Interview With an Ex-Adventist: Ronald L. Numbers

Ronald L. Numbers is Hilldale Professor of the History of Science and Medicine and of Religious Studies, and a member of the department of medical history and bioethics at the University of Wisconsin-Madison, where he has taught for over three and a half decades. He has written or edited more than two dozen books, including, most recently, Galileo Goes to Jail and Other Myths about Science and Religion (Harvard, 2009), Biology and Ideology from Descartes to Dawkins (Chicago, 2010), edited with Denis Alexander, and the recently published Science and Religion around the World (Oxford, 2011), edited with John Hedley Brooke. He is a past president of the History of Science Society, the American Society of Church History, and the International Union of History and Philosophy of Science.

Numbers is also the author of Prophetess of Health: Ellen G. White and the Origins of Seventh-day Adventist Health Reform, a book that arguably did for Seventh-day Adventism what No Man Knows My History did for Mormonism. (In other words, it’s not at the top of most Adventist reading lists.) Revealing Adventism co-founder Ellen White’s talent for plagiarizing the health reformers of her time and casting doubt upon the divine nature of her prophetic visions got Numbers fired from Loma Linda University, the Adventist stronghold in California, but it also got him this interview with me. So perhaps it was for the best.

Vegetarian Adventist dietitians have had a big influence on the American Dietetic Association’s position paper on a vegetarian diet since 1988, when the ADA started endorsing vegetarianism. Not all Adventists are vegetarian — some estimates have it around 50 percent, and Numbers has seen estimates as low as 10 percent — but most Adventists believe that God told Ellen White in a vision that vegetarianism, and maybe even near-veganism, is the proper diet for mankind. Could this be in the back of Adventist researchers’ minds as they conduct studies proving the superiority of a vegetarian diet? You can probably guess what I think, but I’m an outsider on this issue and I wanted to hear what a former Adventist scholar had to say about it.

Were you raised as a vegetarian Adventist?

Yes. I’m a fourth-generation Adventist. My maternal grandfather was president of the international church. And all my male relatives are ministers, or were ministers, both grandfathers, father, uncles on both sides of my family, brother-in-law, my nephew. I went from first grade through college in Adventist schools. So I was thoroughly integrated into the Adventist church.  

Adventism is not the only religion with dietary guidelines. But Mormons don’t care if gentiles drink caffeine and Jews don’t care if gentiles eat treif. Yet it seems to me that Adventists want to spread vegetarianism even outside the bounds of their religion. Is that a correct impression?

Well I’ve got to say that if that were a goal of theirs, they haven’t done very well. Adventists tend to be very insular. And other groups have taken over and promoted vegetarianism and vegetarian meat substitutes more than the Adventists have. By and large, the Adventists are out to convert to world to Adventism, but not to vegetarianism. Keep in mind, I don’t know if as many as 10 percent of Adventists are vegetarians. You know about the theology?  

Which aspect?

So if you’re an Adventist, you’re encouraged not to eat meat. But you can still be saved if you eat clean meat and fish — fish, if they have fins and scales, and mammals that chew their cud and have cloven hooves. It’s the Old Testament Levitical rules.

Now, the only penalty for eating clean meat is that you cannot be translated, which is a term they use for going to heaven without seeing death. So if you eat meat, clean meat, you can be saved but you’ll have to die. If you don’t eat any meat, then you have the privilege of living through the worst period in the history of the earth, “the time of troubles.” I’ve been thinking of setting up workshops encouraging all Adventists to eat one bite of meat so that they die before the time of troubles. That’s a joke.

I, however, have not eaten any meat, even though I left Adventism decades ago. It’s because of psychopathology now. I just think of dead animals. I’m not principled at all.

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--Tagged under: American Dietetic Association--

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--Tagged under: SeventhDay Adventists--

Movie Review: Forks Over Knives

Let’s start with an excerpt from the Web site for “Forks Over Knives”:

Brian Wendel [the producer of “Forks Over Knives”] had a long-time interest in nutrition and health. In the summer of 2008, he read The China Study by T. Colin Campbell and realized that the scientific case that a whole foods plant-based diet could prevent—and even reverse—disease was greater than he had ever imagined. This concept deserved a “seat at the table” in the national discussion. Brian decided the most effective way to bring this message to a broad audience was by feature film. … Brian has worked in real estate for almost 15 years, and is a partner in an investment and management firm. FORKS OVER KNIVES is his furst feature film. [Typo added by me.]

Want a seat at this table? Read on.

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--Tagged under: Vegan Leaders--

--Tagged under: American Dietetic Association--

“Even the Conservative American Dietetic Association Supports Veganism.” Or Does It?

There are three sources vegans tend to cite to prove that veganism is a healthy diet: The American Dietetic Association (which they often refer to as “the conservative ADA” to boost its credibility), The China Study and the Adventist Health Studies. However, “the conservative ADA” seems to be the vegan favorite:

Ryan M: Women can be perfectly healthy on a vegan diet throughout pregnancy and during nursing, as even the conservative ADA has said. Thanks for sharing your story, but you can hang onto the advice.

Vegan Street: By the way, the conservative ADA has acknowledged for years that it is possible to be healthy on a plant-based diet.

NYCVeg: To be honest, I’m a little concerned that your midwife seems so ignorant about vegetarian diets. Even the notoriously conservative ADA says that vegetarian (and vegan) diets are healthy for all stages of life, including pregnancy.

Kathy Freston: Even the very conservative ADA (American Dietetic Association) says:

Vegetarian diets are often associated with a number of health advantages, including lower blood cholesterol levels, lower risk of heart disease, lower blood pressure levels, and lower risk of hypertension and type 2 diabetes. Vegetarians tend to have a lower body mass index (BMI) .. and lower overall cancer rates.

Spartacus: Even the pretty conservative ADA (American Dietetic Association) has the following to say about this:

It is the position of the American Dietetic Association that appropriately planned vegetarian diets, including total vegetarian or vegan diets, are healthful, nutritionally adequate, and may provide health benefits in the prevention and treatment of certain diseases. Well-planned vegetarian diets are appropriate for individuals during all stages of the life cycle, including pregnancy, lactation, infancy, childhood, and adolescence, and for athletes.

Alan Benedict: Readers interested in an objective assessment of the facts by an authoritative source need only review the well documented position of the nutritionally conservative American Dietetic Association…

Alex: Your argument has been refuted by the conservative American Dietetic Association (ADA), arguing, as it does, that veganism is healthy at all stages of the life cycle.

Virginia Messina [co-author of the 1997 and 2003 ADA position papers on a vegetarian diet, as well as a reviewer for the 1993 and 2009 vegetarian position papers]: It’s a safe bet that Angelina didn’t understand healthful vegan eating, though. After all, even the conservative American Dietetic Association says that a vegan diet is safe and healthful.

It’s true that the American Dietetic Association has published positive position papers on vegetarianism since 1988, shortly after the formation of the Vegetarian Nutrition Dietetic Practice Group, which has been in charge of the ADA’s vegetarian position papers since that time. Yet despite the cohesive image the ADA likes to present of its members, there seems to be a slight schism between what the Vegetarian Nutrition Dietetic Practice Group members (most of whom are vegetarians or vegans themselves) think of a vegan diet, and what the other “conservative” ADA members think.

Here are a few quotes from non-vegan ADA spokespeople who seem less enthusiastic about veganism than they are supposed to be:

Keri Gans

(NY Daily News):

“You can meet a child’s nutritional needs with a vegan diet, but it is very difficult,” says Keri Gans, RD, MS, CDN, spokeswoman for the American Dietetic Association. “When you take away dairy food, you have to worry about how the child will get calcium and vitamin D.”

And while it’s possible to ensure that a child gets these nutrients from other sources, it’s hard - unless your kid absolutely loves vegetables. To get the calcium in one cup of milk, a child would need to consume four cups of broccoli, Gans points out.

Another risk with a vegan diet is that a child may not get enough protein - or at least the complete protein that is offered by meat and dairy products.

Non-meat protein sources don’t necessarily have all the amino acids, pediatric dietitian Helen Wilcock, a member of the British Dietetic Association, told The Guardian.

“If a child eats meat or fish, it’s easy to get all the right amino acids,” she says. “But if a child is getting protein from pulses [beans], the problem is that one type of bean might not provide every amino acid, so there has to be a good balance of pulses.” A kid who eats meat gets all the amino acids, she notes, but a kid who consumes just one type of bean will not.

Other nutritional deficiencies that can crop up with a vegan diet include not getting enough iron or omega 3s, Gans points out. Those omega 3s are essential for cardiovascular health as well as brain development, she says.

While a vegan diet can work for an adult, a child’s growing body requires many nutrients if he or she is to thrive, Gans says. “If the family knows what they are doing, works with a professional and gets the proper supplements, the needs could be met,” she says.

In general, kids on vegan diets tend to be a little smaller than other kids. Part of the problem with feeding them stems from the fact that a lot of the foods they eat just are not that calorie-dense, so they need to eat a lot in order to get enough calories.

A PR rep from The American Dietetic Association disowned Gans’ statements here, saying they were taken out of context. I emailed the reporter of this article to see if she had a transcript of their conversation, but she didn’t respond. Judging from other Keri Gans quotes and paraphrases in the media, though, the above seems close enough to her true views:

(ABC News):

But as American Dietetic Association spokeswoman Keri Gans noted, vegetarianism must be done right to reap the benefits. … Specifically, vegetarians must find sources other than meat for protein. Those who opt to go vegan must be even more vigilant when it comes to finding substitutes for other nutrients, such as the calcium that they might otherwise get from dairy products.

(USA Today):

“A lot of individuals are interested in trying [veganism],” says Keri Gans, a registered dietitian in New York City and spokeswoman for the American Dietetic Association (ADA). “Unfortunately, they don’t all do the necessary research that can make it a healthy choice.”

Gans says some under-informed newbie vegans end up just plain hungry, attempting to subsist on salads and soy milk. Others “end up gaining weight because they eat too many carbohydrates from pasta and rice or too many fatty nuts and seeds,” says Tara Gidus, a registered dietitian in Orlando, who also is an ADA spokeswoman.

Dawn Jackson Blatner

(CBS News):

“A vegan lifestyle can be healthy, but it takes more planning than most other types of diets to ensure no deficiencies, especially of protein, iron, zinc, calcium, Vitamin-D, B12 and omega-three fatty acids,” said Blatner, who is also a spokeswoman for the American Dietetic Association.

(The Seattle Times):

Dawn Jackson Blatner, a spokeswoman for the American Dietetic Association, approves of the vegan-before-6 idea. But like full-time vegans and vegetarians, part-timers need to be aware of getting enough of certain nutrients, she says. Among these are Vitamin B12 (found mostly in meats), protein, iron and zinc (all of which are in beans), calcium and vitamin D (mostly in dairy products, and in fortified soy and almond milks), and omega-3 fats (in fish, flax seed and walnuts).

Blatner also cautions that while Bittman lost weight through his new way of eating, it’s easy for vegans and vegetarians to consume too many calories. “You can do it wrong,” she says. “You could overeat olive oil, nuts and seeds, or over-portion peanut butter, so you’d eat too many calories.”

(WebMD):

Blatner thinks [vegan] dieters would benefit from having nutrition information and a nutrient analysis of recipes and meals, because vegetarian diets can be lacking in protein, iron, zinc, calcium, vitamin D, riboflavin, vitamin B12, omega 3 fatty acids, and iodine.

Dave Grotto

(Park City Daily News):

“With tenacity and proper planning, a vegan diet can meet the needs of 10-year-olds,” said registered dietitian Dave Grotto, a spokesman for the American Dietetic Association. … The most common potential problems for vegetarians include a reduced intake of iron, calcium and vitamin B-12. Grotto, who advocates plant-based foods but doesn’t believe vegan diets are optimal for children because they require constant monitoring, recommends taking a multivitamin that contains iron and zinc as a safety net. But even this is tricky because certain compounds can decrease iron and zinc absorption.

Jackie Newgent

(The Day):

“This is particularly a problem among teen vegetarians,” says dietitian Jackie Newgent, a New York spokeswoman for the American Dietetic Association, because teenagers require more calcium and iron than adults do.

“It’s possible to still get these nutrients from vegetarian sources-you can drink calcium fortified orange juice and include legumes, dark, leafy greens and iron-fortiried cereals and breads in your diet. But you need to plan your diet properly in order to get these essential vitamins and minerals.”

Shareen Marshall

(St. Paul Business Journal):

Shareen Marshall, a dietitian at St. Louis Park-based Park Nicollet Health Services [and a member of the American Dietetic Association], said vegetarian diets may be healthy. But the diets, especially vegan diets, can also be difficult, with a great deal of attention needed to prevent lack of protein, calcium, vitamin D, iron and vitamin B-12.

“You could be at risk for not having all your nutrients,” Marshall said.

Lona Sandon

(Dallas Morning News):

Lona Sandon, a registered dietitian at UT Southwestern Medical Center and a spokeswoman for the American Dietetic Association, confirmed that plant-based diets, including Mediterranean and vegetarian ones, can provide health benefits.

She cautioned that strict vegan diets often come up short on vitamin D, calcium, zinc, iron and protein, in addition to B vitamins. A vegan diet typically is much higher in fiber than people are accustomed to, which can interfere with iron absorption and can initially cause gastrointestinal distress, she said.

“It can be a healthy diet in terms of fighting heart disease,” Sandon says. “But it comes with its own pitfalls with vitamin and mineral deficiencies that people need to be careful about. You don’t have to go to extremes to have a healthy heart.”

--Tagged under: American Dietetic Association--

--Tagged under: Health--

--Tagged under: Vegan Cliches--

Myth: The American Dietetic Association Knows What it’s Talking About

I was browsing the American Dietetic Association’s site and saw this odd document called “Vegetarian Eating: Fact vs. Fiction” (PDF).

No doubt this is from the Vegetarian Nutrition Dietetic Practice Group, the official pro-vegetarian wing of the ADA (although all of the ADA supposedly agrees). But a couple of these “Myth” and “Fact” comparisons are surprising, even coming from the ADA’s veg*an contingent: 

Myth: Vegetarianism is just a fad that will pass in a few years.

Fact: Most people throughout world history have eaten a largely vegetarian diet. Relatively recently, in Europe and North America, where meat and animal products have become affordable, diets centered around meats have become widespread. In other parts of the world, plant-based diets remain more common.

Which is why it’s so easy to travel as a vegan. Meat is a relatively new thing? What is their source for this? The freaking China Study? 

Myth: A vegetarian diet is too strict and limiting. It would be too hard to follow.

Fact: There are many different types of vegetarian diets. A lacto-ovo vegetarian avoids meat, fish and poultry but may eat eggs and dairy products. A lacto-vegetarian will avoid meat, fish, and poultry but will eat milk, cheese and dairy. They will avoid eggs or derivatives of eggs. Vegans are strict vegetarians who avoid all animal products.

That one is more awkward than anything else, and a bit of a non-sequitur on a site that is supposedly all about nutrition and not preaching a veggie lifestyle. (Why does the ADA feel compelled to insist that vegetarianism isn’t difficult? Working with people who have chosen vegetarianism is different than trying to talk them into it.) But after including “vegan” under the definition of “vegetarian,” they go on to say…

Myth: Vegetarians need to take vitamin or mineral supplements.

Fact: Most healthy vegetarians don’t need to take supplements although there may be exceptions. Someone switching to a vegetarian diet should meet with a registered dietitian to be sure that all necessary vitamins and minerals are being consumed from food sources.

Vegetarians (and vegans?) don’t need to supplement? What is the ADA trying accomplish with this? Are they more concerned with educating us on adequate nutrition or with spreading vegetarianism? They don’t even want to mention B12 in case any non-supplementing vegans are reading this for validation?  

Apparently these sorts of articles do have an effect, judging by a letter published in the ADA’s Vegetarian Nutrition Update:

I have just recently decided to become a vegan-I am also a Registered Dietitian. I work in an outpatient hospital setting doing education in a cardiac rehab program and I am working on building a private practice. I have been overwhelmed with the plethora of acceptable research on the health benefits of vegan diets-especially T. Colin Campbell’s The China Study and the information on this ADA [Vegetarian Nutrition Dietetic Practice Group’s] web site. … I am getting so much resistance from clients to even listen to or read the compelling information on the health benefits of a milk- and meat-free diet. I don’t want to be pushy but I want them to be well informed as well. 

--Tagged under: Health--

--Tagged under: American Dietetic Association--

Veg*an Leaders: Winston J. Craig

WinstonCraigVideo

Dr. Winston Craig, MPH, PhD, RD.

Claim to Fame: Co-author of the American Dietetic Association’s 2009 position paper on a vegetarian diet.

Education: Master in Public Health in Nutrition at Loma Linda University, a Seventh-day Adventist university in California that promotes a vegetarian diet.

Profession: Nutrition chair and professor at Andrews University, a Seventh-day Adventist university in Michigan that promotes a vegetarian diet.

Employer’s Mission: “The mission of the Nutrition Department of Andrews University is to prepare dietetic and nutrition professionals for service in church, society, and the world and to influence the community-at large to affirm the Seventh-day Adventist lifestyle, including the vegetarian diet.”

Previous Employment: Chemistry instructor at Kingsway College, a Seventh-day Adventist boarding school in Ontario (1974 - 1976). Assistant professor in Chemistry and Health Science at Adventist College of West Africa (1976 - 1979). Assistant/Associate Prof. in Nutrition at Loma Linda University (1979 - 1984).

Religion: Catholic. Just kidding. Seventh-day Adventist.

Winston "The Mustache" Craig

Likes: Seventh-day Adventist prophet Ellen G. White, plant-based diets, herb.

Dislikes: Mustard, intemperance, animal flesh.

Most Trusted Nutrition Resources: Prophet Ellen G. White, cereal and enema kingpin John Harvey Kellogg, and God.

Prophetess of HealthJohn Harvey KelloggGod

Accent: Aussi.

Most Popular Books and Articles: Some Valuable Things I Learnt About Nutrition and Health from Ellen WhiteThe Use and Safety of Common Herbs and Herbal TeasThe Top Ten For Good Health!Dietary FatRaw Foods Diet and Vegetarian Meat Substitutes.

Quotes: “Did you know the Bible describes the best foods for our bodies in Genesis 1:29 and 3:18?”

“The total elimination of oil or visible fat from the diet cannot be supported from science, the Bible, or the writings of Ellen G. White.”

Winston Craig

“Temperance in all things is necessary for health and the development of a balanced Christian character (Ellen G. White, Counsels on Health, p. 38). In today’s world, we are continually tempted to excesses or to extremes. Being self-controlled includes restraining ourselves from extremes. Self-control is listed as part of the fruit of the Spirit (Gal. 5:22) and is essential for living an effective and productive Christian life (2 Peter 1:6).”

“The original diet given to humans in Genesis One is a plant-based diet. After the permission to eat flesh food the longevity of people was greatly shortened.”

WinstonCraigVideo2

“Sylvester Graham in 1839 wrote that humans would never suffer illness if they ate only uncooked foods. His ideas on a raw food diet were not endorsed by other health reformers of that time, such as John Harvey Kellogg and Ellen White. Dr Kellogg wrote that he could not endorse the extravagant and unsubstantiated claims made by the promoters of the raw food fad. Ellen White also did not recommend that we eat only a raw food diet. … Ellen White clearly promoted the importance of cooking or baking legumes, grains, potatoes and other starchy foods.”

Winston Craig

Controversies: Winston Craig occasionally quotes himself as a source in his own articles. His most common “source” is the General Conference Nutrition Council, a Seventh-day Adventist group with a logo modeled off the United Nations flag. When Craig cites them as a source, he is actually citing his own articles that are published anonymously on that site. Craig even references the General Conference Nutrition Council (himself) in his ADA position paper on a vegetarian diet. After all, when you quote yourself, you’re quoting the most reliable person you know.

General Conference Nutrition Council LogoUnited Nations Flag

Hobbies: Wildlife photography, travel, hiking, birding and growing herb.

Unusual beliefs: God put mustard on this planet to test our faith.*

Celebrity Doppelganger: Andy Stitzer from 40 Year-Old Virgin.

CraigWinston Craig Doppleganger

Related Reading: Did Ellen G. White have brain damage?

* He doesn’t say this specifically, but if humans shouldn’t eat mustard, why else would God have put it here?

--Tagged under: American Dietetic Association--

--Tagged under: Health--

--Tagged under: Vegan Leaders--

--Tagged under: SeventhDay Adventists--

Other ADA Position Papers Gang Up on Veganism

In case it weren’t enough for the ADA to bash veganism within an inch of its life in its position paper on vegetarianism, even their position papers that have nothing to do with veganism take gratuitous swipes at the compassionate diet. To be even bigger assholes about it, the ADA bolded all instances of non-vegan food recommendations, really hammering it home: “We do not consider a vegan diet to be nutritionally adequate for any stage of life.” Okay, jeez, we get it!

Nutrition and Lifestyle for a Healthy Pregnancy Outcome

If a woman has iron-deficiency anemia when she becomes pregnant, repleting her iron stores during pregnancy may be difficult. Therefore, women of childbearing age are advised to eat foods high in heme iron [only in animal products]

Pregnant women should consume a variety of foods

Women who avoid dairy products and rely instead on calcium-fortified orange juice or other fortified foods may have lower intakes of vitamin D and magnesium than milk consumers.

Nutrition Guidance For Children Aged 2 - 11 Years

Failure to meet calcium requirements in combination with a sedentary lifestyle in childhood can impede the achievement of maximal skeletal growth and bone mineralization, thereby increasing the diet-related risk of developing osteoporosis later in life.

Consumption of sweetened dairy products was positively associated with calcium intakes for children.

Children 2 to 8 years should consume 2 cups per day fat-free or low-fat milk or equivalent milk products. Children 9 years of age and older should consume 3 cups per day fat-free or lowfat milk or equivalent milk products.

Keep total fat intake between 30% to 35% of calories for children 2 to 3 years of age and between 25% to 35% of calories for children 4 to 18 years of age, with most fats coming from sources of polyunsaturated and monounsaturated fatty acids, such as fish, poultry, lean meats, nuts, and vegetable oils.

Dietary Fatty Acids

ADA and DC recommend a food-based approach for achieving these fatty acid recommendations; that is, a dietary pattern high in fruits and vegetables, whole grains, legumes, nuts and seeds, lean protein (ie, lean meats, poultry, and low-fat dairy products), fish (especially fatty fish high in n-3 fatty acids), and use of nonhydrogenated margarines and oils.

Fish and seafood, particularly fatty fish such as mackerel, herring, salmon, tuna, and trout, as well as oysters, are the richest dietary sources of the n-3 longer carbon chain PUFA, EPA, and DHA.

For primary prevention of coronary heart disease (CHD), the US Dietary Guidelines Advisory Committee, AHA, the National Heart Foundation of Australia, and the United Kingdom Scientific Advisory Committee all recommend two servings of fish per week, preferably fatty fish, providing about 450 to 500 mg EPA and DHA per day.

The National Health and Medical Research Council (2006) Nutrient Reference Values for Australia and New Zealand recommend 610 mg/day [of fish] for men and 430 mg/day [of fish] for women for chronic disease risk reduction. The National Academies recently recommended that adolescent males, adult males, and females who will not become pregnant, as well as adult males and females who are at risk of CVD consume two 3-oz servings of fish per week. The report acknowledged that females who are or may become pregnant or who are breastfeeding, and children up to age 12 may benefit from consuming two 3-oz servings of seafood, especially those with higher concentrations of EPA and DHA.


ADA and DC consider that n-3 PUFA from fish are an important part of a healthful diet, and recommend two servings per week, preferably fatty fish. Approximately 8 oz of cooked fish per week provides about 500 mg/day EPA and DHA. For vegans who do not consume any preformed sources of EPA and DHA, additional research is needed before recommendations can be made for these fatty acids, including supplements.

Up to 12 oz per week of low-mercury fish are recommended, such as shrimp, canned light tuna, salmon, pollock, and catfish.

Other recent meta-analyses reported that five or more servings of fish per week was associated with a lower CHD mortality and a lower incidence of stroke when compared with no fish or fish less than once per month. A recent systematic review of the literature of primary and secondary prevention studies with 1 year duration with fish or fish oils also reported reduced rates of all-cause mortality, cardiac and sudden death, and possibly stroke. Epidemiologic studies have reported that high fish intakes are associated with a reduced risk of breast and colorectal cancer, which is consistent with evidence that EPA and DHA may reduce markers of colorectal cancer and reduce expression of genes involved in colorectal cancer cell growth.

In the Zutphen Elderly Study, individuals who consumed fish had considerably less 5-year cognitive decline than nonconsumers.

The Avon Longitudinal Study of Parents and Children reported that the verbal intelligence quotients were higher among children 6 months to 8 years of age of mothers who consumed more than 349 g seafood per week during pregnancy than among children of mothers who reported no seafood consumption.

Weight Management

In order to meet current nutritional recommendations, incorporate 3-4 servings of low-fat dairy foods a day as part of the diet component of a comprehensive weight management program. Research suggests that calcium intake lower than the recommended level is associated with increased body weight.

Total Diet Approach

Soybeans have n-3 fatty acids, flavonoids, and phytoestrogens with health-promoting properties (?!?!), but soy also contains phytates that diminish absorption of zinc and iron and the health benefits of adding soy to the diet have not been consistently supported by research. For example, animal studies in which soy intake was higher than that found in Asian diets found an increase in tumor growth.

The increased risks for cardiovascular disease associated with ingestion of trans fat produced during processing of foods might lead to the classification of all trans fat as bad. However, a type of trans fat that occurs naturally from ruminant animal sources (dairy and meat), conjugated linoleic acid, has far different effects on metabolic function, genetic regulation, and physiological outcomes. In contrast to the atherogenic nature of most synthetic forms of trans fat, conjugated linoleic acid has been shown to have beneficial effects on cardiovascular disease, diabetes, immune response, energy distribution, and growth.

Health Implications of Dietary Fiber

Case histories have reported diarrhea when excessive amounts of dietary fiber are consumed.

Potential negative effects of excessive dietary fiber include reduced absorption of vitamins, minerals, proteins, and energy.

Fiber is just one low-digestible carbohydrate. Sugar alcohols and resistant starch are also poorly digested and absorbed. Thus, all of these poorly digested carbohydrates may cause diarrhea and other gastrointestinal symptoms such as flatulence, bloating, and abdominal discomfort.

Fermentation of dietary fiber or other nondigested carbohydrates by anaerobic bacteria in the large intestine produces gas, including hydrogen, methane, and carbon dioxide, which may be related to complaints of distention or flatulence.

Nutrient Supplementation

Among the groups most vulnerable to inadequacy of one or more nutrients are older adults; pregnant women; people who are food insecure (ie, they are, “at times, uncertain of having, or unable to acquire, enough food for all household members because they had insufficient money and other resources for food”); alcohol-dependent individuals; strict vegetarians and vegans; and those with increased needs due to a health condition or the chronic use of a medication that decreases nutrient absorption or increases metabolism or excretion.

Functional Foods

For intestinal health maintenance, fermented dairy products (probiotics) may improve irritable bowel syndrome;

--Tagged under: Health--

--Tagged under: American Dietetic Association--

Bad News For Vegans in the ADA’s Position Paper on Vegetarian Diets

I finally got around to reading the American Dietitian Association’s 2009 position paper on vegetarian and vegan diets. Wow, a lot of bad news for veg*ans, especially those of the non-asterisked persuasion.

But I wouldn’t worry too much about it. Based on the multiple pleas for vegans and vegetarians to seek professional nutritional counseling, I figure this position paper is just one big scare tactic to drum up business for dietitians.

For anyone who hasn’t read the whole thing, here are the highlights:

The variability of dietary practices among vegetarians makes individual assessment of dietary adequacy essential. In addition to assessing dietary adequacy, food and nutrition professionals can also play key roles in educating vegetarians about sources of specific nutrients, food purchase and preparation, and dietary modifications to meet their needs.
(p. 1266)

Vegans and some other vegetarians may have lower intakes of vitamin B-12, calcium, vitamin D, zinc, and long-chain n-3 fatty acids.
(p. 1267)

Studies have found that although isolated soy protein can meet protein needs as effectively as animal protein, wheat protein eaten alone, for example, may result in a reduced efficiency of nitrogen utilization. Thus, estimates of protein requirements of vegans may vary, depending to some degree on dietary choices. Food and nutrition professionals should be aware that protein needs might be somewhat higher than the Recommended Dietary Allowance in those vegetarians whose dietary protein sources are mainly those that are less well digested, such as some cereals and legumes.

Cereals tend to be low in lysine, an essential amino acid. This may be relevant when evaluating diets of individuals who do not consume animal protein sources…

Because of lower bioavailability of iron from a vegetarian diet, the recommended iron intakes for vegetarians are 1.8 times those of nonvegetarians.

Whereas vegetarian diets are generally rich in n-6 fatty acids, they may be marginal in n-3 fatty acids. Diets that do not include fish, eggs, or generous amounts of algae generally are low in eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), fatty acids important for cardiovascular health as well as eye and brain development. The bioconversion of alpha-linolenic acid (ALA), a plant-based n-3 fatty acid, to EPA is generally less than 10% in humans; conversion of ALA to DHA is substantially less. Vegetarians, and particularly vegans, tend to have lower blood levels of EPA and DHA than nonvegetarians.

The Dietary Reference Intakes recommend intakes of 1.6 and 1.1 g ALA per day, for men and women, respectively. These recommendations may not be optimal for vegetarians who consume little if any DHA and EPA and thus may need additional ALA for conversion to DHA and EPA.

The iron in plant foods is nonheme iron, which is sensitive to both inhibitors and enhancers of iron absorption. Inhibitors of iron absorption include phytates, calcium, and the polyphenolics in tea, coffee, herb teas, and cocoa.

The bioavailability of zinc from vegetarian diets is lower than from nonvegetarian diets, mainly due to the higher phytic acid content of vegetarian diets. Thus, zinc requirements for some vegetarians whose diets consist mainly of phytate-rich unrefined grains and legumes may exceed the Recommended Dietary Allowance. Zinc intakes of vegetarians vary with some research showing zinc intakes near recommendations and other research finding zinc intakes of vegetarians significantly below recommendations.
(p. 1268)

Foods such as soybeans, cruciferous vegetables, and sweet potatoes contain natural goitrogens. These foods have not been associated with thyroid insufficiency in healthy people provided iodine intake is adequate.

Some studies suggest that vegans who do not consume key sources of iodine, such as iodized salt or sea vegetables, may be at risk for iodine deficiency, because plant-based diets are typically low in iodine. Sea salt and kosher salt are generally not iodized nor are salty seasonings such as tamari.
(p. 1268 - 1269)

Calcium intakes of lacto-ovo-vegetarians are similar to, or higher than, those of nonvegetarians, whereas intakes of vegans tend to be lower than both groups and may fall below recommended intakes. In the Oxford component of the European Prospective Investigation into Cancer and Nutrition (EPIC-Oxford) study, the risk of bone fracture was similar for lacto-ovo-vegetarians and meat eaters, whereas vegans had a 30% higher risk of fracture possibly due to their considerably lower mean calcium intake.

In addition, some studies show that the ratio of dietary calcium to protein is a better predictor of bone health than calcium intake alone. Typically, this ratio is high in lacto ovo-vegetarian diets and favors bone health, whereas vegans have a ratio of calcium to protein that is similar to or lower than that of nonvegetarians.

The bioavailability of calcium from soy milk fortified with calcium carbonate is equivalent to cow’s milk although limited research has shown that calcium availability is substantially less when tricalcium phosphate is used to fortify the soy beverage.

Oxalates in some foods, such as spinach and Swiss chard, greatly reduce calcium absorption, making these vegetables a poor source of usable calcium. Foods rich in phytate may also inhibit calcium absorption.

Low vitamin D intakes, low serum 25-hydroxyvitamin D levels, and reduced bone mass have been reported in some vegan and macrobiotic groups who did not use vitamin D supplements or fortified foods.

The vitamin B-12 status of some vegetarians is less than adequate due to not regularly consuming reliable sources of vitamin B-12. Lacto-ovo-vegetarians can obtain adequate vitamin B-12 from dairy foods, eggs, or other reliable vitamin B-12 sources (fortified foods and supplements), if regularly consumed. For vegans, vitamin B-12 must be obtained from regular use of vitamin B-12-fortified foods, such as fortified soy and rice beverages, some breakfast cereals and meat analogs, or Red Star Vegetarian Support Formula nutritional yeast; otherwise a daily vitamin B-12 supplement is needed. No unfortified plant food contains any significant amount of active vitamin B-12. Fermented soy products cannot be considered a reliable source of active B-12.

Vegetarian diets are typically rich in folacin, which may mask the hematological symptoms of vitamin B-12 deficiency, so that vitamin B-12 deficiency may go undetected until after neurological signs and symptoms may be manifest.
(p. 1269)

Pregnant vegetarians receive statistically lower levels of protein than pregnant nonvegetarians; and pregnant vegetarians receive statistically higher levels of carbohydrates than pregnant nonvegetarians.

No research was identified that focused on macronutrient intakes among pregnant vegans.

Key nutrients in pregnancy include vitamin B-12, vitamin D, iron, and folate whereas key nutrients in lactation include vitamin B-12, vitamin D, calcium, and zinc.

The following micronutrients had lower intake among vegetarians than nonvegetarians: Vitamin B-12; vitamin C; calcium; and zinc.

In addition, one study reported that lower B-12 levels are more likely to be associated with high serum total homocysteine in lacto-ovo-vegetarians than low meat eaters or omnivores. Whereas zinc levels were not significantly different between nonveganvegetarians and nonvegetarians, vegetarians who have a high intake of calcium may be at risk for zinc deficiency (because of the interaction between phytate, calcium, and zinc).

Birth Outcomes. Four cohort studies were identified that examined the relationship between maternal macronutrient intake during pregnancy and birth outcomes such as birth weight and length. None of the studies focused on pregnant vegans.

Limited evidence from seven studies (all outside the United States) indicated that the micronutrient content of a balanced maternal vegetarian diet does not have detrimental outcomes for the health of the child at birth. There may be, however, a risk for a false positive diagnosis of Down syndrome in the fetus when maternal serum free beta-human chorionic gonadotropin and alpha fetoprotein levels are used as markers in vegetarian mothers.
(p. 1270 - 1271)

No studies included in the evidence-analysis examined vitamin D status during vegetarian pregnancy. Iron supplements may be needed to prevent or treat iron-deficiency anemia, which is common in pregnancy.

DHA also plays a role in pregnancy and lactation. Infants of vegetarian mothers appear to have lower cord and plasma DHA than do infants of nonvegetarians. Breast milk DHA is lower in vegans and lacto-ovovegetarians than in nonvegetarians. Because of DHA’s beneficial effects on gestational length, infant visual function, and neurodevelopment, pregnant and lactating vegetarians and vegans should choose food sources of DHA (fortified foods or eggs from hens fed DHA-rich microalgae) or use a microalgae-derived DHA supplement. Supplementation with ALA, a DHA precursor, in pregnancy and lactation has not been shown to be effective in increasing infant DHA levels or breast milk DHA concentration.

The safety of extremely restrictive diets such as fruitarian and raw foods diets has not been studied in children. These diets can be very low in energy, protein, some vitamins, and some minerals and cannot be recommended for infants and children.

Soy formula is the only option for nonbreastfed vegan infants. Other preparations including soymilk, rice milk, and homemade formulas should not be used to replace breast milk or commercial infant formula.

Solid foods should be introduced in the same progression as for nonvegetarian infants, replacing strained meat with mashed or pureed tofu, legumes (pureed and strained if necessary), soy or dairy yogurt, cooked egg yolk, and cottage cheese.

Little information about the growth of nonmacrobiotic vegan children has been published. Some studies suggest that vegan children tend to be slightly smaller but within the normal ranges of the standards for weight and height.

Vegan children may have slightly higher protein needs because of differences in protein digestibility and amino acid composition.
(p. 1271)

Key nutrients of concern for adolescent vegetarians include calcium, vitamin D, iron, zinc, and vitamin B-12. Being vegetarian does not cause disordered eating as some have suggested although a vegetarian diet may be selected to camouflage an existing eating disorder. Because of this, vegetarian diets are somewhat more common among adolescents with eating disorders than in the general adolescent population.
(p. 1271 - 1272)

With aging, energy needs decrease but recommendations for several nutrients, including calcium, vitamin D, and vitamin B-6 are higher.

Cutaneous vitamin D production decreases with aging so that dietary or supplemental sources of vitamin D are especially important. Although current recommendations for protein for healthy older adults are the same as those for younger adults on a body weight basis, this is a controversial area. Certainly older adults who have low energy requirements will need to consume concentrated sources of protein.

Research is needed on the relation between vegetarian diet and [athletic] performance.

Vegetarian athletes may have lower muscle creatine concentration due to low dietary creatine levels. Vegetarian athletes participating in short-term, high-intensity exercise and resistance training may benefit from creatine supplementation. Some, but not all research suggests that amenorrhea [loss of menstruation] may be more common among vegetarian than nonvegetarian athletes.
(p. 1272)

Not all aspects of vegetarian diets are associated with reduced risk for heart disease. The higher serum homocysteine levels that have been reported in some vegetarians, apparently due to inadequate vitamin B-12 intake, may increase risk of CVD [cardiovascular disease] although not all studies support this.

Several studies have reported lower blood pressure in vegetarians compared to nonvegetarians although other studies reported little difference in blood pressure between vegetarians and nonvegetarians.

Variations in dietary intake and lifestyle within groups of vegetarians may limit the strength of conclusions with regard to the relationship between vegetarian diets and blood pressure.
(p. 1273)

Among survivors of early stage breast cancer in the Women’s Healthy Eating and Living trial, the adoption of a diet enhanced by additional daily fruit and vegetable servings did not reduce additional breast cancer events or mortality over a 7-year period.

Although there is such a variety of potent phytochemicals in fruit and vegetables, human population studies have not shown large differences in cancer incidence or mortality rates between vegetarians and nonvegetarians.
(p. 1274)

A pooled analysis of 13 prospective cohort studies reported a high dietary fiber intake was not associated with a decreased risk of colorectal cancer after accounting for multiple risk factors.

Although very little data exist on the bone health of vegans, some studies suggest that bone density is lower among vegans compared with nonvegetarians. The Asian vegan women in these studies had very low intakes of protein and calcium. An inadequate protein and low calcium intake has been shown to be associated with bone loss and fractures at the hip and spine in elderly adults. In addition, vitamin D status is compromised in some vegans.

Results from the EPIC-Oxford study provide evidence that the risk of bone fractures for vegetarians is similar to that of omnivores. The higher risk of bone fracture in vegans appeared to be a consequence of a lower calcium intake.

Although excessive protein intake may compromise bone health, evidence exists that low protein intakes may increase the risk of low bone integrity.
(p. 1275)

Poor vitamin B-12 status has been linked to an increased risk of dementia apparently due to the hyperhomocysteinemia that is seen with vitamin B-12 deficiency.
(p. 1276)

Food and nutrition professionals have an important role in providing assistance in the planning of healthful vegetarian diets for those who express an interest in adopting vegetarian diets or who already eat a vegetarian diet.
(p. 1277)

It may be small consolation at this point, but the ADA does say veg*anism might be good for your heart. Problem with that is, correlation does not imply causation and it’s arguable that good hearts are what lead people into veganism. Diabetes and obesity are also cited as plagues that veg*ans may be less likely to suffer. So if you can dodge nutritional deficiency long enough to reach heart attack age, you might be better off than all those SAD folk.

But aside from one paragraph on dementia that is a mixed bag for veg*ans, the ADA’s position paper doesn’t look at how vegan nutrition affects brain health. My experience tells me that when veganism goes after you, it doesn’t bother with those purely mechanical organs — it goes straight for the brain.

Your hearts are strong… but watch your minds.

--Tagged under: Health--

--Tagged under: American Dietetic Association--

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