of epidemiological research are traditionally
expressed in terms of relative risk, a difficult
concept for the athletic and consumer population
to grasp. In a recent re-examination of data from
the Adventist Health Study (Fraser et al.1995),
novel statistical calculations show how certain
effects may delay or advance the first expression
of disease. The Adventist Health Study is a
cohort investigation of approximately 34 000 Cal-
ifornian, non-Hispanic, white subjects living in
Seventh Day Adventist households who were
followed for 6 years. Some of the findings from
this study are as follows.
1 Non-vegetarians develop coronary disease
1.77 years earlier than vegetarians.
2 Among males, non-vegetarians have a remain-
ing lifetime risk of developing coronary dis-
ease that is 11.9% higher (P<0.05) than that of
vegetarians.
3 Non-vegetarian females have a remaining life-
time risk of developing coronary disease that is
0.26 percentage points lower than that of female
vegetarians.
4 Those who rarely consume nuts develop coro-
nary disease 2.6 years earlier and have a remain-
ing lifetime risk 11.9 percentage points greater
(P<0.05) than persons who eat nuts at least
five times per week.
While Seventh Day Adventists show a reduced
risk of several chronic diseases, many of them
also abstain from smoking and alcohol, and they
are more physically active than non-vegetarians,
which also affects the prevalence of chronic dis-
eases. To date, no one has followed a vegetarian
athletic population to see if they show the same
health benefits.Nutritional adequacy of
vegetarian diets
Protein quality
A nutritionally sound vegetarian diet is possible
if adequate amounts of a wide variety of foods
are consumed (Grandjean 1989; Harding et al.
1996), but there are certain nutrients that vegetar-
ians must be aware of and plan for to ensure
the presence of adequate amounts in their diets.
The most obvious nutrient of concern is
protein. Lacto-ovovegetarians and ovovegetari-
ans receive high-quality complete proteins and
are unlikely to incur protein deficiencies. Vege-the vegetarian athlete 445
Table 33.1Classifications of various types of vegetarian diets. From Rudd (1989), with permission.
Diet Description
Semivegetarian Some but not all groups of animal-derived products, such as meat, poultry, fish,
seafood, eggs, milk and milk products may be included in this diet
New vegetarian Plant-food diet supplemented with some groups of animal products, but emphasis is
placed on foods that are ‘organic, natural and unprocessed or unrefined’
Pescovegetarian Excludes red meats, but consumes fish as well as plant foods
Lacto-ovovegetarian Milk and milk products and eggs included in this diet, but meat, poultry, fish, seafood
and eggs excluded
Ovovegetarians Eggs are included in this diet, but milk and milk products, meat, poultry, fish and
seafood are excluded
Strict vegetarian/vegan All animal-derived foods, including meat, poultry, fish, seafood, eggs, milk and milk
products are excluded from this diet
Macrobiotic Avoids all animal foods. Uses only unprocessed, unrefined, natural and organic foods.
In some types there is fluid restriction. Tamari, miso and various seaweeds are used
Fruitarian This diet consists of raw or dried fruits, nuts, seeds, honey and vegetable oil