Vegetarian dietary guidelines: a comparative dietetic and communicational analysis of eleven international pictorial representations
DOI:
https://doi.org/10.14306/renhyd.24.2.953Keywords:
Diet, Vegetarian, Vegan, Serving Size, Portion Size, Nutrition Policy, dietary guidelines, food-based dietary guidelines.Abstract
Introduction: This study aimed to analyze the main pictorial representations of food-based vegetarian dietary guidelines from different countries as a starting point to design a new guide for this specific population in Spain.
Material and methods: Searching in evidence-based databases and webs. Associations of dieticians and nutritionists, research groups, universities, and private entities endorsed by nutritionists were chosen. Format, target population, type and number of dietetic (as food grouping, servings, quantities), nutritional and lifestyle messages were compared. Messages’ content and visual aspects, their position in the illustrations and their esthetic style were also analyzed.
Results: Eleven healthy eating guidelines with illustration for the vegetarian population worldwide were selected. Most of the graphics were intended for vegans and vegetarians; eight of them were pyramids, two were plates and one food shelving. Five food groups were always present: vegetables, fruits, cereals and derivative products, pulses and soybean products, and nuts. Messages about physical activity were present in four of them and vitamin B12 supplementation in five. One of the illustrations contained a message about environmental sustainability; most of them (7 out of 11) reached up to fourteen dietetic and nutritional messages and more than 45 food, supplements and lifestyle icons. None has a hypertext or use digital tools in the online version.
Conclusions: There are differences in the position and composition of food grouping in vegetarian food guide illustrations. The main recommendation to consume grains, vegetables, fruits, pulses, soybean products and nuts daily was consistent in all the illustrations included. There is a need for more information on quantities and servings, foods rich in calcium or omega-3, vitamin B12 supplementation and environmental sustainability. Adding recommendations about the consumption of iodized salt would be important in the Spanish context.
References
(1) World Health Organization, CH and Food and Agriculture Organization of the United Nations, IT. Preparation and Use of Food-Based Dietary Guidelines. Report of the Joint FAO/WHO consultation; 1996 Mar 2-7; Nicosia, CY. WHO Technical report series No.:880. Geneva (CH): WHO; 1998.
(2) Aranceta Bartrina J, Serra Majem LL. Objetivos nutricionales y guías dietéticas. In: Aranceta Bartrina J, Serra Majem LL, editors. Nutricion y Salud Pública. Métodos, Bases Científicas y Aplicaciones. 2nd ed. Barcelona, SP: Elsevier Masson; 2006. p. 684–97.
(3) Davis CA, Britten P, Myers EF. Past, present, and future of the food guide pyramid. J Am Diet Assoc. 2001;101(8):881-85.
(4) Gatenby SJ, Hunt P, Rayner M. The National Food Guide: development of dietetic criteria and nutritional characteristics. J Hum Nutr Dietet. 1995;8(5):323-34.
(5) Gil A, Mañas M, Martínez de Victoria E. Ingestas dietéticas de referencia, objetivos nutricionales y guías. In: Gil A (editor). Tratado de Nutrición: Bases Fisiológicas y bioquímicas de la nutrición. 2nd ed. Madrid, ES: Editorial Médica Panamericana; 2010: p. 31-65.
(6) Painter J, Rah JH, Lee Y-K. Comparison of international food guide pictorial representations. J Am Diet Assoc. 2002;102(4):483-89.
(7) Molina V (División de Nutrición de la Organización de las Naciones Unidas para la Alimentación y la Agricultura). El estado de las guías alimentarias basadas en alimentos en América Latina y el Caribe. Roma, IT: FAO; 2014: p. 30-36.
(8) Molina V. Guías alimentarias en América Latina. Informe de la consulta técnica regional de las Guías Alimentarias. An Venez Nutr. 2008;21:31-41.
(9) World Health Organization, CH and Food and Agriculture Organization, IT. Chapter 4. Development and implementation of food-based dietary guidelines. In: Preparation and use of food-based dietary guidelines. Report of the Joint FAO/WHO consultation; 1996 Mar 2-7; Nicosia, CY. WHO Technical report series No.:880. Geneva (CH): WHO; 1998: p.37.
(10) fao.org [Internet]. Food and Agriculture Organization of the United Nations. Food-based dietary guidelines [cited 2019 Mar 5]. Available from: http://www.fao.org/nutrition/education/food-dietary-guidelines/home/en/
(11) Nestle M. In defense of the USDA Food Guide Pyramid. Nutr Today. 1998;33(5):189-92.
(12) vegetarisme.fr [Internet]. Association végétarienne de France. Pyramide Végétarienne [cited 2019 Mar 5]. Available from: https://www.vegetarisme.fr/boutique/pyramide-alimentaire-vegetale/
(13) vegetariannutrition.org [Internet]. Loma Linda University School of Public Health, Department of Nutrition. The Vegetarian Food Pyramid Guidelines for Healthful Vegetarian Diets. Loma Linda:2008 [cited 2019 Mar 5]. Available from: http://www.vegetariannutrition.org/6icvn/food-pyramid.pdf
(14) Venti CA, Johnston CS. Modified food guide pyramid for lactovegetarians and vegans. J Nutr. 2002;132(5):1050-54.
(15) Hodgkin G, Haddad E. Chapter 27: Vegetarian Diets. In: California Food Guide: Fulfilling the Dietary Guidelines for Americans. Sacramento, California: California Department of Health Care and California Department of Public Health; 2008.
(16) Nakamoto K, Arashi M, Noparatanawong S, et al. A new Japanese vegetarian food guide. Asia Pac J Public Health. 2009;21(2):160-9.
(17) Keller M, Leitzmann C. Vegetarische Ernährung. In: Stange R, Leitzmann C (editors). Ernährung und Fasten als Therapie. Berlin: Springer; 2010.
(18) unionvegetariana.org [Internet]. Unión Vegetariana Española. Pirámide de la alimentación vegana; c2018. [cited 2019 Mar 5]. Available from: https://unionvegetariana.org/piramide-de-la-alimentacion-vegana/
(19) oldwayspt.org [Internet]. Oldways, health through heritage. Vegetarian and Vegan Diet Pyramid; c2013. [cited 2019 Mar 5]. Available from: https://oldwayspt.org/system/files/atoms/files/Vegetarian-Vegan%2520brochure.pdf
(20) vebu.de [Internet]. ProVeg International. Vegane Ernährungspyramide. [cited 2019 Mar 5]. Available from: https://vebu.de/fitness-gesundheit/ernaehrungspyramide/vegane-ernaehrungspyramide/
(21) vrg.org [Internet]. Mangels R. My Vegan Plate of the Vegetarian Research Group [cited 2019 Mar 5]. 2011. Available from: https://www.vrg.org/nutshell/MyVeganPlate.pdf
(22) Davis B, Vesanto M. The vegan plate. In: Becoming Vegan: The Complete Reference to Plant-Base Nutrition. Vancouver (CA): Vesanto; 2014:p.434.
(23) The University of Sidney [Internet]. Sidney (AU): The Glycemic Index Database. C2017 – [cited 2019 May 13]. Available from: https://www.glycemicindex.com/
(24) Barclay AW, Petocz P, McMillan-Price J, et al. Glycemic index, glycemic load, and chronic disease risk–a meta-analysis of observational studies. Am J Clin Nutr. 2008;87(3):627-37.
(25) Abargouei AS, Janghorbani M, Salehi-Marzijarani M, Esmaillzadeh A. Effect of dairy consumption on weight and body composition in adults: a systematic review and meta-analysis of randomized controlled clinical trials. Int J Obes (Lond). 2012;36(12):1485-93.
(26) Kratz M, Baars T, Guyenet S. The relationship between high-fat dairy consumption and obesity, cardiovascular, and metabolic disease. Eur J Nutr. 2013;52(1):1-24.
(27) Scarborough P, Appleby PN, Mizdrak A, Briggs ADM, Travis RC, Bradbury KE, Key TJ. Dietary greenhouse gas emissions of meat-eaters, fish-eaters, vegetarians and vegans in the UK, Climatic Change. 2014;125(2):179-92.
(28) Van Dooren C, Marinussen M, Blonk H, Aiking H, Vellinga P. Exploring dietary guidelines based on ecological and nutritional values: a comparison of six dietary patterns. Food Policy. 2014;44:36-46.
(29) Gonzalez Fisher C, Garnet T (Food and Agriculture Organization, IT and Food Climate Research Network, UK). Plates, pyramids, planet. Developments in national healthy and sustainable dietary guidelines: a state of play assessment. Oxford (UK); 2016: p. 6-7.
(30) Sabaté J, Soret S. Sustainability of plant-based diets: back to the future. Am J Clin Nutr. 2014;100 Suppl 1:476S-82S.
(31) Chai BC, Van der Voort JR, Grofelnik K, Eliasdottir HG, Klöss I, & Perez-Cueto FJ. Which diet has the least environmental impact on our planet? A systematic review of vegan, vegetarian and omnivorous diets. Sustainability. 2019;11(15):4110.
(32) Segovia Siapco G, Sabaté J. Health and sustainability outcomes of vegetarian dietary patterns: a revisit of the EPIC-Oxford and the Adventist Health Study-2 cohorts. Eur J Clin Nutr. 2019;72(1):60-70.
(33) Warburton DE, Bredin SS. Health benefits of physical activity: a systematic review of current systematic reviews. Curr Opin Cardiol. 2017;32(5):541-56.
(34) Agencia Española de Seguridad alimentaria y Nutrición. Evaluación nutricional de la dieta española II. Micronutrientes. In: Encuesta Nacional de Ingesta Dietética (ENIDE). Madrid, SP: AESAN; 2011.
(35) Agencia Española de Seguridad Alimentaria y Nutrición. Evaluación nutricional de la dieta española I. Energía y macronutrientes. In: Encuesta Nacional de Ingesta Dietética (ENIDE). Madrid, SP: AESAN; 2011.
(36) Menal-Puey S, Morán del Ruste M, Marques-Lopes I. Food and nutrient intake in Spanish vegetarians and vegans. Progr Nutr. 2018;20(2):189-96.
(37) Carlos JV, Rolim S, Bueno MB, Fisber RM. Porcionamento dos principais alimentos e preparações consumidos por adultos e idosos residentes en el municipio de São Paulo. Rev Nutr. 2008;21(4):383-91.
(38) Marques-Lopes I, Menal-Puey S, Martínez, JA, Russolillo G. Development of a Spanish food exchange list: application of statistical criteria to a rationale procedure. J Acad Nutr Diet. 2018;118(7):1161-69.
(39) Kaufer-Horwitz M, Valdés-Ramos R., Willett WC, Anderson A, Solomons, NW. A comparative analysis of the scientific basis and visual appeal of seven dietary guideline graphics. Nutr Res. 2005;25(4):335-47.
(40) Olivares S. Oportunidades y desafíos para la educación en nutrición utilizando las guías alimentarias en Chile. Perspect Nut Hum. 2009;11:107-17.
(41) Menal-Puey S, Marques-Lopes I. Development of Criteria for Incorporating Occasionally Consumed Foods into a National Dietary Guideline: A Practical Approach Adapted to the Spanish Population. Nutrients. 2018;11(1):58.
(42) Molina V. Lineamientos generales para la elaboración de guías alimentarias: una propuesta del INCAP. Guatemala City, GT: Editorial INCAP; 1995.
This journal 