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LEADING ARTICLE
Vegetarian Diets
Nutritional Considerations for Athletes
Angela M. Venderley and Wayne W. Campbell
Department of Foods and Nutrition, Purdue University, West Lafayette, Indiana, USA
Abstract
The quality of vegetarian diets to meet nutritional needs and support peak
performance among athletes continues to be questioned. Appropriately planned
vegetarian diets can provide sufficient energy and an appropriate range of carbohydrate, fat and protein intakes to support performance and health. The acceptable
macronutrient distribution ranges for carbohydrate, fat and protein of 4565%,
2035% and 1035%, respectively, are appropriate for vegetarian and
non-vegetarian athletes alike, especially those who perform endurance events.
Vegetarian athletes can meet their protein needs from predominantly or exclusively plant-based sources when a variety of these foods are consumed daily and
energy intake is adequate. Muscle creatine stores are lower in vegetarians than
non-vegetarians. Creatine supplementation provides ergogenic responses in both
vegetarian and non-vegetarian athletes, with limited data supporting greater
ergogenic effects on lean body mass accretion and work performance for vegetarians. The potential adverse effect of a vegetarian diet on iron status is based on the
bioavailability of iron from plant foods rather than the amount of total iron present
in the diet. Vegetarian and non-vegetarian athletes alike must consume sufficient
iron to prevent deficiency, which will adversely affect performance. Other nutrients of concern for vegetarian athletes include zinc, vitamin B12 (cyanocobalamin), vitamin D (cholecalciferol) and calcium. The main sources of these nutrients
are animal products; however, they can be found in many food sources suitable for
vegetarians, including fortified soy milk and whole grain cereals. Vegetarians
have higher antioxidant status for vitamin C (ascorbic acid), vitamin E (tocopherol), and -carotene than omnivores, which might help reduce exercise-induced
oxidative stress. Research is needed comparing antioxidant defences in vegetarian
and non-vegetarian athletes.
Vegetarian diets are receiving increased scientific scrutiny and popularity among the general public
for potential health-promoting benefits. The American Dietetic Association (ADA) states that well
planned vegetarian diets are healthful, nutritionally
adequate, and provide health benefits in the prevention and treatment of certain diseases.[1] Vegetarian
diets tend to be higher in complex carbohydrates,
fibre, fruits, vegetables, antioxidants, phytochemi-
294
tion of animal-based foods, and to possibly eliminate the use of some, especially red, meats. This
eating style typically has been referred to as semivegetarian. While this term has gained popularity in
its use, it is ambiguous and should be avoided since
the consumption of meat, no matter how little, is
carnivorous.
1.1 Lacto-Ovo-Vegetarian Diet
Food patterns
Lacto-ovovegetarian
Vegan
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296
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vegetarian office workers with similar physical activity levels to the vegans. The assessments included
forced expiratory volume and forced vital capacity
by spirometry, cardiovascular response to submaximal exercise on a cycle ergometer, and estimates of
thigh muscle width from circumference and skinfold
measurements. There were no differences in the
variables measured in vegans compared with the
non-vegetarians. The results showed that a vegan
diet does not impair the physiological response to
submaximal exercise.[33]
Hanne et al.[34] studied the effects of different
vegetarian diets on physical fitness. Various fitness
parameters were used to compare vegetarian (31
lacto-ovo-vegetarians, 13 lacto-vegetarians and 5
vegans) with non-vegetarian athletes matched for
age, sex, body size and type of athletic activity. No
significant differences in fitness parameters were
found between vegetarian and non-vegetarian athletes in a variety of physical fitness, anthropometric
and metabolic measures, including aerobic and anaerobic capacity, hand grip, back strength,
haemoglobin, total serum protein and pulmonary
function. While the results of this study generally
support that consumption of a vegetarian diet does
not impair the capacity to perform aerobic and anaerobic exercise, the study also underscores the importance of defining and controlling the types of
subjects studied and other experimental design issues.[15] It is difficult to apply these findings when
the subjects consumed a wide variety of diets for
which the energy and macronutrient contents were
not documented, the subjects performed numerous
types of athletic activities ranging from long-distance running to football to basketball, and the subject age range was 1760 years.
Raben et al.[35] studied the effect of a lacto-ovovegetarian diet and a mixed diet with meat on endurance performance in male athletes. The study group
consisted of eight well trained male endurance ath 2max)
letes with a mean maximal oxygen uptake (VO
of 67 mL/kg/min. The athletes were fed a lacto-ovovegetarian diet for 6 weeks and a mixed diet for 6
weeks. An aerobic endurance test was performed on
subjects using a cycle ergometer or treadmill after 0,
Sports Med 2006; 36 (4)
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The use of trade names is for product identification purposes only and does not imply endorsement.
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302
Function
Iron
Zinc
Vitamin B12
(cyanocobalamin)
Vitamin D
(cholecalciferol)
Riboflavin
Calcium
that low iron stores increase the risk for iron deficiency anaemia and may adversely affect physical
performance, especially aerobic activity.[14,18,27]
Vegetarian athletes can increase total iron intake
by incorporating more leafy green vegetables such
spinach, soy foods, legumes, dried beans, iron-fortified grains (such as fortified breakfast cereals), nuts,
seeds and dried fruits (table II).[1,14,15,20,59,60] In addition, include fresh fruits, vegetables or juices rich in
vitamin C to enhance iron absorption.[61]
6. Zinc
Zinc is another nutrient of concern in a vegetarian
diet. Zinc is an essential trace mineral that is a
component of >100 enzymes and is involved in
immune function, protein synthesis and blood formation.[15,18,27] Total zinc intake is generally lower
in vegetarian athletes than non-vegetarian athletes.[15,18,20] The best sources of zinc are animal
products, meats and dairy products in particular,
which provide 5070% of the zinc in an omnivore
diet. In a vegetarian diet, zinc is found in legumes,
whole grains, nuts, seeds, soy and dairy products
(table II).[14,15,18,27]
It may be difficult for a vegetarian athlete to
maintain clinically normal plasma zinc concentration because exercise, especially strenuous exercise,
increases zinc loss from the body.[15,20,54] Exercise 2006 Adis Data Information BV. All rights reserved.
induced losses of zinc occur in urine and may represent up to 79% of dietary zinc that is absorbed.[62]
Zinc losses may also be substantial for athletes who
exercise in hot, humid environments, although training and environmental acclimatisation may decrease
these losses.[62] Zinc status may also influence exercise-induced changes in zinc mobilisation, with the
combined stresses of low zinc intake and maximal
exercise contributing to alterations in some body
zinc pools, as reflected by a reduction in circulating
exchangeable zinc.[63] Zinc bioavailability also appears to contribute to zinc deficiency in vegetarians.
As seen with iron, zinc absorption from plant foods
may be impaired by phytate, a potent zinc inhibitor.[2,15,18,20,27] A food preparation technique vegetarian athletes may want to consider that enhances
zinc absorption is soaking beans, grains and seeds
(table II).[1]
7. Other Nutrients
Vegetarian athletes may be at risk for low intakes
of several other nutrients including vitamin B12,
vitamin D, riboflavin and calcium (table
II).[1,14,15,18,19] The main sources for these nutrients
are in animal products but can be found in many
alternative sources suitable for vegetarians. To help
meet calcium needs, vegetarians, especially vegans,
should consider consuming calcium-fortified soy
Sports Med 2006; 36 (4)
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Correspondence and offprints: Dr Wayne W. Campbell, Department of Foods and Nutrition, Purdue University, 700
West State Street, West Lafayette, IN 47906-2059, USA.
E-mail: campbellw@purdue.edu