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Transcript
Dana Hrnčířová
Dpt. of Nutrition, 3rd Faculty of Medicine,
Charles University in Prague
• In general, people who exclude meat, poultry, fish, and animalderived foods from their diets.
• A wide diversity of dietary practices
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Vegans (total vegetarians)
Lacto-vegetarians
Ovo-vegetarians
Lacto-ovo- vegetarians
Semi-vegetarians (flexitarians)
• Pescaterians
• Pollo-vegetarians
• Pollo-pescetarians
• Raw vegan (raw food diet)
• Macrobiotic diet
• USA 2012 National Poll
• 4% of adults are vegetarians/vegans (approx. 9 million)
• 1% are vegans (approx. 2 millions)
• No much difference between male, female, region, or age for
actual vegetarians
(Harris Interactive poll by the Vegetarian Resource Group)
• Veg. Statistics - European vegetarian Union
http://www.euroveg.eu/lang/en/info/howmany.php
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Environmental/Ecological
Animal welfare, ethics
Religious
Economical
Health
Family lifestyle
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Protein quality
Vitamin B12
Omega-3 Fatty Acids
Vitamin D
Calcium
Iron
Zinc
Protein
Protein Digestibility Corrected Amino Acid Score
mg of limiting amino acid in 1 g of test protein
mg of same amino acid in 1 g of reference protein
*
faecal true
digestibility %
• E.g. Rice
• limiting amino acid - lysine 62 % (of the 2-5 yrs old child
needs / g of protein)
• Digestibility of protein …. 88 %
• PDCAAS for rice: 0,62 x 0,88 = 0,55
1.00
0.92
0.91
0.76
0.75
0.73
0.70
0.59
0.52
0.42
casein, whey (milk proteins), egg white, soy protein
beef
soybeans
fruits
black beans
vegetables
other legumes
cereals and derivatives
peanuts
whole wheat
• essential amino acids in a food protein which fall short of
meeting the amino acids required by humans
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legumes → methionine
wheat → lysine
maize → tryptophan
soya beans → methionine and cysteine
• The combination of plant protein foods which when eaten
together provide all the essential amino acids.
• E.g. Legumes + cereals
[Propionyl CoA]
Odd Chain FA or
Branched Chain AA
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Zdroj: NIH Dietary Supplement Fact Sheets for B12. http://ods.od.nih.gov/factsheets/VitaminB12/. Accessed 8-11-2011
• Hematological (megaloblastic anemia)
• Neurological (numbness and tingling of arms and legs, difficulty
walking, memory loss, disorientation, dementia)
• Gastrointestinal (tongue soreness, apetite loss, constipation)
• Deficiency of vit. B12 leads to secondary deficiency of folic
acid
• Adults
• Pregnant women
• Lactation
(i.e. + 0,13 mcg/ 100g of
3 mcg /day
3,5 mcg /day
4 mcg /day
mother milk)
• Food of animal origin (liver, shellfish, vension, some fish)
• Fortified food
• Food supplements
Food
Serving
Vitamin B12 (mcg)
Clams (steamed)
3 ounces
84.0
Mussels (steamed)
3 ounces
20.4
Crab (steamed)
3 ounces
8.8
Salmon (baked)
3 ounces
2.4
Rockfish (baked)
3 ounces
1.0
Beef (cooked)
3 ounces
2.1
Chicken (roasted)
3 ounces
0.3
Turkey (roasted)
3 ounces
0.3
Egg (poached)
1 large
0.6
Milk (skim)
8 ounces
0.9
Brie (cheese)
1 ounce
0.5
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Ischemic Heart Disease
Hypertension
Diabetes
Obesity
Cancer
Osteoporosis
Diverticular Disease
Gallstones
Rheumatoid Arthritis
• Lower risk of death
• Adjustment for BMI, smoking habits, social class
• Incidence 24% lower in lifelong vegetarians
• Incidence 57% lower in lifelong vegans
• Lower TCh, LDL-Ch
• Higher intakes of fiber, plant sterols; nuts, soy
• Lower intakes of SFA
• Lower rates of hypertension:
• Non-vegetarians > vegetarians > vegans
• Lower blood pressure
• Non-vegetarians > vegetarians
• diet or lower BMI?
• Beneficial nutrients
• Potassium, magnesium, antioxidants, fiber, fat
• 5-10 servings of fruits and vegetables significantly
lowers BP
• Positive associations between intakes of red meat and
processed meat and risk of diabetes after adjusting for
BMI, total energy intake, exercise …
• Beneficial nutrients: vegetables, whole-grain foods,
legumes, and nuts
• diets rich in whole-grain foods are associated with
improved insulin sensitivity
• People consuming 3 servings per day of wholegrain foods are 20-30% less likely to develop
DM2 than people consuming 3 servings per week.
• 1 serving = 16 g of whole-grain food
• Vegetarians maintain lower BMI than non-vegetarians
• Non-vegetarians > vegetarians > vegans (BMI)
• Lower weight correlates with high intakes of fiber and
low intakes of fat
• Significantly lower rates of cancer non-dependent on
smoking (colorectal and prostate cancer)
• Obesity is significant risk factor for breast cancer; meat?
• Cancer-protective dietary factors:
• Fiber, vit. C, carotenoids, flavonoids, lycopene
• fruits, vegetables (lung, mouth, esophagus, stomach)
• Legumes (prostate, stomach)
• Soy isoflavones (breast) ???
• Dairy products, green leafy vegetables, and calciumfortified plant foods – calcium for vegetarians
• no differences in bone mineral density between omnivores
and lacto-ovo-vegetarians
• Increased intake of friuts and vegetables (K, Mg) - positive
effect on the calcium economy
• High protein intake, especially animal protein, can produce
increased calciuria
• Low protein intakes may increase the risk of low bone
integrity
• The more restricted the vegetarian diet, the
greater the challenge to achieve a nutritionally
adequate diet.
• The goal: consume a variety of foods to obtain
all of the needed nutrients.
• Nutritional consciousness is essential!
Foods
1serving
Number of Servings/day
Fruits
½ cup fresh/canned/frozen
3–4
Vegetables
Whole Grains
½ cup cooked/1 cup raw
4–6
1 slice whole-grain bread
1 cup whole-grain cereal,
½ cup cooked rice/pasta
5–8
½ cup cooked legumes
½ cup tofu
1 cup soy milk
3–6
Nuts, Seeds
¼ cup nuts or seeds
1–3
Plant Oils
1 teaspoon
up to 5
Eggs
Dairy
1 egg
4–6 per week
1 cup milk/yogurt
¼ cup cheese
½ cup cottage cheese
1–3
Legumes
Oldways 2013
Nutrient
Nonvegetarian
Lacto-ovo
vegetarian
Vegan
Fat (% total
calories)
34-38
30-36
28-33
Cholesterol (total
grams)
300-500
150-300
0
Carbohydrate (%
total calories)
<50
50-55
50-65
Dietary fiber (total
grams)/day
10-12
20-35
25-50
Protein (% total
calories)
14-18
12-14
10-12
Animal protein (%
total protein)
60-70
40-60
0
• Meat replacements: products made to look and taste like meat,
fish, poultry
• Tofu: a curd made from soybean
• Tempeh: a fermented soybean food
• Textured soy protein (TSP), soy meat: processed soybeans
TOFU
TEMPEH
TSP
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Dietary guidelines for Americans 2010
Position paper of American Dietetic Association 2009
American Heart Association papers
Physicians Committee for Responsible Medicine - Dietary
Guidelines Goals and Recommendations
• Harvard School of Public Health papers
• Up-to-date research