Vegetarian Diets

Adequate Vegetarian Diet Patterns

There are many individuals who have little or no risk of dietary inadequacy from their vegetarian eating patterns; for example, an adult male who regards himself as a vegetarian (also referred to as a meat avoider, or semi-vegetarian) but has a dietary pattern that consists solely of occasionally avoiding red meat about half of the time with no other dietary alterations. Such an individual is unlikely to need further dietary assessment.

Some characteristics of sound, adequate vegetarian diet patterns include the following:
  • Use of a nutritionally sound food guide of diet planning; vegan and vegetarian food guides that conform to the latest recommendations of expert groups may help to ensure that nutrient needs will be met with balance and without excessive intakes.
  • If diet alone does not meet the RDAs, regular use of appropriate vitamin mineral supplements plus use of a nutritionally sound food guide.
  • Vegans and some other vegetarians sometimes have multiple food avoidances; intakes of nutrients likely to be deficient can be increased by use of rich sources of whole foods, foods fortified with the nutrients falling short, and/or vitamin or mineral supplements.
  • Consumption of a wide variety of food groups and foods within each group.
  • Membership of a family with a long history of adherence to healthy vegetarian eating styles.
  • Avoidances are limited to a few foods or are sporadic in nature.

Signs of Possibly Inadequate Vegetarian Diet Patterns

The more of the following characteristics that apply, the higher the potential risk of inadequacy and the greater the need for further assessment. Diet First it is important to examine what food groups, foods, or products are avoided or de-emphasized on vegetarian diets, and then some additional characteristics of dietary patterns, personal characteristics, and belief systems that further increase risk of dietary inadequacy and other health problems:

  • Many types and extensive avoidance of animal food groups. Assessment of the nutritional adequacy of vegetarian eating patterns begins by examining animal food groups (red meat, poultry, fish and seafood, milk and milk products, eggs) and specific foods within these that are avoided entirely or eaten only in minimal amounts. Unless other foods or food groups rich in these nutrients or nutrient-containing dietary supplements are used, problems may arise.
  • Many types and extensive avoidance of fortified foods, nutrient-containing dietary supplements, and processed foods. Some vegetarians believe that fortified foods (highly fortified cereals, calcium fortified soy milk and/or juices, B12 fortified yeast), processed foods (frozen, canned, and in extreme cases cooked foods for raw food eaters), and nutrient-containing dietary supplements (vitamins, minerals, fatty acids) should be avoided for various philosophical, ideological, or religious reasons, and refuse to use them. Usage needs to be assessed since such avoidances limit options for nutrition intervention strategies.
  • Few acceptable foods and supplements. Foods and groups that are stressed and emphasized on the vegetarian diet should be noted. If very few foods or food groups are acceptable for one reason or another, or if only special foods are permitted (organic, nonprocessed, etc.) this may further limit intakes. Some vegetarians are willing to use both fortified foods and nutrient-containing dietary supplements. Use of these may have implications for health and should be recorded. Nutrient intervention strategies for increasing intakes of nutrients falling short in diets may be limited since such individuals may refuse to use fortified foods and/or dietary supplements.
  • Many practices such as fasting, altered diet during illness, and use of special foods for medicinal purposes. These practices may further increase risks of nutritional inadequacy. If medical care or treatment is avoided, additional risks may accrue.

Other practices Other practices must also be considered:

  • Other lifestyle practices with beneficial potential health impacts. Vegetarians have other health habits and lifestyles that alter risks for chronic diseases for the better, such as nonsmoking, abstinence from alcohol, and high levels of physical activity. Therefore, differences in their health outcomes are probably due to a range of factors, and not solely to differences in their diets.
  • Lack of ongoing health surveillance by a physician. Lack of medical supervision increases the chances that preventable or treatable health problems will be dealt with expeditiously.

Personal characteristics Among these are the following:

  • Nutritionally vulnerable because of age or physiological condition. The very young, the old, the rapidly growing, pregnant and lactating women, pubertal children, the elderly, and the ill and frail all fall into this group. Individuals at especially high risk are those with chronic diseases and conditions that alter nutritional needs who also have inadequate dietary intakes.
  • Low weight for height. If weight for height, as measured by body mass index, is below 18.5 or if unintentional weight loss has totaled more than about 5–7 kg (10–15 pounds), there is reason for concern.
  • Rapid weight loss. Unintentional loss of more than 5% of weight in a month is a cause for concern.

Beliefs Ideology is also important:

  • Deeply held beliefs in alternative philosophical or religious systems that govern food choice. Some individuals feel bound to make their diets conform to their ethical, philosophical, or religious systems. This can further constrain choice and nutrient intakes.
  • Membership of a quasi-philosophical or religious group that includes vegetarian diets that are not planned in line with nutritional recommendations by experts. Some groups, e.g., the Seventh-Day Adventists or certain other lacto-ovo vegetarian groups, make a conscious effort to incorporate the recommendations of expert groups, such as those of the Food and Nutrition Board/Institute of Medicine and Health Canada in English-speaking North America into the regimens they recommend. In such cases, the group support provided may be of positive benefit and help to ensure nutritional adequacy. However, at times in the past other groups have insisted on regimens that did not incorporate such recommendations. For those who are active in such groups, the group’s support may reinforce negative attitudes toward meeting such expert recommendations.

Using the characteristics above, it is usually possible to sort out those consuming vegetarian diets who are at low or no risk of inadequacy from those who may potentially have problems and need further assessment and counseling.

Current Vegetarian Eating Patterns and Practices

Until about 40 years ago, in Western countries virtually all of the common vegetarian eating patterns involved avoidance of animal flesh (meat and poultry); categorization of vegetarian patterns was relatively straightforward and consisted simply of differentiating between those who ate no animal foods at all (vegan vegetarians), those who also consumed milk and milk products (lacto vegetarians), and those who ate eggs as well (lacto-ovo vegetarians).

This simple categorization scheme broke down in the 1960s and 1970s as a result of greater exposure to the cuisines of other cultures, new Eastern religions and philosophical systems with a vegetarian tradition, and other influences, which led to the emergence of new patterns of vegetarianism. Today, myriad vegetarian eating patterns exist, and they cannot be easily described by focusing on a single dimension, such as animal food intake. Meatless and vegetarian eating patterns and life styles are growing in popularity today. They continue to be fostered by a greater availability and variety of meat alternatives and analogs for animal products.

There is also a good deal of favorable publicity about phytochemicals with supposedly beneficial health effects. At the same time, concerns about the healthfulness of animal foods have been triggered by publicity on the bovine spongiform encephalopathy (BSE) epidemic in the UK, a later epidemic of hoof and mouth disease in cattle, and most recently an epidemic of SARS spread from animals to people. Worries about saturated fat/trans fat coronary artery disease links, dietary fat and cancers, food safety, and other factors probably also contributed to the increased prevalence of vegetarian eating.

At the same time, vegetarian eating patterns are much more heterogeneous today than in the past. The availability and variety of plant foods, as well as commercially available and tasty meat analogs has greatly increased. Fortified foods today include soy milks fortified with vitamins B12 and D and a highly bioavailable form of calcium, and highly fortified breakfast cereals. These foods and nutrientcontaining dietary supplements make it easier for vegans and vegetarians to obtain nutrients that would otherwise be low or lacking.

Conformity to Nutritional Recommendations

Well-planned vegetarian diets have nutritional profiles that are in line with recent expert recommendations. A well-planned vegetarian diet pattern, if sustained throughout adulthood, may reduce risks of coronary artery and other chronic degenerative diseases associated with excessive weight. Generally, vegetarian diets tend to be low in saturated fat and cholesterol and high in complex carbohydrates, dietary fiber, magnesium, potassium, folic acid, and antioxidant nutrients such as vitamins C and E. They also tend to be relatively low in energy. Thus, the diet-related risks for a number of chronic degenerative diseases associated with intakes of these nutrients may be decreased on vegetarian diets. Some risks are clearly lower; for example, vegetarians generally tend to have lower weight for height than do nonvegetarians. Constipation tends to be less of a problem in this group, perhaps due in part to the higher intake of dietary fiber.


Vegetarian diets should be planned in accordance with expert nutritional recommendations. When this is followed, such diets are healthful and nutritionally adequate. When they are not planned, the nutrients that are  likely to fall short usually differ somewhat from those on nonvegetarian diets. In some cases these deficits can be remedied by dietary counseling. In others differences between ideologies about diet and nutrient needs are such that acceptable dietary strategies cannot be found. Nutrition scientists and practitioners can help vegetarians who seek their advice by monitoring the nutritional status of high-risk individuals, by identifying food sources of specific nutrients, and by suggesting dietary modifications that may be necessary to meet individual needs when intakes fall short.


Source: Nutrisional Suplement (Vegetarian Diets)
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