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Lecture Notes | Approved: 7 years ago | 100.23 kB | Comments: 0
...AdolescentVegetariansHowWellDoTheirDietaryPatternsMeettheHealthyPeople2010Objectives?CherylL.Perry,PhD;MaureenT.McGuire,PhD;DianneNeumark-Sztainer,PhD,RD;MaryStory,PhD,RDToexaminewhetheradolescentvegetar-iansweremorelikelythannonvegetarianpeerstomeetthedietaryrecommendationsoftheHealthyPeople2010objectivesandtoexaminedifferencesinothernutrientsbetweenthese2groups.Atotalof4746adolescentsfrom31middleandhighschoolsintheTwinCitiesareaofMinnesota.Datawerecollectedviaself-reportsurveys,withastudentre-sponserateof81.5%.Urbansecondaryschools.Participantswereequallydividedbysex.Themeanagewas14.9years;34.3%wereinjuniorhighschooland65.7%inhighschool.Theracial/ethnicdis-tributionwas48.5%white,19.0%AfricanAmerican,19.2%AsianAmerican,5.8%Hispanic,3.5%AmericanIndian,and3.9%mixedorother.MainOutcomeMeasures:Questionsonvegetariansta-tusandwhetherparticularfoods(eggs,dairyfoods,chicken,fish)wereexcluded.DietaryintakewasassessedusingtheYouthandAdolescentFoodFrequencyQuestionnaire.VegetarianadolescentsweresignificantlymorelikelythannonvegetarianadolescentstomeettheHealthyPeople2010objectives.Thiswasparticularlynotewor-thyfortotalfat(70%vs48%),saturatedfat(65%vs39%),dailyservingsofvegetables(26%vs14%),and5ormoreservingsoffruitsandvegetables(39%vs28%).Vegetar-ianswerealsolesslikelytoeatfastfoodordrinkregularsodaandfruitdrinks.Vegetariansconsumedlessvita-minB,moredietsoda,morecaffeine,andmoreiron.Adolescentvegetarianshaveadietarypat-ternthatismorelikelythannonvegetarianstomeettheHealthyPeople2010objectives.ArchPediatrAdolescMed.2002;156:431-437 foravarietyofreasons,choosetolimittheirintakeofmeatandotheranimalproducts.Somevegetarianseatnoanimalproducts(vegans),whereasothersincludemilkproducts(lactovegetarians)oreggs(ovovegetarians).Manyself-iden-tifiedvegetariansalsoeatsomemeat,par-ticularlyfishandchicken(semivegetarians).Adultvegetarianismhasbeenstudiedfortherelationshipsamongaplant-baseddiet,chronicdiseases,andlengthoflife.all,adultvegetarianstendtolivesignifi-cantlylongerlivesthannonvegetarians,withsubstantiallylowerratesofcardiovasculardiseases,hypertension,type2diabetesmelli-tus,obesity,andsometypesofcancer.Vegetariandiets,likealldiets,needtobeplannedappropriatelytobenutrition-allyadequate.Ofconcernwithadultveg-etariansissufficientconsumptionofnutri-entsoftenfoundinanimalproducts.Nutrientsofmostconcernincludeiron,calcium,zinc,andvitaminBWhiteandpointoutthatclinicalnutritiondeficienciesareuncommonevenamongvegans,althoughtheysuggestthatcare-fulplanningand,insomecases,vitaminsupplementationmaybewarranted.Theintakeofthesenutrientshasnotbeenex-aminedinalargeadolescentvegetarianGiventhatdietarypatternsareadoptedandappeartobemaintainedduringado-lescenceandyoungadulthood,anin-terestingquestioniswhetheryoungerveg-etariansreporthealthierdietarypatternsthannonvegetariancounterparts.Specifi-cally,whatpercentageofadolescentveg-etarians(vsnonvegetarians)complywiththedietaryrecommendationsoutlinedintheHealthyPeople2010objectives?Doadolescentvegetariansconsumelessfatandsaturatedfat,consumemorefruitsandvegetablesandfiber,andmaintainhealthierForeditorialcommentseepage426 FromtheDivisionofEpidemiology,SchoolofPublicHealth,UniversityofMinnesota,Minneapolis. (REPRINTED)ARCHPEDIATRADOLESCMED/VOL156,MAY2002WWW.ARCHPEDIATRICS.COM ©2002AmericanMedicalAssociation.Allrightsreserved....
...www.archpediatrics.com Downloaded from reportedbeingvegetarian.Amongthevegetarians,nearlythreefourths(73.7%)werefemale.Nearlyhalf(47.5%)ofthevegetarianswerewhite,26.8%wereAsian,11.1%wereAfricanAmerican,5.8%wereHispanic,5.0%wereAmericanIndian,andtheremaining4%wereHawaiianorPacificIslanderorother.BecausethereweresofewHis-panic,AmericanIndian,andmixedorothervegetarians(be-causeofthesamplesizesofthoserace/ethnicitiesintheen-tiresample),thesegroupswerecombinedandreferredtoasotherintherace/ethnicityanalyses.Amongthevegetar-ians,38.6%wereinhighschool(vsmiddleorjuniorhighschool).Morethanhalfofthevegetarians(62%)reportedeatingchickenand/orfishandweresemivegetarians;32%ateeggsand/ordairyproducts(butnotchickenorfish),and6%werevegans,sothat38%wereclassifiedaslacto-ovo-vegansfortheseanalyses.AsgiveninTable1,thereweresignificantdifferencesbetweenvegetariansandnon-vegetariansinthesexandracialmakeupofthesamples.Overall,adolescentvegetariansweresignificantlymorelikelytomeetthedietaryrecommendationsofHealthyPeople2010asgiveninTable2.Vegetarianado-lescentsweremorethantwiceaslikelytoeatlessthan30%oftheircaloriesfromfatandnearly3timesmorelikelytoeatlessthan10%oftheircaloriesfromsatu-ratedfat.Theywerealso1.4to2timesmorelikelytoeat2ormoreservingsoffruit,3ormoreservingsofveg-etables,3ormoreservingsofvegetablesincluding1thatisdarkyelloworgreen,and5ormoreservingsoffruitsandvegetablesdaily.Therewerenosignificantdiffer-encesindailycalciumintakeorservingsofgrains.Therewerealsonosignificantsexvegetarianstatusorracevegetarianstatusinteractions.Differencesbetweenvegetariansandnonvegetar-iansforavarietyofotherfoodintakevariablesaregivenTable3.Vegetarianadolescents,comparedwithnonvegetarianadolescents,consumedsignificantlylessvitaminB,cholesterol,regularsoda,fruitdrink,andfastfood,aswellasthepercentageofcaloriesfrompro-teinandalltypesoffat.Vegetariansweresignificantlymorelikelythannonvegetarianstoconsumemoreiron,(YAQ).TheYAQasksaboutspecificfooditems,identifiesamountsofeachfood,andasksforfrequencyofconsump-tion.Forexample,onequestionasksabouthowfre-quently2piecesofpizzaareconsumed(never,1-3timespermonth,onceaweek,2-4timesperweek,5timesperweek).ValidityandreliabilityoftheYAQhavebeentestedamongarandomsampleofchildren(aged9-18years)ofparticipantsintheNursesHealthStudyandfoundtobewithinacceptablerangesfordietaryassessmenttools.Meancorrelationforenergy-adjustednutrientsbetweentwoYAQsandthree24-hourrecalls(implementedin3sea-sons)was0.45.Themeanenergyintake(incalories)fortheYAQwashigherthanfortherecallsbutwithin1%ofthem.Test-retestcorrelationsbetween2YAQsduringa1-yearperiodwere0.49forfruitand0.48forvegetables.Responsestoquestionsonthefrequencyofintakeofthefollowingfruitsandvegetablesweresummedtoassessaveragetotaldailyintakeoffruitsandvegetables:apples,applejuice,bananas,beets,broccoli,carrots,celery,cole-slaw,corn,grapes,greensorkale,lettuce,melon,mixedvegetables,oranges,orangejuice,peachesorplums,pears,peas,peppers,potatoes(notincludingFrenchfries),rai-sins,spinach,strawberries,stringbeans,tomatoes,to-matoorspaghettisauce,yams,andzucchiniorsquash.Con-sumptionoffruitsandvegetableswasgenerallyreportedusing5-pointscales(eg,neverorlessthanonceamonth,1-3timespermonth,onceaweek,2-4timesperweek,timesperweek).Dietaryintakeinthepresentstudywasevaluatedin2ways:relativetotheHealthyPeople2010objectives(forrelevantnutrientsandfoods)andasmeandailyintake.Inthecurrentstudy,nutrientandfoodbehaviorsexaminedrelativetotheHealthyPeople2010objectivesincludedthefollowing:totalfat(percentageoftotalenergy),saturatedfat(percentageoftotalenergy),calcium(milligrams),fruits(servings),vegetables(servings),andgrains(servings).ThesewereconvertedtothepercentageofstudentswhocompliedwiththeHealthyPeople2010objectives.Otherdailynutrientintakesincludedthefollowing:calories(ki-localories),protein(grams),calcium(milligrams),zinc(mil-ligrams),iron(milligrams),vitaminA(units),vitaminB(milligrams),vitaminB(micrograms),vitaminC(milli-grams),folate(micrograms),linoleicacid(grams),cho-lesterol(milligrams),caffeine(milligrams),andfiber(grams).Otherdailyfoodintakesincludedsoda(dailyserv-ings),dietsoda(dailyservings),fruitdrink(noncarbon-ated,dailyservings),andfastfood(frequencyinthepastweek).Wealsoexaminedthepercentageofcaloriesfromprotein,carbohydrates,totalfat,saturatedfat,polyunsatu-ratedfat,andmonounsaturatedfat,aswellastheaveragedailyservingsoffruitandvegetables.Thesewereselectedtoassesswhethervegetarianswereatgreaterorlesserriskthannonvegetariansfornutrientinadequaciesofparticu-larconcernduringadolescence.DATAANALYSESThepresentstudyassesseddietaryintakeassociatedwithadolescentvegetarians.Inthefirstsetofanalyses,theper-centagesofadolescentswhomettheHealthyPeople2010dietaryobjectiveswerecomparedbetweenvegetariansandnonvegetarians.Theseanalysesalsoassessedwhetherdi-etaryintakewasmoderatedbysex(ie,sex-by-vegetarianinteractions)orrace/ethnicity(ie,race/ethnicityvegetarianinteractions).Dailyintakeofspecificnutrientsandfoodswasalsocomparedbetweenvegetariansandnonveg-etarians.Inthesecondsetofanalyses,thepercentagesofado-lescentswhometHealthyPeople2010objectiveswerecom-paredbetweenspecificvegetariangroups.Fortheseanalyses,vegetarianswhowerelacto-ovo-veganswerecomparedwithsemivegetarians.Logisticandlinearregressionanalyseswereconductedtotestforstatisticaldifferencesbetweenthecom-parisongroupswhenthedependentvariableswereeitherdi-chotomousorlinear,respectively.Allanalysescontrolledforsexandracesincethereweredifferencesbetweengroupsinsexandracialmake-up.Theinteractionanalysesbysexandracewerecontrolledforraceorsex,respectively..05wasconsideredsignificant.valueswerenotadjustedformul-tipletestingbecausefalse-positivedifferenceswereun-likelywhenthevaluesaresmall(.01),whichwasthecaseformostofthecomparisons.Allanalyseswerecon-ductedusingtheStatisticalAnalysisSystem. (REPRINTED)ARCHPEDIATRADOLESCMED/VOL156,MAY2002WWW.ARCHPEDIATRICS.COM ©2002AmericanMedicalAssociation.Allrightsreserved. on...
...www.archpediatrics.com Downloaded from vitaminA,folate,caffeine,fiber,anddietsoda,aswellasagreaterpercentageofcaloriesfromcarbohydratesandmoreservingsoffruitandvegetables.Therewerenon-significantdifferencesbetweenthe2groupsforcalo-ries,protein,calcium,zinc,vitaminB,vitaminC,andlinoleicacid.Amongthevegetarians,differencesbetweenthelacto-ovo-vegansandsemivegetarians(whoatechickenand/orfish)wereexamined.TheresultsforthepercentageofeachgroupwhometthedietaryguidelinesoftheHealthyPeople2010objectivesaregiveninTable4.Lacto-ovo-vegansweremorethantwiceaslikelyassemivegetar-ianstoeatlessthan30%ofthecaloriesintheirdietfromfat,morethan2servingsoffruitperday,and5ormoreservingsoffruitsandvegetablesperday.Comparinglacto-ovo-veganswithsemivegetar-ians,therewerenointeractionsbetweenadherencetotheHealthyPeople2010objectivesbysex,buttherewere5significantinteractionsbyrace.Whitesemivegetariansweresignificantlylesslikelythanwhitelacto-ovo-veganstomeetthedailyrequirementforcalcium(22.6%vs43.9%;oddsratio,0.37;95%confidenceinter-val,0.16-0.82),toeatmorethan2servingsoffruiteachday(34.5%vs68.6%;OR,0.24;95%CI,0.11-0.54),toeatmorethan3servingsofvegetableseachday(8.6%vs35.3%;OR,0.17;95%CI,0.06-0.49),toeatmorethan3vegetableseachday,including1deepyelloworgreenvegetable(6.2%vs22.8%;OR,0.22;95%CI,0.07-0.74),andtoeat6ormoreservingsofgrainseachday(30.0%vs53.7%;OR,0.36;95%CI,0.17-0.79).Therewerenosignificantdifferencesbetweenlacto-ovo-vegansandsemivegetariansontheseitemsamongAfri-canAmericans,Asians,orothers. Overall,vegetarianadolescentsweremuchmorelikelythannonvegetarianstomeettheHealthyPeople2010ob-jectives.Thepercentageofvegetariansvsnonvegetar-ianswhomettheobjectiveswasparticularlynotewor-thyforfatconsumption(70%vs48%),saturatedfatconsumption(65%vs39%),dailyservingsofvegetables(26%vs14%),and5ormoredailyservingsoffruitsandvegetables(39%vs28%).Thesearesubstantivediffer-encesinthemajortargeteddietarybehaviorsforcardio-vasculardisease(fatintake)andcancer(fruitandveg-etableintake)andsuggestthatvegetarianadolescents,similartotheiradultcounterparts,havedietarypat-ternsthat,ifmaintained,couldsignificantlylowertheirriskoftheleadingcausesofdeathasadults.Theresultsfromthepresentstudyondietaryfatwerecorroboratedbycomparingvegetariansandnonvegetar-averagedailyintakeoffat.Onaverage,26%ofthetotalcalorieswerefromfat,comparedwith30%ofnonvegetarianscalories,a13%reductioninfatconsumption.Morenotably,intakeofsaturatedfatandcholesterolwas14%and22%lower,respectively,thannonvegetarians.Similarresultswerefoundforfruitandvegetablein-take.Vegetarians,comparedwithnonvegetarians,con-sumed0.4moreservingsoffruitand0.5moreservingsofvegetablesdaily.Infact,thelacto-ovo-veganscon-sumed5.8servingsoffruitsandvegetablesperday.Thiscanbecomparedwith4.1servingsfornonvegetariansand4.7servingsforsemivegetarians.Onlythelacto-ovo-vegans,thosewhodidnoteatchickenand/orfish,consumed,onaverage,morethantherecommended5servingsoffruitsandvegetableseachday.Themagnitudeofthedifferencesbetweenvegetar-iansandnonvegetariansforfatconsumptionandfruitandvegetableintakewassubstantial.Forexample,theTable1.DemographicComparisonsofVegetarianandNonvegetarianAdolescents Vegetarian,%(n=262)Nonvegetarian,%(n=4259)ValueGirls73.748.4White47.549.8 AfricanAmerican11.118.2Asian26.818.7Other14.613.3Highschool38.634.8.21SocioeconomicstatusLow35.136.1...
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