(1999). "IV applied vegetarian nutrition." Am J Clin Nutr 70(3 Suppl): 633S-634S.
(1999). "Proceedings of the 3rd International Congress on Vegetarian Nutrition. Loma Linda, California, USA. March 24-26, 1997." Am J Clin Nutr 70(3 Suppl): 429S-634S.
Appleby, P. N., et al. (1999). "The Oxford Vegetarian Study: an overview." Am J Clin Nutr 70(3 Suppl): 525S-531S.
The Oxford Vegetarian Study is a prospective study of 6000 vegetarians and 5000 nonvegetarian control subjects recruited in the United Kingdom between 1980 and 1984. Cross-sectional analyses of study data showed that vegans had lower total- and LDL-cholesterol concentrations than did meat eaters; vegetarians and fish eaters had intermediate and similar values. Meat and cheese consumption were positively associated, and dietary fiber intake was inversely associated, with total-cholesterol concentration in both men and women. After 12 y of follow-up, all-cause mortality in the whole cohort was roughly half that in the population of England and Wales (standardized mortality ratio, 0.46; 95% CI, 0.42, 0.51). After adjusting for smoking, body mass index, and social class, death rates were lower in non-meat-eaters than in meat eaters for each of the mortality endpoints studied [relative risks and 95% CIs: 0.80 (0. 65, 0.99) for all causes of death, 0.72 (0.47, 1.10) for ischemic heart disease, and 0.61 (0.44, 0.84) for all malignant neoplasms]. Mortality from ischemic heart disease was also positively associated with estimated intakes of total animal fat, saturated animal fat, and dietary cholesterol. Other analyses showed that non-meat-eaters had only half the risk of meat eaters of requiring an emergency appendectomy, and that vegans in Britain may be at risk for iodine deficiency. Thus, the health of vegetarians in this study is generally good and compares favorably with that of the nonvegetarian control subjects. Larger studies are needed to examine rates of specific cancers and other diseases among vegetarians.
Ball, M. J. and M. A. Bartlett (1999). "Dietary intake and iron status of Australian vegetarian women." Am J Clin Nutr 70(3): 353-358.
BACKGROUND: Despite the possible overall health benefits of a vegetarian diet, there is concern that some vegetarians and infrequent meat eaters, particularly females, may have inadequate iron status because of low or no heme-iron intakes. OBJECTIVE: The objective was to investigate the nutritional intake and iron status of vegetarian women. DESIGN: The nutritional intakes of 50 free-living vegetarian women aged 18-45 y and 24 age-matched omnivorous control women were assessed by using 12-d weighed dietary records. Iron status was assessed by measuring hemoglobin and serum ferritin concentrations. RESULTS: There was no significant difference between mean (+/-SD) daily iron intakes of vegetarians and omnivores (10.7 +/- 4.4 and 9.9 +/- 2.9 mg, respectively), although heme-iron intakes were low in the vegetarians. Vegetarians had significantly lower intakes of protein (P < 0.01), saturated fat (P < 0.01), and cholesterol (P < 0.001), and significantly higher intakes of dietary fiber (P < 0.001) and vitamin C (P < 0.05). Mean serum ferritin concentrations were significantly lower (P = 0.025) in vegetarians (25.0 +/- 16.2 microg/L) than in omnivores (45.5 +/- 42.5 microg/L). However, similar numbers of vegetarians (18%) and omnivores (13%) had serum ferritin concentrations <12 microg/L, which is a value often used as an indicator of low iron stores. Hemoglobin concentrations were not significantly different. CONCLUSION: It is important that both vegetarian and omnivorous women maintain an adequate iron status and follow dietary practices that enhance iron absorption.
Bissoli, L., et al. (1999). "Resting metabolic rate and thermogenic effect of food in vegetarian diets compared with Mediterranean diets." Ann Nutr Metab 43(3): 140-144.
The purpose of our work is to compare the resting metabolic rate (RMR) and thermogenic effect of food (TEF) in a group of vegetarians and a group of subjects consuming a Mediterranean diet. The composition of the diets was similar. Thirty-two subjects were studied: 16 vegetarians (age 34 +/- 9 years, BMI 21 +/- 2) and 16 omnivors (age 30 +/- 5 years, BMI 22 +/- 3). All were in excellent general health. Each subject consumed a dish of pasta (100 g) and bread (30 g) after RMR had been measured. TEF was measured over the next 3 h and calculated as the incremental area above RMR. Energy (vegetarians and omnivors 7,727 +/- 3,516 vs 8,970 +/- 2,273 kJ/day, respectively) and carbohydrate (vegetarians and omnivors 285.1 +/- 141.3 vs. 300.1 +/- 74 g/day, respectively) intakes of the 2 groups were similar. The vegetarian group consumed a higher quantity of fiber (30.5 +/- 16.7 vs. 16.5 +/- 7.9) and a lower amount of protein (44.9 +/- 18.3 vs. 70.1 +/- 14.9) than the omnivorous group. No significant differences were observed in RMR (4.23 +/- 0.96 vs. 4.06 +/- 0.54 kJ/min) and TEF (0.50 +/- 0.25 vs. 0.38 +/- 0.25 Delta kJ/min) between the groups. Results did not change after correcting for weight, age and gender. Our study failed to show any significant differences in RMR and TEF between vegetarians and subjects consuming a Mediterranean diet. We conclude that vegetarianism per se is not accompanied by a difference in RMR and TEF when the carbohydrate content of the diet is similar to a control group of nonvegetarians.
Bysshe, J. (1999). "Advising the vegetarian family on a balanced diet." Prof Care Mother Child 9(6): 163-166.
Famodu, A. A., et al. (1999). "The influence of a vegetarian diet on haemostatic risk factors for cardiovascular disease in Africans." Thromb Res 95(1): 31-36.
Dietary habits have been implicated in the occurrence of cardiovascular diseases. Elevated plasma fibrinogen levels and decreased fibrinolytic activity have been identified as major independent cardiovascular risk factors. In this study, we compared the blood pressure, plasma fibrinogen concentration, and fibrinolytic activity of 40 nonvegetarians (NON-VEGs) with 36 vegetarians (8 VEGs and 28 SEMI-VEGs). The latter group consisted of students and lecturers of the Adventist Seminary Institute of West Africa, Ilishan Remo. All subjects had blood pressures below 140/90 mmHg, no underlying haemostatic disorders and were not on any medical treatment. The NON-VEGs had significantly decreased fibrinolytic activity (p<0.001) and increased plasma fibrinogen levels (p<0.001) compared with the SEMI-VEGs and VEGs. There were no significant differences between the blood pressure levels of the three groups, although the NON-VEGs had lower diastolic blood pressures. It is concluded that black African Seventh-Day Adventists who follow a vegetarian diet may be protected against premature cardiovascular disease because of beneficial dietary effects on plasma fibrinogen levels and fibrinolytic activity.
Haddad, E. H., et al. (1999). "Vegetarian food guide pyramid: a conceptual framework." Am J Clin Nutr 70(3 Suppl): 615S-619S.
The purpose of this article and the accompanying vegetarian food guide pyramid graphic is to provide the conceptual framework for the development of a new and unique food guide. Food guides for vegetarians have tended to be adaptations of guides developed for the general nonvegetarian population instead of being designed to emphasize the healthy components of vegetarian dietary patterns. A subcommittee of the organizers of the Third International Congress on Vegetarian Nutrition began a process that led to the development of a pyramid-shaped graphic illustration and a supporting document, both of which were introduced at the congress. The 5 major plant-based food groups (whole grains, legumes, vegetables, fruit, nuts, and seeds) form the trapezoid-shaped lower portion of the pyramid. Optional food groups, which may be avoided by some vegetarians (vegetable oils, dairy, eggs, and sweets), form the smaller, separate, triangle-shaped top portion of the pyramid. The supporting document discusses the concepts that affect vegetarian food guidance and the rationale for selecting the food groups. It is hoped that this framework will provide the impetus for further research and discussion and will lead to the development of a guide that is nutritionally adequate, is conducive to good health, and can be adopted by vegetarians of diverse eating practices.
Hebbelinck, M., et al. (1999). "Growth, development, and physical fitness of Flemish vegetarian children, adolescents, and young adults." Am J Clin Nutr 70(3 Suppl): 579S-585S.
This study was designed to assess average daily dietary intakes of energy in 82 vegetarian children (group A: 6- 9-y-old girls and 6-11-y-old boys), adolescents (group B: 10- 15-y-old girls and 12-17-y-old boys), and young adults (group C: 16-30-y-old females and 18-30-y-old males) and included determination of height and weight; triceps, suprailiac, and calf skinfold thicknesses; puberty ratings; and physical fitness. Dietary energy intake was lower than recommended values in all 3 groups. Height and weight did not differ significantly from the reference data except in group B, which had significantly lower heights and weights and lower body mass indexes (P<0.05). Triceps and suprailiac skinfold thicknesses were lower in all age groups, whereas the calf skinfold thickness was only significantly lower in the 10-15-y-old girls (P<0.05). The vegetarian children were as physically fit as the reference group. The vegetarian adolescent boys and girls and the young adults scored significantly lower on the standing long jump and 30-s sit-up (P<0.05). The vegetarian subjects of groups B and C recovered significantly faster from the step test (P<0.05). Puberty ratings plotted on percentile graphs showed that all vegetarian subjects, except for 1 girl, were within the normal developmental range. We conclude that, within the limits of this study, vegetarian subjects have lower relative body weights and skinfold thicknesses in adolescence than do nonvegetarians. They scored lower on the strength tests and better on the cardiorespiratory test when compared with reference values. The growth and maturation status of the vegetarian population were within the normal range.
Ivanov, A. N., et al. (1999). "[The effect of an antiatherogenic vegetarian diet on the clinico-hemodynamic and biochemical indices in elderly patients with ischemic heart disease]." Ter Arkh 71(2): 75-78.
AIM: To study the effects of newly developed antiatherogenic vegetarian diet enriched with soya bean products on clinico-hemodynamic characteristics of elderly patients with coronary heart disease (CHD). MATERIALS AND METHODS: Clinico-hemodynamic parameters, lipid blood spectrum and plasmic hemostasis were studied in 28 elderly CHD patients divided into groups by dyslipidemia type (IIA, IIB, IV). RESULTS: The antiatherogenic vegetarian diet promoted normalization of central hemodynamics, lowering of blood atherogenic lipids, positive changes in blood rheology. CONCLUSION: The proposed balanced antiatherogenic vegetarian diet proved to be an effective monotherapy of dyslipidemia in elderly patients with coronary heart disease.
Kerr, M. (1999). "What should be done to compensate for the shortcomings of a vegetarian diet?" Nutr Health 13(2): 85-94.
Key, T. J., et al. (1999). "Health benefits of a vegetarian diet." Proc Nutr Soc 58(2): 271-275.
Compared with non-vegetarians, Western vegetarians have a lower mean BMI (by about 1 kg/m2), a lower mean plasma total cholesterol concentration (by about 0.5 mmol/l), and a lower mortality from IHD (by about 25%). They may also have a lower risk for some other diseases such as constipation, diverticular disease, gallstones and appendicitis. No differences in mortality from common cancers have been established. There is no evidence of adverse effects on mortality. Much more information is needed, particularly on other causes of death, other morbidity including osteoporosis, and long-term health in vegans. The evidence available suggests that widespread adoption of a vegetarian diet could prevent approximately 40,000 deaths from IHD in Britain each year.
Kjeldsen-Kragh, J. (1999). "Rheumatoid arthritis treated with vegetarian diets." Am J Clin Nutr 70(3 Suppl): 594S-600S.
The notion that dietary factors may influence rheumatoid arthritis (RA) has been a part of the folklore of the disease, but scientific support for this has been sparse. In a controlled, single-blind trial we tested the effect of fasting for 7-10 d, then consuming an individually adjusted, gluten-free, vegan diet for 3.5 mo, and then consuming an individually adjusted lactovegetarian diet for 9 mo on patients with RA. For all clinical variables and most laboratory variables measured, the 27 patients in the fasting and vegetarian diet groups improved significantly compared with the 26 patients in the control group who followed their usual omnivorous diet throughout the study period. One year after the patients completed the trial, they were reexamined. Compared with baseline, the improvements measured were significantly greater in the vegetarians who previously benefited from the diet (diet responders) than in diet nonresponders and omnivores. The beneficial effect could not be explained by patients' psychologic characteristics, antibody activity against food antigens, or changes in concentrations of prostaglandin and leukotriene precursors. However, the fecal flora differed significantly between samples collected at time points at which there was substantial clinical improvement and time points at which there were no or only minor improvements. In summary, the results show that some patients with RA can benefit from a fasting period followed by a vegetarian diet. Thus, dietary treatment may be a valuable adjunct to the ordinary therapeutic armamentarium for RA.
Li, D., et al. (1999). "Effect of dietary alpha-linolenic acid on thrombotic risk factors in vegetarian men." Am J Clin Nutr 69(5): 872-882.
BACKGROUND: Vegetarians have lower platelet and plasma concentrations of n-3 polyunsaturated fatty acids (PUFAs) than do omnivores. We recently showed that male vegetarians have higher platelet aggregability than do omnivores. OBJECTIVE: We investigated whether male vegetarians (n = 17) who consumed an increased amount of dietary alpha-linolenic acid (ALA) showed any changes in their tissue profile of PUFAs, plasma thromboxane concentrations, platelet aggregability, or hemostatic factors. DESIGN: During the study, all subjects maintained their habitual vegetarian diets except that a proportion of dietary fat was replaced with vegetable oils and margarines that were provided. Initially, all subjects consumed a low-ALA diet (containing safflower oil and safflower oil-based margarine) for 14 d; they then consumed either a moderate-ALA diet (containing canola oil and canola oil-based margarine) or a high-ALA diet (containing linseed oil and linseed oil-based margarine) for 28 d. Blood samples were collected at day 0 (baseline), day 14, and day 42. RESULTS: Eicosapentaenoic acid, docosapentaenoic acid, total n-3 PUFAs, and the ratio of n-3 to n-6 PUFAs were significantly increased (P < 0.05), whereas the ratio of arachidonic acid to eicosapentaenoic acid was decreased (P < 0.05), in platelet phospholipids, plasma phospholipids, and triacylglycerols after either the moderate-ALA or high-ALA diet compared with the low-ALA diet. No significant differences were observed in thrombotic risk factors. CONCLUSION: ALA from vegetable oils (canola and linseed) has a beneficial effect on n-3 PUFA concentrations of platelet phospholipids and plasma lipids in vegetarian males.
Martins, Y., et al. (1999). "Restrained eating among vegetarians: does a vegetarian eating style mask concerns about weight?" Appetite 32(1): 145-154.
The present study explored the relationships among dietary style (ranging from meat eating to veganism), cognitive restraint and feminist values. Two-hundred and twenty-seven participants with varying dietary styles completed the restraint subscale of the Three Factor Eating Questionnaire (TFEQ) and Attitudes Towards Feminism Scale (ATFS). Results indicated that among males, those who are high in cognitive restraint are more likely to exhibit a vegetarian dietary style than those low in cognitive restraint. Among women who are high in feminist values, those with high cognitive restraint are more likely to exhibit a vegetarian dietary style than those with low cognitive restraint, whereas for women low in feminist values those with high and low cognitive restraint are equally likely to exhibit vegetarian and non-vegetarian dietary styles. It is suggested that for some individuals, adoption of a vegetarian dietary style is an attempt to mask their dieting behaviour from others.
Nicholson, A. S., et al. (1999). "Toward improved management of NIDDM: A randomized, controlled, pilot intervention using a lowfat, vegetarian diet." Prev Med 29(2): 87-91.
OBJECTIVE: To investigate whether glycemic and lipid control in patients with non-insulin-dependent diabetes (NIDDM) can be significantly improved using a low-fat, vegetarian (vegan) diet in the absence of recommendations regarding exercise or other lifestyle changes. METHODS: Eleven subjects with NIDDM recruited from the Georgetown University Medical Center or the local community were randomly assigned to a low-fat vegan diet (seven subjects) or a conventional low-fat diet (four subjects). Two additional subjects assigned to the control group failed to complete the study. The diets were not designed to be isocaloric. Fasting serum glucose, body weight, medication use, and blood pressure were assessed at baseline and biweekly thereafter for 12 weeks. Serum lipids, glycosylated hemoglobin, urinary albumin, and dietary macronutrients were assessed at baseline and 12 weeks. RESULTS: Although the sample was intentionally small in accordance with the pilot study design, the 28% mean reduction in fasting serum glucose of the experimental group, from 10.7 to 7.75 mmol/L (195 to 141 mg/dl), was significantly greater than the 12% decrease, from 9.86 to 8.64 mmol/L (179 to 157 mg/dl), for the control group (P < 0.05). The mean weight loss was 7.2 kg in the experimental group, compared to 3. 8 kg for the control group (P < 0.005). Of six experimental group subjects on oral hypoglycemic agents, medication use was discontinued in one and reduced in three. Insulin was reduced in both experimental group patients on insulin. No patient in the control group reduced medication use. Differences between the diet groups in the reductions of serum cholesterol and 24-h microalbuminuria did not reach statistical significance; however, high-density lipoprotein concentration fell more sharply (0.20 mmol/L) in the experimental group than in the control group (0.02 mmol/L) (P < 0.05). CONCLUSION: The use of a low-fat, vegetarian diet in patients with NIDDM was associated with significant reductions in fasting serum glucose concentration and body weight in the absence of recommendations for exercise. A larger study is needed for confirmation.
Nieman, D. C. (1999). "Physical fitness and vegetarian diets: is there a relation?" Am J Clin Nutr 70(3 Suppl): 570S-575S.
The available evidence supports neither a beneficial nor a detrimental effect of a vegetarian diet on physical performance capacity, especially when carbohydrate intake is controlled for. Concerns have been raised that an emphasis on plant foods to enhance carbohydrate intake and optimize body glycogen stores may lead to increases in dietary fiber and phytic acid intake to concentrations that reduce the bioavailability of several nutrients, including zinc, iron, and some other trace minerals. There is no convincing evidence, however, that vegetarian athletes suffer impaired nutrient status from the interactive effect of their heavy exertion and plant-food based dietary practices to the extent that performance, health, or both are impaired. Although there has been some concern about protein intake for vegetarian athletes, data indicate that all essential and nonessential amino acids can be supplied by plant food sources alone as long as a variety of foods is consumed and the energy intake is adequate. There has been some concern that vegetarian female athletes are at increased risk for oligoamenorrhea, but evidence suggests that low energy intake, not dietary quality, is the major cause. In conclusion, a vegetarian diet per se is not associated with improved aerobic endurance performance. Although some concerns have been raised about the nutrient status of vegetarian athletes, a varied and well-planned vegetarian diet is compatible with successful athletic endeavor.
Remer, T., et al. (1999). "Increased risk of iodine deficiency with vegetarian nutrition." Br J Nutr 81(1): 45-49.
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) micrograms/d) than with the normal and the protein-rich diets (50.2 (SD 14.0) and 61.0 (SD 8.0) micrograms/d respectively). Accordingly, a markedly reduced I intake was confirmed analytically for the lactovegetarian diet (15.6 micrograms/d v. 35.2 and 44.5 micrograms/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.
Renault, F., et al. (1999). "Neuropathy in two cobalamin-deficient breast-fed infants of vegetarian mothers." Muscle Nerve 22(2): 252-254.
We describe the electrophysiological findings in 2 infants with deficient cobalamin intake. After normal development, psychomotor regression appeared after the 6th month, leading to severe hypotonia and apathy before the 12th month. Electrodiagnostic evaluation showed sensory neuropathy in both cases, associated with motor neuropathy in 1 case. Thus, in an acquired floppy infant syndrome, electrophysiological signs of peripheral neuropathy contributed to the diagnosis of a curable metabolic disorder.
Rudkin, C. L. (1999). "Vegetarian diet planning for adolescents with diabetes." Pediatr Nurs 25(3): 262-266.
Adolescents with insulin dependent diabetes mellitus (IDDM) who choose to be vegetarian have complex nutritional needs because of their continued physical growth and development, their participation in strenuous activities, and their need to consume sufficient carbohydrates to match their insulin doses. Since diet control is a cornerstone of diabetes management, the adolescent who chooses a vegetarian diet may cause their parents needless anxiety. Nurses working with these adolescents can provide support and guidance and liaison with the endocrinologist, nutritionist or dietitian, and diabetic educator. Although adolescent diabetic vegetarians have not been studied extensively as a population, facts about nutrition and diabetes can be used to assist in meal planning. A complete growth and nutritional assessment must be done to search for any problem areas. If protein dense flesh food is eliminated and a largely carbohydrate diet is consumed, there are additional areas of concern in regulating insulin needs. Blood glucose should be monitored very carefully during diet changes. Vegetarian girls with diabetes also should be carefully monitored for the adequacy of their diet because they may be at risk of developing an eating disorder.
Sabate, J. (1999). "Nut consumption, vegetarian diets, ischemic heart disease risk, and all-cause mortality: evidence from epidemiologic studies." Am J Clin Nutr 70(3 Suppl): 500S-503S.
Perhaps one of the most unexpected and novel findings in nutritional epidemiology in the past 5 y has been that nut consumption seems to protect against ischemic heart disease (IHD). Frequency and quantity of nut consumption have been documented to be higher in vegetarian than in nonvegetarian populations. Nuts also constitute an important part of other plant-based diets, such as Mediterranean and Asian diets. In a large, prospective epidemiologic study of Seventh-day Adventists in California, we found that frequency of nut consumption had a substantial and highly significant inverse association with risk of myocardial infarction and death from IHD. The Iowa Women's Health Study also documented an association between nut consumption and decreased risk of IHD. The protective effect of nuts on IHD has been found in men and women and in the elderly. Importantly, nuts have similar associations in both vegetarians and nonvegetarians. The protective effect of nut consumption on IHD is not offset by increased mortality from other causes. Moreover, frequency of nut consumption has been found to be inversely related to all-cause mortality in several population groups such as whites, blacks, and the elderly. Thus, nut consumption may not only offer protection against IHD, but also increase longevity.
Sabate, J., et al. (1999). "Publication trends of vegetarian nutrition articles in biomedical literature, 1966-1995." Am J Clin Nutr 70(3 Suppl): 601S-607S.
We documented publication trends of vegetarian nutrition articles in biomedical literature between 1966 and 1995 using the National Institutes of Health MEDLINE bibliographic database. The publication rate of vegetarian articles increased steadily during the 3 decades, from an average of <10/y in the late 1960s to 76/y in the early 1990s. After adjusting for the total number of articles indexed in MEDLINE annually, we found that publication of vegetarian nutrition articles increased dramatically, by 4-fold, during the 1970s and reached an oscillating plateau during the 1980s. In the early 1990s, the proportion of vegetarian nutrition articles 8 articles per 1000 vegetarian nutrition articles and approximately 20 per 100000 articles indexed by MEDLINE. Non-nutrition journals have progressively published a larger share of all vegetarian articles in the biomedical literature during the period studied. The nature and study design of published vegetarian research has changed over the years as well. The proportion of original research and review articles increased whereas case series and letters to the editor decreased. Reports of epidemiologic studies of vegetarians with longitudinal designs have superseded cross-sectional designs in number and proportion. In 40% of all publications, preventive and therapeutic applications of vegetarian diets constituted the major themes of vegetarian articles in the decade of 1986-1995. However, 20 y earlier the main focus was on the nutritional adequacy of vegetarian diets. The progressive change in the themes of vegetarian nutrition publications is interpreted as a shift in the role of vegetarian diets in human nutrition.
Segasothy, M. and P. A. Phillips (1999). "Vegetarian diet: panacea for modern lifestyle diseases?" QJM 92(9): 531-544.
We review the beneficial and adverse effects of vegetarian diets in various medical conditions. Soybean-protein diet, legumes, nuts and soluble fibre significantly decrease total cholesterol, low-density lipoprotein cholesterol and triglycerides. Diets rich in fibre and complex carbohydrate, and restricted in fat, improve control of blood glucose concentration, lower insulin requirement and aid in weight control in diabetic patients. An inverse association has been reported between nut, fruit, vegetable and fibre consumption, and the risk of coronary heart disease. Patients eating a vegetarian diet, with comprehensive lifestyle changes, have had reduced frequency, duration and severity of angina as well as regression of coronary atherosclerosis and improved coronary perfusion. An inverse association between fruit and vegetable consumption and stroke has been suggested. Consumption of fruits and vegetables, especially spinach and collard green, was associated with a lower risk of age-related ocular macular degeneration. There is an inverse association between dietary fibre intake and incidence of colon and breast cancer as well as prevalence of colonic diverticula and gallstones. A decreased breast cancer risk has been associated with high intake of soy bean products. The beneficial effects could be due to the diet (monounsaturated and polyunsaturated fatty acids, minerals, fibre, complex carbohydrate, antioxidant vitamins, flavanoids, folic acid and phytoestrogens) as well as the associated healthy lifestyle in vegetarians. There are few adverse effects, mainly increased intestinal gas production and a small risk of vitamin B12 deficiency.
Weaver, C. M., et al. (1999). "Choices for achieving adequate dietary calcium with a vegetarian diet." Am J Clin Nutr 70(3 Suppl): 543S-548S.
To achieve adequate dietary calcium intake, several choices are available that accommodate a variety of lifestyles and tastes. Liberal consumption of dairy products in the diet is the approach of most Americans. Some plants provide absorbable calcium, but the quantity of vegetables required to reach sufficient calcium intake make an exclusively plant-based diet impractical for most individuals unless fortified foods or supplements are included. Also, dietary constituents that decrease calcium retention, such as salt, protein, and caffeine, can be high in the vegetarian diet. Although it is possible to obtain calcium balance from a plant-based diet in a Western lifestyle, it may be more convenient to achieve calcium balance by increasing calcium consumption than by limiting other dietary factors.
Willett, W. C. (1999). "Convergence of philosophy and science: the third international congress on vegetarian nutrition." Am J Clin Nutr 70(3 Suppl): 434S-438S.
Populations of vegetarians living in affluent countries appear to enjoy unusually good health, characterized by low rates of cancer, cardiovascular disease, and total mortality. These important observations have fueled much research and have raised 3 general questions about vegetarians in relation to nonvegetarians: Are these observations the result of better nondietary lifestyle factors, such as lower prevalences of smoking and higher levels of physical activity?; Are they the result of lower intakes of harmful dietary components, in particular meat?; and Are they the result of higher intakes of beneficial dietary components that tend to replace meat in the diet? Current evidence suggests that the answer to all 3 questions is "Yes." Low smoking rates contribute importantly to the low rates of cardiovascular disease and many cancers, probably including colon cancer, in Seventh-day Adventists and other vegetarian populations. Also, avoidance of red meat is likely to account in part for low rates of cardiovascular disease and colon cancer, but this does not appear to be the primary reason for general good health in these populations. Evidence accumulated in the past decade emphasizes the importance of adequate consumption of beneficial dietary factors-rather than just the avoidance of harmful factors-including an abundance of fruit, vegetables, and whole grains and regular consumption of vegetable oils, including those from nuts. Although current knowledge already provides general guidance toward healthy diets, accumulated evidence now strongly indicates that diet has a powerful yet complex effect on health and that further investigation is needed.
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