WAGYU INTERNAT'ONAL i?t Special I DGE Position "Vegan Diet"
Corrected et ve15ion Vegan Diet (Erratum) :i !! ?c Position of the German Nutrition Society (DGE)
Morgrit Richter, Heiner Boeing, Dorle Orinewold Funk, Helmut HesekeL Anio Kroke, Evo Leschik-Bonnet, Helmut Ober tter, Danielo Strohm, Bernhord Watzl for the Cermon Nutrition Saciety (DCE)1
Abstract is feh.le, young, educrted r.d wealthy. tives in . rity nlld follows a on the b3ri5 oi cur€nt sci.ntitic lire.ature, rhe Ceman Nutdtion Socjety (DC€) har "h6lthv lif.sr_vlr" I1. ll. develop€d a position on the vegan diet- with a pure plant based diel it ir dimcu[ or imposible to attain an adequate supply of 5ooe nuhentJ. The moit crilcal nutn€nt ir vitamin 8,,- Other potentially dtical nur.ients m i vegan diet in.lode proteln resp- indirpentablc amino acids,long chain n-3laity acids, oth{vitamins D.po,djtrg on th( lbrm of lcgctar- (iboflavin, vitamin O) and mi.€lals (calcium, non, iodine, zinc and relenium) The i.njsm (. fablc 1), eith.r s.l€ct.d DCEdoer not recomfrend a vcgan dieifor pregnanr women, lactaring women, in minral foods (c.8. ('g8s o. rniN) de fanti,.hjldren oradoleftentJ. P€Bontwho neverthelers wish tolollow a vegan diet consmed. or animal tbods and ad- 5hould permanently tale. vitamin Br, iupplement, pay anention to an adequare dtives iR (otolly.voided, includinA ntake of nunients, especially citical nutnenti, and posslbly use fodilied loods or foods whft lnimll .ompon.nts are dietary supplements. They should €ceive advice irom a nutrition counsellor and added dunng th. trodu.tion p'b- thei.supplyofcriticaln!trients should be regularly checked by a phylician cess. A vgan diei is a !.ry st.ici i!!L'".rd!r vegan diet, critical nutrients, vitamin 8, fom of vrSetarian dids. V€ans exclnsively consu,r. plant-bas.d 1@ds &d ft.id iU Un{s of ,nimai fods. $$.rimcs in.luding hont-1.. lntrodu
92 L'n,ehrudqrlJm(hau,.rfrotoior r2ord Vegeta an di.ts oflen have a mor. a .ompardhk diel with d low level ble .ich di.ts $ch as vegdsrian favourablr .ohposihon with r€s- of meat. I lowder. it cnn bc assu- dirts (. Tabh I ) .re aseciatcd with pcct to thesc foods ths th€ mincd nrd that a plet-bascd diet (with or Sood slpplies of so,nc vitamins di.t which is convcntional in cer- withoui l(,w leds of meat) is as- (vilamin C, vitamjn E, thiamine hanY consid.ring the supply sdiatd to a rrdu.'.d risk or nutri and folst. I14. 16 l3l). hincr.ls of nutrienis and other benencial hon-r.laid diseases in cornpafton (naAnesiud and pot.ssium I14, phyto.h€micals. A mda-inalysis wiih th{ cu.r.ntly convenftrr.l 17-191), dietary librr and phykts of ohs.ruational siudi€r tound thal .hont.h I24,251. ln .omp.rison p.rsons adhering to a vegetarian to a mixd diet, allveg.tarjan diets di.t exhibit.d a lowo risk of meF .ontain. for .xample, bwer l.v€ls abolic and cardiovns.Lr6r diseiscs Nutrient intake in oI satnrat.d fatty a.idr nnd.h.les than p.rsons noi on a veg.t.rlan vegan nutrition t.rol Il4. 24,251. di€t. 'llr risks oI isclafmic heart Thc ri5k of an nladcqlatc supply of disc.sc ihd cnncer werc also lowcr rhc mix&l di.t re(ommcnd.d bi/ th. troh ients or of n uiritio.al det.ioiL:y llOl. How€v.r. wilhin th. diff.retrt DGEmntains low lry€k ot meat and pR)Er$siv.ly in.Ras.s .s ihe s.lcc studjes, it is importani io cohsider mcat prodlcts, as h'ell as fish. Thc tion of ftDds be.ours nnrr. rsiric which referenc€ grorps ar€ us.d dimal-bised loods ih this diet co)r- twr ed thc di€t lrcom.s lcss van.d and whcther othcr differcn es in rrihute to tlr supf,ly of rhc Dub(nts Tbis applics in principle to all fo.ms lifestyle wcr. considered in the proiein resp. 4s.ntial amnro acids, as ol nutritio!. Adequ.i. nuhition..n statistical rDalysis. Thcr. is evi- wcllaslon8 chain,r-3 fatty acids (.i- be achi€vcd lo. ve8.t$ians who d.nce that some ofthe invcstigat€d cos.rpcntaerDic acid IEPAI nnd doco dt no E.at or nreat produ.ts, bul B.oups had v.ry dili?.ot lif€styles. srhe$enoic acid lDti^l), Miamin D. .ons,rmd othfu animal toods. ..8. so that the low.r risk of dis€se is ritrflaviD, vitamir B)1 tobalamnr), milk, dairy produ.ts aDd cggs. Ir a prcsunrably Dot only du. to nuhi- .alciuh, iron, iodnre, zinc ahd selc- vegan diet, the most .ritical nuiri tio.al difierdc.s 1111. ln an ana- niom. As vcgdanan di€ts {. Table l) cnt is vitamin Brr. Potmtially niti.al lysis of two prosDectiv. studies, avoid sry$ll or .vcn all of th$! nul.ients in a vcsnD di.t DDr.over persons adhcring to a v.g.iari.n foods, & ad.qurte supply ol thes. include prctdn r$p. inrlispen$bte dirt (p.sco. wo lacto vegetari,ns nutricnts may be difficult. idequitc amnro a.ids, as well is lorg-chaiu and vegans) were cohpared with supply ofthse nuhicnis husi be cF n-3 firtty a.ids (EPAand DIr\), othe. p€.sons on a high vcgetabl. mixed surcd bt. a well djrcctrd scl.dion of vitintins {riboflavin, vitanrin Dr) iDd diet, containing 1ow lNek of meat plaDFbased lbods. Altemative sour minerals (c!lcim, iron. n)dine, zjD. and meat producis. The.r werc cs of nutn.nB for vcges dc. sm- ed sdoium)r I14, 25, 291. ho differocrs berweeD the two Ard€Ni ofthe liurtions dsigns SrouPs with rrspecl to moriality only a frw stldics hav. invesii- ol dcficiencics for ih. pokntially.rjii ll2l. Thes€ r.sulis indi.atr that w. gatcd tht nutritional physiologiol Lal nutrimts.an bc lound in th€ r.t. .annot @rrcntly assum€ a health quality of restri.tive diets such as r$cc valu$ for nutriert iniake 1301. advania8e of vegetariDs iri coh- ih. v€g& diei &d cohpired ihese panson with prsons .onsuming with other djds ll3 151 V€g.ti-
@odrth.i a.e avoi.l€d plant-based foods, nsh, eggs, milk and Meatand all prcducts derived thercof
Ovo-la(to vegetarians plant based foods, e995, milkahd dairy meat, fBh (lnc uding other aquatic ani mal, and all produ(ts de ved thereof plant-baled foodr, milk and dairy meat, fish (in(luding other aquatic ani malr, eggs and al produ(ts derived
plant basedfoods, eggs meat, ikh (including other aquatic ani- malr, rnill and dairy products and al products deived thereol all animal foods, also honey
Tdb l: Fo.mi ofveg€tarianism r.rp. veqetarian orie.t€d di€tr (mod. from: [a])
ttu€hruhss Uhrh:u intnotml | 1/2016 93 Special I DCE Position "Vegan Diet"
v.ee,,bh n*!.n, $ur? l(,,mfrcnr1Di rhFveean dpr
e9un,e.i nu6,.c.cak (who. qrarn), oi rc.d5, . , d v.,i.ty ol veg.table proiein $ur@i, 5u(h as ..rcali/ l€gumes ,nd pot toe!, rre di5Eibut.d pobioer spe.iftaty.ombi.ed and.onsumed overthed.y[33]alonswi$adeluacen€Byintak I3,t], pEEin requLtrn.nE on b. owr.d overtho dry (e9 ceEa5+ egu"reri ioya prc [35, 36]. rt k uhcl.r whehe hir B atio p6ibt.torroddreE. rr.oding to youNc rhd pElm, hom.l grcwrh L inded poiibl€ in ditdh ir drey E iv. .n sduiv.ty ptrnt br.d di.i rnd f dfi.Gnt prct h $u@s are ..mnn€d [31t. oh fi€ orhs tund, t( rcov d tl. ronjd.Ed ti rh. rcquirmenB Lr indi5p€nsbr€ ahino ..jdr ..nnot b. qd8*ly (md by pldnr pdeir in p\.g oJ high Fqu'@mtr tudr d gro*ih, s rhe p6r. n qu,t,ry or pbnt p6r.,n B t{n[ rh,! or .n'm.t prctdn ls4. . 'han s, rdrdiErt d dbininq difi@r $urs of ptant ptukj4 rre pmr.in q!.tiry ot d.ry prctcin jnblc inDI. .an h. in.@$d, a Gn dp or a[ indkpeEbte amho ..Lt taa, 391. . rnr.nB.nd crirdM require Er.riEly moE indi+pnr5e aano *idr h plbl.b th.n .duts do [roi.Ouiingg@th, ndE€{@ehriatto6juElhdinbtdotp.or.inedoli.disp.niht. ei.o.c*k6w.ll.sa.rqvintak eadqute rood fodlied . wirh oir f.oh mrrotga. Wlh . f,id v.g!n dd, 6rE n fi.rdty any i.DLe or .i.oep.nb.noic did (tp^) o. do.or; h.ffiok &d @Hr). Mon\rc, (on6ion of the rl rary a.id orihot.nr r.id (ALA; e.9. rom f.$(d, w.rlra, apeor hpno,k, ro pAdndD-(.\iFr.dtgrt . Ollr tDh mk@lg& .o.bin DH^ 192-941. Mi.oatgat oitr lmm rh. hicrc.tga. U l.nra ahd S.hDo.hytrium h.ve b&n approved d N6v€t F@ds I95, 961. !ome munmoms (e.q. common nrushbom5/ A unique .h.Edeiru. or virliih D G itat it @nnor onty be obrain.d rEm tood, bur .an . !o be chaDtercr er, roodi todiried wrh viramin D ryntherFd b, th! huFan body iB€lr ir the 5kin is€xpoRdrorunlighr(LJVB)l3ol. oi i.cd5, nut, kqumer, vaioui iyp{ orvcqo- rdbe(e9 b,oc.oi,kate)andwhote gain.ercdG
rood5lorUried wiih B . viramtn r I fonfhd food! .re rt'r'cr]y exduded in a v
. lodinard and fluondard bbte . sh as rel ,r Tl'e t.&hl lnrnu. rr Rirr @i&6 rhar dned atg.t prcdu.lr ot iodine .on roodr prepar€d (d th€er g€ne6ly .eom. ra^r > 20 ng/rg .'. hamrut ^llessenrb he.tth and advires aq,inn $.n (onlump o.Ilo4l. . Co(rcg..'( rbrbn(s ,n Drrnr brH rood\, \ut prrnb, .Soiltldtifr€dwirhq.tqa.andorddn h kbo.94 $yr b..n. .d r*er di! por,rto.r mr, d(Be d'. treu,itdtrt'N or whr h m/y b. inp@nrlf,od,.. incrE di.. Whole.gzin, egumes, oi r*dr, nutr PreprHtioi proc.dur.r N.h a! iou. dough termenration ahd qehnrrion i6prov. bio. c.bhage (e q. bro..oli, whiic.abbage), bu b Thc co.t.nr in I anlba\ed loodj ij highy dependenroh rhe e: or flnt(c, ar d.ppndr v.g.DbLar (a c. qarti., 6nionr, m -ri" rh.5o LIrt. paBqui and lequmer, &azit nuts 94 Ehdrungru6r.h.u'nr.aoro@,trt2or6 / l.b r'Potenti6l.riii<.l nulir.nts in c veqan dietdndveg.t bl. nut.ient iour.6 o, $6.nuhenB. k lroland uRr wvw d9. d€/wB3e.*hdfi/rer.(nAene/ btuide hm rh. .ommenB "fLt.h{. on bki.g di&ry v.g.ns, lik€ rh. gd€r,l popul.t:on, .ohpl, wilh dE Eomm€ndatotr 'uppl.m€nB, 'hould on v,ramin K adminiiduon to neonde! (oBr adminilrrauon or 3 r 2 m9 vibmin K) and o. vitamin o adminktorioi to inranB (daily ro u9 vi' hmrn D) andlorrhe inbka of foli. a.id ropplements by women intendinq to 9et pregnait(dait400 !g ryithetl.loli. a.ld);lollcacid intaks b€tor. rhe sbn ol th. prgn.h.y ,nd .onrinue uhtil rh. .nd ol rh. tu( uim6t{ ot prcgnr..y lrol. Vitamin Br? .eption is an indep.ndent risl fac- lor tl)csc groups at risk. Case .c- tor fbr cobrpli(atbns during preg- ports show that th€ supply ofvits- Vjtanrin B,: is solely produ.ed by hancy (hiscarriaSe, pre-ecl.mp- mtu Bu aDd iodine of irflnts whosc mi..oorgmisms. Th. form that is sia) and tor n€gative eff&ts on mothers w.re oo a vegan diet was available to th. humrD body o.- the neonatc {low bi.th wright, not.dequkly fludanterd and th.t .urs ahnost exclusively in adm.l neural iube d.ttct) 138-411. If thc th.y dcvdopcd neurolosical disor loods (.'r'able 2) I2i. Thus a v.Ban hoih.r is on . sirici v.,{an di.t ders ind hcgalobl6sti. anaehia or di.t iD..cas.s the .isk of vita mnr Brr wittiout dirtary supplcnreDts and goit..146.47,52.561. deiiciency (unless a vitamin Bj: th€ n€onate is exclusiv€ly br€ast- Nuirirnt supply in a vegan diet supplem.nt is us.d) I311. Swer.l fed, vitamin Bi: deflciency md its in pregnahcy was investjgated studi.s onveg.ns who took novi- conscquen..s (nrurological dis- ih a syst.maiic rryicw. The shF tamin B,r supplcments havr found ord.rs, h€Aaloblasti. anarhia) dies w.r. h.tcro8enou3, with rc- that (h. prevdl.n.r ol low viti- could already be observed in th. spe.i to both th.t m.thodoloity min Brr supply resp. vitamin Br: first months ol life l42-s.ll. and their r.rults sdn. of th. deficirncy was uD to 86,]6, depen vitamin BD supply .rn be asses- studits wce raled as bdis of poor ding on lhe p.rdm.ters cxamn d sed with s@errl bionrrk.rs. Thesc qualil'y. B.aring in nind thcsc I32.3:ll. ihchrde blood con.entrations of limitations, th. authors concludcd VitanriD B,r participates in thc vitamin B,r, holotranscobalamin thai , frt€1y chosen veg.tariah or regulition of l)ohocysteine cof- (HTC), scrur methylmiionic acid vegan diei wjthoul financial r.stri. .eni.atiobs .nd hethionihe me- (MMA) 6nd plasma hohocys- tions is $f. durinB prgnanry, ifn'F tabolish, ar w(ll !s ha€matopoi€- tenl.. Nod. ofthesc biomlkers is trient supply is obseNed.Dd Dutri.nt sis antl th. inctabolism of fatty suiiablc as thc sole parrD.t.r to defi.its are cohpensated ftr l3l. a.ids atrd ahino acids. I.ow seftm waluate vitamin 8u supply I551. For population groups with spc- .oncentrations of vitamii BI are .ial requirements for nutricnt associntcd with hiah plasra con- supply, a w€ll-diE.t€d selection of centrnti(nrs of ln)morysteine. High loods and modcs ofpreparaLion is Population groups with plasDi. hoho.yst.inr .on.entr.- n.cessary, i.e. hiAh quality, nutri spe€ial requirements for tions hlve been consid.r.d to br r ent dcnse foods, preparaiion ard fisL lactor tbr cirdiovrseular dis- administEtion appropriaie to a8e oses l-14 361. Itotra.t€d lLrw witr- ln p€.sons on r v.8an di.t, th.rearr Pnrticularly in phascs ol Srowth rnnr B,: nrbk oD also impair ..ll dim.ulries with th. supply of sonrc or of indeascd r.quirements tbr fun.tion and DNA s-l,nthcsis aDd nutrjcnh (. Tablc 2), and tlis nay nutricDts, the intake and supply may l.ad to nk,{aloblastic anaoria havr unfavourable con!equ.nces of nutrients sholld be regularly or ncurological disordeB Il7l. tor health, particuiarly fo. p.o- checkrd by a trutrition counrel- As ihc liver siore of viinmin B r pl. ifl s.nsiiivc phases of liL (e.8. lor or physician. If intAke is inn- ls . trnaehrungr Ums.hau /ir.rndno rd 4,ra16 95 Special I DGE Position "Vegan Diet" increasing the intake of individual brrD rriti(ised 161 631. Howde.. Food related nut.ition nutri.nts by means of th. f,re- these foods can support nut.ieDt re(ommendations cisely caiculated -.onsunption of suppty to vcgans, in so fhr as thc! forhfed foods or by takinadi.tary ar. fortificd with nutrients Food-relatcd nutritioD r.Lomnr.hda- supplrments 12, 3l According to . Table 2 shows the options for tjons for vegan .rlirition have been the cu.rent state of knowledge, ii v€gan nutrjtion thai msrrre ih€ in- publish.d hv various scientifi. so.ic- is not possibte to ehsure an aJ€- t3kr of potentially criti.al nuftinis ties aDd ext)crts. Thr Gi€ss?rvegeta- quate Yitamin B r suplly witb a Thc sour.cs for potentially critical ri.n food pyramid.ontans a-ll food vcSan diet without takinB dictary nulricnts ar. Dahnal tbods nch n) groups ror dvola.to v.ll.tariaDs thesc nutri.nts nntified tbods and and also tor v.g.ns, with the corl dietiry supplements. v.gans should mrni that v.gans should use forti- specifiGlly inar?orat thcs. in thcir fi€d lbods or di{ary suppleh€nis Food selection in mctrus. In iNs way md with spc- io covcr ihci. .equirrmok t2l. ln a vegan diet cifi. food s€lcrtion and Sood plan- ordcr to support the plannin8 of a ning, it is Possible to ceat. a vcgdn vegclanan dict, u)! Di€tary Guide- The ioods consunred in a vegan di.t diei jrl which no nuirieni dcli.iency lines for ArEtralix conirin specific are not n...ssrily nlrritionally fa notc! lor ovo lacto v.geta.i.ns aDd vourable or h.alth-prcmotnrg. Thc Onc s.nsitivc popnlation Eloup ar. vcgaDs on indivjdual food Eroups foods consuhed may in.lude vege- infants who are noi o. only par- 1691. As part of thc rlor5 Dietary tables, ieSum€s, fruit, nuts, se.ds, tially brorstfed.withnrdustrially cuidelines for Am$icans, tlrc Llnitcd valuable plani oils or whole-graiD produ..d nllant lorntrlas l)ased on st.ies Deprrtment of Agriculturr p.oducts, all of which hav. been cowi mill. hralihy non-brcast (USDA) devdopEd nutririon .ecom- shown to havr favou.ablc rffects fed nrf&t5 .ftc. a maru-e lrirth arc bottutiors for a llcalthy Vcget.- I8, 9, s7l. ll however high lryels ol provided wjth adequate DUtlienG in .ian Pahern l70l and provid.s sue- su8ar. fat or table salt are added to th. frrst nroDths, indcpeDd.ntly ol Scstions for .onsumcrs who wish k) ve8!D dishes, then they aenutritio' the hoiher'! diet. Apart llom in- adhcre to a veg.taaa! diet l7l l- nally ufavourabk 19, 5 7, s 81. Iood fant lormulas bascd on .ows' hilk. I. theGie$to veg€tarim ldd pyra- selection mny deprnd on thr indivi- ther. ar. also infaDt fomulas based mid, it is r€commeDded tltlt veg.- dual hotlvc for a vega. diet (€.8. on soya A curre.t rcvi@ 164l con- ia.ians and veg.ns should replacc ani'nal vaella.c or hralth rea$ns) .hrdcs that u)denr intant fonDul.s he.t, 6sh, nrilk altd caSs with Ic t15, s9t. bas.d on tuya aresiie and that thdr Bu.res. su.h as p.as, beans, .hick- Due io dary changes and an en eff€cis on growth, bone health, and pe.s and kniils, or h,ith soya pro larg€mcnt in thr diilable (proftssed) on reproductive, €ndrrrine .nd neu- ducts and other protein y,u..es. ,\ foods ed lossitk food supplies for rok,Sical function and ihc nnhunc compa.ison betwecn a wholcsohc vegansiD th. r..6t years, thc supply systcm do noi dillcr from those oi di.t i,r accordanc. with thc ..com- situation tor p.Bons on a vqan diet other infanl fonrul.s or ol brcart mcndations of the DG! and the r. his p.obnbly xnprc\,,sd Atroui 90%ol mill on tlr oih€r h.nd. the Federal commendations fo vegan di.t in Lhr 8s2 vegrDs surveyed in an onlh. hrstitntr for Risk Assessm.nt {Bltr) the Giessm vcsetdiaD lood pyr.inid survry tJuly,/August 2013) lcportcd 1651, ih€ Young raDily Network show! that both havc the san{ basis ihat it had become much simpl.r in l66land the Nutrition comnittec of and thc corr.spondinS food-rclat.d recent years to follow a v€8an diet Jl t. thc Gerhan Paediairic I67. 68lon- r(ommendations are vrry simila. Due to ihe iloeased demand, an side. that infant lormulas based on (. Tible 3). l_low.ver, ihe folk wlnd ibuDdaht .nn8e of ve8an convoi soy! .amoi r.pla.. producis based sp(cilic poiDts must b. corsider€d .nc( aod rcpla.onolt products .rc oD .ows' milk rnd arc rct iDt.ndcd now availablc, {cn nrcluding ihi! for the nuhiiion of heakhy iila.ts. VegeLables. includinB l€gu m es ates of meat products and che.s.. B..ausr of thdr coDtrnt or phy- and liuil pro\ide the basis for These d€ inknded to respond to thc to-ocstro8cns and the highc. level h.alth-pronn)iin8 nutritioD, hccaus. custom.rs wish for a wid. reg. of lhminium in.ompdGon to in- of their high nutnent d.nsity, thdr of choi.€s and a..ustomcd dishes. fant forhul.r barcd on cows' hilk, hiSh contcDt ol dictar,u fib.c and The )n6nufdcturin8 conditions hav. inl!nis who h6ve not bcen br..st- lIytocheDricals and their potential loDB achi€vcd thr 1.ve1 for convn- f€d kr only pdrti.lly) should onlv to prevfni various nutnhoD-r.lated tional foods 1601. Somc of ihes. br giv€n soy. products rcgrrlarly in direases. "5 . day", i.e. 5 po.nons of are lighly process.d products con u.cl,tional rnd justified c.ses {e.g vegetabls ind fruitll day, arc tucom- taining many additiv.s, and th.ir galactosarmia) and on ml{ical rt- hddcd. ror vcgetariatr (includnrg nuhitional value has som.timcs comnrcndation I6s-681. wgah) nuir'ition, lhe Gie$€n vcSeta- 96 Emrchiung! umnhau {. onahot 4t2at6 wohr.somN di€t (mir.d di.t) jh d&drh.€ wi$ rhe DcE vcqan.u<kD in i(ordrnr. wr$tnc ci.n€n (r.r.Enre v.r!$ ror .du[, t8o, 3r I wgerari.n rooil py.rhld t2l Aboot 2 I @Jr a d., e 9. wholegEi. bE!d, fl a-5 ri<6 (2oo-roo 9) or bGd o. jic.s(150-250 3-5 9) orbread.nd 50-609.ere, fl.k.r and g--l r po^'on (26 2to q) potatoei (.@Lcd) or I ponior (2G-25o 9) noodler (.6k€d) or I po.tion (r 5o-130 g) d.. (cooked) PE erably whol. grain podu.B Ar lea$ 40o I or 3 ponionr o, v.grbbl.r (ror € ar r.an ] pod:onr (aoo q) or v€s.r.br.s: ..l.iuh suppl, i.ld da* 9r& v€qebl.t l0o 9 cooled v€qdbl€t and lm g r.w ,tuit a.d 200 q cooked veqeiabl$ and 200 a raw frult .nd At Ld l0o 9 or 2 podions aruir daily, rFfl€m€nt $! Arreast 2 porrionr (250 q)1ruit t.,h tun with marifrally 50 9 dry ltuirand tuun Nurr rd sadri lojo g d.ily (i. padkular, ,,nonds and i6,m supply high lReL or dkium) Mllkand darrypbducts gE 200-2509 owratmrlkahndairypbdu.r gl 2nks(50 60 s) ro*ht.h.-" w.kly l.gum.r su.h .r p.ai, b€,ns, .hi.lp€,s rnd lenik: (prupareO.nd Maa!he pbdldr, df ]oo 600 9 l€an meat lean mar r-2 mea s porw..k and soy. phdu.tsGoya milki fth and e995 Joy, jogh u ni to,u, rempeh, etc....) and other gE r po(onGo r5o9)rowfatsartwaterrish(prcparcd) prol.in rouE6 (..9 3eiia.):50-l50 g/dry and g r podion (7o q) r"ry elNakr fiih (prcpared) and € upto 3 eq$ (in.luding pmce$.d cgg, Group6: drly unPro..$ed v.gebble oils and Lts: oirr and,ats €l 10 15 I oll (..q. ap., warnut d roF dD and 2-4 bt'lesFonr p6 day bar bu(6 ol n-l tdty € r s-m g harga.in. d burbr .cidt ,€ Bpe, llaa€ad and walnrt dl C.oup7. diily calcium{i.hwaldandoth.rakoho te.,low onnkr str about 1 5l- preleEb y lowene.qyorenercylr..dnnk Addrtidj.smk € rodhi.d .nd lluodd.r.d bbk ilr r! ro b€ r*d 5E suiriqfit ot h-r 1s mih-/d.y) rd rDmh D € h a rg.n di.! rh. Rlr$|. tupply ol vitami. € a un que.rEads6rr. ofviramin D 6 thar it E norony 3r and D should be eBored by approprirte obbrned ,.oh food, but th rh.hlman body.an ako prcdu.e vibmin D irself il rhe skin i: erpoFd to Tab.3: Food groups inthe wholesome nutrition (mired diet) ahd in the vegan nuoition ri6D f@d pyraBid emfhasises d.rk legumos, nuts and oil sceds. as tuay supply fiitical .utdcnts in gr.m leafy v.g.t.bl.s d nd dfied lruits. sou'les ol prct.in, B vitamins, zin( vegan nuirition. Tlis statenrent is In addiiion. cereals h the forfr of dd iron. a w.ll as iht usc of fortifr.d .ssotidlly bascd on North Amcn!_a. whol. graifl produ.ts rnd polatocs fd r (r.9. soya milkwith cilcim).lf wher€ Nore fortificd foods arc oD provide aD iddition.l basis.nd firtiri.a fmdr 3.. not..n{nned.r,rc ihe market than lre in CcrmaDy should be. component ofheals. unavailablc, ihtake of various dietary A .urrcnt swcy on fortin.d foods Thc .mmmcndations for oik. fats suppl.ments is r.ommcndcd (vita- availablc in diffcrcnt bran(hc5 or atrd drinks dr. almost idort.al {but- tnin B,r. vitamin t, calcium). lood retailers iD Gcrmany (Bonn) t.r aDd spreddable fat containing hui Measures ia improve nrnient .on- pe.mlts the conchrsion thlt iD Ger ter ire dch'ded from . v.g6n dirt). tcni (r.8. aermination of cdr.ls) maDy lb.tjfed lb.rds nay mak. a lthough thc fmd Sroups mni( aM and the bicvailability of nutricDts Dot.worthy contribution b nu dan'y prod!.ts and ,nc.i and ncrt lrom plant bascd foods .rc .dditio- trient iDlake too; c.8 the rcitrencc producc, as well as Ush and c8gs, nal sirat€i.s that should bc r.com- value for .iboflavin intake can be arc omitt€d from a veSan diet. th. m€ndcd to impruve nutrienl supply @chcd with 200 mL dt a multivi food rclat€d raomm.ndrtioG for ! tamiDjtuce On the oth.r hond, the vc8an diet in thr cic$or vegdarian Ir intcrnaiioml publicatioDs, it is addcd form aDd the bioavdihbility tuod pyramid lay mo.. eDphasis oD oftcn stated that lorti^cd ioods ofthe Dutri.nts from th.s. foodl ar. trnaehrungr ums.hau,,r.rndrorat 412a16 97 Special I DCE Position "Vegan Diet" oncn uclear and the add€d qumti- qlality milk prot.in. ties my be very variable within :i Thc network,Healihy Si.1rt - sin8l. p('duct Sroup J721. Youn8 rahily N€twork" states that a vegan dict js unsuitable for infants and ioddlels. as ii does not lnternational and ssur. thcir nutrient supplics. The for national statement5 and n.twork emphnsises the .isks thc chi-ld'$ dwclopm.nt, as wcll as recommendations the nec.ssity of medical advice and The A..demy of NutritioD aDd takiDg dietary suppl.mehts 176- Dicteti.sr 12415 iakes the position 791. Moreover, the r.commcrda- that an appropriat.ly planned hons of the Nut.ition Committee vegan diet th.t includ.s dictary of thc Gcrman So.iety of Pacdia- 3\rppkmcnts and for$6€d foods trics and Adotesceht Mrdi.ine ft- is nutritionally ad.quate and is je.ts a v.gan diet for healthy in- appropriate for i.dividuals du- fants. unles5 dietary suppl.ments rihg all rtag€s of th. Iife.ycle, in- chrdjng pftgnant lnd laclatinS women. rhis position is suppor- ted by scientiilc so.ieties in other countries. in.hrding thr National Health and Medical ResEr.h Com- cil in the DUtritiob rccobm.nda- tions for Australia I691. thc Portu- guese National Programmr lbr th. Promotion of a H.althy Dict l74l and - for adults - the British Nu- trition Fourdation I251. Thc Canadiar Paediatric Socieiy IT5lalso st6t.s that a well-plann.d veAsn dict, includnr! dietary sup- pi.m.nts, can cov€r thc nutrient requirem.nts i1l childr.n and ado- ].sc.nts, if adequatr energy iniake is cnsured. li thc opnrion ol th. British Nutriti(nr Fouldation I:51 r wdt-pltrD.d. balan.ed v.seta rirn or vtSan dict car b. nut.itio- nally adcquat€. More .xtr.nrc djets. srch as shi.t nracrobi{)tic and Ew food dick are orten k in durgy ahd a rahge ofnrioonui.icDts, ma kjng thcm whouy ihrdequ.tc ard inappropriai. for cbildr.n Morc- over, th. Portngu.s. National Programmc for the Promotion of a Healthy Di.t I74l ..comm€nds thct br.lstfe.dina for infants on a vcgan diei should bc extcuded beyond ih. re.o,nm.nd€d pcriod 1nnti, 2012 ltrmn ir th. M.ric.n Di.khc of six nNnths until 2 years of rThr20ls P6illoh of th. A.:d.my ol Nuhi age during th. food diversificatiod tion dnd Di.kti.s: v.8.larian Di.ts l73l wa process. ln this way, it could be withd'rm f,n' .ryisn n duriq rh pr.?rra Ehnrr€d that inJants and todders hor of thn positid paFr w. lh 9a Em.ehiuns,uml.hau rfuntaLanat 4i2o16 drns. fi\)ds ind tirriificd toods, in oftl$ to r.sure srrpply of Th! *atement hai been ca.erully.he.ked lor it .ont n! by th. put lkh.; howd.r, . nutrienls, pa.trNlarl), critical gurrantee ror th. .ontenr annor be ac.ep /\r ndequat. nrtnkc !l nutrj.Dts fufti$ts (. Tiblt 2); t.d. Nenher the publr!her, nor the edirotr 1s.. ..l.rcn.e \,,rhr.s lirr nuh'i(nt t possibly ]Ev. th. $,ppli.r ol arc liable tor any petron.linjury or dahage i!!t.rkr I rLrlt {rn br iss,,red l!} olh(r .rili.il !ut.i.r(s r.SU J vari(l !.d divers. sr'l.chor 01 larl) checkcd by a t)l)ysi.i!ir, ri)ods r\nv dict that do.s not L.d il th..c is a dii,rit. or possibli t,) thE ihtNh. ofad.qu.lc l.,cls of nurriti()ndl d.ilcicn.y, the nu rssdtti.l and (n.rgy is lrrti.,n shoukl h..djrtstcd arrd ')utricrils th. outh6 rnh ro rhont Pnl. !k\. thc .nti.d nutrieots shnrld lr k arlceo, ltul u Helmut & B 4ed q, 'lh. jn D(;ll r..onrtrrcrds i dl.t that .ddcd - eithcr dietar), sup- Ptol. Dt. HdB hhnq, Ptal. D. MtLhael kh r\d, in.luics !ll ghups or lo.ds i,r I)lcmcnls or li,tifi&l roods. Prct &. M6hikonan.r, tEtnot6, Prot Dr lh. nntritn,r cinl. i!.1!ding until th! nutricrt defi.Nrn,lrirs tl d.ga.d Pt tftu, P'ot. Dt. c,thtd t *\\qnq, Ptol. Dt. Cobti?le Ptot Dt rniml In otlr(r woftls. \sr , trl)du.ts. P.t! a6h, Ptot. Dt. ro -heivv 4nd, Prof. Dt D(;1.: ih. .rconrln.mls a a.l()l. 'consult . qu.lili€d nutriiiolr C.n rd e ra. ond Prol. Ot. cnnrh4 r dt h s(rnr di.t ir) t|c li,rm oi a nrixrd .ounn br J8l1 tirr r..ivin8 tor liti.otlt t.yb4ng the ndhuytipt and lat (liet thJ( lrrgcly !onsists ol tl.nl h.rsrd lr)ds rnJ. lo n l.ss.r rx Ihc risli Df nulridrt urddsup- t.rjt, ol ,tn,nril loods, jn.ludifg ply or . nuhiti()n.l (ldlci.n.y ll{h, nr.rl rnd nr(ni f( ucis luO, ( grtdtrr in p.rsons rn scnsirivr 8ll thas.s ot' liie, such.s pr.Bn.Dcv, I h. UGE ulso conside.s thit pcs.o l.ct.tion aird in intiants, chiLl- inri ovo-l.Ltd vqt.tarian di.ts nr. r.n and ndol.s.rnts taki.8 o. s'ritnb1. irr h.nlt)iv p..knrs nr I )rc being givrn i vegi^ did, iha. in long t.rnr i, at)t,nTri!Lc.lt. r. lrenlth), adulrs on a v.grn di.t. Di. Dotl. crihewald-Funtr h\,.s arc c,rrsid.r.d Lo o|tihizL lvith somc nuhi(nts, a \'.San diet Prot, Dr. Helnut Hes.k.'tr ilrr futri\ni i.tak.. Sfccinl carc is t! ihout lorlificd tir)ds or tli.t.i, v ,ictJrJ tn. Aroups h,ilh sp..ial rr suppl.nrents l.ads to nEd.quat. quir.nrrDts for .utrj.nt supply, intnk., whn:h nuy havr .onsid- rg pr.gnxnl (1)nrer', li.taling .r,lnc untivo,irrbl. .ons.qu.n rtot. or. tr?6h.'d w.tul. ,L(tDeD. inl:nts ind knldl.rs ..s li)r ht.lth. sirm r.j.(ting.ny i D.ut.hec.s.llr.hanliirFmahrung e v. n is tln vegin dr.t, it dilliflilt o. i'n- a.inral foods ir.r.asts ih..isk (DGE), Ood.rbergerAlLee 13, s3175 Bonn posslble to cnsur! rdrquit. sut, ol nut.i.nt defiricDri.s and thus r O€ut.he! rnnituirirE,nahrun9do6.hun9 pl) d, sorF n!tri.nts. llrr nx)r( of liralrh disord$s, r vrfrn di.t (oxt), A(h urs.n{ h.n.^rree 111 ! 16, .rili.al ruid.nt is !itfnrin B l is ft.onrmrnd.d by llrr DGE" r tompehn? rL, komhuniknrion pulJLi. ()t[.r potcntiill] .riti..1 trutri- durnrA'rct prt8nan.y or k(tition, or he.lrh emahrunq, Pt 02 2,r 50, r or 26 S.dan on a vcgan r .nts di.t nr.lirdc pro- for childr.n or adol.s.rnts ofany ro*jtutrarEhlhrunq, Konsum und cesund. t.it r.st'. l.disi)o)s.bl. arnino ag. lt is rss..ti.l thrt t)e.sons h.i( Unive6lilr Pad.rbom, wal6ul9e. st. I oo, ..ids and knrg.hain n-3 lat(y whr ne\'€.thrltss d$id. nr adhdc n.ds (EPr\ .fd Dll,\), otlrrf vilr io n vrgin dict slroul.l n(*c tlrr r Hochschlle Fulda, Fa.hberei.h O..oropho. nrirrs (dhnh\iirr. vit!mrr Dl ro9ie, Leipziger sr. r21,16037 turd. irnl . M.r pubner hnnu! aundgrofthungiinnr. nrir.ral5 (.rl.iurn, nanr, iodjnc, rutlLjrEm;hrunq und L.benrm tl. i rn5t(ur zid( d.Ll scleriuri) A v.8.n dirl fur Phynolog. Lnd BiodemiederEm:ih- is orrlu.hlc b fullil r.quikh€nts rung, Haid-und Neo-Sr. 9, 76111 K.rl5ruh. i, tL. inl,h'ing poids,)r..on- ridrr.(l i,r'rnns (u r v.gnn dirt . l!Le n !il.mi llLr sufl)lcnr.nl in lli.lo,,g t.r r ind h.,ve ih.lr nlt)plics .r vitimib B.r rrgu- lxrlv.h.(Ned by a phvsi(ianj . srlr.t \,(r'' sp..ilicatly trutri.ni td 1t2ar6 99 I DCE Position "Vegan Diet" l20l{) GmDarnm 0l nurritinal qual- 26 Jm6 C Vramin D ltr: Rer AC Gt llso irr_ ol lt!c ldgan. !+\r mian. scni-\t8d rr' R Cdsins Rld al (llsr MdiinulritM l. (*$h[c&$h P (2015) Vqrn did nG ri. pd@v{darirn and omntrorous dld ln hElrh uid duasc ll A!i. Liprinq{r rns .pprc.t ,.d dudrrh lmlirt re Nurids6: lll8-ll!2 willirG & willin!. Philaddphia (201.1L rirs ola q!.irir6riv! scidogiol srudr 11 knrasd NL Madsd ML llons ]H d s 278,292 Ernahitrngs Um$huu 62: 9&l0l al (1015)hhlieoirosG ind mnourri- 27 Znisminn A CumnEI lf (2010) Nn- :. Leirztuni C G{lE M v+darircne orr in &.ish rBans NurJ lJ lrl classiol vira(in D loids Nuriori l: Lrn{hrung I al1$l AuA, Ulmd. SrLrll' l5 orlich lVJ, JaaldGsiel ( lirhlle.l 11 rL r20l I ) Plr rds ot ri{d MemJx u amd8 23 Xmi a $'rlrd al H&,Ii al ldb+ l. PiccdiCBOariR MgdtilNir al (2015) vedrrirnr and noFrgdailir &r N0r Fnrdrndrr und Nihr!orzufuhr Er9(+ Vegan.,lgcariai dl6s h pre8iaiq dan8c ll2:1644 l6il ir&d6 N6rioial6 Vdzdrtsrudi! II ln: o p6ni@l A syirdEric na ftlnt rqa ll' &r Sl, Bogl'lm IM (20001 Rd tr. O lscficosdlshan tu Frn,hrung (llgr EJql t?2 621 63.1 adghr, sciShr 16r efioris rnd n[triml iE- l1 t nlhrungsbcthl l0ll thnn l:012). ,l Dd$.he C6dl*hd lt liir E n{hrun8 llXlE) l!t6 lmng h6llh-srids \edrriu- (!O (iais ll ) Fl6nrriE - di. riJtrlo trgr,.i{ Fsr lcgd!.ian rnd no\ed!rian $ons 19. W] (2009r H@lrh elTcrs ol reqln IXiErlo I46 l1') !86 l8lo50 ., in (bllNdr 19:78J-788 did! An,l C]lr Noll 89] r627]l6ll$ 5 ltuvnrd v. ltrmis U OulrM KZ a al 17 l}lq Cl( 5por6 U\ Appl.h! PN d al ,10 Ddrsn. (bdlcl,Il br Fir{trune lX;E[ 1201 5 ) (itrcinogdicrr ! ol@nsumplid ol t2001)!Plc.61i{d litNll(dand{ iN o$neiliki\e c6dhch,n ftr Frnrhug rd dnd irGsgl mer. Land (hNl 16 and mrtliar iiultd i! a dt'{rl ol]l 88ll lCxjE), Srhr.i.sisch. c6dlllhrn f0r m!al6and lll 5.16 nm @r qt* in rhihflng tSCE:r (l1g). Rdco?{ck hr di. 6 &Eng I PriBlion dMh lindhrunS ln. rhe ln( PuhlirllshhNrrr6 2t9 269 NIhdrolfzutuhr.2 tu^. I Alrg,Bnn r?015) rrlhctu 1j6dl*hal hir &nIhrug (Hgi l8 DQpsA l$isl MalhirmNdrl 1199:r) ll.MNr! L lisrt trGrdrNi{Pd ul l2 li(i htungstEichr 2(r13. Bn. 12011l. Tn.6d$ {nd nliriol inrat.a 0ldilid.nl lz0lll ltu inpacl olv€an did on &ll ! -t t9-354 rtp6 oir'qdarianr d os lor sumlddrsl' starus !r h@lrhy omnivmd Avilor rru 7 $/eld (!n€ R.sErch fund IWCRF). soalilr$udr A1r Sq Pd T{ind Alnnhr A0dian In lrul? fn ON{ Rs€rch 19 D,i ad.t P .AlBvldEs ]( llebHin.I M ]l 20S lt2 (AlaRr 0lg) !on. nurrnin. phr_sidl a(' d rl t2010)NurlNnal (irus d Fiftidr .1, Pasla\ R thtrdt Sl. RnJ sd dl r:0llr rirn!-,. aid lh. p.adl io oadtrd a gl.t{l rBtt,riaN mp€rd $nh nocngd.r H@ p@llor is,iramin Illzl deA. pdq,ariv. washingio 1r12007) ius a firl.hsl s,f,pjd nudy \urioirs dflq a oig le-qdal aisl Nrfi R* 7l -1i0 8 Bejne H. l5:tl hdd A &h d al. t2n l2 r 1 18! Gni@l t6as lCcablc and iun ,n rh. 20 oilsing. AMl. Go$cF1, Uor..d-Wrighl Zd ll Pr\i0l & larr stl Fabirdidc I r20l1l 'lhe F6mlj(h olchmic dsaics Eur I Clin al r1010) SEUm trdlrallons olvitanii prn-0|!nce ol sbalrmin defi.is{ B:,Dd Iiiare in &ilish mlt mnivdL\. ammg \qdarians sswl h- s,n il!- 9 fbrsd1e G6d lsha i lnr Bnrhrung llXiE) ve€ia!ians and v.8ans: 16ulrs liM ! nrn B,: a B'fl ol litdar rc lxr J Oin (llg) Kohlmhtdrarzutunr und Pr{|d. rG$sd imal analysis of r hc EPIt:Gldd rid ausg!\rihlrs mehnngsmn Min$d colLn sud). tur I Oin Nurr(4 9ll r39 l.l. wlldaann A (G!tiz[e Jw. Leitzmann C Kranklrelro - liid6zbasil,le Leir ini! ll. [email protected] M. Sitr'oicir R. d al 12004) HomGlsldmand sobalamin &.n l20ll) URtr aN dEd. riMs.h &linslii K !1 al ll9rJ) lileld rn,ninJ sr DS in (jqnatr r+!ns Publir llallh dft, leirlinien lcirlinie-kohlshydr!rcl and riiedtr6l' rn blqn olveclanus. Zugrtrl I n2 16 lnn Nulr Mdabl9i ll,l-li9 l5 lldhn A W{ldmann A(200,1r Gsund mrl l0.llinu M. bhircR (inrini Gt d al. r20l6) 22. Maldrzali U Singu I Marnc M q 1l r.ind PAanz{16r'l Uninaglz0 thnn(d V.ssanai. lesai di(i aid frulriplehBhh 12006) tlviramii srarus aid cmolra. tutm6 . srstddl]c r.is rYnh n!. tims oi hmoqndn. in A!s[i! n m.,rds- 16 OhJshl D CtarrEll DC. D'rnnd' A d rl ra-,nalj:ar oI0osav!!iNrl srudi6 (rir vedarians and !$ins Intr Ntrlr Md.b (:0llr fllsma lorsl hMr!ustr. srarrs lid Fo] &iNurr Ibuhaha'd olnifll 50 485--491 oi veerarlans umpdoi $nh omrivor* a | | (soaG U@r t Mllrll I(d al. (2011) 2-1. Rizzo NS hoddoliiBl K Sdbnre J d rl sysrmtic rdis and nda-anal$'s. 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