The article was published in the Journal of the American Dietetic Association, November 1997, Volume 97, Issue 11 Authors - Virginia K. Messina, MPH, RD, and Kenneth I. Burke, PhD, RD Reviewers - Winston J. Craig, PhD, RD; Johanna Dwyer, DSc, RD; Suzanne Havala, MS, RD, FADA; D. Enette Larson, MS, RD; A. Reed Mangels, PhD, RD, FADA; Vegetarian Nutrition dietetic practice group (Lenore Hodges, PhD, RD; Cyndi Reeser, MPH, RD)
Scientific data indicate the positive role of vegetarianism in reducing the risk of chronic degenerative diseases, including obesity, coronary artery disease, hypertension, diabetes and some types of cancer. Vegetarianism, like all other types of food should be properly planned.
The official wording of the position Position of the American Dietetic Association (ADA) is the following: well-planned vegetarian diet is a complete and useful for the prevention and treatment of certain diseases.
Vegetarianism in the future Vegetarian diets can vary greatly. Lacto-ovo-vegetarian diet consists of fruits, vegetables, grains, legumes, seeds, nuts, dairy products and eggs. It excludes meat, fish, and poultry. Vegan or strict vegetarian diet is different from laktoovovegetarianstva absence of eggs, dairy products and other foods of animal origin. But within this framework, different people to varying degrees, reject animal products. Therefore, to accurately determine the edibility of a vegetarian diet it must be considered specifically.
Studies show that vegetarians often have lower morbidity than non-vegetarians (1) and mortality (2) of certain chronic degenerative diseases. Nedieticheskie factors such as physical activity and abstinence from smoking and alcohol, may also play a role, but the diet - a crucial factor.
People are switching to vegetarianism not only medical considerations, but also for reasons of ecology and world hunger. Also among the reasons why people become vegetarians - considerations of economy, issues of ethics, religious beliefs. Consumer demand for vegetarian foods leads to an increase in catering, offering products for vegetarians. At present most cafeterias in universities offer vegetarian meals.
The value of vegetarianism for health Vegetarian diets low in fat, or saturated fat, has been used successfully as part of a comprehensive program of health care to reverse the situation with coronary artery disease (3,4). Vegetarian diets are useful for prevention, because they have less saturated fat, cholesterol and animal protein, more folate, which reduces homocysteine levels in serum (5), antioxidants such as vitamins C and E, carotenoids, and phytochemicals (6). Vegetarianism stops the development of coronary heart disease (8,9) and reduces mortality from coronary heart disease (7). Do vegetarians generally lower total cholesterol and low density lipoprotein, but the level of high density liporoteina and triglyceride levels vary depending on the type of vegetarian diets (10).
Vegetarians are less susceptible to hypertension than non-vegetarians (11). This effect appears to be manifested regardless of body weight and sodium intake. Vegetarians are much less likely to die from type 2 diabetes, may then cause a higher consumption of complex carbohydrates and a lower body mass index (12). Vegetarians are less susceptible to lung cancer and cancer of the rectum (2,13). Reducing the risk of colon cancer associated with an increased consumption of fiber, vegetables, and fruits (14,15). The microflora of the large intestine for vegetarians, significantly different from non-vegetarians microflora, which reduces the risk of colon cancer (16,17). Among Western vegetarian does not decrease the incidence of breast cancer, but data from the comparison of different nationalities, indicate that the risk of breast cancer later in the settlements, where the diet based on plant foods. (18). Protective factor may be lower estrogen levels in vegetarians. (19).
A well-planned vegetarian diet can be useful for preventing and treating kidney disease. Clinical studies and modeling of on animals have shown that some plant proteins may increase the chance of survival and reduce proteinuria, glomerular filtration rate, blood flow to the kidneys, and histological kidney damage compared to non-vegetarian diet (20,21).
Analysis of food vegetarians Required number of important amino acids can be obtained from plant sources of protein, provided that the plant diet is diverse and contains enough calories. The study shows that the introduction of additional proteins is not required, but a daily intake of various sources of amino acids ensures the normal detention and the use of nitrogen in healthy people (22). Although vegetarian diets lower total protein, and, possibly, its use should be slightly larger because of the lower quality of some vegetable proteins, and laktoovovegetariantsy and vegans get enough protein (16).
Plant foods contain only negemsoderzhaschee iron, which is more sensitive than heme-containing, to the inhibitors (moderator) and to agents that increase the absorption of iron. Although vegetarian diets generally is higher for the iron content than non-vegetarian, the reserves of iron in the body below the vegetarians, because iron from plant foods is absorbed in a smaller number (23). But the clinical significance of this phenomenon, if any, is unclear, because the incidence of iron deficiency anemia is the same for vegetarians and meat-eaters in (23). Iron absorption can be improved, resulting in a higher content of vitamin C.
Vegetable foods can contain vitamin B 12 on its surface in the form of residual soil, but this is not a reliable source of B-12 for vegetarians. Most of the vitamin B-12 located in spirulina, sea cabbage, sea vegetables, tempeh (fermented soy product), and miso showed itself more as an inactive analog of the B-12 than a full vitamin. Although dairy products and eggs contain vitamin B-12, the study shows low levels of vitamin B-12 in blood lacto-ovo-vegetarians. Vegetarians who avoid or limit foods of animal origin, it is recommended to consume dietary supplements or foods fortified with vitamin B 12 (24).
Since the human body requires very little vitamin B-12, and his holdings are stored and reused, signs of deficiency may appear many years later. With age, the assimilation of vitamin B-12 is reduced, so all older vegetarians should take supplements.
Lacto-ovo-vegetarians get enough calcium, as much or even more than non-vegetarians (25,26). However, vegans get less calcium than lacto-ovo-vegetarians and people with mixed diet (26). It should be noted that vegans may need less calcium than non-vegetarians, because if a diet with less protein and plenty of alkaline food is savings of calcium (27).
In addition, when a person eats food with low protein and sodium and has enough physical activity, their need for calcium may be lower than in those who lead sedentary lives and feeds on a standard Western diet. These factors, as well as genetic predisposition, help explain why the state of the bones sometimes does not depend on the consumption of calcium.
Because is not already installed, how much calcium is required vegan, and given that its deficiency leads to osteoporosis in women, vegans should consume as much calcium as the Institute of Medicine has established for their age group (28). Calcium is well absorbed from many plant products, and vegan diets contain enough of this element, if they regularly attend foods rich in calcium (29). In addition, many new vegetarian foods enriched with calcium. If vegans do not get the required calcium from food, dietary supplements are recommended.
Vitamin D in food is small (this also applies to vegetarian and non-vegetarian food), if it does not include products enriched with vitamin D. In the vegan diet may be enough of this substance, since it is the most common source - cow's milk fortified with vitamin D. But now you can buy vegan foods with vitamin D, such as soy milk and some products from cereals. In addition, studies show that the body receives the dose of vitamin D by exposure to sunlight, and that its important to get the food only when the little man is in the sun (30).
It is believed to obtain sufficient amounts of vitamin D is enough to expose to the sun hands, shoulders and face for 5-15 minutes a day (31). People with dark skin, as well as those who live in northern latitudes, cloud or smoke-filled areas are likely to need to spend more time in the sun. Synthesis of vitamin D prevents the use of sunscreen. If vegans are a little on the sun, they are recommended supplements of vitamin D. This is especially true for older people, whose body synthesize vitamin D less efficiently.
Studies show that consumption of zinc for vegetarians or below is the same as non-vegetarians (16). Most studies show that vegetarians zinc levels in hair, serum and saliva in normal conditions (32). When feeding, poor zinc, vegetarians may help to compensatory mechanisms (33). But, because zinc in plant foods is small, and the effects of zinc deficiency are not yet fully understood, vegetarians need to eat as much zinc as recommended in the norms of consumption, or even more.
In the diet without eggs, and fish contain little fatty acids omega-3 (dokozegeksakislota or DHA). In the blood of vegetarians is lower lipid levels of this fatty acid, although not all studies agree with this statement (34.35). One of the essential fatty acids - linoleic acid, can be converted into DHA, although conversion rates appear ineffective and high consumption of linoleic acid prevents this transformation (36). The impact of low DHA is not known. But vegetarians are encouraged to include in the diet are good sources of linoleic acid.
Table 1 shows the sources of nutrients that are important for vegetarians (doc-file).
Tab. 1. Sources pitatelnyhveschestv. Poinformatsionnym data: Pennington J. Bowe's and Church's Food Values of Portions Commonly Used. 16th ed. Lippincott-Raven; 1994. Provisional Table on the Content of Omega-3 Fatty Acids and Other Fat Components in Selected Foods, 1988. Washington, DC: US Dept of Agriculture: 1988: Publication No. HNIS/PT-103. Hytowitz DB, Matthews RH. Composition of Foods: Legumes and Legume Products. Washington, DC: US Dept of Agriculture; 1986. Agriculture Handbook No. 8-16. aRed Star Yeast and Products, a division of Universal Foods Corp, Milwaukee, Wisc.
Vegetarianism in different age periods of life. A balanced vegan or lacto-ovo-vegetarian diet is suitable for all periods of life, including during pregnancy and lactation. It also meets the nutritional needs of infants, children and adolescents and promote their normal growth (37). Lack of nutrients is most likely in people with very limited diet. All children are vegans must have a reliable source of vitamin B-12 and, if they are few in the sun, receive nutritional supplements of vitamin D, or enrichment of foods. In the diet should include foods rich in calcium, iron, and zinc. To meet the energy needs children vegetarians help frequent meals and small snacks, as well as some refined and fat-rich products. Basic principles regarding dietary supplements of iron, vitamin D, and the introduction of the diet of solid food the same for normal infants and infants with vegetarians. When the time comes to enter into the diet of protein foods, kids, vegetarians can get cleaned tofu, cottage cheese, and beans (peeled and ground). Babies-vegans that are still breastfed should receive vitamin B-12, if the mother's diet is lacking, and vitamin D, if they are few in the sun.
Vegetarianism somewhat more common among adolescents with eating disorders, therefore, nutritionists need to know about teenagers who are very limited selection of products and who are showing signs of eating disorders (38). However, current data, on its own transition to vegetarianism does not lead to eating disorders (39). If properly planned diet, vegetarianism - is a correct and healthy choice for adolescents.
Vegetarian diets also satisfy the needs of athletes during the competitions. The amount of protein may be increased because exercise increases the metabolism of amino acids, but vegetarian diets, which cover the costs of energy and are good sources of protein (for example: soy products, beans), can provide the desired protein without using any special foods or supplements. For young athletes, special attention should be paid to calorie, protein and iron. Among the vegetarian athletes may meet more often amenorrhea than among nevegetarianok, although not all studies confirm this observation (40,41). One way to maintain normal menstrual cycles can be diet with high calorie, high in fat and less fiber, and reduced training intensity.
Lacto-ovo-vegetarian and vegan diets can meet the needs of pregnant women in nutrients and energy. Body weight infants who were born to eat vegetarian, corresponds to the norm (42). Pregnant and lactating vegankam be added to the daily ration of 2.0 to 2.6 micrograms of vitamin B-12. And, eslizhenschina little happens in the sun, 10 micrograms of vitamin D daily (43,44). Nutritional supplements of folate are recommended for all pregnant women, although usually vegetarian food folate than in the diet nevegetarianok.
Planning a vegetarian diet The diversity of approaches in planning the menu will help ensure an adequate vegetarian diet. Table 2 offers one such approach. In addition, the following guidelines can help vegetarians to plan a healthy diet:
* Choose a variety of foods, including cereals whole foods, vegetables, fruits, beans, nuts, seeds, can be dairy products and eggs.
* Most choose seamless, unrefined foods, and limit foods with high sugar, fat and very refined.
* Choose a variety of fruits and vegetables.
* If you use a food of animal origin - eggs and dairy products - choose those that have a lower fat content. Cheese and other fatty dairy products and eggs, eat in limited quantities, because they have a lot of saturated fat, and also because of their expense reduces the amount of plant products.
* Vegans should include regularly in food vitamin B-12, as well as vitamin D, if sun exposure is limited.
* Babies who are only breastfed from 4-6 months should receive iron supplements, and, if sun exposure is limited, vitamin D. As well as dietary supplements of vitamin B-12, if the mother's diet of this vitamin is not enough.
* Do not restrict fat in the diet of children under 2 years. And to older children receive enough energy and nutrients, including the diet of foods rich in unsaturated fats (such as nuts, seeds, oil nuts and seeds, avocados and vegetable oils)
Scientific data indicate the positive role of vegetarianism in reducing the risk of chronic degenerative diseases, including obesity, coronary artery disease, hypertension, diabetes and some types of cancer. Vegetarianism, like all other types of food should be properly planned.
The official wording of the position Position of the American Dietetic Association (ADA) is the following: well-planned vegetarian diet is a complete and useful for the prevention and treatment of certain diseases.
Vegetarianism in the future Vegetarian diets can vary greatly. Lacto-ovo-vegetarian diet consists of fruits, vegetables, grains, legumes, seeds, nuts, dairy products and eggs. It excludes meat, fish, and poultry. Vegan or strict vegetarian diet is different from laktoovovegetarianstva absence of eggs, dairy products and other foods of animal origin. But within this framework, different people to varying degrees, reject animal products. Therefore, to accurately determine the edibility of a vegetarian diet it must be considered specifically.
Studies show that vegetarians often have lower morbidity than non-vegetarians (1) and mortality (2) of certain chronic degenerative diseases. Nedieticheskie factors such as physical activity and abstinence from smoking and alcohol, may also play a role, but the diet - a crucial factor.
People are switching to vegetarianism not only medical considerations, but also for reasons of ecology and world hunger. Also among the reasons why people become vegetarians - considerations of economy, issues of ethics, religious beliefs. Consumer demand for vegetarian foods leads to an increase in catering, offering products for vegetarians. At present most cafeterias in universities offer vegetarian meals.
The value of vegetarianism for health Vegetarian diets low in fat, or saturated fat, has been used successfully as part of a comprehensive program of health care to reverse the situation with coronary artery disease (3,4). Vegetarian diets are useful for prevention, because they have less saturated fat, cholesterol and animal protein, more folate, which reduces homocysteine levels in serum (5), antioxidants such as vitamins C and E, carotenoids, and phytochemicals (6). Vegetarianism stops the development of coronary heart disease (8,9) and reduces mortality from coronary heart disease (7). Do vegetarians generally lower total cholesterol and low density lipoprotein, but the level of high density liporoteina and triglyceride levels vary depending on the type of vegetarian diets (10).
Vegetarians are less susceptible to hypertension than non-vegetarians (11). This effect appears to be manifested regardless of body weight and sodium intake. Vegetarians are much less likely to die from type 2 diabetes, may then cause a higher consumption of complex carbohydrates and a lower body mass index (12). Vegetarians are less susceptible to lung cancer and cancer of the rectum (2,13). Reducing the risk of colon cancer associated with an increased consumption of fiber, vegetables, and fruits (14,15). The microflora of the large intestine for vegetarians, significantly different from non-vegetarians microflora, which reduces the risk of colon cancer (16,17). Among Western vegetarian does not decrease the incidence of breast cancer, but data from the comparison of different nationalities, indicate that the risk of breast cancer later in the settlements, where the diet based on plant foods. (18). Protective factor may be lower estrogen levels in vegetarians. (19).
A well-planned vegetarian diet can be useful for preventing and treating kidney disease. Clinical studies and modeling of on animals have shown that some plant proteins may increase the chance of survival and reduce proteinuria, glomerular filtration rate, blood flow to the kidneys, and histological kidney damage compared to non-vegetarian diet (20,21).
Analysis of food vegetarians Required number of important amino acids can be obtained from plant sources of protein, provided that the plant diet is diverse and contains enough calories. The study shows that the introduction of additional proteins is not required, but a daily intake of various sources of amino acids ensures the normal detention and the use of nitrogen in healthy people (22). Although vegetarian diets lower total protein, and, possibly, its use should be slightly larger because of the lower quality of some vegetable proteins, and laktoovovegetariantsy and vegans get enough protein (16).
Plant foods contain only negemsoderzhaschee iron, which is more sensitive than heme-containing, to the inhibitors (moderator) and to agents that increase the absorption of iron. Although vegetarian diets generally is higher for the iron content than non-vegetarian, the reserves of iron in the body below the vegetarians, because iron from plant foods is absorbed in a smaller number (23). But the clinical significance of this phenomenon, if any, is unclear, because the incidence of iron deficiency anemia is the same for vegetarians and meat-eaters in (23). Iron absorption can be improved, resulting in a higher content of vitamin C.
Vegetable foods can contain vitamin B 12 on its surface in the form of residual soil, but this is not a reliable source of B-12 for vegetarians. Most of the vitamin B-12 located in spirulina, sea cabbage, sea vegetables, tempeh (fermented soy product), and miso showed itself more as an inactive analog of the B-12 than a full vitamin. Although dairy products and eggs contain vitamin B-12, the study shows low levels of vitamin B-12 in blood lacto-ovo-vegetarians. Vegetarians who avoid or limit foods of animal origin, it is recommended to consume dietary supplements or foods fortified with vitamin B 12 (24).
Since the human body requires very little vitamin B-12, and his holdings are stored and reused, signs of deficiency may appear many years later. With age, the assimilation of vitamin B-12 is reduced, so all older vegetarians should take supplements.
Lacto-ovo-vegetarians get enough calcium, as much or even more than non-vegetarians (25,26). However, vegans get less calcium than lacto-ovo-vegetarians and people with mixed diet (26). It should be noted that vegans may need less calcium than non-vegetarians, because if a diet with less protein and plenty of alkaline food is savings of calcium (27).
In addition, when a person eats food with low protein and sodium and has enough physical activity, their need for calcium may be lower than in those who lead sedentary lives and feeds on a standard Western diet. These factors, as well as genetic predisposition, help explain why the state of the bones sometimes does not depend on the consumption of calcium.
Because is not already installed, how much calcium is required vegan, and given that its deficiency leads to osteoporosis in women, vegans should consume as much calcium as the Institute of Medicine has established for their age group (28). Calcium is well absorbed from many plant products, and vegan diets contain enough of this element, if they regularly attend foods rich in calcium (29). In addition, many new vegetarian foods enriched with calcium. If vegans do not get the required calcium from food, dietary supplements are recommended.
Vitamin D in food is small (this also applies to vegetarian and non-vegetarian food), if it does not include products enriched with vitamin D. In the vegan diet may be enough of this substance, since it is the most common source - cow's milk fortified with vitamin D. But now you can buy vegan foods with vitamin D, such as soy milk and some products from cereals. In addition, studies show that the body receives the dose of vitamin D by exposure to sunlight, and that its important to get the food only when the little man is in the sun (30).
It is believed to obtain sufficient amounts of vitamin D is enough to expose to the sun hands, shoulders and face for 5-15 minutes a day (31). People with dark skin, as well as those who live in northern latitudes, cloud or smoke-filled areas are likely to need to spend more time in the sun. Synthesis of vitamin D prevents the use of sunscreen. If vegans are a little on the sun, they are recommended supplements of vitamin D. This is especially true for older people, whose body synthesize vitamin D less efficiently.
Studies show that consumption of zinc for vegetarians or below is the same as non-vegetarians (16). Most studies show that vegetarians zinc levels in hair, serum and saliva in normal conditions (32). When feeding, poor zinc, vegetarians may help to compensatory mechanisms (33). But, because zinc in plant foods is small, and the effects of zinc deficiency are not yet fully understood, vegetarians need to eat as much zinc as recommended in the norms of consumption, or even more.
In the diet without eggs, and fish contain little fatty acids omega-3 (dokozegeksakislota or DHA). In the blood of vegetarians is lower lipid levels of this fatty acid, although not all studies agree with this statement (34.35). One of the essential fatty acids - linoleic acid, can be converted into DHA, although conversion rates appear ineffective and high consumption of linoleic acid prevents this transformation (36). The impact of low DHA is not known. But vegetarians are encouraged to include in the diet are good sources of linoleic acid.
Table 1 shows the sources of nutrients that are important for vegetarians (doc-file).
Tab. 1. Sources pitatelnyhveschestv. Poinformatsionnym data: Pennington J. Bowe's and Church's Food Values of Portions Commonly Used. 16th ed. Lippincott-Raven; 1994. Provisional Table on the Content of Omega-3 Fatty Acids and Other Fat Components in Selected Foods, 1988. Washington, DC: US Dept of Agriculture: 1988: Publication No. HNIS/PT-103. Hytowitz DB, Matthews RH. Composition of Foods: Legumes and Legume Products. Washington, DC: US Dept of Agriculture; 1986. Agriculture Handbook No. 8-16. aRed Star Yeast and Products, a division of Universal Foods Corp, Milwaukee, Wisc.
Vegetarianism in different age periods of life. A balanced vegan or lacto-ovo-vegetarian diet is suitable for all periods of life, including during pregnancy and lactation. It also meets the nutritional needs of infants, children and adolescents and promote their normal growth (37). Lack of nutrients is most likely in people with very limited diet. All children are vegans must have a reliable source of vitamin B-12 and, if they are few in the sun, receive nutritional supplements of vitamin D, or enrichment of foods. In the diet should include foods rich in calcium, iron, and zinc. To meet the energy needs children vegetarians help frequent meals and small snacks, as well as some refined and fat-rich products. Basic principles regarding dietary supplements of iron, vitamin D, and the introduction of the diet of solid food the same for normal infants and infants with vegetarians. When the time comes to enter into the diet of protein foods, kids, vegetarians can get cleaned tofu, cottage cheese, and beans (peeled and ground). Babies-vegans that are still breastfed should receive vitamin B-12, if the mother's diet is lacking, and vitamin D, if they are few in the sun.
Vegetarianism somewhat more common among adolescents with eating disorders, therefore, nutritionists need to know about teenagers who are very limited selection of products and who are showing signs of eating disorders (38). However, current data, on its own transition to vegetarianism does not lead to eating disorders (39). If properly planned diet, vegetarianism - is a correct and healthy choice for adolescents.
Vegetarian diets also satisfy the needs of athletes during the competitions. The amount of protein may be increased because exercise increases the metabolism of amino acids, but vegetarian diets, which cover the costs of energy and are good sources of protein (for example: soy products, beans), can provide the desired protein without using any special foods or supplements. For young athletes, special attention should be paid to calorie, protein and iron. Among the vegetarian athletes may meet more often amenorrhea than among nevegetarianok, although not all studies confirm this observation (40,41). One way to maintain normal menstrual cycles can be diet with high calorie, high in fat and less fiber, and reduced training intensity.
Lacto-ovo-vegetarian and vegan diets can meet the needs of pregnant women in nutrients and energy. Body weight infants who were born to eat vegetarian, corresponds to the norm (42). Pregnant and lactating vegankam be added to the daily ration of 2.0 to 2.6 micrograms of vitamin B-12. And, eslizhenschina little happens in the sun, 10 micrograms of vitamin D daily (43,44). Nutritional supplements of folate are recommended for all pregnant women, although usually vegetarian food folate than in the diet nevegetarianok.
Planning a vegetarian diet The diversity of approaches in planning the menu will help ensure an adequate vegetarian diet. Table 2 offers one such approach. In addition, the following guidelines can help vegetarians to plan a healthy diet:
* Choose a variety of foods, including cereals whole foods, vegetables, fruits, beans, nuts, seeds, can be dairy products and eggs.
* Most choose seamless, unrefined foods, and limit foods with high sugar, fat and very refined.
* Choose a variety of fruits and vegetables.
* If you use a food of animal origin - eggs and dairy products - choose those that have a lower fat content. Cheese and other fatty dairy products and eggs, eat in limited quantities, because they have a lot of saturated fat, and also because of their expense reduces the amount of plant products.
* Vegans should include regularly in food vitamin B-12, as well as vitamin D, if sun exposure is limited.
* Babies who are only breastfed from 4-6 months should receive iron supplements, and, if sun exposure is limited, vitamin D. As well as dietary supplements of vitamin B-12, if the mother's diet of this vitamin is not enough.
* Do not restrict fat in the diet of children under 2 years. And to older children receive enough energy and nutrients, including the diet of foods rich in unsaturated fats (such as nuts, seeds, oil nuts and seeds, avocados and vegetable oils)
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