Conclusions

Vegetarian diets normally contain substantial amounts of potassium, folic acid, magnesium, manganese, copper, fiber, vitamins C, E, and K, and vitamin A (carotenoids). Since the different types of vegetarian diets are quite varied in their composition, nutrient concerns will vary from one to another. Appropriately planned vegan or LOV diets can be nutritionally adequate. However, there are significant nutritional concerns regarding vegetarian diets such as a strict macrobiotic diet.

Lacto-ovo-vegetarians and vegans tend to consume sufficient protein in their diets. Even though vegetarians consume iron in a less bioavailable form (non-heme iron), the consumption of a well-balanced vegetarian diet is not associated with any greater risk of iron deficiency. Vegetarian females, especially vegans, tend to have a lower zinc intake and possibly a lower zinc status than omnivores. However, the zinc intake of vegetarian males, both LOV and vegan, appears to be adequate. Female vegans should be encouraged to consume greater levels of zinc-rich foods.

In Western countries, there is a heightened interest to provide adequate calcium to support the attainment of optimal bone mineral density. Lacto-ovo-vegetarian diets are not likely to be deficient in calcium when low-fat dairy foods are regularly eaten. Vegan diets need to be appropriately planned to contain adequate calcium. Some vegans, particularly Caucasian and Asian females, may need to consume calcium-fortified foods or supplemental calcium to ensure nutritional adequacy.

Vegetarians can obtain vitamin D from exposure to sunlight or from consuming vitamin D-fortified foods such as cow's milk, many soy beverages, and some breakfast cereals. Vegetarians who live in northern climates may need to take supplemental vitamin D during the winter months, particularly if their exposure to sunlight is limited. Vegetarians who regularly use dairy products or eat vitamin B12-fortified foods generally have an adequate B12 status. Vegans may need a daily supplement of vitamin B12, unless they are consuming vitamin B12-fortified foods. Preliminary data indicates that many vegans may have low iodine intakes, which can be easily remedied by the regular use of iodized salt. For optimal health, elderly vegetarians need to pay special attention to getting adequate vitamin D and B12 intakes.

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