Position of the American Dietetic Association and Dietitians of Canada: Vegetarian Diets

It is the position of the American Dietetic Association and Dietitians of Canada that appropriately planned vegetarian diets are healthful, nutritionally adequate, and provide health benefits in the prevention and treatment of certain diseases. Approximately 2.5% of adults in the United States and 4% of adults in Canada follow vegetarian diets. A vegetarian diet is defined as one that does not include meat, fish, or fowl. Interest in vegetarianism appears to be increasing, with many restaurants and college foodservices offering vegetarian meals routinely. Substantial growth in sales of foods attractive to vegetarians has occurred and these foods appear in many supermarkets. This position paper reviews the current scientific data related to key nutrients for vegetarians including protein, iron, zinc, calcium, vitamin D, riboflavin, vitamin B-12, vitamin A, n-3 fatty acids, and iodine. A vegetarian, including vegan, diet can meet current recommendations for all of these nutrients. In some cases, use of fortified foods or supplements can be helpful in meeting recommendations for individual nutrients. Well-planned vegan and other types of vegetarian diets are appropriate for all stages of the life-cycle including during pregnancy, lactation, infancy, childhood, and adolescence. Vegetarian diets offer a number of nutritional benefits including lower levels of saturated fat, cholesterol, and animal protein as well as higher levels of carbohydrates, fibre, magnesium, potassium, folate, antioxidants such as vitamins C and E, and phytochemicals. Vegetarians have been reported to have lower body mass indices than non-vegetarians, as well as lower rates of death from ischemic heart disease, lower blood cholesterol levels, lower blood pressure, and lower rates of hypertension, type 2 diabetes, and prostate and colon cancer. While a number of federally funded and institutional feeding programs can accommodate vegetarians, few have foods suitable for vegans at this time. Because of the variability of dietary practices among vegetarians, individual assessment of dietary intakes of vegetarians is required. Dietetics professionals have a responsibility to support and encourage those who express an interest in consuming a vegetarian diet. They can play key roles in educating vegetarian clients about food sources of specific nutrients, food purchase and preparation, and any dietary modifications that may be necessary to meet individual needs. Menu planning for vegetarians can be simplified by use of a food guide that specifies food groups and serving sizes.

Download Full-text

Vegetarian diets in childhood and adolescence

Molecular and Cellular Pediatrics ◽

10.1186/s40348-019-0091-z ◽

2019 ◽

Vol 6 (1) ◽

Cited By ~ 4

Author(s):

Silvia Rudloff ◽

Christoph Bührer ◽

Frank Jochum ◽

Thomas Kauth ◽

Mathilde Kersting ◽

...

Keyword(s):

Vitamin B12 ◽

Saturated Fatty Acids ◽

Age Groups ◽

Vegetarian Diet ◽

Vegan Diet ◽

Childhood And Adolescence ◽

Nutrient Deficiencies ◽

Omega 3 ◽

Animal Products ◽

Vegetarian Diets

Abstract In Western countries, vegetarian diets are associated with lower intakes of energy, saturated fatty acids and animal protein and higher intakes of fibre and phytochemicals, compared to omnivorous diets. Whether the corresponding health benefits in vegetarians outweigh the risks of nutrient deficiencies has not been fully clarified. It should be noted that vegetarians often have a higher socioeconomic status, follow a more health-conscious lifestyle with higher physical activity, and refrain from smoking more often than non-vegetarians. The nutritional needs of growing children and adolescents can generally be met through a balanced, vegetable-based diet; however, due to their higher nutrient requirements per kilogramme of body weight, vegetarian children have a higher risk for developing nutrient deficiencies than adults. With a vegetarian diet, the mean intakes of some nutrients, such as the omega-3 fatty acid docosahexaenoic acid (DHA), are lower than in omnivores or those eating fish. For other nutrients, such as iron and zinc, the bioavailability from vegetable foodstuffs is reduced when the intake of phytates and fibre is high; thus, the prevalence of iron deficiency can be increased despite high vitamin C intake. In addition, vitamin B12 is only found in animal-source foods. Vitamin B12 should be supplemented in people of all age groups who follow a strict vegan diet without consuming animal products. A vegetarian diet in childhood and adolescence requires good information and supervision by a paediatrician, if necessary, in cooperation with an appropriately trained dietary specialist.

Download Full-text

Health Implications of a Vegetarian Diet

American Journal of Lifestyle Medicine ◽

10.1177/1559827611425762 ◽

2011 ◽

Vol 6 (3) ◽

pp. 250-267 ◽

Cited By ~ 21

Author(s):

Kate Marsh ◽

Carol Zeuschner ◽

Angela Saunders

Keyword(s):

Health Benefits ◽

Saturated Fat ◽

Vegetarian Diet ◽

Whole Grains ◽

Vegan Diet ◽

Eating Pattern ◽

Nutritional Needs ◽

Vegetarian Diets ◽

Treatment Of Obesity ◽

Chronic Health Problems

There is now a significant amount of research that demonstrates the health benefits of vegetarian and plant-based diets, which have been associated with a reduced risk of obesity, diabetes, heart disease, and some types of cancer as well as increased longevity. Vegetarian diets are typically lower in fat, particularly saturated fat, and higher in dietary fiber. They are also likely to include more whole grains, legumes, nuts, and soy protein, and together with the absence of red meat, this type of eating plan may provide many benefits for the prevention and treatment of obesity and chronic health problems, including diabetes and cardiovascular disease. Although a well-planned vegetarian or vegan diet can meet all the nutritional needs of an individual, it may be necessary to pay particular attention to some nutrients to ensure an adequate intake, particularly if the person is on a vegan diet. This article will review the evidence for the health benefits of a vegetarian diet and also discuss strategies for meeting the nutritional needs of those following a vegetarian or plant-based eating pattern.

Download Full-text

Knowledge of Health Professionals Regarding Vegetarian Diets from Pregnancy to Adolescence: An Observational Study

Nutrients ◽

10.3390/nu11051149 ◽

2019 ◽

Vol 11 (5) ◽

pp. 1149 ◽

Cited By ~ 3

Author(s):

Maria Enrica Bettinelli ◽

Elena Bezze ◽

Laura Morasca ◽

Laura Plevani ◽

Gabriele Sorrentino ◽

...

Keyword(s):

Service Learning ◽

Health Professionals ◽

Dietary Habits ◽

Vegetarian Diet ◽

Life Cycles ◽

Vegan Diet ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Correct Definition ◽

Vegetarian Diets

The number of people adopting vegetarian diets is constantly increasing, and many among them are young parents who decide to share their diet with their children. The aim of this study was to investigate health professionals’ knowledge regarding the adoption of vegetarian diets from pregnancy to adolescence. A cross-sectional survey was conducted. The administered questionnaire, which was based on the recommendations of the most up-to-date guidelines, included two macro areas: The first investigated the sociodemographic and professional profile of the interviewees and the second addressed the knowledge of the participants regarding vegetarian diets. A total of 418 health professionals in Italy were interviewed, of whom 65.8% were nursing staff. Among the participants, 79.9% had not attended a nutrition course in the previous five years. A correct definition of a vegetarian/vegan diet was provided by 34.1% of the participants. The answers regarding knowledge of nutrients were correct in 20% of cases, whereas correct answers to questions assessing knowledge of the risk and benefits of a vegetarian diet and the adoption of a vegetarian diet throughout the life cycle were given by 45% and 39.4% of the participants, respectively. A significant correlation between the items of the second macro area that investigated the knowledge and dietary habits of the participants was found for seven items. The results of the study indicate that health professionals do not have complete and exhaustive knowledge about vegetarian diets and lack information on health outcomes and the adoption of a vegetarian diet throughout the different life cycles and nutrients. Improving pre- and in-service learning opportunities in vegetarian nutrition for health professionals is strongly advisable.

Download Full-text

National Cholesterol Education Program (NCEP): Highlights of the Report of the Expert Panel on Blood Cholesterol Levels in Children and Adolescents

PEDIATRICS ◽

10.1542/peds.89.3.495 ◽

1992 ◽

Vol 89 (3) ◽

pp. 495-501 ◽

Cited By ~ 3

Author(s):

Keyword(s):

Risk Factors ◽

Children And Adolescents ◽

Expert Panel ◽

The United States ◽

Blood Cholesterol ◽

Childhood And Adolescence ◽

Cholesterol Levels ◽

Chd Risk ◽

Atherosclerotic Process ◽

Chd Risk Factors

Compelling evidence exists that the atherosclerotic process begins in childhood and progresses slowly into adulthood, at which time it leads frequently to coronary heart disease (CHD), the major cause of death in the United States. Despite substantial success in reducing CHD mortality in the past two decades, the disease is still responsible for more than 500 000 deaths annually. About 20% of hospital discharges for acute CHD are for premature disease, ie, in patients younger than 55 years of age. Many of these adults have children who may have CHD risk factors that need attention. Estimates of the annual cost of CHD range from $41.5 to $56 billion. The Report of the Expert Panel on Blood Cholesterol Levels in Children and Adolescents (which appears as a supplement to this issue of the journal) reviews the evidence that atherosclerosis or its precursors begin in young people; that elevated cholesterol levels early in life play a role in the development of adult atherosclerosis; that eating patterns and genetics affect blood cholesterol levels and CHD risk; and that lowering levels in children and adolescents will be beneficial. Cholesterol is the focus of the report, but other risk factors for atherosclerosis and CHD may originate early in life and should be addressed as well. Specifically, cigarette smoking should be discouraged; hypertension should be identified and treated; obesity should be avoided or reduced; regular aerobic exercise should be encouraged; and diabetes mellitus should be diagnosed and treated. SIGNIFICANCE OF BLOOD CHOLESTEROL LEVELS IN CHILDHOOD AND ADOLESCENCE

Download Full-text

Effects of Vegetarian Diets on Blood Pressure Lowering: A Systematic Review with Meta-Analysis and Trial Sequential Analysis

Nutrients ◽

10.3390/nu12061604 ◽

2020 ◽

Vol 12 (6) ◽

pp. 1604

Author(s):

Kai Wei Lee ◽

Hong Chuan Loh ◽

Siew Mooi Ching ◽

Navin Kumar Devaraj ◽

Fan Kee Hoo

Keyword(s):

Systematic Review ◽

Blood Pressure ◽

Sequential Analysis ◽

Relative Effectiveness ◽

Blood Pressure Reduction ◽

Vegetarian Diet ◽

Vegan Diet ◽

Trial Sequential Analysis ◽

Cochrane Central Register ◽

Vegetarian Diets

The beneficial effects of a vegetarian diet on blood pressure (BP) control have been reported in previous systematic reviews; however, so far, their relative effectiveness is not well established. Here, we performed a systematic review together with trial sequential analysis to determine the effect of a vegetarian diet on the reduction of blood pressure. We searched the randomized controlled trial (RCT) through Medline, PubMed and Cochrane Central Register. Fifteen eligible RCTs with 856 subjects were entered into the analysis. The pooled results demonstrated that vegetarian diet consumption significantly lowered the systolic blood pressure (weighted mean difference (WMD), −2.66 mmHg (95% confidence interval (CI) = −3.76, −1.55, p < 0.001) and diastolic BP was WMD, −1.69 95% CI = −2.97, −0.41, p < 0.001) as compared to an omnivorous diet. In subgroup analysis, a vegan diet demonstrated a greater reduction in systolic BP (WMD, −3.12 mmHg; 95% CI = −4.54, −1.70, p < 0.001) as compared with a lacto-ovo-vegetarian diet (WMD, −1.75 mmHg, 95% CI −5.38, 1.88, p = 0.05). The vegan diet has showed a similar trend in terms of diastolic blood pressure reduction (WMD, −1.92 mmHg (95% CI = −3.18, −0.66, p < 0.001) but those with a lacto-ovo-vegetarian diet showed no changes in diastolic BP reduction (WMD, 0.00, 95% CI = 0.00, 0.00), p = 0.432). In conclusion, vegetarian diets are associated with significant reductions in BP compared with omnivorous diets, suggesting that they may play a key role in the primary prevention and overall management of hypertension.

Download Full-text

Cross-sectional and longitudinal comparisons of metabolic profiles between vegetarian and non-vegetarian subjects: a matched cohort study

British Journal Of Nutrition ◽

10.1017/s0007114515002937 ◽

2015 ◽

Vol 114 (8) ◽

pp. 1313-1320 ◽

Cited By ~ 30

Author(s):

Yen-Feng Chiu ◽

Chih-Cheng Hsu ◽

Tina H. T. Chiu ◽

Chun-Yi Lee ◽

Ting-Ting Liu ◽

...

Keyword(s):

Blood Pressure ◽

Metabolic Profile ◽

Fasting Blood Glucose ◽

Vegetarian Diet ◽

Vegan Diet ◽

Cross Sectional ◽

Metabolic Traits ◽

Elevated Glucose ◽

Vegetarian Diets ◽

The Impact

AbstractSeveral previous cross-sectional studies have shown that vegetarians have a better metabolic profile than non-vegetarians, suggesting that a vegetarian dietary pattern may help prevent chronic degenerative diseases. However, longitudinal studies on the impact of vegetarian diets on metabolic traits are scarce. We studied how several sub-types of vegetarian diets affect metabolic traits, including waist circumference, BMI, systolic blood pressure (SBP), diastolic blood pressure, fasting blood glucose, total cholesterol (TC), HDL, LDL, TAG and TC:HDL ratio, through both cross-sectional and longitudinal study designs. The study used the MJ Health Screening database, with data collected from 1994 to 2008 in Taiwan, which included 4415 lacto-ovo-vegetarians, 1855 lacto-vegetarians and 1913 vegans; each vegetarian was matched with five non-vegetarians based on age, sex and study site. In the longitudinal follow-up, each additional year of vegan diet lowered the risk of obesity by 7 % (95 % CI 0·88, 0·99), whereas each additional year of lacto-vegetarian diet lowered the risk of elevated SBP by 8 % (95 % CI 0·85, 0·99) and elevated glucose by 7 % (95 % CI 0·87, 0·99), and each additional year of ovo-lacto-vegetarian diet increased abnormal HDL by 7 % (95 % CI 1·03, 1·12), compared with non-vegetarians. In the cross-sectional comparisons, all sub-types of vegetarians had lower likelihoods of abnormalities compared with non-vegetarians on all metabolic traits (P<0·001 for all comparisons), except for HDL and TAG. The better metabolic profile in vegetarians is partially attributable to lower BMI. With proper management of TAG and HDL, along with caution about the intake of refined carbohydrates and fructose, a plant-based diet may benefit all aspects of the metabolic profile.

Download Full-text

Vegetarian diet and cholesterol and TAG levels by gender

Public Health Nutrition ◽

10.1017/s1368980014000883 ◽

2014 ◽

Vol 18 (4) ◽

pp. 721-726 ◽

Cited By ~ 18

Author(s):

Zhi-Hong Jian ◽

Yi-Chen Chiang ◽

Chia-Chi Lung ◽

Chien-Chang Ho ◽

Pei-Chieh Ko ◽

...

Keyword(s):

Linear Regression Analysis ◽

Hdl Cholesterol ◽

Vegetarian Diet ◽

Cross Sectional Study ◽

Study Data ◽

Vegan Diet ◽

Multivariate Linear Regression Analysis ◽

Cross Sectional ◽

Vegetarian Diets ◽

Omnivorous Diet

AbstractObjectiveThe present study assessed the effects of vegetarian and omnivorous diets on HDL-cholesterol (HDL-C), LDL-cholesterol (LDL-C), TAG and the ratio of HDL-C to total cholesterol (TC) by gender.DesignHDL-C, LDL-C, TAG and HDL-C:TC were compared among three diet groups (vegan, ovo-lacto vegetarian and omnivorous). Multivariate linear regression analysis was performed to examine factors significantly and independently associated with vegetarian status and to estimate the β value of lipid profiles for the diet groups.SettingsA cross-sectional study. Data were obtained from the Taiwanese Survey on the Prevalence of Hyperglycemia, Hyperlipidemia and Hypertension (TwSHHH).SubjectsThe study comprised included 3257 men and 3551 women.ResultsAfter adjusting for confounders, vegan and ovo-lacto vegetarian diets lowered LDL-C levels (β=−10·98, P=0·005 and β=−7·12, P=0·025, respectively) in men compared with omnivorous diet. There was a significant association between HDL-C and vegan diet (β=−6·53, P=0·004). In females, the β values of HDL-C, TAG and HDL-C:TC were −5·72 (P<0·0001), 16·51 (P=0·011) and −0·02 (P=0·012) for vegan diet, and −4·86 (P=0·002), 15·09 (P=0·008) and −0·01 (P=0·026) for ovo-lacto vegetarian diet, when compared with omnivorous diet.ConclusionsVegan diet was associated with lower HDL-C concentrations in both males and females. Because the ovo-lacto vegetarian diet was effective in lowering LDL-C, it may be more appropriate for males.

Download Full-text

Vegetarische Kostformen in der Kinderernährung?

DMW - Deutsche Medizinische Wochenschrift ◽

10.1055/s-0043-119864 ◽

2018 ◽

Vol 143 (04) ◽

pp. 279-286 ◽

Cited By ~ 8

Author(s):

Mathilde Kersting ◽

Hermann Kalhoff ◽

Michael Melter ◽

Thomas Lücke

Keyword(s):

Growth And Development ◽

Metabolic Disorders ◽

Vegetarian Diet ◽

Vegan Diet ◽

Animal Origin ◽

Food Groups ◽

Dietary History ◽

Vegetarian Diets ◽

Critical Nutrients ◽

Dietary Strategies

AbstractIn Germany, the “Dietary Schedule for the 1st year of life” and the “Optimised Mixed Diet” for children and adolescents serve as scientifically based and generally applicable dietary concepts throughout the period of growth and development. Vegetarian diets as the lacto-ovo-vegetarian diet (exclusion of meat, fish) and the vegan diet (exclusion of all food groups of animal origin) need to be evaluated for their potential to safely meet the high and specific requirements for growth and development. In this regard, high-quality studies are needed. In individuals on lacto-ovo-vegetarian diets, the safe supply with critical nutrients should be checked by thorough dietary history, possibly additional laboratory tests in risk situations like pregnancy, infancy and toddlerhood. Children on pure vegan diet need ongoing elaborate dietary strategies and continuous supplementation at any age, similar to nutritional management in children with metabolic disorders. A vegan diet is disadvised during all periods with intense growth and development.

Download Full-text

Training and Racing Behaviors of Omnivorous, Vegetarian, and Vegan Endurance Runners—Results from the NURMI Study (Step 1)

Nutrients ◽

10.3390/nu13103521 ◽

2021 ◽

Vol 13 (10) ◽

pp. 3521

Author(s):

Katharina Wirnitzer ◽

Mohamad Motevalli ◽

Derrick Tanous ◽

Gerold Wirnitzer ◽

Claus Leitzmann ◽

...

Keyword(s):

Online Survey ◽

Critical Role ◽

Vegetarian Diet ◽

Food Sources ◽

Vegan Diet ◽

Data Sets ◽

Training Adaptations ◽

Racing Performance ◽

Time Period ◽

Endurance Runners

As a key modulator of training adaptations and racing performance, nutrition plays a critical role in endurance runners’ success, and the training/racing behaviors of runners are potentially affected by their diet types. The present study aimed to investigate whether distance runners with a vegan diet (i.e., devoid of foods or ingredients from animal sources), vegetarian diet (i.e., devoid of meat and flesh foods), and omnivorous diet (i.e., a mixed diet with no restriction on food sources) have different training and racing patterns in general and based on race distance subgroups. A total of 3835 recreational runners completed an online survey. Runners were assigned to dietary (omnivorous, vegetarian, and vegan) and race distance (<21 km, half-marathon, and marathon/ultra-marathon) groups. In addition to sociodemographic information, a complete profile of data sets focusing on running and racing behaviors/patterns was evaluated using a questionnaire-based epidemiological approach. There were 1272 omnivores (47% females), 598 vegetarians (64% females), and 994 vegans (65% females). Compared to vegans and vegetarians, omnivorous runners prepared for a longer time period for running events, had a higher number of half-marathons and marathons completed with a better finish time, and had more reliance on training under supervision (p < 0.05). The present findings indicate an important association of diet types with patterns of training and racing amongst endurance runners that may be related to different motives of omnivorous, vegetarian, and vegan runners for participating in events.

Download Full-text

A New Japanese Vegetarian Food Guide

Asia Pacific Journal of Public Health ◽

10.1177/1010539509331595 ◽

2009 ◽

Vol 21 (2) ◽

pp. 160-169 ◽

Cited By ~ 3

Author(s):

Keiko Nakamoto ◽

Masako Arashi ◽

Somboon Noparatanawong ◽

Seika Kamohara ◽

Tim Radak ◽

...

Keyword(s):

Health Professionals ◽

General Public ◽

Vegetarian Diet ◽

Position Paper ◽

American Dietetic Association ◽

Vegetarian Diets ◽

Spinning Top

Vegetarianism continues to gain popularity in Japan and the Westernized world, in part from decades of science supporting the health advantages of properly planned vegetarian-based diets. Although there are Asian nutritional tools, one specific to a Japanese vegetarian diet is lacking. Thus, the Japanese vegetarian food guide (JVFG) was developed and based in part on the American Dietetic Association position paper for vegetarian diets and the Japanese Food Guide Spinning Top. The JVFG was developed by collecting dietary information from 3 different institutes in Japan that specialize in regularly offering vegetarian meals. The JVFG was divided into 6 groups with respective recommended servings: vegetables (7.5), grains (4.5), protein foods (4), milk (3), fruits (2), and fats, sugar, and seasonings (<3). The JVFG was developed so that it would adequately provide for all nutrients and be structured for practical use by the general public as well as health professionals.

Download Full-text