minerals(iron,calcium, andzinc),vitamins(vitamin
D,riboflavin,vitamin B 12 , andvitamin A),iodine, and
n-3 fatty acids. The 2003 vegetarian food guide rec-
ommends that ovolactovegetarians over 50 years of
age should take supplements of vitamin B 12 and vita-
min D, or use foods fortified with these nutrients.
Vitamin D supplements are particularly important
for older vegetarians living in northern latitudes or
other situations in which they receive little sun
exposure.
In addition to nutritional concerns, there is some
evidence that ovolactovegetarian diets may actually
increase the risk of breast cancer in women, particu-
larly in those with lactose intolerance who use large
amounts of soy-based products as milk replacements.
Soybeans contain phytoestrogens, or plant estrogens,
which have been implicated in breast cancer. The plant
estrogens in soy-based products may also explain why
vegetarians have a disproportionate number of female
babies, and why these girls have a higher rate of preco-
cious puberty than girls born to nonvegetarian
mothers.
Some researchers think that an ovolactovegetar-
ian diet may delay physical maturation in girls. A
study done in California in the early 1990s reported
that girls using the Seventh-day Adventist diet were
less tall prior to adolescence than their age-matched
nonvegetarian counterparts. Further research in this
field is necessary, however.
Ovolactovegetarianism may also be less benefi-
cial thanovovegetarianismto maintaining fertility in
women of childbearing age. A group of researchers at
the Harvard School of Public Health reported in
early 2007 that a high intake of low-fat dairy foods
is associated with infertility in women caused by fail-
ure to ovulate.Research and general acceptance
General acceptance
Vegetarianism in general is accepted by all main-
stream medical associations and professional nutri-
tionists’ societies, and positively recommended by
some. The position statement jointly adopted by the
ADA and DC in 2003 states: ‘‘It is the position of the
American Dietetic Association and Dietitians of Can-
ada that appropriately planned vegetarian diets are
healthful, nutritionally adequate and provide health
benefits in the prevention and treatment of certain
diseases.... Well-planned vegan and other types of
vegetarian diets are appropriate for all stages of the
life cycle, including during pregnancy, lactation,
infancy, childhood and adolescence.’’
The ADA has a professional subgroup called the
Vegetarian Nutrition Dietary Practice Group, or
DPG, which publishes a quarterly newsletter called
Vegetarian Nutrition Update. The newsletter is avail-
able to nonmembers of the ADA for an annual sub-
scription fee of $25. The Vegetarian Nutrition DPG
also has its own website at http://www.vegetarian
nutrition.net/index.htm, with articles available to the
public on vegetarian diets and cancer prevention,
treatment of rheumatoid arthritis,sports nutrition,
and pregnancy. Most of these articles assume that
readers are ovolactovegetarians.
Once considered an eccentricity, ovolactovege-
tarianism is widely accepted by the general public in
developed countries as a legitimate dietary option in
the early 2000s. Most restaurants, school cafeterias,
airlines, and other public food services presently offer
ovolactovegetarian dishes as a matter of course. The
ADA and DC state that about 2.5% of adults (defined
as people over 18 years of age) in the United States and
4% of Canadian adults follow some type of vegetarian
diet. The Vegetarian Resource Group (VRG), a non-
profit research organization, conducted a poll in 2006.
It estimated that 2.3% of adults in the United States—
4.7 million people—are vegetarians, with half to two-
thirds of this group being ovolactovegetarians. In
addition, the VRG notes that 30 to 40% of American
adults choose vegetarian dishes over meat dishes at
least some of the time.
Most of the opposition in developed countries to
ovolactovegetarians is within vegetarian societies or
groups rather than between this subgroup ofQUESTIONS TO ASK YOUR
DOCTOR Would you recommend a vegan diet rather than
an ovolactovegetarian diet?
Have any of your other patients used either a
modified Mediterranean diet or the Seventh-day
Adventist ovolactovegetarian diet? Would you
recommend these diets?
Will I need to take vitamins or other dietary
supplements if I adopt an ovolactovegetarian
diet?
Have you ever tried this type of vegetarian diet
yourself?
What is your opinion of the EPIC study and other
recent long-term studies of ovolactovegetarians?Ovolactovegetarianism