Vegetarian Dietary Pattern Research Articles

Malnutrition and nutritional therapy of chronic kidney disease in developing countries: the asian perspective

There is a paucity of data regarding the prevalence and clinical consequences of protein-energy malnutrition (PEM) in the chronic renal failure, maintenance dialysis, and renal transplant population in developing countries. Malnutrition, which is reported to be present in 42% to 77% of the end-stage renal disease population in developing countries, is strongly associated with morbidity and mortality. Many religious practices in developing countries promote abstinence from meat, fish, and eggs. Both a vegetarian dietary pattern, which is being adopted by an increasing number of people, and ingestion of inadequate protein and calories in the diet to arrest the progression of chronic renal failure, may lead to malnutrition. The attendant complications of PEM, malaise, wasting, anemia, and decreased immunity, may predispose these patients to infections. This is commonly seen in both the maintenance hemodialysis and peritoneal dialysis population and may decrease their survival. There is an urgent need for nutritional counseling by a dietitian to contain the damage of malnutrition and to provide important nutritional information to the patient. Consultation with a dietitian should take place at least 3 times yearly and, in malnourished patients, more often, as needed. Dietetic documentation should include reports of food intake, subjective global assessment, anthropometric measurements, estimation of the nPNA, serum albumin, and prealbumin, the serum lipid profile, sodium and potassium intake, calcium and phosphorus status, and any changes in body weight.

Chemo- and dietary prevention of colorectal cancer.

Because of the substantial morbidity and mortality associated with colorectal cancer, and the limitations and costs of treating this disease, prevention remains a desirable (if elusive) goal. In this paper, we discuss both chemo- and dietary prevention strategies for colorectal cancer, recognising the overlap and cross-fertilisation between these two approaches. Chemopreventive compounds are drugs and are developed for clinical use like other pharmaceuticals. A formal sequential multi-phase programme for development of chemopreventive agents has been instituted by the National Cancer Institute, U.S.A. This involves both preclinical efficacy and clinical studies. Such studies increasingly employ preneoplastic intermediate markers (such as proliferation measures) as well as neoplastic adenomas as endpoints. Promising chemopreventive agents include calcium, aspirin and other non-steroidal anti-inflammatory drugs, vitamins (such as vitamin E and folate), 2-dimethylfluorornithine (DFMO), oltipraz and ursodeoxycholic acid. Several lines of evidence implicate diet in colorectal carcinogenesis. Key hypotheses in diet and colorectal cancer (which are amenable to prevention, research and action), in addition to those pertaining to the micronutrient chemopreventives, include dietary fat and fibre, food mutagens, red meat, and overall low-fat, high-fibre, high fruit and vegetable dietary patterns and cuisines. Several adenomatous polyp recurrence studies with fibre supplement, macronutrient or dietary pattern interventions have been undertaken internationally. We review early findings from this new generation of studies, and anticipate the future results from these investigations and the ambitious Women's Health initiative in the U.S.A. Results from these studies may convert the promise of colorectal cancer prevention into reality.

Nutrient intake

A 3-day diary with portion sizes weighed by the subject and a 24-h recall were obtained on 50 sets of subjects: Seventh-day Adventist lacto-ovo-vegetarians and nonvegetarians, and general population nonvegetarians, matched on age (±5 yr), sex, marital status, education, type of milk preferred, and an index of the frequency of dairy and egg product use. An additional 18 unmatched persons who follow a pure vegetarian dietary pattern (use no meat, fish, fowl, dairy, or egg products) were recruited into the study. The rational for the dietary methods used is presented and details of each of the methods used are given. The results of the nutrient analysis of the 24-h recall and 3-day diary are presented. The 3-day nutrient intake means for the four groups are compared to the sex-specific recommended daily allowance both with and without supplements. The contribution of nutritional supplements to the nutrient intake is discussed. All groups show adequate or excess intake levels of calories, protein, and fat when either the 24-h recall or the 3-day diary values are considered. The higher intake of calories noted among nonvegetarians can be explained by a higher intake of both fat and protein in these groups. A, B, and C vitamin levels (3-day dairy estimates) are adequate both with and without supplements. Calcium intake is much below recommended levels for pure vegetarian females. Iron intake is low for all females. A heme iron source does not improve the intake levels for nonvegetarian females. A comparison of these results with prior reports of nutrient intake among Seventh-day Adventists is presented.