1. Dana Hrnčířová Dpt. of Nutrition, 3rd Faculty of Medicine, Charles University in Prague

2. In general, people who exclude meat, poultry, fish, and animal- derived foods from their diets. A wide diversity of dietary practices

3. Vegans (total vegetarians) Lacto-vegetarians Ovo-vegetarians Lacto-ovo- vegetarians Semi-vegetarians (flexitarians) Pescaterians Pollo-vegetarians Pollo-pescetarians Raw vegan (raw food diet) Macrobiotic diet

4. USA 2012 National Poll 4% of adults are vegetarians/vegans (approx. 9 million) 1% are vegans (approx. 2 millions) No much difference between male, female, region, or age for actual vegetarians (Harris Interactive poll by the Vegetarian Resource Group) Veg. Statistics - European vegetarian Union http://www.euroveg.eu/lang/en/info/howmany.php

6. Environmental/Ecological Animal welfare, ethics Religious Economical Health Family lifestyle

7. Protein quality Vitamin B 12 Omega-3 Fatty Acids Vitamin D Calcium Iron Zinc Protein

8. Protein Digestibility Corrected Amino Acid Score E.g. Rice limiting amino acid - lysine 62 % (of the 2-5 yrs old child needs / g of protein) Digestibility of protein …. 88 % PDCAAS for rice: 0,62 x 0,88 = 0,55 faecal true digestibility % mg of limiting amino acid in 1 g of test protein mg of same amino acid in 1 g of reference protein *

9. 1.00casein, whey (milk proteins), egg white, soy protein 0.92beef 0.91soybeans 0.76fruits 0.75black beans 0.73vegetables 0.70other legumes 0.59cereals and derivatives 0.52peanuts 0.42whole wheat

10. essential amino acids in a food protein which fall short of meeting the amino acids required by humans legumes → methionine wheat → lysine maize → tryptophan soya beans → methionine and cysteine

11. The combination of plant protein foods which when eaten together provide all the essential amino acids. E.g. Legumes + cereals

13. Zdroj: NIH Dietary Supplement Fact Sheets for B12. http://ods.od.nih.gov/factsheets/VitaminB12/. Accessed 8-11-2011 [Propionyl CoA] Odd Chain FA or Branched Chain AA

14. Hematological (megaloblastic anemia) Neurological (numbness and tingling of arms and legs, difficulty walking, memory loss, disorientation, dementia) Gastrointestinal (tongue soreness, apetite loss, constipation) Deficiency of vit. B12 leads to secondary deficiency of folic acid

15. Adults3 mcg /day Pregnant women3,5 mcg /day Lactation 4 mcg /day (i.e. + 0,13 mcg/ 100g of mother milk)

16. Food of animal origin (liver, shellfish, vension, some fish) Fortified food Food supplements

17. FoodServingVitamin B 12 (mcg) Clams (steamed)3 ounces84.0 Mussels (steamed)3 ounces20.4 Crab (steamed)3 ounces8.8 Salmon (baked)3 ounces2.4 Rockfish (baked)3 ounces1.0 Beef (cooked)3 ounces2.1 Chicken (roasted)3 ounces0.3 Turkey (roasted)3 ounces0.3 Egg (poached)1 large0.6 Milk (skim)8 ounces0.9 Brie (cheese)1 ounce0.5

18. Ischemic Heart Disease Hypertension Diabetes Obesity Cancer Osteoporosis Diverticular Disease Gallstones Rheumatoid Arthritis

19. Lower risk of death Adjustment for BMI, smoking habits, social class Incidence 24% lower in lifelong vegetarians Incidence 57% lower in lifelong vegans Lower TCh, LDL-Ch Higher intakes of fiber, plant sterols; nuts, soy Lower intakes of SFA

20. Lower rates of hypertension: Non-vegetarians > vegetarians > vegans Lower blood pressure Non-vegetarians > vegetarians diet or lower BMI? Beneficial nutrients Potassium, magnesium, antioxidants, fiber, fat 5-10 servings of fruits and vegetables significantly lowers BP

21. Positive associations between intakes of red meat and processed meat and risk of diabetes after adjusting for BMI, total energy intake, exercise … Beneficial nutrients: vegetables, whole-grain foods, legumes, and nuts diets rich in whole-grain foods are associated with improved insulin sensitivity

22. People consuming 3 servings per day of whole- grain foods are 20-30% less likely to develop DM2 than people consuming 3 servings per week. 1 serving = 16 g of whole-grain food

23. Vegetarians maintain lower BMI than non-vegetarians Non-vegetarians > vegetarians > vegans (BMI) Lower weight correlates with high intakes of fiber and low intakes of fat

24. Significantly lower rates of cancer non-dependent on smoking (colorectal and prostate cancer) Obesity is significant risk factor for breast cancer; meat? Cancer-protective dietary factors: Fiber, vit. C, carotenoids, flavonoids, lycopene fruits, vegetables (lung, mouth, esophagus, stomach) Legumes (prostate, stomach) Soy isoflavones (breast) ???

25. Dairy products, green leafy vegetables, and calcium- fortified plant foods – calcium for vegetarians no differences in bone mineral density between omnivores and lacto-ovo-vegetarians Increased intake of friuts and vegetables (K, Mg) - positive effect on the calcium economy High protein intake, especially animal protein, can produce increased calciuria Low protein intakes may increase the risk of low bone integrity

26. The more restricted the vegetarian diet, the greater the challenge to achieve a nutritionally adequate diet. The goal: consume a variety of foods to obtain all of the needed nutrients. Nutritional consciousness is essential!

27. Foods 1serving Number of Servings/day Fruits ½ cup fresh/canned/frozen3–4 Vegetables ½ cup cooked/1 cup raw4–6 Whole Grains 1 slice whole-grain bread 1 cup whole-grain cereal, ½ cup cooked rice/pasta 5–8 Legumes ½ cup cooked legumes ½ cup tofu 1 cup soy milk 3–6 Nuts, Seeds ¼ cup nuts or seeds1–3 Plant Oils 1 teaspoonup to 5 Eggs 1 egg 4–6 per week Dairy 1 cup milk/yogurt ¼ cup cheese ½ cup cottage cheese 1–3 Oldways 2013

29. NutrientNonvegetarianLacto-ovo vegetarian Vegan Fat (% total calories) 34-3830-3628-33 Cholesterol (total grams) 300-500150-3000 Carbohydrate (% total calories) <5050-5550-65 Dietary fiber (total grams)/day 10-1220-3525-50 Protein (% total calories) 14-1812-1410-12 Animal protein (% total protein) 60-7040-600

30. Meat replacements: products made to look and taste like meat, fish, poultry Tofu: a curd made from soybean Tempeh: a fermented soybean food Textured soy protein (TSP), soy meat: processed soybeans TOFUTEMPEH TSP

31. Dietary guidelines for Americans 2010 Position paper of American Dietetic Association 2009 American Heart Association papers Physicians Committee for Responsible Medicine - Dietary Guidelines Goals and Recommendations Harvard School of Public Health papers Up-to-date research