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Itisimportanttoaddresssubstantivedifferencesbe-tweenvegetariansandnonvegetariansthatmightac-countforthedietarydifferencesobservedinthisstudy.Thesedemographicandpsychosocialdifferenceswerethefocusofapriorpublicationwiththissamepopulationofstudents.Theadolescentvegetariansweremorelikelythannonvegetarianstobefemale,notAfricanAmeri-can,inmiddleschool(ratherthanhighschool),weightandbodyconscious,dissatisfiedwiththeirbodies,andinvolvedinavarietyofhealthyandunhealthyweightcon-trolbehaviors.Inaddition,vegetariansmoreoftenre-portedhavingbeentoldbyaphysicianthattheyhadaneatingdisorderandweremorelikelytohavecontem-platedandattemptedsuicide.Otherbehaviors,suchassubstanceuseandphysicalactivity,werenotdifferentbetweenvegetariansandnonvegetarians.Thus,theado-lescentvegetariansdifferfromthenonvegetariansinbeingfemale(althoughitisnoteworthythattherelationshipbetweenvegetarianstatusandpsychosocialfactorsdidnotdifferbysex)andintheirfocusonweightanddietandeatingbehaviors;thisfocusonweightanddietseemstobetheprimarymotivationforadoptingavegetariandiet,ratherthanitslong-termhealthbenefits.carepractitionersshouldbeawareofadolescentswhogreatlylimitfoodchoicesandwhoexhibitsymptomsofeatingdisorders.However,datasuggestthatvegetariandietsdonotleadtoeatingdisorders.Adolescentswhoadoptvegetarianeatinghabitswithoutadequatenutri-tionknowledgeandwithadesiretoachieveweightlossaremostvulnerabletomalnutritionandgrowthandshouldreceiveaddedattention.Thus,al-thoughtheadoptionofavegetarian-eatingpatternmayhavebenefitsintermsofnutritionalintakeformanyado-lescents,forothersitmaybeamethodofunhealthyfoodrestriction.Therefore,adolescentswhochoosetobe-comevegetariansshouldbemonitoredforadequatein-takeandquestionedabouttheirmotivationsbyahealthcarepractitioner.Thisstudyhadseveralstrengthsandlimitations.Thequestionsonvegetarianismanddietaryfactorsweremorecomprehensivethanpriorpopulation-basedstudies.Wechosearepresentativesampleofadolescentsfromthema-jorurbanschooldistrictsinMinnesotaandthushadsuf-ficientdatatoexamineethnicgroupandsexdiffer-ences.Thestudywaslimitedbytheself-reportingofvegetarianismandthecross-sectionaldesignofthestudy.Furthermore,althoughtheYAQhasbeenfoundtohaveacceptablereliabilityandvalidity,aswithanydi-etaryassessmenttool,ithaslimitations.Specifically,itislimitedbyitsrelianceonadolescentsrecall,thelackofspecificityofportionsizes,andtheinabilitytoassessnutrientcontentofnonstandardmixeddishes(suchashomemadespinachlasagna).Moreworkisneededonadietarymeasurethancanbeself-administeredinaschoolsettingandyetcanalsoprovidemorereliableandvalidInthecurrentstudy,adolescentvegetariansweremorelikelythannonvegetarianstobeadheringtotheHealthyPeople2010objectivesrelevanttonutritionalhealth.Thiswasevenmorethecaseamongthelacto-ovo-vegans.Thus,itseemsthatratherthanviewingado-lescentvegetarianismasadifficultphaseorfad,thedi-etarypatterncouldbeviewedasahealthyalternativetothetraditionalAmericanmeat-baseddiet.Withcarefulplanning,usingthevegetarianfoodguidepyramidasavegetarianadolescentscouldlearnpropernu-tritionalpatternsandpracticesthatcouldleadtoalife-longdietarypracticethatmightbesalutaryforthem-selvesandtheirfamiliesinthefuture.AcceptedforpublicationJanuary1,2002.ThisstudywassupportedbygrantMCJ-270834(DrNeumark-Sztainer)fromtheMaternalandChildHealthBu-reau(TitleV,SocialSecurityAct),HealthResourcesandServiceAdministration,USDepartmentofHealthandHu-manServices,Washington,DC.Correspondingauthorandreprints:CherylL.Perry,PhD,DivisionofEpidemiology,SchoolofPublicHealth,Uni-versityofMinnesota,Minneapolis,MN55454(e-mail: 1.WhiteR,FrankE.Healtheffectsandprevalenceofvegetarianism.WestJMed.2.DwyerJT.Healthaspectsofvegetariandiets.AmJClinNutr.3.ApplebyPN,ThorogoodM,MannJI,KeyTJ.TheOxfordVegetarianStudy:anAmJClinNutr.4.KeyTJ,FraserGE,ThorogoodM,etal.Mortalityinvegetariansandnonvegetar-ians:detailedfindingsfromacollaborativeanalysisof5prospectivestudies.JClinNutr.1999;70(suppl):516S-524S.5.SnowdenDA.Animalproductconsumptionandmortalitybecauseofallcausescombined,coronaryheartdisease,stroke,diabetes,andcancerinSeventh-dayAmJClinNutr.6.WillettWC.Convergenceofphilosophyandscience:theThirdInternationalCon-gressonVegetarianNutrition.AmJClinNutr.1999;70(suppl):434S-438S.7.AmericanDieteticAssociation.Vegetariandiets:positionofADA.JAmDiet8.JanelleKC,BarrSI.Nutrientintakesandeatingbehaviorscoresofvegetarianandnonvegetarianwomen.JAmDietAssoc.9.DwyerJT.Consequencesofvegetarianism.AnnuRevNutr.10.KelderSH,PerryCL,KleppK-I,LytleLA.Longitudinaltrackingofadolescentsmok-ingphysicalactivity,andfoodchoicebehaviors.AmJPublicHealth.11.PerryCL,StoryM,LytleLA.Promotinghealthydietarybehaviors.In:Weissberg WhatThisStudyAddsFewadolescentsmeetthedietaryguidelinesoftheHealthyPeople2010objectives.Priorresearchhasindicatedthatadolescentvegetariansmayeatmorefruitsandveg-etables,fewersweets,andfewersaltysnackfoodsthannonvegetarianpeers.Thepreviousstudiesofvegetar-ianswerelimitedintheirassessmentofdiet,smallsamplesofadolescents,andlackofrepresentationofmultiplera-cial/ethnicgroups.Thepresentstudyexaminesthedi-etarypatternsofadolescentvegetariansandcomparesthemwithnonvegetarianadolescentsandtheHealthyPeople2010objectives.Thestudyisperformedwithalarge,multiethnicpopulationinanurbanareaintheUp-perMidwest.AdolescentvegetariansweresignificantlymorelikelytomeettheHealthyPeople2010objectives,especiallyforfatintakeandfruitsandvegetables.Thissuggeststhatvegetarianismmayprovideahealthydi-etarypatternforadolescents,particularlyifitiswellplannedtoaddresspotentialdeficiencies. 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