Health Implications of a Vegetarian Diet: A Review

American Journal of Lifestyle Medicine

Volumn 6, Issue 3, 2012, Pages 250-267

  Marsh, Kate ^a   Zeuschner, Carol ^a   Saunders, Angela ^a  

^a Northside Nutrition and Dietetics   (Australia)

Author keywords

calcium; cancer; cardiovascular disease; diabetes; essential fatty acids; health; iron; obesity; protein; vegan; vegetarian; vitamin B12; vitamin D; zinc

Indexed keywords

EID: 84860499337     PISSN: 15598276     EISSN: 15598284     Source Type: Journal    
DOI: 10.1177/1559827611425762     Document Type: Review

References (190)

1. The Vegetarian Resource Group. How many vegetarians are there?http://www.vrg.org/press/2009poll.htm. Accessed September 27, 2011.
2. Leitzmann C.Vegetarian diets: what are the advantages?.Forum Nutr. 2005; (57): 147-156.
3. Segasothy M,Phillips PA.Vegetarian diet: panacea for modern lifestyle diseases?.QJM. 1999;92:531-544.
4. Bedford JL,Barr SI.Diets and selected lifestyle practices of self-defined adult vegetarians from a population-based sample suggest they are more "health conscious.".Int J Behav Nutr Phys Act. 2005;2:4.
5. Singh PN,Sabate J,Fraser GE.Does low meat consumption increase life expectancy in humans?.Am J Clin Nutr. 2003;78 (3 suppl): 526S-532S.
6. Fraser GE,Shavlik DJ.Ten years of life: is it a matter of choice?.Arch Intern Med. 2001;161:1645-1652.
7. Sabate J.The contribution of vegetarian diets to health and disease: a paradigm shift?.Am J Clin Nutr. 2003;78 (3 suppl): 502S-507S.
8. Wang Y,Beydoun MA.Meat consumption is associated with obesity and central obesity among US adults.Int J Obes. 2009;33:621-628.
9. Fung TT,Schulze M,Manson JE,Willett WC,Hu FB.Dietary patterns, meat intake, and the risk of type 2 diabetes in women.Arch Intern Med. 2004;164:2235-2240.
10. Schulze MB,Manson JE,Willett WC,Hu FB.Processed meat intake and incidence of type 2 diabetes in younger and middle-aged women.Diabetologia. 2003;46:1465-1473.
11. Song Y,Manson JE,Buring JE,Liu S.A prospective study of red meat consumption and type 2 diabetes in middle-aged and elderly women: the women s health study.Diabetes Care. 2004;27:2108-2115.
12. Vang A,Singh PN,Lee JW,Haddad EH,Brinegar CH.Meats, processed meats, obesity, weight gain and occurrence of diabetes among adults: findings from Adventist Health Studies.Ann Nutr Metab. 2008;52:96-104.
13. van Dam RM,Willett WC,Rimm EB,Stampfer MJ,Hu FB.Dietary fat and meat intake in relation to risk of type 2 diabetes in men.Diabetes Care. 2002;25:417-424.
14. Zhang C,Schulze MB,Solomon CG,Hu FB.A prospective study of dietary patterns, meat intake and the risk of gestational diabetes mellitus.Diabetologia. 2006;49:2604-2613.
15. Kontogianni MD,Panagiotakos DB,Pitsavos C,Chrysohoou C,Stefanadis C.Relationship between meat intake and the development of acute coronary syndromes: the CARDIO2000 case-control study.Eur J Clin Nutr. 2008;62:171-177.
16. Qi L,van Dam RM,Rexrode K,Hu FB.Heme iron from diet as a risk factor for coronary heart disease in women with type 2 diabetes.Diabetes Care. 2007;30:101-106.
17. Bernstein AM,Sun Q,Hu FB,Stampfer MJ,Manson JE,Willett WC.Major dietary protein sources and risk of coronary heart disease in women.Circulation. 2010;122:876-883.
18. Cross AJ,Leitzmann MF,Gail MH,Hollenbeck AR,Schatzkin A,Sinha R.A prospective study of red and processed meat intake in relation to cancer risk.PLoS Med. 2007;4:e325.
19. Cross AJ,Peters U,Kirsh VA, et al.A prospective study of meat and meat mutagens and prostate cancer risk.Cancer Res. 2005;65:11779-11784.
20. Norat T,Bingham S,Ferrari P, et al.Meat, fish, and colorectal cancer risk: the European Prospective Investigation into cancer and nutrition.J Natl Cancer Inst. 2005;97:906-916.
21. Bosetti C,Negri E,Franceschi S, et al.Diet and ovarian cancer risk: a case-control study in Italy.Int J Cancer. 2001;93:911-915.
22. Cross AJ,Ferrucci LM,Risch A, et al.A large prospective study of meat consumption and colorectal cancer risk: an investigation of potential mechanisms underlying this association.Cancer. 2010;70:2406-2414.
23. Lagiou P,Talamini R,Samoli E, et al.Diet and upper-aerodigestive tract cancer in Europe: the ARCAGE study.Int J Cancer. 2009;124:2671-2676.
24. Navarro Silvera SA,Mayne ST,Risch H, et al.Food group intake and risk of subtypes of esophageal and gastric cancer.Int J Cancer. 2008;123:852-860.
25. Kolahdooz F,Ibiebele TI,van der Pols JC,Webb PM.Dietary patterns and ovarian cancer risk.Am J Clin Nutr. 2009;89:297-304.
26. Sinha R,Cross AJ,Graubard BI,Leitzmann MF,Schatzkin A.Meat intake and mortality: a prospective study of over half a million people.Arch Intern Med. 2009;169:562-571.
27. Berkow SE,Barnard N.Vegetarian diets and weight status.Nutr Rev. 2006;64:175-188.
28. Rosell M,Appleby P,Spencer E,Key T.Weight gain over 5 years in 21,966 meat-eating, fish-eating, vegetarian, and vegan men and women in EPIC-Oxford.Int J Obes (Lond). 2006;30:1389-1396.
29. Spencer EA,Appleby PN,Davey GK,Key TJ.Diet and body mass index in 38000 EPIC-Oxford meat-eaters, fish-eaters, vegetarians and vegans.Int J Obes Relat Metab Disord. 2003;27:728-734.
30. Tonstad S,Butler T,Yan R,Fraser GE.Type of vegetarian diet, body weight, and prevalence of type 2 diabetes.Diabetes Care. 2009;32:791-796.
31. Mattes RD.The energetics of nut consumption.Asia Pac J Clin Nutr. 2008;17 (suppl 1): 337-339.
32. Mattes RD,Kris-Etherton PM,Foster GD.Impact of peanuts and tree nuts on body weight and healthy weight loss in adults.J Nutr. 2008;138:1741S-1745S.
33. Gaesser GA.Carbohydrate quantity and quality in relation to body mass index.J Am Diet Assoc. 2007;107:1768-1780.
34. Vergnaud AC,Norat T,Romaguera D, et al.Meat consumption and prospective weight change in participants of the EPIC-PANACEA study.Am J Clin Nutr. 2010;92:398-407.
35. Schulz M,Kroke A,Liese AD,Hoffmann K,Bergmann MM,Boeing H.Food groups as predictors for short-term weight changes in men and women of the EPIC-Potsdam cohort.J Nutr. 2002;132:1335-1340.
36. Romaguera D,Norat T,Vergnaud AC, et al.Mediterranean dietary patterns and prospective weight change in participants of the EPIC-PANACEA project.Am J Clin Nutr. 2010;92:912-921.
37. Appleby PN,Thorogood M,Mann JI,Key TJ.The Oxford Vegetarian Study: an overview.Am J Clin Nutr. 1999;70 (3 suppl): 525S-531S.
38. Burr ML,Butland BK.Heart disease in British vegetarians.Am J Clin Nutr. 1988;48 (3 suppl): 830-832.
39. Chang-Claude J,Hermann S,Eilber U,Steindorf K.Lifestyle determinants and mortality in German vegetarians and health-conscious persons: results of a 21-year follow-up.Cancer Epidemiol Biomarkers Prev. 2005;14:963-968.
40. Fraser GE.Associations between diet and cancer, ischemic heart disease, and all-cause mortality in non-Hispanic white California Seventh-day Adventists.Am J Clin Nutr. 1999;70 (3 suppl): 532S-538S.
41. Snowdon DA,Phillips RL,Fraser GE.Meat consumption and fatal ischemic heart disease.Prev Med. 1984;13:490-500.
42. Key TJ,Fraser GE,Thorogood M, et al.Mortality in vegetarians and non-vegetarians: a collaborative analysis of 8300 deaths among 76,000 men and women in five prospective studies.Public Health Nutr. 1998;1:33-41.
43. Key TJ,Fraser GE,Thorogood M, et al.Mortality in vegetarians and nonvegetarians: detailed findings from a collaborative analysis of 5 prospective studies.Am J Clin Nutr. 1999;70 (3 suppl): 516S-524S.
44. Appleby PN,Key TJ,Burr ML,Thorogood M.Associations between plasma lipid concentrations and dietary, lifestyle and physical factors in the Oxford Vegetarian Study.J Hum Nutr Diet. 1995;8:305-314.
45. West RO,Hayes OB.Diet and serum cholersterol levels: a comparison between vegetarians and nonvegetarians in a Seventh-day Adventist group.Am J Clin Nutr. 1968;21:853-862.
46. Nieman DC,Sherman KM,Arabatzis K, et al.Hematological, anthropometric, and metabolic comparisons between vegetarian and nonvegetarian elderly women.Int J Sports Med. 1989;10:243-251.
47. De Biase SG,Fernandes SF,Gianini RJ,Duarte JL.Vegetarian diet and cholesterol and triglycerides levels.Arq Bras Cardiol. 2007;88:35-39.
48. Chen CW,Lin YL,Lin TK,Lin CT,Chen BC,Lin CL.Total cardiovascular risk profile of Taiwanese vegetarians.Eur J Clin Nutr. 2008;62:138-144.
49. Snowdon DA,Phillips RL.Does a vegetarian diet reduce the occurrence of diabetes?.Am J Public Health. 1985;75:507-512.
50. Appleby PN,Davey GK,Key TJ.Hypertension and blood pressure among meat eaters, fish eaters, vegetarians and vegans in EPIC-Oxford.Public Health Nutr. 2002;5:645-654.
51. Fraser GE.Vegetarian diets: what do we know of their effects on common chronic diseases?.Am J Clin Nutr. 2009;89:1607S-1612S.
52. Rouse IL,Armstrong BK,Beilin LJ.The relationship of blood pressure to diet and lifestyle in two religious populations.J Hypertens. 1983;1:65-71.
53. Lu SC,Wu WH,Lee CA,Chou HF,Lee HR,Huang PC.LDL of Taiwanese vegetarians are less oxidizable than those of omnivores.J Nutr. 2000;130:1591-1596.
54. Hu FB.Plant-based foods and prevention of cardiovascular disease: an overview.Am J Clin Nutr. 2003;78 (3 suppl): 544S-551S.
55. Mellen PB,Walsh TF,Herrington DM.Whole grain intake and cardiovascular disease: a meta-analysis.Nutr Metab Cardiovasc Dis. 2008;18:283-290.
56. Bazzano LA,He J,Ogden LG, et al.Legume consumption and risk of coronary heart disease in US men and women: NHANES I Epidemiologic Follow-up Study.Arch Intern Med. 2001;161:2573-2578.
57. Nagura J,Iso H,Watanabe Y, et al.Fruit, vegetable and bean intake and mortality from cardiovascular disease among Japanese men and women: the JACC Study.Br J Nutr. 2009;102:285-292.
58. Kris-Etherton PM,Hu FB,Ros E,Sabaté J.The role of tree nuts and peanuts in the prevention of coronary heart disease: multiple potential mechanisms.J Nutr. 2008;138:1746S-1751S.
59. Harland JI,Haffner TA.Systematic review, meta-analysis and regression of randomised controlled trials reporting an association between an intake of circa 25 g soya protein per day and blood cholesterol.Atherosclerosis. 2008;200:13-27.
60. Food and Drug Administration, HHS. Final rule.Fed Regist. 1999;64:57700-57733.
61. Jenkins DJ,Kendall CW,Faulkner D, et al.A dietary portfolio approach to cholesterol reduction: combined effects of plant sterols, vegetable proteins, and viscous fibers in hypercholesterolemia.Metabolism. 2002;51:1596-1604.
62. Bernstein AM,Sun Q,Hu FB,Stampfer MJ,Manson JE,Willett WC.Major dietary protein sources and risk of coronary heart disease in women.Circulation. 2010;122:876-883.
63. Micha R,Wallace SK,Mozaffarian D.Red and processed meat consumption and risk of incident coronary heart disease, stroke, and diabetes mellitus: a systematic review and meta-analysis.Circulation. 2010;121:2271-2283.
64. Guallar-Castillón P,Rodríguez-Artalejo F,Tormo MJ, et al.Major dietary patterns and risk of coronary heart disease in middle-aged persons from a Mediterranean country: The EPIC-Spain cohort study.Nutr Metab Cardiovasc Dis. 2010;2010:11.
65. Fung TT,Rexrode KM,Mantzoros CS,Manson JE,Willett WC,Hu FB.Mediterranean diet and incidence of and mortality from coronary heart disease and stroke in women.Circulation. 2009;119:1093-1100.
66. Martínez-González MA,Fernández-Jarne E,Serrano-Martínez M,Marti A,Martinez JA,Martín-Moreno JM.Mediterranean diet and reduction in the risk of a first acute myocardial infarction: an operational healthy dietary score.Eur J Nutr. 2002;41:153-160.
67. Berkow SE,Barnard ND.Blood pressure regulation and vegetarian diets.Nutr Rev. 2005;63:1-8.
68. Margetts BM,Beilin LJ,Vandongen R,Armstrong BK.Vegetarian diet in mild hypertension: a randomised controlled trial.Br Med J (Clin Res Ed). 1986;293:1468-1471.
69. Rouse IL,Beilin LJ,Armstrong BK,Vandongen R.Blood-pressure-lowering effect of a vegetarian diet: controlled trial in normotensive subjects.Lancet. 1983;1:5-10.
70. Appel LJ,Giles TD,Black HR, et al.ASH position paper: dietary approaches to lower blood pressure.J Am Soc Hypertens. 2010;4:79-89.
71. Rouse IL,Beilin LJ,Mahoney DP, et al.Nutrient intake, blood pressure, serum and urinary prostaglandins and serum thromboxane B2 in a controlled trial with a lacto-ovo-vegetarian diet.J Hypertens. 1986;4:241-250.
72. Appel LJ,Moore TJ,Obarzanek E, et al.A clinical trial of the effects of dietary patterns on blood pressure. DASH Collaborative Research Group.N Engl J Med. 1997;336:1117-1124.
73. Key TJ,Appleby PN,Spencer EA,Travis RC,Roddam AW,Allen NE.Mortality in British vegetarians: results from the European Prospective Investigation into Cancer and Nutrition (EPIC-Oxford).Am J Clin Nutr. 2009;89:1613S-1619S.
74. Key TJ,Appleby PN,Rosell MS.Health effects of vegetarian and vegan diets.Proc Nutr Soc. 2006;65:35-41.
75. Montgomery S,Herring P,Yancey A, et al.Comparing self-reported disease outcomes, diet, and lifestyles in a national cohort of black and white Seventh-day Adventists.Prev Chronic Dis. 2007;4:A62.
76. Slimani N,Fahey M,Welch AA, et al.Diversity of dietary patterns observed in the European Prospective Investigation into Cancer and Nutrition (EPIC) project.Public Health Nutr. 2002;5 (6B): 1311-1328.
77. Agudo A,Slimani N,Ocké MC, et al.Consumption of vegetables, fruit and other plant foods in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohorts from 10 European countries.Public Health Nutr. 2002;5 (6B): 1179-1196.
78. Key TJ,Appleby PN,Spencer EA,Travis RC,Roddam AW,Allen NE.Cancer incidence in vegetarians: results from the European Prospective Investigation into Cancer and Nutrition (EPIC-Oxford).Am J Clin Nutr. 2009;89:1620S-1626S.
79. Sanjoaquin MA,Appleby PN,Spencer EA,Key TJ.Nutrition and lifestyle in relation to bowel movement frequency: a cross-sectional study of 20630 men and women in EPIC-Oxford.Public Health Nutr. 2004;7:77-83.
80. Fardet A.New hypotheses for the health-protective mechanisms of whole-grain cereals: what is beyond fibre?.Nutr Res Rev. 2010;23:65-134.
81. Slavin J.Why whole grains are protective: biological mechanisms.Proc Nutr Soc. 2003;62:129-134.
82. Lipkin M,Uehara K,Winawer S, et al.Seventh-Day Adventist vegetarians have a quiescent proliferative activity in colonic mucosa.Cancer Lett. 1985;26:139-144.
83. van Dokkum W,de Boer BC,van Faassen A,Pikaar NA,Hermus RJ.Diet, faecal pH and colorectal cancer.Br J Cancer. 1983;48:109-110.
84. Schatzkin A,Park Y,Leitzmann MF,Hollenbeck AR,Cross AJ.Prospective study of dietary fiber, whole grain foods, and small intestinal cancer.Gastroenterology. 2008;135:1163-1167.
85. Park Y,Hunter DJ,Spiegelman D, et al.Dietary fiber intake and risk of colorectal cancer: a pooled analysis of prospective cohort studies.JAMA. 2005;294:2849-2857.
86. Butler LM,Wu AH,Wang R,Koh WP,Yuan JM,Yu MC.A vegetable-fruit-soy dietary pattern protects against breast cancer among postmenopausal Singapore Chinese women.Am J Clin Nutr. 2010;91:1013-1019.
87. Cade JE,Taylor EF,Burley VJ,Greenwood DC.Common dietary patterns and risk of breast cancer: analysis from the United Kingdom Women's Cohort Study.Nutr Cancer. 2010;62:300-306.
88. Dos Santos Silva I,Mangtani P,McCormack V,Bhakta D,Sevak L,McMichael AJ.Lifelong vegetarianism and risk of breast cancer: a population-based case-control study among South Asian migrant women living in England.Int J Cancer. 2002;99:238-244.
89. Lu LJ,Anderson KE,Grady JJ,Kohen F,Nagamani M.Decreased ovarian hormones during a soya diet: implications for breast cancer prevention.Cancer Res. 2000;60:4112-4121.
90. Taylor EF,Burley VJ,Greenwood DC,Cade JE.Meat consumption and risk of breast cancer in the UK Women's Cohort Study.Br J Cancer. 2007;96:1139-1146.
91. Dewell A,Weidner G,Sumner MD,Chi CS,Ornish D.A very-low-fat vegan diet increases intake of protective dietary factors and decreases intake of pathogenic dietary factors.J Am Diet Assoc. 2008;108:347-356.
92. Steinmetz KA,Potter JD.Vegetables, fruit, and cancer prevention: a review.J Am Diet Assoc. 1996;96:1027-1039.
93. Gullett NP,Ruhul Amin AR,Bayraktar S, et al.Cancer prevention with natural compounds.Semin Oncol. 2010;37:258-281.
94. Park EJ,Pezzuto JM.Botanicals in cancer chemoprevention.Cancer Metastasis Rev. 2002;21:231-255.
95. Potter JD,Steinmetz K.Vegetables, fruit and phytoestrogens as preventive agents.IARC Sci Publ. 1996; (139): 61-90.
96. Gonzalez CA,Riboli E.Diet and cancer prevention: contributions from the European Prospective Investigation into Cancer and Nutrition (EPIC) study.Eur J Cancer. 2010;46:2555-2562.
97. Lam TK,Cross AJ,Consonni D, et al.Intakes of red meat, processed meat, and meat mutagens increase lung cancer risk.Cancer Res. 2009;69:932-939.
98. Ferrucci LM,Cross AJ,Graubard BI, et al.Intake of meat, meat mutagens, and iron and the risk of breast cancer in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial.Br J Cancer. 2009;101:178-184.
99. Divisi D,Di Tommaso S,Salvemini S,Garramone M,Crisci R.Diet and cancer.Acta Biomed. 2006;77:118-123.
100. Jiang R,Ma J,Ascherio A,Stampfer MJ,Willett WC,Hu FB.Dietary iron intake and blood donations in relation to risk of type 2 diabetes in men: a prospective cohort study.Am J Clin Nutr. 2004;79:70-75.
101. Jiang R,Manson JE,Meigs JB,Ma J,Rifai N,Hu FB.Body iron stores in relation to risk of type 2 diabetes in apparently healthy women.JAMA. 2004;291:711-717.
102. Lee DH,Folsom AR,Jacobs DR.Dietary iron intake and type 2 diabetes incidence in postmenopausal women: the Iowa Women s Health Study.Diabetologia. 2004;47:185-194.
103. Luan de C,Li H,Li SJ,Zhao Z,Li X,Liu ZM.Body iron stores and dietary iron intake in relation to diabetes in adults in north China.Diabetes Care. 2008;31:285-286.
104. Aune D,Ursin G,Veierod MB.Meat consumption and the risk of type 2 diabetes: a systematic review and meta-analysis of cohort studies.Diabetologia. 2009;7:7.
105. Anderson JW.Beneficial effects of soy protein consumption for renal function.Asia Pac J Clin Nutr. 2008;17 (suppl 1): 324-328.
106. Azadbakht L,Atabak S,Esmaillzadeh A.Soy protein intake, cardiorenal indices, and c-reactive protein in type 2 diabetes with nephropathy: a longitudinal randomized clinical trial.Diabetes Care. 2008;31:648-654.
107. Azadbakht L,Esmaillzadeh A.Soy-protein consumption and kidney-related biomarkers among type 2 diabetics: a crossover, randomized clinical trial.J Ren Nutr. 2009;14:14.
108. de Mello VD,Zelmanovitz T,Perassolo MS,Azevedo MJ,Gross JL.Withdrawal of red meat from the usual diet reduces albuminuria and improves serum fatty acid profile in type 2 diabetes patients with macroalbuminuria.Am J Clin Nutr. 2006;83:1032-1038.
109. Jibani MM,Bloodworth LL,Foden E,Griffiths KD,Galpin OP.Predominantly vegetarian diet in patients with incipient and early clinical diabetic nephropathy: effects on albumin excretion rate and nutritional status.Diabet Med. 1991;8:949-953.
110. Stephenson TJ,Setchell KD,Kendall CW,Jenkins DJ,Anderson JW,Fanti P.Effect of soy protein-rich diet on renal function in young adults with insulin-dependent diabetes mellitus.Clin Nephrol. 2005;64:1-11.
111. Jenkins DJ,Kendall CW,Marchie A, et al.Type 2 diabetes and the vegetarian diet.Am J Clin Nutr. 2003;78 (3 suppl): 610S-616S.
112. Barnard ND,Cohen J,Jenkins DJ, et al.A low-fat vegan diet improves glycemic control and cardiovascular risk factors in a randomized clinical trial in individuals with type 2 diabetes.Diabetes Care. 2006;29:1777-1783.
113. Barnard RJ,Jung T,Inkeles SB.Diet and exercise in the treatment of NIDDM: the need for early emphasis.Diabetes Care. 1994;17:1469-1472.
114. Nicholson AS,Sklar M,Barnard ND,Gore S,Sullivan R,Browning S.Toward improved management of NIDDM: a randomized, controlled, pilot intervention using a low fat, vegetarian diet.Prev Med. 1999;29:87-91.
115. Nair P,Mayberry JF.Vegetarianism, dietary fibre and gastro-intestinal disease.Dig Dis. 1994;12:177-185.
116. Gear JS,Ware A,Fursdon P, et al.Symptomless diverticular disease and intake of dietary fibre.Lancet. 1979;1:511-514.
117. Pixley F,Wilson D,McPherson K,Mann J.Effect of vegetarianism on development of gall stones in women.Br Med J (Clin Res Ed). 1985;291:11-12.
118. Tsai CJ,Leitzmann MF,Willett WC,Giovannucci EL.Dietary protein and the risk of cholecystectomy in a cohort of US women: the Nurses' Health Study.Am J Epidemiol. 2004;160:11-18.
119. Tsai CJ,Leitzmann MF,Willett WC,Giovannucci EL.Fruit and vegetable consumption and risk of cholecystectomy in women.Am J Med. 2006;119:760-767.
120. Kritchevsky D,Klurfeld DM.Gallstone formation in hamsters: effect of varying animal and vegetable protein levels.Am J Clin Nutr. 1983;37:802-804.
121. Kritchevsky D,Klurfeld DM.Influence of vegetable protein on gallstone formation in hamsters.Am J Clin Nutr. 1979;32:2174-2176.
122. Smith DA,Gee MI.A dietary survey to determine the relationship between diet and cholelithiasis.Am J Clin Nutr. 1979;32:1519-1526.
123. Tsai CJ,Leitzmann MF,Willett WC,Giovannucci EL.Long-term intake of dietary fiber and decreased risk of cholecystectomy in women.Am J Gastroenterol. 2004;99:1364-1370.
124. Choi HK,Atkinson K,Karlson EW,Willett W,Curhan G.Purine-rich foods, dairy and protein intake, and the risk of gout in men.N Engl J Med. 2004;350:1093-1103.
125. Siener R,Hesse A.The effect of a vegetarian and different omnivorous diets on urinary risk factors for uric acid stone formation.Eur J Nutr. 2003;42:332-337.
126. Elkan AC,Sjöberg B,Kolsrud B,Ringertz B,Hafström I,Frostegård J.Gluten-free vegan diet induces decreased LDL and oxidized LDL levels and raised atheroprotective natural antibodies against phosphorylcholine in patients with rheumatoid arthritis: a randomized study.Arthritis Res Ther. 2008;10:R34.
127. Hafström I,Ringertz B,Spångberg A, et al.A vegan diet free of gluten improves the signs and symptoms of rheumatoid arthritis: the effects on arthritis correlate with a reduction in antibodies to food antigens.Rheumatology (Oxford). 2001;40:1175-1179.
128. Kjeldsen-Kragh J.Rheumatoid arthritis treated with vegetarian diets.Am J Clin Nutr. 1999;70 (3 suppl): 594S-600S.
129. McDougall J,Bruce B,Spiller G,Westerdahl J,McDougall M.Effects of a very low-fat, vegan diet in subjects with rheumatoid arthritis.J Altern Complement Med. 2002;8:71-75.
130. Muller H,de Toledo FW,Resch KL.Fasting followed by vegetarian diet in patients with rheumatoid arthritis: a systematic review.Scand J Rheumatol. 2001;30:1-10.
131. Sköldstam L,Brudin L,Hagfors L,Johansson G.Weight reduction is not a major reason for improvement in rheumatoid arthritis from lacto-vegetarian, vegan or Mediterranean diets.Nutr J. 2005;4:15.
132. Nettleton JA,Steffen LM,Palmas W,Burke GL,Jacobs DR.Associations between microalbuminuria and animal foods, plant foods, and dietary patterns in the Multiethnic Study of Atherosclerosis.Am J Clin Nutr. 2008;87:1825-1836.
133. Craig WJ,Mangels AR.Position of the American Dietetic Association: vegetarian diets.J Am Diet Assoc. 2009;109:1266-1282.
134. Young VR,Pellett PL.Plant proteins in relation to human protein and amino acid nutrition.Am J Clin Nutr. 1994;59 (5 suppl): 1203S-1212S.
135. Young VR.Soy protein in relation to human protein and amino acid nutrition.J Am Diet Assoc. 1991;91:828-835.
136. Gilsing AM,Crowe FL,Lloyd-Wright Z, et al.Serum concentrations of vitamin B12 and folate in British male omnivores, vegetarians and vegans: results from a cross-sectional analysis of the EPIC-Oxford cohort study.Eur J Clin Nutr. 2010;64:933-939.
137. Allen LH.How common is vitamin B-12 deficiency?.Am J Clin Nutr. 2009;89:693S-696S.
138. Watanabe F.Vitamin B12 sources and bioavailability.Exp Biol Med (Maywood). 2007;232:1266-1274.
139. Koyyalamudi SR,Jeong SC,Cho KY,Pang G.Vitamin B12 is the active corrinoid produced in cultivated white button mushrooms (Agaricus bisporus).J Agric Food Chem. 2009;57:6327-6333.
140. Dror DK,Allen LH.Effect of vitamin B12 deficiency on neurodevelopment in infants: current knowledge and possible mechanisms.Nutr Rev. 2008;66:250-255.
141. Hallberg L.Bioavailability of dietary iron in man.Annu Rev Nutr. 1981;1:123-147.
142. Rossander L,Hallberg L,Bjorn-Rasmussen E.Absorption of iron from breakfast meals.Am J Clin Nutr. 1979;32:2484-2489.
143. Hallberg L,Brune M,Rossander L.Iron absorption in man: ascorbic acid and dose-dependent inhibition by phytate.Am J Clin Nutr. 1989;49:140-144.
144. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc: A Report of the Panel on Micronutrients and the Standing Committee on the Scientific Evaluation of Dietary Reference Intakes. Washington, DC: National Academies Press; 2001:.
145. Siegenberg D,Baynes RD,Bothwell TH, et al.Ascorbic acid prevents the dose-dependent inhibitory effects of polyphenols and phytates on nonheme-iron absorption.Am J Clin Nutr. 1991;53:537-541.
146. Reddy MB.Algorithms to assess non-heme iron bioavailability.Int J Vitam Nutr Res. 2005;75:405-412.
147. Cook JD,Dassenko SA,Lynch SR.Assessment of the role of nonheme-iron availability in iron balance.Am J Clin Nutr. 1991;54:717-722.
148. Davey GK,Spencer EA,Appleby PN,Allen NE,Knox KH,Key TJ.EPIC-Oxford: lifestyle characteristics and nutrient intakes in a cohort of 33 883 meat-eaters and 31 546 non meat-eaters in the UK.Public Health Nutr. 2003;6:259-269.
149. National Diet and Nutrition Survey: Adults Aged 19 to 64 Years: Vitamin and Mineral Intake and Urinary Analytes. London, UK: TSO; 2003:.
150. Ball MJ,Bartlett MA.Dietary intake and iron status of Australian vegetarian women.Am J Clin Nutr. 1999;70:353-358.
151. Haddad EH,Berk LS,Kettering JD,Hubbard RW,Peters WR.Dietary intake and biochemical, hematologic, and immune status of vegans compared with nonvegetarians.Am J Clin Nutr. 1999;70 (3 suppl): 586S-593S.
152. Hunt JR.Bioavailability of iron, zinc, and other trace minerals from vegetarian diets.Am J Clin Nutr. 2003;78 (3 suppl): 633S-639S.
153. Messina V,Mangels AR,Messina MThe Dietitian's Guide to Vegetarian Diets: Issues and Applications. 2nd ed.Sudbury, MA: Jones & Bartlett; 2004.Sudbury, MA: Jones & Bartlett; 2004:.
154. Hunt JR,Roughead ZK.Adaptation of iron absorption in men consuming diets with high or low iron bioavailability.Am J Clin Nutr. 2000;71:94-102.
155. Hurrell R,Egli I.Iron bioavailability and dietary reference values.Am J Clin Nutr. 2010;91:1461S-1467S.
156. Cook JD.Adaptation in iron metabolism.Am J Clin Nutr. 1990;51:301-308.
157. Hunt JR,Roughead ZK.Nonheme-iron absorption, fecal ferritin excretion, and blood indexes of iron status in women consuming controlled lactoovovegetarian diets for 8 wk.Am J Clin Nutr. 1999;69:944-952.
158. Barrett JF,Whittaker PG,Williams JG,Lind T.Absorption of non-haem iron from food during normal pregnancy.BMJ. 1994;309:79-82.
159. Whittaker PG,Barrett JF,Lind T.The erythrocyte incorporation of absorbed non-haem iron in pregnant women.Br J Nutr. 2001;86:323-329.
160. Hunt JR,Beiseigel JM,Johnson LK.Adaptation in human zinc absorption as influenced by dietary zinc and bioavailability.Am J Clin Nutr. 2008;87:1336-1345.
161. Gibson RS,Perlas L,Hotz C.Improving the bioavailability of nutrients in plant foods at the household level.Proc Nutr Soc. 2006;65:160-168.
162. Hambidge KM,Miller LV,Westcott JE,Sheng X,Krebs NF.Zinc bioavailability and homeostasis.Am J Clin Nutr. 2010;91:1478S-1483S.
163. Weaver CM,Proulx WR,Heaney R.Choices for achieving adequate dietary calcium with a vegetarian diet.Am J Clin Nutr. 1999;70 (3 suppl): 543S-548S.
164. Appleby P,Roddam A,Allen N,Key T.Comparative fracture risk in vegetarians and nonvegetarians in EPIC-Oxford.Eur J Clin Nutr. 2007;61:1400-1406.
165. Ho-Pham LT,Nguyen ND,Nguyen TV.Effect of vegetarian diets on bone mineral density: a Bayesian meta-analysis.Am J Clin Nutr. 2009;90:943-950.
166. New SA.Do vegetarians have a normal bone mass?.Osteoporos Int. 2004;15:679-688.
167. Ho-Pham LT,Nguyen PL,Le TT, et al.Veganism, bone mineral density, and body composition: a study in Buddhist nuns.Osteoporos Int. 2009;20:2087-2093.
168. Sellmeyer DE,Stone KL,Sebastian A,Cummings SR.A high ratio of dietary animal to vegetable protein increases the rate of bone loss and the risk of fracture in postmenopausal women. Study of Osteoporotic Fractures Research Group.Am J Clin Nutr. 2001;73:118-122.
169. Frassetto LA,Todd KM,Morris RC,Sebastian A.Worldwide incidence of hip fracture in elderly women: relation to consumption of animal and vegetable foods.J Gerontol A Biol Sci Med Sci. 2000;55:M585-M592.
170. Kerstetter JE,O'Brien KO,Insogna KL.Dietary protein, calcium metabolism, and skeletal homeostasis revisited.Am J Clin Nutr. 2003;78 (3 suppl): 584S-592S.
171. Weikert C,Walter D,Hoffmann K,Kroke A,Bergmann MM,Boeing H.The relation between dietary protein, calcium and bone health in women: results from the EPIC-Potsdam cohort.Ann Nutr Metab. 2005;49:312-318.
172. Zhong Y,Okoro CA,Balluz LS.Association of total calcium and dietary protein intakes with fracture risk in postmenopausal women: the 1999-2002 National Health and Nutrition Examination Survey (NHANES).Nutrition. 2009;25:647-654.
173. Yashodhara BM,Umakanth S,Pappachan JM,Bhat SK,Kamath R,Choo BH.Omega-3 fatty acids: a comprehensive review of their role in health and disease.Postgrad Med J. 2009;85:84-90.
174. Davis BC,Kris-Etherton PM.Achieving optimal essential fatty acid status in vegetarians: current knowledge and practical implications.Am J Clin Nutr. 2003;78 (3 suppl): 640S-646S.
175. Li D,Ball M,Bartlett M,Sinclair A.Lipoprotein(a), essential fatty acid status and lipoprotein lipids in female Australian vegetarians.Clin Sci (Lond). 1999;97:175-181.
176. Welch AA,Shakya-Shrestha S,Lentjes MAH,Wareham NJ,Khaw K-T.Dietary intake and status of n-3 polyunsaturated fatty acids in a population of fish-eating and non-fish-eating meat-eaters, vegetarians, and vegans and the precursor-product ratio of {alpha}-linolenic acid to long-chain n-3 polyunsaturated fatty acids: results from the EPIC-Norfolk cohort.Am J Clin Nutr. 2010;92:1040-1051.
177. Sanders TA.DHA status of vegetarians.Prostaglandins Leukot Essent Fatty Acids. 2009;81:137-141.
178. Rosell MS,Lloyd-Wright Z,Appleby PN,Sanders TA,Allen NE,Key TJ.Long-chain n-3 polyunsaturated fatty acids in plasma in British meat-eating, vegetarian, and vegan men.Am J Clin Nutr. 2005;82:327-334.
179. Hibbeln JR,Nieminen LR,Blasbalg TL,Riggs JA,Lands WE.Healthy intakes of n-3 and n-6 fatty acids: estimations considering worldwide diversity.Am J Clin Nutr. 2006;83 (6 suppl): 1483S-1493S.
180. Mangat I.Do vegetarians have to eat fish for optimal cardiovascular protection?.Am J Clin Nutr. 2009;89:1597S-1601S.
181. Sanders TA.Essential fatty acid requirements of vegetarians in pregnancy, lactation, and infancy.Am J Clin Nutr. 1999;70 (3 suppl): 555S-559S.
182. Geppert J,Kraft V,Demmelmair H,Koletzko B.Docosahexaenoic acid supplementation in vegetarians effectively increases omega-3 index: a randomized trial.Lipids. 2005;40:807-814.
183. Holick MF,Biancuzzo RM,Chen TC, et al.Vitamin D2 is as effective as vitamin D3 in maintaining circulating concentrations of 25-hydroxyvitamin D.J Clin Endocrinol Metab. 2008;93:677-681.
184. Raiten DJ,Picciano MF.Vitamin D and health in the 21st century: bone and beyond. Executive summary.Am J Clin Nutr. 2004;80 (6 suppl): 1673S-1677S.
185. Koyyalamudi SR,Jeong SC,Song CH,Cho KY,Pang G.Vitamin D2 formation and bioavailability from Agaricus bisporus button mushrooms treated with ultraviolet irradiation.J Agric Food Chem. 2009;57:3351-3355.
186. Panebianco SM.The merits and pitfalls of vegetarianism.Explore (NY). 2007;3:55-58.
187. Alexander D,Ball MJ,Mann J.Nutrient intake and haematological status of vegetarians and age-sex matched omnivores.Eur J Clin Nutr. 1994;48:538-546.
188. Lamberg-Allardt C,Kärkkäinen M,Seppänen R,Biström H.Low serum 25-hydroxyvitamin D concentrations and secondary hyperparathyroidism in middle-aged white strict vegetarians.Am J Clin Nutr. 1993;58:684-689.
189. Outila TA,Kärkkäinen MU,Seppänen RH,Lamberg-Allardt CJ.Dietary intake of vitamin D in premenopausal, healthy vegans was insufficient to maintain concentrations of serum 25-hydroxyvitamin D and intact parathyroid hormone within normal ranges during the winter in Finland.J Am Diet Assoc. 2000;100:434-441.
190. Chan J,Jaceldo-Siegl K,Fraser GE.Serum 25-hydroxyvitamin D status of vegetarians, partial vegetarians, and nonvegetarians: the Adventist Health Study-2.Am J Clin Nutr. 2009;89:1686S-1692S.