Perceptions and practices of self-defined current vegetarian, former vegetarian, and nonvegetarian women

OBJECTIVE: To assess the diversity of vegetarians' dietary practices and how they change over time, and to explore perceptions of meat and dairy products among vegetarians, former vegetarians, and nonvegetarians. DESIGN: Cross-sectional survey; qualitative interviews with a subsample. SUBJECTS/SETTING: Ninety self-defined current vegetarian, 35 former vegetarian and 68 nonvegetarian women in Vancouver, British Columbia. A subsample of 15 subjects completed qualitative interviews. STATISTICAL ANALYSIS PERFORMED: Group comparisons using 1-way analysis of variance with post-hoc testing for continuous variables, chi2 for categorical variables. RESULTS: Of 90 current vegetarians, 51 and 14 reported occasional use of fish or chicken respectively. Fifty-six vegetarians, including 4 of 6 vegans, reported that their diets had become more restrictive over time, and 48 planned additional changes, most frequently a reduction in dairy product use. Reasons cited by former vegetarians for resuming omnivorous diets included: not feeling healthy, concern about their nutritional status, a change in living situation, or missing the taste of meat. Perceptions of meat and dairy products differed significantly by dietary pattern: nonvegetarians and former vegetarians were more likely than current vegetarians to agree with statements inferring positive attributes (eg, nutrient content). In contrast, more current and former vegetarians than nonvegetarians agreed with statements inferring negative attributes (eg, presence of contaminants). APPLICATIONS/CONCLUSIONS: Dietitians who counsel women need to be aware of the heterogeneity of dietary practices and beliefs regarding use of animal products to provide advice appropriate to each individual. At a broader level, addressing women's food safety and animal welfare concerns will likely require collaboration among food industry and government, health, and consumer agencies.     

Long-chain n-3 polyunsaturated fatty acids in plasma in British meat-eating, vegetarian, and vegan men

BACKGROUND: Plasma concentrations of long-chain n-3 polyunsaturated fatty acids are lower in vegetarians and in vegans than in omnivores. No data are available on whether these concentrations differ between long- and short-term vegetarians and vegans. OBJECTIVES: We compared plasma fatty acid composition in meat-eaters, vegetarians, and vegans and examined whether the proportions of eicosapentaenoic acid (20:5n-3; EPA), docosapentaenoic acid (22:5n-3; DPA), and docosahexaenoic acid (22:6n-3; DHA) were related to the subjects' duration of adherence to their diets or to the proportions of plasma linoleic acid (18:2n-6; LA) and alpha-linolenic acid (18:3n-3; ALA). DESIGN: The present cross-sectional study included 196 meat-eating, 231 vegetarian, and 232 vegan men in the United Kingdom. Information on anthropometry, diet, and smoking habits was obtained through a questionnaire. Total fatty acid composition in plasma was measured. RESULTS: The proportions of plasma EPA and DHA were lower in the vegetarians and in the vegans than in the meat-eaters, whereas only small differences were seen for DPA. Plasma EPA, DPA, and DHA proportions were not significantly associated with the duration of time since the subjects became vegetarian or vegan, which ranged from <1 y to >20 y. In the vegetarians and the vegans, plasma DHA was inversely correlated with plasma LA. CONCLUSIONS: The proportions of plasma long-chain n-3 fatty acids were not significantly affected by the duration of adherence to a vegetarian or vegan diet. This finding suggests that when animal foods are wholly excluded from the diet, the endogenous production of EPA and DHA results in low but stable plasma concentrations of these fatty acids.     

The binding of blood-borne estrogens in normal vegetarian and omnivorous women and the risk of breast cancer

Serial blood samples were taken at two-hour intervals over a 24-hour period from 25 premenopausal vegetarians (12 vegans and 13 ovolactovegetarians) and from 21 omnivorous controls. All members of the former group had been on a vegetarian diet for a minimum of three years. The mean proportion of estradiol unbound to blood proteins was similar in both vegetarians (1.26%) and meat eaters (1.16%). However, the amount bound to albumin was significantly raised in vegetarians (50.1% vs. 43.1%, p less than 0.009), whereas that bound to sex hormone-binding globulin (SHBG) was correspondingly lower (48.7% vs. 55.8%, p = 0.01). Mean levels of SHBG were similar in vegetarians (59.9 nmole/l) and omnivores (62.0 nmole/l), as was the total amount of free fatty acid (0.42 mmole/l for both). Within the vegetarian group, no differences were detected between vegans and ovolactovegetarians.     

Adolescent and Young Adult Vegetarianism: Better Dietary Intake and Weight Outcomes but Increased Risk of Disordered Eating Behaviors

Objective

Examine characteristics of current and former adolescent and young adult vegetarians and investigate the relationships between vegetarianism, weight, dietary intake, and weight-control behaviors.

Design

Cross-sectional analysis using data from a population-based study in Minnesota (Project EAT-II: Eating Among Teens).

Setting

Participants completed a mailed survey and food frequency questionnaire in 2004.

Participants

Males and females (n=2,516), ages 15-23 years.

Main outcome measures

Weight status, dietary intake (fruit, vegetables, fat, calories), unhealthful weight-control behaviors.

Analysis

Multiple regression models controlling for socioeconomic status and sex were used to test for significant differences between current, former, and never vegetarians within the younger and older cohort.

Results

Participants were identified as current (4.3%), former (10.8%), and never (84.9%) vegetarians. Current vegetarians in the younger and older cohorts had healthier dietary intakes than nonvegetarians with regard to fruits, vegetables, and fat. Among young adults, current vegetarians were less likely than never vegetarians to be overweight or obese. Adolescent and young adult current vegetarians were more likely to report binge eating with loss of control when compared to nonvegetarians. Among adolescents, former vegetarians were more likely than never vegetarians to engage in extreme unhealthful weight-control behaviors. Among young adults, former vegetarians were more likely than current and never vegetarians to engage in extreme unhealthful weight-control behaviors.

Conclusions and implications

Adolescent and young adult vegetarians may experience the health benefits associated with increased fruit and vegetable intake and young adults may experience the added benefit of decreased risk for overweight and obesity. However, current vegetarians may be at increased risk for binge eating with loss of control, while former vegetarians may be at increased risk for extreme unhealthful weight-control behaviors. It would be beneficial for clinicians to inquire about current and former vegetarian status when assessing risk for disordered eating behaviors.     

Comparative fracture risk in vegetarians and nonvegetarians in EPIC-Oxford

OBJECTIVE: To compare fracture rates in four diet groups (meat eaters, fish eaters, vegetarians and vegans) in the Oxford cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Oxford). DESIGN: Prospective cohort study of self-reported fracture risk at follow-up. SETTING: The United Kingdom. SUBJECTS: A total of 7947 men and 26,749 women aged 20-89 years, including 19,249 meat eaters, 4901 fish eaters, 9420 vegetarians and 1126 vegans, recruited by postal methods and through general practice surgeries. METHODS: Cox regression. RESULTS: Over an average of 5.2 years of follow-up, 343 men and 1555 women reported one or more fractures. Compared with meat eaters, fracture incidence rate ratios in men and women combined adjusted for sex, age and non-dietary factors were 1.01 (95% CI 0.88-1.17) for fish eaters, 1.00 (0.89-1.13) for vegetarians and 1.30 (1.02-1.66) for vegans. After further adjustment for dietary energy and calcium intake the incidence rate ratio among vegans compared with meat eaters was 1.15 (0.89-1.49). Among subjects consuming at least 525 mg/day calcium the corresponding incidence rate ratios were 1.05 (0.90-1.21) for fish eaters, 1.02 (0.90-1.15) for vegetarians and 1.00 (0.69-1.44) for vegans. CONCLUSIONS: In this population, fracture risk was similar for meat eaters, fish eaters and vegetarians. The higher fracture risk in the vegans appeared to be a consequence of their considerably lower mean calcium intake. An adequate calcium intake is essential for bone health, irrespective of dietary preferences. SPONSORSHIP: The EPIC-Oxford study is supported by The Medical Research Council and Cancer Research UK.     

To eat or not to eat red meat. A closer look at the relationship between restrained eating and vegetarianism in college females

Previous research has suggested that vegetarianism may serve as a mask for restrained eating. The purpose of this study was to compare the dietary habits and lifestyle behaviors of vegetarians (n = 55), pesco-vegetarians (n = 28), semi-vegetarians (n = 29), and flexitarians (n = 37), to omnivores (n = 91), who do not restrict animal products from their diets. A convenience sample of college-age females completed questionnaires about their eating habits, food choice motivations, and personality characteristics. Results indicated that while vegetarians and pesco-vegetarians were more open to new experiences and less food neophobic, they were not more restrained than omnivores. Rather semi-vegetarians; those who restricted only red meat from their diet, and flexitarians; those who occasionally eat red meat, were significantly more restrained than omnivores. Whereas food choices of semi-vegetarians and flexitarians were motivated by weight control, vegetarians and pesco-vegetarians’ food choices were motivated by ethical concerns. By focusing specifically on semi-vegetarian and flexitarian subgroups, more effective approaches can be developed to ensure that their concerns about weight loss do not lead to unhealthful or disordered eating patterns.     

Health effects of vegetarian and vegan diets

Vegetarian diets do not contain meat, poultry or fish; vegan diets further exclude dairy products and eggs. Vegetarian and vegan diets can vary widely, but the empirical evidence largely relates to the nutritional content and health effects of the average diet of well-educated vegetarians living in Western countries, together with some information on vegetarians in non-Western countries. In general, vegetarian diets provide relatively large amounts of cereals, pulses, nuts, fruits and vegetables. In terms of nutrients, vegetarian diets are usually rich in carbohydrates, n-6 fatty acids, dietary fibre, carotenoids, folic acid, vitamin C, vitamin E and Mg, and relatively low in protein, saturated fat, long-chain n-3 fatty acids, retinol, vitamin B(12) and Zn; vegans may have particularly low intakes of vitamin B(12) and low intakes of Ca. Cross-sectional studies of vegetarians and vegans have shown that on average they have a relatively low BMI and a low plasma cholesterol concentration; recent studies have also shown higher plasma homocysteine concentrations than in non-vegetarians. Cohort studies of vegetarians have shown a moderate reduction in mortality from IHD but little difference in other major causes of death or all-cause mortality in comparison with health-conscious non-vegetarians from the same population. Studies of cancer have not shown clear differences in cancer rates between vegetarians and non-vegetarians. More data are needed, particularly on the health of vegans and on the possible impacts on health of low intakes of long-chain n-3 fatty acids and vitamin B(12). Overall, the data suggest that the health of Western vegetarians is good and similar to that of comparable non-vegetarians.     

Will the real vegetarian please stand up? An investigation of dietary restraint and eating disorder symptoms in vegetarians versus non-vegetarians

Adherence to a vegetarian diet has been hypothesized to be a factor in the onset and maintenance of disordered eating behavior; however, evidence to support this assumption has been largely mixed. The two studies presented here sought to address the causes of inconsistent findings in previous research, including: small samples of true vegetarians, lack of appropriate operational definitions of "vegetarianism", and uncertainty about the appropriateness of existing assessments of eating behaviors for semi-vegetarians. Study 1 assessed eating behaviors in the largest samples of confirmed true vegetarians and vegans surveyed to date, and compared them to semi-vegetarians and omnivores. Semi-vegetarians reported the highest levels of eating-related pathology; true vegetarians and vegans appeared to be healthiest in regards to weight and eating. Study 2 examined differences between semi-vegetarians and omnivores in terms of restraint and disordered eating and found little evidence for more eating-related pathology in semi-vegetarians, compared to omnivores. Semi-vegetarians' higher scores on traditional assessments of eating behaviors appeared artificially inflated by ratings of items assessing avoidance of specific food items which should be considered normative in the context of a vegetarian diet. Findings shed light on the sources of inconsistencies in prior research on eating behaviors in vegetarians and suggest that semi-vegetarianism - as opposed to true vegetarianism or veganism - is the most likely related to disordered eating.     

Diet-Related Phototoxic Reactions in Psoriatic Patients Undergoing Phototherapy: Results from a Multicenter Prospective Study

Vegans and vegetarians often consume foods containing photosensitizers capable of triggering phytophotodermatitis. The potential effect of vegan and vegetarian diets on the response of psoriatic patients undergoing phototherapy is not well characterized. We assessed clinical outcomes of vegan, vegetarian and omnivore adult psoriatic patients undergoing band ultraviolet B phototherapy (NB-UVB). In this multicenter prospective observational study, we enrolled 119 adult, psoriatic patients, of whom 40 were omnivores, 41 were vegetarians and 38 were vegans, with phototherapy indication. After determining the minimum erythemal dose (MED), we performed NB-UVB sessions for 8 weeks. The first irradiation dosage was 70.00% of the MED, then increased by 20.00% (no erythema) or by 10.00% (presence of erythema) until a maximum single dose of 3 J/cm² was reached and constantly maintained. All the enrolled patients completed the 8 weeks of therapy. Severe erythema was present in 16 (42.11%) vegans, 7 (17.07%) vegetarians and 4 (10.00%) omnivores (p < 0.01). MED was lowest among vegans (21.18 ± 4.85 J/m²), followed by vegetarians (28.90 ± 6.66 J/m²) and omnivores (33.63 ± 4.53 J/m², p < 0.01). Patients with severe erythema were more likely to have a high furocumarin intake (OR 5.67, 95% CI 3.74–8.61, p < 0.01). Vegans consumed the highest amount of furocumarin-rich foods. A model examining erythema, adjusted for gender, age, skin type, MED, phototherapy type, number of phototherapies and furocumarin intake, confirmed that vegans had a lower number of treatments. Vegans had more frequent severe erythema from NB-UVB, even after adjustment of the phototherapy protocol for their lower MED. Assessing diet information and adapting the protocol for vegan patients may be prudent.     

Risk of overweight and obesity among semivegetarian, lactovegetarian, and vegan women

BACKGROUND: Observational studies suggest that a plant-based diet is inversely related to body mass index (BMI), overweight, and obesity. OBJECTIVE: Our objective was to examine the BMI (kg/m(2)) and risk of overweight and obesity of self-defined semivegetarian, lactovegetarian, and vegan women. DESIGN: Data analyzed in this cross-sectional study were from 55459 healthy women participating in the Swedish Mammography Cohort. Women were asked whether they considered themselves to be omnivores (n = 54257), semivegetarians (n = 960), lactovegetarians (n = 159), or vegans (n = 83), and this question was the main exposure variable in this study. In secondary analyses, we reclassified women as lactovegetarians on the basis of food intakes reported on the food-frequency questionnaire. RESULTS: The prevalence of overweight or obesity (BMI >/= 25) was 40% among omnivores, 29% among both semivegetarians and vegans, and 25% among lactovegetarians. In multivariate, adjusted logistic regression analyses, self-identified vegans had a significantly lower risk of overweight or obesity [odds ratio (OR) = 0.35; 95% CI: 0.18, 0.69] than did omnivores, as did lactovegetarians (OR = 0.54; 95% CI: 0.35, 0.85) and semivegetarians (OR = 0.52; 95% CI: 0.43, 0.62). Risk of overweight or obesity remained significantly lower among lactovegetarians classified on the basis of the food-frequency questionnaire (OR = 0.48; 95% CI: 0.30, 0.78). CONCLUSIONS: Even if vegetarians consume some animal products, our results suggest that self-identified semivegetarian, lactovegetarian, and vegan women have a lower risk of overweight and obesity than do omnivorous women. The advice to consume more plant foods and less animal products may help individuals control their weight.     

Nutrient intake and iron status of Australian male vegetarians

OBJECTIVE: The study was designed to investigate the iron intake and status of Australian, male vegetarians aged between 20 and 50 y. DESIGN: Cross-sectional comparison of male vegetarians and age/sex matched omnivores. SETTING: Free-living community subjects. SUBJECTS: 39 ovolactovegetarians, 10 vegans and 25 omnivores were recruited by local advertisement. OUTCOME MEASURES: A 12-d semiquantitative dietary record to assess iron and zinc intake. Iron status was assessed by measurement of serum ferritin and haemoglobin concentrations. RESULTS: 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. CONCLUSION: Australian male vegetarians had iron intakes higher than those of omnivores and above recommended levels, but their iron status was significantly lower.     

Selected nutritional behaviours in adults of differentiated nourishment pattern

The aim of the work was to analyse the selected nutritional behaviours in the adults of differentiated nourishment pattern. The research comprised 90 people of a traditional pattern of nourishment, 86 lactoovovegetarians and 32 vegans aged 20-30. The average vegetarian practice was 6.5 years and vegan 2.9 years. A specially designed questionnaire survey was used in this study. Lactoovovegetarians most frequently declare the consumption of 4.5 meals daily (37%) and vegans--1.2 (24%). The group of people who consume meals with most regularity are vegetarians (nearly 63%) and the least--the people of a traditional style of nourishment. A more frequent consumption of whole-meal bread (4-7 times a week) is declared by 1/4 people of a traditional pattern of nourishment and a half of vegetarians, more often lactoovovegetarians (58%) than vegans (47%). The highest consumption of gruel was reported among lactoovovegetarians and vegans. Fresh fruit is consumed daily or at least 4 times a week by almost all the vegans (94%), over 2/3 lactoovovegetarians and 60% of traditional people. Pulses are consumed 4-7 times a week by 53% vegans, 1-3 times weekly by nearly 2/3 lactoovovegetarians, but 60% people of a traditional feeding pattern do not consume them every week. The people of a traditional pattern of nourishment assess their way of nourishment as the weakest one and express their highest disbelief in its efficiency in the prevention of diet-dependent ailments.     

Cardiovascular Disease Risk Factors are Lower in African-American Vegans Compared to Lacto-Ovo-vegetarians

Objective: This study was undertaken to determine if African-American strict vegetarians (vegans) exhibit lower blood pressure (BP) and a more favorable serum lipid profile than their lacto-ovo vegetarian (LOV) counterparts, and if plasma ascorbic acid (AA) concentrations could explain any group differences in these cardiovascular disease (CVD) risk factors.

Methods: Habitual dietary intake, anthropometric characteristics, blood pressure, and blood lipids and ascorbic acid concentrations were determined in African-American study participants (male vegans, n=14, age=45.6 years; male LOV, n=49, age=49.8; female vegans, n=31, age=51.1, female LOV, n=94, age=52.1) recruited from Seventh-Day Adventist Churches in several cities in the northeastern United States.

Results: Body mass index (BMI) was significantly lower in the vegans (24.7±1.9 kg/m²) compared to LOV (26.4±0.45 kg/m²). There were no diet or gender differences in BP. Serum total cholesterol (3.75±0.12 vs. 4.51±0.10 mmol/L), LDL-cholesterol (2.06±0.13 vs. 2.65±0.09 mmol/l), and triglycerides (0.94±0.07 vs. 1.17±0.04 mmol/L) were significantly (p<0.05) lower in vegans compared to LOV, but there were no dietary group differences in HDL-C. The ratio of total to HDL-cholesterol was significantly lower in vegans than in LOV (3.0±0.13 vs. 3.7±0.13). There were no dietary group differences in plasma AA concentrations. However, in the entire sample, plasma AA was inversely associated with BP (SBP: r=?0.46, p<0.001, DBP: r=?0.32, p<0.001), but unrelated to the serum lipid concentrations.

Conclusion: African-American vegans exhibit a more favorable serum lipid profile than lacto-ovovegetarians and plasma AA is inversely related to BP in African-American vegetarians but does not explain any of the differences in CVD risk factors between vegans and lacto-ovo vegetarians.     

Zinc intake and status in Australian vegetarians

Vegetarians have a lower incidence of many chronic diseases than omnivores. However, vegetarian diets could potentially result in lower intakes of some minerals, particularly Zn. In a cross-sectional study, dietary Zn intake was measured using 12 d weighed records in ninety-nine vegetarians (ten vegans) aged 18-50 years and forty-nine age- and sex-matched omnivores. In men, the mean daily Zn intake and Zn density values were similar in omnivores, ovolactovegetarians and vegans, but in women they were significantly lower in vegetarians (mean intake 6.8 mg v. 8.4 mg in omnivores) and few achieved the recommended intake. Significantly more vegetarian than omnivorous women had a daily Zn intake < 6 mg (44% v. 13%). Mean serum Zn concentrations were similar in female omnivores and vegetarians, despite the differences in intake. However, omnivorous men had a lower mean serum Zn concentration (0.85 microgram/ml v. 0.95 microgram/ml) and more subjects had levels below the reference range of 0.72-1.44 micrograms/ml than ovolactovegetarians (P < 0.01). Overall more women than men had low Zn concentrations; and these women generally had intakes below 6 mg/d. There was a significant correlation between serum Zn concentration and dietary Zn density in vegetarians, especially females (P < 0.001), but not in omnivores. Ovolactovegetarians did not have a significantly greater risk of low Zn status than omnivores.     

Vegans,Vegetarians and Pescatarians Are at Risk of Iodine Deficiency in Norway

Low iodine intakes have been documented in different population groups in Norway. We aimed to assess iodine status, dietary intake, supplement and macroalgae use, and iodine knowledge in vegans, vegetarians and pescatarians. In this study, 115 vegans, 55 vegetarians and 35 pescatarians from the Oslo region of Norway, aged 18–60 years, participated. A spot urine sample was collected along with a dietary assessment of iodine intake, supplement and macroalgae use. The median urinary iodine concentration (MUIC) in vegans was 43 µg/L (moderate iodine deficiency), in vegetarians 67 µg/L and in pescatarians 96 µg/L (mild iodine deficiency). In multiple linear regression analysis, use of iodine supplements was one of the strongest predictors of UIC. About half of the participants had median 24-h iodine intakes below estimated average requirement (EAR) of 100 µg/day. Fifty percent had low knowledge score, while 27% had very low knowledge score. Vegans, vegetarians and possibly pescatarians in Norway, are unable to reach the recommended iodine intake merely from food and are dependent on iodine supplements. There is an urgent need for dietary guidance targeting vegans, vegetarians and pescatarians to avoid inadequate iodine intake in non-supplement users, as well as avoiding excess iodine intake in macroalgae users.     

Vegan Diet,Subnormal Vitamin B-12 Status and Cardiovascular Health

Vegetarian diets have been associated with atherosclerosis protection, with healthier atherosclerosis risk profiles, as well as lower prevalence of, and mortality from, ischemic heart disease and stroke. However, there are few data concerning the possible cardiovascular effects of a vegan diet (with no meat, dairy or egg products). Vitamin B-12 deficiency is highly prevalent in vegetarians; this can be partially alleviated by taking dairy/egg products in lact-ovo-vegetarians. However, metabolic vitamin B-12 deficiency is highly prevalent in vegetarians in Australia, Germany, Italy and Austria, and in vegans (80%) in Hong Kong and India, where vegans rarely take vitamin B-12 fortified food or vitamin B-12 supplements. Similar deficiencies exist in northern Chinese rural communities consuming inadequate meat, egg or dairy products due to poverty or dietary habits. Vascular studies have demonstrated impaired arterial endothelial function and increased carotid intima-media thickness as atherosclerosis surrogates in such metabolic vitamin B-12 deficient populations, but not in lactovegetarians in China. Vitamin B-12 supplementation has a favourable impact on these vascular surrogates in Hong Kong vegans and in underprivileged communities in northern rural China. Regular monitoring of vitamin B-12 status is thus potentially beneficial for early detection and treatment of metabolic vitamin B-12 deficiency in vegans, and possibly for prevention of atherosclerosis-related diseases.     

Personal and professional correlates of US medical students' vegetarianism

OBJECTIVE: To determine prevalence and correlates of US medical students' self-identification as vegetarians. DESIGN: Medical students were anonymously surveyed via questionnaire three times: at freshmen orientation, orientation to wards, and during senior year. SUBJECTS: Medical students in the Class of 2003 (n=1,849) at 15 US medical schools (response rate 80%). OUTCOME MEASURES: We examined self-reported vegetarianism, abstinence from meat items on a food frequency questionnaire, and associations between students' vegetarianism and their health-related outcomes. STATISTICAL ANALYSES: Bivariate associations were tested with chi(2) tests. RESULTS: During medical school, 7.2% of students self-identified as vegetarians; this percentage declined over time. Those who were vegetarians for health reasons (66% of vegetarians) ate more fruits and vegetables than those who were vegetarians for nonhealth reasons (P=0.02). Vegetarians were more likely (P<0.01) than nonvegetarians to eat more fruits and vegetables (P=0.002); be women (P=0.009); be Hindu, Buddhist, or Seventh Day Adventist (P< or =0.0004); be politically liberal (P=0.007); have a body mass index < or =25 (P=0.008); or, as freshmen, to perceive nutrition counseling as highly relevant to their intended practices (P=0.007). Vegetarian students were no more likely to counsel patients about nutrition than were nonvegetarians. CONCLUSIONS: Prevalence of vegetarianism was higher among US medical students than among other US adults, although the prevalence declined during medical school. Medical students and physicians with healthful personal practices are more likely to encourage such behaviors in their patients, although the specific nutrition habit of vegetarianism among medical students was unassociated with their nutrition counseling practices.     

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

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.     

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, fiber, magnesium, potassium, folate, and antioxidants such as vitamins C and E and phytochemicals. Vegetarians have been reported to have lower body mass indices than nonvegetarians, as well as lower rates of death from ischemic heart disease; vegetarians also show lower blood cholesterol levels; lower blood pressure; and lower rates of hypertension, type 2 diabetes, and prostate and colon cancer. Although 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. J Am Diet Assoc. 2003;103:748-765.     

Attitudes towards following meat, vegetarian and vegan diets: an examination of the role of ambivalence

Vegetarianism within the U.K. is growing in popularity, with the current estimate of 7% of the population eating a vegetarian diet. This study examined differences between the attitudes and beliefs of four dietary groups (meat eaters, meat avoiders, vegetarians and vegans) and the extent to which attitudes influenced intentions to follow each diet. In addition, the role of attitudinal ambivalence as a moderator variable was examined. Completed questionnaires were obtained from 111 respondents (25 meat eaters, 26 meat avoiders, 34 vegetarians, 26 vegans). In general, predictions were supported, in that respondents displayed most positive attitudes and beliefs towards their own diets, and most negative attitudes and beliefs towards the diet most different form their own. Regression analyses showed that, as predicted by the Theory of Planned Behaviour, attitudes, subjective norm and perceived behavioural control were significant predictors of intention to follow each diet (apart from the vegetarian diet, where subjective norm was non-significant). In each case, attitudinal ambivalence was found to moderate the attitude-intention relationship, such that attitudes were found to be stronger predictors at lower levels of ambivalence. The results not only highlight the extent to which such alternative diets are an interesting focus for psychological research, but also lend further support to the argument that ambivalence in an important influence on attitude strength.