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Plant-based, i.e. vegetarian (without meat and fish) or vegan (exclusively plant-based foods) diets are in trend also among children and adolescents, but data on food intake in this group are lacking. Here, we compare the consumption of food groups of vegetarian (n 145), vegan (n 110) and omnivore (n 135) children and adolescents (6–18 years) in Germany using data of the VeChi Youth Study. Each food item reported in 3 d weighed dietary records was assigned to one of eighteen food groups and individual mean intake per day (g/MJ) was calculated. Group differences were assessed using covariance analyses adjusted for age, sex and other covariates. For food groups with a high number of non-consumers, non-parametric Kruskal–Wallis tests were run. Pairwise comparison of vegetarian and vegan groups indicated significantly higher intakes of legumes, nuts, milk alternatives (all P = 0·0003) and meat alternatives (P = 0·0065) among vegan subjects. Intake of these food groups of omnivore participants was low (Q3:0·0 g/MJ for legumes, milk alternatives and meat alternatives, 0·5 g/MJ for nuts). Dairy intake of vegetarians (11·6 g/MJ) was significantly lower than of omnivore subjects (24·7 g/MJ) (P = 0·0003). Intake of fats/oils and sweet foods was lowest in vegan compared with vegetarian and omnivore participants (P< 0·05). Whole grain intake was higher in vegan participants (14·5 g/MJ) than of vegetarian (9·1 g/MJ) and omnivore (6·5 g/MJ) participants (P = 0·0003). Longitudinal studies are necessary to evaluate the long-term health consequences of vegetarian, vegan and omnivore food patterns, especially in childhood and adolescence.

Prevalence and trends of different vegetarian diets remain unknown, with estimates varying depending on the source. Evidence suggests that vegetarian diets are associated with a more favourable cardiovascular risk profile. The present study aimed to assess the prevalence and trends of different types of vegetarian diets in a population-based representative sample, sociodemographic characteristics of participants following such diets and the association of these diets with cardiovascular risk factors. Using repeated cross-sectional population-based surveys conducted in Geneva, Switzerland, 10 797 individuals participated in the study between 2005 and 2017. Participants were classified as vegetarians, pescatarians, flexitarians or omnivores using an FFQ. Sociodemographic and cardiovascular risk factors were evaluated through questionnaires, anthropometric measurements and blood tests. Findings show prevalence of vegetarians increased from 0·5 to 1·2 %, pescatarians from 0·3 to 1·1 % and flexitarians remained stable at 15·6 % of the population over the study period. Compared with omnivores, vegetarians were more likely to be young (OR 2·38; 95 % CI 1·01, 5·6), have higher education (OR 1·59; 95 % CI 1·01, 2·49) and lower income (OR 1·83; 95 % CI 1·04, 3·21); pescatarians and flexitarians were more likely to be women (pescatarian: OR 1·81; 95 % CI 1·10, 3·00; vegetarian: OR 1·57; 95 % CI 1·41, 1·75) and flexitarians were also more likely to have a lower income (OR 1·31; 95 % CI 1·13, 1·53). Participants who adhered to any diet excluding/reducing meat intake had lower BMI, total cholesterol and hypertension compared with omnivores. The present study shows an increase in the prevalence of vegetarians over a 13-year period and suggests that the different vegetarian diets assessed are associated with a better cardiovascular risk profile.

Balanced vegetarian diets are popular, although they are nearly absent in creatine and carnosine and contain considerably less carnitine than non-vegetarian diets. Few longitudinal intervention studies investigating the effect of a vegetarian diet on the availability of these compounds currently exist. We aimed to investigate the effect of transiently switching omnivores onto a vegetarian diet for 6 months on muscle and plasma creatine, carnitine and carnosine homeostasis. In a 6-month intervention, forty omnivorous women were ascribed to three groups: continued omnivorous diet (control,n10), vegetarian diet without supplementation (Veg+Pla,n15) and vegetarian diet combined with dailyβ-alanine (0·8–0·4 g/d) and creatine supplementation (1 g creatine monohydrate/d) (Veg+Suppl,n15). Before (0 months; 0M), after 3 months (3M) and 6 months (6M), a fasted venous blood sample and 24-h urine was collected, and muscle carnosine content was determined by proton magnetic resonance spectroscopy (1H-MRS). Muscle biopsies were obtained at 0M and 3M. Plasma creatine and muscle total creatine content declined from 0M to 3M in Veg+Pla (P=0·013 andP=0·009, respectively), whereas plasma creatine increased from 0M in Veg+Suppl (P=0·004). None of the carnitine-related compounds in plasma or muscle showed a significant time×group interaction effect.1H-MRS-determined muscle carnosine content was unchanged over 6M in control and Veg+Pla, but increased in Veg+Suppl in soleus (PP=0·001) muscle. To conclude, the body creatine pool declined over a 3-month vegetarian diet in omnivorous women, which was ameliorated when accompanied by low-dose dietary creatine supplementation. Carnitine and carnosine homeostasis was unaffected by a 3- or 6-month vegetarian diet, respectively.

The lower threshold plasma 25-hydroxy vitamin D (25(OH)D) level for optimal cardiovascular health is unclear, whereas the toxicity threshold is less clear. The aim of this study was to examine the cardiovascular–vitamin D dose–response curve in a normal rat model. Doses of cholecalciferol ranged from deficiency to toxic levels (equivalent to human doses of 0, 0·015, 0·25 and 3·75mg/d) for 4 weeks, and then cardiovascular health was examined using blood pressure telemetry and high-resolution ultrasound in normal male rats (n 16/group, 64 rats total). After 1 month, only the 0·25mg/d group had plasma 25(OH)D that was within current recommended range (100–125 nmol/l), and all groups failed to change plasma Ca or phosphate. Systolic blood pressure increased significantly (10–15 mmHg) in the rat groups with plasma 25(OH)D levels at both 30 and 561 nmol/l (groups fed 0 and 3·75mg/d) compared with the group fed the equivalent to 0·015mg/d (43 nmol/l 25(OH)D). Although not significant, the group fed the equivalent to 0·25mg/d (108 nmol/l 25(OH)D) also showed a 10 mmHg increase in systolic blood pressure. Carotid artery diameter was significantly smaller and wall thickness was larger, leading to higher peak carotid systolic blood velocity in these two groups. Despite these vascular changes, cardiac function did not differ among treatment groups. The key finding in this study is that arterial stiffness and systolic blood pressure both showed a U-shaped dose–response for vitamin D, with lowest values (best cardiovascular health) observed when plasma 25(OH)D levels were 43 nmol/l in normal male rats.

Among cancers in American women, breast cancer (BC) has the second highest incidence and mortality. The association of BC with diet has been inconsistent. Studies that evaluate associations with dietary patterns are less common and reflect an individual’s whole diet. We associated dietary patterns with the risk of BC in American women of the Adventist Health Study-2 (AHS-2), a prospective cohort of 96 001 subjects recruited between 2002 and 2007. Answers to a previously validated FFQ were used to classify subjects to vegan, lacto-ovo-vegetarian, pesco-vegetarian, semi-vegetarian and non-vegetarian dietary patterns. Incident BC were identified by matching AHS-2 subjects to data from forty-eight state cancer registries. Statistical analyses used proportional hazard regression analyses with covariates that were chosena priori. From 50 404 female participants (26 193 vegetarians), we identified 892 incident BC cases, with 478 cases among vegetarians. As compared with non-vegetarians, all vegetarians combined did not have a significantly lower risk (hazard ratio (HR) 0·97; CI 0·84, 1·11;P=0·64). However, vegans showed consistently lower (but non-significant) point estimates when compared with non-vegetarians (all cases: HR 0·78; CI 0·58, 1·05;P=0·09). In summary, participants in this cohort who follow a vegetarian dietary pattern did not experience a lower risk of BC as compared with non-vegetarians, although lower risk in vegans is possible. These findings add to the very limited literature associating vegetarian diets with BC risk and can assist nutritionists when evaluating the impact of these diets. The findings will also motivate further evaluation of vegan diets and their special characteristics.

The vegetarian dietary pattern is traditionally a plant-based diet that includes fruits, vegetables, cereals, legumes, nuts, vegetable oils, soya, and possibly dairy products and/or eggs. Vegetarians and other populations who follow a plant-based dietary pattern enjoy longevity. Specifically, vegetarian dietary patterns have been associated with a lower risk for developing IHD, type 2 diabetes, hypertension, specific cancers, lower all-cause mortality and reduction in cause-specific mortality. The prevalence of the metabolic syndrome (MetS) in the USA is approximately 20 % and is currently increasing in developing countries in line with the obesity epidemic. The health care costs associated with the MetS are on a magnitude of 1·6 overall compared with healthy individuals, which makes it an important public health problem. Current evidence from several cross-sectional and case–control studies shows an association between consumption of a vegetarian dietary pattern and a reduced prevalence or risk of developing the MetS. There is a need for further research to be conducted, particularly prospective cohort studies to evaluate the effect of vegetarian dietary patterns on reducing the incidence of the MetS and, clinical trials should be designed to explore vegetarian dietary patterns for the reversal of the MetS in high-risk populations. This research could contribute to reduce the societal and economic burdens associated with the disorder.

CVD remains the major cause of death for dialysis patients. Dialysis patients have both traditional and nontraditional risk factors, including the retention of advanced glycation end products (AGE). Tissue AGE can be measured by skin autofluorescence (SAF) and are a reliable measurement of chronic exposure. Dietary intake of AGE may be lower in vegetarian patients than in non-vegetarian patients, so we determined whether vegetarian patients had lower SAF than non-vegetarian patients. We measured SAF in 332 adult haemodialysis patients using a UV technique in a standardised manner. Information about patients' demographic data, laboratory results and current medicinal prescriptions was collected retrospectively from the hospital's computerised database. The mean patient age was 65·2 (sd 15·1) years, 64 % were men, 42 % were diabetic, and 66 % were Caucasian. The mean SAF was 3·26 (sd 0·95) arbitrary units (AU), and SAF was lower in vegetarians as compared to non-vegetarians (2·71 (sd 0·6) v. 3·31 (sd 0·97) AU, P= 0·002). SAF was negatively correlated on both univariate (r − 0·17, P= 0·002) and multiple linear regression (β coefficient − 0·39, 95 % CI − 0·7, − 0·07, P= 0·019). SAF, a marker of tissue AGE deposition, was reduced in vegetarian haemodialysis patients after correction for known confounders, which suggests that a vegetarian diet may reduce exposure to preformed dietary AGE. Dietary manipulation could potentially reduce tissue AGE and SAF as well as CVD risk, but further prospective studies are warranted to confirm the present findings.

Vegetarian dietary patterns have been reported to be associated with a number of favourable health outcomes in epidemiological studies, including the Adventist Health Study 2 (AHS-2). Such dietary patterns may vary and need further characterisation regarding foods consumed. The aims of the present study were to characterise and compare the food consumption patterns of several vegetarian and non-vegetarian diets. Dietary intake was measured using an FFQ among more than 89 000 members of the AHS-2 cohort. Vegetarian dietary patterns were defined a priori, based on the absence of certain animal foods in the diet. Foods were categorised into fifty-eight minor food groups comprising seventeen major food groups. The adjusted mean consumption of each food group for the vegetarian dietary patterns was compared with that for the non-vegetarian dietary pattern. Mean consumption was found to differ significantly across the dietary patterns for all food groups. Increased consumption of many plant foods including fruits, vegetables, avocados, non-fried potatoes, whole grains, legumes, soya foods, nuts and seeds was observed among vegetarians. Conversely, reduced consumption of meats, dairy products, eggs, refined grains, added fats, sweets, snack foods and non-water beverages was observed among vegetarians. Thus, although vegetarian dietary patterns in the AHS-2 have been defined based on the absence of animal foods in the diet, they differ greatly with respect to the consumption of many other food groups. These differences in food consumption patterns may be important in helping to explain the association of vegetarian diets with several important health outcomes.

The present study examines the effect of animal-source-food (ASF) intake on arm muscle area growth as part of a larger study examining causal links between ASF intake, growth rate, physical activity, cognitive function and micronutrient status in Kenyan schoolchildren. This randomised, controlled feeding intervention study was designed with three isoenergetic feeding interventions of meat, milk, and plain traditional vegetable stew (githeri), and a control group receiving no snack. A total of twelve elementary schools were randomly assigned to interventions, with three schools per group, and two cohorts of 518 and 392 schoolchildren were enrolled 1 year apart. Children in each cohort were given feedings at school and studied for three school terms per year over 2 years, a total of 9 months per year: cohort I from 1998 to 2000 and cohort II from 1999 to 2001. Food intake was assessed by 24 h recall every 1–2 months and biochemical analysis for micronutrient status conducted annually (in cohort I only). Anthropometric measurements included height, weight, triceps skinfold (TSF) and mid-upper-arm circumference (MUAC). Mid-upper-arm muscle area (MAMA) and mid-upper-arm fat area (MAFA) were calculated. The two cohorts were combined for analyses. The meat group showed the steepest rates of gain in MUAC and MAMA over time, and the milk group showed the next largest significant MUAC and MAMA gain compared with the plaingitheriand control groups (P

Nutritional recovery with a soyabean diet decreases body and fat weights when compared with a casein diet. We investigated whether the reduced adiposity observed in rats recovering from early-life malnutrition with a soyabean diet results from alterations in lipid metabolism in white adipose tissue (WAT) and/or brown adipose tissue (BAT). Male rats from mothers fed either 17 or 6 % protein during pregnancy and lactation were maintained on 17 % casein (CC and LC groups), 17 % soyabean (CS and LS groups) or 6 % casein (LL group) diets over 60 d. The rats maintained on a soyabean diet had similar relative food intakes, but lower body and retroperitoneal WAT weights and a reduced lipid content in the retroperitoneal WAT. The insulin levels were lower in the recovered rats and were elevated in those fed a soyabean diet. Serum T3 concentration and uncoupling protein 1 content in the BAT were decreased in the recovered rats. The thermogenic capacity of the BAT was not affected by the soyabean diet. The lipogenesis rate in the retroperitoneal WAT was similar in all of the groups except for the LL group, which had exacerbated lipogenesis. The enhancement of the lipolysis rate by isoproterenol was decreased in white adipocytes from the soyabean-recovered rats and was elevated in adipocytes from the soyabean-control rats. Thus, in animals maintained on a soyabean diet, the proportions of fat deposits are determined by the lipolysis rate, which differs depending on the previous nutritional status.

In our previous study, we demonstrated that abstaining from meat, for 1 month, by healthy omnivores (lacto-ovovegetarian model) resulted in a statistical decrease in pancreatic secretion as measured by faecal elastase-1 output. However, no correlation between relative and non-relative changes of energy and nutrient consumption and pancreatic secretion was documented. Therefore, in the present study, we aimed to assess the changes of exocrine pancreatic secretion with a more restrictive dietetic modification, by applying a vegan diet. A total of twenty-one healthy omnivores (sixteen females and five males) participated in the prospective study lasting for 6 weeks. The nutrient intake and faecal output of pancreatic enzymes (elastase-1, chymotrypsin and lipase) were assessed twice during the study. Each assessment period lasted for 7 d: the first before the transition to the vegan diet (omnivore diet) and the second during the last week of the study (vegan diet). The dietary modification resulted in a significant decrease in faecal elastase-1 (P P P v.animal (P P

The present study examines the prevalence and characteristics of vegetarians in the Taiwanese elderly. We analysed data from the Elderly Nutrition and Health Survey in Taiwan (1999–2000), which used a multi-staged, stratified, clustered probability sampling design. Community-dwelling elderly (n 1071), aged 65 years and older, were included. Sociodemographic, anthropometric, lifestyle and metabolic variables, and eating habits were obtained through household interviews and health examinations. Nutrient intake was assessed using a 24 h dietary recall. Multivariable logistic regression analysis was performed to examine factors significantly and independently associated with vegetarian status and to estimate the OR of the hypertension and the metabolic syndrome (MS) for vegetarians compared with omnivores. About 25 % of the Taiwanese elderly persons were vegetarians. Systolic pressure (OR 1·01, 95 % CI 1, 1·02, P = 0·038), female sex (OR 5·02, 95 % CI 3·11, 8·1, P P = 0·034; current smoker (OR 0·45, 95 % CI 0·24, 0·85, P = 0·014)) and regular exercise (OR 1·87, 95 % CI 1·37, 2·56, P P P = 0·002), a higher percentage of fat as PUFA (P = 0·022), higher Ca (P P = 0·041) compared with omnivores. Between the two vegetarian diets, ovo- or lacto-vegetarian diets contained more beneficial micronutrients, such as K, Ca and Mg, and higher crude fibres than vegan diets (all P

Daily nutrition varies considerably among individuals. The number of vegetarians is increasing continuously due to ethical, environmental, religious or other reasons. There is growing concern over their nutritional status with respect to micronutrient deficiencies. Among the essential trace elements, Se is of prime importance as it is part of the active site in selenoproteins. European soil and plants are relatively poor sources of Se, while farm animals are generally supplemented with Se in order to improve their health and avoid deficiency syndromes. We therefore wondered whether German vegetarians display a measurable Se deficiency. To this end, we compared young vegetarians (n 54) and omnivores (n 53). We assessed their Se status by measuring extracellular glutathione peroxidase 3 (GPX3) activity, and concentrations of total serum Se and circulating Se-transport protein selenoprotein P (SEPP). GPX3 activities were not different between the groups, whereas both total Se and SEPP concentrations were reduced to 79·5 and 71·2 % in vegetarians compared with omnivores. When splitting the group of vegetarians into vegans (n 26) and vegetarians consuming egg and milk products (n 28), analyses of the Se-dependent biomarkers did not reveal significant differences. We conclude that low serum Se is mirrored by circulating SEPP concentrations, but not by GPX3 activities in marginally supplied individuals. The specific dietary Se sources, divergent metabolic routes of selenomethionine v. selenocysteine and the different saturation kinetics of GPX3 and SEPP probably underlie our contradictory findings. Whether German vegetarians and vegans need to be considered as a Se-deficient group depends on the biomarker chosen.

The purpose of the present study was to investigate the sex hormonal and metabolic profiles in vegetarians and compare these with the profiles in omnivores. The design of the present study was cross-sectional. The study sample of pre- and post-menopausal women included forty-one omnivores and twenty-one vegetarians. Thereafter we determined: (1) plasma sex hormones, (2) fasting insulin, NEFA as well as apo-A and apo-B, (3) BMI, (4) a dietary profile (3 d dietary records), (5) physical activity and (6) total faecal excretion per 72 h and total urinary excretion per 72 h. Vegetarians showed higher levels of sex hormone-binding globulin (SHBG), apo-A, total faecal excretion per 72 h and total fibre intake as well as lower levels of apo-B, free oestradiol, free testosterone, dehydroepiandrosterone sulfate (DHEA-s) and BMI. Interestingly, after controlling for BMI, significant differences between groups still persisted except for apo-B. Moreover, stepwise regression analysis showed that total fibre intake explained 15·2 % of the variation in SHBG in our cohort, which accounted for the greatest source of unique variance. Results of the present study indicate that pre- and post-menopausal vegetarians present higher concentrations of SHBG, which could be explained, in part, by higher levels of fibre intake. This may explain, at least in part, the lower risk of developing type 2 diabetes.

The aim of these studies was to evaluate the potential of some nutritional approaches to prevent or reduce the body load of organochlorines (OC) in humans. Study 1 compared plasma OC concentrations between vegans and omnivores while study 2 verified if the dietary fat substitute olestra could prevent the increase in OC concentrations that is generally observed in response to a weight-reducing programme. In study 1, nine vegans and fifteen omnivores were recruited and the concentrations of twenty-six OC (β-hexachlorocyclohexane (β-HCH),p,p′-dichlorodiphenyldichloroethane (p,p′-DDE),p,p′-dichlorodiphenyltrichloroethane (p,p′-DDT), hexachlorobenzene, mirex, aldrin, α-chlordane, γ-chlordane, oxychlordane,cis-nonachlor,trans-nonachlor, polychlorinated biphenyl (PCB) nos. 28, 52, 99, 101, 105, 118, 128, 138, 153, 156, 170, 180, 183 and 187, and aroclor 1260) were determined. In study 2, the concentrations of these twenty-six OC were measured before and after weight loss over 3 months in thirty-seven obese men assigned to one of the following treatments: standard group (33 % fat diet;n13), fat-reduced group (25 % fat diet;n14) or fat-substituted group (1/3 of dietary lipids substituted by olestra;n10). In study 1, plasma concentrations of five OC compounds (aroclor 1260 and PCB 99, PCB 138, PCB 153 and PCB 180) were significantly lower in vegans compared with omnivores. In study 2, β-HCH was the only OC which decreased in the fat-substituted group while increasing in the other two groups (P = 0·045). In conclusion, there was a trend toward lesser contamination in vegans than in omnivores, and olestra had a favourable influence on β-HCH but did not prevent plasma hyperconcentration of the other OC during ongoing weight loss.

The amount and the type of dietary protein could play a role in determining the quantity of skeletal muscle mass. The aim was to examine the relationship between the type of protein intake and the level of muscle mass in healthy omnivorous and vegetarian Caucasian women. The design of the present study was an observational and cross-sectional study. Twenty-one omnivores (Om) and nineteen vegetarians (Ve) were recruited. Muscle mass index (urinary creatinine), dietary intake (5 d dietary records) and biochemical analyses (hormone, phyto-oestrogen and lipid profiles) were obtained. We found differences between groups for muscle mass (Ve: 18 kgv.Om: 23 kg;P = 0·010), muscle mass index (Ve: 6·7 kg/m2v.Om: 8·3 kg/m2;P = 0·002), animal protein intake in g/d (P = 0·001) and in g/kg body weight per d (P = 0·003), plant protein intake in g/d (P = 0·015) and in g/kg body weight per d (P = 0·007), the animal:plant protein intake ratio (P = 0·001) and sex hormone-binding globulin (SHBG) (P = 0·001). Muscle mass index still correlated with animal protein intake in g/d (P = 0·001) and in g/kg body weight per d (P = 0·008), and the animal:plant protein intake ratio (P = 0·007) even after controlling for SHBG and plant protein intake. Finally, animal protein intake (g/d) was the independent predictor of muscle mass index (adjustedr20·42). Thus, a vegetarian diet is associated with a lower muscle mass index than is an omnivorous diet at the same protein intake. A good indicator of muscle mass index in women seems to be animal protein intake.

A dog's nutrient requirements can theoretically be met from a properly balanced meat-free diet; however, proof for this is lacking. Exercise places additional demands on the body, and dogs fed a meat-free diet may be at increased risk of developing sports anaemia. We hypothesised that exercising dogs would remain in good health and not develop anaemia when fed a nutritionally balanced meat-free diet. To this end, twelve sprint-racing Siberian huskies were fed either a commercial diet recommended for active dogs (n 6), or a meat-free diet formulated to the same nutrient specifications (n 6). The commercial diet contained 43 % poultry meal, whereas soyabean meal and maize gluten made up 43 % of the meat-free diet, as the main protein ingredients. Dogs were fed these diets as their sole nutrient intake for 16 weeks, including 10 weeks of competitive racing. Blood samples were collected at weeks 0, 3, 8 and 16, and veterinary health checks were conducted at weeks 0, 8 and 16. Haematology results for all dogs, irrespective of diet, were within normal range throughout the study and the consulting veterinarian assessed all dogs to be in excellent physical condition. No dogs in the present study developed anaemia. On the contrary, erythrocyte counts and Hb values increased significantly over time (P

Certain dietary patterns may be related to the risk of CVD. We hypothesised that a plant-centred dietary pattern would be associated with a reduced risk of first myocardial infarction (MI). A case–control study of Norwegian men and postmenopausal women (age 45–75 years) was performed. A FFQ was administered, generally within 3 d after incident MI (n106 cases). Controls (n105) were frequency matched on sex, age and geographic location. On the FFQ, 190 items were categorised into thirty-five food groups and ana priorihealthy diet pattern score was created. We estimated OR using logistic regression with adjustment for energy intake, family history of heart disease, marital status, current smoking, education and age. Among food groups, the risk of MI was significantly higher persdof butter and margarine (OR 1·66 (95 % CI 1·12, 2·46)), and lower persdof tomatoes (OR 0·53 (95 % CI 0·35, 0·79)), high-fat fish (OR 0·57 (95 % CI 0·38, 0·86)), wine (OR 0·58 (95 % CI 0·41, 0·83)), salad (OR 0·59 (95 % CI 0·40, 0·87)), wholegrain breakfast cereals (OR 0·64 (95 % CI 0·45, 0·90)), cruciferous vegetables (OR 0·66 (95 % CI 0·47, 0·93)) and non-hydrogenated vegetable oil (OR 0·68 (95 % CI 0·49, 0·95)). An abundance of cases were found to have a lowa priorihealthy diet pattern score. A dietary pattern emphasising nutrient-rich plant foods and high-fat fish and low intransfatty acids was associated with decreased risk of MI among Norwegians.

Since the vegetarian diet lacks the substrate for pancreatic elastase-1 as an enzyme, a decreased secretion of this enzyme could be expected. We aimed therefore to assess the changes of exocrine pancreatic secretion in a prospective way in a group of healthy omnivores who modified their diet by abstaining from meat for 1 month. Twenty healthy omnivores (fourteen females and six males) were used in the study. The nutrient intake was assessed for 7 d before commencing the study (omnivore diet) and after 1 month of dietary modification (modified diet; meat excluded). Similarly, the faecal output of pancreatic enzymes (elastase-1, chymotrypsin and lipase) was assessed before and 1 month after the period of dietary modification. Statistical differences between two points of the assessment (paired data) were calculated with the use of the Wilcoxon rank test. The relationship between the changes of faecal enzyme output and the changes in nutrient intake was assessed using multiple regression analysis. The dietary changes resulted in statistically significant decrease of faecal elastase-1 output (P

Triacylglycerol (TG) lowering effects ofn−3 long-chain PUFA (n−3 LCPUFA) have been repeatedly demonstrated, but studies investigating the individual effects of EPA or DHA on plasma TG and lipoproteins in man are rare. The effects of a new DHA-rich, almost EPA-free microalgae oil (Ulkeniasp.) on plasma lipids and several safety parameters were investigated in a double-blind, placebo-controlled, parallel design intervention study. Normolipidaemic vegetarians (eighty-seven females, twenty-seven males) consumed daily microalgae oil (0·94g DHA/d) or olive oil (as placebo) for 8 weeks. DHA supplementation decreased plasma TG by 23% from 1·08 (sem 0·07) to 0·83 (sem 0·04) mmol/l (pr−0·627,pUlkeniasp. was well tolerated and can be considered a suitable vegetarian source ofn−3 LCPUFA. Although DHA supplementation improved some CHD risk factors (plasma TG, TG:HDL cholesterol ratio), LDL cholesterol increased. Therefore, the overall effects of this intervention on CHD risk deserve further investigation.

The Orthodox Christian diet is unique in regularly interchanging from an omnivore to a vegetarian-type diet, and no study to date has focused on the impact of this on Fe status. Thirty-five Greek Orthodox Christian strict fasters (n17 male,n18 female; mean age 43·6±13·2 years) and twenty-four controls (n11 male,n13 female; mean age 39·8±7·6 years) were studied before (pre) and near completion (end) of the Christmas fasting (CF) period (40 d), during which meat and dairy products are prohibited. Fe status was assessed using standard haematological parameters, and Fe deficiency was determined via serum ferritin levels (P=0·02) and decreased their total Fe-binding capacity (PP=0·038 andP=0·001, respectively). Adherence to the Orthodox Christian dietary guidelines does not have a major impact on Fe status and is not associated with a significantly greater degree of Fe deficiency.

Meat increases absorption of non-haem iron in single-meal studies. The aim of the present study was to investigate, over a 5 d period, the potential increasing effect of consumption of pork meat in a whole diet on the fractional absorption of non-haem iron and the total absorption of iron, when compared to a vegetarian diet. A randomised cross-over design with 3×5 d whole-diet periods with diets containing Danish-produced meat, Polish-produced meat or a vegetarian diet was conducted. Nineteen healthy female subjects completed the study. All main meals in the meat diets contained 60 g of pork meat and all diets had high phytic acid content (1250 μmol/d). All main meals were extrinsically labelled with the radioactive isotope59Fe and absorption of iron was measured in a whole body counter. The non-haem iron absorption from the Danish meat diet was significantly higher compared to the vegetarian diet (P=0·031). The mean fractional absorption of non-haem iron was 7·9 (se1·1), 6·8 (se 1·0) and 5·3 (se 0·6) % for the Danish and Polish meat diets and vegetarian diet, respectively. Total absorption of iron was higher for both meat diets compared to the vegetarian diet (Danish meat diet:P=0·006, Polish meat diet:P=0·003). The absorption ratios of the present study were well in accordance with absorption ratios estimated using algorithms on iron bioavailability. Neither the meat diets nor the vegetarian diets fulfilled the estimated daily requirements of absorbed iron in spite of a meat intake of 180 g/d in the meat diets.

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 mgv. 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 μg/mlv. 0·95 μg/ml) and more subjects had levels below the reference range of 0·72–1·44 μg/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.

Observational studies primarily based on diet questionnaires or food records have reported that vegetarians can have a very low I intake. However, analytically ascertained data on the possible degree of I deficiency with this form of diet is lacking. Six healthy adult volunteers participated in the present controlled experimental diet study carried out in four separate 5 d diet periods. The study diets, normal, protein-rich, lactovegetarian, and repeat of the initial normal diet, were almost isoenergetic and contained no fish, sea food, iodized salt or processed foods fortified with I. During the last 48 h of each diet period two 24 h urine samples were obtained from each subject. I analyses were performed in the urine samples and in representative samples taken from all ingested diets. Urinary I excretion was significantly lower with the lactovegetarian diet (36·6 (sd 8·8) μg/d) than with the normal and the protein-rich diets (50·2 (sd 14·0) and 61·0 (sd 8·0) μg/d respectively). Accordingly, a markedly reduced I intake was confirmed analytically for the lactovegetarian diet (15·6 μg/dv.35·2 and 44·5 μg/d respectively). Our results provide experimental confirmation of literature findings indicating that I supply is higher with non-vegetarian than with vegetarian diets. Specifically, the extremely low intake and urinary output of I as analytically determined for one exemplary vegetarian diet, demonstrate that dietary I may be limiting when strict forms of vegetarian dietary practices (no iodized salt, no I supplements) are followed. The present study is, therefore, the first diet-experiment-based pointer to the potential danger of I deficiency disorders due to strict forms of vegetarian nutrition, especially when fruits and vegetables grown in soils with low I levels are ingested.

Faecal bulk, pH, water content, the concentrations of neutral sterols and bile acids and dietary intakes were measured in twenty-two Indian vegetarian, twenty-two white omnivorous and eighteen white vegetarian premenopausal women. Faecal bulk and water content were greater and pH lower in the Indian vegetarians. Total faecal animal sterol and coprostanol concentrations expressed on a dry-weight basis were lower in the vegetarians compared with the omnivores. The faecal sterol concentrations were correlated with dietary cholesterol intake. Primary bile acids were detected in six Indian vegetarians, two white vegetarians and two white omnivores; secondary bile acids were detected in all the white omnivore and vegetarian subjects but not in two of the Indian vegetarians. Total faecal free bile acid and conjugated bile acid concentrations were lower in the white vegetarians compared with the omnivores. Faecal lithocholic acid concentrations were lower in both Indian and white vegetarians. The lithocholic: deoxycholic acid ratio and coprostanol: total animal sterols ratio were significantly lower in the Indian vegetarians compared with the omnivores. Both ratios were positively correlated with faecal pH. Stepwise multiple regression analyses were undertaken in order to identify which nutrients influenced faecal pH, lithocholic and deoxycholic acid concentrations. The intakes of starch and dietary fibre were negatively associated with faecal concentrations of lithocholic and deoxycholic acid. Starch intake alone was negatively associated with faecal pH. The results of this study confirm that diets high in dietary fibre decrease faecal bile acid concentrations and suggest that the complex carbohydrates present in Indian vegetarian diets influence faecal pH and inhibit the degradation of faecal steroids.

In a controlled clinical trial we have recently shown that patients with rheumatoid arthritis (RA) improved after fasting for 7–10 d and that the improvement could be sustained through 3.5 months with a vegan, diet and 9 months with a lactovegetarian diet. Other studies have indicated that the inflammatory process in R A can be reduced through manipulation of dietary fatty acids. A switch to a vegetarian diet significantly alters the intake of fatty acids. Therefore, we have analysed the changes in fatty acid profiles of the plasma phospholipid fraction and related these changes to disease activity. The concentrations of the fatty acids 20: 3n-6 and 20: 4n-6 were significantly reduced after 3.5 months with a vegan diet (P< 0.0001 andP< 0.01 respectively), but the concentration increased to baseline values with a lactovegetarian diet. The concentration of 20: 5n-3 was significantly reduced after the vegan diet (P< 0.0001) and the lactovegetarian diet periods (P< 0.01). There was no significant difference in fatty acid concentrations between diet responders and diet non-responders after the vegan or lactovegetarian diet periods. Our results indicate that the changes in the fatty acid profiles cannot explain the clinical improvement.

The tripeptide glutathione is proposed to be protective against a number of chronic diseases including cardiovascular disease and cancer. However, there have been few studies of plasma glutathione levels in humans and in those studies the numbers of participants have been very small. In an exploratory analysis the determinants of plasma total glutathione (GSHt) were investigated in a group of 100 volunteers aged 18–61 years in Atlanta, Georgia, USA during June and July 1989. Data on demographic and health-related factors were collected by interview and plasma GSHt was measured using a recently modified laboratory method. The mean concentration of plasma GSHt for all 100 participants was 761 μg/l, with a standard deviation of 451 μg/l, a range of 86–2889 μg/1 and a median of 649 μg/l. Men had significantly higher levels of plasma GSHt than women (924 v. 692 μg/l; P = 0·006). Seventh-day Adventists participating in the present study had higher plasma GSHt levels than other subgroups defined by race and/or religion. Among Seventh-day Adventists consumption of a vegetarian diet was associated with increased plasma GSHt concentration (P = 0·002). Plasma GSHt levels also appeared to vary by race, but relationships with race could not be clearly disassociated from relationships with religion. Among white participants plasma GSHt concentration decreased with age in women but increased with age in men (P = 0·05). Few other factors were associated with plasma GSHt concentration, although use of oral contraceptives (P = 0·10) was somewhat associated with decreased plasma GSHt levels. These findings suggest that plasma GSHt levels may vary with several demographic and health-related attributes and support the need for further research on this potentially important disease-preventive compound.

Vegetarians of three types were studied in Greater London:thirty-four meat-avoiders, fifty-two lacto- ovo-vegetarians, and thirty-eight vegans. Weighed dietary intake measures were made over 3 d. Cereals were the mainstay of the diet, supplemented by dairy products (demi-vegetarians and lacto-ovo- vegetarians), vegetables and fruit, and soya-bean products (vegans). Many vegans progressed by stages to complete avoidance of animal foods; some had retreated, but most were highly committed. Demi- vegetarians were the least involved in a ‘vegetarian lifestyle’. All groups had mean energy intakes close to the current dietary reference values (DRV), with adequate protein intakes. Only vegans had fat intakes close to current recommendations; all groups had high dietary po1yunsaturated:saturated fatty acid ratios. Mean intakes of all micronutrients studied for demi- and lacto-ovo-vegetarians met the UK DRV. Intakes of iodine, riboflavin, and vitamin B12 for vegans were below DRV; more than half considered their diets supplied all necessary vitamins. About 25% took some type of dietary supplement during the survey. The impact of low I intakes should be further studied, and it is recommended that ‘new’ vegetarians and vegans should use appropriate dietary supplements.

The effects of a strict uncooked vegan diet on serum lipid and sterol concentrations were studied in patients with rheumatoid arthritis. The subjects were randomized into a vegan diet group (n16), who consumed a vegan diet for 2–3 months, or into a control group (n13), who continued their usual omnivorous diets. Serum total and LDL-cholesterol and -phospholipid concentrations were significantly decreased by the vegan diet. The levels of serum cholestanol and lathosterol also decreased, but serum cholestanol:total cholesterol and lathosterol:total cholesterol did not change. The effect of a vegan diet on serum plant sterols was divergent as the concentration of campesterol decreased while that of sitosterol increased. This effect resulted in a significantly greater sitosterol:campesterol value in the vegan diet group than in the control group (1.48 (SD 0.39)V.0.72 (sd 0.14); P