A vegetarian-style dietary pattern is associated with lower energy, saturated fat, and sodium intakes; and higher whole grains, legumes, nuts, and soy intakes by adults: NHANES 2013-2016

Authors: Bowman, Shanthy

Submitted to: Nutrients
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 8/29/2020
Publication Date: 9/1/2020
Citation: Bowman, S.A. 2020. A vegetarian-style dietary pattern is associated with lower energy, saturated fat, and sodium intakes; and higher whole grains, legumes, nuts, and soy intakes by adults: NHANES 2013-2016. Nutrients. 12(9):2668. https://doi.org/10.3390/nu12092668.
DOI: https://doi.org/10.3390/nu12092668

Interpretive Summary: There is a growing trend among consumers for clean, natural, and sustainable foods, which has increased demand for plant-based foods. Plant-based proteins and meat-alternates are one of the top trends in the restaurant industry. The National Restaurant Association research predicts that plant-based protein food products will continue to grow in popularity during the next decade. The healthy vegetarian-style dietary pattern as defined by the Dietary Guidelines for Americans 2015-2020 includes plant-based foods, eggs, and dairy; and excludes meat, poultry, and seafood. This study compares selected nutrients and food patterns group intakes, body measures, and serum cholesterol levels of adults eating a vegetarian-style diet (vegetarians) with that of adults eating a non-vegetarians diet (nonvegetarians). Adults ages 20+ years (N=10064) in the What We Eat in America, National Health and Nutrition Examination Surveys 2013-2016 were included in the study. The vegetarian-style diet was substantially lower in energy, total fat, saturated fat, and protein; and higher in dietary fiber than the nonvegetarian diet. It was also lower in sodium, vitamin B6, vitamin B12 and vitamin D, potassium, phosphorus, and zinc. An analysis of micronutrient density, estimated per 1,000 calories showed that the vegetarian-style diet was more nutrient dense than the nonvegetarian diet for several micronutrients, but continued to be low in vitamin B12 and zinc. No significant differences were noted in the mean Body Mass Index, percentage of overweight adults, and serum total and high-density lipoprotein cholesterol between the two groups. Because the vegetarian diet was 419 kcals lower in energy and 1,274 mg lower in sodium, incorporating more plant-based foods in the diet may help reduce caloric intake as well as sodium intakes.

Technical Abstract: The healthy vegetarian-style dietary pattern as defined by the Dietary Guidelines for Americans (DGA) 2015-2020 includes plant-based foods, eggs, and dairy; and excludes meat, poultry, and seafood. The objectives of the study were to find out whether there were differences in the mean intakes of selected nutrients and food pattern groups, body measurements, and serum cholesterol levels of adults eating a vegetarian-style diet and adults eating a nonvegetarian diet. Adults ages 20 years and over with complete, reliable dietary data on day one of the What We Eat in America, National Health and Nutrition Examination Surveys 2013-2016 were included in the data analysis (N=10064). The DGA 2015-2016 definition of vegetarian-style dietary pattern was used to divide the adults into two groups: (1) Adults who had a vegetarian-style dietary pattern (vegetarians), and (2) Adults who did not have a vegetarian-style dietary pattern (nonvegetarians). Survey sample weights and design effects were used in the analysis. Means were compared using linear contrasts. A P-value <0.01 was considered significantly different for all comparisons. The vegetarian-style dietary pattern was associated with lower intakes of energy, total fat, and sodium and higher intakes of whole grains; legumes; nuts, seeds, and soy products. The vegetarians ate an estimated 419 fewer calories, 19 grams less total fat, 7 grams less saturated fat, and 1,274 milligrams less sodium. Their diet was also significantly lower in essential micronutrients such as vitamin B6, vitamin B12, vitamin D, phosphorus, potassium, and zinc. However, micronutrient density estimated per 1,000 calories showed that the vegetarian-style diet was more nutrient dense with respect to dietary fiber, calcium, magnesium, potassium, and iron than the nonvegetarian diet, but continued to be low in vitamin B12 and zinc. There were no significant differences in the mean Body Mass Index and percentages of overweight adult males and females in both groups. Mean serum total cholesterol and HDL-cholesterol were not significantly different between the groups. A vegetarian-style dietary pattern is useful for calorie, sodium, and saturated fat reduction. Since a vegetarian-style diet was limiting in essential micronutrients such as vitamin B12 and zinc, vegetarians may need to use dietary supplements.