(1988). "First International Congress on Vegetarian Nutrition. Proceedings. Washington, DC, USA, March 16-18, 1987." Am J Clin Nutr 48(3 Suppl): 707-927.

               

(1988). "Position of the American Dietetic Association: vegetarian diets." J Am Diet Assoc 88(3): 351.

               

(1988). "Position of the American Dietetic Association: vegetarian diets--technical support paper." J Am Diet Assoc 88(3): 352-355.

               

(1988). "Vegetarian weaning. Nutrition Standing Committee of the British Paediatric Association." Arch Dis Child 63(10): 1286-1292.

               

Barsotti, G., et al. (1988). "Effects of a vegetarian, supplemented diet on renal function, proteinuria, and glucose metabolism in patients with 'overt' diabetic nephropathy and renal insufficiency." Contrib Nephrol 65: 87-94.

               

Beilin, L. J., et al. (1988). "Vegetarian diet and blood pressure levels: incidental or causal association?" Am J Clin Nutr 48(3 Suppl): 806-810.

                Evidence that nutrients other than the major cations may influence blood pressure levels stems from studies of acculturated vegetarians and from randomized controlled dietary trials. Earlier studies of vegetarians focused on religious groups and on vegans, making it difficult to know whether their lower blood pressures were due to diet per se or to other aspects of lifestyle. Seventh-day Adventist vegetarians showed significantly less hypertension and lower blood pressures compared with Mormon omnivores, effects which were independent of differences in obesity and not due to altered sodium intake. Subsequently, controlled dietary intervention studies in healthy normotensive omnivores provided more direct evidence for a blood pressure-lowering effect of a lactoovovegetarian diet with reversible changes of 5-6 mm Hg systolic and 2-3 mm Hg diastolic occurring over 6-wk periods. Similar dietary effects in mild hypertensive subjects provides impetus for identifying the responsible nutrients.

 

Bostman, L. and O. Bostman (1988). "[Acute osteoporosis in a breast-feeding vegetarian woman]." Duodecim 104(12): 937-940.

               

Chanarin, I. and E. Stephenson (1988). "Vegetarian diet and cobalamin deficiency: their association with tuberculosis." J Clin Pathol 41(7): 759-762.

                To determine whether the high incidence of tuberculosis among Asiatic Indians in the United Kingdom was due to impaired killing of Mycobacterium tuberculosis by macrophages from patients deficient in cobalamin, a nutritional survey was carried out among 1187 Indians and the incidence of tuberculosis determined from medical records. The question asked was whether tuberculosis was significantly more common among life-long vegetarians compared with omnivores. The incidence of tuberculosis in vegetarians was 133 in 1000 and that in subjects on mixed diets 48 in 1000. These findings lend support to the hypothesis that dietary factors are of major importance in determining the susceptibility of Asiatic Indians to tuberculosis.

 

Close, G. C. (1988). "Vegetarian diet and vitamin B12 deficiency." Eur J Pediatr 147(3): 333.

               

Connell, B. C. (1988). "Quantity vegetarian meal patterns." Am J Clin Nutr 48(3 Suppl): 910-912.

                Production and service of quantity vegetarian meals requires skills that are used in most quantity food kitchens around the world. Menu planning with the vegetarian in mind requires the substitution of meat, fish, and poultry entrees with vegetable sources of protein. Variety of available alternatives is good in many locations; creativity in selecting alternatives contributes to excitement in meals and improved nutrition. Specific protein sources appropriate for quantity feeding include many ethnic foods as well as standard North American and Western European favorites that may require slight modifications. The computer plays a role in monitoring nutritional quality of menus served to customers. Other computer applications provide feedback for cost analysis and control of menu, inventory, and production planning. Research in production times of vegetarian entrees provides a basis for comparison of production times of menu items for cost analysis.

 

Dwyer, J. T. (1988). "Health aspects of vegetarian diets." Am J Clin Nutr 48(3 Suppl): 712-738.

                Recent studies of vegetarian diets and their effects on morbidity and mortality are reviewed. Vegetarian diets are heterogeneous as are their effects on nutritional status, health, and longevity. Mortality rates are similar or lower for vegetarians than for nonvegetarians. Risks of dietary deficiency disease are increased on vegan but not on all vegetarian diets. Evidence for decreased risks for certain chronic degenerative diseases varies. Both vegetarian dietary and lifestyle practices are involved. Data are strong that vegetarians are at lesser risk for obesity, atonic constipation, lung cancer, and alcoholism. Evidence is good that risks for hypertension, coronary artery disease, type II diabetes, and gallstones are lower. Data are only fair to poor that risks of breast cancer, diverticular disease of the colon, colonic cancer, calcium kidney stones, osteoporosis, dental erosion, and dental caries are lower among vegetarians. Reduced risks for chronic degenerative diseases can also be achieved by manipulations of omnivorous diets and lifestyles.

 

Fentiman, I. S., et al. (1988). "The binding of blood-borne estrogens in normal vegetarian and omnivorous women and the risk of breast cancer." Nutr Cancer 11(2): 101-106.

                Serial blood samples were taken at two-hour intervals over a 24-hour period from 25 premenopausal vegetarians (12 vegans and 13 ovolactovegetarians) and from 21 omnivorous controls. All members of the former group had been on a vegetarian diet for a minimum of three years. The mean proportion of estradiol unbound to blood proteins was similar in both vegetarians (1.26%) and meat eaters (1.16%). However, the amount bound to albumin was significantly raised in vegetarians (50.1% vs. 43.1%, p less than 0.009), whereas that bound to sex hormone-binding globulin (SHBG) was correspondingly lower (48.7% vs. 55.8%, p = 0.01). Mean levels of SHBG were similar in vegetarians (59.9 nmole/l) and omnivores (62.0 nmole/l), as was the total amount of free fatty acid (0.42 mmole/l for both). Within the vegetarian group, no differences were detected between vegans and ovolactovegetarians.

 

Freeland-Graves, J. (1988). "Mineral adequacy of vegetarian diets." Am J Clin Nutr 48(3 Suppl): 859-862.

                The bioavailability of a number of minerals may be altered by the special characteristics of vegetarian diets. Concern has centered on both inadequate and high dietary levels of specific minerals as well as reduced bioavailability because of a variety of dietary components. The possibility that plant-based diets may compromise mineral status is briefly reviewed for the following minerals: zinc, calcium, iron, manganese, selenium, and copper.

 

Harland, B. F., et al. (1988). "Nutritional status and phytate:zinc and phytate x calcium:zinc dietary molar ratios of lacto-ovo vegetarian Trappist monks: 10 years later." J Am Diet Assoc 88(12): 1562-1566.

                A nutrition assessment of 16 members of a community of lacto-ovo vegetarian Trappist monks was conducted in 1977. Plasma zinc was found to be low-normal, which was attributed primarily to high intakes of phytate-containing foods. Individual and group counseling were instituted over a 10-year period in an attempt to emphasize the importance of wise food selection within the constraints of lacto-ovo vegetarianism. In 1987, a more comprehensive nutrition assessment of 21 members of the same community was performed. Food composites were analyzed, and 3-day instead of 24-hour dietary records were kept. Intakes of phytate-containing foods had decreased from 4,569 to 972 mg/day; intake of dietary zinc had increased from 7.4 to 9.7 mg/day; and the phytate:zinc molar ratio had decreased from 67 to 14 for the years 1977 and 1987, respectively. An analyzed phytate:zinc molar ratio of 9.8 and an analyzed phytate x calcium:zinc molar ratio of 0.3 were representative of the 1987 community. Both were within normal ranges. Plasma zinc had risen to upper-normal levels. The 1987 nutrition assessment showed that it is possible to be adequately nourished with a lacto-ovo vegetarian diet provided one has proper knowledge of the phytate-containing foods and the methods for compensating with foods of greater mineral density (primarily zinc).

 

Jacobs, C. and J. T. Dwyer (1988). "Vegetarian children: appropriate and inappropriate diets." Am J Clin Nutr 48(3 Suppl): 811-818.

                Acceptable and appropriate vegetarian diets fulfill the Recommended Dietary Allowances and other authoritative dietary guidelines dealing with balance, variety, moderation, and developmental appropriateness of diets for children. Vegetarian regimes currently fed to infants and children are evaluated using these criteria. Vegan-like diets, fed early in infancy and childhood, pose special problems with respect to sufficiency of certain nutrients, energy, and bulk, especially if they are unplanned and unaccompanied by ongoing health supervision. Lactovegetarian, lactoovovegetarian, and semivegetarian patterns are more likely to be satisfactory. They conform closely with the pediatric recommendations for promoting health and reducing risks of chronic degenerative diseases, are sufficient without being excessive in nutrients, are low in bulk, and are developmentally appropriate.

 

Johnston, P. K. (1988). "Counseling the pregnant vegetarian." Am J Clin Nutr 48(3 Suppl): 901-905.

                Underlying any successful counseling effort must be an understanding of the acceptable and unacceptable foods of the particular person being counseled, with the recognition that nutrient needs may be met in many ways. This knowledge base necessary for successful counseling along with an understanding of other lifestyle practices that may have an impact on health will be difficult to develop unless rapport is established. Nonjudgmental, accepting attitudes on the part of the health professional are essential to the development of relationships with those individuals who may be suspicious of traditional medical and health-care practices. Strategies for counseling with particular attention to the vegetarian are noted.

 

Margetts, B. M., et al. (1988). "Vegetarian diet in mild hypertension: effects of fat and fiber." Am J Clin Nutr 48(3 Suppl): 801-805.

                Recently, a relatively small reduction in systolic blood pressure (approximately 5 mm Hg) was estimated to substantially reduce the numbers of major coronary events. The blood pressure reduction is about the same as the difference seen between typical ovolactovegetarians and omnivores. This paper reviews the evidence for the blood pressure-lowering effects of a vegetarian diet on those with elevated blood pressure. It also reviews whether the effect on blood pressure of a vegetarian diet can be attributed either to elevation of the dietary P:S ratio or to fiber intake alone.

 

Marsh, A. G., et al. (1988). "Vegetarian lifestyle and bone mineral density." Am J Clin Nutr 48(3 Suppl): 837-841.

                The amount and type of dietary protein affect bone mineral loss after the menopause. This observation was substantiated in 10 y of studies by direct photon absorptiometry, four results of which follow. 1) Studies of 1600 women in southwestern Michigan revealed that those who had followed the lactoovovegetarian diet for at least 20 y had only 18% less bone mineral by age 80 whereas closely paired omnivores had 35% less bone mineral. 2) A study of self-selected weighed food intake showed no statistical difference in nutrient intakes but a difference in Ca:P ratio and acid-base formation of diet, each significant to p less than 0.001. 3) When sulfur intake of a fixed diet was increased, the titratable acidity of the urine increased proportionately. 4) Bone mineral densities of 304 older women from the continental United States closely paralleled those from earlier Michigan studies.

 

Mutch, P. B. (1988). "Food guides for the vegetarian." Am J Clin Nutr 48(3 Suppl): 913-919.

                Special consideration must be given to providing key risk nutrients in planning food guides for vegetarians especially if the diet chosen excludes all animal products, such as dairy foods and eggs. The practical use of food guides for education is also important. Several food guides for adult vegans, including pregnant vegan women, were analyzed by computer for nutritional adequacy using 7-d menus and comparisons were made with the RDA for energy, protein, iron, calcium, and riboflavin. Several patterns were identified that supply the RDA for protein, iron, calcium, and riboflavin and have educational merit. None of the patterns provide sufficient energy to meet the RDA.

 

Nieman, D. C. (1988). "Vegetarian dietary practices and endurance performance." Am J Clin Nutr 48(3 Suppl): 754-761.

                Confounding influences of varying fat, protein, and carbohydrate (CHO) levels, training habits, and lifestyle patterns make the interpretation of specific influences of the diet on endurance performance unclear. In general, exhaustion during prolonged, hard endurance exercise is tied to low muscle glycogen stores. Athletes in heavy training are urged to consume 70% of calories as CHO to maximize body CHO stores. A deemphasis in animal products with an emphasis in high-CHO plant foods would facilitate athletes in conforming to nutritional recommendations. Some female athletes may increase their risk of iron deficiency and/or amenorrhea if a restrictive vegetarian diet is adopted. In general, the high-CHO nature of the vegetarian diet can help the endurance athlete in heavy training maximize body glycogen stores and thus the ability to perform. The balanced vegetarian diet provides the athlete with added reduction in coronary risk factors while meeting all known nutritional needs.

 

Sanders, T. A. (1988). "Vegetarian and macrobiotic diets." Midwife Health Visit Community Nurse 24(5): 154-155.

               

Specker, B. L., et al. (1988). "Increased urinary methylmalonic acid excretion in breast-fed infants of vegetarian mothers and identification of an acceptable dietary source of vitamin B-12." Am J Clin Nutr 47(1): 89-92.

                Increased urinary methylmalonic acid (UMMA) concentrations might indicate vitamin B-12 deficiency. Our study tested the hypothesis that elevated UMMA in breast-fed infants is associated with decreased maternal serum B-12 concentrations. UMMA concentrations were measured in 17 vegetarian mothers and their infants and in six infants of nonvegetarian mothers. Serum vitamin B-12 concentrations were determined in all mothers. Range of UMMA for vegetarian infants (3-924 mcg/mg [2.6-790.9 mumol/mmol] creatinine) was much broader than that for omnivorous infants (2-25 mcg/mg [1.7-21.4 mumol/mmol] creatinine). Maternal UMMA and serum vitamin B-12 were negatively correlated (r = -0.700, p = 0.003). Infant UMMA concentrations correlated positively with maternal UMMA concentrations (r = 0.686, p = 0.003) and inversely with maternal serum vitamin B-12 concentrations (r = -0.681, p less than 0.001). In three infants with high UMMA concentrations, vitamin B-12 treatment (oral B-12, vitamin B-12 injection, or a modification of maternal diet within the vegetarian philosophy) led to an abrupt decrease of UMMA.

 

Wirths, W., et al. (1988). "[Effect of an egg-milk-vegetarian diet on nutritional and blood status. II. Findings of a study on circulation, blood status; discussion]." Z Ernahrungswiss 27(2): 84-100.

                Blood analyses were performed concerning glucose, uric acid, potassium, total protein, s-GOT, S-GPT, total cholesterol, HDL-, LDL-cholesterol, triglycerides, iron, ferritine, iron binding capacity (IBC), hemoglobin, thiamine, riboflavin, ascorbic acid. Significant changes with regard to improving blood levels at the end of period L, compared with the initial position, could be registrated for the following parameters: uric acid, s-GPT, HDL-, VLDL-cholesterol, triglycerides, IBC, thiamine, ascorbic acid. In both periods, the food volumes actually eaten served basically for the comparison of clinical-chemical parameters. Only a few subjects with inconvenient blood levels had an inadequate intake of the nutrient that was to be correlated with a blood parameter. On the other hand, every blood parameter showed subjects with levels above the average of the group, but averaging, at the same time, far beyond the group's nutrient supply.