Download To Be A Vegetarian or Not to Be A Vegetarian

To Be or Not to Be:
Vegan vs Omnivore
4/21/2016
To Be or Not to Be:
Vegan vs Omnivore
K-L. CAT HERI NE J EN, PH. D.
PROFESSOR, DEPA RT MENT OF NUT RI T I ON
A ND FOOD SCI ENCE
WAYNE STAT E UNI V ERSI T Y
MICHIGA N ACADEMY OF NUTRITION AND DIETETIC S
ANNUAL CONFERE N C E
APRIL 21, 2016
Glossary
 Vegetarians: A general term used to describe
people who exclude meat, poultry, fish or
other animal-derived foods from their diets
 Vegans: People who exclude all animalderived food (meat, poultry, fish, eggs, and
dairy products) from their diets
 Lacto-vegetarians: People who consume milk
and dairy products, but exclude meat, poultry,
fish, seafood, and eggs from their diet
Glossary
 Lacto-ovo-vegetarians: People who consume
milk, dairy products, and eggs, but exclude
meat, poultry, fish, and seafood from their diet
 Pesco-vegetarians: People who consume milk,
dairy products, eggs, fish, and seafood but
exclude meat, poultry, from their diet
 Omnivores: People who have no restriction on
eating any foods
Dietary Patterns
Dietary pattern
Red meats
Poultry/fish
Dairy/eggs
Non-vegetarian
(Omnivore)
Mediterranean
Pesco-vegetarian
Lacto-ovo-vegetarian
Lacto-vegetarian
Vegan
K-L. Catherine Jen, Ph.D.
1
To Be or Not to Be:
Vegan vs Omnivore
4/21/2016
Mediterranean Diet
 High intake of fruits, vegetables, legumes, nuts,
Is a Vegan diet better than
Mediterranean, DASH, Ornish, others,
pesco-vegetarian, lacto-vegetarian?
seeds and unrefined cereals
 Moderate intake of fish
 Low intake of saturated fats but high intake of
unsaturated fats (olive oil)
 Low intake of red and processed meats
 Low to moderate intake of seafood and dairy
products (cheese and yogurt), poultry and eggs
 Modest intake of wine (with meals)
Mediterranean Diet
Mediterranean Diet
 Compared to DASH diet
 Higher fruit and fish intake
 Lower dairy products
 The EPIC Study
 Compared to vegetarian diet
 Meat and seafood are consumed
 Lower legumes, nuts/seeds and processed soy
products
 The PREDIMED Study
 European
Prospective Investigation into Cancer and
Nutrition
 PREvención
 Primary
con DIeta MEDiterránea
prevention trial
 Lyon Diet Heart Study
 Secondary
prevention trial in MI survivors
K-L. Catherine Jen, Ph.D.
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To Be or Not to Be:
Vegan vs Omnivore
4/21/2016
The EPIC Studies
The EPIC Studies
 A multicenter, prospective cohort study
Number of death before age 90 years and HR (95% CI)
investigating the role of biological, dietary and
environmental factors on cancers and other
chronic diseases
 23 centers, 10 European countries, ~520,000
participants
 Mediterranean-diet scale used to evaluate the
adherence to Mediterranean diet
Reg meat
eaters
Low meat eaters
Fish eaters
Vegetarians/vegans
All cancer
1.00
0.96* (0.86, 1.07) 0.81 (0.69, 0.95)
0.91 (0.80, 1.03)
Ischemic heart
disease
CVD
1.00
0.96 (0.78, 1.19)
1.06 (0.80, 1.42)
1.03 (0.82, 1.28)
1.00
0.88 (0.68, 1.13)
1.35 (0.98, 1.36)
1.19 (0.91, 1.54)
All causes
1.00
0.93 (0.86, 1.00)
0.94 (0.85, 1.04)
0.99 (0.92, 1.07)
*After adjusting BMI
 Scores
of 0-9: 0 – min adherence diet; 9: max
adherence
Appleby et al, Am J Clin Nutr, 103:218-230, 2016
EPIC-Oxford Cohort Study
The PREDIMED Study
 Multicenter, nutrition intervention RCT in
Vitamin B12 intake (ug/day)
Vitamin B12 deficiency (%)
Spain from 2003-2011
10
60
8
50
6
40

30

20

4
2
10
0
0
Omnivores
Vegetarians
Vegans
 7447 participants with high risk of CVD

Omnivores
Vegetarians
Vegans


Men:55-75 years old
Women: 60-80 years old
Mean BMI: 30 kg/m2
50% with diabetes
70% with dislipidemia
80% with HTN
Gilsing et al, Eur J Clin Nutr, 2010
K-L. Catherine Jen, Ph.D.
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To Be or Not to Be:
Vegan vs Omnivore
4/21/2016
Hazard Ratios of 2 MD Diets vs Low Fat
Control Diet
The PREDIMED Study
1.20
 Three intervention groups
 Mediterranean
 Primary end point
 Major cardiovascular events (MI, stroke, death)
 Median follow-up: 4.8 years
Hazard Ratio
diet + extra-virgin olive oil (MD +
EVOO)
 Mediterranean diet + nuts (MD + Nuts)
 Control diet (low fat)
MD Diets vs Low Fat diet
1.00
0.80
MD+EVOO
0.60
MD+Nuts
Low Fat
0.40
0.20
0.00
Primary CVD
Stroke
MI
CVD death All cause death
K-L. Catherine Jen, Ph.D.
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To Be or Not to Be:
Vegan vs Omnivore
4/21/2016
Conclusion
 Vegan diet is not the ONLY diet to have
Practical Issues of A Vegan Diet Pattern
 Health benefits of vegan diet may not be
universal
health benefits
 Add a little animal protein, especially fish,
may improve health outcome
 Women
benefit less than men
 Seventh-day Adventists studies
 People
in certain countries benefit less
 Taiwan: Vegans have higher HR for metabolic syndrome
than lacto-ovo-vegetarians, pescovegetarinas and
nonvegetarians
 Compliance issues
So, What Should Professionals Tell Patients?
 Dietary advice should be tailored to each
“There are more than five times as many
former vegetarians/vegans than there are
current vegetarians/vegans. Put differently,
84% of vegetarians/vegans abandon their
diet.”
“Interestingly, while 86% of lapsed vegetarians
abandon their diet, a smaller proportion (70%)
of lapsed vegans do so, suggesting that while
people are far less likely to adopt a vegan diet,
vegans are also less apt to start opting for
meat.”
patient’s own personal dietary history, beliefs,
preferences, motivation and clinical conditions
 Controlling energy intake still should be the
primary goal of nutrition counseling
 Regardless of dietary patterns
Reduce intake of sugar, sugar-sweetened soft drinks, refined
grains, saturated fats, trans fats
 Increase intake of fruits, vegetables, legumes, whole grains,
nuts

K-L. Catherine Jen, Ph.D.
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To Be or Not to Be:
Vegan vs Omnivore
4/21/2016
THANK YOU
K-L. Catherine Jen, Ph.D.
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