Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
PANf
should be addressed.
5.
31 January 1994. Revision accepted 29 July 1994.
212
VEGETARIAN
SUBJECTS
AND METHODS
TABLE 1
Subject characteristics1
Female
Male
20)20.6
(n =>
Age, y
Height, cm
Weight, kg
Body mass index, kg/m2
Duration
ySupplementation,
of vegetarian
diets,
1.0171.7
4.1
62.7 3.7
21.3 1.2
052100Vegetarian
23)22.6
(n =
4.4a
168.1 4.9
56.4 6.5
20.0
1.3a5.5
4.662000Nonvegetarian
39)20.3
(n =
1.1
161.1 4.1
53.7 5.9
20.7 2.6
022000Vegetarian
32)24.8
(n 4.0b
158.5 6.1
50.4 8.0
20.1 2.8
6.242212
6.7
no. of users
taminsVitamin
Multivi
CVitamin
BVitamin
ECalciumNonvegetarian
Values are means so. Superscripts indicate a significant difference between dietary groups within sex according to Student's
test: aP <
0.05, bP < 0.001.
213
SHAW ET AL.
214
RESULTS
The two dietary groups (vegetarian and nonvegetarian) were of comparable age and body size
(Table 1). Although
the vegetarian groups were
slightly older than the nonvegetarian groups and the
nonvegetarian males had a slightly greater body mass
index than the vegetarian males, these differences
were not expected to impair the comparison of iron
status. The duration of vegetarian practice ranged
from 2 to 23 y, which was expected to be sufficient to
demonstrate dietary effects on individual iron status.
More vegetarian subjects took nutrient supplements
VEGETARIAN
215
TABLE 2
Daily nutrient intakes of energy, protein, iron, vitamin C and fiber1
MaleDietary
20)1.9
(n Fe density, mg/MJ
Energy intake, MJ/d
Protein, g/d
Fe, mg/d
<100% RDA,2 n
23)2.2
|n -
1.2
8.4 1.3a
80 13a
16.1 2.9ab
0.8
8.4 1.3a
72 16b
18.4 7.3a
39)2.0
(n 0.3
5.9 1.2b
62 12C
11.7 2.6C
32)2.0
(n 0.7
7.8 1.6"
69 171"0
15.6 5.4b
0
1
37
19
5.6 2.2ab
5.0 1.7ab
6.1 2.7a
4.7 1.0b
Crude fiber, g/d
196 98aVegetarian 137 41b
155 85bVegetarian 132 52bFemaleNonvegetarian
Vitamin C, mg/dNonvegetarian
'Values are means so. Within a row, values with different superscripts differ significantly by Duncan's multiple range test (P < 0.05).
2The RDA for iron is 10 mg/d for male and 15 mg/d for female (NRC 1989).
TABLE 3
Hematological
and nonvegetarians1
MaleNonvegetariansIndexHemoglobin,
20)0.2a4b8b6b12b(37-532)<12
mmol/LAnemic
nTransferrin,
subjects,
umoi/LTIBC,3
\imol/L>71
-9.40326431627291a< -9.2
39)i0.5b4gab7b12b(3-145)9Vegetarians(n7.61
035
69
623
nPlasma
nmol/L
\imol/LTransferrin
iron,
%<15%,
saturation,
nPlasma
ferritin,4 |jg/L[n
36
047b23)0.5a4oab5a8a(9-182)1FemaleNonvegetarians(n7.953569151727327e-
ng/L,5 n0Vegetarians(n
'Values are means + SD. Within a row, values with different superscripts differ significantly by Duncan's multiple range test (P < 0.05).
2Cutoff hemoglobin values for anemia are 8.1 mmol/L for males and 7.4 mmol/L for females (FAO/WHO 1968).
3TIBC = total iron-binding capacity.
4Values are medians with ranges in parentheses. Median plasma ferritin values for all groups were significantly different by Duncan's
multiple range test (P < 0.05), after log transformation of data.
5Number of subjects who had a ferritin concentration lower than the indicated value. The value of 12 ^g/L indicates depletion of iron
storage (Cook and Finch 1979).
216
SHAW ET AL.
50
1A: Mai
PJB omniTor
l'"
IMO
50
i"
n ni
10:
DISCUSSION
Iron status is generally less adequate in menstru
ating women than in their male peers (NRC 1989).
The underlying reasons are physiological, because
women have increased iron loss due to menstruation
and lower iron intake due to lower energy con
sumption (Finch and Cook 1984). In this study, the
gender difference and the relationship between energy
and iron intake were also observed in the two dietary
groups (vegetarian and nonvegetarian). For nonvegetarian women, the first limiting factor was energy
intake. If energy intake is increased from 5.9 to 7.5
MJ/d, iron intake can be increased from 11.6 to -15
mg/d.
In this study, the prevalence of iron depletion in
both nonvegetarian groups was consistent with that
estimated for the male and female populations age 16
to 44 y in Taiwan, which was about 2 and 20%,
respectively (unpublished data). Although some sub
jects took vitamin or mineral supplements, the per
centage is relatively low when compared with
* 10
e
transferrin saturation and plasma iron in nonvegetarian females was not found in the vegetarian
females. When the four groups were pooled, the corre
lation between hemoglobin concentration and iron
intake was significant (r = 0.26, P = 0.005), whereas
that between ferritin and iron intake was only mar
ginally significant (r = 0.17, P = 0.064). Such correla
tions did not exist in individual groups.
Famal
800
Male r=-0.38
p=0.077
w Female
r=-0.12
p=0.53
<
ID: rml
^H omn-vora!
I I ragatarlani
^-s
30
t- 180
li
*
B
1M
BO
19
ti
-V
3
Fcrrltln
40
(uf/L)
Trnferrln
(nmol/L)
a
IB
Duration
le
(7)
VEGETARIAN
217
TABLE 4
Pearson's correlation
coefficients
between
hematological
Hematological
indices2Hb
FerHb
vs.
TIBCHb
vs.
TSHb
vs.
PFeFer
vs.
TIBCFer
vs.
TSFer
vs.
PFeTIBC
vs.
vs. PFeNonvegetarianNSNSNSNSNSNSNSNSMaleVegetarianNSNSNSNS-0.50NSNSNSFemalePooledNSNSNSNSNSNSNSNSNonvegetarianNSNS0
'The level of significance is P < 0.05. NS = not significant.
2Hb = hemoglobin, Fer = plasma ferritin, TIBC - total iron binding capacity, TS transferrin saturation and PFe - plasma iron.
218
SHAW ET AL.
LITERATURECITED
Abdulla, M., Andersson, I., Asp, N., Berthelsen, K., Birkhed, D.,
Dencker, I., Johansson, C., Jagerstad, M., Kolar, K., Nair, B.,
Nilsoon-Ehle, P., Norden, A., Rassner, S., Akesson, B. & Ockerman, P. (1981) Nutrient intake and health status of vegans:
chemical analyses of diets using the duplicate portion sampling
technique. Am. J. Clin. Nutr. 34: 2464-2477.
American Dietetic Association (1986) Exchange Lists for Meal
Planning, revised. ADA, Chicago, IL.
American Dietetic Association (1993) Position of the American
Dietetic Association: vegetarian diets, f. Am. Diet. Assoc. 93:
1317-1319.
Anderson, B. M., Gibson, R. S. &. Sabry, J. H. (1981) The iron and
zinc status of long-term vegetarian women. Am. J. Clin. Nutr.
34: 1042-1048.
Cook, J. D., Dassenko, S. A. & Lynch, S. R. (1991) Assessment of
the role of nonheme-iron availability in iron balance. Am. f.
Clin. Nutr. 54: 717-722.
Cook, J. D. & Finch, C. A. (1979) Assessing iron status of a
population. Am. J. Clin. Nutr. 32: 2115-2119.
Cook, I. D., Morck, T. A. & Lynch, S. R. (1981) The inhibitory
effect of soy products on nonheme iron absorption in man. Am.
I. Clin. Nutr. 34: 2622-2629.
Cook, J. D., Watson, S. S., Simpson, K. M., Lipschitz, D. A. &
Skikne, B. S. (1984] The effect of high ascorbic acid supplemen
tation on body iron stores. Blood 64: 721-726.
FAO/WHO (1968) Nutritional Anemias. WHO Technical Report
Series, no. 405, Geneva, Switzerland.
Faraudi, M. & Mejia, L. A. (1987) Development and evaluation of a
simplified method to collect blood samples to determine hemo
globin and hematocrit using Chromatographie paper discs. Am. J.
Clin. Nutr. 45: 790-796.
Finch, C. A. & Cook, J. D. (1984) Iron deficiency. Am. J. Clin. Nutr.
39: 471-477.
Hallberg, L. (1981) Bioavailability of dietary iron in man. Annu.
Rev. Nutr. 1: 123-147.
Hallberg, L. & Rossander, L. (1982) Effect of soy protein on
nonheme iron absorption in man. Am. J. Clin. Nutr. 36:
514-520.
Helman, A. D. & Darnton-Hill, I. (1987) Vitamin and iron status in
new vegetarians. Am. }. Clin. Nutr. 45: 785-789.
Huang, P., Wei, H., Huang, S. &. Yu, S. (1978) Composition of foods
used in TaiwanSupplements.
J. Chinese Nutr. Soc. 3:
110-115.
VEGETARIAN
Pan, W., Lee, M., Yu, S. & Huang, P. (1992) Foods predictive of
nutrient intake in Chinese diet in Taiwan: D. vitamin A,
vitamin Bl, vitamin B2, vitamin C and calcium. Int. J.
Epidemiol. 21: 929-934.
Pirzio-Biroli, G. & Finch, C. A. (1960) Iron absorption, m. The
influence of iron stores on iron absorption in the normal subject.
J. Lab. Clin. Med. 55: 216-220.
Reddy, S. & Sanders, T.A.B. (1990) Haematological studies on premenopausal Indian and Caucasian vegetarians compared with
Caucasian omnivores. Br. J. Nutr. 64: 331-338.
Remington, R. D. & Schork, M. A. (1985) Statistics with Applica
tions to the Biological and Health Sciences, 2nd ed. PrenticeHall, Englewood Cliffs, NJ.
Schricker, B. R., Miller, D. D. & Van Campen, D. (1982) In vitro
estimation of iron availability in meals containing soy products.
J. Nutr. 112: 1696-1705.
Shultz, T. D. & Leklem, J. E. (1983) Dietary status of Seventh-Day
Adventists and nonvegetarians. J. Am. Diet. Assoc. 83: 27-33.
Takkunen, H. & Seppanen, R. (1975) Iron deficiency and dietary
factors in Finland. Am. J. Clin. Nutr. 28: 1141-1147.
Tung, T., Huang, P., Li, H. & Chen, H. (1961) Composition of foods
used in Taiwan. J. Formosan Med. Assoc. 60: 973-1005.
Worthington-Roberts, B. S., Breskin, M. W. & Monsen, E. R. (1988)
Iron status of premenopausal women in a university community
and its relationship to habitual dietary sources of protein. Am. J.
Clin. Nutr. 47: 275-279.
219