in vegans as compared to omnivores for both sexes (p < 0.001). Vegan participants showed a significantly higher intake of total fruits, vegetables, nuts, seeds, and legumes compared to omnivorous participants (p < 0.001). HEI – 2015 scores were 58.18 ± 13.20 in vegans and 68.74 ± 7.72 in omnivores (p < 0.001). Conclusions: Turkish vegans, in our study, had a well-balanced and healthy macronutrient intake with lower saturated fatty acids (SFA) and higher fiber intake. However, vegans showed a lower intake of micronutrients such as vitamin B12 and calcium. This indicates a need for greater care toward ensuring recommended daily intake of these specific micronutrients. Further research is required to evaluate dietary intake and nutritional biomarkers in Turkish vegans for the long-term effects of vegan diets. Keywords: dietary assessment, dietary intake, macronutrients, micronutrients, vegan diet.
... In fact, and especially for more strict dietary patterns, the long-term success of a healthy diet and the guarantee of the nutritional needs can increase with the follow-up from nutrition specialists [54]. Also, a significantly higher proportion of vegetarians compared to omnivorous individuals taking micronutrient supplements was also noted in previous studies [55][56][57][58], especially with regards to vitamin B12. This suggests that vegetarians may be aware of the possible negative health impacts of their stricter diet, thus adopting behaviors to tackle this potential problem. ...
... This suggests that vegetarians may be aware of the possible negative health impacts of their stricter diet, thus adopting behaviors to tackle this potential problem. Importantly, our study indicates a higher prevalence of B12 supplementation among vegans (93%), when compared with other studies [55,57,58] showing a prevalence between 20% and 52%. ...
Objectives: This study aimed to compare the anthropometry and body composition of vegetarian and omnivorous adults living in Portugal, while exploring nutritional and health parameters underlying observed differences. Methods: 425 omnivorous (OMNI), lacto-ovo-vegetarian (LOV), or vegan (VEG) healthy adults were recruited. Anthropometry was measured, and bioelectrical impedance analysis was performed. Participants answered food frequency, sociodemographic, and lifestyle questionnaires. Serum iron, ferritin, and CRP were quantified by spectrophotometry, and serum B12 vitamin and homocysteine were quantified by chemiluminescent microparticle immunoassay. Results: Total protein intake significantly decreased with increasing strictness of vegetarian habits (median (P25; P75) in g/day: 98.6 (79.5; 123.1), 90.4 (65.9; 121.0), and 87.6 (59.8; 118.5) for OMNI, LOV and VEG, respectively; p = 0.020), and carbohydrate intake was the highest in LOV (median (P25; P75) in g/day: 231.5 (178.4; 287.9), 283.9 (227.3; 342.6), and 263.0 (222.0; 348.3) for OMNI, LOV and VEG, respectively; p = 0.001). VEG were the main users of B12 vitamin (93% in VEG vs. 17% in OMNI and 59% in LOV, p = 0.001), and LOV were the main users of iron supplements (29% in LOV vs. 14% in OMNI and 13% in VEG, p = 0.042), respectively. Blood levels of B12 vitamin correlated negatively with blood homocysteine (rs = −0.386, p < 0.001) and positively with % muscle mass (rs = 0.136, p = 0.005). Participants using iron supplements presented higher C-reactive protein (CRP) (p = 0.014) and they had lower % MM (p = 0.003). Finally, when compared to being OMNI, being LOV independently associated with: (a) having +4.8% (p = 0.002) of fat mass, which could be due to higher carbohydrate intake, and (b) having −2.2% (p = 0.043) of muscle mass. Our data suggest that the association between diet and muscle mass could be attenuated in VEG due to B12 supplementation and/or aggravated in LOV due to iron supplementation-associated inflammation.
... It has been generally confirmed in all the conducted studies that the amount of vitamin B 2 in the diet increases with the addition of animal-based food in the daily rations. Almost all the authors agree that vegans have less vitamin B 2 in their diet than omnivores [47][48][49][50][51][52][53][54][55][56]. However, Draper et al. [57], Schüpbach et al. [58], Millet et al. [59], Shultz and Leklem [60] didn't find any difference in the intake of vitamin B 2 in different diet groups (table 3). ...
... In the case of vegans, there are slight variations among different authors. Larsson and Johansson [49] have calculated the least intake of the vitamin in males to be 1.2 mg/day, while Draper et al. [57] ob-served the least consumption among females -0.98 mg/day. Data collected by other authors are also pretty close to those numbers [47,48,50,52,54,55,58,61,63]. ...
The main goal of this review was to briefly highlight the key points of today’s knowledge about the role and metabolism of vitamin B2 as well as to compare its status in vegans, vegetarians, and omnivores according to present data. Biologically active forms of water-soluble vitamin B2 (riboflavin) are represented by flavin mononucleotide (FMN) and flavin adenine diphosphate (FAD), which are coenzymes in the reactions of the electron transport chain and the pyruvate dehydrogenase complex. Riboflavin is also involved in the metabolism of fatty acids, the synthesis of cholesterol and steroid hormones. Riboflavin also participates in the folate cycle. Vitamin B2 is crucial for the metabolism of other vitamins. FMN is necessary for the for-mation of the active form of vitamin B6, while FAD is necessary for the synthesis of niacin. Severe clinical insufficiency of vitamin B2 is not common. Besides insufficient riboflavin consumption, hypothyroidism can also be a cause of vitamin B2 deficiency as thyroxine regulates the conversion of ribo-flavin to its active forms FMN and FAD. Lack of riboflavin can cause tissue damage; especially of the epithelial, reproductive, and nervous system. The variety of its manifestations is related to the fact that riboflavin deficiency also disrupts the metabolism of vitamins B6, or PP. Similarly, riboflavin deficiency can also disrupt the folate cycle, increasing the level of homocysteine which damages vascular intima and leads to endothelial dysfunction and atherosclerosis as a result. Rapid urinary excretion of riboflavin makes it safe even if taken in a high dose, changing the urine colour into bright-yellow. This safety of riboflavin makes it unharmful to be used as an oral tracer for monitoring compliance in clinical research. Ultra-high doses of ribo-flavin (more than 400 mg/day) can cause diarrhoea or polyuria. The content of vitamin B2 in animal-derived products is higher than in plant-based ones. This also determines its lower intake in vegans and vegetarians compared to omnivores. While there is a shred of evidence that plant-based diets in-crease the production of bioavailable riboflavin by the gut microbiota, this does not appear to be sufficient to completely compensate for the vegetari-ans’/vegans’ reduced dietary intake of vitamin B2, as most of the researches point the fact that vegans and vegetarians are more prone to lack vita-min B2 than omnivores. At the same time, it should be noted that there exists no universally adopted optimal method for assessing the status of vit-amin B2 in the body. Further research and standardization of methods may ease to assess the prevalence and risks of riboflavin deficiency in various dietary groups
... A priori, the sample size was determined based on a previously conducted study in young Swedish vegans and omnivores that detected group differences with 30 participants in each diet group [23]. Our final sample size was determined by the recruitment feasibility since the study took place during the COVID-19 pandemic. ...
... Also, the importance of consuming fortified foods or supplementing for certain micronutrients when following plant-based diets to compensate for the lower presence of some micronutrients in the diet. Our findings are consistent with previous research [11], including previous findings in young Swedish vegans [23]. Furthermore, our findings are also partly in coherence with ...
Purpose
Whether youth who follow plant-based diets in Nordic countries meet their dietary needs for micronutrients remains unclear. This study aims to evaluate micronutrient intake and status in Norwegian youth following vegan, lacto-ovo-vegetarian, pescatarian, flexitarian and omnivore diets.
Methods
Cross-sectional design, with healthy 16-to-24-year-olds (n = 165). Participants were asked to complete a questionnaire and four 24-hour dietary recalls. Dried blood spots (DBS) and spot-urine samples were collected for analysis of methyl malonic acid (MMA) (n = 65), haemoglobin (Hb) (n = 164) and urinary iodine concentration (UIC) (n = 163).
Results
Vegans reported highest habitual supplement usage of multivitamin (58%), B12 (90%) and macroalgae consumption (32%), while flexitarians reported highest habitual usage of omega-3 supplements (56%). For daily supplement usage, vegans reported highest use of multivitamins (42%), B12 (79%), iodine (37%) and iron (63%). Increased risk of inadequate intake (energy-adjusted) were found for vitamin D (60% within lacto-ovo-vegetarians), selenium (70% within lacto-ovo-vegetarians, 65% within omnivores), and iodine (63% within vegans). Median MMA levels suggest low risk of insufficient B12 status across all groups (MMA 0.04‒0.37µmol/l) and 2% had MMA levels indicating possible B12 deficiency and 8% had elevated levels. Median Hb levels indicated low risk of anemia across all groups (≥ 12.0 females, ≥ 13.0 g/dl males), though 7% had Hb values indicating risk of mild anemia and 4% risk of moderate anemia. The median UIC indicates mild iodine deficiency in all groups (UIC < 100 µg/l), except vegans, who were moderately iodine deficient (UIC < 50 µg/l).
Conclusions
Our study indicated that the participating youth had low risk of inadequate intake of most micronutrients, partly due to high supplement usage. However, for iodine, vitamin D, and selenium higher risk of inadequate intake was found. UIC corroborated the low iodine intake among vegans. Thus, we suggest iodine status of youth in Norway should be monitored, especially among young fertile women who omits dietary iodine sources, until a mandatory iodine fortification program is implemented. Furthermore, we suggest that food education on how to secure sufficient nutrients from food in general should be provided to the Norwegian youth population, especially how to secure adequate intake of vitamin D, selenium and iodine.
... Vegan diet: Due to the widespread use of social networking sites as a platform for opinion-sharing and information sharing, vegan diets may be more well-known now [The Telegraph in ten years, the population of vegetarians in Britain has increased by 360% 2016] promoted by some on the grounds that it lowers blood pressure, LDL, heart disease risk, type II diabetes risk, and cancer risk [Marsh K et al., 2012;Larson C.L. et al., 2002] [24,22] . Even the strict vegan diet, which forbids the consumption of dairy, eggs, meat, and fish, is becoming more and more well-liked, particularly among younger people (Forestell CA et al., 2018) [13] . ...
... Los beneficios de escoger una dieta vegetariana/vegana serán tales siempre que al adoptarla se efectúe una adecuada planificación, para evitar potenciales riesgos en la salud por la carencia de nutrientes críticos cuyo aporte puede verse más comprometido (10)(11)(12) ...
... Compared to omnivores, vegans have higher intakes of fibre, vitamin C and magnesium, but risk deficiencies in several critical nutrients including vitamin B12, calcium, iron, zinc, and vitamin D [10,11]. However, most available studies comparing the nutrition and health status of vegans with those of omnivores have not considered vegan diet quality [4,[12][13][14]. ...
Background
Vegan diets have recently gained popularity in Switzerland as well as globally. The aim of the present study was to develop a diet quality score for vegans (DQS-V) based on the Swiss dietary recommendations for vegans.
Methods
The dataset included 52 healthy vegan adults. Dietary intake data were assessed by three-day weighed food records. Body weight and height were measured, and a venous blood sample for the analysis of vitamin and mineral status was collected. Spearman rank correlation coefficients were used due to not-normally distributed data. Dietary patterns were identified using principal component analysis (PCA).
Results
The DQS-V score (mean ± SD) was 48.9 ± 14.7. Most vegans adhered to the recommended portions of vegetables, vitamin C-rich vegetables, fruits, omega-3-rich nuts, fats and oils, and iodized salt. However, the intake of green leafy vegetables, vitamin C-rich fruits, wholegrains, legumes, nuts and seeds, selenium-rich nuts, zero caloric liquid, and calcium-fortified foods was suboptimal. The sample overconsumed sweet-, salty-, fried foods, and alcohol. The DQS-V had a significantly positive correlation with intakes of fibre, polyunsaturated fatty acids, potassium, zinc, and phosphorus intakes (p’s < 0.05) but was negatively correlated with vitamin B12 and niacin intakes (p’s < 0.05). Two dietary patterns were derived from PCA: 1) refined grains and sweets and 2) wholegrains and nuts. The correlation between the DQS-V and the first dietary pattern was negative (− 0.41, p = 0.004) and positive for the second dietary pattern (0.37, p = 0.01). The refined grains and sweets dietary pattern was inversely correlated with beta-carotene status (− 0.41, p = 0.004) and vitamin C status (r = − 0.51, p = 0.0002).
Conclusion
The newly developed DQS-V provides a single score for estimating diet quality among vegan adults. Further validation studies examining the DQS-V in relation to an independent dietary assessment method and to biomarkers of nutritional intake and status are still needed before the general application of the DQS-V.
... For example, a vegan diet typically includes more whole foods, such as vegetables and legumes. In contrast, an omnivore diet typically includes more ultra-processed and refined foods such as cake, pastries, and chocolate [72]. When exceeding recommended amounts, sugar, sodium, and fat levels are associated with a low-quality diet and are considerably higher in self-nominated omnivore foods [73]. ...
Dietary patterns rich in plant foods are associated with a lower risk of depression. Yet vegetarians face a higher susceptibility to depressive symptoms Existing literature may overlook the role of eating behaviors in a socially oriented context. This study surveying 319 lifelong vegans (51%) or vegetarians (49%) explored diet quality, social connectedness and depressive symptoms. Hierarchical linear regression revealed an inverse association between diet quality and depressive symptoms (β = -.23; 95%CI: -.30, -.10), no longer significant after controlling for sociodemographic and lifestyle factors. Within-group analyses showed differences between low and high diet quality and depressive symptoms. Mediation analysis suggested social connectedness mediated the diet quality-depressive symptoms relationship (c’ = -.10, p < .001). Results imply that lifetime adherence to a plant-based diet may be positively associated with social interactions, fostering stronger connections with others that, in turn, play a role in buffering the experience of depressive symptoms.
... The intakes of vegan men and women were 33 and 25 μg Se/day, respectively, while men and women of the general population had intakes of 52 and 39 μg Se/day, respectively (41). Also, in an earlier study from Sweden, the intake of selenium among vegans was lower than that of omnivores (42). A similar difference was seen in Finnish vegans and non-vegetarians, 79 ± 65 μg Se/ day and 149 ± 108 μg Se/day (mean ± standard deviation [SD]), respectively (43), but their intakes were generally higher than that in Denmark and Sweden. ...
Selenium is an essential trace element in humans, critical to the normal physiology in all animal species. The main form of selenium in food is selenomethionine, selenocysteine and a variety of organic compounds, while inorganic salts mainly occur in food supplements. In animals and humans, selenium occurs as selenocysteine in selenoproteins encoded by 25 genes (specific selenium pool). Several selenoproteins are part of the antioxidant enzyme system and serve as oxido-reductases and in thyroid hormone regulation. SelenoproteinP (SELENOP) transports selenium to peripheral tissues, is the main plasma selenoprotein, and has been used as biomarker of selenium status and intake. SELENOP in plasma represents a saturable pool of selenium and is maximised at a selenium concentration in plasma of about 110 μg/L or an intake of selenomethionine at about 1.2 μg/kg body weight in adults. In Finland, with an estimated selenium intake of 88 μg/day in men and 68 μg/day in women, the average selenium concentration in plasma is about 110 μg/L. Imported wheat from selenium rich areas is an important dietary source in Norway. Dietary intakes in the Nordic and Baltic area vary from 39 to 88 μg/day in men and 22 to 68 μg/day in women, the highest levels were from Finland. Most intervention trials on the effect of selenium supplementation on health outcomes have been carried out in ‘selenium-replete’-popula-tions and show no beneficial effect, which from a nutritional point of view would rather not be expected. Some intervention studies conducted in populations low in selenium have showed a beneficial effect. Observational studies suggest an inverse relationship between selenium status and risk of cardiovascular diseases (CVDs), cancer and all-cause mortality, and some other outcomes at low levels of intake (<55 μg/day) or in plasma or serum (<100 μg/L). However, a lack of quantitative data and inconsistencies between studies precludes these studies to be used to derive dietary reference values. At high intakes above 330 to 450 μg/day selenium may cause toxic effects affecting liver, peripheral nerves, skin, nails, and hair. An upper tolerable level (UL) of 255 μg selenium/day in adults was established by EFSA
... Iron deficiency anaemia was more common among OM individuals than VN individuals (20% vs. 7%). Additionally, VN males had lower body mass and BMI than OM males [50]. In 2019, the Royal Academy of Medicine of Belgium, an advisory agency for Belgium's government institutions, released a brief and poorly referenced publication suggesting that the consumption of VN diets poses risks to pregnant women and children. ...
The scientific discourse on vegan diets for children and adolescents primarily involves referencing position statement papers from different scientific and professional organizations, including paediatric associations. Over the past two decades, specialized associations have issued official statements and published position papers about adopting well-designed vegan diets during crucial life stages, including pregnancy and lactation, infancy, and childhood. A subset of these associations firmly supports the notion that a well-designed vegan diet can indeed be healthy and support normal growth and development during particularly delicate life stages, emphasizing careful planning, vitamin B12 supplementation, and regular supervised medical and dietetics oversight. In contrast, specific paediatric associations caution against vegan diets for children and adolescents, citing potential harm and the lack of adequate substantiation. These criticisms in position papers frequently point to lower-quality studies and/or outdated studies. Additionally, concerns extend to comparing vegan and omnivorous diets, considering public health issues such as obesity and early stages of cardiovascular disease as well as the risk of prediabetes and type 2 diabetes. Notably, some scepticism stems from studies where children's adherence to a well-designed vegan diet is incomplete. Scientific rigor suggests performing a comparable assessment of omnivorous and vegan diets. This narrative review highlights the need for a comprehensive, up-to-date literature review to inform balanced perspectives on vegan diets for children and adolescents. Researchers and decision-makers should aim to actively improve the design and consistent implementation of both diet types.
... When we look at the situations that are getting riboflavin deficiency worse, the current changes in lifestyle, especially in well-nourished countries, with diets based on a lack of dairy and species of meat combination with more exercise, could potentially increase the risk of riboflavin deficiency. In line with these studies, studies on the daily riboflavin intake of people who adhere to a vegan diet lifestyle have shown that these individuals meet less than 48% of the daily intake level recommendation, which increases the risk for riboflavin deficiency [39][40][41] . ...
... The same applies to the intake of vitamin D with food. Such results have already been confirmed in previous studies [79,80]. Long-term vitamin D deficiency may be associated with osteomalacia, osteoporosis, and rickets. ...
Many vegetarians are motivated by the health aspect of starting a plant-based diet. This diet can offer many health benefits. The study aimed to check whether people on a vegetarian diet are in good health, have a good nutritional intake, and follow the principles of healthy eating compared with omnivores. Twenty-two vegetarians on a vegetarian diet for more than five years and 22 omnivores aged 18-45 were interviewed. Each of them was given a food questionnaire, body composition analysis (BIA), and biochemical blood analysis, and their 7-day diet was analyzed. Polish vegetarians exhibit similar health statuses and tend towards better health than omnivores. They have an adequate body composition. Biochemical blood analysis showed no significant differences in blood parameters between vegetarians and omnivores, despite specific deficiencies such as vitamin B 12 , vitamin D and elevated homocysteine levels in vegetarians. They have a better nutritional status and follow good dietary principles. However, they were more likely to consume alcohol, add salt to their meals and sweeten hot drinks. In addition, the lifestyle of vegetarians can be described as healthier, as they are more likely to engage in leisure-time physical activity and get enough sleep.
... Plant-based diets are increasingly popular. Even the more restrictive vegan diet, excluding meat, fish, dairy, and eggs, *Address correspondence to this author at the Department of of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Università Politecnica delle Marche, Ancona, Italy; Tel/Fax: +390712206200/+390712206032; E-mail: p.barbadoro@univpm.it is gaining more popularity, especially among younger people [5]. ...
Background
A large number of individuals around the world consider themselves to be vegetarians for many individual reasons, and the vegetarian diet appears very heterogeneous. The prevalence of vegetarianism varies widely around the world.
Objective
This paper examined the variables associated with the non-consumption of meat and valued trends in the plant-based diet among Italian adults in relation to the level of self-perceived health in this category of people in 4 years (2013-2016).
Method
Data were drawn from the survey “Aspects of daily life” conducted by the ISTAT (Istituto Nazionale di Statistica). We considered the data of the 2013-2016 editions to evaluate the trend and attitude of the Italian population towards the non-consumption of meat during 4 years and assessed trends in the plant-based diet among Italian adults in relation to the level of self-perceived health.
Results
The results showed an increasing trend from 2013 to 2016. In statistical analysis, vegetarian status was associated to under the age of 45, having a high level of education, being mainly separated or divorced, being resident in the North-West regions, and with a poor self-perceived state of health. Furthermore, vegetarians had shown healthier lifestyles and lower risk factors for non-communicable diseases than non-vegetarians.
Conclusion
The results suggest that despite perceiving a worse health status, the long-term health of vegetarians is good and may be better than that of comparable non-vegetarians for some conditions and diseases, such as Obesity and IHD. As for all types of diet, well-designed health educational interventions conveying information on correct eating behavior may significantly contribute to increasing the degree of perceived health.
Conclusion
The results suggest that despite perceiving a worse health status, the long-term health of vegetarians is good, and may be better than that of comparable non-vegetarians for some conditions and diseases such as obesity and IHD.
Other
As for all types of diet, well-designed health educational interventions conveying information on correct eating behavior may significantly contribute to increasing the degree of perceived health.
... Beyond BMI, which dietary factors in the vegetarian diet may account for effects on BP levels is not well understood. Vegetarians have higher fiber and K intakes as a result of their greater intakes of fruits, vegetables, fruits, nuts and wholegrain products [37][38][39]. Current meta-analyses of randomized trials [16,17] demonstrate small but significant effects of Fiber, particularly in those with higher baseline pressures. ...
Objective
Past vegetarians research has often found that they have lower blood pressure (BP). Effects may include their lower BMI and higher intake levels of fruit and vegetables. Besides, the study pursues to extend this evidence in a diverse population containing vegans, lacto-ovo vegetarians and omnivores.
Design
The study analyzed data on five hundred vigorous individuals aged 20 years or older from a standard medical screening program and provided validated questionnaire. Criteria were established for vegan, lacto-ovo vegetarian, partial vegetarian and omnivorous dietary patterns.
Setting
Health screening programs were conducted at a standard medical screening program in Taiwan between 2006 and 2017. Dietary data were gathered by self-administered questionnaire.
Subjects
Five hundred Taiwanese subjects representing the cohort.
Results
Multiple regression analyses confirmed that the vegan vegetarians had lower systolic and diastolic BP (mmHg) than omnivorous Taiwanese (β = − 6.8, p < 0.05 and β = − 6.9, p < 0.001). Findings for lacto-ovo vegetarians (β = − 9.1, p < 0.001 and β = − 5.8, p < 0.001) were similar. The vegetarians were also less likely to be using antihypertensive medications. Defining hypertension as systolic BP > 139 mmHg or diastolic BP > 89 mmHg or routine of antihypertensive medications, the odds ratio of hypertension compared with omnivores was 0.37 (95% CI = 0.19–0.74), 0.57 (95% CI = 0.36–0.92) and 0.92 (95% CI = 0.50–1.70), respectively, for vegans, lacto-ovo vegetarians and partial vegetarians. Results were reduced after adjustment for BMI.
Conclusions
The study concludes from this relatively large study that vegetarians, especially vegans, with otherwise diverse characteristics but stable diets, do have lower systolic and diastolic BP and less hypertension than omnivores.
... For example, a vegan diet typically includes more whole foods, such as vegetables and legumes. In contrast, an omnivore diet typically includes more ultra-processed and refined foods such as cake, pastries, and chocolate [72]. When exceeding recommended amounts, sugar, sodium, and fat levels are associated with a low-quality diet and are considerably higher in self-nominated omnivore foods [73]. ...
Dietary patterns and depressive symptoms are associated in cross-sectional and prospective-designed research. However, limited research has considered depression risk related to meat-based and plant-based dietary patterns. This study explores the association between diet quality and depressive symptoms across omnivore, vegan, and vegetarian dietary patterns. A cross-sectional online survey utilised the Dietary Screening Tool (DST) and the Centre for Epidemiological Studies of Depression Scale (CESD-20) to measure diet quality and depressive symptoms, respectively. A total of 496 participants identified as either omnivores (n = 129), vegetarians (n = 151), or vegans (n = 216). ANOVA with Bonferroni post hoc corrections indicates that dietary quality was significantly different between groups F(2, 493) = 23.61, p < 0.001 for omnivores and vegetarians and omnivores and vegans. Diet quality was highest in the vegan sample, followed by vegetarian and omnivore patterns. The results show a significant, moderately negative relationship between higher diet quality and lower depressive symptoms (r = −0.385, p < 0.001) across groups. Hierarchical regression showed that diet quality accounted for 13% of the variability in depressive symptoms for the omnivore sample, 6% for vegetarians, and 8% for vegans. This study suggests that diet quality in a meat-based or plant-based diet could be a modifiable lifestyle factor with the potential to reduce the risk of depressive symptoms. The study indicates a greater protective role of a high-quality plant-based diet and lower depressive symptoms. Further intervention research is needed to understand the bi-directional relationship between diet quality and depressive symptoms across dietary patterns.
... Their production poses a serious threat to the environment because of the resources used or the effects accompanying these processes. Restricting or eliminating specific foods from the diet is one of the form of dietary restriction of a qualitative nature (Larson et al., 2002). Dietary restrictions may also be quantitative in nature, i.e. reduction of energy intake (Respondek, 2011). ...
Consumption of highly processed foods may be determined by social factors, including the family environment. There is still a lack of knowledge on the consumption of highly processed foods in adults in relation to their childhood food experiences. To fill this gap, the aim of the study presented here was to evaluate the relationship between childhood food experiences resulting from parental feeding practices and the use of restrictions on consumption of highly processed foods in adulthood. The cross-sectional study was conducted in 2020/2021 using the CAWI (Computer Assisted Web Interview) method among 702 Polish adults aged 35 and under. The questionnaire included questions from AMoFiC (Adults’ Memories of Feeding in Childhood), questions on current use of food restrictions, including highly processed foods, and socio-demographic characteristics. Frequency analysis and cross-tabulations were performed, means and standard deviations were calculated. Pearson's Chi2test and Mann-Whitney’s test were used, with an accepted level of significance of p < 0.05. About 80% of the study sample declared using restrictions on the consumption of foods, including highly processed foods. The use of restrictions by parents to limit a child's intake of high-fat foods and sweets has shown an association with the use of restrictions in adulthood, including restrictions on the intake of highly processed foods. Low-intensity restriction combined with provision good role models and nutritional knowledge can encourage children to adopt healthy eating behaviors. At the same time, such parental feeding practices may increase the likelihood of reducing consumption of highly processed foods in adulthood.
... For example, a vegan diet typically includes more whole foods, such as vegetables and legumes. In contrast, an omnivore diet typically includes more ultra-processed and refined foods such as cake, pastries, and chocolate [72]. When exceeding recommended amounts, sugar, sodium, and fat levels are associated with a low-quality diet and are considerably higher in self-nominated omnivore foods [73]. ...
Dietary patterns and depressive symptoms are associated in cross-sectional and prospective-designed research. However, limited research has considered depression risk related to meat-based and plant-based dietary patterns. This study explores the association between diet quality and depressive symptoms across omnivore, vegan, and vegetarian dietary patterns. A cross-sectional online survey utilised the Dietary Screening Tool (DST) and the Centre for Epidemiological Studies of Depression Scale (CESD-20) to measure diet quality and depressive symptoms. A total of 496 participants identified as either omnivores (n = 129), vegetarians (n = 151), or vegans (n = 216). ANOVA with Bonferonni post hoc corrections indicates that dietary quality was significantly different between groups F(2, 493) = 23.61, p <.001 in omnivores and vegetarians; and omnivores and vegans. Diet quality was highest in the vegan sample, followed by vegetarian and omnivore patterns. The results show a significant, moderate negative relationship between higher diet quality and lower depressive symptoms (r = -.385, p <.001) across groups. Hierarchical regression showed that diet quality accounted for 13% of the variability in depressive symptoms for the omnivore sample, 6% for vegetarians, and 8% for vegans. This study suggests that diet quality in a meat-based or plant-based diet could be a modifiable lifestyle factor with the potential to reduce the risk of depressive symptoms. The study indicates a greater protective role of a high-quality plant-based diet and lower depressive symptoms. Further intervention research is needed to understand the bi-directional relationship between diet quality and depressive symptoms across dietary patterns.
... These results are in accordance with the results of the EPIC-Oxford study, which included >30,000 adults (omnivores, fish eaters, vegetarians, and vegans) in the United Kingdom and documented a lower selenium intake in vegetarians and vegans [16]. Similarly, other studies with adults [17][18][19][20][21], including one with young adults [22], have shown a lower selenium intake and/or status with vegetarian and/or vegan diets compared to omnivorous diets. However, no differences between the different diet groups (vegetarian, vegan, and omnivorous) were found in a study by Schüpbach et al. (2017) from Switzerland [23]. ...
In regions with low selenium soil concentrations, selenium can be considered a critical nutrient for vegetarians and vegans. While the number of vegetarians and vegans is increasing in many countries, a large research gap remains in this field. For example, to date, no study seems to have assessed selenium intake in vegetarian and vegan children. Therefore, the selenium intake of 1- to 3-year-old vegetarian, vegan, and omnivorous children who participated in the cross-sectional VeChi Diet study was determined. Selenium intake was assessed based on 3-day food diaries (not including supplements) and food selenium concentrations provided by the European Food Safety Authority (EFSA). Between-group differences were assessed with analysis of covariance (ANCOVA). The median daily selenium intake was 17 µg, 19 µg, and 22 µg in vegetarian, vegan, and omnivorous children, respectively. However, only the difference between the vegan and omnivorous children was statistically significant. On average, all three groups met the harmonized average requirement (H-AR) for selenium of 17 µg/day. Nevertheless, the hypothesis that vegetarian and vegan children generally consume less selenium than omnivorous children could be confirmed, and 39% of vegetarians, 36% of vegans, and 16% of omnivores fell below the adequate intake for selenium (provided by EFSA) of 15 µg/day.
... Balcı'nın (2018) çalışmasında vejetaryen beslenme tipleri %46.3 V ve %34.7 LOV olarak ve ayrıca dini sebeplerle tercih edenlerin %2.1 olduğu tespit edilmiştir. Etik nedenlerle vejetaryen beslenmeyi tercih edenlerin, diğer nedenler sebebi ile tercih edenlere göre beslenmelerine daha az dikkat ettikleri bildirilmiştir (Larsson & Johansson, 2002). Vejetaryen beslenmeyi seçmenin yaygın nedenleri arasında sağlık, çevreyle ilgili endişeler ve hayvan refahı faktörleri, ekonomik nedenler, etik düşünceler, dünyadaki açlık sorunları ve dini inançlar gösterilmektedir. ...
Amaç: Bu çalışma vegan ve diğer tiplerde vejetaryen beslenen yetişkinlerin beden kütle indeksi, besin desteği kullanımı ve besin tüketim miktar ve sıklıklarını incelemek amacıyla planlanmıştır. Yöntem: Bu kesitsel çalışma Ağustos-Kasım 2021 tarihleri arasında, 108 vejetaryen bireyde yürütülmüştür. Çalışmada online anket kullanılmıştır. Anketin birinci bölümü yaş, boy uzunluğu, vücut ağırlığı, cinsiyet gibi genel özellikler, ikinci bölümü ise vejetaryen/vegan beslenme tarzına ait sorular ve besin tüketim sıklık ve miktar sorularından oluşmaktadır. Katılımcılar vegan ve non-vegan (Lakto vejetaryen, Lakto-ovo vejetaryen, Semi vejetaryen, Pesko-pollo-vejetaryen) olarak değerlendirilmişlerdir. Bulgular: Çalışmaya katılanların %86’sı kadın, %14’ü erkektir. Vejetaryen beslenen katılımcıların çoğunun kadın, bekâr, yüksek gelir ve eğitim düzeyinde olduğu görülmektedir (p0.05). Katılımcıların vitamin ve mineral açısından zenginleştirilmiş alternatif süt ürünlerini nadir tükettikleri, çoğunlukla günlük olarak sebze ve meyve tükettikleri, kurubaklagil ve kuru yemişleri ise tahıllardan daha sık tükettikleri bulunmuştur. Bireylerin her gün çay ve kahve tükettikleri tespit edilmiştir. Çalışmamızda vegan bireylerin bitkisel kıyma, tofu ve soya ürünleri tüketimlerinin non-veganlardan daha yüksek, yağlı tohumları ise non-veganlardan daha az tükettikleri saptanmıştır. Sonuç ve öneriler: Kişileri bu tarz beslenmeye motive eden faktörlerden bağımsız olarak, yeni başlayacakları bu hayat düzeninde olası sağlık risklerinin önlenmesi adına iyi bir beslenme eğitimi almaları ve bir uzman takibi ile adaptasyon sürecinde olası makro ve mikro besin ögeleri yetersizliğinin önüne geçilmesi gerekmektedir.
... Children and adolescents on plant-based vegan diets had lower intakes of protein and dietary sugars, but a higher intake of carbohydrates and dietary fibre in particular when compared with omnivores. Vegetarian diets are in the middle range [87][88][89]. Food consumption data showed a more favourable food choice with a higher intake of legumes, nuts, and whole grain of children on a vegetarian and, in particular, a vegan diet compared with omnivores [90]. However, the long-term effects of adherence to these plant-based diets during childhood and adolescence are not yet clear. ...
To summarize current knowledge and gaps regarding the role of postprandial glycaemic response in the paediatric population, a workshop was organized in June 2021 by the European branch of the International Life Science Institute (ILSI). This virtual event comprised of talks given by experts followed by in-depth discussions in breakout sessions with workshop participants. The main pre-specified topics addressed by the workshop organizing committee to the invited speakers and the workshop participants were: (1) the role of glycaemic responses for paediatric health, based on mechanistic insights from animal and human data, and long-term evidence from observational and intervention studies in paediatric populations, and (2) changes in metabolism and changes in dietary needs from infancy to adolescence. Each talk as well as the discussions were summarised, including the main identified research gaps. The workshop led to the consensus on the crucial role on health of postprandial glycaemic response in paediatric population. However, a lack of scientific data has been identified regarding detailed glucose and insulin profiles in response to foods commonly consumed by paediatric populations, as well as a lack of long-term evidence including the need for suitable predictors during childhood and adolescence to anticipate health effects during adulthood.
... En los vegetarianos, las proteínas siempre han sido un tema controversial; sin embargo, la mayoría de los estudios indican que a medida que el vegetarianismo se hace más excluyente en grupos de alimentos el consumo proteico es menor (25). Por el contrario, Clarys et al. (26), tras evaluar a 1475 participantes y comparar la calidad y los componentes de las dietas veganas, vegetarianas (ovolactovegetariana, lactovegetariana y ovovegetariana), semivegetarianas (comían carne, pescado o pollo no más de una vez por semana), pesco-vegetarianas y omnívoras, mostraron que el consumo de proteínas en las dietas vegetarianas evaluadas no variaba de forma significativa con respecto a la dieta omnívora, excepto en veganos, donde el consumo de proteínas tuvo una diferencia significativa en relación con los individuos que practicaban la dieta omnívora. ...
Introduction: vegetarian diets are diets that avoid animal meat, it includes ovolactovegetarian and vegan diets, among other plant-based variants. Objective: to characterize food consumption, anthropometric nutritional assessment, physical activity level and motivations in a sample of vegetarian adults from the Capital District, Yaracuy and Carabobo states of Venezuela. Materials and methods: 51 adults were evaluated, 23.5% vegan and 76.5% ovo-lacto vegetarian, aged between 18 and 65 years. A 24-hour dietary recall was carried out, indicators of dimension (BMI and waist circumference) and body composition (muscle area and percentage of fat) were taken, the long IPAQ instrument of physical activity was applied and it was asked about the main motivation to follow these diets. Results: the diet was deficient in calories (60.8%), low in carbohydrates (72.5%) and fats (58.8%), and high in proteins (43.1%) and dietary fiber (70.6 %). The anthropometric nutritional assessment of the individuals resulted in an adequate weight (62.7%), average muscularity (51%) and fat (68.6%), and low risk according to waist circumference (86.3%). The level of physical activity that prevailed were the moderate and intense categories with 39.2% each. The majority decided to follow the vegetarian diet for health reasons 72.5%. Conclusions: the majority of the study group, despite having an unbalanced diet (low in carbohydrates and fats, but high in proteins and fiber), presented an anthropometric nutritional status and levels of physical activity within acceptable ranges
... Unfortunately, it was difficult to involve an adequate number of participants for each subsample. Anyway, the total number of participants is acceptable/good (N = 378) and also by reviewing other studies on food tribes, we found that the sample size was however small (e.g., Barnard et al., 2021;Larsson & Johansson, 2002). The correlations found within each group can be considered exploratory for future studies with a larger sample. ...
Some people choose to follow a certain dietary habit because they are guided by strong beliefs, but also to pursue a healthy lifestyle. Food tribes are defined as social groups sharing common values and beliefs that underlie food and lifestyle choices. The current study aimed to investigate potential differences in emotion regulation between specific food tribes, and when comparing food tribes to people who conversely do not follow a dietary habit. Specifically, we examined the presence of rumination, psychological inflexibility, and emotional contagion as components of emotion dysregulation. A Google form was developed to obtain all the information needed to respond to our research questions and goals, and investigate the following food groups: Veganism, Fruitarianism, Raw Food Diet, Paleodiet, Blood Type group, Breatharianism, Macrobiotic Diet, and Other. The final sample consisted of 378 healthy subjects (117 males, 258 females, 3 other) ranging in age from 18 to 70 years. The first part of Google form consisted of general questions about the participant’s dietary habits while the second part included specific questionnaires assessing the psychological constructs we investigated. Vegan people were less conditioned by others in their food choices when compared to the other food tribes. The Paleodiet group associated its food choice with health reasons as well as the Blood Type group. Differences were found in the presence of cognitive inflexibility and rumination, reflective thinking, emotional dysregulation, emotional contagion and also in the representation of their real and ideal (food) communities. Clinical implications are discussed.
... The leading cause is low absorption of bioavailable iron from the diet, rapid growth, and iron spoilage due to small intestines' imperfect absorption of food materials. [94]. One possible cause of anemia is the infection with intestinal parasites available only from small, unrepresentative sample surveys [95]. ...
The most frequent intestinal parasites that cause severe disorders in humans are Giardia lamblia and Entamoeba histolytica, which alter serum concentrations of deferent markers due to virulence factors and pathogenicity. A large number of people with infection are asymptomatic, and they can go for up to a year without showing any signs or symptoms. Additionally, due to prolonged diarrhoea but not acute diarrhoea, these parasites can cause malnutrition, weight loss, growth delay, and possibly low cognitive development. The aim of this study is to look at how giardiasis and amoebiasis affect the levels of certain biomarkers in the blood.
... Several (but not all (Sobiecki et al. 2016;) observational studies in Europe have shown a borderline low selenium intake in vegans (Weikert et al. 2020;Abdulla et al. 1981;Kristensen et al. 2015;Lightowler and Davies 2000;Larsson and Johansson 2002;Hoeflich et al. 2010). One study from Shanghai documented a very low selenium intake and lower toenail selenium in vegetarians and vegans compared to non-vegetarians (Gu et al. 2020). ...
Humans must obtain vitamin B 9 (folate) from plant-based diet. The sources as well as the effect of food processing are discussed in detail. Industrial production, fortification and biofortification, kinetics, and physiological role in humans are described. As folate deficiency leads to several pathological states, current opinions toward prevention through fortification are discussed. Claimed risks of increased folate intake are mentioned as well as analytical ways for measurement of folate.
Objective
To assess the intakes of food groups, energy, and macronutrients among youth in Sweden who adhere to vegan, lacto-ovo-vegetarian, pescatarian or omnivorous diets. Further, to evaluate youth’s adherence to the food-based dietary guidelines (FBDG).
Design
In this cross-sectional study, dietary intake data was obtained through repeated non-consecutive 24-h dietary recalls (24HDR) and a dietary screener assessing consumption frequency of food groups. Usual daily intakes were estimated using the Multiple Source Method (MSM), and for usual intakes of food groups the 24HDR intake data was combined with consumption frequency.
Setting
Gothenburg, Sweden, December 2022–January 2024.
Participants
In total 235 youth (78% female, mean age 22 ± 2 years), consisting of 60 vegans, 59 lacto-ovo-vegetarians, 55 pescatarians, and 61 omnivores.
Results
For usual intakes (median value), both g/d and g/MJ, all plant-based dietary groups had higher intakes of legumes and plant-based meat analogs compared to omnivores (for all, p < 0.001), and vegans and lacto-ovo-vegetarians had higher intakes of plant-based dairy substitutes (vs. pescatarians and omnivores, p < 0.001). Moreover, vegans had higher intakes of refined grain products (vs. pescatarians, p = 0.012), nuts/seeds (vs. pescatarians and omnivores, p = 0.002), and vegetable oil (vs. omnivores, p = 0.014). Omnivores had higher intakes of fried/premade potato dishes (vs. lacto-ovo-vegetarians and vegans, p < 0.001), and lower intakes of plain potatoes (vs. lacto-ovo-vegetarians and pescatarians, p < 0.001). Overall intakes of ‘sweets and snack foods’ did not differ between dietary groups. Omnivores had higher usual intakes of energy compared to lacto-ovo-vegetarians and pescatarians (10 vs. 9 MJ/d, p = 0.016). Most macronutrient recommendations were met across groups, except for carbohydrates (below for omnivores), fiber (below for omnivores and pescatarians), and saturated fatty acids (exceeded by all except vegans). For the FBDG for whole grains, omnivores (23%) had a higher adherence vs. vegans (2%) and lacto-ovo-vegetarians (3%), p < 0.001. No difference was found between dietary groups for adherence to the FBDG’s for fruits, berries, and vegetables (10%), nuts (24%), and vegetable oil (4%).
Conclusion
Swedish youth, regardless of dietary practice, need to increase intakes of fruits, berries, vegetables, nuts, and whole grains, and limit consumption of discretionary foods to better align with food and nutrition recommendations.
Aim:
This study aimed to evaluate papers analysing dietary intake, 25-hydroxyvitamin D (25(OH)D) concentrations and anthropometry in children on vegetarian, vegan and omnivorous diets, as research indicates all diets generally fall below recommended vitamin D intake.
Methods:
This mini review examined the vitamin D status of children aged 1-18 years by systematically searching PubMed, Google Scholar and Scopus databases from January 1, 2000, to December 31, 2023.
Results:
The review included nine studies published between 2000 and 2023. Four studies reported lower vitamin D intake in children on vegetarian and vegan diets compared to omnivores. Three studies reported lower 25(OH)D concentrations in children on vegetarian and vegan diets. Specifically, one study found lower concentrations in vegans compared to omnivores, another found lower concentrations in vegetarians and vegans not taking supplements and a third reported lower 25(OH)D concentrations in Asian children aged 3-4.5 years compared to Caucasian children. Three studies found no significant differences in 25(OH)D between diet groups. Three studies assessing anthropometry showed that vegetarians have similar body weight and height as omnivores.
Conclusion:
Children across all dietary groups may have low vitamin D intakes; supplementation should be considered for those with inadequate sun exposure, especially those avoiding animal products.
Sugars, salt, and milkfat have different functions with reference to food and beverage productions, on the technical level. However, the use of sugars, salt, and milkfat products should be evaluated also on the basis of nutritional requirements for human diets. In other words, are these compounds or categories really needed? This chapter is dedicated to three case studies or analyses of the current knowledge concerning sugars, sodium chloride, and milkfat products in food and beverage preparations. With reference to sugars, available recommendations are mainly based on weight-related and disease-related evidences. More research is needed in this research area. With relation to salt, a general trend towards high consumption may be assumed, while lower values than accepted and recommended amounts are not a specific problem so far. Available recommendations are lowering the consumption of salt on a general level, but high consumption can be still observed so far. Finally, available dietary recommendations concerning the necessity of lowering cholesterol intake and chemical profiles of milkfat should be evaluated product by product (by means of the nutritional label) and also considering the class of consumer. More efforts are surely needed in this ambit.
Objectives
We aimed to validate dietary assessment methods against the gold standard, doubly labeled water (DLW), for estimating total energy intake (TEI).
Methods
PubMed, Scopus, Web of Science, and Google Scholar databases were searched until May 2023. Inclusion criteria encompassed studies involving participants aged 1–18 years, employing dietary assessment methods like food records, dietary histories, food frequency questionnaire (FFQ), or 24‐h recalls estimating TEI alongside DLW to measure total energy expenditure (TEE). Data were pooled using random‐effects meta‐analysis models.
Results
Thirty‐three studies were identified, with sample sizes ranging from 9 to 118 participants. Meta‐analysis of 22 studies identified underestimation of TEI (mean difference [MD] = −262.9 kcal/day [95% CI: −380.0, −145.8]; I ² = 93.55%) for food records compared with TEE estimated by DLW. Other dietary assessment methods, including food recalls ( n = 9) (MD = 54.2 kcal/day [95% CI: −19.8, 128.1]; I ² = 49.62%), FFQ ( n = 7) (MD = 44.5 kcal/day [95% CI: −317.8, 406.8]; I ² = 94.94%), and diet history ( n = 3) (MD = −130.8 kcal/day [95% CI: −455.8, 194.1]; I ² = 77.48%), showed no significant differences in TEI compared with DLW‐estimated TEE. All studies were of high quality.
Conclusion
Food records may underestimate TEI, yet additional research is needed to identify the most accurate methods for assessing children's dietary intake.
Vitamin B12 (cobalamin) is essential for normal metabolic function, and even moderate deficiency of this vitamin has negative health effects. Vitamin B12 is found in animal foods, and as vegetarian diets are increasingly popular in Western countries, one might expect a higher prevalence of vitamin B12 deficiency in the Nordic population. Setting recommendations for vitamin B12 intake has proven to be difficult, as uptake of vitamin B12 varies substantially, the clinical deficiency symptoms are often diffuse, and there is no clear agreement on the decision limits for vitamin B12 deficiency. Vitamin B12 deficiency is reported to be particularly common among pregnant women and infants, despite the fact that less than 1% of Norwegian pregnant women have a cobalamin intake below the Nordic Nutrition Recommendations 2012-recommended level of 2.0 µg/day. In addition, the assumption that breast milk contains sufficient vitamin B12 for optimal health and neurodevelopment during the first 6 months of life does not comply with the high prevalence of insufficient vitamin B12 status in this age group. Recommended intakes of vitamin B12 vary among age groups and must be based on markers of cobalamin status, indicating an optimal intracellular biochemical status, and not merely absence of clinical signs of vitamin B12 deficiency.
Health effects of vegan diets among children and adolescents are a controversial public health topic. Thus, the aim of the present systematic review is to evaluate a broad range of health outcomes among vegan children and adolescents aged 0 to 18 years. 18 studies met the inclusion criteria (17 cross-sectional, 1 RCT). Meta-analyses showed lower protein, calcium, vitamin B2, saturated fatty acid, and cholesterol intakes, and lower ferritin, HDL and LDL levels as well as height in vegan compared to omnivorous children/adolescents. Higher intakes of carbohydrates, polyunsaturated fatty acids, fiber, folate, vitamins C and E, magnesium, iron, and potassium were observed in vegans. Blood levels of vitamin B12 were higher among vegan children due to supplement use. Single study results suggested further differences between vegan and non-vegan children, such as lower bone mineral content or urinary iodine among vegan children. Risk of Bias was rated as high or very high in 7 out of 18 studies. The certainty of evidence for the meta-analyses was low (n = 2) or very low (n = 46). Overall, the available evidence points to both risks and benefits associated with a vegan diet among children, although more and better designed studies are needed.
Objective
To investigate whether food literacy competencies and diet quality vary between 16-to-24-year-olds vegans, lacto-ovo vegetarians, pescatarians, flexitarians, and omnivores, and to assess if food literacy are associated with diet quality.
Design
Cross-sectional study. Food literacy (general nutrition knowledge, critical nutrition literacy, and food skills) and diet quality were measured using an electronic questionnaire.
Setting
Southern Norway, September 2021-March 2022.
Participants
Healthy 16-24-year-olds (n = 165).
Results
Overall, the mean general nutrition knowledge score was moderate (48·0 out of 67·0); the lowest mean score was found in omnivores and the highest in flexitarians (45·6 vs. 51·5) ( p =0·034). The mean score of critical nutrition literacy was also moderate (3·7 out of 5·0), vegans showed higher scores compared to other dietary practices ( p =0·018). No difference observed in food skills between the different dietary practices. The overall median diet quality score was 46·0 out of 80·0; lowest in omnivores and highest in vegans (42·0 vs. 56·0) ( p =<0·001). In multivariate regression analyses, general nutrition knowledge, food skills, and vegan dietary practice were significantly associated with higher diet quality.
Conclusions
We found moderate levels of food literacy across all dietary practices. The food literacy competencies, general nutrition knowledge, and food skills were associated with higher diet quality in our sample. Omnivores showed both the lowest general nutrition knowledge level and lowest diet quality scores. In contrast, both flexitarians and vegans scored highest on general nutrition knowledge and diet quality scores, despite being one of the less restrictive and one of the strictest plant-based dietary practices, respectively.
How harmful is food, which food components cause illness? And what is healthy? What should no longer be eaten? What must be eaten in order to make a long, healthy life possible? These questions can be heard and read almost daily. From a scientific point of view, there are usually no answers. In this chapter, these questions are investigated using typical examples from a physical-chemical and physiological perspective.
Increasing numbers of populations in the West are restricting their intake of meat and other animal products for reasons relating to health or ethics; in many countries, these restrictions are already common for cultural, religious, or socio-economic reasons. By following their parent's diet, children are exposed in parallel. This narrative review aims at assessing current data regarding vegetarian diets in children from birth to 18 years of age, which include, by increasing degree of restriction, flexitarian, lacto-ovo-vegetarian, lacto-vegetarian, pescatarian, vegan and macrobiotic diets. The 202 references include 45 studies in children. The more restrictive the diet and the younger the child, the greater the risk of nutritional deficiency. Of particular concern are vitamin B12, iron, zinc, calcium, n-3 long-chain polyunsaturated fatty acids, and protein and energy intake, especially in pregnant and nursing women, infants and young children. Providing an adequate lacto-ovo-vegetarian diet is relatively easy, whereas the maintenance of more restrictive diets may be challenging. The benefits and risks of vegetarian diets in adults are relatively well documented, but data for children are scarce. Vegan and macrobiotic diets should be discouraged in pregnant and lactating mothers as well as in young children, who, otherwise, should pay careful attention to ensuring nutritional adequacy, blood testing and appropriate supplementation. The health consequences of a chosen diet should be discussed with parents and adolescents to ensure the best possible adherence to advice and prescriptions. There is a need for well conducted studies in children but also for better knowledge of nutrition in healthcare professionals.Abbreviations: ALA: α-linolenic acid; ARA: arachidonic acid; ASF: animal source foods; BMC: bone mineral content; BMD: bone mineral density; DHA: docosahexaenoic acid; DRV: dietary reference value; EPA: eicosapentaenoic acid; FLD: flexitarian diet; LA: linoleic acid; LC-PUFA: long-chain polyunsaturated fatty acids; LOVD: lacto-ovo-vegetarian diet; LVD: lacto-vegetarian diet; MAD: macrobiotic diet; OMD: omnivorous diet; PSF: plant-source foods; SFA: saturated fatty acids; VGD: vegetarian diets; VND: vegan diet.
Vitamin B1 is a water-soluble vitamin whose alternative name is thiamine or thiamin. The metabolically active form of vitamin B1 is thi-amin diphosphate, also known as thiamin pyrophosphate. Thiamin diphosphate is a coenzyme in the pyruvate dehydrogenase complex and in the Krebs cycle. Thus, it is directly involved in catabolism. In addition, vitamin B1 also takes part in the pentose phosphate shunt, which contributes to the synthesis of nucleotides and their derivatives. Similarly, thiamin diphosphate plays an important role in myelin synthesis, amino acid metabolism, and the metabolism of neurotransmitters and hormones. There is also evidence for its direct regulation of ion channel activity. Lack of vitamin B1 affects all organs and tissues, but the earliest manifestations of its deficiency are found in the nervous system. There are several reasons for this. Firstly, the nervous tissue is extremely and continuously dependent on glucose oxidation, which can be disrupted in case of insufficiency of the pyruvate dehydrogenase complex. Secondly, myelin production is interrupted. Thirdly, there is an imbalance of neurotransmitters. The fourth reason is the high activity of transmembrane ion-exchange processes in the nervous tissue. All these lead to damage to the central and peripheral nervous system and, in severe cases, the development of beriberi or Wernicke-Korsakoff syndrome. B1 hypervitaminosis is an unlikely event. The hydrophilic thiamin diphosphate is rapidly excreted through the urine with an increase in its serum concentrations. In addition, the intake of large amounts of thiamin with food significantly reduces its intestinal absorption. As thiamin is relatively safe even in high quantities, the high vitamin B1 dose is used to treat symptoms of chronic cluster headaches and some neurodegenerative diseases. Thiamin is quite evenly distributed in both animal-and plant-derived products. Its highest concentrations are found in the outer layer of cereals, legumes, seeds, or nuts. As a result, most studies show that thiamin intake is higher in vegans and vegetarians than in omnivores. But, with regard to the status of vitamin B1, not everything is so crystal clear. There are not many studies done on this topic to date. The lack of general consensus on a single accepted methodology for assessing the status of vitamin B1 seems to be the main hurdle. Although most of the data indicate a better supply of vitamin B1 in vegans and vegetarians, further research and standardization of methods are still needed.
Amaç: Demir, vitamin B12 ve folat eksikliği tüm dünyada özellikle çocuklarda sık görülen mikrobesin eksikliklerindendir. Demir, vitamin B12 ve folat birçok enzimin yapısına girerek vücut metabolizması, hücre bölünme ve farklılaşması, immun sistemin düzenlenmesi, kemik gelişimi, algılama ve zekâ fonksiyonunda rol oynamaktadır. Çalışmada, çocuklarda serum demir, vitamin B12 ve folat eksikliği prevalansını araştırdık. Gereç ve Yöntem: Zonguldak Bülent Ecevit Üniversitesi Tıp Fakültesi Hastanesi Genel Çocuk Polikliniği’ne başvuran 6-14 yaş arası toplam 392 çocukta serum demir düzeyi, demir bağlama kapasitesi, ferritin, vitamin B12, folat düzeyi ve tam kan sayımı çalışıldı. Sosyoekonomik düzey, beslenme şekli, fiziksel gelişimi, eğitim düzeyi gibi çeşitli parametreleri içeren anket düzenlendi. Bulgular: Çalışmamız 223 kız, 169 erkek toplam 392 çocukla yapıldı. Olguların %60,5’inde demir eksikliği (DE), %33,4’ünde vitamin B12 eksikliği, %7,6’sında folat eksikliği ve yetersizliği saptandı. Olgular 6-10 yaş (n=211) ve 11-14 yaş (n=181) olarak iki grupta incelendiğinde vitamin B12 eksikliğinin görülme sıklığında adölesanlarda istatistiksel olarak anlamlı fark saptandı (p
Aim: Vegan and vegetarian diets are in an increasing trend worldwide in recent years. Vegan/vegetarian diets, which are known to have positive effects on health, may result in nutrient deficiencies if they are not balanced. It is important to determine the nutritional status of vegan and vegetarian individuals, whose number is increasing in Turkey, in order to build national recommendations. This study was conducted as a pilot study to determine the energy and nutrient intake of vegan/vegetarian individuals living in Turkey. Subjects and Method: A total of 285 volunteered vegan/vegetarian individuals aged 19-64 years participated in the study. The general information and vegan/vegetarian status of the participants were questioned with an online survey. After answering the survey, 38 volunteered participants kept a consecutive three-day “24-h food record” and shared it with the researchers. The energy and nutrient intakes of the individuals and the rates of meeting their requirements were calculated. Chi-square test of independence was used to compare individuals’ vegan/vegetarian status by gender and general knowledge by vegan/vegetarian status; independent sample t-test and Mann-Whitney U test were used for age, energy and nutrient comparisons between groups. Results: The majority of the participants were female (79.3%), holding at least a bachelor’s degree (89.5%), and had a normal BMI value (72.6%). Rate of vegan and vegetarian participants that were not able to meet their energy and nutrient requirements were as follows respectively: 76.5%, 85.7% for energy (kcal); 52.9%, 95.2% for carbohydrate (%); 100%, 52.4% for vitamin B12; 64.7% 61.9% for folate; 94.1%, 76.2% for calcium; 64.7%, 76.2% for iron; and 88.2%, 71.4% for zinc. Conclusion: It has been observed that vegan and vegetarian individuals living in Turkey are at risk of several nutrient deficiencies. Considering the increasing trend of vegan and vegetarian diets, it is necessary to determine the nutritional status of individuals on a large scale and to raise awareness of individuals. It is important that the recommendations specific to vegan/vegetarian individuals in national nutrition guidelines are implemented by vegan/vegetarian individuals, health professionals and food service providers.
Accepting a continued rise in the prevalence of vegan type diets in the general population is also likely to occur in athletic populations, it is of importance to assess the potential impact on athletic performance, adaptation and recovery. Nutritional consideration for the athlete requires optimisation of energy, macro- and micro- nutrient intakes, and potentially the judicious selection of dietary supplements, all specified to meet the individual athlete's training and performance goals. The purpose of this review is to assess whether adopting a vegan diet is likely to impinge on such optimal nutrition and, where so, consider evidence based yet practical and pragmatic nutritional recommendations. Current evidence does not support that a vegan-type diet will enhance performance, adaptation or recovery in athletes, but equally suggests that an athlete can follow a (more) vegan diet without detriment. A clear caveat, however, is that vegan diets consumed spontaneously, may induce suboptimal intakes of key nutrients, most notably quantity and/or quality of dietary protein and specific micronutrients (e.g., iron, calcium, vitamin B12 and vitamin D). As such, optimal vegan sports nutrition requires (more) careful consideration, evaluation and planning. Individual/seasonal goals, training modalities, athlete type, and sensory/cultural/ethical preferences, among other factors, should all be considered when planning and adopting a vegan diet.
O cálcio é um mineral comumente presente em produtos lácteos e folhosos verdes escuros, no qual possui papel fundamental no metabolismo ósseo. Outro micronutriente importante nesse mecanismo é a vitamina D, que participa de diversas ações fisiológicas de regulação do cálcio e do paratormônio (PTH), porém não é amplamente encontrado nos alimentos, sendo a exposição solar a sua fonte mais efetiva de obtenção. A ingestão inadequada desses micronutrientes pode trazer prejuízos principalmente a população feminina, já que durante a menopausa ocorrem mudanças hormonais que tendem a favorecer a perda de cálcio e desencadear comorbidades associadas ao tecido ósseo. Diante disto, torna-se relevante estudar sobre a ingestão diária desses micronutrientes no público feminino. O presente estudo teve como objetivo avaliar o consumo habitual de cálcio e vitamina D dietéticos em alunas de uma instituição de ensino superior no município do Rio de Janeiro. Trata-se de um estudo transversal, onde a avaliação do consumo habitual de cálcio e vitamina D foi determinada por meio de um registro alimentar. A coleta de dados ocorreu durante o período de Março/2017 a Maio/2017. A análise dos dados foi executada através do software AVANUTRI Revolution® 4.0 e foram adotadas como referência as recomendações do DietaryReferencesIntake (DRI).
More adolescents are choosing to follow plant-based diets. In this chapter we explore why young people choose to follow vegetarian diets and identify a range of vegetarian diet practices. A well-balanced vegetarian diet can provide for the nutritional needs of a growing adolescent; however, particular attention should be paid to adequate intake of protein, energy, and specific micronutrients. In strict vegans with no intake of animal products, supplementation may be required. Those with limited nutritional knowledge should seek appropriate resources to ensure dietary adequacy. We discuss how parents can support their child to meet their nutritional needs and identify when further support is warranted. Adolescents on restrictive vegetarian diets should be considered “at risk” with close monitoring and screened for eating disorders and appropriate growth and development.
Plant-based diets may increase the risk of vitamin B12 deficiency due to limited intake of animal-source foods, while dietary folate increases when adhering to plant-based diets.
In this cross-sectional study, we evaluated the B12 and folate status of Norwegian vegans and vegetarians using dietary B12 intake, B12- and folic acid supplement use, and biomarkers (serum B12 [B12], plasma total-homocysteine [tHcy], plasma-methylmalonic acid [MMA], and serum-folate). Vegans (n=115) and vegetarians (n=90) completed a 24-hour dietary recall and a food-frequency questionnaire and provided a non-fasting blood sample. cB12, a combined indicator for evaluation of B12 status, was calculated. B12 status were adequate in both vegans and vegetarians according to the cB12 indicator, however 4% had elevated B12. Serum B12, tHcy, MMA concentrations and the cB12 indicator (overall median: 357pmol/L, 9.0µmol/L, 0.18µmol/L, 1.30 (cB12)) did not differ between vegans and vegetarians, unlike for folate (vegans: 25.8nmol/L, vegetarians: 21.6nmol/L, p=0.027). Serum B12 concentration <221pmol/L, was found in 14% of all participants. Vegetarians revealed the highest proportion of participants below the RDI of 2 µg/day including supplements (40 vs. 18%, p<0.001). Predictors of higher serum B12 concentrations were average daily supplement use and older age. Folate deficiency (<10 nmol/L) was uncommon overall (<2.5%). The combined indicator cB12 suggested that none of the participants was B12 depleted, however low serum B12 concentration was found in 14% of the participants. Folate concentrations were adequate, indicating adequate folate intake in Norwegian vegans and vegetarians.
Six middle-aged lactovegetarians (three men and three women) collected copies of four 24-h diets using the duplicate portion sampling technique. By chemical analyses, the nutrient composition of the lactovegetarian diet was determined in detail and compared with that of a mixed Swedish diet (normal) and a vegan diet (vegan) studied previously. The nutrient composition of the lactovegetarian diet expressed per 1000 kcal represented an average between normal and vegan diets. It was in closer agreement with Swedish recommended dietary allowances than the normal Swedish diet. Thus, the lactovegetarian diet contained 35% of the energy as fat and was rich in polyunsaturated fatty acids, especially linoleic acid, which resulted in a polyunsaturated/saturated fat ratio of 0.6. The lactovegetarian diet had a cholesterol concentration only half of that of a normal diet. Protein content and amino acid composition were well above recommendations. The lactovegetarian diets contained less sucrose than normal and vegan diets, but the sum of the intake of low molecular weight carbohydrates was comparable to normal and vegan diets. Dietary fiber was three times higher than in a normal diet. Essential minerals and trace elements, ie, Ca, Mg, Na, K, Fe, Zn, Cu, Se, satisfied current requirements. The intake of vitamin B12 by the lactovegetarians was around 1.4 µg daily, which is below the recommendations. The intake of folates was high, 300 to 400 µg daily. The clinical and biochemical investigation of the subjects revealed no signs of nutritional deficiency. Their plasma lipoproteins and the blood pressures were low for their age, in agreement with observations made earlier in a group of vegans.
Nutritional intake and iron status were investigated in 35 vegetarians (15 vegetarian males, 20 vegetarian females) and 32 nonvegetarians (13 vegetarian males, 19 nonvegetarian females). Each subject completed a 12-d diet record. Hemoglobin, plasma iron, ferritin, total iron binding capacity, and transferrin saturation were measured. Vegetarians had lower dietary fat, protein, fiber, vitamin A, iron, cholesterol and sodium intakes than nonvegetarians. No significant differences were found in carbohydrate, thiamin, vitamin C, and calcium intakes between the 2 major groups. Although vegetarians had lower iron intake than nonvegetarians, their iron intake was 275% and 142% above the Taiwan Recommended Daily Nutrient Allowance (RDNA) for vegetarian males and females (p < 0.05), respectively. One vegetarian female was in an anemia stage with a plasma iron level of 32 μg/dL; 2 female subjects (1 vegetarian, 1 nonvegetarian) had anemic ferritin levels (< 10 ng/mL); 5 vegetarian females and 1 nonvegetarian female subject had anemic total iron binding capacity levels > 410 μg/dL; and 3 vegetarian males, 6 vegetarian females and 1 nonvegetarian female showed anemia with transferrin saturation < 15%. Six vegetarian females and 1 nonvegetarian female were anemic because they had two or more abnormal biochemical indices of iron status. Although vegetarian subjects had sufficient iron intake, the bioavailability of iron seemed limited to maintaining iron balance, especially in women.
Using cross-sectional data from the longitudinal Coronary Artery Risk Development in Young Adults (CARDIA) study, we assessed associations between meat consumption and other dietary- and health-status indicators. Less than one percent of this sample (n = 32) ate no red meat or poultry, and another 1% (n = 47) ate red meat or poultry less than once per week. Individuals who ate red meat and poultry less than once per week were less likely to drink alcohol (P = 0.003); reported more physical activity (P less than or equal to 0.001); had lower [corrected] Keys scores (P less than or equal to 0.001); consumed diets higher in carbohydrates, starch, fiber, vitamins A and C, and calcium and lower in energy, fat, and protein (P less than or equal to 0.001); had smaller body sizes as indicated by the body mass index [calculated as wt(kg)/ht(m2)] (P = 0.01); and had lower concentrations of total serum cholesterol (P = 0.001), low-density-lipoprotein cholesterol (P = 0.001), and triglycerides (P = 0.015) compared with individuals who consumed meat more frequently.
Dietary protein exerts a significant calciuretic effect. A twofold increase in protein at constant levels of calcium and phosphorus intakes causes a 50% increase in urinary calcium. The protein-induced hypercalciuria results primarily from decreased fractional renal tubular reabsorption of calcium associated with catabolism of excess sulfur amino acids and the resultant urinary excretion of acid and sulfate. A protein-induced elevation in glomerular filtration rate also contributes to the calciuresis. Dietary phosphorus also modifies the calciuretic effect of proteins, as it increases renal tubular reabsorption of calcium and thereby exerts a hypocalciuretic effect. Consequently, a soy-based diet was able to maintain calcium balance at a calcium intake of 457 mg/day in spite of a protein intake of 90 g, presumably due to the lower level of sulfur amino acids in the soy diet and to the 1450 mg phosphorus which accompanied the soy protein.
Many aspects of vegetarian diets are currently of interest from a health standpoint. It is becoming increasingly important to recognize that both values and scientific issues come into play in evaluating data on diet and nutrition.
To examine the associations of diet and other lifestyle factors with body mass index (BMI) using data from the Oxford Vegetarian Study.
1914 male and 3378 female non-smokers aged 20-89 y at recruitment to the study.
All subjects completed a diet/lifestyle questionnaire at recruitment giving details of their usual diet and other characteristics including height and weight, smoking and drinking habits, amount of exercise, occupation and reproductive history. Answers to the food frequency questionnaire were used to classify subjects as either meat eaters or non-meat eaters, and to estimate intakes of animal fat and dietary fibre. Subjects were further classified according to their alcohol consumption, exercise level, social class, past smoking habits and parity.
Mean BMI was lower in non-meat eaters than in meat eaters in all age groups for both men and women. Overall age-adjusted mean BMIs in kg/m2 were 23.18 and 22.05 for male meat eaters and non-meat eaters respectively (P < 0.0001) and 22.32 and 21.32 for female meat eaters and non-meat eaters respectively (P < 0.0001). In addition to meat consumption, dietary fibre intake, animal fat intake, social class and past smoking were all independently associated with BMI in both men and women; alcohol consumption was independently associated with BMI in men, and parity was independently associated with BMI in women. After adjusting for these factors, the differences in mean BMI between meat eaters and non-meat eaters were reduced by 36% in men and 31% in women.
Non-meat eaters are thinner than meat eaters. This may be partly due to a higher intake of dietary fibre, a lower intake of animal fat, and only in men a lower intake of alcohol.
To describe the characteristics of dietary supplement users in a large cohort of women and test the hypothesis that supplement users would be more likely to have a healthier lifestyle than non-users.
Comparison of nutrient intakes from food frequency questionnaire (FFQ) data for 8409 supplement users and 5413 non-users. Use of logistic regression modelling to determine predictors of supplement use in this cohort.
13,822 subjects from the UK Women's Cohort Study (UKWCS) for whom data on supplement use was available.
Significant differences in nutrient intakes from FFQ were seen between the two groups, with supplement users having higher intakes of all nutrients, except for fat and vitamin B12. Use of dietary supplements was associated with being vegetarian, vegan or fish-eating, consuming more fruit and vegetables, being more physically active and having a lower alcohol intake. Supplement use was less likely in those with a body mass index above 25 and those who reported smoking regularly.
The findings are consistent with the hypothesis that supplement use is associated with a healthier lifestyle profile and an adequate nutritional intake, suggesting that supplement users do not need to take supplements to meet a nutrient deficiency.
We evaluated iron status and its determinants in healthy adolescents. Fasting morning blood samples from a school‐based cross‐sectional study were analyzed for serum ferritin (SF), serum iron, total iron‐binding capacity, and circulating transferrin receptors. Physical development, chronic disease, medication, dietary intake, and physical activity were assessed using clinical examination, questionnaires, and 7‐day records. The risk of having low serum ferritin values was estimated using bivariate and multivariate regression. Subjects were 867 healthy Swedish adolescents, 14− and 17‐year‐olds (472 boys and 395 girls). SF values increased with pubertal stage in boys but not in girls. Five percent of the boys and 15% of the girls had SF values <12 μg/L. Of the 17‐year‐old boys, 7% compared to 1% of the 17‐year‐old girls had SF values > 100 μg/L. Forty‐one percent of cases with SF values >12 μg/L had serum iron values < 15 μ M , and 22% had transferrin saturation values <16%. Mean total iron intakes of the boys were high [1.6 times recommended daily allowance (RDA)] and mean intakes of the girls were adequate (0.9 times RDA). Low heme iron intakes increased the risk of low iron stores (<12 μg/L) in girls but not in boys. Total iron intake or other dietary factors, physical development, or level of physical activity did not influence the risk of low SF. The findings of this study suggest that the differences in iron status between boys and girls in adolescence results primarily from biological differences other than menstrual bleeding or insufficient iron intake. Furthermore, the results question the role of SF as an indicator of iron deficiency in adolescence, in particular if age and sex are not taken into consideration. We suggest that different reference values for SF, including the cut‐off limit for low SF, adjusted for age and sex, should be considered. The high iron intakes and corresponding high SF values found in the older boys are noticeable in light of the possible negative health consequences of iron overload.
Health practices, attitudes, and beliefs were studied in 150 vegetarians and 150 nonvegetarians matched for age and sex. A questionnaire was administered that included a medical history and questions concerning use of medications, recreational drugs, nutrition supplements, and alcohol; smoking habits; exercise; and relaxation activities. The questionnaire also included Likert scales on which the subjects rated themselves according to their knowledge and practice of nutrition and diet and their agreement or disagreement with statements concerning health. Vegetarians believed in visiting a physician when they were ill but were more willing to try alternative or unusual therapies and/or preventive treatments. Substances that are potentially harmful to the body, such as alcohol, tobacco, or prescription drugs, were used less frequently by vegetarians. Conversely, greater use was seen of substances that are thought to improve health. The area of greatest difference between the groups was in their attitudes and beliefs concerning health. Although the vegetarians believed that they as a group were healthier than nonvegetarians, the lack of differences in self-ratings of health and incidence of health problems suggest that that perception may not be true.
A study was performed by surveying 124 Swedish upper secondary schools via telephone interviews. Those responsible for the school meals reported the number of students having different kinds of vegetarian food. Vegetarian food was defined as lacto-ovo-fish- vegetarian, lacto-ovo-vegetarian and vegan food (strict vegetarian food). The results showed that vegetarian food was served regularly in 88% (109) of the schools. In these schools, lacto-ovo-vegetarian food was the most common vegetarian food served. Twenty-seven per cent of the schools served vegan food to their students. Assuming that students eating vegetarian food at school lunch really are vegetarians, the prevalence of vegetarians in the Swedish school population, at the age of 16-20 years, was calculated to be 5.0%, i.e. 2.0% lacto-ovo-fish- vegetarians, 2.9% lacto-ovo-vegetarians and 0.1% vegans. The high occurrence of vegans (2%) found in the town of Umea (northern Sweden), is probably attributable to the local popularity of the 'Straight Edge' philosophy. This philosophy emphasizes the avoidance of animal products for ethical reasons. However, we suspect, that the Straight Edge vegans have too little interest in nutritional questions, and therefore are consuming a poor diet. This fact may lead to serious health consequences in the future for this group of adolescents, and further investigations are necessary.
The Meal Model 'Matmallen' is a means of estimating portion sizes in connection with both prospective and retrospective dietary studies. It consists of line drawings and photographs that illustrate different portion sizes of dishes and foods. The purpose of this study was to evaluate the validity of the Meal Model by studying differences between served and estimated amounts of foods and also to examine the consequences of these differences when calculating energy and nutrient intakes. There may be both under- and overestimations as a result of choosing the incorrect illustration in the Model, but these differences are levelled out for most individuals when registering several meals. The under- and overestimations varied with the composition of the meal, which is associated with the choice of illustration in the Meal Model. At three of four meals, the fat intake diverged significantly. Contents of proteins and carbohydrates diverged significantly only at one of the meals, and for vitamins C and B12 there were no significant divergences at any of the meals. Differences between weighed and estimated portions may be assumed to depend on the design of the Meal Model since the variation between meals was larger than the variation between individuals. However, when estimating four meals, the differences that emerged as a result of underestimates and overestimates of the different meals were eliminated. The present investigation demonstrates that the Meal Model is a fairly good means of assessing portion sizes but it can be improved.
The aim of this study was to measure the prevalence of teenage vegetarianism and associated food habits and beliefs. Two thousand senior secondary school students (mean age 16 years), from 52 schools in South Australia, participated in a two part survey. The findings show that teenage vegetarianism is primarily a female phenomenon, ranging in prevalence, according to definition, from 8 to 37% of women and 1 to 12% of men. Support for vegetarian practices was high especially from mothers (63%) and classmates (46%). Generally, “teenage vegetarians” consumed fewer red meats than non-vegetarians but ate more chicken. They cited health, animal welfare and environmental reasons in support of their habits. The importance of operational definitions of vegetarianism is emphasized and the findings are discussed in relation to likely motivational influences.
Urine calcium excretion is known to be directly correlated with the level of dietary protein intake. In this experiment we examined the persistence of the hypercalciuria induced by the consumption of high protein diets, and the mechanism of the calciuric response. In a 95-day metabolic study, each of six adult male subjects received formula diets supplying 12 g nitrogen or 36 g nitrogen, and approximately 1400 mg calcium per day. Urine calcium increased rapidly and significantly from an average of 191 mg/day on the 12 g nitrogen diet to 277 mg/day on the 36 g nitrogen diet. There was no significant difference in the apparent absorption of calcium, so that overall calcium balance was -37 mg/day on the 12 g nitrogen diet, and significantly lower at -137 mg/day in subjects consuming the high protein diet. Levels of urinary hydroxyproline, serum insulin, and parathyroid hormone were not significantly increased by high intakes of protein. A decrease in the fractional reabsorption of calcium by the kidney seems to be the most likely cause of the protein-induced hypercalciuria. The consumption of high calcium diets is unlikely to prevent the negative calcium balance and probable bone loss induced by the consumption of high protein diets.
Routinely measuring iron status is necessary because about 6% of Americans have negative iron balance, about 10% have a gene for positive balance, and about 1% have iron overload. Deviations from normal iron status are as follows. (a) Stage I and II negative iron balance, ie, iron depletion: In these stages iron stores are low and there is no dysfunction. In stage I negative iron balance, reduced iron absorption produces moderately depleted iron stores. Stage II negative iron balance is characterized by severely depleted iron stores. More than half of all cases of negative iron balance fall into these two stages. When persons in these stages are treated with iron, they never develop dysfunction or disease. (b) Stage III and IV negative iron balance, ie, iron deficiency: Iron deficiency is characterized by inadequate body iron for normal function, producing dysfunction and disease. In stage III negative iron balance, dysfunction is not accompanied by anemia; anemia develops in stage IV negative iron balance. (c) Stage I and II positive iron balance: Stage I positive balance usually lasts for several years with no dysfunction. Supplements of iron and/or vitamin C promote progression to dysfunction or disease. Iron removal prevents progression to disease. Iron overload disease develops in stage II positive iron balance after years of iron overload has caused progressive damage to tissues and organs. Again, iron removal stops disease progression. There are a variety of indicators of iron status. Serum ferritin is in equilibrium with body iron stores.(ABSTRACT TRUNCATED AT 250 WORDS)
The aim of the study was to evaluate the compliance in a dietary intervention study. When drawing conclusions about the relationship between dietary intake and disease occurrence/disease-related variables it is important to obtain valid dietary data. 20 healthy, non-smoking normal-weight omnivores changed from a mixed to a lactovegetarian diet. Dietary surveys (four 24 h recalls per person and time-period), urinary and faecal sample collections were performed before and 3, 6 and 12 months after the dietary shift. The validation of energy, protein, sodium and potassium yielded approximately the same ratio of dietary intake to biological marker at 0 and 3 months. This ratio decreased towards 6 months and continued to decrease towards 12 months. The fibre intake was compared to the total faecal weight directly and indirectly by calculating the fibre intake from the stool weight, the water content in faeces and the excretion of short-chain fatty acids (SCFAs). These four methods of fibre validation showed that the ratio of dietary intake to biological marker was always highest at 12 months, indicating an overestimation of the fibre intake at the end of the study. This is the first time these methods of validating fibre intake have been used in an epidemiological study. The ratio of dietary calcium intake to urinary and faecal calcium excretion did not show any statistical difference between the period before and 3 months after the dietary shift. To conclude, almost all investigated dietary data show approximately the same validity before and 3 months after the dietary shift, and show the least validity 12 months after the dietary shift. Thus, this study demonstrates that it is difficult to obtain valid dietary data 1 year after a drastic dietary change, indicating a decreased compliance to the new dietary regimen at the end of the 1 year study period. This represents important information when attempting to relate biological effects to dietary intake, and illustrates the importance of using biological markers for food intake in dietary surveys.
This study assessed the biochemical status of a number of vitamins and iron in a group of new vegetarians. Values were compared with a group of omnivores of similar age. Satisfactory to high levels of serum folate, vitamin E, and riboflavin were found, and all were significantly higher in vegetarians than omnivores. Thiamin status was satisfactory in both groups although a small but statistically significant difference in favor of the omnivores was found. Serum vitamin B-12 was significantly lower in vegetarians, and iron status as measured by serum ferritin was very significantly lower in vegetarians. Pyridoxine status was similar in both groups. A number of sex differences were found in the vegetarian sample. New vegetarian women appear to be at particular risk of developing low iron stores.
For a long time selenium was known only for its toxic characteristics. During the last few decades selenium deficiency has been recognized as an important agricultural problem in Sweden. On average, grains and pastures only contain one tenth of the amount of selenium considered necessary to avoid symptoms of deficiency. However, the incidence of muscle degeneration among the animals has been low, probably due to imported animal feed. Since 1980 selenium has been added to animal feed, but only minor changes in the selenium content of Swedish food stuffs have been recorded. Some studies have shown that the average Swedish dietary intake of selenium is 10-70 micrograms/day. The lowest levels were found in vegan diets, based on locally-grown products. Swedish studies have found depressed glutathione peroxidase (GSH-Px) levels in patients with various skin disorders, including acne; myotonic dystrophy and rheumatic arthritis. Clinical trials with selenium supplementation have given positive results in some of these disorders as well as in some patients with disabling muscular and joint pains. Today there is a large sale of selenium tablets sometimes with additional vitamin E. The marketing of these tablets, however, is often based on unsubstantiated claims.
Health practices, attitudes, and beliefs were studied in 150 vegetarians and 150 nonvegetarians matched for age and sex. A questionnaire was administered that included a medical history and questions concerning use of medications, recreational drugs, nutrition supplements, and alcohol; smoking habits; exercise; and relaxation activities. The questionnaire also included Likert scales on which the subjects rated themselves according to their knowledge and practice of nutrition and diet and their agreement or disagreement with statements concerning health. Vegetarians believed in visiting a physician when they were ill but were more willing to try alternative or unusual therapies and/or preventive treatments. Substances that are potentially harmful to the body, such as alcohol, tobacco, or prescription drugs, were used less frequently by vegetarians. Conversely, greater use was seen of substances that are thought to improve health. The area of greatest difference between the groups was in their attitudes and beliefs concerning health. Although the vegetarians believed that they as a group were healthier than nonvegetarians, the lack of differences in self-ratings of health and incidence of health problems suggest that that perception may not be true.
In order to determine the value of 24 h urine nitrogen (N) excretion as a way of validating dietary methods of measuring protein intake in individuals, daily N intake and excretion has been measured in eight healthy subjects while consuming their usual, varying, diets for 28 days. Daily duplicates of all food eaten were obtained and consecutive 24 h collections of urine and feces were made throughout and analyzed for N by the Kjeldahl method. The completeness of the 24 h urine collections was verified by the use of PABA and of feces by radiopaque pellets. N losses in blood and from the skin were measured. The within person variation in dietary intake ranged from 14 to 26% (coefficient of variation, CV) while urine N was more constant, varying from 11 to 18% (CV) within individuals. In these subjects eight 24 h urine collections, verified for their completeness, were sufficient to estimate dietary N intake to within 81 +/- 5% (SD) as assessed by 18 day dietary records.
Food and other avoidances and attitudes toward health services of 100 young vegetarians are reported.
The effect of level of protein intake on the excretion and reten tion of calcium in the adult human male was studied. Nine young men given 800 mg calcium daily were fed 47, 95 and 142 g protein each for 15 days. Sub jects retained an average of 12 and 1 mg calcium, respectively, when fed 47 and 95 g protein but lost 85 mg when fed 142 g. There was a highly significant dif ference in urinary calcium at each level of protein intake, the respective values being 217, 303 and 426 mg calcium when the subjects were fed the low, medium and high protein diet. Fecal calcium was significantly decreased as the protein intake was increased from 47 to either 95 or 142 g daily but not when it was increased from 95 to 142 g. Protein intake had no effect on serum calcium. J. Nutr. 102: 1297-1302, 1972.
Health professionals, food scientists and food communicators need to recognize that vegetarian practices today cover a wide range of eating styles with disparate and sometimes contradictory health effects. Some forms of vegetarianism do increase the risks of dietary deficiencies, malnutrition and serious diseases or death. Other forms have obvious benefits as evidenced by those individuals and population groups who have practiced vegetarianism on a long-term basis and have demonstrated excellent health. The health risks of vegetarianism can be avoided and the benefits-maximized when dietary planning is based on accurate up-to-date nutritional guidelines.
Here, anthropometric, clinical, and biochemical data on 76 contemporary men and women vegetarians are reported and discussed.
We evaluated iron status and its determinants in healthy adolescents. Fasting morning blood samples from a school-based cross-sectional study were analyzed for serum ferritin (SF), serum iron, total iron-binding capacity, and circulating transferrin receptors. Physical development, chronic disease, medication, dietary intake, and physical activity were assessed using clinical examination, questionnaires, and 7-day records. The risk of having low serum ferritin values was estimated using bivariate and multivariate regression. Subjects were 867 healthy Swedish adolescents, 14- and 17-year-olds (472 boys and 395 girls). SF values increased with pubertal stage in boys but not in girls. Five percent of the boys and 15% of the girls had SF values < 12 micrograms/L. Of the 17-year-old boys, 7% compared to 1% of the 17-year-old girls had SF values > 100 micrograms/L. Forty-one percent of cases with SF values > 12 micrograms/L had serum iron values < 15 microM, and 22% had transferrin saturation values < 16%. Mean total iron intakes of the boys were high [1.6 times recommended daily allowance (RDA)] and mean intakes of the girls were adequate (0.9 times RDA). Low heme iron intakes increased the risk of low iron stores (< 12 micrograms/L) in girls but not in boys. Total iron intake or other dietary factors, physical development, or level of physical activity did not influence the risk of low SF. The findings of this study suggest that the differences in iron status between boys and girls in adolescence results primarily from biological differences other than menstrual bleeding or insufficient iron intake. Furthermore, the results question the role of SF as an indicator of iron deficiency in adolescence, in particular if age and sex are not taken into consideration. We suggest that different reference values for SF, including the cut-off limit for low SF, adjusted for age and sex, should be considered. The high iron intakes and corresponding high SF values found in the older boys are noticeable in light of the possible negative health consequences of iron overload.
The study was designed to investigate the nutritional intake and haematological status of adult vegetarians.
Cross-sectional comparison of vegetarians and age/sex-matched omnivores.
Free-living community subjects.
Fifty vegetarians were recruited by local advertisement. Each vegetarian selected their own age/sex-matched 'friend' control.
Each subject completed a 12 day dietary record. Haemoglobin, red cell indices, and serum ferritin, B12 and folate were measured.
Protein, saturated fat and vitamin D intake were significantly lower in the vegetarians, particularly in the vegans. Dietary fibre was higher in the vegetarians, and intake of calcium and zinc was similar. Mean (SD) iron intake in the vegetarians and vegans of 16.8 (4.8) mg/day was significantly greater than that of the omnivores: 14.6 (4.3) mg/day (P = 0.02). All the iron consumed by the vegetarians was non-haem; for the omnivores 10% was haem iron. Serum ferritin concentrations were significantly lower in male vegetarians than omnivores; mean (SD): 36.6 (36.0) and 105.4 (78.7) ng/ml, respectively, P < 0.01; and significantly more had values below 12 ng/ml (P < 0.001), despite having higher iron intakes which exceeded the Recommended Nutrient Intake (RNI). Female vegetarians also had lower ferritin concentrations than omnivores; mean (SD) 13.6 (7.5) compared to 33.6 (54.3) ng/ml, P < 0.01, but similar numbers of women had values below 12 ng/ml (42% and 39%). The vegans all had B12 intakes below the RNI; and 35% of the long-term vegetarians and vegans had serum vitamin B12 concentrations below the reference range.
Although the vegetarians had diets nearer to the recommended diet with a lower fat and salt content, a significant number need advice to improve their haematological status. Recommended intakes of iron may also need to be higher for vegetarians, particularly men.
This review compares the content and major food sources of copper, manganese, selenium, and zinc in vegetarian and omnivorous diets. Interactions affecting trace element bioavailability and their impact on the trace element status of vegetarians are discussed. Adult vegetarian diets often have a lower zinc and selenium content but a higher copper and manganese content compared with omnivorous diets. Cereals are the primary sources of copper, manganese, and selenium in most diets and the major source of zinc in many vegetarian diets; flesh floods are the primary source of zinc and secondary source of selenium in omnivorous diets. Despite the apparent lower bioavailability of zinc, copper, manganese, and selenium in vegetarian diets because of the high contents of phytic acid and/or dietary fiber and the low content of flesh foods in the diet, the trace element status of most adult vegetarians appears to be adequate. Children, however, appear to be more vulnerable to suboptimal zinc status, presumably because of their high zinc requirements for growth and their bodies' failure to adapt to a vegetarian diet by increased absorption of dietary zinc.
Vegetarianism pursued for reasons of physical health is a recent practice historically. Before the 19th century, avoidance of animal food was justified with moral and metaphysical arguments. During the early 1800s, however, an intensified desire for improved health combined with the ascendance of science to a position of cultural authority helped to promote the formulation of physiological arguments for vegetarianism. Theories of the nutritional superiority of a vegetable diet were nevertheless shaped by moral convictions, giving vegetarian spokesmen such as Sylvester Graham and John Harvey Kellogg the appearance of being dietary fanatics. Only as nutritional science expanded from the mid-20th century onward did vegetarianism acquire general recognition as a healthful dietary alternative. But because that alternative is still often selected for moral or other nonscientific reasons, nutritional education of vegetarians remains an essential activity.
The doubly labeled-water technique can be used as a noninvasive measure of energy expenditure, and, with no gains or losses in weight, expenditure should equal intake. Provided sufficiently complete urine collections are obtained, urine nitrogen is an accurate measure of protein intake in individuals in nitrogen balance. Validations of dietary surveys by using estimates of energy expenditure and the 24-h urine nitrogen technique show that inaccurate reports of food intake occur in a proportion of individuals within a group, leading to bias in overall average intakes for some nutrients, if only one method of dietary assessment is used. Errors between methods however are not usually correlated, so that improved estimates can be obtained from a combination of two or more methods of dietary assessment. All future dietary surveys should require independent evidence of their validity.
A school-based dietary survey, using seven-day records, was performed in two cohorts of Swedish adolescents; 14- and 17-year-olds. The study comprised 366 boys and 365 girls. When compared to previous studies in Sweden, a striking finding was a decrease in dietary fat intake and an increase in carbohydrate intake. However, the relative intake of saturated fat had not changed (15% of total energy). The dietary change was mainly due to an increased consumption of cereal products. There were no major differences in dietary habits or nutrient density of the food between the two age groups, or between boys and girls. The mean intakes of protein, fat and carbohydrate, expressed as a percentage of the total energy intake, were 15, 33 and 52%, respectively. The mean intakes of vitamins and minerals were low only for selenium. The boys had a high iron intake (1.5 and 1.7 times the recommended intake for 14- and 17-year-olds, respectively) while the mean iron intake for girls was 0.9 times the recommended dietary allowances in both age groups. The intake of dietary salt was higher in boys than in girls (7.7 g and 9.0 g per day in 14- and 17-year-old boys, respectively, and 5.8 g per day in both 14- and 17-year-old girls). In a long-term health perspective, this positive change in nutrient intake in adolescents may contribute to a reduction in the incidence of diet-related diseases in Sweden.(ABSTRACT TRUNCATED AT 250 WORDS)
To assess the iron and zinc status of young females, aged 14 to 19 years, consuming vegetarian and omnivorous diets.
Dietary intakes (via 3-day weighed food records), BMI, and laboratory indices of iron and zinc status were compared in a convenience sample of 79 lacto-ovo-vegetarians (LOV), 16 semi-vegetarians (SV), and 29 omnivorous (OM) females.
Twenty-nine percent LOV, 44% SV, and 17% OM had low iron stores (i.e., plasma ferritin < 12 micrograms/L); only 3% had anemia. As well, 24% LOV, 33% SV, and 18% OM had serum zinc < 10.71 mumol/L and 14% LOV, 14% SV, and 17% OM had hair zinc < 1.68 mumol/g. Intakes of iron and ascorbic acid from the weighed food records were associated with serum iron (p < 0.04) and total iron binding capacity (negatively; p < 0.02), respectively, whereas Phy:Zn molar ratios were associated with serum zinc (negatively; p < 0.04). Z-scores for BMI were associated with serum zinc (p < 0.02) and diet type (p < 0.001); serum AP activity was associated with age (p < 0.0001) and oral contraceptive use (p < 0.04).
Suboptimal iron and zinc status was attributed to low intakes of poorly available iron and zinc in all dietary groups.
To determine the energy and nutrient intakes of some omnivorous and vegetarian female adolescents to compare their risk for nutrient inadequacies.
A convenience sample of 78 lacto-ovo-vegetarians (LOV), 15 semi-vegetarians (SV), and 29 omnivorous (OM) females aged 14-19 years completed three-day weighed records from which mean intakes and major food sources of energy, nutrients, and dietary fiber (as nonstarch polysaccharides (NSP)) were calculated.
Mean daily intakes for energy and most nutrients were comparable for the three groups although LOV had higher intakes (p < 0.01) of NSP, copper, and manganese. Lacto-ovo-vegetarians consumed (g/d) less dairy products, flesh foods, and sweets but more legumes, nuts, and vegetables. Major food sources were cereal products for energy, most nutrients, NSP, dairy products for calcium, and fruits and vegetables for vitamin C. More LOV and SV had energy intakes less than two-thirds of Canadian recommendations, and higher probability estimates of inadequacy for protein, calcium, iron, zinc, and riboflavin than OM. Fewer LOV (35%) than SV (53%) and OM (41%) had diets with less than 30% energy from fat.
LOV and SV were more at risk for nutrient inadequacies than OM, although about 33% of OM were also at risk for inadequate intakes of iron and zinc.
The aim of this study was to evaluate the dietary iron intake of 15-year-old adolescents from two different regions of Sweden, in relation to their iron status. The study comprised 185 boys and 209 girls, randomly selected from the official population register. The iron intake was calculated from a 7-day record, and varied between 7 and 35 and 6 and 27 mg per day for boys and girls, respectively. The daily median intakes in boys and girls were 18.7 and 14.2 mg, respectively. S-ferritin, s-iron, and s-transferrin saturation, measured in all the subjects, did not differ significantly between the two regions. However, the mean serum ferritin concentration was significantly higher in the boys (36.4 micrograms l-1) than in the girls (29.4 micrograms l-1) (p < 0.001). Low s-ferritin levels, defined as s-ferritin < 12 micrograms l-1 were found in seven boys (3.7%) and in 29 girls (13.9%). None of the adolescents had iron deficiency anaemia, defined as Hb < 110 gl-1 in combination with s-ferritin < 12 micrograms l-1. Regression and correlation analyses did not show any significant correlation between dietary iron intake and s-ferritin, or between s-ferritin and haemoglobin (Hb), MCH and MCHC. A significant correlation was found, however, between s-ferritin and transferrin saturation (p < 0.005) in both sexes. When the adolescents who still had s-ferritin < 12 micrograms l-1 at a second blood examination were given a 6 weeks trial with oral iron therapy, all of them showed an increase both in s-ferritin and in blood Hb. The 95% confidence intervals of s-ferritin for 15-year-old Swedish boys and girls were defined as 11-90 and 7-85 micrograms l-1, respectively.
To determine the total day-to-day intraindividual variability of ferritin and transferrin receptor (TfR), we collected venous serum and plasma and capillary serum and plasma samples during 10 nonconsecutive days over a 4-wk period from a group of healthy men (n = 10) and women (n = 11) aged 19-46 y. On the basis of a method previously established in younger and older adults, biological (sigma 2 day) and analytical (sigma 2 rep) variance components were computed and summed to obtain the total day-to-day intraindividual variability (sigma 2 tot). The total day-to-day intraindividual CV (CVtot) was lower for TfR than for ferritin measurements. One to two discrete blood samples are required to accurately determine capillary and venous TfR, whereas capillary and venous ferritin, which have a higher CVtot, require three to six samples. Results from the current study showing the low biological and analytical variability of TfR support the use of this new test for assessing a person's iron status.
To compare validation of reported dietary intakes from weighed records against urinary nitrogen excretion and energy expenditure measured by DLW, and to examine the utility of the Goldberg cut-off for EI:BMR in the identification of under-reporters.
Energy (EI) and nitrogen (protein) intake (NI) were measured by 16 d of weighed diet records collected over 1 y. They were validated against urinary nitrogen excretion in 5-8 (mean 6.0) 24 h urine collections and total energy expenditure (EE) measured by doubly labelled water (DLW). Basal metabolic rate (BMR) as measured by whole body calorimetry in women or bedside ventilated hood (Deltatrac) in men. Individual subjects were identified as under-reporters if Urine N:NI was > 1.00 or if EI:EE was < 0.79. The agreement between the two ratios in detecting under-reporting was examined. The results from the direct validation by DLW were also compared with validation using the Goldberg cut-off for EI:BMR (Goldberg et al, 1991).
Eighteen women aged 50-65 y and 27 men aged 55-87 y were selected from participants in two larger dietary surveys as representing the full range of dietary reporting as measured by Urine N:NI. Data from a previous study of 11 post-obese subjects were also included.
The two ratios, Urine N:NI and EI:EE, were significantly related (r = -0.48, P < 0.01). Using the above cut-offs, seven (4F, 3M) subjects were identified as under-reporters by both methods, one (1M) by Urine N:NI only and 8 (3F, 5M) by EI:EE only. There was close agreement in post-obese subjects where 6 subjects showed a substantial degree of under-reporting by both methods (r = -0.87, P < 0.001). The correlation between direct validation by DLW and EI:BMRest was 0.65 (P < 0.001). Some limitations of the Goldberg cut-off for identifying individual under-reporters were demonstrated.
EI:EE provides an estimate of the degree of under-reporting of energy at the group and individual level. Urine N:NI identifies under-reporting of protein intake and the most obvious under-reporters of energy, but is probably of lesser value in estimating the overall degree of under-reporting of energy at group level. Good validation by EI:BMR depends on knowledge of physical activity at both group and individual level. However, the correlation of 0.65 between EI:EE and EI:BMRest suggests that EI:BMR could be usefully incorporated into analysis of data from epidemiological studies. Validation measures consisting of at least predicted EI:BMR ratios and urinary measures should be incorporated into dietary surveys.
This work was funded by the Ministry of Agriculture Fisheries and Food, the Medical Research Council, the Cancer Research Council and the Swedish Medical Research Council and the Henning and Johan Throne-Holst Foundation.
The study was designed to investigate the iron intake and status of Australian, male vegetarians aged between 20 and 50 y.
Cross-sectional comparison of male vegetarians and age/sex matched omnivores.
Free-living community subjects.
39 ovolactovegetarians, 10 vegans and 25 omnivores were recruited by local advertisement.
A 12-d semiquantitative dietary record to assess iron and zinc intake. Iron status was assessed by measurement of serum ferritin and haemoglobin concentrations.
Mean (s.d.) daily iron intakes of both the ovolactovegetarians (20.4 (7.7) mg/d) and vegans (22.9 (6.2) mg/d), were significantly higher than the omnivores' intake of 15.8 (4.5) mg/d. Ovo-lactovegetarians and vegans had significantly (P < 0.001 and P < 0.05, respectively) lower serum ferritin concentrations than omnivores: mean (s.d.): 64 (46.9), 65 (49.9) and 121 (72.5) ng/ml, respectively. Significantly more ovolactovegetarians and vegans than omnivores had serum ferritin concentrations below 25 ng/ml and below 12 ng/ml (P < 0.05). A higher proportion of omnivores had concentrations above 200 ng/ml (P < 0.05). The differences in serum ferritin concentrations between the vegetarians and omnivores remained significant even after exclusion of iron supplement users.
Australian male vegetarians had iron intakes higher than those of omnivores and above recommended levels, but their iron status was significantly lower.
Despite the possible overall health benefits of a vegetarian diet, there is concern that some vegetarians and infrequent meat eaters, particularly females, may have inadequate iron status because of low or no heme-iron intakes.
The objective was to investigate the nutritional intake and iron status of vegetarian women.
The nutritional intakes of 50 free-living vegetarian women aged 18-45 y and 24 age-matched omnivorous control women were assessed by using 12-d weighed dietary records. Iron status was assessed by measuring hemoglobin and serum ferritin concentrations.
There was no significant difference between mean (+/-SD) daily iron intakes of vegetarians and omnivores (10.7 +/- 4.4 and 9.9 +/- 2.9 mg, respectively), although heme-iron intakes were low in the vegetarians. Vegetarians had significantly lower intakes of protein (P < 0.01), saturated fat (P < 0.01), and cholesterol (P < 0.001), and significantly higher intakes of dietary fiber (P < 0.001) and vitamin C (P < 0.05). Mean serum ferritin concentrations were significantly lower (P = 0.025) in vegetarians (25.0 +/- 16.2 microg/L) than in omnivores (45.5 +/- 42.5 microg/L). However, similar numbers of vegetarians (18%) and omnivores (13%) had serum ferritin concentrations <12 microg/L, which is a value often used as an indicator of low iron stores. Hemoglobin concentrations were not significantly different.
It is important that both vegetarian and omnivorous women maintain an adequate iron status and follow dietary practices that enhance iron absorption.
To develop a method to make use of incomplete 24-hour urinary samples in nutritional epidemiology, especially when validating the dietary intake of nitrogen (protein), sodium and potassium.
Urinary data for men and women collected in three different studies were evaluated. The concentration of para-aminobenzoic acid (PABA) in one 24-hour urine sample per person was compared with the concentrations of nitrogen, sodium, potassium and creatinine.
Men and women living in Cambridge, UK and women living in the town of Varberg, Sweden.
In total, this study consists of data from 73 Swedish women (20-50 years of age), 165 UK women (50-65 years) and 75 UK men (55-88 years).
On average four out of 10 people in this study had a PABA recovery below 85%. The linear regression equations for urinary excretion of nitrogen, sodium and potassium in relation to PABA recovery were y=2.3 + 0.088 x chi (r=0.99), y=45 + 0.82 x chi (r= 0.87) and y = 19 + 0.60 x chi (r= 0.93), respectively.
The linear regression equations can be used for adjusting urinary nitrogen, sodium and potassium in urinary collections in cases where the PABA recovery is below 85%. Since it is common to obtain 24-hour urine collections with a PABA recovery below 85%, this method should increase the usefulness of biological markers of food intake in nutritional epidemiological studies and also increase the possibilities to study people that previously have been part of the drop-out group or the group with low motivation and cooperation. It is important to stress that we have not studied the relationship between PABA recovery and various urinary variables below the PABA recovery of 50%. Thus, in a case of PABA recovery below 50%, we do not recommend the use of this method to compensate for incomplete collections.
Variation in absorption efficiency explains more of the variability in calcium balance than does actual calcium intake. Several investigators have suggested that the relatively high phosphorus and protein intakes of the diets of industrialized nations reduce calcium absorption and thereby aggravate the problem of calcium deficiency.
My objective was to test whether variation in phosphorus and protein intakes is associated with variation in calcium absorption.
One hundred ninety-one Roman Catholic nuns aged 48.7 +/- 7.0 y were studied approximately 3 times each over a >20-y period with a full metabolic balance regimen; controlled, chemically analyzed diets; and double-tracer measurement of calcium absorption.
Although the expected associations with absorption were found for age, calcium intake, and estrogen status, no association was observed for intakes of either phosphorus or protein.
Phosphorus and protein intakes do not contribute to the wide variability in calcium absorption efficiency.
It is difficult to obtain accurate reports of dietary intake; therefore, reported dietary intakes must be validated. Researchers need low-cost methods of estimating energy expenditure to validate reports of energy intake in groups with different lifestyles and eating habits.
We sought to validate the reported energy expenditure and energy and protein intakes of Swedish adolescent vegans and omnivores.
We compared 16 vegans (7 females and 9 males; mean age: 17.4 +/- 0.8 y) with 16 omnivores matched for sex, age, and height. Energy expenditure as reported in a physical activity interview and energy and protein intakes as reported by diet history were validated by using the doubly labeled water method and by measuring urinary nitrogen excretion.
The validity of reported energy expenditure and energy and protein intakes was not significantly different between vegans and omnivores. The physical activity interview had a bias toward underestimating energy expenditure by 1.4 +/- 2.6 MJ/d (95% CI: 2.4, 0.5 MJ/d). The diet-history interview had a bias toward underestimating energy intake by 1.9 +/- 2.7 MJ/d (95% CI: 2.9, 1.0 MJ/d) but showed good agreement with the validation method for nitrogen (protein) intake (underestimate of 0.40 +/- 1.90 g N/d; 95% CI: 1.10, 0.29 g N/d).
The physical activity and diet-history interviews underestimated energy expenditure and energy intake, respectively. Energy intake and expenditure were underestimated to the same extent, and the degree of underestimation was not significantly different between vegans and omnivores. Valid protein intakes were obtained with the diet-history method for both vegans and omnivores.
Dietary guidelines: vegetarian diet position paper (UK)
- British Dietetic Association
British Dietetic Association. Dietary guidelines: vegetarian diet
position paper (UK). Int J Veg Nutr 1997;1:106-14.
Attempts to estimate sodium intake in humans
- M J Fregly
- M J Horan
- M Blaustein
- J B Dunbar
- W Dachadorian
- N B Kaplan
Fregly MJ. Attempts to estimate sodium intake in humans. In:
Horan MJ, Blaustein M, Dunbar JB, Dachadorian W, Kaplan NB,
Simopoulos AP, eds. NIH workshop on nutrition and hypertension.
New York: Biomedical Information, 1985:93-112.
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