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Position of the American Dietetic Association: Vegetarian Diets

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Abstract

It is the position of the American Dietetic Association that appropriately planned vegetarian diets, including total vegetarian or vegan diets, are healthful, nutritionally adequate, and may provide health benefits in the prevention and treatment of certain diseases. Well-planned vegetarian diets are appropriate for individuals during all stages of the life cycle, including pregnancy, lactation, infancy, childhood, and adolescence, and for athletes. A vegetarian diet is defined as one that does not include meat (including fowl) or seafood, or products containing those foods. This article reviews the current data related to key nutrients for vegetarians including protein, n-3 fatty acids, iron, zinc, iodine, calcium, and vitamins D and B-12. A vegetarian diet can meet current recommendations for all of these nutrients. In some cases, supplements or fortified foods can provide useful amounts of important nutrients. An evidence-based review showed that vegetarian diets can be nutritionally adequate in pregnancy and result in positive maternal and infant health outcomes. The results of an evidence-based review showed that a vegetarian diet is associated with a lower risk of death from ischemic heart disease. Vegetarians also appear to have lower low-density lipoprotein cholesterol levels, lower blood pressure, and lower rates of hypertension and type 2 diabetes than nonvegetarians. Furthermore, vegetarians tend to have a lower body mass index and lower overall cancer rates. Features of a vegetarian diet that may reduce risk of chronic disease include lower intakes of saturated fat and cholesterol and higher intakes of fruits, vegetables, whole grains, nuts, soy products, fiber, and phytochemicals. The variability of dietary practices among vegetarians makes individual assessment of dietary adequacy essential. In addition to assessing dietary adequacy, food and nutrition professionals can also play key roles in educating vegetarians about sources of specific nutrients, food purchase and preparation, and dietary modifications to meet their needs.

Section snippets

Position Statement

It is the position of the American Dietetic Association that appropriately planned vegetarian diets, including total vegetarian or vegan diets, are healthful, nutritionally adequate, and may provide health benefits in the prevention and treatment of certain diseases. Well-planned vegetarian diets are appropriate for individuals during all stages of the lifecycle, including pregnancy, lactation, infancy, childhood, and adolescence, and for athletes.

Vegetarian Diets in Perspective

A vegetarian is a person who does not eat meat (including fowl) or seafood, or products containing these foods. The eating patterns of vegetarians may vary considerably. The lacto-ovo-vegetarian eating pattern is based on grains, vegetables, fruits, legumes, seeds, nuts, dairy products, and eggs. The lacto-vegetarian excludes eggs as well as meat, fish, and fowl. The vegan, or total vegetarian, eating pattern excludes eggs, dairy, and other animal products. Even within these patterns,

Protein

Plant protein can meet protein requirements when a variety of plant foods is consumed and energy needs are met. Research indicates that an assortment of plant foods eaten over the course of a day can provide all essential amino acids and ensure adequate nitrogen retention and use in healthy adults; thus, complementary proteins do not need to be consumed at the same meal (8).

A meta-analysis of nitrogen balance studies found no significant difference in protein needs due to the source of dietary

Vegetarian Diets Throughout the Life Cycle

Well-planned vegan, lacto-vegetarian, and lacto-ovo-vegetarian diets are appropriate for all stages of the life cycle, including pregnancy and lactation. Appropriately planned vegan, lacto-vegetarian, and lacto-ovo-vegetarian diets satisfy nutrient needs of infants, children, and adolescents and promote normal growth (49, 50, 51, 52). Figure 1 provides specific suggestions for meal planning for vegetarian diets. Lifelong vegetarians have adult height, weight, and BMIs that are similar to those

Cardiovascular Disease (CVD)

Evidence-based analysis of the research literature is being used to evaluate existing research on the relationship between vegetarian dietary patterns and CVD risk factors (96). Two evidence analysis questions have been completed:

  • What is the relationship between a vegetarian diet and ischemic heart disease?

  • How is micronutrient intake in a vegetarian diet associated with CVD risk factors?

Special Supplemental Nutrition Program for Women, Infants, and Children

The Special Supplemental Nutrition Program for Women, Infants, and Children is a federal grant program that serves pregnant, postpartum, and breastfeeding women; infants; and children up to age 5 years who are documented as being at nutritional risk with family income below federal standards. This program provides vouchers to purchase some foods suitable for vegetarians including infant formula, iron-fortified infant cereal, vitamin C–rich fruit or vegetable juice, carrots, cow's milk, cheese,

Roles and Responsibilities of Food and Nutrition Professionals

Nutrition counseling can be highly beneficial for vegetarian clients who manifest specific health problems related to poor dietary choices and for vegetarians with existing clinical conditions that require additional dietary modifications (eg, diabetes, hyperlipidemia, and kidney disease). Depending on the client's knowledge level, nutrition counseling may be useful for new vegetarians and for individuals at various stages of the life cycle including pregnancy, infancy, childhood, adolescence,

Conclusions

Appropriately planned vegetarian diets have been shown to be healthful, nutritionally adequate, and may be beneficial in the prevention and treatment of certain diseases. Vegetarian diets are appropriate for all stages of the life cycle. There are many reasons for the rising interest in vegetarian diets. The number of vegetarians in the United States is expected to increase during the next decade. Food and nutrition professionals can assist vegetarian clients by providing current, accurate

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