Pregnancy support - Treatment

Nutrition - updated: 03 November 2008

Adequacy of a vegetarian diet at old age (Dutch Nutrition Surveillance System).

J Am Coll Nutr. 1990 Aug;9(4):292-302

Brants HA, Löwik MR, Westenbrink S, Hulshof KF, Kistemaker C.

To assess the adequacy of a vegetarian diet at old age, the dietary intake (assessed through dietary history with cross-check) of 44 apparently healthy lacto-(ovo-)vegetarians, aged 65-97 years, was evaluated. Adequacy was assessed by a comparison of nutrient intake with (Dutch) recommendations and by evaluating data on nutritional status. The results were also compared with data of elderly omnivores. In contrast to elderly omnivores, percentages of energy from protein (13%), fat (37%), and carbohydrates (50%) as well as P/S ratio (0.63) were close to or within the range of Dutch guidelines regarding a healthy diet (percentages of energy from protein, fat, and carbohydrates 10-15, 30-35, and 55%, respectively: P/S ratio 0.5-1.0). For most of the micronutrients studied intake was adequate, and nutrient density of the vegetarian diet was higher than of the omnivorous diet. However, the supply of zinc (average daily intake 8.5 and 7.6 mg for men and women, respectively), iron (because of lower bioavailability of nonheme iron), vitamin B12 (women only: intake 2.3 micrograms/day), and water (daily intake less than 1600 ml for 30% of the vegetarians) need special attention, considering the relatively high prevalence of a marginal status of these nutrients. In conclusion, a lacto-(ovo-)vegetarian diet can be adequate at old age, provided that it is carefully planned, especially with respect to the supply of iron, zinc, and vitamin B12.

Publication Types:

• Dutch Nutrition Surveillance System

Nutritional counseling for vegetarians during pregnancy and lactation

J Midwifery Womens Health. 2008 Jan-Feb;53(1):37-44

Penney DS, Miller KG.

A woman's nutritional status directly affects pregnancy outcome and the quality of breast milk after birth. Clinicians who provide prenatal care have an important role in assessing the nutritional status of women and directing them to appropriate resources while respecting their choices. Vegetarian and vegan diets may present with unique nutrient deficiencies that can be addressed during prenatal nutritional counseling.

Dietary fiber intake, dietary glycemic load, and the risk for gestational diabetes mellitus

Diabetes Care. 2006 Oct;29(10):2223-30

Zhang C, Liu S, Solomon CG, Hu FB.

OBJECTIVE: We aimed to examine whether pregravid dietary fiber consumptions from cereal, fruit, and vegetable sources and dietary glycemic load were related to gestational diabetes mellitus (GDM) risk. RESEARCH DESIGN AND METHODS: This study was a prospective cohort study among 13,110 eligible women in the Nurses' Health Study II. GDM was self-reported and validated by medical record review in a subsample. RESULTS: We documented 758 incident GDM cases during 8 years of follow-up. After adjustment for age, parity, prepregnancy BMI, and other covariates, dietary total fiber and cereal and fruit fiber were strongly associated with GDM risk. Each 10-g/day increment in total fiber intake was associated with 26% (95% CI 9-49) reduction in risk; each 5-g/day increment in cereal or fruit fiber was associated with a 23% (9-36) or 26% (5-42) reduction, respectively. Dietary glycemic load was positively related to GDM risk. Multivariate relative risk for highest versus lowest quintiles was 1.61 (1.02-2.53) (P for trend 0.03). The combination of high-glycemic load and low-cereal fiber diet was associated with 2.15-fold (1.04-4.29) increased risk compared with the reciprocal diet. CONCLUSIONS: These findings suggested that prepregnancy diet might be associated with women's GDM risk. In particular, diet with low fiber and high glycemic load was associated with an increased risk. Future clinical and metabolic studies are warranted to confirm these findings.

Publication Types:

• Nurses' Health Study II

Dietary fiber, glycemic load, and risk of non-insulin-dependent diabetes mellitus in women

JAMA. 1997 Feb 12;277(6):472-7

Salmerón J, Manson JE, Stampfer MJ, Colditz GA, Wing AL, Willett WC.

OBJECTIVE: To examine prospectively the relationship between glycemic diets, low fiber intake, and risk of non-insulin-dependent diabetes mellitus. DESIGN: Cohort study. SETTING: In 1986, a total of 65173 US women 40 to 65 years of age and free from diagnosed cardiovascular disease, cancer, and diabetes completed a detailed dietary questionnaire from which we calculated usual intake of total and specific sources of dietary fiber, dietary glycemic index, and glycemic load. MAIN OUTCOME MEASURE: Non-insulin-dependent diabetes mellitus. RESULTS: During 6 years of follow-up, 915 incident cases of diabetes were documented. The dietary glycemic index was positively associated with risk of diabetes after adjustment for age, body mass index, smoking, physical activity, family history of diabetes, alcohol and cereal fiber intake, and total energy intake. Comparing the highest with the lowest quintile, the relative risk (RR) of diabetes was 1.37 (95% confidence interval [CI], 1.09-1.71, P trend=.005). The glycemic load (an indicator of a global dietary insulin demand) was also positively associated with diabetes (RR= 1.47; 95% CI, 1.16-1.86, P trend=.003). Cereal fiber intake was inversely associated with risk of diabetes when comparing the extreme quintiles (RR=0.72, 95% CI, 0.58-0.90, P trend=.001). The combination of a high glycemic load and a low cereal fiber intake further increased the risk of diabetes (RR=2.50, 95% CI, 1.14-5.51) when compared with a low glycemic load and high cereal fiber intake. CONCLUSIONS: Our results support the hypothesis that diets with a high glycemic load and a low cereal fiber content increase risk of diabetes in women. Further, they suggest that grains should be consumed in a minimally refined form to reduce the incidence of diabetes.

Publication Types:

• Cohort study

Publication Types:

• Review