Journal of Plant Foods

ISSN: 0142-968X (Print) (Online) Journal homepage: http://www.tandfonline.com/loi/iijf17

A Comparative Evaluation Of Vegan, Vegetarian

And Omnivore Diets

E. Carlson, M. Kipps, A. Lockie & J. Thomson

To cite this article: E. Carlson, M. Kipps, A. Lockie & J. Thomson (1985) A Comparative
Evaluation Of Vegan, Vegetarian And Omnivore Diets, Journal of Plant Foods, 6:2, 89-100, DOI:
10.1080/0142968X.1985.11904301

To link to this article: http://dx.doi.org/10.1080/0142968X.1985.11904301

Published online: 27 Sep 2017.

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 Journal of Plant Foods (1985) 6, 89-100.

A COMPARATIVE EVALUATION OF VEGAN, VEGETARIAN AND

OMNIVORE DIETS

E. CARLSON, M. KIPPS, A. LOCKIE and J. THOMSON

Department of Hotel, Catering and Tourism Management, University of Surrey,
Guildford, Surrey GU2 5XH, UK.
Received: 16th Apri I 1984.
Revised version received: 1st August 1984.
Accepted: 1st August 1984.
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Any group which is health-conscious will tend to pay carefu l attention to what
they eat. To determine whether one dietary regimen would more closely
approximate the current thinking on diet and good health than another, we
investigated the diets of vegans, !acto-ova-vegetarians, whole food omnivores
and average omnivores by analysing nine day weighed food intakes. Thirty·
seven adults participated in this pilot study. The medical practitioner responsible
for the physical measurements was Dr Andrew Lockie of Guildford.
T he pilot study showed that the weight for height for all participants fell
within the desirable range given by the Royal College of Physicians (NACNE,
1983).
The vegan diet was high in dietary fibre and carbohydrates, and low in fats
and cholesterol. It was low in riboflavin and vitamin B 12, but met all other
United Kingdom dietary recommendations.
The lacto-ovo-vegetarian diet met all recommended requirements for
nutrients. T he diet had an ample quantity of dietary fibre, a moderate quantity
of carbohydrates with a low sugar and alcohol content. Fats contributed 18
per cent of the energy and energy from animal food s represented 15.6 per cent
of total energy but cholesterol levels were significantly lower than the
omnivore diets.
The who le food omnivore diet had low levels of energy and sodium but
contrary to expectations, dietary fibre was the lowest of the four diets and
energy derived from an imal fats was the highest. Whole grain cereals were
eate n, but represented a small proportion of the diet.
The average omnivore diet had an excess of all nutrients. It had low levels
of dietary fibre, carbohydrates and potassium and high levels of fat and sugar.
Both dietary intake of cholesterol and blood levels were und esirably high.
Apart from illustrating that better nutrition education is needed for the
population in general, the study showed that more information on the
nutritional content of food s is required by those people who arc trying to alter
their eating habits .

Introduction
There is an in creasin g body of evidence linking the affluent food habits of the
Western World with high blood pressure, coro nary heart disease, diabetes
me lli tus, diverticu lar disease, denta l caries and obes ity. Beca use o f the in crease
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 in di e ta ry rela ted di seases it would be desirable for people t o bec om e aware of
wh at th ey are ac tuall y eatin g rath er th an wh at th ey think th ey are eating.
This pil o t study investivated th e food habits o f three gro up s o f people wh o
have adapted thei r life style fo r reaso ns o th er th an religious belie fs, and
comp ared th em to an average gro up eatin g th e traditi o nal British di et. Th e
three group s co nsumin g a 'min o rity ' di et were : vegans- who ate no animal
produ cts; !act o-ova-v ege tari ans - who ate eggs and dairy products and
o ccasio nally fi sh but no mea t (see fo otnote ), and whol e- food omnivores - who
a te 80 p er ce nt o f th e ce reals in th e di et as unrefin ed cereals. They were
co mp are d t o ave rage omnivo res - wh o ate eve ry thin g in th e 'average ' British
diet.
Th reaso ns given for prac ti sing th ese fo od habits (ranked in o rder of
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imp o rtance) we re : vegan - ethi cal reaso ns, and two out o f ten gave health as
an additional re aso n; lac to-ovo-vege ta ri ans- e thi cal reason s, health, avoidan ce
o f chemi cals and additiv es, th e need to eco nomi se on world food supply;
whol e- fo o d o mnivores - health , avo idance of che mi cals and additives , and
ave rage o mniv o res- traditi o n, 'I eat wh at I enjo y '.
Th e particip ants we re rec ruited fr o m sta ff o f the Univ ersity of Surrey and
may no t represe nt th e average o mnivore.

Methodology
Forty people p arti cip a ted in th e inves tiga tio n whi ch too k place durin g July
1983. All came to th e Medi cal Unit o f th e Unive rsity o f Surrey wh ere th ey
were interviewed by a nutriti o nist and examin ed by a ph ysician. Weight a nd
height were m easured and blo o d , urin e and hair sampl es were t aken. They were
in stru cted how t o weigh and reco rd every thin g th ey a te and drank over a
period las tin g 9 d ays including one we ek-e nd.
Th e di et reco rds were return ed and th e nutri ent co ntent was calculated using
th e co mputer program SUPERDIET and appropri a te foo d composition tables.
Because vegan s, !ac to-ova-vege tarian s and wh ole-fo od o mnivo res eat a wide
range of fo od pro du cts whi ch we re no t in McCance and Widdowson's Food
composition tables (Paul & South gat e, 1978) including som e comm on items
like appl e juice , a to tal o f 84 foodstuffs were added to th ese ta bles. An analysis
fo r fibre , fa t, ca rb ohy dra te, energy, thi amin , rib o navin, ni co tini c ac id, vitamin s
C, A and D and th e min erals calcium a nd iro n we re obtain ed fro m oth e r food
tables (Wa tt & Me rrill196 3, FAOJUN , 1972) for 79 p er ce nt o f the items. A
full nutriti onal analysis was obta ined eith er fro m th e fo od manufac tures or
fro m foo d wrappe rs for 3.6 per ce nt o f th e items, but manufacturers could
o nl y provide info rm a ti o n on fibre , fat, carb oh ydra te, pro tein and energy
co nte nt fo r 16.7 pe r ce nt o f th ese items. Th e limita ti ons o f manufac turer's
inform a ti o n affect ed th e study o f ce rtain items in all di ets. Th e way in whi ch,
o n ave rage, each ty pe o f di et was a ffec ted was (m eas ured as items p er perso n):
vegans 2. 7, !ac to-avo-vege tari ans 1.1 , who le-food omnivo res 1. 3 and average
o mnivo res 0.7 ; Whil e th ese are gro up averages, in form a ti on o n individuals was
so me tim e:; m o re se ri o usly a ffec ted: better inform a ti on about nutriti o nal

Edi tors foo tno te: Lac to -ovo-vege tarians w h o eat f ish are n o t {strictly speahing) vege tarians.

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 co ntent is require d fr o m food m a nufac turers.
Fo r co mp ara ti ve reaso ns, valu es arc ex pressed as perce ntage o f recomm ended
dail y all o wance (RDA ) to adju st fo r differences in age , sex , levels of ac tivity
and lac ta ti o n. Grams o f nutri ents eaten h ave b ee n used wh en n o recomm enda-
tio n has bee n fi xe d.
Signifi cant differences betwee n th e co rresp ondin g mean valu es of data
appl yin g t o eac h o f th e gro up s we re tes ted by an analys is o f vari ance F -t csts,
usin g th e rel evant sta ti sti cal tables (Finn ey , 1980; Lindl ey & Miller, 1952).

Results and discu ssion

Of th e 4 0 people wh o p arti cipa ted , o nly 3 7 di e t records we re co mpl e te en ou gh
to usc .
Th e study included ten vegans (fi ve men and fi ve wo m en) , nine lac to-ovo-
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v ·ge tari an s (fo ur me n a nd fi ve wo me n) , e ight wh ole- food o mnivores (fo ur m en

and fo ur wo me n) and ten average o mni vo res equ all y di vided b e tween m en and
wo men . Th eir ages range d fro m 2 7 to 4 9 years. All we re non -s m o kers except
fo r th e ave rage o mnivo re gro up: o ne fe male sm o ked three ciga rettes o n average
p er day and two me n sm o ked pip es .
All nutritio n al va lu es were b ase d o n di e tary intake alo ne, h o wever 3 0 per
ce nt o f vegans, 56 p er cent o f lac to-ovo-vege tari ans, 50 p er cent of whol e food
o mni vo res and 20 p er ce nt o f ave rage o mnivo res were takin g a wide vari ety o f
di e tary suppl ements.
On e p arti c ipant h ad bee n a life- tim e vegan a nd two p eopl e h ad bee n life-tim e
'vvh ole food o mni vo res, but th e ave rage length o f tim e th e subj ec ts h ad been
foll owin g th eir di e ta ry regim ens we re : vegan, 13 yea rs ; lac t o-ovo-vege tari an ,
4 years; wh o le fo od o mni vores, 19 years.
Individu al energy re quirements arc b ase d o n energy ex p enditure and intakes
mu st balance ex p enditure if th e b ody is n eith e r gaining or los in g weight. To
all ow fo r indi vidu al vari ability in e nergy requirements, a bo d y m ass index
(BMI) was used to assess w he th er energy inta kes wcr adequ a t . A rati o o f
we ight in kil ograms fo r h eight in me ters squ ared has been sugges ted by th e
Royal Co ll ege o f Ph ys i ian s t o indicate th e optimum we ight fo r height and sex
(published in IIEC di sc uss io n p ap er o n 'Pro posals fo r Nutriti o nal guidelines fo r
health edu ca ti o n in Brita in , 198 3).
Table 1. Ave rage male and fem ale BMI for vegans, lacto-ovo -vegetarians, whole-food
omnivores and average omnivores compared to acceptable averages.
Male Female
Mean Range Mean Range

Acceptable averages/ranges: 22 20.1 -25 .0 20.8 18.7-23 .8

Vegan 23 19 -27 23 19 -30 *

L-0 veget ari an 22 20 -25 22 19 -24 **
W.F . omnivore 24 2 1 -26 20 18 -21
Av . omnivorP 24 20 -28 22 19 -24

* includ es two lactating wom en . ** in cludes on e lactating wom an .

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 Th ere was no significant difference in weight for height between the four
gro up s.
Since only one male vegan and three whole food omniviores h ad followed
th eir dietary hab its since birth, the o th ers adopting th eir food habits as adults,
no co mp ariso n has been made on stature and weight between groups.
The nutri ent co ntent of th e four diets, expressed as a percentage of RDA, is
shown in Table 2. The sta ndard deviations (sd) indicat e a m ore consistent diet
among vegans, th an am o ng th e oth er sampl es.
Dietary fibre
The value is base d on a recomm endation o f 25 g dietary fibre p er day. NACNE
sugges ts this should be in crease d to 3 0 g p er day over th e nex t few years. Vegan
and vegetari an diets co ntain ed signifi cantl y m o re di etary fibre than th e two
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group s o f o mnivores. Mean average dietary fibre intake per day (a) for the
gro up s were 49, 39, 22, 23 g for vegan, lact o-ovo-vege tarian, whole-food
o mnvi ores and average o mnviores, resp ectively .

Energy
Energy was low in th e whole-food o mnivore diet. The vegan and lac to-ovo-
vegetarian di ets were m arginally low in energy . During the da ta coll ection
perio d, S. Engla nd was experie ncing unusuall y warm weather, which may have
h ad a bearin g o n the qu antity and kinds o f foods eate n. It is acce p ted that the
constraints imp ose d by weighing all foods and beverages influ ences di e tary
behaviour to so me exte nt.

Protein
Alth ough the protein conte nt o f the vegan diet was signifi cantl y lower than the
o th er three gro up s, all gro up s met di etary recommendations for pro tein
includin g the vegans who were solely dependent o n pl ant food as a so urce o f
pro tein.

Thiamin and nicotinic acid

All groups met th e RDAs for thiamin and ni cotinic ac id.

Folic acid
Total folate was low in all di ets , but lowest in the two o mnivore group s. Raw
leafy gree n vegetables a nd offal are good so urces o f thi s vitamin and pulses,
bread, o ranges and bananas also p rov ide folic ac id, but other fruits, meat and
dairy products co ntain little . It is currently thought that th e RDA for folic
acid may over-estimate requirements and at th e same tim e cu rrent val ues of
food folates may be underes tim ated due t o assay procedures (Bates et al.,
1982, 1983).
A defi ciency o f folic ac id and B 1 gives th e same clinical picture, ie a
macrocy ti c anae mi a, but red cell vorumes were norm al in all subj ects.
Riboflavin
The vegan di et was significantly low (only 75 p er ce nt of RDA) in riboflavin
alth ough there were no clinical signs o f a deficiency . While this vitamin is

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 Table 2. Comparison of the nutritive value of vegan, lacto-ovo-vegetarian, whole-food omnivore and average omnivore diets (expressed as a
percentage of RDA). DHSS 1979: Recommend daily amounts of food energy and nutrients for groups of people in the United
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Kingdom. London: HMSO.

Vegan Lacto-ovo-vegetarian Whole-food omnivore Average omnivore

% S.d. 0/
/0 S.d. % s.d. % S.d.

Dietary fibre* 197.5 44.1 155.1 67 .6 87 75.4 93.5 71.1

Energy 98 .0 16.0 9 1.8 29.4 75.8 34.0 100.9 35.9
Prote in 110.2 26.3 123.7 35 .3 106.1 42.3 134.7 41 .3
Th iamin 176.0 41.8 160.3 60.5 113.6 68.0 125.4 70.6
Riboflavin 74.9 24.9 139.1 60.4 108.0 68.2 125.7 64.0
Nicotinic acid 197.0 63.3 202.9 97.5 116.6 104.5 234.6 101 .7
Folate (total) 96.5 29.0 91.8 42.3 62.6 47 68.4 43.5
Vitam in: 8 12 ** 69.9 47.8 118.1 47.6 442.0 304.8 248.8 298.6
Vitamin C 704 383 639 506 485 547 351.0 501
Vitam in A 164.9 36.5 208.0 85.0 254.8 170.5 110.5 154.9
Vitamin D 32 .3 17.7 34.2 24.9 23.0 28.9 35.2 28.6
Calcium 98.5 41.9 241 .3 96.5 132.4 106.7 187.4 101.7
Iron 186.3 60.5 158.4 84.8 125.3 95.7 128.2 99.1

*using 25 g per day as a recommended goal (NACNE ); ** RDA 2 J19 per day (Mclaren, 1981 ).
 widely distributed in plant and animal foods, th e major source in the
traditi o nal di e t is milk, meat and eggs . Nuts (alm o nds in parti cul ar) are a
potentially goo d source o f ribo nav in, as arc pulses, wh en eaten in large enough
qu antiti es . Care should be ta ken t o preve nt th e loss o f thi s vitamin in th e
preparation and coo kin g o f vege tables.

Vitamin B 12
Vitam in B 12 does no t occ ur in pl ant foods, unl ess they arc fe rm e nted products,
and the vegan di et was predi ctably low, abo ut 70 p er ce nt of RDA. There were
however, no clinical o r hacm at ological sig ns aTmcgoblas tic anaemia in thi s
popul ati o n. No RDA has b ee n es tablished since most p eople obtain an ample
a mount but 2 J..L g has bee n suggested as a minimum requirement (McCl aren,
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1981) . Most vegan subj ec ts included food items with added B 12 ( cg, Vc con
and Natcx).

Vitamins C and A
RDAs were amply me t b y all di ets .

Vitamin D
Intake was low in all di e ts. Few foods contain thi s vitamin and it is thou ght
th a t the act ion of ultra vio le t light on th e skin is th e major source .

Calcium
No all owance was made in the calc ul a ti ons for calcium obtain ed from drinkin g
and cookin g wate r. The average intake of calcium fr om drinkin g water in th e
UK is 75 mg o r 15 p er ce nt o f RDA, and can range from nil in Sco tl and to 200
mg in th e Lo ndon area (Dav idso n et al. , 1979). However th e vegan di et was
ma rgin all y low and two lacta tin g women obtained only 4 1 and 3 0 per cent of
th eir RDA for calcium fr o m the di e t. On e lac to-ovo-vegc tari an, who was also
lactatin g, had a di etary in take of calcium o f 73 per cent o f RDA.

Iron
All di et s suppli ed iro n in excess o f RDA, howeve r, iron is less easily a bso rb ed
fr o m pla nt food. Absorption is influ enced b y leve ls o f dietary fibre , phyta tcs,
oxala tes and vitamin C, as well as individual requirements. F our vegan (two
male and two fem ale ) and two ave rage o mnivore women had slightly low
hac m oglobin s. Th e vegan results may represent an iron d e fi c i c n ~y ::.nac mi a or
an early vitamin B 12 de fi c iency, which occ urs before the classical m ac rocy ti c
pic ture develops. The evidence o f iron deficiency anaemi a in t he vegan gro up
regardless o f the high intake o f di e tary iro n a nd vitamin Cis further evidence
th at iron is no t easil y utili zed fr o m plant foods.

Sodium
There are no RD As for sodium, because it occurs naturall y in many foods and
salt is used ex tensively in foo d processin g. A di etary excess o f sodium is a
greater pro bl em than de fi ciency . There is stron g evidence to sugges t a

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 rela ti o nship be twee n levels o f salt in th e di e t, and hyp ertensi on, and th at hi gh
blood pressure is a co ntributin g fac to r to isc haemi c h eart disease, strokes and
kidn ey d amage . So me ch a rac teri sti cs co mm o n to gro up s with low or zero
prevalence o f hyp ertensio n arc a lac k o f o bes ity, hi gh levels o f ac tivity , di ets
lo w in anim a l fats , a hi gh di e tary intake o f p o tass ium a nd a low intake o f
so dium.
T abl e 3 is an analysis of th e sodium and potass ium co ntent of the four diets
calcula ted fr o m the we ighed salt u se d in cookin g and a t table , and th e known
so dium and p otassium content of fo ods fr o m foo d co mposition tables.
Table 3. The sodium and potassium content of vegan, lacto-ovo-vegetarian, whole-food
omnivores and average omnivore diets compared with average values.
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Sodium Potassium Sodium to

Potassium
(X mg/day) s.d. (X mg/day) s.d. ratio

Vegan 2935 744 4855 ** 849 1:1.7

L-0 vegetarian 2688 1105 4676 1491 1:1.4
W.F. omnivore 2104 * 1335 3012 1711 1:1.4
Av. omnivore 3186 1353 3362 1703 1: 1.1

* P< 0.05 : differs significantly from vegans and av.o.; ** P< 0.05 : differs significantly from
P< 0.001: differs significantly from wf.o. and av.o.
1-o-v; **

Th e ra ised levels o f potass ium in th e vegan di e t came fro m wh ole grain ce reals,
fres h vege ta bles and pul ses, fr esh fruits, fruit jui ces and nuts.
Rece nt research h as sh o wn th a t sail res tri c ti o n should beco me part of th e
man age me nt o r h yp ertensio n (MacG rego r et al ., ] 982) and th a t salt res tri c ti o n
sho uld be tri ed b e fo re dru gs (M o rgan ct al., 1978). Oth er resea r h has shown
th a t sa lt res tri c ti o n, co upl ed with an in creased inta ke of p o tass ium helps to
preve nt hy p ert ensio n and th a t salt se nsiti ve subj ec ts ex ist and th a t th ese
subj ·c ts wo uld bene fit m os t fro m such a di e t (Skra bcl et al., 1982 ). A lo w sa lt/
high p o tass ium di e t refe rred to by Skra bel et al. represe nts 1150 mg sodium p er
day (50 mm o l) and 7800 mg p o tass ium (200 mm ol) per day o r a ra ti o o f l :6.8
Th ese leve ls o f p o tass ium w rc no t ac hi eved by di e t alo n but included
po tas ium suppl em ents. Th e highes t ra ti o o f p o tass ium to sodium from th e di e t
in thi s research was ac hi eved by vegans. On e vega n w o m an had a rati o as hi gh as
1 :4.3 and o ne man 1 : 2.4 .
All p arti c ip ants m enti o n ed th a t th ey we re awa re o f th e h ealth ri sks du e t o
di e tary salt ; h oweve r it sho uld be n o ted th a t salt , sea salt a nd 'bi o-salts' (sold
in h ealth food sho ps) arc app rox im a tely 4 0 p er ce nt sodium , and alth o ugh sea
salt a nd 'bi osalts' co nta in small amo unts o f o th ·r min e rals sub stitutin g th em
fo r o rdin ary salt in th e di e t d ocs no t lowe r sodium inta ke.
Fats carbo hydra tes and prot('ins
En ergy is der ive d fro m di e tary fa t, a rb o hydra tcs and prote in s as well as
a lc o h ol. Pro tein s arc re quired fo r rebuilding bo dy ti ss ue, but pro tein in excess

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 o f bodil y requirements is co nve rt ed to e nergy. Alcohol and sugar provide
e nergy but very few vitamin s and min erals a nd arc referred to as 'e mpty
calo ri es' . Di ets mee tin g energy requirements with empt y calories h ave a lower
vitamin min e ral and trace elem ent co ntent.
Th ere n ow ex ists a n ex tensiv e body of ev idence linking di seases like
Coro n ary heart di sease (CHD), hy pertension, obesity, di abe tes and dental
cari es to the levels o f fa ts and su gars in the di e t. Th e Nat ional Advisory
Committee on Nutrition Educatio n (NACNE 1983 ) has reco mmended guide
lin es fo r th e Briti sh diet in an effor t to redu ce th e risks [ro m di et relat ed
di seases . Howeve r, since th e se nsiti ve individu als arc diffi cult t o identify ,
guidelin es fo r th e whole p opula ti o n wi ll help so me witho ut harmin g anyon e.
Table 4 illu stra tes th ese guidelin es and co mp ares the source o f energy in th e
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fo ur di ets analyse d in this resea rch.

Energy derived from fat in the vegan di et was signifi cantly lower than th e
tw o o mnivore di ets a nd was the o nly o ne t o approx im ate di etary goals
(t = 2 .24 and t = 2.97 or P < 0 .05), while fa t intake in th e o th er three di ets was
undesirabl y hi gh.
The evidence sugges ts th at th e level of satura ted fa ts in th e di et is a criti cal
fact o r to th e cause o f CHD. Sin ce th e prop ortion of sa tura ted fa tty acids (SF A)
to poly un satura ted fa tty ac ids (PUFA) is grea tes t in foods o f anim al o rigin
e nergy derived from anim al fa ts is given in Tab le 4. f ats in th e fo ll owing foods
have high levels o f SFA: b aco n, beef, lamb, pork co ntain 4 0.50 per ce nt;
kidn ey and liver over 50 per ce nt; dairy products (butter, cheese, milk) ove r 60
per ce nt. It should be n o ted h oweve r, th at two pl ant o il s palm and coconut o il
co ntain high levels o f SF As: 4 7 and 76 per cent respec ti vely, and m arga rin es
usin g these o il s can raise th e leve l o f SFA to that o f butter. Th e WHO 1982
Report on th e Preventi on of Coronary Heart Disease sugges ts th at SFA should
supply n o more th an 10 per ce nt o f t he energy in a di et.
The two o mni vore di ets h ad signifi cantl y m ore anim al [a t (t = 2.21 and
t = 2.1 re spec tively o r < P 0.05) than th e lac to-ovo vegetarian diet, neverth eless
a nim al fa t in th e lac to-ovo vege ta ri an di et was in excess o f des irable optim a.
Carbo hydra te levels o f the vegan di e t wh e n co mp ared to th e o ther three
di e ts were signifi cantl y hi gher (t = 2.46, t = 3 .0 6 , t = 5.57 respec tively o r
P < 0 .05 ). th e sugar co ntent o f th e vegan die t was elevated but th e ave rage
o mnivore di e t co ntain ed th e highest p rop orti o n o f sugar to total carbohy dra te.
Many of th e parti cip ants in a ll group s use d hon ey or dem erara sugar as a
sub stitute fo r white sugar. Whil e th ese swee tn ers contain m argin all y m ore trace
min eral s th an white sugar, th ey re ma in a very p oo r di eta ry so urce fo r any
nutri ent except e nergy . This research illu stra tes th a t vegans can obtain
suffi c ient pro tein from a wh o ll y p lant foo d di et a nd th at th e pro tein levels o f
the o th er di e ts we re in excess o f w hat is currently beli eved t o be necessary for
health.
Du e to a wide range o f individu al alcohol co nsumpti ons, th ere was no
signifi cant differe nce be twee n th e four d iets in thi s nutri ent .

Ch olestero l
Cholestero l is fo und in all anim al ti ssue, but eggs are th e o nl y co mm o n food

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Table 4. Fats, carbohydrates, alcohol and protein sources of energy in the diet expressed as a percent of total energy.

Fats Animal All All Alcohol Protein

fats carbohydrates sugars
% s.d. % S.d. % S.d. % s.d. % s.d. % S.d.

Vegans 32.6 6.5 54.4 6 .9 20.6 4.8 2.0 2.9 11.4 1.7
Lacto·ovo-vegetarians 38.5 10.0 15.6 4.0 45.1 11.4 15.2 6.3 2.8 3.8 14.1 3.1
Whole-food omnivores 38.0 11.3 22.8 9.2 45.1 13.4 18.6 8 .1 4.2 5.1 14.2 3.5
Average omn ivores 41.0 12.2 21 .5 10.8 38.5 13.2 16.8 9.0 7.0 7.8 14.0 3.4

UK - 1981 Average* 42 .2 44.9 4.9 12.9

NACN E Gui delines 30.0 55.0 4.0 11.0

• Household Food Consumption and Expenditure 1981 , MA F F, HMSO, 1983.

 rich in ch o lestero l. It is virtu all y abse nt from plant foods . The co ntent of m os t
Western diets ranges from 500-1000 mg per day and th e WHO Committee
recommend limiting di etary ch olest erol to less th an 300 mg per day .
An Amcri an trial including 360 000 me n and women testin g th e e ffect of
ch olestero l reduction o n CHD (Ano n 1984 ) shows t ha t fo r every plasm a
ch o lesterol in cre m en t above 4 .5mm olf1 175 mg/dl), th e risk of fatal CHD
in creases : Most of th e attributable cases of CHD in the p opul atio n arise from
the large numb er o f people w h o c holestero l va lu es arc aro und average, n ot fr o m
the few in wh o m the conce ntrat ion is con sp icu ously hi gh. They further state
t h at the basic management of hypc rcholesterolaem ia sho uld be di etary .
Cholestero l values for foodstuffs are in co mpl ete in food co mp osition tab les
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and food m anu facturcrs seld om suppl y this informat io n. Where it was avail abl e,
it was calc ul ated for the survey popu latio n and the results arc shown in Table
5, togeth er w ith the p las ma levels for the same p o pul atio n.

Table 5 . Cholestero l values of diets compared with p lasma cholesterol from physical
measurements.

Dietary cholesterol Plasma cholesterol

X mg/day s.d. X mmol/1 s.d.

Vega n 29.0* 15.5 3.89 0 .78

Lacto·o vo-vegetar ian 295.9 190.6 4 .27 0.96
Whol e food omnivore 339.4 233.1 4.95** 1.19
Average omnivore 374 .5 258.8 5.61 *** 1.96

* P< 0.001 differs significantly from other three groups;** P< 0.05 differs significantly
from both vegan and lacto-ovo -vegeta ri an; *** P< 0 .05 differs si gnificantly from both vegan
and lacto -ovo-vegetarian .

Several factors whi ch arc known to innucncc pl asma cho lcs tcroll cvc ls arc:
high intakes of SFA; th e amount of fib re in the diet; exerc ise, and stress . The
re latio nship between SF A a nd cho les terol is that SF A tend to raise the level o f
low density lipotroteins (LDL) in th e body. LDL's transport fa t and cho lesterol
to t he ce lls and high density lip oprotein s (HDL) remove ch oles terol from the
circul atio n . SF A tend to raise LDL leve ls and arc, therefore, p o tenti all y
dangero us because they increase the ri sk of atheroscleros is. Cholesterol can be
reduced b y limiting total dietary fa t as the foll owin g examp le illustra tes. The
ph ys ical measurements of the survey popu latio n revealed that o ne omn ivore
subj ect had plasma cho lestero l levels in excess of 10 mm o l/1.
Plant proteins arc known to reduce plasma cho lesterol co nce ntra ti o ns
(Si rtori et al., (1977)) and oth er resu lts su ggest complex carbo hydrates from
fruit, vegetables an d wh ole grain cereals have some effect on cholestero l
sy n thes is and metabo li sm. The effect of dietary fi bre o n an individu al's
metabolism is e it h er through slower absorpt io n or in creased faeca l loss . The
property of fib re mos t relevant to cho lesterol metabolism is that o f binding bile
ac ids (T he Royal Co ll ege o f Ph ys ic ians, 1980).
98
 General discussion a nd conclusion s
The tas k of weighing and recordin g o ne's di et is n o t an easy o ne and require s a
great d eal o f dili ge nce and p at ience . Di etary recall m etho ds arc subj ec t to many
in accurac ies which can add up to a fairl y in co mpl ete picture. Wei ghin g a ll foods
to be eaten can influ ence whether o ne cats b e twee n m eals, but it does give a
reasonab ly accurate picture of the average di et, if th e record is kept for a 7- or
9-clay period including a week-end (Wo rksh o p at Fourth European Nutrition
Conference 1983 ). Seasonal changes m ay influ ence h ow food is prepared a nd
eate n, but on th e whole food h abits are fairl y con stant. The we ighed record
is b oth inform ative a nd in stru ctive . It wi ll indicate areas of defi cien cies or
excesses whi ch may need to b e changed to ensure health and w ell being. This
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study se t out to assess th e relati o nship b etween di et and health and alth ough it
in volved o nl y a sm all numb er o f people , fo ur subj ec ts were identified as h aving
diet related health problems (three vegans and one average omnivo re). It
sugges ted that di e tary assess ment, co upl ed with ph ys ical measurements can
identify th ose who arc at risk so th at n ecessary ch an ges can b e made.
Th e do min a tin g fa c to r governin g what vegans a te, was t h at it sh ou ld h ave
nothin g to d o wit h anim als. Six of the ten h ad been Jacto -ovo-vegetarians
before b eco min g vegans. Three o f th e couples h ad a total o f eight children; all
bein g ra ise d as vegans. Th ere is a growin g number o f seco nd generation vegans
and t hi s is an area where furth er research is needed.
Th e vegan di et m et m os t o f the reco mm enda ti o ns fo r a h ea lth y di e t w ith out
th e a iel o f di e tary supplem ents. Di e tary iro n intak e was hi gh but di et app ea red
to be a fac to r in three cases o f an ae mi a . The vegan di e t. was high in fibre and
ca rb o hydrates and moderate ly low in fats. It h ad the hi gh es t ratio o f p otassium
to so dium. lt was low in energy fr o m alc o ho l. They co n sum ed th e high est leve l
o f na tural su gars as we ll as su gar in drink s and swee ts; 60 p er ce nt too k sugar in
tea and co ffee and 60 p er ce nt dra nk so ft drinks o f on e kind or oth er, but
sugar as a prop or ti o n of to tal carboh y dra tes was the lowest of all th e di ets.
The lacto -ovo-vcgetar ian di e t met all recommended dietary al lowances
w ith o ut added suppl em ents. Th e diet h ad an ampl e qu anti ty of fibre a nd hi gh
leve ls o f protein. It h ad a modera te qu antity o f carbohydrate with a low suga r
and alco h o l co ntent. As a gro up, fat co nsumpti o n was hi gh er than levels
co nsidered des irable for goo d h ealth.
Both th e lacto-ovo-vegetarians and who le-foo d o mni vo res indi ca ted health
beli efs as a fac to r underlying th eir food h ab its and th e fo ll owin g co mm ents
appl y to both gro up s. It was n o ted th at many p eo pl e switchin g fro m a
traditi o nal diet to o ne they believed to be h ealthier arc n ot sufficie ntl y aware
of th e nutri ents in the foods th ey arc adop tin g. They were un aware th a t a diet
base d o n eggs and dairy p roduc ts, as a m ajor source o f protein, m ay h ave an
eve n hi gher saturate d fat co ntent than a m eat di et .
Alth o ugh th e whole foo d o mnivores ate whole grain ce reals, cereals and
pu lses did no t form a sufficient ly large enough pro p or tion o r th eir di et to
in crease carb o hy drates and dietary fibre levels, or to decrease saturate d fa t
leve ls. Mea~ and dairy pro du c ts were th e ma in so urce o f pro tein as we ll as fat.
Who le- foo d om ni vores had th e lowest intak e o f so dium.
Whi le th e average om nivores sa id t hey a te what they like d , they all ate so me
99
 w ho lem eal bread, cereals and pul ses and were co nsc io us o f the health ri sks
fro m hi gh int akes of salt , however they h ad th e lowes t ratio o f p otass ium t o
so dium. As o ne might ex p ect, the ave rage om nivore di et had an excess o f all
reco mm ended nutri ents exce pt fo late . It h ad a n excess o f fats and anim al fa ts,
indi catin g hi gh intak es o f saturarc d fats, togeth er with the highest levels o f
choles tero l. Sugar fro m all so urces , as a percentage of total carb oh y dra te , was
th e hi ghest o f an y o f th e diets; 3 0 p er ce nt added su gar t o tea or co ffee and 80
per ce nt drank vary in g amo unts o f so ft drink s. Alc o ho l co nsumpti o n was the
hi gh es t.
Some gro up s in the p op u la ti o n arc see kin g alte rn a ti ve ea tin g h ab its, but
require m o re inform a ti o n o n th e nutriti o nal co nt ent of what they arc ea tin g.
Better nutriti o nal lab ellin g is required o n all foo d stuffs regard less o f whether
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they a rc purchased in sup erm ark ets or health food sho p s. Many manufacturers
o f processed foo d s co uld o nl y suppl y a list o f in gredi ents (in ad equ a te fo r
di etary analys is or for helpin g indi vidu als to m ak e wise and informed di etary
cho ices ).
Some health food s can co nta in excess ive am o unt s o f so m e nutri ents which
arc n o t m e nti o ned in th e nutriti o nal la bellin g eg 'All -Bran' in additi o n to the
fib r and D vitamin s, co nta in s 4 per ce nt salt and 15 per ce nt suga r.
Pop ul ar nutriti o n informa ti on focu ses too much a tt enti on o n ncrgy co ntent
rather th an o n co n te nt o f o th er var iabl es, and it is o ft en not lear whether fat s,
arbo hy drates or proteins arc th e so urce o f th at energy .
Acknowledge m ents - Our th an ks arc due to th e fo ll owing: th e subj ec ts of th e stud y, who
w illingly and carefull y we igh ed every thin g th ey a te and drank; Mrs Margaret Price,
tec hnician, who m eticul ou sly m onitored th e subj ec ts, and entered the d a ta o nto th e
co mpute r; Dr Graham Parl ett , wh o provid ed advice on computerised statistical an alysis
an<,i New m an-Turner publica ti o ns, w h o prov id ed so m e o f th e fundin g for th e stud y.

Bates , CJ . e t al. (1982): The discrepan cy b etw een normal fol ate intakes and the fol a te
RDA. Hu m. Nut.: Appl. Nut. 36A 422 -429 .
Bates, C,J. e ta/. ( 19 83 ): Folic acid Br. Nu tr. Fdn. Bull. 8, 2, pp . 8 1.
Davidson, S. , Passmore, R., Brock, j .F ., & Truswell, A.S . (1979): Human nutrit ion and
die te tics, 7th edn. p . 99. Edinburgh : Churchill Livingstone.
Finney, OJ . (1980): Statistics for biologists. London: Chapman and Hall.
Lind ley , D.v ., & Miller, J .C .P. (195 2): Cambridge elemen tary sta tistical t ab les Cambridge:
Cambridge University Press.
MacGregor, G .A . eta/. ( 1982 ): Double-blind randomised crossover trial of moderate sodium
restriction in essential hyperten sion . Lan ce t 1, 351.
Mc Laren, D.S. (19 8 1) : Nutrition and its disorders, 3rd edn . p . 94 . Edinburgh: Churchill
Livings to n e.
Morgan, T. e t a/. ( 197 8): Hyp ertensio n treated b y salt res tric tion. Lance t 1, 22 7.
NACNE (1983): A discussion p ap er on propo sals for nutritional guidelin es for he alth
ed ucati o n in Britain , London: Heal th Edu cation Council.
Sirt ori, C.R., Agradi, E., Conti, F., Mantero, 0. , & Gatti, E. (1977): Lance t 1, 275-277.
Skrabal, F., Aub ock ,J., & 1-Iorntage , 1-1. (1981): Lo w sodium/high potass ium diet for
preventio n of h yp ertension: probable mechanism of ac tion . Lan ce t 2, 895.
Royal Co llege o( Physicians ( 19 8 0) : R eport on th e aspects of die tary fibre, pp . 84-92.
Ano n ( 1984): Is th e redu ctio n of blood chol es terol e ffec tive? L ance t 1, 3 17.
WIIO (1982): Preven tion of coronary heart disease, Tech. Rep . Se r. 678 Geneva: WHO.
Workshop o n Reappraisal o f m e thod s o f estimating food co nsumption (1983): Fourth
European NutritionC o nference, Netherlands, May 19 83.

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