Vegetarianism - healthy eating or fad diet?
A recent issue of the NutraIngredients newsletter summarized a strange-sounding article on vegetarianism and weight control behaviours among young people (1,2). About 2,500 youths, 15 to 23 years of age, were enrolled in a study, about 15% of whom were current or former vegetarians. Investigators compared the subjects′ dietary habits and body weight.
What they found was that the vegetarians in the group were less likely to be overweight or obese, but more likely to engage in "binge eating" or "extreme unhealthful weight-control behavior" (2). Interestingly, meat — the food group that sets vegetarians apart from non-vegetarians — wasn′t even mentioned in the abstract (2), which is all I read of the paper.
It turns out that this is not the first time that eating disorders in young vegetarians have been noted:
"Vegetarian diets are somewhat more common among adolescents with eating disorders than in the general adolescent population. … vegetarian diets may be selected to camouflage an existing eating disorder." (3)
I rather suspect that these young people tried a vegetarian diet to get their weight under control. The binge eating episodes presumably involved a perfectly vegetarian "food group" — sweets.
I have no interest in binge eating among vegetarians; the report simply made me look at what′s known about the comparative health benefits of vegetarian and non-vegetarian diets. I found three recent review articles on the topic, published in 2003 (3), 2006 (4), and 2008 (5), respectively. I only had access to the abstract of the 2008 paper.
All three review articles made the point that a vegetarian diet is healthy and suitable for all age groups, but that overall health outcomes are comparable in vegetarians and health-conscious non-vegetarians, with a couple of exceptions.
All three articles reported that vegetarians had a moderately lower death rate from ischemic heart disease than non-vegetarians. This was attributed (3) to lower blood cholesterol levels, which in turn could be due to lower dietary cholesterol and higher fiber intake; plant foods don′t contain cholesterol, and fiber reduces cholesterol absorption. Higher antioxidant consumption from fruits and vegetables is expected to reduce the rate of LDL-cholesterol oxidation, which would further lower the risk of atherosclerosis.
There was disagreement on the effect of a vegetarian diet on death rates from cancer. It was generally agreed that the death rates from most cancers were comparable between vegetarians and non-vegetarians, but the 2003 review reported significantly lower prostate and colon cancer rates in vegetarians. The lower colon cancer rates were attributed to greater fiber intake, lower concentrations of potentially carcinogenic bile acids and fewer intestinal bacteria.
Interestingly, an analysis of a recently completed large-scale prospective study involving more than 60,000 men and women in the U.K (6) found higher colorectal cancer rates in vegetarians than in non-vegetarians; all other cancer rates were somewhat lower among the vegetarians. The authors point out that cancer rates in both the vegetarians and non-vegetarians they studied were below national averages (6).
The reviews (3-5) also noted lower obesity rates, cholesterol levels, blood pressure and saturated fat intake among vegetarians, as well as higher antioxidant, fiber, and phytonutrient consumption.
There is of course no question that fruits and vegetables are an important part of a healthy diet. The question is though whether the health benefits of vegetarianism are due to greater fruit and vegetable consumption or to the avoidance of meat. I tend to agree with the author of the 2008 review:
"Very probably, an ample consumption of fruits and vegetables and not the exclusion of meat make vegetarians healthful. … Vegetarianism is a form of food restriction; and in our overfed society, food restriction is a plus unless it results in a nutritional deficiency “ (5).
Sources:
What they found was that the vegetarians in the group were less likely to be overweight or obese, but more likely to engage in "binge eating" or "extreme unhealthful weight-control behavior" (2). Interestingly, meat — the food group that sets vegetarians apart from non-vegetarians — wasn′t even mentioned in the abstract (2), which is all I read of the paper.
It turns out that this is not the first time that eating disorders in young vegetarians have been noted:
"Vegetarian diets are somewhat more common among adolescents with eating disorders than in the general adolescent population. … vegetarian diets may be selected to camouflage an existing eating disorder." (3)
I rather suspect that these young people tried a vegetarian diet to get their weight under control. The binge eating episodes presumably involved a perfectly vegetarian "food group" — sweets.
I have no interest in binge eating among vegetarians; the report simply made me look at what′s known about the comparative health benefits of vegetarian and non-vegetarian diets. I found three recent review articles on the topic, published in 2003 (3), 2006 (4), and 2008 (5), respectively. I only had access to the abstract of the 2008 paper.
All three review articles made the point that a vegetarian diet is healthy and suitable for all age groups, but that overall health outcomes are comparable in vegetarians and health-conscious non-vegetarians, with a couple of exceptions.
All three articles reported that vegetarians had a moderately lower death rate from ischemic heart disease than non-vegetarians. This was attributed (3) to lower blood cholesterol levels, which in turn could be due to lower dietary cholesterol and higher fiber intake; plant foods don′t contain cholesterol, and fiber reduces cholesterol absorption. Higher antioxidant consumption from fruits and vegetables is expected to reduce the rate of LDL-cholesterol oxidation, which would further lower the risk of atherosclerosis.
There was disagreement on the effect of a vegetarian diet on death rates from cancer. It was generally agreed that the death rates from most cancers were comparable between vegetarians and non-vegetarians, but the 2003 review reported significantly lower prostate and colon cancer rates in vegetarians. The lower colon cancer rates were attributed to greater fiber intake, lower concentrations of potentially carcinogenic bile acids and fewer intestinal bacteria.
Interestingly, an analysis of a recently completed large-scale prospective study involving more than 60,000 men and women in the U.K (6) found higher colorectal cancer rates in vegetarians than in non-vegetarians; all other cancer rates were somewhat lower among the vegetarians. The authors point out that cancer rates in both the vegetarians and non-vegetarians they studied were below national averages (6).
The reviews (3-5) also noted lower obesity rates, cholesterol levels, blood pressure and saturated fat intake among vegetarians, as well as higher antioxidant, fiber, and phytonutrient consumption.
There is of course no question that fruits and vegetables are an important part of a healthy diet. The question is though whether the health benefits of vegetarianism are due to greater fruit and vegetable consumption or to the avoidance of meat. I tend to agree with the author of the 2008 review:
"Very probably, an ample consumption of fruits and vegetables and not the exclusion of meat make vegetarians healthful. … Vegetarianism is a form of food restriction; and in our overfed society, food restriction is a plus unless it results in a nutritional deficiency “ (5).
Sources:
- Benefits and detriments of vegetarian diets may not balance out: Report. NutraIngredients-usa.com Apr 1, 2009.
[Full Text] - Robinson-O′Brien R et al. Adolescent and young adult vegetarianism: Better dietary intake and weight outcomes but increased risk of disordered eating behaviors. J Am Diet Assoc 2009;109:648-655.
[Abstract] - Position of the American Dietetic Association and Dietitians of Canada: Vegetarian diets. J Am Diet Assoc 2003;103:748-765.
[Full Text] - Key TJ, Appleby PN, Rosell MS. Health effects of vegetarian and vegan diets. Proc Nutr Soc 2006;65:35-41.
[Full Text] - Ginter E. Vegetarian diets, chronic diseases and longevity. Bratisl Lek Listy 2008;109:463-466.
[Abstract] - 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;.
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