The Paradox of Ingestion of Dietary Cholesterol in "Vegans"-Reply.

In a comment on several articles on the vegan dietary pattern, Antoniazzi & Acosta-Navarro (2017) mentioned the paradox of the presence of dietary cholesterol as a nutritional component in the analysis of the vegan dietary pattern [1]. [...].

Comparison of nutritional quality of the vegan, vegetarian, semi-vegetarian, pesco-vegetarian and omnivorous diet.

The number of studies comparing nutritional quality of restrictive diets is limited. Data on vegan subjects are especially lacking. It was the aim of the present study to compare the quality and the contributing components of vegan, vegetarian, semi-vegetarian, pesco-vegetarian and omnivorous diets. Dietary intake was estimated using a cross-sectional online survey with a 52-items food frequency questionnaire (FFQ). Healthy Eating Index 2010 (HEI-2010) and the Mediterranean Diet Score (MDS) were calculated as indicators for diet quality. After analysis of the diet questionnaire and the FFQ, 1475 participants were classified as vegans (n = 104), vegetarians (n = 573), semi-vegetarians (n = 498), pesco-vegetarians (n = 145), and omnivores (n = 155). The most restricted diet, i.e., the vegan diet, had the lowest total energy intake, better fat intake profile, lowest protein and highest dietary fiber intake in contrast to the omnivorous diet. Calcium intake was lowest for the vegans and below national dietary recommendations. The vegan diet received the highest index values and the omnivorous the lowest for HEI-2010 and MDS. Typical aspects of a vegan diet (high fruit and vegetable intake, low sodium intake, and low intake of saturated fat) contributed substantially to the total score, independent of the indexing system used. The score for the more prudent diets (vegetarians, semi-vegetarians and pesco-vegetarians) differed as a function of the used indexing system but they were mostly better in terms of nutrient quality than the omnivores.

Dietary pattern analysis: a comparison between matched vegetarian and omnivorous subjects.

BACKGROUND: Dietary pattern analysis, based on the concept that foods eaten together are as important as a reductive methodology characterized by a single food or nutrient analysis, has emerged as an alternative approach to study the relation between nutrition and disease. The aim of the present study was to compare nutritional intake and the results of dietary pattern analysis in properly matched vegetarian and omnivorous subjects. METHODS: Vegetarians (n = 69) were recruited via purposeful sampling and matched non-vegetarians (n = 69) with same age, gender, health and lifestyle characteristics were searched for via convenience sampling. Two dietary pattern analysis methods, the Healthy Eating Index-2010 (HEI-2010) and the Mediterranean Diet Score (MDS) were calculated and analysed in function of the nutrient intake. RESULTS: Mean total energy intake was comparable between vegetarians and omnivorous subjects (p > 0.05). Macronutrient analysis revealed significant differences between the mean values for vegetarians and omnivorous subjects (absolute and relative protein and total fat intake were significantly lower in vegetarians, while carbohydrate and fibre intakes were significantly higher in vegetarians than in omnivorous subjects). The HEI and MDS were significantly higher for the vegetarians (HEI = 53.8.1 ± 11.2; MDS = 4.3 ± 1.3) compared to the omnivorous subjects (HEI = 46.4 ± 15.3; MDS = 3.8 ± 1.4). CONCLUSIONS: Our results indicate a more nutrient dense pattern, closer to the current dietary recommendations for the vegetarians compared to the omnivorous subjects. Both indexing systems were able to discriminate between the vegetarians and the non-vegetarians with higher scores for the vegetarian subjects.

Health aspects, nutrition and physical characteristics in matched samples of institutionalized vegetarian and non-vegetarian elderly (> 65yrs).

BACKGROUND: Epidemiological studies indicate that a well balanced vegetarian diet offers several health benefits including a lower prevalence of prosperity diseases in vegetarians compared to omnivores. It was the purpose of the present study to compare nutritional and physical characteristics in matched samples of institutionalized vegetarian (V) and non-vegetarian (NV) elderly. METHODS: Twenty-two female and 7 male V (females: 84.1 ± 5.1yrs, males: 80.5 ± 7.5yrs) and 23 female and 7 male NV (females: 84.3 ± 5.0yrs, males: 80.6 ± 7.3yrs) participated. All subjects were over 65 years of age, and free of major disease or physical handicap. Dietary intake, blood profile, anthropometrics, and handgrip strength were determined. RESULTS: Mean daily energy intake was 6.8 ± 2.0MJ in V females, and 8.0 ± 1.4MJ in the NV females, only the V did not reach the recommended value of 7.8 MJ. Male V and NV had a mean daily energy intake of 8.7 ± 1.6MJ and 8.7 ± 1.2MJ respectively (RDI: 8.8 MJ). Mean carbohydrate intake was significantly below the RDI in NV only (female V: 47.8 ± 7.5E%, female NV: 43.3 ± 4.6E%, male V: 48.1 ± 6.4E%, male NV: 42.3 ± 3.6E%), while protein (female V: 17.3 ± 3.4E%, female NV: 19.5 ± 3.5E%, male V: 17.8 ± 3.4E%, male NV: 21.0 ± 2.0E%), and saturated fat intake (female V: 25.4 ± 8.2 g/day, female NV: 32.2 ± 6.9 g/day, male V: 31.4 ± 12.9 g/day, male NV: 33.4 ± 4.7 g/day) were too high in both V and NV. Mean micronutrient intakes met the RDI's in all 4 groups. Mean blood concentrations for vitamin B12, folic acid, iron, and calcium were normal in all 4 groups. Mean zinc blood serum was below the reference value in all groups, whereas estimated zinc intake was in agreement with the RDI. The mean blood cholesterol concentration was above the 200 mg/dl upper limit in the V group (213 ± 40 mg/dl) and below that limit in the NV (188 ± 33 mg/dl) group. Mean BMI was 26.1 ± 4.7 kg/m2 in the female V, 26.8 ± 3.7 kg/m2 in the female NV, 23.5 ± 3.7 kg/m2 in the male V, and 25.2 ± 4.2 kg/m2 in the male NV. V and NV scored below the reference values for the handgrip strength test. CONCLUSIONS: Generally, our results show a similar profile for V and NV concerning dietary intake, blood values, and physical characteristics. Attention should be paid to the intake of mono- and disaccharides and saturated fats in the diet of both V and NV. This study indicates that a vegetarian lifestyle has no negative impact on the health status at older age.

Energy and macronutrient intake in adolescent sprint athletes: a follow-up study.

Macronutrient intake, height, weight, and body composition of 60 adolescent sprint athletes were estimated every 6 months over 3 years. Seven-day food records were analysed based on the Belgian and Dutch food databanks. The age of participants at the start of the 3-year study was 14.8 ± 1.6 years for female athletes and 14.7 ± 1.9 years for male athletes. Girls and boys gained height (3.4 ± 4.6 cm and 5.9 ± 6.6 cm respectively) and weight (5.6 ± 3.5 kg and 8.7 ± 5.5 kg respectively), whereas percent body fat remained unchanged in both girls and boys (around 17.0% and 8.5% respectively). Mean protein intake of around 1.5 g · kg⁻¹ body weight was within recommendations on each occasion for both sexes. Carbohydrate intakes between 5 and 7 g · kg⁻¹ body weight support a training programme of moderate intensity. Total and saturated fat intakes were high at the start of the study (girls: 31.8 ± 3.5% and 12.2 ± 2.0% of energy intake; boys: 30.3 ± 4.6% and 12.0 ± 1.9% of energy intake) and it appeared to be difficult to achieve and maintain lower intakes. Consistent low fluid intakes around 40 ml · kg⁻¹ body weight were observed. General non-stringent advice for improvement of the diet resulted in significant favourable changes only for the consumption of wholegrain bread, vegetables, and soft drinks. Dietary habits of adolescent sprint athletes are not always according to guidelines and are relatively stable but repeated advice can induce moderate improvements.

Dietary acid-base balance in adolescent sprint athletes: a follow-up study.

Sprinters are advised to include additional protein sources in their diet. Basal metabolism and vigorous physical activities generate hydrogen ions that need to be buffered. The present follow-up study estimates the dietary potential renal acid load (PRAL) and net endogenous acid production (NEAP) in adolescent sprint athletes. Seven-day food diaries and anthropometrics of 60 adolescent sprint athletes (mean age at start 14.7 ± 1.9 years) were collected every six months over a three year period. Comparisons were made between athletes with a negative (PRAL(-)) versus positive PRAL (PRAL(+)). For the entire sample, mean PRAL values of up to 6 mEq/day were slightly positive despite a relatively high protein intake of around 1.5 g/kg. The NEAP ranging between 42 and 46 mEq/day remained stable during the study period. Athletes with a PRAL(-) (-8 to -10 mEq/day) consumed significantly more fruit and fruit juice than athletes with a PRAL(+) (+9 to 14 mEq/day). Athletes with a PRAL(+) did not consume more meat, fish and poultry than athletes with a PRAL(-). Grains and dairy products were only discriminative between the two groups on one measurement occasion. Lowering the PRAL can be obtained by increasing the consumption of potatoes, fruits, vegetables and vegetable soup.

Nutrient based estimation of acid-base balance in vegetarians and non-vegetarians.

A first objective of the present study was to estimate the acid-base balance of the food intake in vegetarians and non-vegetarians. A second objective was to evaluate if additional input of specific food items on the existing potential renal acid load (PRAL) list was necessary for the comparison of the two dietary patterns. Thirty vegetarians between the age of 18 and 30 years were matched for sex, age and BMI with 30 non-vegetarians. Based on the 3-days food diaries the acid-base status of the food intake was estimated using the PRAL method. Mean PRAL values as estimated with the standard table yielded an alkaline load of -5.4 +/- 14.4 mEq/d in the vegetarians compared to an acid load of 10.3 +/- 14.4 mEq/d in the nonvegetarians (p<0.001). Mean PRAL values as estimated with the extended table yielded an alkaline load of -10.9 +/-19.7 mEq/d in the vegetarians compared to an acid load of 13.8 +/- 17.1 mEq/d for the non-vegetarians (p<0.001). The findings of this study indicate that vegetarian food intake produces more alkaline outcomes compared to non-vegetarian diets. The use of the standard PRAL table was sufficient for discrimination between the two diets.

Nutritional status of Flemish vegetarians compared with non-vegetarians: a matched samples study.

The present study compares the nutritional status of vegetarian (V) with non-vegetarian (NV) subjects. A three-day food record and a health questionnaire were completed by 106 V and 106 NV matched for following characteristics: sex, age, BMI, physical activity, tobacco use and alcohol consumption. Total energy intake was not significantly different (men: V: 2,346 ± 685 kcal/d; NV: 2,628 ± 632 kcal/d; p = 0.078; women: V: 1,991 ± 539 kcal/d; NV: 1,973 ± 592 kcal/d; p = 0.849). Macronutrients intake differed significantly between the V and NV subjects for protein (men: V:12.7 ± 2.3 E%; NV:15.3 ± 4.5 E%; p = 0.003; women: V: 13.2 ± 2.3 E%; NV:16.0 ± 4.0 E%; p < 0.001), fat (men: V: 29.3 ± 8.4 E%; NV: 33.8 ± 5.3 E%; p = 0.010; women: V: 29.7 ± 6.9 E%; NV: 34.7 ± 9.0 E%; p < 0.001), and carbohydrate (men: V: 55.3 ± 10.1 E%; NV: 47.4 ± 6.9 E%; p < 0.001; women: V: 55.1 ± 7.6 E%; NV: 47.2 ± 8.2 E%; p < 0.001). The intake of most minerals was significantly different between the V and the NV subjects. V had a lower sodium intake, higher calcium, zinc, and iron intake compared to the NV subjects. Our results clearly indicate that a vegetarian diet can be adequate to sustain the nutritional demands to at least the same degree as that of omnivores. The intakes of the V subjects were closer to the recommendations for a healthy diet when compared to a group of well matched NV subjects.

Developmental changes and predictability of static strength in individuals of different maturity: a 30-year longitudinal study.

This longitudinal study analyses the development and predictability of static strength and their interactions with maturation in youth. Of 515 children followed annually from age 6 to 18 years, 59 males and 60 females were measured again at age 35. Early, average, and late maturity groups were established. Body height and mass were assessed. Static strength was measured using handgrip dynamometry. Pearson correlations were used as tracking coefficients. From 6 to 12 years of age, no static strength differences were found to exist between the maturity groups of both sexes. Static strength is significantly higher in early than in average and late maturing boys (age 13-16). In girls, a dose-response effect exists (age 11-14). Adult static strength predictability is low in early maturing boys and late maturing girls. It is moderate to high (50-76%) in the other maturity groups up to age 14. Predictors for adult static strength are childhood and adolescent handgrip dynamometry (in females only), medicine ball throw, sit-up, hockey ball throw, and 25-m sprint. Handgrip is a fair predictor of adult static strength at most ages in early and average maturing females; in average maturing males, it is a predictor at age 11. Other indicators of strength (e.g. hockey ball throw) are predictors in males.

Nutritional habits of Flemish adolescent sprint athletes.

PURPOSE AND METHODS: To investigate dietary habits of Flemish adolescent track and field athletes using a 7-d weighed-food record. Besides adequacy for growth, development, and physical performance, dietary health aspects were considered. RESULTS: Twenty-nine girls and 31 boys, with minimum 2 yr of track and field training practice, were recruited. All participants had daily breakfast (girls 22.5% +/- 5.5% of total energy intake [TEI]; boys 19.8% +/- 7.3%). Fruit in girls and juices and sports drinks in boys were consumed mostly between meals (girls 21.3% +/- 8.1% of TEI; boys 24.3% +/- 10.1%). Soft drinks contributed considerably to energy intake between meals in both sexes. Protein intake (1.5 +/- 0.3 g . kg-1 . d-1 for both sexes) was within the recommended daily intake (RDI) for strength athletes. Mean daily carbohydrate intake in girls was lower than in boys (girls 5.1 +/- 1.1 g/kg; boys 6.0 +/- 0.9 g/kg), with mono- and disaccharides contributing 26% to TEI in both sexes. Total fat intake was above 30% of TEI in more than half the participants, and only 10 participants had a saturated-fat intake below 10% of TEI. Fiber intake (girls 23.7 +/- 7.9 g; boys 29.1 +/- 11.2 g) was far below the Belgian RDI. Intake of vitamins and minerals were generally low, despite micronutrient supplementation in 37.5% of the participants. CONCLUSION: Few athletes reached all nutrient RDIs. Unhealthy food habits with regard to refined sugars, fat, and micronutrients were observed. These adolescent sprinters should be encouraged to consume more nonsweetened beverages, fruits, and vegetables.

Estimation of daily human intake of food flavonoids.

The daily intake of food flavonoids was determined using a semiquantitative food frequency questionnaire (FFQ) and a 4-day food record (4DFR) in a group of 45 female Flemish dietitians. The subjects were asked to report their food intake three times: day 1 using the FFQ (FFQ1); between days 2 and 13 using a 4-day non-consecutive food diary (4DFR); and again using the FFQ on day 14 (FFQ2). The total flavonoid intakes (mean and standard deviation) as estimated with the different methods were: for FFQ1, 166.0 +/- 146.6 mg/day; for 4DFR, 203.0 +/- 243.2 mg/day; and for FFQ2, 158.3 +/- 151.8 mg/day. There was a significant different estimate for the amount of flavan-3-ols, flavanones and flavones when comparing the two FFQs with the 4DFR. The two research methods classified 88% of the 45 dietitians in the same or in an adjacent quartile for total flavonoid intake. The findings of this study indicate that the developed FFQ seems to be a simple and reliable method to assign subjects in quartiles of flavonoid intake.

Stability of somatotypes: A longitudinal study of Belgian children age 6 to 17 years.

The purpose of this study was to investigate the stability of somatotypes in Belgian children and adolescents, 52 boys and 30 girls, followed longitudinally from 6 to 17 years of age. The anthropometric Heath-Carter somatotypes, with a stature correction for endomorphy, were estimated at 1-year intervals. Mean somatotypes were most different between the earliest and oldest ages in both boys and girls. For boys, the means from 9 to 13 years and from 14 to 17 years did not differ. Means were 2-4-2½, 2½-4-4, and 2-4-4 at 6, 12, and 17 years, respectively. The scatter of somatotypes about their means was smallest at 6-8 years and greatest at 11-13 years in both boys and girls (P <0.05). For girls, the mean somatotypes from 8 or 9 years through adolescence were not different, although they tended to become more meso-endomorphic. Means were 2-4½-2½, 3-4-3½, and 3½-3½-3 at 6, 12, and 17 years, respectively. The average migratory distance for boys was 6.4 (range = 3.7-12.9) and 7.8 (3.9-21.8) for girls. Many subjects had changes that were three to four times greater than others. Boys were lower in ectomorphy at 6-8 years than at older ages, while girls were higher in mesomorphy at 6 than at 12-17 years (P <.05). Interage partial correlations for each component were highest (r2 ⩾ .49) between adjacent years, but were poor to moderate as time intervals increased. The findings of this longitudinal study confirm and further define the instability of somatotypes previously observed in cross-sectional studies of Belgian children and adolescents. © 1995 Wiley-Liss, Inc.