Nutritional Status and Characteristics of Vegetarians

Source: Larsson CL, Johansson GK. Dietary intake and nutritional status of young vegans and omnivores in Sweden. Am J Clin Nutr 2002;76:100-106.

Objective: To compare the dietary intake and nutritional status of young Swedish vegans and omnivores.

Design: The dietary intakes of 30 vegans (15 males and 15 females; mean age 17.5 ± 1.0 years) and 30 sex-, age-, and height-matched omnivores were assessed with the use of a diet-history interview and validated by the doubly labeled water method and by measuring nitrogen, sodium, and potassium excretion in urine. Iron status and serum vitamin B12 and folate concentrations were measured in blood samples.

Outcomes: Vegans had higher intakes of vegetables, legumes, and dietary supplements and lower intakes of cake, cookies, candy, and chocolate than did omnivores. Vegans had dietary intakes lower than the average requirements of riboflavin, vitamin B12, vitamin D, calcium, and selenium. Intakes of calcium and selenium remained low even with the inclusion of dietary supplements. There was no significant difference in the prevalence of low iron status among vegans (20%) and omnivores (23%). Two vegans with low intakes of vitamin B12 had low serum concentrations.

Conclusion: The dietary habits of the vegans varied considerably and did not comply with the average requirements for some essential nutrients.

Source: Larsson CL, et al. Lifestyle-related characteristics of young low-meat consumers and omnivores in Sweden and Norway. J Adolescent Health 2002;31:190-198.

Objective: To compare the lifestyle-related characteristics of low-meat consumers and omnivore adolescents in Sweden and Norway.

Methods: A total of 2,041 students, with a mean age of 15.5 years, completed a questionnaire. Information was collected about physical characteristics, and health; family situation; and social, exercise, alcohol, and tobacco habits. The response rate ranged from 83-95%. Statistical analyses included chi-square and Mann-Whitney U tests.

Results: There was no reported difference between low-meat consumers and omnivores with respect to alcohol use, smoking, weight, or amount of exercise. Female low-meat consumers more frequently used smokeless tobacco, reported having more sick days during the last year, attached less importance to "being healthy," and had been depressed more often than female omnivores. Male low-meat consumers reported, to a greater extent than male omnivores, having been tired without reason, having often had headaches, and having been depressed. Female low-meat consumers had parents with a higher average level of education than did female omnivores and more often spent time with friends after school.

Conclusion: In this study, vegetarianism or low-meat consumption is mainly a female phenomenon among adolescents. Adherence to a low-meat diet may not correlate with other health promotion practices among adolescents in Sweden and Norway.

Comments: Given the high rates of chronic cardiovascular disease and cancer in women, as well as the increasing rates of obesity in the United States, strategies that would start healthy life habits early would be of great interest to health care providers. The need for this is made more urgent by the emergence of chronic metabolic diseases such as Type II diabetes and hyperlipidemia in an increasingly obese adolescent population.

These two articles give us insight into the health risks and benefits of this practice as well as its ability to predict other healthy habits. First, most adolescents chose this diet for ethical or ecological, not health reasons. Thus, these subjects still were very likely to make typical food choices such as pizza, white bread, and other snack foods. In addition, other healthy habits, such as abstinence from alcohol or smoking or increasing exercise, were not more likely in these vegetarians.

On the positive side, these subjects were more likely to have a lower weight and body mass index (especially males) and have much higher intake of key foods such as fruits, vegetables, and legumes. In fact, a survey in the United States of 4,746 adolescents showed that the vegetarian teens were more likely than their omnivorous counterparts to actually meet the Healthy People 2010 objectives.

Much has been made of the inadequacy of vegetarian diets, especially the more restrictive or vegan version, for key nutrients. In this study, vegans had lower intake of riboflavin, vitamin B12, vitamin D, calcium, and selenium. Iron intake was generally adequate. Supplementation did not fully correct these deficits. It would be important to encourage careful dietary planning and adequate supplementation for vegetarian or vegan teens and pregnant women to ensure adequate micronutrients.

Although teens do not choose this diet for their health, it is important to educate them about the benefits of this diet as a life-long choice. Diets high in these foods have been associated with lower risks of heart disease, stroke, and cancer (including breast cancer). Low-fat vegetarian diets also have been suggested for rheumatoid arthritis and fibromyalgia, two diseases more common in women. We therefore recommend that if you are seeing an adolescent or young woman who has made this lifestyle choice, educate her to ensure proper micronutrient consumption and re-enforce the health benefits that can accrue over a lifetime.